bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of intravenous and inhalation anesthesia on patients undergoing esophageal cancer surgery: a retrospective observational study
Authors: Ma Yue , Ren Jie , Chen Zhuo , Chen Jingwen , Wei Ming , Wang Yu , Chen Hong , Wang Liping 
Published: March 2023

Abstract
Background
Different anesthetics may have opposite effects on the immune system, thus affecting the prognosis of tumor patients. Cell-mediated immunity forms the primary defense against the invasion of tumor cells, so manipulation of the immune system to produce an enhanced anti-tumor response could be utilized as an adjuvant oncological therapy. Sevoflurane has proinflammatory effects, while propofol, has anti-inflammatory and antioxidant effects. Therefore, we compared the overall survival (OS) and disease-free survival (DFS) of patients with esophageal cancer under total intravenous anesthesia and inhalation anesthesia.

Methods
This study collected the electronic medical records of patients undergoing esophagectomy from January 1, 2014 to December 31, 2016. According to the intraoperative anesthetics, the patients were divided into total intravenous anesthesia (TIVA) group or inhalational anesthesia (INHA) group. Stabilized inverse probability of treatment weighting (SIPTW) was used to minimize differences. Kaplan–Meier survival curve was established to evaluate the correlation between different anesthesia methods in overall survival and disease-free survival of patients undergoing esophageal cancer surgery.

Results
A total of 420 patients with elective esophageal cancer were collected, including 363 patients eligible for study (TIVA, n = 147, INHA, n = 216). After SIPTW there were no significant differences between two groups in overall survival and disease-free survival. However, the adjuvant therapy was statistically significant in improving OS, and the degree of differentiation was correlated with OS and DFS.

Conclusions
In conclusion, there were no significant difference in overall survival and disease-free survival between total intravenous anesthesia and inhalational anesthesia in patients undergoing esophageal cancer surgery.
Quantification of left ventricular ejection fraction and cardiac output using a novel semi-automated echocardiographic method: a prospective observational study in coronary artery bypass patients
Authors: Komanek Thomas , Rabis Marco , Omer Saed , Peters Jürgen , Frey Ulrich H. 
Published: March 2023

Abstract
Background
Echocardiographic quantification of ejection fraction (EF) by manual endocardial tracing requires training, is time-consuming and potentially user-dependent, whereas determination of cardiac output by pulmonary artery catheterization (PAC) is invasive and carries a risk of complications. Recently, a novel software for semi-automated EF and CO assessment (AutoEF) using transthoracic echocardiography (TTE) has been introduced. We hypothesized that AutoEF would provide EF values different from those obtained by the modified Simpson’s method in transoesophageal echocardiography (TOE) and that AutoEF CO measurements would not agree with those obtained via VTILVOT in TOE and by thermodilution using PAC.

Methods
In 167 patients undergoing coronary artery bypass graft surgery (CABG), TTE cine loops of apical 4- and 2-chamber views were recorded after anaesthesia induction under steady-state conditions. Subsequently, TOE was performed following a standardized protocol, and CO was determined by thermodilution. EF and CO were assessed by TTE AutoEF as well as TOE, using the modified Simpson’s method, and Doppler measurements via velocity time integral in the LV outflow tract (VTILVOT). We determined Pearson’s correlation coefficients r and carried out Bland–Altman analyses. The primary endpoints were differences in EF and CO. The secondary endpoints were differences in left ventricular volumes at end diastole (LVEDV) and end systole (LVESV).

Results
AutoEF and the modified Simpson’s method in TOE showed moderate EF correlation (r = 0.38, p < 0.01) with a bias of -12.6% (95% limits of agreement (95%LOA): -36.6 – 11.3%). AutoEF CO correlated poorly both with VTILVOT in TOE (r = 0.19, p < 0.01) and thermodilution (r = 0.28, p < 0.01). The CO bias between AutoEF and VTILVOT was 1.33 l min−1 (95%LOA: -1.72 – 4.38 l min−1) and 1.39 l min−1 (95%LOA -1.34 – 4.12 l min−1) between AutoEF and thermodilution, respectively. AutoEF yielded both significantly lower EF (EFAutoEF: 42.0% (IQR 29.0 — 55.0%) vs. EFTOE Simpson: 55.2% (IQR 40.1 — 70.3%), p < 0.01) and CO values than the reference methods (COAutoEF biplane: 2.30 l min−1 (IQR 1.30 - 3.30 l min−1) vs. COVTI LVOT: 3.64 l min−1 (IQR 2.05 - 5.23 l min−1) and COPAC: 3.90 l min−1 (IQR 2.30 - 5.50 l min−1), p < 0.01)).

Conclusions
AutoEF correlated moderately with TOE EF determined by the modified Simpson’s method but poorly both with VTILVOT and thermodilution CO. A systematic bias was detected overestimating LV volumes and underestimating both EF and CO compared to the reference methods.

Trial registration
German Register for Clinical Trials (DRKS-ID DRKS00010666, date of registration: 08/07/2016).
Group-delivered cognitive behavioural therapy versus waiting list in the treatment of insomnia in primary care: study protocol for a pragmatic, multicentre randomized controlled trial
Authors: Hrozanova Maria , Meisingset Ingebrigt , Kallestad Håvard , Pallesen Ståle , Nordstoga Anne Lovise , Skarpsno Eivind Schjelderup 
Published: March 2023

Abstract
Background
Insomnia is common in the general population and is a risk factor for ill-health, which highlights the importance of treating insomnia effectively and cost-efficiently. Cognitive-behavioural therapy for insomnia (CBT-I) is recommended as first-line treatment due to its long-term effectiveness and few side-effects, but its availability is limited. The aim of this pragmatic, multicentre randomized controlled trial is to investigate the effectiveness of group-delivered CBT-I in primary care compared to a waiting-list control group.

Methods
A pragmatic multicentre randomized controlled trial will be conducted with about 300 participants recruited across 26 Healthy Life Centres in Norway. Participants will complete online screening and provide consent before enrolment. Those who meet the eligibility criteria will be randomized to a group-delivered CBT-I or to a waiting list according to a 2:1 ratio. The intervention consists of four two-hour sessions. Assessments will be performed at baseline, 4 weeks, 3- and 6 months post-intervention, respectively. The primary outcome is self-reported insomnia severity at 3 months post-intervention. Secondary outcomes include health-related quality of life, fatigue, mental distress, dysfunctional beliefs and attitudes about sleep, sleep reactivity, 7-day sleep diaries, and data obtained from national health registries (sick leave, use of relevant prescribed medications, healthcare utilization). Exploratory analyses will identify factors influencing treatment effectiveness, and we will conduct a mixed-method process evaluation to identify facilitators and barriers of participants’ treatment adherence. The study protocol was approved by the Regional Committee for Medical and Health Research ethics in Mid-Norway (ID 465241).

Discussion
This large-scale pragmatic trial will investigate the effectiveness of group-delivered cognitive behavioural therapy versus waiting list in the treatment of insomnia, generating findings that are generalizable to day-to-day treatment of insomnia in interdisciplinary primary care services. The trial will identify those who would benefit from the group-delivered therapy, and will investigate the rates of sick leave, medication use, and healthcare utilization among adults who undergo the group-delivered therapy.

Trial registration
The trial was retrospectively registered in the ISRCTN registry (ISRCTN16185698).
Development of a Risk Score for AKI onset in COVID-19 Patients: COV-AKI Score
Authors: Palomba Henrique , Cubos Daniel , Bozza Fernando , Zampieri Fernando Godinho , Romano Thiago Gomes 
Published: March 2023

Abstract
Purpose
Acute Kidney Injury (AKI) in COVID-19 patients is associated with increased morbidity and mortality. In the present study, we aimed to develop a prognostic score to predict AKI development in these patients.

Materials and methods
This was a retrospective observational study of 2334 COVID 19 patients admitted to 23 different hospitals in Brazil, between January 10th and August 30rd, 2020. The primary outcome of AKI was defined as any increase in serum creatinine (SCr) by 0.3 mg/dL within 48 h or a change in SCr by ≥ 1.5 times of baseline within 1 week, based on Kidney Disease Improving Global Outcomes (KDIGO) guidelines. All patients aged ≥ 18 y/o admitted with confirmed SARS-COV-2 infection were included. Discrimination of variables was calculated by the Receiver Operator Characteristic Curve (ROC curve) utilizing area under curve. Some continuous variables were categorized through ROC curve. The cutoff points were calculated using the value with the best sensitivity and specificity.

Results
A total of 1131 patients with COVID-19 admitted to the ICU were included. Patients mean age was 52 ± 15,8 y/o., with a prevalence of males 60% (n = 678). The risk of AKI was 33% (n = 376), 78% (n = 293) of which did not require dialysis. Overall mortality was 11% (n = 127), while for AKI patients, mortality rate was 21% (n = 80). Variables selected for the logistic regression model and inclusion in the final prognostic score were the following: age, diabetes, ACEis, ARBs, chronic kidney disease and hypertension.

Conclusion
AKI development in COVID 19 patients is accurately predicted by common clinical variables, allowing early interventions to attenuate the impact of AKI in these patients.
One year overall survival of wilms tumor cases and its predictors, among children diagnosed at a teaching hospital in South Western Uganda: a retrospective cohort study
Authors: Ekuk Eddymond , Odongo Charles Newton , Tibaijuka Leevan , Oyania Felix , Egesa Walufu Ivan , Bongomin Felix , Atwiine Raymond , Acan Moses , Situma Martin 
Published: March 2023

Abstract
Background
Wilms tumor (WT) is the second most common solid tumor in Africa with both low overall survival (OS) and event-free survival (EFS) rates. However, no known factors are predicting this poor overall survival.

Objective
The study was to determine the one-year overall survival of WT cases and its predictors among children diagnosed in the pediatric oncology and surgical units of Mbarara regional referral hospital (MRRH), western Uganda.

Methodology
Children’s treatment charts and files diagnosed and managed for WT were retrospectively followed up for the period between January 2017 to January 2021. Charts of children with histologically confirmed diagnoses were reviewed for demographics, clinical and histological characteristics, as well as treatment modalities.

Results
One-year overall survival was found to be 59.3% (95% CI: 40.7–73.3), with tumor size greater than 15 cm (p 0.021) and unfavorable WT type (p 0.012) being the predominant predictors.

Conclusion
Overall survival (OS) of WT at MRRH was found to be 59.3%, and predictive factors noted were unfavorable histology and tumor size greater than 115 cm.
Hyperacute optic neuritis in a patient with COVID-19 infection and vaccination: a case report
Authors: Zhang Jessica , Joiner Devon , Zhang Cheng 
Published: March 2023

Abstract
Background
As scientific knowledge continues to grow regarding coronavirus disease 2019 (COVID-19) infection, several neuro-ophthalmological manifestations have emerged, including rare reports of optic neuritis. Optic neuritis is an inflammatory demyelinating condition of the optic nerve that typically presents as subacute, unilateral vision loss and pain on eye movement. Several cases of COVID-19 infection and COVID-19 vaccination related cases of optic neuritis have been reported. We present a case of hyperacute, unilateral optic neuritis after both recent COVID-19 infection and subsequent booster vaccination.

Case presentation
Within two hours after receiving her COVID-19 booster vaccination, a 58-year-old female began experiencing bilateral eye pain, worsened by eye movements. The patient had previously contracted a mild COVID-19 infection three weeks prior to receiving her booster vaccination, confirmed by a rapid antigen test. The pain persisted in her right eye for a week at which time she presented to an ophthalmology clinic. She denied any changes to her visual acuity. Neuroimaging revealed right optic nerve enhancement, and the patient was admitted to the hospital for a course of intravenous steroids, which quickly resolved her eye pain.

Conclusion
To our knowledge, this is the first reported case of COVID-19 related optic neuritis following both COVID-19 infection and vaccination. High clinical suspicion is needed to make the appropriate diagnosis, as cases of COVID-19 related optic neuritis may exhibit mild presentations, as was the case with our patient.
Comparison of femoral neck system and three cannulated cancellous screws in the treatment of vertical femoral neck fractures: clinical observation and finite element analysis
Authors: Huang Shaolong , Zhang Yazhong , Zhang Xu , Zhou Chengqiang , Li Wenbo , Wang Yunqing , Wang Bin , Zhu Ziqiang 
Published: March 2023

Abstract
Objective
The purpose of this study was to compare the biomechanical and clinical results of two surgical methods for the treatment of vertical femoral neck fractures: Femoral neck system (FNS) and traditional three cannulated cancellous screws (CCS).

Methods
First, we developed three different vertical femoral neck fracture models for the finite element analysis, with angles of 55°, 65°, and 75°, respectively. Two experimental groups were set up: the FNS group and the CCS group. Each fracture group was tested under axial loads of 2100 N to measure the femur's displacement, Von Mises stress (VMS), and its internal fixation components. Secondly, we retrospectively included the cases of vertical femoral neck fractures with FNS and CCS in our hospital from May 2019 to May 2021. In this study, we compared the duration of intraoperative fluoroscopy, operative time, hospital stay, fracture healing time, Hemoglobin loss, Harris score of hip joint function, and postoperative complications among patients undergoing hip joint replacement.

Results
In terms of finite element analysis, FNS has better anti-displacement stability than CCS at 55°and 65°, while FNS is greater than CCS in Von Mises stress. Clinically, we followed up on 87 patients for an average of 12 months. FNS was superior to traditional CCS in fracture healing time, operation time, fluoroscopy duration, fracture healing time, and Harris hip function score.

Conclusion
FNS is superior to traditional CCS in biomechanical and clinical aspects of treating vertical femoral neck fractures. There is potential for FNS to become a new treatment option for vertical femoral neck fractures.
Serum growth differentiation factor-15 and non-esterified fatty acid levels in patients with coronary artery disease and hyperuricemia
Authors: Cheng Jingru , Lyu Yongnan , Mei Yufeng , Chen Qian , Liu Hang , Li Yan 
Published: March 2023

Abstract
Background
High serum NEFA and GDF-15 are risk factors for CAD and have been linked to detrimental cardiovascular events. It has been hypothesized that hyperuricemia causes CAD via the oxidative metabolism and inflammation. The current study sought to clarify the relationship between serum GDF-15/NEFA and CAD in individuals with hyperuricemia.

Methods
Blood samples collected from 350 male patients with hyperuricemia(191 patients without CAD and 159 patients with CAD, serum UA > 420 μmol/L) to measure serum GDF-15 and NEFA concentrations with baseline parameters.

Results
Serum circulating GDF-15 concentrations(pg/dL) [8.48(6.67,12.73)] and NEFA levels(mmol/L) [0.45(0.32,0.60)] were higher in hyperuricemia patients with CAD. Logistic regression analysis revealed that the OR (95% CI) for CAD were 10.476 (4.158, 26.391) and 11.244 (4.740, 26.669) in quartile 4 (highest) respectively. The AUC of the combined serum GDF-15 and NEFA was 0.813 (0.767,0.858) as a predictor of whether CAD occurred in male with hyperuricemia.

Conclusions
Circulating GDF-15 and NEFA levels correlated positively with CAD in male patients with hyperuricemia and measurements may be a useful clinical adjunct.
Roles of MXenes in biomedical applications: recent developments and prospects
Authors: Li Hui , Fan Rangrang , Zou Bingwen , Yan Jiazhen , Shi Qiwu , Guo Gang 
Published: March 2023

Abstract....With the development of nanomedical technology, the application of various novel nanomaterials in the biomedical field has been greatly developed in recent years. MXenes, which are new inorganic nanomaterials with ultrathin atomic thickness, consist of layered transition metal carbides and nitrides or carbonitrides and have the general structural formula Mn+1XnTx (n = 1–3). Based on the unique structural features of MXenes, such as ultrathin atomic thickness and high specific surface area, and their excellent physicochemical properties, such as high photothermal conversion efficiency and antibacterial properties, MXenes have been widely applied in the biomedical field. This review systematically summarizes the application of MXene-based materials in biomedicine. The first section is a brief summary of their synthesis methods and surface modification strategies, which is followed by a focused overview and analysis of MXenes applications in biosensors, diagnosis, therapy, antibacterial agents, and implants, among other areas. We also review two popular research areas: wearable devices and immunotherapy. Finally, the difficulties and research progress in the clinical translation of MXene-based materials in biomedical applications are briefly discussed.
Graphical Abstract
Effect study of exosomes derived from platelet-rich plasma in the treatment of knee cartilage defects in rats
Authors: Zhao Hangyu , Zhao Zihang , Li Dailuo , Wang Xin , Dai Dehao , Fu Hailiang 
Published: March 2023

Abstract
Background
The repair of articular cartilage defects has always been a difficult problem. We aimed to investigate the therapeutic effect of intra-articular injection of platelet-rich plasma (RPR) and PRP-derived exosomes (PRP-Exos) on cartilage defects in rat knee joints and then provide experience for the use of PRP-exos in cartilage defect repair.

Methods
Rat abdominal aortic blood was collected, and PRP was extracted by two-step centrifugation. PRP-exos were obtained by kit extraction, and PRP-exos were identified by various methods. After the rats were anesthetized, a cartilage defect subchondral bone was created at the proximal end of the origin of the femoral cruciate ligament with a drill. SD rats were divided into 4 groups, including PRP group, 50 μg/ml PRP-exos group, 5 μg/ml PRP-exos group, and control group. One week after the operation, 50 μg/ml PRP, 50 μg/ml PRP-exos, 5 μg/ml PRP-exos and normal saline were injected into the knee joint cavity of rats in each group, once a week. A total of two injections were given. On the 5th and 10th week after drug injection, the serum levels of matrix metalloproteinase 3 (MMP-3) and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1) were detected by each treatment method, respectively. The rats were killed at the 5th and 10th weeks, respectively, and the cartilage defect repair was observed and scored. The defect repair tissue sections were used for HE staining and type II collagen immunohistochemical staining.

Results
The histological results showed that both PRP-exos and PRP could promote cartilage defect repair and type II collagen formation, and the promoting effect of PRP-exos was significantly better than that of PRP. In addition, enzyme-linked immunosorbent assay (ELISA) results showed that compared with PRP, PRP-exos could significantly increase serum TIMP-1 and decrease serum MMP-3 in rats. And the promoting effect of PRP-exos was concentration dependent.

Conclusion
Intra-articular injection of PRP-exos and PRP can promote the repair of articular cartilage defects, and the therapeutic effect of PRP-exos is better than the same concentration of PRP. PRP-exos are expected to be an effective treatment for cartilage repair and regeneration.
Preoperative intra-articular steroid injections within 3 months increase the risk of periprosthetic joint infection in total knee arthroplasty: a systematic review and meta-analysis
Authors: Kim Young Mo , Joo Yong Bum , Song Ju-Ho 
Published: March 2023

Abstract
Objective
Albeit with no disease-modifying effects, intra-articular steroid injections (IASIs) are still widely used to relieve symptoms of knee osteoarthritis. Previous literature has reported conflicting results regarding the safety of IASI in terms of periprosthetic joint infection (PJI) in total knee arthroplasty (TKA). This study tried to determine whether preoperative IASIs increased the risk of PJI, with different time intervals between the injections and surgery.

Methods
A computerized search of MEDLINE, EMBASE, and Cochrane Library was conducted for studies published before October 2022, which investigated the PJI rates of patients who received IASIs before TKA and patients who did not. The primary outcome was the association between preoperative IASI and PJI in TKA. The time point from which IASIs could be applied without risking PJI was also assessed.

Results
Fourteen studies, with 113,032 patients in the IASI group and 256,987 patients in the control group, were included. The pooled odds ratio of PJI was 1.13 (95% confidence interval [CI] 1.00–1.27, p = 0.05), indicating no increased risk of PJI. With the time interval < 6 months, the pooled odds ratio was 1.19 (95% CI 0.99–1.43, p = 0.06). However, with the time interval < 3 months, the pooled odds ratio was 1.26 (95% CI 1.06–1.50, p < 0.01).

Conclusion
IASI is not a safe procedure for patients who are expected to undergo TKA. The time interval between the injections and surgery was an important factor in assessing the safety of IASI. Preoperative injections that were applied within 3 months increased the risk of PJI in TKA.