bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of peripheral nerve block versus general anesthesia on the hemodynamics and prognosis of diabetic patients undergoing diabetic foot Surgery
Authors: Zhu Gehua , Xu Jiamin , Dai Hanying , Min Dinghong , Guo Guanghua 
Published: October 2023

Abstract
Background
Diabetic foot ulcers (DFUs) represent a significant foot-related concern for patients with multiple co-morbidities, and surgical intervention is often employed. Notably, peripheral nerve block anesthesia (PNB) has emerged as a new approach for the surgical management of DFUs, providing sustained hemodynamic stability and superior postoperative pain control compared to general anesthesia (GEA).

Methods
The present study utilized a retrospective analysis of hospitalized patients who met the inclusion criteria for DFUs over a period of 7 years. Patients were categorized into two groups based on the type of anesthesia employed during the procedure: GEA or PNB. Extensive patient information was gathered and analyzed, such as demographics, intraoperative hemodynamic parameters, numeric rating scale (NRS) scores, and healing outcomes. The preliminary results assessed in this study were intraoperative hemodynamic stability and postoperative analgesic efficacy.

Results
During the study period, 117 patients received surgical therapy based on GEA, while 145 patients received PNB. Notably, the mean intraoperative blood pressure was significantly lower in the GEA group, and this difference remained statistically significant even after Bonferroni adjustment using linear mixed models. Additionally, the frequency of hypotensive episodes was higher in the GEA group (P < 0.05). Furthermore, the perioperative transfusion volume, overall intraoperative fluid input, and intraoperative bleeding volume were significantly more significant in the GEA group than in the PNB group. The postoperative pain NRS scores differed considerably between the two groups (Bonferroni corrected P < 0.01), with the GEA group exhibiting higher opioid consumption on the day of surgery and the first postoperative day when using patient-controlled intravenous analgesia (PCIA). Supplemental analgesic medication was more significant in the GEA group 24 h postoperatively. However, the two groups had no difference in hospital stay or treatment outcomes. There was no difference between the two groups regarding secondary surgery and amputation procedures. Although the 5-year mortality rate is 30.5%, no significant difference in mortality rates between the two groups was observed.

Conclusions
Compared to GEA, PNB is a safe and effective alternative therapy for managing DFUs. Our findings suggest that PNB administration during surgical intervention for this condition results in more stable intraoperative hemodynamics and superior postoperative analgesic effects, despite no significant difference in overall treatment outcomes between the two groups. The two groups did not differ in re-surgery, amputation, or 5-year mortality.
Preferable effects of pemafibrate on liver function and fibrosis in subjects with type 2 diabetes complicated with liver damage
Authors: Nomoto Hiroshi , Kito Kenichi , Iesaka Hiroshi , Handa Takahisa , Yanagiya Shingo , Miya Aika , Kameda Hiraku , Cho Kyu Yong , Takeuchi Jun , Nagai So , Sakuma Ichiro , Nakamura Akinobu , Atsumi Tatsuya 
Published: October 2023

Abstract
Background
Pemafibrate has been reported to ameliorate lipid profiles and liver dysfunction. However, which patients derive benefit from the hepatoprotective effects of pemafibrate is unclear.

Methods
We conducted a sub-analysis of the PARM-T2D study where subjects with type 2 diabetes complicated by hypertriglyceridemia were prospectively treated with pemafibrate or conventional therapies for 52 weeks. From the original cohort, subjects who had metabolic-associated fatty liver disease without changing their treatment regimens for comorbidities were analyzed. Eligible subjects (n = 293) (average age 61.2 ± 11.7 years, 37.5% female) treated with pemafibrate (pemafibrate, n = 152) or controls who did not change their treatment regimens (controls, n = 141) were divided into three groups based on their alanine aminotransferase (ALT) levels: ALT ≤ upper normal limit (UNL) (pemafibrate, n = 65; controls, n = 50), UNL < ALT ≤ 2×UNL (pemafibrate, n = 58; controls, n = 54), and 2×UNL < ALT (pemafibrate, n = 29; controls, n = 27).

Results
Pemafibrate treatment significantly ameliorated ALT levels (from 29 to 22 U/L, p < 0.001 by Wilcoxon’s signed-rank test) in the total cohort and subjects with high ALT levels (2×ULN < ALT), and improved liver fibrosis as assessed by the Fibrosis-4 index (mean change − 0.05 (95% confidence interval: −0.22 to − 0.02), p < 0.05 versus baseline by the Mann-Whitney U-test and p < 0.05 versus the ALT ≤ UNL group by the Kruskal–Wallis test followed by Dunn’s post-hoc analysis).

Conclusions
The hepatoprotective effects of pemafibrate were dominant in subjects with type 2 diabetes complicated with liver dysfunction.

Trial registration
This study was registered with the University Hospital Medical Information Network Center Clinical Trials Registry (UMIN000037385).
CT and MR imaging of primary biliary cholangitis: a pictorial review
Authors: Zhang Yun , Zheng Tianying , Huang Zixing , Song Bin 
Published: October 2023

AbstractPrimary biliary cholangitis (PBC) is a rare chronic autoimmune-mediated cholestatic liver disease involving medium and small bile ducts that can lead to liver fibrosis and cirrhosis. To date, the pathogenesis of PBC remains elusive, and there is currently no curative medical treatment. Computed tomography (CT) and magnetic resonance (MR) imaging, as common technical tools that allow non-invasive monitoring of liver tissue in vivo, play crucial roles in the diagnosis, staging, and prognosis prediction in PBC by enabling assessment of abnormalities in liver morphology and parenchyma, irregular configuration of bile ducts, lymphadenopathy, portal hypertension, and complications of cirrhosis. Moreover, CT and MRI can be used to monitor the disease progression after treatment of PBC (e.g. the onset of cirrhotic decompensation or HCC) to guide the clinical decisions for liver transplantation. With the optimization of imaging technology, magnetic resonance elastography (MRE) offers additional information on liver stiffness, allows for the identification of early cirrhosis in PBC and provides a basis for predicting prognosis. Gadoxetic acid-enhanced MRI enables the assessment of liver function in patients with PBC. The purpose of this review is to detail and illustrate the definition, pathological basis, and clinical importance of CT and MRI features of PBC to help radiologists and clinicians enhance their understanding of PBC.Critical Relevance StatementCharacteristic CT and MR imaging manifestations of primary biliary cholangitis may reflect the course of the disease and provide information associated with histological grading and altered cellular function.Key points• Imaging has become highly useful for differentiating PBC from other diseases.• Key pathological alterations of PBC can be captured by CT and MRI.• Characteristic manifestations provide information associated with histological grade and cellular function.• Despite this, the CT or MRI features of PBC are not specific.
Graphical Abstract
Prognostic utility of body composition parameters based on computed tomography analysis of advanced non-small cell lung cancer treated with immune checkpoint inhibitors
Authors: Park Ji Eun , Jo Jaemin , Youk Jeonghwan , Kim Miso , Yoon Soon Ho , Keam Bhumsuk , Kim Tae Min , Kim Dong-Wan 
Published: October 2023

Abstract
Objective
The purpose of this study was to evaluate the prognostic impact of body composition parameters based on computed tomography (CT) in patients with non-small cell lung cancer (NSCLC) who received ICI treatment.

Methods
This retrospective study analyzed the data from advanced NSCLC patients treated with ICI therapy between 2013 and 2019. We included patients with NSCLC who underwent baseline CT scans. The exclusion criteria included patients who received three or more lines of chemotherapy, those with insufficient clinical information, or those without treatment response evaluation.

Results
A total of 136 patients were enrolled. Among the volumetric body composition parameters, patients in the highest quartiles (Q2–4) of the visceral fat index (VFI) exhibited a higher response rate to ICI therapy than those in the lowest quartile (Q1) of VFI (Q1 vs. Q2–4: 18.2% vs. 43.1%, p = 0.012). Patients with a VFI in Q2–4 had significantly prolonged progression-free survival (PFS) and overall survival (OS) (PFS, Q1 vs. Q2–4: 3.0 months vs. 6.4 months, p = 0.043; OS, Q1 vs. Q2–4: 5.6 months vs. 16.3 months, p = 0.004). Kaplan–Meier analysis based on the VFI and visceral fat Hounsfield unit (HU) revealed that patients with VFI in Q1 and HU in Q2–4 had the worst prognosis.

Conclusions
Visceral fat volume is significantly associated with treatment outcomes in ICI-treated patients with NSCLC. Moreover, fat quality may impact the treatment outcomes. This finding underscores the potential significance of both fat compartments and fat quality as prognostic indicators.

Critical relevance statement
Visceral fat volume is significantly associated with treatment outcomes in ICI-treated patients with non-small cell lung cancer. Moreover, fat quality may impact the treatment outcomes. This finding underscores the potential significance of both fat compartments and fat quality as prognostic indicators.

Graphical Abstract

Key points
• We found that visceral fat volume positively correlated with treatment response and survival in patients with non-small cell lung cancer receiving immune checkpoint inhibitors.
• Additionally, a trend toward a negative correlation between visceral fat attenuation and survival was observed.
• The findings highlight the prognostic utility of fat compartments and fat quality.
Optimal combination periprosthetic vasculature visualization and metal artifact reduction by spectral computed tomography using virtual monoenergetic images in total hip arthroplasty
Authors: Zhao Jie , Cheng Qiang , Liu Chuan , Wang Qiqi , Lv Yuchan , Tang Ziyi , Luo Yuxi , Yang Haitao 
Published: October 2023

Abstract
Objectives
To investigate the optimal parameters of spectral CT for preferably visualizing the periprosthetic vasculature and metal artifact reduction (MAR) in total hip arthroplasty (THA).

Methods
A total of 34 THA of 30 patients were retrospectively included. Image reconstructions included conventional image (CI), CI combined with MAR (CIMAR), and virtual monoenergetic images (VMI) combined with MAR (VMIMAR) at 50–120 keV. The attenuation and standard deviation of the vessel and artifact, and the width of artifact were measured. Qualitative scoring was evaluated including the vascular contour, the extent of artifact, and overall diagnostic evaluation.

Results
The attenuation, noise of the vessel and artifact, and the width of artifact decreased as the energy level increased (p < 0.001). The downtrend was relatively flat at 80–120 keV, and the vascular attenuation dropped to 200 HU at 90 keV. The qualitative rating of vascular contour was significantly higher at CIMAR (3.47) and VMIMAR 60–80 keV (2.82–3.65) compared with CI (2.03) (p ≤ 0.029), and the highest score occurred at 70 and 80 keV (3.65 and 3.56). The score of the extent of artifact was higher at VMIMAR 80 keV than CIMAR (3.53 VS 3.12, p = 0.003). The score of the overall diagnostic evaluation was higher at VMIMAR 70 and 80 keV (3.32 and 3.53, respectively) than CIMAR (3.12) (p ≤ 0.035).

Conclusion
Eighty kiloelectron volts on VMIMAR, providing satisfactorily reduced metal artifacts and improved vascular visualization, can be an optimal recommended parameter of spectrum CT for the assessment of periprosthetic vasculature in THA patients.

Critical relevance statement
The metal artifact is gradually reducing with increasing energy level; however, the vascular visualization is worsening. The vascular visualization is terrible above 100 keV, while the vessel is disturbed by artifacts below 70 keV. The best performance is found at 80 keV.

Key points
• VMIMAR can provide both reduced metal artifacts and improved vascular visualization.
• Eighty kiloelectron volts on VMIMAR performs best in vascular visualization of total hip arthroplasty patients.
• Energy spectrum CT is recommended for routine use in patients with total hip arthroplasty.

Graphical Abstract
Baseline 18F-FDG PET/CT radiomics for prognosis prediction in diffuse large B cell lymphoma
Authors: Jing Fenglian , Liu Yunuan , Zhao Xinming , Wang Na , Dai Meng , Chen Xiaolin , Zhang Zhaoqi , Zhang Jingmian , Wang Jianfang , Wang Yingchen 
Published: October 2023

Abstract
Background
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma in adults. Standard treatment includes chemoimmunotherapy with R-CHOP or similar regimens. Despite treatment advancements, many patients with DLBCL experience refractory disease or relapse. While baseline 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) parameters have shown promise in predicting survival, they may not fully capture lesion heterogeneity. This study aimed to assess the prognostic value of baseline 18F-FDG PET radiomics features in comparison with clinical factors and metabolic parameters for assessing 2-year progression-free survival (PFS) and 5-year overall survival (OS) in patients with DLBCL.

Results
A total of 201 patients with DLBCL were enrolled in this study, and 1328 radiomics features were extracted. The radiomics signatures, clinical factors, and metabolic parameters showed significant prognostic value for individualized prognosis prediction in patients with DLBCL. Radiomics signatures showed the lowest Akaike information criterion (AIC) value and highest Harrell’s concordance index (C-index) value in comparison with clinical factors and metabolic parameters for both PFS (AIC: 571.688 vs. 596.040 vs. 576.481; C-index: 0.732 vs. 0.658 vs. 0.702, respectively) and OS (AIC: 339.843 vs. 363.671 vs. 358.412; C-index: 0.759 vs. 0.667 vs. 0.659, respectively). Statistically significant differences were observed in the area under the curve (AUC) values between the radiomics signatures and clinical factors for both PFS (AUC: 0.768 vs. 0.681, P = 0.017) and OS (AUC: 0.767 vs. 0.667, P = 0.023). For OS, the AUC of the radiomics signatures were significantly higher than those of metabolic parameters (AUC: 0.767 vs. 0.688, P = 0.007). However, for PFS, no significant difference was observed between the radiomics signatures and metabolic parameters (AUC: 0.768 vs. 0.756, P = 0.654). The combined model and the best-performing individual model (radiomics signatures) alone showed no significant difference for both PFS (AUC: 0.784 vs. 0.768, P = 0.163) or OS (AUC: 0.772 vs. 0.767, P = 0.403).

Conclusions
Radiomics signatures derived from PET images showed the high predictive power for progression in patients with DLBCL. The combination of radiomics signatures, clinical factors, and metabolic parameters may not significantly improve predictive value beyond that of radiomics signatures alone.
Metabolites of non-aureus staphylococci affect the ability of Staphylococcus aureus to adhere to and internalize into bovine mammary epithelial cells
Authors: Toledo-Silva Bruno , Oliveira Ana Cláudia Dumont , Souza Fernando N. , Haesebrouck Freddy , De Vliegher Sarne 
Published: October 2023

AbstractThis study investigated whether cell-free supernatants (SN) from four bovine non-aureus staphylococcal (NAS) isolates prevent Staphylococcus aureus adhesion to and internalization into bovine mammary epithelial cells (MAC-T cells) and if so, to determine whether such effects were potentially associated with the S. aureus accessory gene regulator (agr) system. Overall, we demonstrated that all SN obtained from the NAS isolates promoted adhesion of a S. aureus agr+ strain to, yet reduced the internalization into MAC-T cells, while similar effects were not observed for its agr− mutant strain. Our findings provide novel anti-virulence strategies for treating and controlling bovine S. aureus mastitis.
The impact of preoperative malnutrition on postoperative delirium: a systematic review and meta-analysis
Authors: Dong Bo , Wang Jing , Li Pan , Li Jianli , Liu Meinv , Zhang Huanhuan 
Published: October 2023

Abstract
Background
Postoperative delirium (POD) is a common postoperative complication, characterized by disturbance of attention, perception, and consciousness within 1 week after surgery, and linked to cognitive decline, increased mortality, and other serious surgical outcomes. Early identification and treatment of risk factors for POD could reduce the occurrence of delirium and the related poor outcomes. Malnutrition as a possible precipitating factor, defined as the poor anthropometric, functional, and clinical outcomes of nutrient deficiency, has been investigated. However, the evidence is controversial. The goal of this systematic review and meta-analysis was to comprehensively assess the correlation between preoperative malnutrition and POD.

Methods
PubMed, Embase, Cochrane Library, and Web of Science were used to search prospective cohort articles that explored the correlation between preoperative malnutrition and POD from inception until September 30, 2022. Two researchers independently conducted the literature selection and data extraction. The quality of the literature was evaluated according to the Newcastle–Ottawa scale (NOS). Odds ratios (ORs) and 95% confidence intervals (CIs) for POD associated with malnutrition relative to normal nutritional status were calculated.

Results
Seven prospective cohort studies qualified for the meta-analysis, which included 2701 patients. The pooled prevalence of preoperative malnutrition was 15.1% (408/2701), and POD occurred in 428 patients (15.8%). The NOS score was above 7 points in all 7 studies. Our results demonstrated that the pooled OR for malnutrition and POD was 2.32 (95% CI 1.62–3.32) based on a random-effects model. Our subgroup analysis suggested that the relationship between malnutrition and POD was significant in adults following noncardiac surgery (OR = 3.04, 95% CI, 1.99–4.62, P < 0.001), while there was no statistical significance in adults following cardiac surgery (OR = 1.76, 95% CI, 0.96–3.22, P = 0.07). Additionally, in the subgroup analysis based on different malnutrition assessment tools (MNA-SF versus others), a significant association was found in the MNA-SF group (OR = 3.04, 95% CI, 1.99–4.62, P < 0.001), but not in the others group (OR = 1.76, 95% CI, 0.96–3.22, P = 0.07). Other subgroup analyses showed that this association was not significantly affected by evaluation instruments for POD, location of the study, or quality of the article (all P < 0.05).

Conclusions
Based on the currently available evidence, our results suggested that preoperative malnutrition was independently associated with POD in adult surgical patients.
Futures literacy in collaborative foresight networks: advancing sustainable shipbuilding
Authors: Jokinen Leena , Balcom Raleigh Nicolas A. , Heikkilä Katariina 
Published: October 2023

AbstractBusinesses are facing increasing pressure from society and regulators to become more sustainable and do their part to address the climate crisis. These businesses will require continual sustainability innovation formulation and implementation processes to meet these demands. Collaborative foresight (CF) has high potential for helping business sectors produce a continuous stream of sustainability options to select and deploy in finished products. Recent developments in futures studies indicate that a capability called futures literacy (FL)—acts of individuals or groups switching their modes and purposes for imagining futures—is relevant to the production of innovation-related outcomes. FL may be key to driving the effectiveness of such foresight collaborations; however, little is known about its exact functions in such business networks and processes. This article examines this issue in the context of a luxury-cruise shipbuilding network in Finland. It analyzes research data from the foresight workstreams of a multi-partner consortium active across three sequential projects between 2016 and 2022. The foresight team took an interventionist research approach, conducting interviews and workshops as part of all three projects. In this article, we analyze the materials produced from these interventions for the appearances of FL enhancement. Based on this analysis, we found that FL can play key functions in CF, such as supporting actors in perceiving new developmental pathways, identifying new opportunities for innovation, and identifying alternative priorities built from new realizations and insights—a finding in line with existing claims by FL scholars and educators. This article contributes to ongoing discussions about the significance of CF and FL in addressing the most pressing environmental issues of our time. It offers an evidence-based argument for the relevance of taking a capabilities approach (i.e., introducing and developing FL) for business networks seeking to use foresight when engaging in sustainability innovation.
On fear of missing out, social networks use disorder tendencies and meaning in life
Authors: Montag Christian , Müller Marko , Pontes Halley M. , Elhai Jon D. 
Published: October 2023

AbstractMuch research has been conducted on the association between social networks use disorder tendencies (SNUD; i.e. problematic social media use) and well-being. In more detail, a meta-analysis and further research suggest an inverse association between higher SNUD tendencies and lower well-being. In existing studies on social media use and well-being, this association has often been investigated by asking participants about their life satisfaction and/or emotional well-being. A path that has only recently been used to shed further light on SNUD tendencies is the assessment of meaning in life. Against this background, the present study aimed to investigate both the search for and presence of meaning in life in the context of SNUD tendencies in 955 participants. To the best of our knowledge and beyond what has been mentioned, this study is the first to investigate the links between meaning in life variables and state/trait fear of missing out (FoMO), with FoMO being a critical variable known to be linked to the overuse of digital technologies. In a structural equation model, we observed that associations between FoMO and meaning in life variables was mediated by SNUD tendencies. Although the present study is of cross-cultural nature and cannot establish causality, it might be the case that proneness to FoMO might trigger SNUD tendencies and as a consequence, results in more search for meaning in life, while hindering presence of meaning in life.