bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the Impact of Enhanced Recovery Programs on Social Vulnerability, Race, and Colorectal Surgery Outcomes
Authors: Smith Burkely P. , Katta Meghna , Hollis Robert H. , Shao Connie , Jones Bayley , McLeod Marshall C. , Tan Tze-Woei , Chu Daniel I. 
Published: December 2023

BACKGROUND:
Increasing social vulnerability measured by the social vulnerability index has been associated with worse surgical outcomes. However, less is known about social vulnerability’s impact on colorectal surgery patients under enhanced recovery programs.

OBJECTIVE:
We hypothesized that increasing social vulnerability is associated with worse outcomes prior to enhanced recovery implementation, but following implementation, disparities in outcomes would be reduced.

DESIGN:
Retrospective cohort study using multivariable logistic regression to identify associations of social vulnerability and enhanced recovery with outcomes.

SETTINGS:
Institutional American College of Surgeons-National Surgical Quality Improvement Program database.

PATIENTS:
Patients undergoing elective colorectal surgery (2010-2020). Enhanced recovery programs implemented in 2015. Those adhering to ≥70% of enhanced recovery program components defined as enhanced recovery and all others non-enhanced recovery.

OUTCOMES:
Length of stay, complications, and readmissions.

RESULTS:
Of 1,523 patients, 589 (38.7%) were in the enhanced recovery group, with 732 (40.3%) patients in the lowest third of social vulnerability index, 498 (27.4%) in the highest third, and no differences in social vulnerability index distribution by enhanced recovery group. On multivariable modeling, social vulnerability was not associated with increased length of stay, complications, or readmissions in either enhanced recovery group. Black race was associated with increased length of stay in both the non-enhanced recovery (OR 1.2, 95% CI, 1.1-1.3) and enhanced recovery groups (OR 1.2, 95% CI, 1.1-1.4). Enhanced recovery adherence was associated with reductions in racial disparities in complications as Black race was associated with increased odds of complications in the non-enhanced recovery (OR 1.9, 95% CI, 1.2-3.0) but not enhanced recovery group (OR 0.8, 95% CI, 0.4-1.6).

LIMITATIONS:
Details of potential factors affecting enhanced recovery program adherence was not assessed and is the subject of current work by this team.

CONCLUSION:
High social vulnerability was not associated with worse outcomes among both enhanced recovery and non-enhanced recovery colorectal patients. Enhanced recovery program adherence was associated with reductions in racial disparities in complication rates. However, disparities in length of stay remain and work is needed to understand the underlying mechanisms driving these disparities.
Assessing the robustness of muscle strength and physical performance measures in women older than 40 years: a test-retest reliability study
Authors: Assis Silva Sebastião Henrique , Orsatti Fábio L. , de Lima Mariana L. , Freitas Augusto C. de Q. , Carneiro Marcelo A.S. , Assumpção Cláudio de Oliveira , Souza Markus Vinicius C. 
Published: December 2023

Abstract

Objectives
This study investigated the test-retest reliability and minimal detectable change (MDC) of muscle strength and physical performance tests in women older than 40 years.

Methods
A total of 113 women, aged 58 ± 11 years (82% postmenopausal women), with a body mass index of 28.5 ± 5.8 kg/m2, participated in this study. One-repetition maximum (1RM) tests were conducted for seven strength exercises: 45° leg press, bench press, leg extension, pec deck, wide-grip lateral pull-down, leg curl, and seated cable row, with a retest after 48 hours. Timed Up and Go (TUG), 6-minute walk, and 30-second sit-to-stand tests were performed on the same day and retested after 72 hours. The tests and retests were administered by the same evaluators. Relative reliability (consistency of participant rank between test-retest) was assessed using the intraclass correlation coefficient for consistency and agreement, and absolute reliability (precision of score) was assessed using the MDC based on the standard error of prediction.

Results
The 1RM and performance tests exhibited excellent reliability: 45° leg press (consistency, 0.99; agreement, 0.98), bench press (consistency, 0.96; agreement, 0.96), leg extension (consistency, 0.93; agreement, 0.91), pec deck (consistency, 0.90; agreement, 0.88), wide-grip lateral pull-down (consistency, 0.91; agreement, 0.89), leg curl (consistency, 0.84; agreement, 0.83), seated cable row (consistency, 0.92; agreement, 0.94), TUG (consistency, 0.87; agreement, 0.87), 6-minute walk (consistency, 0.96; agreement, 0.95), and 30-second sit to stand (consistency, 0.85; agreement, 0.80). These tests showed meaningful MDC values, particularly for the 1RM test performed on the machine and the 30-second sit-to-stand test: 45° leg press, 22.2 kg (15%); bench press, 4.9 kg (19%); leg extension, 9.2 kg (35%); pec deck, 8.8 kg (44%); wide-grip lateral pull-down, 9.4 kg (31%); leg curl, 9.2 kg (51%); seated cable row, 11.4 kg (29%); TUG, 1.4 seconds (20%); 6-minute walk, 50.9 m (10%); and 30-second sit to stand, 4.6 reps (30%).

Conclusions
Although the muscle strength and physical performance tests demonstrate excellent relative reliability in women older than 40 years, they exhibit low absolute reliability, particularly the 1RM test performed on the machine and the 30-second sit-to-stand test. Therefore, although these tests show good consistency in the positioning of women within the group after repeated measures, their precision measure is relatively low (high fluctuation). Changes in these tests that are smaller than the MDC may not indicate real changes in women at middle age and older.
Treatment-induced menopause symptoms among women with breast cancer undergoing chemotherapy in China: a comparison to age- and menopause status–matched controls
Authors: Zhao Di , Ma Qinghua , Li Guopeng , Qin Rui , Meng Yingtao , Li Ping 
Published: December 2023

Abstract

Objective
Whether women with breast cancer experience more severe menopause symptoms than comparison women without a history of breast cancer diagnosis remains unclear. We aimed to investigate whether women with breast cancer undergoing chemotherapy experience more severe menopause symptoms than comparison women and explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy.

Methods
This cross-sectional observational study recruited 423 women with breast cancer undergoing chemotherapy and 1,829 community women without breast cancer. All participants completed a questionnaire assessing menopause symptoms using the Menopause Rating Scale and general characteristics (eg, sociodemographic and clinical data). Propensity score matching was used to reduce the confounders between the two groups. Student's t test or Mann-Whitney U test and chi-square tests were used to compare the differences in menopause symptoms between the two groups. Multivariate linear regression analysis was performed to explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy.

Results
After propensity score matching, 808 participants were included. The mean ages of women with breast cancer undergoing chemotherapy and comparison women were 49.58 and 49.10 years, respectively. Women with breast cancer undergoing chemotherapy experienced significantly more severe vasomotor symptoms than comparison women. However, comparison women had higher Menopause Rating Scale scores and more severe menopause symptoms than women with breast cancer undergoing chemotherapy. Age, occupational status, chemotherapy-induced amenorrhea, family history of cancer, chemotherapy stage, mindfulness, resiliency, and illness perception were associated with menopause symptoms in women with breast cancer undergoing chemotherapy.

Conclusions
Vasomotor symptoms are prominent among women with breast cancer undergoing chemotherapy. Understanding the factors contributing to menopause symptoms is crucial for healthcare practitioners to develop supportive guidelines for the well-being of women with breast cancer undergoing chemotherapy.
Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault
Authors: Alfonso-Bartolozzi Belén , Fernández-Vega-Cueto Luis , Lisa Carlos , Palacios Ana , Madrid-Costa David , Alfonso José F. 
Published: December 2023

Purpose:To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault.Setting:Fernández-Vega Ophthalmological Institute, Oviedo, Spain.Design:Retrospective and comparative case series.Methods:This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed.Results:37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively (P= .4). No pigment dispersion glaucoma or other vision-threatening complications were reported.Conclusions:This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.
The Relationship Between Care Preparedness and Altruism Levels in Caregivers of Stroke Patients
Authors: Çekici Ayşe , Yurttaş Afife 
Published: December 2023

ABSTRACT

BACKGROUND: Stroke care partners and caregivers experience emotional and physical burden, and 80% of stroke patients need support after discharge. This study examines the relationship between caregiver preparedness and altruism levels of stroke patients. METHODS: The population of this descriptive and correlational study consisted of the caregivers of stroke patients who were hospitalized at the stroke center of a hospital between January 2021 and August 2021. The sample was determined as 240 with the known sampling formula. The descriptive information form, the Preparedness for Caregiving Scale, and the Altruism Scale were used to collect the study data. RESULTS: The total mean score of the caregivers' preparedness to provide care was found to be 25.04 (7.36), and the mean total altruism score was 85.78 (9.20). The mean score of Donation, which is one of the subdimensions of the Altruism Scale, was 26.67 (4.08), and that of Helping Status was 59.10 (6.92). No statistically significant relationships were detected between caregivers' preparedness to provide care scores, Helping Status scores, Donation scores, and total altruism scores in this study (P = .241, P = .245, and P = .129, respectively). CONCLUSION: No statistically significant relationships were detected between the preparedness and altruism levels of the caregivers of the stroke patients in this study.
Comparison of short-term outcomes of robotic-assisted radical colon cancer surgery using the Kangduo Surgical Robotic System and the Da Vinci Si Robotic System: a prospective cohort study
Authors: Liu Yunxiao , Wang Yuliuming , Wang Chunlin , Wang Xin , Zhang Xin , Yang Yihaoran , Wei Zhengqiang , Xiao Yi , Wang Guiyu 
Published: December 2023

Background:
Robotic surgery has been a revolution for colon cancer (CC) patients, with the increasing availability of different competitive robotic systems, but evidence of relevant oncologic outcomes is indeed scarce. Our goal was to compare the surgical quality and short-term oncologic outcomes of the Kangduo Surgical Robotic System and the da Vinci Si Robotic System in patients with CC.

Methods:
These are results from a subcohort of a multicenter randomized controlled noninferiority trial performed in three centers in China. Enrolled patients were randomly assigned to undergo surgery using either the KD-SR-01 system (KD group) or the da Vinci Si (DV) robotic system (DV group). Neither investigators nor patients were masked to treatment allocation, but assessment of pathological outcomes was masked to treatment allocation. The primary endpoint was surgical success rate. The secondary endpoints were surgical outcomes, pathologic outcomes, and postoperative outcomes. The study is registered at www.chictr.org.cn (ChiCTR2200063172). Although the long-term follow-up results were not a predefined endpoint for this study, late-stage work is in progress.

Results:
A total of 58 CC patients were included in this study, 28 in the KD group and 30 in the DV group. All patients were successfully operated without any intermediate open/conventional laparoscopic surgery and the success rate of surgery was 100%. Assessment of equipment docking task load and intraoperative operating sensation score were similar between the two groups. Adverse events and Clavien–Dindo grade II or higher grade complication rates were comparable between the two groups. Device arm docking time, robotic arm operation time, and intraoperative bleeding were not significantly different between the two groups. Similar results were obtained from postoperative pathological outcomes and internal environment indexes.

Conclusions:
The efficacy and safety of the Kangduo Robotic Surgical System has been proved, operation of the Kangduo Robotic System by experienced surgeons for CC is not less effective than the da Vinci robotic System.
Natural History of Serviceable Hearing During Active Surveillance of Nongrowing Sporadic Vestibular Schwannoma Supports Consideration of Initial Wait-and-Scan Management
Authors: Khandalavala Karl R. , Marinelli John P. , Lohse Christine M. , Daher Ghazal S. , Kocharyan Armine , Neff Brian A. , Van Gompel Jamie J. , Driscoll Colin L.W. , Celda Maria Peris , Link Michael J. , Carlson Matthew L. 
Published: December 2023

ObjectiveThe treatment paradigm of vestibular schwannoma (VS) focuses on preservation of neurologic function, with small tumors increasingly managed with active surveillance. Often, tumor size and hearing outcomes are poorly correlated. The aim of the current work was to describe the natural history of hearing among patients with nongrowing VS during observational management.Study DesignHistorical cohort study.PatientsAdults with sporadic VS.InterventionWait-and-scan management.Main Outcome MeasureMaintenance of serviceable hearing (SH) after diagnosis.ResultsAmong 228 patients with nongrowing VS, 157 patients had SH at diagnosis. Rates of maintaining SH (95% CI; number still at risk) at 1, 3, and 5 years after diagnosis were 94% (89–98; 118), 81% (74–89; 65), and 78% (71–87; 42), respectively. Poorer hearing at diagnosis (hazard ratio [HR] per 10 dB hearing level increase in pure-tone average of 2.51,p< 0.001; HR per 10% decrease in word recognition score of 1.70,p= 0.001) was associated with increased likelihood of developing non-SH during observation. When controlling for baseline hearing status, tumors measuring 5 mm or greater in the internal auditory canal or with cerebellopontine angle extension were associated with significantly increased risk of developing non-SH (HR, 4.87;p= 0.03). At 5 years after diagnosis, 95% of patients with nongrowing intracanalicular VS measuring less than 5 mm maintained SH.ConclusionsHearing worsens during periods of nongrowth in sporadic VS. Patients with small (<5 mm) intracanalicular tumors demonstrate robust maintenance of SH over time, reinforcing the consideration of initial observation in this patient subset.
Intraoperative Measured Electrocochleography and Fluoroscopy Video to Detect Cochlea Trauma
Authors: Greisiger Ralf , Bester Christofer , Sørensen Torquil , Korslund Hilde , Bunne Marie , O'Leary Stephen , Jablonski Greg Eigner 
Published: December 2023

Hypothesis
Gross electrode movements detected with intraoperative, real-time X-ray fluoroscopy will correlate with fluctuations in cochlear output, as measured with intraoperative electrocochleography (ECochG).

Background
Indications for cochlear implantation (CI) are expanding to include patients with residual hearing; however, implant recipients often lose residual hearing after CI. The objective of this study was to identify probable traumatic events during implantation by combining electrophysiological monitoring of cochlear function with simultaneous X-ray monitoring. The surgical timing of these apparently traumatic events was then investigated.

Methods
For 19 adult patients (21 surgeries, 2 bilateral), the ECochG responses were measured during implantation of a cochlear nucleus slim modiolar electrode (CI532/CI632, Cochlear Ltd Australia Nucleus slim modiolar). Simultaneous fluoroscopy was performed, as well as a postoperative cone-beam computed tomography (CT) scan. For all patients, pre- and postoperative audiograms were recorded up to 1 year after surgery to record the loss of residual hearing.

Results
Electrode insertions for 21 surgeries were successfully monitored. A drop in ECochG response was significantly correlated with reduced hearing preservation compared with patients with preserved responses throughout. Drops in the ECochG response were measured to occur during insertion, because of movement of the array after insertion was complete, including while sealing of the electrode array at the round window or coiling of the array lead within the mastoid cavity. In some patients, a reduction in cochlear output, resulting in poor ECochG response, was inferred to occur before the beginning of implantation.

Conclusion
The combination of perioperative ECochG measurements, microscope video, fluoroscopy, and postoperative CT scan may inform on what causes the loss of residual hearing after implantation. These findings will be used to improve the surgical procedure in future.
Long-Term Follow-Up in Active Transcutaneous Bone Conduction Implants
Authors: Koro Eleonor , Lundgren Elenor , Smeds Henrik , Werner Mimmi 
Published: December 2023

Objective
To evaluate long-term outcomes of active transcutaneous bone conduction implants (atBCIs) regarding safety, hearing, and quality of life.

Study design
A clinical study with retrospective medical record analysis combined with prospective audiometry and quality of life questionnaires.

Setting
Three secondary to tertiary care hospitals.

Patients
All subjects operated with an atBCI in three regions in Sweden were asked for informed consent. Indications for atBCI were single-sided deafness (SSD) and conductive or mixed hearing loss (CMHL).

Intervention
Evaluation of atBCI.

Main Outcome Measures
Pure tone and speech audiometry and Glasgow Benefit Inventory (GBI).

Result
Thirty-three subjects were included and 29 completed all parts. The total follow-up time was 124.1 subject-years. Nineteen subjects had CMHL and in this group, pure tone averages (PTA4) were 56.6 dB HL unaided and 29.6 dB HL aided, comparable with a functional gain of 26.0 dB. Effective gain (EG) was −12.7 dB. With bilateral hearing, Word Recognition Scores (WRS) in noise were 36.5% unaided and 59.1% aided. Fourteen subjects had SSD or asymmetric hearing loss (AHL) and in this group, PTA4 were >100 dB HL unaided and 32.1 dB HL aided with the contralateral ear blocked. EG was −9.1 dB. With bilateral hearing, WRSs were 53.2% unaided and 67.9% aided. The means of the total GBI scores were 31.7 for CMHL and 23.6 for SSD/AHL.

Conclusion
Few complications occurred during the study. The atBCI is concluded to provide a safe and effective long-term hearing rehabilitation.
Comparison of Postoperative Outcomes in Cystic Versus Solid Vestibular Schwannoma in a Multi-institutional Cohort
Authors: Zhang Lisa , Ostrander Benjamin T. , Duhon Bailey , Moshitaghi Omid , Lee Joshua , Harris Micah , Hardesty Douglas A. , Prevedello Daniel M. , Schwartz Marc S. , Dodson Edward E. , Friedman Rick A. , Adunka Oliver F. , Ren Yin 
Published: December 2023

Objective
Cystic vestibular schwannomas (cVSs) have more variable and less favorable clinical outcomes after microsurgical resection compared with solid VS (sVS). This study compares the preoperative presentation and postoperative outcomes between cVS and sVS.

Study Design
Retrospective cohort study.

Setting
Two tertiary skull base referral centers.

Methods
Consecutive adult patients who underwent VS resection from 2016 to 2021 were included. Univariate and multivariate analyses compared differences in baseline symptoms and postoperative outcomes between cVS and sVS.

Results
There were a total of 315 patients (64% female; mean age, 54 yrs) and 46 (15%) were cystic. cVS were significantly larger than sVS (maximum diameter, 28 vs. 18 mm, p < 0.001) and had higher rates of dysphagia and dysphonia preoperatively (p < 0.02). cVSs were more likely to undergo translabyrinthine resection (76 vs. 50%, p = 0.001) and have a higher rate of subtotal resection (STR) compared with sVS (30 vs. 13%, p = 0.003). At latest follow-up, fewer cVS achieved good facial nerve (FN) outcome (House-Brackmann [HB] I/II) (80 vs. 90%, p = 0.048). Subanalysis of cVS and sVS matched in tumor size, and surgical approach did not show differences in the rate of STR or FN outcomes (HB I/II, 82 vs. 78%, p = 0.79).

Conclusion
In this large multi-institutional series, cVSs represent a distinct entity and are characterized by larger tumor size and higher incidence of atypical symptoms. Although cVSs were more likely to undergo STR and portend worse FN outcomes than sVSs, this may be due to their larger tumor size rather than the presence of the cystic component.
Does Catastrophizing Predict Response to Treatment in Patients With Vestibular Disorders? A Prospective Cohort Study
Authors: Gillard Danielle M. , Hum Maxwell , Gardi Adam , Centore Linda , Sharon Jeffrey D. 
Published: December 2023

Objective
Determine levels of catastrophizing in patients with vestibular disorders and prospectively evaluate their relationship with patient-reported outcome measures.

Study Design
Prospective cohort study.

Setting
Tertiary care neurotology vestibular disorders clinic.

Patients
Adult patients with various vestibular disorders.

Interventions
Patients were given the Dizziness Handicap Inventory (DHI) and the Dizziness Catastrophizing Scale (DCS) at a baseline visit and follow-up visit after treatment.

Main outcome measures
Correlation studies were used to determine the relationships between DHI and DCS. Multivariable linear regression was performed to determine the relationship between DCS and DHI change with treatment, accounting for demographic variables.

Results
Forty-six subjects completed both the DHI and the DCS before and after treatment. Patients with higher baseline DCS scores had higher baseline DHI scores (p < 0.001). There was a significant improvement in both DHI score (p < 0.001) and DCS (p < 0.001) at follow-up. Patients who had reduction in DCS scores during were more likely to show reduction in DHI scores (p < 0.001). A subset of patients had a mindfulness-based stress reduction program included in their treatment. These patients had a greater reduction in both DCS and DHI scores at follow-up compared with those who received other treatments.

Conclusions
Catastrophizing is associated with higher pretreatment DHI scores and worse treatment outcomes. Addressing dizziness catastrophizing may help improve vestibular outcomes.