bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of anesthesia induction with butorphanol on postoperative nausea and vomiting: A randomized controlled trial
Authors: Xie Fang , Sun De-Feng , Yang Lin , Sun Zhong-Liang 
Published: November 2023

BACKGROUND
Postoperative nausea and vomiting (PONV) are common complications that affect the recovery and well-being of elderly patients undergoing gastrointestinal laparoscopic surgery.
AIM
To investigate the effect of butorphanol on PONV in this patient population.
METHODS
A total of 110 elderly patients (≥ 65 years old) who underwent gastrointestinal laparoscopic surgery were randomly assigned to receive butorphanol (40 μg/kg) or sufentanil (0.3 μg/kg) during anesthesia induction in a 1:1 ratio. The measured outcomes included the incidence of PONV at 48 h after surgery, intraoperative dose of propofol and remifentanil, Bruggrmann Comfort Scale score in the postanesthesia care unit (PACU), number of compressions for postoperative patient-controlled intravenous analgesia (PCIA), and time to first flatulence after surgery.
RESULTS
The results revealed a noteworthy reduction in the occurrence of PONV at 24 h after surgery in the butorphanol group, when compared to the sufentanil group (T1: 23.64% vs 5.45%, T2: 43.64% vs 20.00%, P < 0.05). However, no significant variations were observed between the two groups, in terms of the clinical characteristics, such as the PONV or motion sickness history, intraoperative and postoperative 48-h total infusion volume and hemodynamic parameters, intraoperative dose of propofol and remifentanil, number of postoperative PCIA compressions, time until the first occurrence of postoperative flatulence, and incidence of PONV at 48 h post-surgery (all, P > 0.05). Furthermore, patients in the butorphanol group were more comfortable, when compared to patients in the sufentanil group in the PACU.
CONCLUSION
The present study revealed that butorphanol can be an efficacious substitute for sufentanil during anesthesia induction to diminish PONV within 24 h following gastrointestinal laparoscopic surgery in the elderly, simultaneously improving patient comfort in the PACU.
Persistent left superior vena cava in right hemiarch replacement under deep hypothermic circulatory arrest: A case report
Authors: Mi Ze-Yu , He Gang , Gao Hong-Li , Li Chao 
Published: November 2023

BACKGROUND
Persistent left superior vena cava (PLSVC), a relatively rare thoracic vascular malformation, can inconvenience perfusionists and operators when encountered during deep hypothermic circulatory arrest (DHCA).
CASE SUMMARY
Herein, we describe the case of a patient with concurrent giant aortic arch aneurysm, aortic stenosis, and PLSVC. To treat these conditions, we performed right hemiarch and aortic valve replacements under DHCA. Notably, we applied “bilateral superior vena cava retrograde cerebral perfusion (RCP)” for cerebral protection, which significantly optimized the surgical procedure and reduced the risk of postoperative complications. The patient was discharged 14 d after surgery with no complications.
CONCLUSION
Surgical intervention for PLSVC under DHCA can be performed using the bilateral superior vena cava RCP approach.
Type II Abernethy malformation with cystic fibrosis in a 12-year-old girl: A case report
Authors: Zhang Li-Jie , Liu Xing-Yu , Chen Teng-Fei , Xu Zhong-Ya , Yin Han-Jun 
Published: November 2023

BACKGROUND
Abernethy malformation, also known as congenital extrahepatic portosystemic shunt, is an uncommon malformation resulting from aberrant development of the portal venous system. Cystic fibrosis (CF) is an autosomal recessive genetic disease caused by mutations in the CFTR gene. It mainly affects the exocrine glands of the respiratory, digestive and reproductive systems. It is considered extremely rare in the Asian population. We present a clinical case involving a pediatric patient of Asian descent who was diagnosed with Abernethy malformation and CF.
CASE SUMMARY
A 12-year-old girl presented with a medical history of recurring respiratory infections and hemoptysis, and chest computed tomography (CT) showed bronchiectasis. Whole exome sequencing was performed for the patient, yielding findings that revealed a compound heterozygous variant of the CFTR gene: c.233_c.234insT/p.Trp79fsTer3 (maternal origin); c.2909G>A/p.Gly970Asp (paternal origin). CF was diagnosed. The physician’s attention was drawn to the presence of splenomegaly during disease progression. Abdominal enhanced CT revealed splenomegaly, compression of the left kidney, and multiple tortuous dilated vascular shadows were seen at the splenic hilum, which flowed back into the left renal vein and portal vein, suggesting Abernethy malformation type II. Intraoperatively, the abnormal blood flow was seen to merge into the inferior vena cava through the left renal vein without hepatic processing, and the pathology of liver biopsy showed hypoplastic, dilated or absent portal vein branches, both of which supported the diagnosis of Abernethy malformation type II. This represents the initial documented instance of Abernethy malformation accompanied by a CFTR gene mutation in the existing body of literature.
CONCLUSION
Coexisting Abernethy malformation and CF are rare. Detailed medical history information, abdominal enhanced CT, venography and genetic testing contribute to diagnosis as well as differential diagnosis.
Primary pulmonary lymphoepithelioma-like carcinoma misdiagnosed as lung squamous cell carcinoma: A case report
Authors: Yin Chang-Jie , Wang Guang-Jie , Su Xiao-Mei , Li Dong 
Published: November 2023

BACKGROUND
Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is an uncommon subtype of squamous cell carcinoma (SCC) of the lung, closely associated with Epstein-Barr virus (EBV) infection. The pathological features of PPLELC closely resemble those of SCC, which makes it prone to misdiagnosis. Surgical intervention constitutes the primary treatment approach for PPLELC.
CASE SUMMARY
This report describes a 44-year-old woman who was hospitalized for 1 mo due to left chest pain. Computed tomography revealed a mass shadow in the anterior basal segment of the left lower lobe, and a subsequent needle biopsy suggested SCC. The patient underwent radical tumor resection in the lower left lobe of the lung, and postoperative pathological examination indicated lymphoepithelial carcinoma, and the test for EBV encoded small RNA was positive. Following surgery, the patient was scheduled to receive four cycles of adjuvant chemotherapy, using the paclitaxel + carboplatin regimen, but the patient refused further treatment.
CONCLUSION
PPLELC is an exceptionally rare subtype of lung SCC and is prone to misdiagnosis.
Uterine rupture due to adenomyosis in an adolescent: A case report and review of literature
Authors: Kim Nah Ihm , Lee Ji Shin , Nam Jong Hee 
Published: November 2023

BACKGROUND
Uterine rupture is a fatal medical complication with a high mortality rate. Most cases of uterine rupture occur in late pregnancy or during labor and are mainly related to uterine scarring due to previous surgical procedures. Adenomyosis is a possible risk factor for uterine rupture. However, spontaneous uterine rupture due to severe adenomyosis in a non-gravida-teenaged female has not been reported in the literature to date.
CASE SUMMARY
A 16-year-old girl was referred to our hospital for acute abdominal pain and hypovolemic shock with a blood pressure of 90/50 mmHg. Radiologic studies revealed a huge endometrial mass with multiple nodules in the lung, suggesting lung metastasis. The patient underwent an emergency total hysterectomy and wedge resection of the lung nodules. Histologically, the uterus showed diffuse adenomyosis with glandular and stromal dissociation. Lung nodules were endometrioma with massive hemorrhage. Immunohistochemistry demonstrated that the tumor cells were positive for PAX8, ER, and PR expression, leading to a final diagnosis of pulmonary endometriosis and uterine adenomyosis. Following surgery, the patient remains in good condition without recurrence.
CONCLUSION
This is the first case of spontaneous uterine rupture due to adenomyosis in a non-gravida adolescent.
Multiple therapies relieve long-term tardive dyskinesia in a patient with chronic schizophrenia: A case report
Authors: Lv Liang , Guo Ping , Feng Min , Fang Yu , Wang Shi-Kai , Chen Huan-Xin 
Published: November 2023

BACKGROUND
Tardive dyskinesia (TD) is a serious and disabling movement disorder; it impairs social function and quality of life and increases the mortality rate. TD is usually induced by the use of antipsychotic drugs; however, the underlying mechanism remains unclear. Pharmacotherapy of TD includes cholinergic drugs, benzodiazepines, ginkgo biloba extract (GBE), antioxidants, amantadine, propanolol, botulinum toxin, valbenazine, and deutetrabenazine, whereas the non-pharmacotherapy approach includes modified electroconvulsive therapy (MECT) and deep brain stimulation. We successfully treated a chronic schizophrenia patient with comorbid long-term severe TD using deutetrabenazine, clozapine, and MECT.
CASE SUMMARY
A 69-year-old woman who was diagnosed as having schizophrenia 16 years ago developed severe TD after 6-mo prescription of risperidone oral solution. Her TD symptoms did not resolve despite various treatments, such as GBE, vitamin E, trihexyphenidyl, promethazine, benzodiazepines, and switching to quetiapine and olanzapine. After admission, she was given deutetrabenazine 6 mg bid. Her buccal tremor was slightly resolved 3 d later; however, her tongue remained protruded and could not be retracted. Quetiapine was switched to clozapine on day 4, and the buccal tremor remarkably resolved, and the tongue could be retracted into the mouth from day 6 onward. After three sessions of MECT, the buccal tremor resolved further. Since then, she has been able to take a semifluid diet, and her quality of life improved remarkably during 6 mo of follow-up.
CONCLUSION
TD is a serious condition which could be caused by antipsychotic medications; however, the best strategy against TD is prevention and monitoring during using antipsychotics. For patients with TD caused by antipsychotic medication use, multiple measures should be considered like switching to clozapine, adjunction with deutetrabenazine, or even MECT.
Lung ultrasound for the early diagnosis of acute lung injury: A case report
Authors: Zheng Xin , Liu Na 
Published: November 2023

BACKGROUND
The extensive availability of ultrasound (US) technology has increased its use for point-of-care applications in many health care settings. During anaesthesia and surgery, acute respiratory failure or pulmonary oedema are common life-threatening events that, if not recognized and treated appropriately, result in a high mortality rate.
CASE SUMMARY
We report a patient under anaesthesia whose lung US examination showed multiple vertical artefacts (B-lines) in the lung tissue, indicating pulmonary oedema. The respiratory state improved with the resolution of the pulmonary oedema after our treatment.
CONCLUSION
We believe that US of the lungs may be a useful tool for dynamic respiratory monitoring at the bedside during anaesthesia.
Net cost savings arising from patient completion of an active self-management program
Authors: Gorniak Maja , Pardillo Marvin , Keating Catherine , Brown Courtney , Schilling Chris 
Published: November 2023

Objective
The objective of this study is to investigate changes in willingness for total knee replacement (TKR) surgery following a randomised control trial (RCT) of an osteoarthritis management program, and to extrapolate orthopaedic cost consequences for private health insurers (PHI).

Methods
Willingness for surgery data from the RCT is analysed using a multinomial logistic regression model. A decision analytic model is used to conduct a break-even cost benefit analysis of the intervention from a PHI payer perspective. The analysis estimates the minimum probability of progression to surgery required for the intervention to be cost-neutral when considering savings limited to reduced orthopaedic costs. Cost data and orthopaedic pathway probabilities are sourced from payer data.

Results
At baseline, 39% of participants in the treatment and control group were willing for surgery. At 12 months, 16% of participants in the treatment group remained willing for surgery, versus 36% in the control group. Participants in the treatment group are 2.96 (95% CI: 1.01–8.66) times more likely than those in the control group to move from initially willing for surgery, to unsure or unwilling at 12 months. The analysis indicates that the intervention is likely to be cost saving when at least 60% of initially willing participants progress to surgery over a 5-year time horizon.

Conclusion
Our study estimates that an education, exercise and weight loss intervention can deliver both improved participant outcomes and a return on investment to Australian PHIs through a reduction in TKR surgery incidence.
Acute myocardial infarction from a lower-middle income country—A comprehensive report on performance measures and quality metrics using National Cardiovascular Data Registry
Authors: Baloch Farhala , Arshad Ainan , Sethi Sher Muhammad , Tai Javed M. 
Published: November 2023

Introduction
Epidemic of cardiovascular disease (CVD) is widely projected in South Asian population and estimated to get double in two decades. Ischemic heart disease (IHD) is one of the spectrums of CVD and acute myocardial infarction (AMI) being the common manifestations of IHD. National Cardiovascular Data Registry (NCDR) is a registry data that measure their practices and improve quality of care. In this project we aim to see our performance trends in the care of IHD including AMI patients over two year’s period.

Material & methods
A cross sectional study conducted at the Aga Khan University Hospital, Karachi, Pakistan. All patients aged 18 years and above admitted to adult Cardiology units with chest pain and acute coronary syndrome are eligible to be included in NCDR data set. Data on demographics and initial characteristics of patients were extracted from NCDR institutional dataset. The data was then compared between 2019 and 2020 on performance, quality, and efficiency metrics.

Result
In 2019 to 2020, 1542 patients with acute coronary syndrome and stable ischemic heart disease were admitted. Out of these, 1042 patients (67.8%) were males. According to our data, the 2020 mortality rate was about 5.25%. In 2019 and 2020, bleeding rates were 1.1% and 1.6%, respectively. Our data showed 100% PCI in 90 minutes in 2019 while 87% in 2020. According to the appropriateness criteria for PCI, 80% were appropriate, while 20% were possibly appropriate in both years. The median length of stay following a procedure was 2 days in 2019 and 1 day in 2020.

Conclusion
This study described the common and unique characteristics of patients with myocardial infarction representing population from South Asian region. Overall, the procedural performance measure and outcome metrics are up to the international benchmarks. Cultural, financial, and pandemic effects identified certain challenges.
Water resources utilization and tourism environment assessment based on water footprint
Authors: Su Juanjuan 
Published: November 2023

Abstract

Purpose
With population growth and economic development, global Water Resources (WR) are becoming increasingly scarce. As an important consumer sector, the tourism industry is increasingly consuming and polluting WR. How to reasonably utilize WR and protect the water environment has become an important issue for the sustainable development of the current tourism industry.

Methods
Based on the Water Footprint of WR utilization and tourism environment assessment, this article used four different WR management schemes in different tourist areas to compare with the traditional scheme.

Result
According to the experimental results, it could be concluded that the wastewater discharge and environmental risk index under low Water Consumption technology in a certain mountainous tourist attraction were approximately 90,000 m3 and 0.25, respectively; the wastewater discharge and environmental risk index of a certain tourist city using renewable water technology were approximately 600,000 m3 and 0.5, respectively. The impact of adopting different WR management schemes in different regions has also varied.

Conclusion
This also indicated that when formulating WR management plans for various tourist areas, it was necessary to fully consider the impact of the tourism environment and develop scientific and reasonable management measures. The research in this article has broad application prospects in practice, which helped to promote sustainable economic development and progress in social civilization.
Acquired immunity against SARS‐CoV‐2 infection and vaccination
Authors: Renia Laurent , Ng Lisa FP 
Published: November 2023

The ongoing severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic has caused more than 700 million confirmed infections and ~7 million fatalities worldwide since its emergence in December 2019. SARS‐CoV‐2 is part of a family of positive‐sense, enveloped RNA viruses known as coronaviruses. Today, at least seven human coronaviruses have been identified and are known to cause respiratory tract illnesses with varying severity. The COVID‐19 pandemic spurred the generation of a vast amount of scientific knowledge on coronaviruses in record time, leading to a broad understanding of host immunity against SARS‐CoV‐2, and the rapid development of life‐saving vaccines (mainly mRNA and adenovirus‐ or inactivated virus‐based vaccines). Real world data on licensed SARS‐CoV‐2 vaccines have shown that efficacy ranges from 50 to 95% depending on viral variants, pre‐infections, and vaccine formulations, regimens, and combinations. While vaccination does markedly decrease the chances of infection and severe disease, breakthrough symptomatic and asymptomatic infections have occurred due to the emergence of immune escape virus variants. Therefore, despite these early successes, a better understanding of the mechanisms of protective immunity against infection is essential for the development of longer lasting and more efficient vaccines against SARS‐CoV‐2 and future coronaviruses.
The New World Economy
Authors: Shokhov Alexander 
Published: November 2023

The article describes the key components of the new world economy that is emerging before our eyes. Russia has the potential to achieve conceptual and intellectual leadership in addressing challenges that remain relevant for all of humanity, such as climate change management, development of scientifically grounded ecological policies, space exploration, new energy generation technologies, reassembling of international organizations activities, and the transition to meaningful comprehensive development governance. The thesis is declared that the world as a cultural-civilizational complex will continue to globalize in the civilizational context (technologies, transportation, communication, comfort, modern clothing, footwear, building materials, etc.), and in the cultural context, it will become more equitable and just. Furthermore, value-added chains will continue to function despite political obstacles and limitations.
Humanity is now faced with the necessity to make a choice between developmental imitation (catch-up or sustainable development) and genuine development, which implies breakthroughs into the unknown, scientific research, and the development of technologies that currently appear inconceivable. Will we continue to play bureaucratic games in the style of &quot;We are merely executors, following rules and procedures, obeying instructions and carrying out orders whose meanings we do not understand,&quot; or will we take responsibility for achieving ambitious results? Every political leader, scientist, manager, and ordinary person finds themselves facing this existential choice today.
Mark Yakovlevich Vygodsky&apos;s Anniversary: Key Biography Facts and the List of His Key Publications
Authors: Gurov Oleg 
Published: November 2023

The year 2023 celebrates the 125th anniversary of the birth of Mark Yakovlevich Vygodsky, a famous Soviet mathematician and pedagogue, one of the founders of the Soviet school of the history of mathematics. Not only the scientist&apos;s scientific achievements, but also his significant contribution to pedagogical theory and practice, allow us to describe him as a significant scientific figure of the twentieth century. His mathematics textbooks and reference books are reprinted almost annually, so that his ideas continue to influence educational and scientific practice to this day. This article is the second in a series of publications prepared by the author, who is the great-grandson of M.Y. Vygodsky. This research presents previously unpublished scientific results and discoveries concerning the life and work of the scholar. Firstly, based on archival data and family memories, detailed facts about his origins, young years and his development as a scientist are presented. At the same time, a rather complete chronology of M.Y. Vygodsky&apos;s scientific activity and personal life is compiled. Secondly, for the first time, a complete list of his main scientific contributions has been prepared, which makes it possible to assess the talent and the scale of his academic achievements. The presented results may be useful for prospective scientific and historical studies. In the modern context, it seems valuable to present a picture of M.Y. Vygodsky&apos;s life and work, as he was an interdisciplinary researcher and in this he was ahead of his time. In our changing world, contemporary challenges require the same interdisciplinarity to solve complex problems, and a fresh look at the life and work of a scholar like M.J. Vygodsky can stimulate inspiration in the modern researcher, student, and anyone seeking development and awareness.
Do passive range of motion exercises lead to quicker postsurgical recovery of canine IVDD?
Authors: Wallace Alexander 
Published: November 2023

PICO Question
In canine patients recovering from surgery for intervertebral disc disease, do passive range of motion exercises, compared to no intervention, lead to a shorter or faster rate of recovery?

Clinical bottom line
Category of research
Treatment.
Number and type of study designs reviewed
Five studies (two randomised controlled trials, two retrospective cohort studies and one retrospective case series) were critically appraised.
Strength of evidence
Weak.
Outcomes reported
There is no evidence that passive range of motion (PROM) exercises are associated with a quicker postsurgical recovery in the canine intervertebral disc disease (IVDD) patient.
Conclusion
There is a lack of evidence about specific rehabilitation techniques for the postoperative canine IVDD patient. Based on the current data, a multimodal approach, including basic and intense rehabilitation techniques is suggested.

How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.