bluuebunny/crossref_metadata_2025_split huggingface dataset:
RETRACTED ARTICLE: Predictors of sternal wound infection post cardiac surgery in a Saudi Centre: a case control study
Authors: Isaac Adil A. 
Published: January 2023

Abstract
Background
Sternal wound infection (SWI) post cardiac surgery remains an important cause of extra morbidity, mortality and cost. The objective was to identify risk factors for SWI in a cardiac centre in Eastern Saudi Arabia as part of the investigation into Surveillance variance in the local rates of SWI.

Methods
We included cases and controls from a cross section of patients who underwent major cardiac surgery between 2017 and 2020 matched for age, sex and time of surgery. An explanatory logistic regression model was fitted to estimate the risk factors.

Results
N = 204 (51 cases and 153 controls matching ratio 1:3, from a source population of 985 patients). factors significantly associated with SWI in the final multivariate model: hospital stay OR (1.05, Cl 1.01–1.10), Graft Conduit BIMA versus No Graft OR (10.94, Cl 1.60–74.63), transfusion of both packed cells plus other blood products versus no transfusion OR (3.53, Cl 93–13.44), HbA1c OR (1.09 Cl 0.84–1.41), BMI OR (1.25, Cl 1.04–1.50), perioperative blood glucose OR (1.02, Cl 1.004–1.03), surgery time OR (1.19, Cl 1.00–1.58).

Conclusions
The diverse aetiology, cross-disciplinary nature of SWI prevention, and despite improved prevention and control practices, including related care bundles with their proven value, SWI remain a serious challenge in cardiac surgery. Multidisciplinary consensus guidelines are well overdue.
Single-port thoracoscopic removal of an azygos vein aneurysm: a case report and literature review
Authors: Yao Yi , Hu Qiuxia , Xie Xiaoyang , Liu Caiyang , Lei Yu , Li Xiaoliang , Wang Yi , Liu Gaohua , Yang Yanhui , Luo Lei , Li Ji 
Published: January 2023

Abstract
Background
Azygos vein aneurysms (AVAs) are extremely rare. The majority of patients have no obvious clinical symptoms, so they are found by physical examination or by chance. There is limited clinical treatment experience that can be referred to, and there are no clear guidelines or research evidence standardizing the surgical and interventional therapy. Here, we report a patient with idiopathic AVA whose three-dimensional reconstruction of the tumor was completed before surgery. On the basis of three-dimensional reconstruction, single-port thoracoscopic resection of the AVA was successfully completed and reported for the first time. The previously reported cases are summarized to provide guidance for the diagnosis and treatment of patients with AVAs.

Case presentation
A 56-year-old man was transferred to our hospital due to “dysphagia”. The diagnosis of AVA was made after enhanced computed tomography, gastroscopy, fiberoptic bronchoscopy, and three-dimensional reconstruction. Congenital weakness or degenerative changes causes the vein walls to be extremely thin that the AVA had the risk of ruptur. Furthermore, the patient had symptoms of dysphagia, he received single-port thoracoscopic surgery. After the operation, his dysphagia disappeared. The postoperative pathology confirmed hemangioma. The patient was discharged 3 days after surgery without any complications.

Conclusions
AVAs are rare. Preoperative three-dimensional reconstruction can greatly help surgeons clarify the disease diagnosis, formulate the surgical plan, avoid damage to the surrounding vital organs, and reduce intraoperative bleeding. Thoracoscopic surgery to remove AVAs is difficult and has a high risk of bleeding, while more minimally invasive single-port thoracoscopic surgery is also safe and effective for the treatment of AVAs.
Analyzing sleep status in children with acute leukemia
Authors: Xi Lu , Wu Guangsheng , Du Xinke 
Published: January 2023

Abstract
Background
Quality sleep is essential for physical and mental health. We aimed to analyze sleep disorders in children with acute leukemia and explore associated factors.

Methods
General data and sleep disorders in children with acute leukemia during chemotherapy were collected by general questionnaires, Children's Sleep Disorders Scale and the Parenting Stress Index-short form.

Results
In total, 173 valid questionnaires were collected. The total Sleep Disorder Scale score > 39 is considered a sleep disorder, while sleep disorders accounted for 45.66% (79/173). In the cohort, 167 children had acute lymphoblastic leukemia, with 40.12% (67/167) having sleep disorders, while six children had acute non-lymphoblastic leukemia, with 50.00% (3/6) having sleep disorders. Single- and multi-factor regression analyses of age, gender, number of children in the family, and time spent using electronic devices showed that factors influencing sleep disorders in these children were mainly parental scolding and adenoid hypertrophy. Children with sleep disorders had more parental stress than those without sleep disorders (P < 0.05).

Conclusions
The high incidence of sleep disorders in children with acute leukemia is related to airway conditions and parental behaviors. Sleep disorders in children can increase parenting stress. Factors potentially affecting sleep quality should be addressed as early as possible, while parental education should be strengthened to better facilitate the physical and psychological recovery of their children.
Effect of cognitive behavior therapy (CBT) on lowering of blood glucose levels in gestational diabetes mellitus (GDM) patients: study protocol for a prospective, open-label, randomized controlled trial
Authors: Pan Ying , Liu Hong-ying , Zhong Shao 
Published: January 2023

Abstract
Background
Gestational diabetes mellitus (GDM) is a common perinatal condition. Convincing evidence has shown that hyperglycemia and other chronic comorbidities of diabetes during the prenatal period increase maternal and fetal risk. Several guidelines have identified lifestyle management as the first-line therapy in GDM patients. To improve the efficacy of lifestyle intervention, cognitive behavior therapy (CBT) is proposed as a solution to improve clinical outcomes. The objective of this trial is to determine the efficacy in treating hyperglycemia of mobile-based CBT interventions in GDM patients, compared with conventional face-to-face interventions.

Methods
This trial is designed as a prospective randomized controlled trial, which enrolled the patients diagnosed with GDM in First People’s Hospital of Kunshan affiliated with Jiangsu University from September 2021 to March 2023 with a 3-month follow-up. The specific randomization method was established and implemented through the central randomization system of EDC clinical trials. The percentage of all blood glucose levels collected within the normal range between the two groups at baseline, during the intervention period, and postpartum infant and maternal outcomes will be measured. Summary statistics for continuous variables will include the number of subjects, mean, median, SD, or the standard error, minimum, and maximum. The chi-square test, t test, and paired-sample t test were used for statistical analysis of differences between groups.

Discussion
This trial investigates the effects of mobile-based CBT intervention on blood glucose levels in GDM patients.

Trial registration
Chinese Clinical Trial Registry (ChiCTR2100048527) [registered: 2021/07/09].
Combination of radiotherapy and targeted therapy for HER2-positive breast cancer brain metastases
Authors: Yang Xiaojing , Ren Hanru , Xu Yi , Peng Xue , Yu Wenxi , Shen Zan 
Published: January 2023

AbstractRadiotherapy and targeted therapy are essential treatments for patients with brain metastases from human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, the combination of radiotherapy and targeted therapy still needs to be investigated, and neurotoxicity induced by radiotherapy for brain metastases has also become an important issue of clinical concern. It remained unclear how to achieve the balance of efficacy and toxicity with the application of new radiotherapy techniques and new targeted therapy drugs. This article reviews the benefits and potential risk of combining radiotherapy and targeted therapy for HER2-positive breast cancer with brain metastases.
A study on the detection of bulging disease in ancient city walls based on fitted initial outer planes from 3D point cloud data
Authors: Hu Yungang , Feng Baicheng , Hou Miaole 
Published: January 2023

Abstract
Bulging is a common disease suffered by ancient city walls, especially clay brick walls. Bulging affects or even threatens the stability of outer structures of ancient city walls. Therefore, accurate identification of bulges is one of the urgent issues to be addressed in ancient city wall conservation. In this study, a novel method is proposed for detecting and identifying bulge information using point cloud data collected from the outer surface of an ancient city wall. The non-bulging points are identified in the sliced point cloud of a city wall, and then the initial plane of the city wall is fitted more accurately with the aid of spatial constraints. Finally, the bulging damage is identified and extracted by comparing the initial plane with the original point cloud. This method was applied to the project of ancient city wall conservation and was compared with other existing methods in effectiveness and accuracy. The results show that the proposed method can detect efficiently budging disease in ancient city walls for architectural heritage conservation.
Sudden unexpected death caused by a colloid cyst in the third ventricle: case report
Authors: Alzahrani Abdulrahman , Albouijan Abdullah , Alshamsi Ghada , Almanjumi Abdulwahab , Hamdi Mohammed , Alteraiqi Battel , Alshaikhi Mohammed 
Published: January 2023

Abstract
Background
Colloid cysts arise from congenital abnormalities of the endodermis and are characteristically comprised of an external fibrous layer, with a lining of cuboidal and columnar epithelial cells and endodermal ciliated cells. They contain a gelatinous matrix, produced by mucus-producing epithelial cells.

Case presentation
An 8-year-old Saudi girl died in Dammam Central Hospital, to which she was admitted by her parents following her complaints of intense headaches. When the body was examined externally, it was noted that she had bilateral eye congestion, evidence of needle marks on all four limbs and in the region of the femoral triangle and bruising in the central chest and left shoulder areas. No other evidence of injury was noted. A cyst in the third ventricle of the brain was identified at post mortem. Investigations for alcohol, toxins and illicit substances were negative.

Conclusion
It was surmised that the child had died as a result of a cerebral colloid cyst and its clinical sequelae.
Serum Mac-2 Binding Protein Glycosylation Isomer Concentrations Are Associated With Incidence of Type 2 Diabetes
Authors: Higashioka Mayu , Hirakawa Yoichiro , Hata Jun , Honda Takanori , Sakata Satoko , Shibata Mao , Kitazono Takanari , Osawa Haruhiko , Ninomiya Toshiharu 
Published: January 2023

Abstract

Context
Serum Mac-2 binding protein glycosylation isomer (M2BPGi) concentrations are known to be an indicator of chronic liver injury and fibrosis.

Objective
This study aimed to investigate the association between serum M2BPGi concentrations and the development of type 2 diabetes in a Japanese community.

Methods
A total of 2143 community-dwelling Japanese individuals aged 40-79 years without diabetes at baseline were followed up for 7 years. Serum M2BPGi concentrations were divided into quintiles: Q1, ≤0.37 cutoff index (COI); Q2, 0.38-0.49 COI; Q3, 0.50-0.62 COI; Q4, 0.62-0.80 COI; and Q5, ≥0.81 COI. Cox proportional hazards models were used to estimate hazard ratios and 95% CIs for the development of type 2 diabetes.

Results
During the follow-up period, 219 individuals developed type 2 diabetes. The age- and sex-adjusted cumulative incidence of type 2 diabetes significantly increased with elevating serum M2BPGi levels (P for trend &lt; .01). This association remained significant after adjustment for potential confounders (P for trend = .04). This significant association attenuated to a nonsignificant level after additionally adjusting for serum high-sensitivity C-reactive protein or homeostasis model assessment of insulin resistance.

Conclusion
The present study demonstrated that higher serum M2BPGi concentrations were significantly associated with higher risk of diabetes in a Japanese community. Moreover, inflammation and insulin resistance were suggested to contribute to the excess risk of diabetes in individuals with higher serum M2BPGi levels. These findings shed light on the importance of inflammation and insulin resistance when considering the pathogenesis of diabetes.
Diazoxide Choline Extended-Release Tablet in People With Prader-Willi Syndrome: A Double-Blind, Placebo-Controlled Trial
Authors: Miller Jennifer L , Gevers Evelien , Bridges Nicola , Yanovski Jack A , Salehi Parisa , Obrynba Kathryn S , Felner Eric I , Bird Lynne M , Shoemaker Ashley H , Angulo Moris , Butler Merlin G , Stevenson David , Abuzzahab Jennifer , Barrett Timothy , Lah Melissa , Littlejohn Elizabeth , Mathew Verghese , Cowen Neil M , Bhatnagar Anish ,   the DESTINY PWS Investigators, Das Urmi , Fleischman Amy , Goldstone Anthony , Harwood Katerina , Holland Prof Anthony , Kimonis Virginia , McCandless Shawn , Schillaci Lori Anne , Shaikh Mohammed , Shea Heidi , Viskochil David , Wilding Prof John 
Published: January 2023

Abstract

Context
Prader-Willi syndrome (PWS) is a rare neurobehavioral-metabolic disease caused by the lack of paternally expressed genes in the chromosome 15q11-q13 region, characterized by hypotonia, neurocognitive problems, behavioral difficulties, endocrinopathies, and hyperphagia resulting in severe obesity if not controlled.

Objective
The primary end point was change from baseline in hyperphagia using the Hyperphagia Questionnaire for Clinical Trials (HQ-CT). Other end points included Global Impression Scores, and changes in body composition, behaviors, and hormones.

Methods
In DESTINY PWS, a 13-week, randomized, double-blind, placebo-controlled, phase 3 trial, 127 participants with PWS aged 4 years and older with hyperphagia were randomly assigned 2:1 to diazoxide choline extended-release tablet (DCCR) or placebo.

Results
DCCR did not significantly improve hyperphagia (HQ-CT least-square mean (LSmean) [SE] −5.94 [0.879] vs −4.27 [1.145]; P = .198), but did so in participants with severe hyperphagia (LSmean [SE] −9.67 [1.429] vs −4.26 [1.896]; P = .012). Two of 3 secondary end points were improved (Clinical Global Impression of Improvement [CGI-I]; P = .029; fat mass; P = .023). In an analysis of results generated pre-COVID, the primary (HQ-CT; P = .037) and secondary end points were all improved (CGI-I; P = .015; Caregiver Global Impression of Change; P = .031; fat mass; P = .003). In general, DCCR was well tolerated with 83.3% in the DCCR group experiencing a treatment-emergent adverse event and 73.8% in the placebo group (not significant).

Conclusion
DCCR did not significantly improve hyperphagia in the primary analysis but did in participants with severe baseline hyperphagia and in the pre-COVID analysis. DCCR treatment was associated with significant improvements in body composition and clinician-reported outcomes.
Impact of Conducting Adrenal Venous Sampling in the Morning Versus Afternoon in Primary Aldosteronism
Authors: Yoneda Mau , Kometani Mitsuhiro , Aiga Ko , Karashima Shigehiro , Usukura Mikiya , Mori Shunsuke , Takeda Yoshimichi , Aono Daisuke , Konishi Seigo , Okumura Kenichiro , Ogi Takahiro , Kobayashi Satoshi , Takeda Yoshiyu , Yoneda Takashi 
Published: January 2023

Abstract

Context
Adrenal venous sampling (AVS) is the gold standard technique for subtype differentiation of primary aldosteronism (PA) and to obtain aldosterone and cortisol measurements; however, their secretion patterns show fluctuations during the day.

Objective
We aimed to examine the effects of AVS timing on AVS results.

Methods
This multicenter, retrospective, observational study included a total of 753 patients who were diagnosed with PA and underwent AVS in 4 centers in Japan. Among them, 504 and 249 patients underwent AVS in the morning (AM-AVS) and in the afternoon (PM-AVS), respectively. The outcome measures were the impact of AVS timing and hormone fluctuations in a day on AVS results.

Results
There were no differences in the success rate of AVS, diagnostic rate of disease type, or frequency of discrepancy in PA subtypes between the AM-AVS and PM-AVS groups. Regarding patients with unilateral PA, aldosterone concentrations in adrenal venous blood did not differ between the 2 groups on the dominant or nondominant side. Conversely, regarding patients with bilateral PA, aldosterone concentrations in adrenal venous blood were significantly higher in the AM-AVS than in the PM-AVS group.

Conclusions
The timing of AVS did not seem to have a significant impact on subtype diagnosis. The aldosterone levels in adrenal venous blood were significantly higher in patients with bilateral PA in the AM-AVS group, but there was no such difference between patients with unilateral PA in the AM-AVS and PM-AVS groups. Each subtype may have a different hormone secretion pattern in a day.
Reducing Volatile Anesthetic Waste Using a Commercial Electronic Health Record Clinical Decision Support Tool to Lower Fresh Gas Flows
Authors: Olmos Andrea V. , Robinowitz David , Feiner John R. , Chen Catherine L. , Gandhi Seema 
Published: January 2023

BACKGROUND:
Volatile anesthetic consumption can be reduced by minimizing excessive fresh gas flows (FGFs). Currently, it is unknown whether decision support tools embedded within commercial electronic health record systems can be successfully adopted to achieve long-term reductions in FGF rates. The authors describe the implementation of an electronic health record–based clinical decision support tool aimed at reducing FGF and evaluate the effectiveness of this intervention in achieving sustained reductions in FGF rates and volatile anesthetic consumption.

METHODS:
On August 29, 2018, we implemented a decision support tool within the Epic Anesthesia Information Management System (AIMS) to alert providers of high FGF (>0.7 L/min for desflurane and >1 L/min for sevoflurane) during maintenance of anesthesia. July 22, 2015, to July 10, 2018, served as our baseline period before the intervention. The intervention period spanned from August 29, 2018, to December 31, 2019. Our primary outcomes were mean FGF (L/min) and volatile agent consumption (mL/MAC-h). Because a simple comparison of 2 time periods may result in false conclusions due to underlying trends independent of the intervention, we performed segmented regression of the interrupted time series to assess the change in level at the start of the intervention and the differences in slopes before and after the intervention. The analysis was also adjusted for potential confounding variables. Data included 44,899 cases using sevoflurane preintervention with 26,911 cases postintervention, and 17,472 cases using desflurane with 1185 cases postintervention.

RESULTS:
Segmented regression of the interrupted times series demonstrated a decrease in mean FGF by 0.6 L/min (95% CI, 0.6–0.6 L/min; P < .0001) for sevoflurane and 0.2 L/min (95% CI, 0.2–0.3 L/min; P < .0001) for desflurane immediately after implementation of the intervention. For sevoflurane, mL/MAC-h decreased by 3.8 mL/MAC-h (95% CI, 3.6–4.1 mL/MAC-h; P < .0001) after implementation of the intervention and decreased by 4.1 mL/MAC-h (95% CI, 2.6–5.6 mL/MAC-h; P < .0001) for desflurane. Slopes for both FGF and mL/MAC-h in the postintervention period were statistically less negative than the preintervention slopes (P < .0001 for sevoflurane and P < .01 for desflurane).

CONCLUSIONS:
A commercial AIMS-based decision support tool can be adopted to change provider FGF management patterns and reduce volatile anesthetic consumption in a sustainable fashion.
Effect of 5% EMLA Cream on Postoperative Sore Throat in Adults Following General Endotracheal Anesthesia: A Randomized Placebo-Controlled Study
Authors: Murugaiyan Abishek , Sahoo Alok Kumar , Rao Parnandi Bhaskar , Misra Satyajeet 
Published: January 2023

BACKGROUND:
Postoperative sore throat (POST) is a distressing complaint in adults after endotracheal intubation. This study aimed to evaluate the effect of topical application of a eutectic mixture of local anesthetics (EMLA) cream over the endotracheal tube (ETT) cuff on the incidence and severity of POST, cough, and hoarseness of voice in adults after surgery.

METHODS:
In this randomized, placebo-controlled study, adult patients 18 to 65 years old, in American Society of Anesthesiologists (ASA) physical status I and II, and of either sex were scheduled to receive 5% EMLA cream (intervention arm) or lubricant gel (placebo-controlled arm) applied over the ETT cuff. POST was graded as none (0), mild (1), moderate (2), or severe (3). A score of ≥2 was considered as significant POST. The incidence of POST at the sixth postoperative hour was the primary outcome. Secondary outcomes included the incidence of POST at 0, second, and 24 hours, and the incidence of significant POST (score ≥2). The incidence and severity of postoperative cough and hoarseness of voice were recorded simultaneously.

RESULTS:
Two hundred and four patients completed the study. The incidence of POST was significantly lower in the EMLA group versus placebo at the sixth postoperative hour (4.9% vs 40.1%; relative risk [RR], 0.12; 95% confidence interval [CI], 0.05–0.29; P < .001); and at 0 hour (74.5% vs 93.1%; RR, 0.8; 95% CI, 0.7–0.9; P < .001) and second hour (51.9% vs 84.3%; RR, 0.61; 95% CI, 0.5–0.75; P < .001) but comparable at 24 hours (1.9% vs 3.9%; RR, 0.5; 95% CI, 0.09–2.67; P = .4). The number needed to treat to prevent POST with EMLA cream application was 5 at 0 hour and 3 at the second and sixth hour. The proportion of patients with significant POST over 24 hours were less in the EMLA group (9.8% vs 43.1%; P < .001). The incidence of postoperative cough and hoarseness of voice was significantly less at the 0, second, and sixth hours in the EMLA group, but comparable at 24 hours. The incidence of severe cough (8.8% vs 31.4%; P < .001) and hoarseness of voice (2% vs 7.4%; P < .001) over 24 hours was less in the EMLA group.

CONCLUSIONS:
The application of EMLA cream over ETT cuff reduces the incidence and severity of POST, cough, and hoarseness of voice in adults after general anesthesia in the early postoperative period compared to lubricant gel.