bluuebunny/crossref_metadata_2025_split huggingface dataset:
Movement-evoked Pain versus Pain at Rest in Postsurgical Clinical Trials and in Meta-analyses: An Updated Systematic Review
Authors: Gilron Ian , Lao Nicholas , Carley Meg , Camiré Daenis , Kehlet Henrik , Brennan Timothy J. , Erb Jason 
Published: February 2024

Background
Given the widespread recognition that postsurgical movement-evoked pain is generally more intense, and more functionally relevant, than pain at rest, the authors conducted an update to a previous 2011 review to re-evaluate the assessment of pain at rest and movement-evoked pain in more recent postsurgical analgesic clinical trials.

Methods
The authors searched MEDLINE and Embase for postsurgical pain randomized controlled trials and meta-analyses published between 2014 and 2023 in the setting of thoracotomy, knee arthroplasty, and hysterectomy using methods consistent with the original 2011 review. Included trials and meta-analyses were characterized according to whether they acknowledged the distinction between pain at rest and movement-evoked pain and whether they included pain at rest and/or movement-evoked pain as a pain outcome. For trials measuring movement-evoked pain, pain-evoking maneuvers used to assess movement-evoked pain were tabulated.

Results
Among the 944 included trials, 504 (53%) did not measure movement-evoked pain (vs. 61% in 2011), and 428 (45%) did not distinguish between pain at rest and movement-evoked pain when defining the pain outcome (vs. 52% in 2011). Among the 439 trials that measured movement-evoked pain, selection of pain-evoking maneuver was highly variable and, notably, was not even described in 139 (32%) trials (vs. 38% in 2011). Among the 186 included meta-analyses, 94 (51%) did not distinguish between pain at rest and movement-evoked pain (vs. 71% in 2011).

Conclusions
This updated review demonstrates a persistent limited proportion of trials including movement-evoked pain as a pain outcome, a substantial proportion of trials failing to distinguish between pain at rest and movement-evoked pain, and a lack of consistency in the use of pain-evoking maneuvers for movement-evoked pain assessment. Future postsurgical trials need to (1) use common terminology surrounding pain at rest and movement-evoked pain, (2) assess movement-evoked pain in virtually every trial if not contraindicated, and (3) standardize movement-evoked pain assessment with common, procedure-specific pain-evoking maneuvers. More widespread knowledge translation and mobilization are required in order to disseminate this message to current and future investigators.

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Rethinking Sjögren Beyond Inflammation: Considering the Role of Nerves in Driving Disease Manifestations
Authors: Sanchez Victor , Dobzinski Noa , Fox Robert , Galor Anat 
Published: February 2024

Abstract:
Sjögren syndrome (SS) is a chronic inflammatory autoimmune disease characterized by destruction of mucosal glands resulting in dry eye and dry mouth. Ocular presentations can be heterogenous in SS with corneal nerves abnormalities that are structural, functional, or both. Some individuals present with corneal hyposensitivity, with a phenotype of decreased tear production and epithelial disruption. Others present with corneal hypersensitivity, with a phenotype of neuropathic pain including light sensitivity and pain out of proportion to signs of tear dysfunction. A similar correlate can be found outside the eye, with dry mouth predominating in some individuals while pain conditions predominate in others. Understanding how nerve status affects SS phenotype is an important first step to improving disease management by targeting nerve abnormalities, as well as inflammation.
Effect of residual sphere on uncorrected visual acuity and satisfaction in patients with monofocal and multifocal intraocular lenses
Authors: Schallhorn Steven C. , Hettinger Keith A. , Hannan Stephen J. , Venter Jan A. , Teenan David , Schallhorn Julie M. 
Published: February 2024

Purpose:
To assess the effect of residual sphere on vision and satisfaction in pseudophakic patients.

Setting:
Private clinics, United Kingdom.

Design:
Retrospective case series.

Methods:
A multivariate model evaluated the effect of 1-month residual sphere on outcomes of pseudophakic patients. Odds ratios (ORs) were calculated to assess the relative risk of not achieving ≥20/20 monocular uncorrected distance visual acuity (UDVA), ≥20/50 uncorrected near visual acuity (UNVA), and not being satisfied with vision. ORs were assessed for residual sphere −1.00 to +1.00 diopter (D) in quarter-diopter steps, using 0.00 D as a reference.

Results:
The analysis included 38 828 multifocal and 11 571 monofocal intraocular lenses (IOLs). The residual myopic sphere ≤−0.25 D and hyperopic sphere ≥+0.50 D had a clinically meaningful effect on UDVA. Although monofocal IOLs had an improvement in UNVA with every additional 0.25 D of myopia, the change in ORs with increasing myopia was not significant for multifocal IOLs. The mean improvement in UNVA comparing eyes with 0.00 D and −1.00 D sphere was 0.26 logMAR for monofocal and 0.03 logMAR for multifocal IOLs. Low near-addition IOLs had a slightly higher gain in UNVA with increasing myopia, but the gain was not as substantial as with monofocal IOLs. The effect of ametropia on satisfaction was more pronounced for multifocal IOLs. For every 0.25 D of residual myopia, there was >25% increase in dissatisfied patients.

Conclusions:
Although myopia improved UNVA in eyes with monofocal IOL, multifocal IOLs did not benefit from residual myopia. Multifocal IOL patients desiring distance vision should be targeted closest to emmetropia, even if it means targeting slight hyperopia.
Long-term functional outcome between Yamane technique and retropupillary iris-claw technique in a large study cohort
Authors: Guerin Pier Luigi , Guerin Gian Marco , Pastore Marco Rocco , Gouigoux Stefano , Tognetto Daniele 
Published: February 2024

Purpose:
To evaluate which secondary intraocular lens (IOL) implantation technique was more successful in achieving the best postoperative results and refractive outcomes between retropupillary iris-claw IOL (ICIOL) and flanged intrascleral IOL (FIIOL) fixation with the Yamane technique.

Setting:
Eye Clinic of the University of Trieste, Trieste, Italy.

Design:
Retrospective observational study.

Methods:
116 eyes of 110 patients who underwent ICIOL or FIIOL were analyzed. Patients with follow-up shorter than 6 months or with incomplete clinical data were excluded. Collected data included demographics, ocular comorbidity, indication of surgery, intraocular pressure, early (≤1 month) and late (>1 month) postoperative complications, corrected distance visual acuity (CDVA), and manifest refraction at the last follow-up visit.

Results:
50% (n = 58) of eyes underwent FIIOL and 50% (n = 58) ICIOL implantation for aphakia (n = 44, 38%) and IOL dislocation (n = 72, 62%). No statistically significant differences in demographics, comorbidity, follow-up duration, postoperative complications, and surgical indications were found. The refractive prediction error (RPE) was 0.69 ± 0.94 diopter (D) in the FIIOL group and 0.21 ± 0.75 D in the ICIOL group (P = .03), indicating residual hyperopia after both techniques. RPE, mean absolute error, and median absolute error were higher in the FIIOL group (P = .003). ICIOL implantation was more successful in obtaining a RPE between −0.50 D and +0.50 D (52% of ICIOL, n = 30, and 31% of FIIOL, n = 18).

Conclusions:
Both techniques were effective in increasing preoperative CDVA with no statistical difference between them. Although complication rates did not significantly differ, the FIIOL group exhibited less predictable refractive outcomes. Adjusting the dioptric power of the 3-piece IOL, as performed in ciliary sulcus implantation, to prevent myopic shift, is not recommended.
Global burden of all cause-specific injuries among children and adolescents from 1990 to 2019 : a prospective cohort study
Authors: Li Cong , Jiao Jinghua , Hua Guangyao , Yundendorj Gantugs , Liu Shunming , Yu Honghua , Zhang Lijun , Yang Xiaohong , Liu Lei 
Published: February 2024

Background:
To assess the burden and change in incidence, death, and disability-adjusted life years (DALYs) for all-cause-specific injuries among children and adolescents in 204 countries and territories between 1990 and 2019.

Materials and Methods:
Data were extracted from the Global Burden of Disease, Injury, and Risk Factor Study 2019 (GBD 2019). Global, regional, and country-level age-standardized rate (per 100,000) of incidence (ASRI), mortality (ASRM), and DALYs (ASRD) with 95% uncertainty interval (95% UI) of injuries were estimated by age, sex, socio-demographic index (SDI), and all-cause specific injuries from 1990 to 2019.

Results:
Overall, the ASRI, ASRM, and ASRD of injury were 9006.18 (95%UI: 7459.74 to 10918.04), 23.04 (20.00 to 26.50), and 2020.19 (1759.47 to 2318.64) among children and adolescents worldwide in 2019, respectively. All the above indicators showed a downward trend from 1990 to 2019. In level 2 cause of injury, both the global transport injury and unintentional injury declined during the study years, while self-harm and interpersonal violence-related injury showed an increasing trend. High SDI regions had higher ASRI of injuries, but low SDI regions had higher ASRM and ASRD of injuries globally in 2019. Males had a higher burden of injuries than those in females. The ASRI of injuries is higher in adolescents aged 15-19 years, whereas the mortality and DALYs rate are higher among children under 5 years old. Moreover, adolescents aged 15-19 years and individuals living in Central Asia, Middle East, and Africa had higher ASRI, ASRM, and ASRD of injuries owing to self-harm and interpersonal violence. Generally, falls and road traffic injuries are the leading cause of injury among the population aged 0-19 years worldwide, but self-harm, interpersonal violence, and conflict and terrorism are also leading types of injuries in some regions, particularly in Low- and Middle-Income Countries.

Conclusions:
Injury remains a major global public health problem among children and adolescents, although its burden at the worldwide level showed a decreasing trend from 1990 to 2019. Of concern, the burden of injuries caused by transport injuries, and unintentional injuries has shown a downward trend in most countries, while the burden caused by self-harm and interpersonal violence has shown an upward trend in most countries. These findings suggest that more targeted and specific strategies to prevent the burden of injuries should be reoriented, and our study provides important findings for decision-makers and healthcare providers to reduce injury burden among children and adolescents.
Development and external validation of a prediction model for digit replantation failure after traumatic amputations based on a prospective multicenter cohort
Authors: Gao Tao , Bao Bingbo , Lin Junqing , Tian Maoyuan , Xia Lei , Wei Haifeng , Cai Qianying , Zhu Hongyi , Zheng Xianyou 
Published: February 2024

Background:
Failure of digit replantation after traumatic amputation is difficult to predict. We aimed to develop a prognostic model to better identify factors that better predict replantation failure following traumatic digit amputation.

Materials and methods:
In this multicenter prospective cohort, we identified patients who had received digit replantation between January 1, 2015, and January 1, 2019. Univariable and multivariable analyses were performed successively to identify independently predictive factors for failure of replanted digit. To reduce overfitting, the Bayesian information criterion was used to reduce variables in the original model. Nomograms were created with the reduced model after model selection. This model was then internally validated with bootstrap resampling and further externally validated in validation cohort.

Results:
Digit replantation was failed in 101 of 1062 (9.5%) digits and 146 of 1156 digits (12.6%) in the training and validation cohorts, respectively. We found that six independent prognostic variables were associated with digit replantation failure: age, mechanism of injury, ischemia duration, smoking status, amputation pattern (complete or incomplete), and surgeon’s experience. The prediction model achieved good discrimination, with concordance indexes of 0.81 (95% CI, 0.76-0.85) and 0.70 (95% CI, 0.65-0.74) in predicting digit failure in the training and validation cohorts, respectively. Calibration curves were well-fitted for both training and validation cohorts.

Conclusions:
The proposed prediction model effectively predicted the failure rate of digit replantation for individual digits of all patients. It could assist in selecting the most suitable surgical plan for the patient.
Data-driven coaching to improve statewide outcomes in CABG: before and after interventional study
Authors: Mejia Omar A.V. , Borgomoni Gabrielle B. , de Freitas Fabiane Letícia , Furlán Lucas S. , Orlandi Bianca Maria M. , Tiveron Marcos G. , Silva Pedro Gabriel M de B e , Nakazone Marcelo A. , Oliveira Marco Antonio P de , Campagnucci Valquíria P. , Normand Sharon-Lise , Dias Roger D. , Jatene Fábio B. ,   REPLICCAR Study Group
Published: February 2024

Background:
The impact of quality improvement initiatives Program (QIP) on coronary artery bypass grafting surgery (CABG) remains scarce, despite improved outcomes in other surgical areas. This study aims to evaluate the impact of a package of QIP on mortality rates among patients undergoing CABG.

Materials and methods:
This prospective cohort study utilized data from the multicenter database Registro Paulista de Cirurgia Cardiovascular II (REPLICCAR II), spanning from July 2017 to June 2019. Data from 4,018 isolated CABG adult patients were collected and analyzed in three phases: before-implementation, implementation, and after-implementation of the intervention (which comprised QIP training for the hospital team). Propensity Score Matching was used to balance the groups of 2,170 patients each for a comparative analysis of the following outcomes: reoperation, deep sternal wound infection/mediastinitis ≤ 30 days, cerebrovascular accident, acute kidney injury, ventilation time>24 hours, length of stay<6 days, length of stay>14 days, morbidity and mortality, and operative mortality. A multiple regression model was constructed to predict mortality outcomes.

Results:
Following implementation, there was a significant reduction of operative mortality (61.7%, P=0.046), as well as deep sternal wound infection/mediastinitis (P<0.001), sepsis (P=0.002), ventilation time in hours (P<0.001), prolonged ventilation time (P=0.009), postoperative peak blood glucose (P<0.001), total length of hospital stay (P<0.001). Additionally, there was a greater use of arterial grafts, including internal thoracic (P<0.001) and radial (P=0.038), along with a higher rate of skeletonized dissection of the internal thoracic artery.

Conclusions:
QIP was associated with a 61.7% reduction in operative mortality following CABG. Although not all complications exhibited a decline, the reduction in mortality suggests a possible decrease in failure to rescue during the after-implementation period.
Surgical outcomes and survival following esophagectomy for squamous cell carcinoma with or without liver cirrhosis: retrospective cohort study
Authors: Park Seong Yong , Shin Jaeseung , Jeon Yeong Jeong , Lee Junghee , Cho Jong Ho , Kim Hong Kwan , Choi Yong Soo , Zo Jae Il , Shim Young Mog 
Published: February 2024

Background & Aims:
Esophageal squamous cell carcinoma (ESCC) shares common risk factors with liver cirrhosis (LC). The influence of LC in patients with ESCC has not been fully investigated. This study aimed to investigate the postoperative and long-term survival outcomes of esophagectomy for ESCC according to LC presence.

Methods:
Among patients who underwent curative-intent surgery for ESCC between 1994 and 2018, 121 patients with Child–Pugh class A LC and 2810 patients without LC were compared.

Results:
Among the LC patients, 73 (60.3%) were diagnosed with LC before surgery and 48 (39.7%) were diagnosed intraoperatively. There were no significant differences in baseline characteristics between patients with LC and those without LC. However, intraoperative blood loss was higher, and operation time, hospital stay, and intensive care unit stay were longer in patients with LC than in those without LC. Moreover, the reoperation, 30-day morbidity (60.6% vs. 73.6%, P=0.006) and 90-day mortality (2.2% vs. 4.9%, P=0.049) were significantly higher in patients with LC. The 5-year overall survival (OS) rate was significantly higher in patients without LC than in those with LC. After adjusting the confounding variables, LC was an adverse risk factor of OS (hazard ratio 1.402, P=0.004). Among patients with LC, the Model of End-Stage Liver Disease score was related to the development of complications of grade more than III (odds ratio 1.459, P=0.013).

Conclusion:
ESCC patients with Child–Pugh class A LC have high incidences of postoperative morbidity and mortality, and poor OS. Thus, careful patient selection, meticulous operation, and careful postoperative care are needed.
Right gastroepiploic artery length determined anastomotic leakage after minimally invasive esophagectomy for esophageal cancer- a prospective cohort study
Authors: Li KunKun , Wang YingJian , Zhang TaiMing , Zhang Liang , Zhao ShuLin , Chen Liang , Bao Tao , Zhao XiaoLong , Xie XianFeng , Guo Wei 
Published: February 2024

Background:
This prospective cohort study, conducted at a high-volume esophageal cancer center from July 2019 to July 2022, aimed to investigate the link between the right gastroepiploic artery (RGEA) length and anastomotic leakage (AL) rates following minimally invasive esophagectomy (MIE). Real-world data on stomach blood supply in the Chinese population were examined.

Materials and Methods:
A total of 516 cases were enrolled, categorized into two groups based on the Youden index-determined optimal cut-off value for the relative length of RGEA (length of RGEA/length of gastric conduit, 64.69%) through ROC analysis: Group SR (short RGEA) and Group LR (long RGEA). The primary observation parameter was the relationship between AL incidence and the ratio of direct blood supply from RGEA. Secondary parameters included the mean length of the right gastroepiploic artery, greater curvature, and the connection type between right and left gastroepiploic vessels. Patient data were prospectively recorded in electronic case report forms.

Results:
The study revealed median lengths of 43.60 cm for greater curvature, 43.16 cm for the gastric conduit, and 26.75 cm for RGEA. AL, the most common postoperative complication, showed a significant difference between groups (16.88% vs. 8.84%, P=0.01). Multivariable binary logistic regression identified Group SR and LR (Odds ratio: 2.651, 95% CI: 1.124–6.250, P=0.03) and Neoadjuvant therapy (Odds ratio: 2.479, 95% CI: 1.374–4.473, P=0.00) as independent predictors of AL.

Conclusions:
The study emphasizes the crucial role of RGEA length in determining AL incidence in MIE for esophageal cancer. Preserving RGEA and fostering capillary arches between RGEA and LGEA are recommended strategies to mitigate AL risk.
Development and validation of a nomogram for pneumonia risk in burn patients with inhalation injury: a multicenter retrospective cohort study
Authors: Li Shijie , Li Dawei , Li Yalong , Liu Xizhu , Song Yaoyao , Xie Xiaoye , Luo Peng , Yuan Huageng , Shen Chuan’an 
Published: February 2024

Background:
Burn patients with inhalation injury are at higher risk of developing pneumonia, and yet there is no reliable tool for the assessment of the risk for such patients at admission. This study aims to establish a predictive model for pneumonia risk for burn patients with inhalation injury based on clinical findings and laboratory tests.

Method:
This retrospective study enrolled 546 burn patients with inhalation injury. They were grouped into a training cohort and a validation cohort. The least absolute shrinkage and selection operator (LASSO) regression analysis and binary logistic regression analysis were utilized to identify risk factors for pneumonia. Based on the factors, a nomogram for predicting pneumonia in burn patients with inhalation injury was constructed. Areas under the receiver operating characteristic curves (AUC), calibration plots and decision curve analysis (DCA) were used to evaluate the efficiency of the nomogram in both the training and validation cohorts.

Results:
The training cohort included 432 patients, and the validation cohort included 114 patients, with a total of 225 (41.2%) patients experiencing pneumonia. Inhalation injury, tracheal intubation/tracheostomy, low serum albumin, and high blood glucose were independent risk factors for pneumonia in burn patients with inhalation injury and they were further used to build the nomogram. The AUC of the nomogram in the training and validation cohorts were 0.938 (95% CI, 0.917-0.960) and 0.966 (95% CI, 0.931-1), respectively. The calibration curve for probability of pneumonia showed optimal agreement between the prediction by nomogram and the actual observation, and the DCA indicated that the constructed nomogram conferred high clinical net benefit.

Conclusion:
This nomogram can accurately predict the risk of developing pneumonia for burn patients with inhalation injury, and help professionals to identify high-risk patients at an early stage as well as to make informed clinical decisions.
Relationship Analysis Between Pericoronary Fat Attenuation Index and Parameters of Single Plaque
Authors: Nie Ji-Yan , Chen Wen-Xi , Wu Qing-De 
Published: February 2024

Objective
The aim of the study is to investigate the relationship between plaque parameters and pericoronary fat attenuation index (FAI).

Methods
A retrospective collection was performed on 227 patients with coronary heart disease who underwent coronary computed tomography angiography examinations in our hospital from May 2021 to April 2023, with a total of 254 right coronary or left anterior descending coronary arteries exhibiting solitary plaques within the FAI measurement area. Based on whether the proximal coronary FAI value was ≥ −70.0 HU, patients and coronary arteries were divided into FAI-positive group (67 cases, 73 coronary arteries) and FAI-negative group (160 cases, 181 coronary arteries). Quantitative parameters of coronary solitary plaques were collected, including stenosis severity, plaque length, plaque volume, plaque composition ratios, minimal luminal area, and calcification score, as well as qualitative parameters such as plaque types and high-risk plaques. Differences in plaque parameters between the FAI-positive and FAI-negative groups were compared.

Results
The proportion of positive remodeling in the FAI-positive group (73 coronary arteries) was higher than that in the FAI-negative group (181 coronary arteries) with statistical significance (89.0% vs 78.5%, P = 0.049). Multivariate analysis revealed that positive remodeling was a risk factor for abnormal FAI values in solitary plaques (odds ratio, 2.271, P = 0.049).

Conclusions
The FAI-positive group had a higher proportion of positive remodeling, and positive remodeling was an independent risk factor for positive FAI values.