bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors of failure to achieve textbook outcome in patients after pancreatoduodenectomy: a systematic review and meta-analysis
Authors: Yuan Jiajun , Du Changjie , Wu Hongyu , Zhong Tao , Zhai Qilong , Peng Jialun , Liu Nan , Li Jinzheng 
Published: February 2025

Background:
Pancreatoduodenectomy (PD) represents one of the most technically demanding surgical procedures, characterized by extensive surgical trauma and high perioperative morbidity. Single outcome measures are insufficient to comprehensively assess the surgical quality of PD. Textbook outcome (TO), as an integrated evaluation system incorporating multiple clinical parameters, offers an objective, reliable, and comprehensive assessment of surgical performance. This systematic review and meta-analysis aimed to identify risk factors associated with failure to achieve textbook outcome (non-TO) following pancreatoduodenectomy.

Materials and methods:
We systematically searched international databases (PubMed, Web of Science, EMBASE, and Cochrane Library) and Chinese databases (China National Knowledge Infrastructure, Weipu Chinese Journals Service Platform, Wanfang Data, and SinoMed) for studies on risk factors of failure to achieve textbook outcome after pancreatoduodenectomy from inception to 31 December 2024. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects models. Heterogeneity testing, sensitivity analysis, and publication bias assessment were conducted.

Results:
Ten studies involving 5238 patients were included in this meta-analysis. Among the 18 factors evaluated, five were significantly associated with failure to achieve textbook outcome after pancreatoduodenectomy: preoperative biliary drainage (OR = 2.09, 95%CI [1.30-3.36], P = 0.002), smaller tumor size (OR = 1.36, 95%CI [1.02-1.81], P = 0.04), soft pancreatic texture (OR = 2.25, 95%CI [1.01-5.02], P = 0.05), small pancreatic duct diameter (OR = 2.30, 95%CI [1.62-3.28], P < 0.00001), and increased intraoperative blood loss (OR = 4.14, 95%CI [1.16-14.83], P = 0.03). The remaining 13 factors showed no significant association with failure to achieve textbook outcome.

Conclusion:
This meta-analysis identified preoperative biliary drainage, tumor morphological characteristics (including size and texture), pancreatic duct diameter, and intraoperative blood loss as key factors affecting the achievement of textbook outcome after pancreatoduodenectomy. These findings may help surgeons identify high-risk patients for failure to achieve textbook outcome, enabling personalized surgical strategies and optimized perioperative management to improve textbook outcome rates.
Pharmacological prevention of gastrointestinal bleeding in critically Ill patients
Authors: Wong Adrian , Kane-Gill Sandra L. , Barletta Jeffrey F. 
Published: February 2025

Purpose of review
Despite advances in critical care medicine, the incidence of clinically important upper gastrointestinal bleeding (UGIB) remains consistent. One therapy that reduces UGIB is the use of stress ulcer prophylaxis (SUP). In the past year, several key manuscripts have been published regarding SUP, providing updated recommendations for its prescription. In this review, we provide commentary on these recommendations and areas for future research.

Recent findings
Risk factors for UGIB include chronic liver disease, coagulopathy, severe neurologic illness or injury, and shock. The prescription of SUP is associated with a decreased occurrence of UGIB but no benefit in mortality. Although both histamine-2 receptor antagonists and proton pump inhibitors (PPIs) are recommended for SUP, it is possible that PPIs may be associated with increased mortality in critically ill patients. The short-term use of SUP is not expected to be associated with most adverse drug events, but inappropriate continuation of SUP increases this risk.

Summary
Patient-specific considerations based on recent data help with improving the prescription of SUP, although additional research is necessary. The use of artificial intelligence may be able to predict at risk patients with the potential to influence appropriate prescription of SUP and reduce the occurrence of UGIB.
A case report of acute intermittent porphyria presenting with reversible cerebral vasoconstriction syndrome
Authors: Rao Wei , Li Lingjuan , Wu Lingfeng , Chai Wen , Li Jie 
Published: February 2025

Rationale:
Acute intermittent porphyria (AIP), an autosomal dominant genetic disorder, is primarily characterized by neuropsychiatric abnormalities and intermittent abdominal pain; however, it is extremely rare for AIP to present with reversible cerebral vasoconstriction syndrome (RCVS).

Patient concerns:
Herein, we report a case of AIP presenting with RCVS in a patient admitted to our hospital.

Diagnoses:
We present a case of a 16-year-old female patient with clinical manifestations including abdominal pain, seizures, headache, and peripheral nerve lesions. Laboratory examination revealed small-cell hypochromic anemia, hyponatremia, hypochloremia, and a positive result of the urine porphobilinogen sun exposure test. The peripheral nerve injury was detected via electromyography. A left occipital epileptic discharge was observed on an electroencephalography. Brain magnetic resonance imaging (MRI) revealed abnormal signals in the bilateral temporal, parietal, and occipital lobes, and stenosis in multiple intracranial vasculatures. The patient was found to carry a mutation site in the hydroxymethylbilane synthase (HMBS) gene, and her father was heterozygous.

Interventions:
After treatment with high glucose, heme arginine, antiepileptic therapy, correction of electrolyte disorders, and nutritional support, the patient’s symptoms were improved considerably.

Outcomes:
Repeat brain MRI showed that the lesion disappeared and the intracranial vasculature returned to normal. The electromyography reexamination results also demonstrated that the peripheral nerve injury was relieved.

Lessons:
RCVS may occur in AIP patients, which is featured with abdominal pain, neuropsychiatric symptoms, and stenosis in multiple intracranial vasculatures. Urine porphobilinogen sun exposure test, brain MRI, and genetic examination can aid in a definitive diagnosis. A high glucose diet, heme arginine, and symptomatic treatment are effective in treating AIP presenting with RCVS.
Bibliometric analysis of research on manual therapy for low back pain from 2013 to 2023
Authors: Guo Yi , Gong Zhichao , Liu Xiaowei , Ai Kun , Li Wu , Li Jiangshan 
Published: February 2025

Background:
Low back pain (LBP) is one of the most common symptoms prompting patients to seek treatment. Manual therapy is widely used to treat LBP. Nevertheless, there is a scarcity of bibliometric analyses examining the worldwide utilization of manual therapy for the treatment of LBP.

Methods:
This research used the Online Bibliometric overview Platform website (https://bibliometric.com), CiteSpace (6.2.R4), and VOSviewer (1.6.19) to provide a comprehensive analysis of the current status and prospective developments in the field. The Web of Science Core Collection (WOSCC) database was searched for publications from August 1, 2013, to August 1, 2023 on manual therapy of low back pain.

Results:
Among the identified articles, 488 fit the criteria. The number of papers on manual therapy for LBP has progressively risen over in the past 10 years, whereas the average number of citations of these papers has decreased. The leading countries producing publications on this discipline were the USA, Canada, and China. There were 345 authors of the studies, with Christine M. Goertz having the most publications. The University of Southern Denmark was the institution that contributed the most to the field. The Journal of Manipulative and Physiological Therapeutics published many of the research papers in this field. Keyword analysis showed that the relationship between low back pain, spinal manipulation, and management has been present throughout the development of this research area.

Conclusions:
Spinal manipulation, management, randomized controlled trials, Physical therapy, care and disability are the current research hotspots in the treatment of LBP with manual therapy. In addition, research on complementary medicine and clinical practice guidelines may become an important trend in the future.
Central-variant posterior reversible encephalopathy syndrome in association with adrenal insufficiency: A case report
Authors: Srichawla Bahadar S. , Kipkorir Vincent , Lalla Rakhee 
Published: February 2025

Rationale:
Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition often linked to hypertension, eclampsia, or renal failure. PRES typically presenting with seizures, headaches, visual disturbances, and altered mental status. A rarer form, the central variant of PRES, involves atypical radiologic findings such as edema in central brain structures. PRES has not been previously associated with adrenal insufficiency, making this case novel and significant.

Patient concerns:
A 59-year-old woman with a history of hypertension, chronic obstructive pulmonary disease, and previous COVID-19 infection presented to the emergency department with seizures and altered mental status. She exhibited a fluctuating systolic blood pressure (79–195 mm Hg) and had a Glasgow Coma Scale (GCS) score of 7.

Diagnoses:
Initial imaging and laboratory tests were inconclusive. Continuous electroencephalogram indicated focal cortical irritability, raising concerns about seizures. Brain magnetic resonance imaging revealed increased T2-weighted signals in the bilateral cerebellar hemispheres, consistent with central variant PRES. Endocrine evaluation showed primary adrenal insufficiency, confirmed by low AM cortisol levels and a positive cosyntropin stimulation test.

Interventions:
The patient was started on levetiracetam for seizure management and hydrocortisone for adrenal insufficiency. She was intubated for airway protection but later extubated as her condition stabilized.

Outcomes:
Follow-up magnetic resonance imaging showed progressive resolution of the cerebellar T2 hyperintensities. The patient was discharged on day 15 with no residual neurological deficits. At a 3-month follow-up, she remained seizure-free and continued oral hydrocortisone and levetiracetam.

Lessons:
This case highlights adrenal insufficiency as a possible novel precipitant of the central variant of PRES, emphasizing the need for prompt diagnosis and treatment to prevent serious neurological outcomes. The underlying pathophysiological mechanism of PRES from adrenal insufficiency is most likely labile blood pressure causing rapid alterations in cerebral perfusion pressure (CPP) precipitating PRES.
A boy and his mother with lipoprotein glomerulopathy: Two case reports and literature review
Authors: Zhang Shuya , Fan Lulu , Li Ziwei , Liu Tiantian , Jing Xiaoping , Guo Qingyin 
Published: February 2025

Rationale:
Lipoprotein glomerulopathy (LPG) is a rare genetic kidney disorder. Here, we report a boy and his mother with LPG.

Patient concerns:
A 6-year-old boy was admitted to our hospital with a history of 6 months of experiencing foamy urine without apparent cause.

Diagnoses:
Urinalysis revealed 3+ protein and 2+ occult blood. A 24-hour urinary protein quantification measured 1110 mg. Other laboratory tests revealed that the level of serum albumin was 43.6 g/L, triglycerides 4.31 mmol/L were elevated, and high-density lipoprotein cholesterol 0.71 mmol/L were reduced, whereas total cholesterol and low-density lipoprotein cholesterol levels were normal. Renal biopsy revealed glomerular capillary loop expansion with lipoprotein thrombi on light microscopy, variable-sized vacuoles within the capillary loops on electron microscopy, positive Oil Red O staining, and positive immunofluorescence staining for ApoE. The mother of the patient had a history of uremia 5 years ago. Genetic testing confirmed a deletion of 9 nucleotides (CAAGCTGCG) in exon 4 of the ApoE gene at positions c.480–488 of the boy and his mother, resulting in a deletion of 3 amino acids (Lys143–Arg145del) in the ApoE amino acid sequence at positions 143–145, which was same variant as ApoE Tokyo/Maebashi.

Interventions:
The boy showed significant improvement after treatment with fenofibrate and telmisartan, with urine protein turning negative after 1 week and blood lipid levels returning to normal after 4 weeks.

Outcomes:
During 1 year follow-up period, the results of urine routine examination and blood lipid profile remained within normal ranges.

Lessons:
LPG is a rare and easily misdiagnosed kidney disease with no clinical characteristics. Early diagnosis by kidney biopsy and whole gene test is conducive to early detection and diagnosis, reducing missed diagnosis and misdiagnosis, and improving the long-term prognosis of patients.
Adjuvant radiotherapy in postmenopausal women with early-stage ER-positive breast cancer: A systematic review and meta-analysis
Authors: Taha Amira M. , Kamel Hanaa Abdelmoneim , Khlidj Yehya , Salem Dalal Salama , Saed Sara Adel Abdelkader , Abouelmagd Khaled , Nguyen Dang , Shash Emad , Chapagain Sanskriti , Kassem Loay 
Published: February 2025

Background:
The management of early breast cancer (BC) includes breast-conserving surgery (BCS), postoperative radiation therapy (PORT) and systemic therapy. Therefore, we aim at evaluating all the efficacy endpoints for PORT compared to no PORT in older women with early-stage BC.

Method:
We searched PubMed, Web of Science, Cochrane, and Scopus databases from inception up to May 2024 for randomized controlled trials (RCTs) where patients were randomized into either PORT vs no PORT. The following outcomes were studied: any local recurrence, nodal recurrence, contralateral BC, distant relapse, all-causes and cancer-specific mortality.

Result:
Seven eligible RCTs with a total of 4860 patients were included; 2435 of them received PORT; and 2425 did not. All patients had a node-negative disease, with 84.4% older than 60 years and only 10.4% had tumors larger than 2 cm. Patients in both treatment arms were offered adjuvant endocrine therapy e.g. tamoxifen and anastrozole. The median follow-up was 9.7 years (95% CI: 5.1–11.3). The survival risk for any local recurrence for patients with no radiotherapy was significantly higher than for those who used PORT (HR: 6.3; 95% CI: 4.17–9.52). Also, patients in the PORT arm had a significantly lower risk of nodal recurrence (risk of recurrence (RR): 0.28, 95% CI: 0.11–0.72, P = .009). However, PORT was not associated with a significant reduction in the risk of contralateral BC, distant relapse, BC-specific mortality or all-cause mortality (RR: 0.883, 1.52, 1.12, 0.995, respectively).

Conclusion:
Postoperative radiotherapy significantly reduces local and regional recurrence following BCS in early estrogen receptor-positive elderly BC with limited value on distant recurrence or mortality. The risk-benefit ratio should be determined for every patient to avoid overtreatment of a significant proportion of patients.
Associations between stroke and vascular dementia combing Mendelian randomization with network pharmacology
Authors: Chen Haixu , Zeng Lianlin 
Published: February 2025

Background:
Stroke and vascular dementia (VaD) are major causes of death and disability worldwide, and there is a complex interplay between them. In this study, we applied the method of Mendelian randomization (MR) and network pharmacology to uncover and elucidate these mechanisms.

Methods:
We employed single nucleotide polymorphisms that exhibit strong associations with stroke and VaD as instrumental variables for MR analysis. Our bidirectional MR analyses were conducted using 3 robust methods: inverse variance weighting, weighted median, Weighted mode and MR-Egger regression. Additionally, we performed sensitivity analyses to assess heterogeneity, sensitivity, and stability levels. Furthermore, we curated and screened targets relevant to stroke and VaD and subsequently carried out gene ontology and KEGG pathway enrichment analyses. Finally, network pharmacology approaches were utilized to explore potential mechanisms underlying stroke and VaD.

Results:
The results of the inverse variance weighted analysis demonstrate a significant positive causal relationship between stroke and VaD (OR = 2.06, 95% confidence interval [CI] = 1.17–3.61, P = .01). Conversely, no evidence suggests that VaD increases the risk of stroke. Network pharmacology analysis reveals a total of 222 common targets shared by both conditions, with particular emphasis on peptide tyrosine phosphorylation pathways, including those associated with resistance to EGFR tyrosine kinase inhibitors and the AGE-RAGE signaling pathway.

Conclusions:
Our MR analysis is based on available summary statistics from genome-wide association studies to support a causal relationship between stroke and VaD. Stroke may contribute to VaD through peptide tyrosine phosphorylation-related biological processes.
Vapocoolant spray application during intra-articular knee injection: myth or reality?: A prospective randomized controlled trial
Authors: Pamuk Çağdaş , Musaoğlu Resul , Gök Ümit , Moralar Ülker 
Published: February 2025

Background:
Intra-articular knee injections play a significant role in the treatment of knee osteoarthritis. This study aims to investigate the effects of vapocoolant spray application during intra-articular injections on pain and anxiety compared with placebo and injections performed without any agent.

Methods:
This prospective randomized controlled trial was conducted to investigate the effect of vapocoolant spray application on pain associated with intra-articular injection compared with placebo and no analgesic agent. Three groups, each consisting of 55 patients, were formed randomly. Vapocoolant spray was applied to 1 group, a placebo was applied to 1 group, and no analgesic was applied to the other group, and the results were evaluated.

Results:
After exclusions from a total of 197 patients, 165 were included in the study. The demographic characteristics of the groups were similar. While there was no significant difference in pain levels during needle insertion between group 1 and group 2, the Visual Analog Scale scores of group 1 and group 2 were significantly lower compared with group 3 (P < .001).

Conclusion:
This study revealed that vapocoolant spray application had no significant advantage over placebo in terms of pain scores during intra-knee injection.
Association of the DRD and OXT Genetic Polymorphisms With Schizophrenia in a Chinese Population
Authors: Li Jingjing , Bi Wen , Xiong Mengqiu , Nasifu Lubanga , Zhang Lingyun , Zhu Chengbin , He Bangshun 
Published: February 2025

Abstract
The polymorphism of dopamine receptor (DRD) and oxytocin (OXT) may be associated with schizophrenia. A case-control study of 248 schizophrenia patients and 236 controls was conducted using the Sequenom MassARRAY platform. The results showed that DRD2 rs1800497 was a heterozygote (AG vs. GG: adjusted odds ratio [OR] = 1.88; 95% confidence interval [CI]: 1.09–3.25) and DRD3 rs7631540 (TC vs. CC: adjusted OR = 0.60; 95% CI: 0.36–1.02) may be associated with an increased risk of developing schizophrenia. In addition, the DRD2 rs1800497 genotype GA showed a reduced risk of schizophrenia in the male subgroup and the late-onset subgroup (>27 years of age). For DRD3 polymorphisms, the rs7631540 TC genotype was associated with schizophrenia in the female subgroup. In OXT polymorphism analysis, rs2740210 codominant CA/AA was a risk factor for schizophrenia in the male and early-onset subgroup (≤27 years old). This study also concluded that OXT rs2740210 codominant CA/AA is associated with schizophrenia.
Impacts of overdose and socio-structural factors on recent mortality among people living with HIV in British Columbia, Canada
Authors: Tam Clara , Zhang Wendy , Moore David , Salters Kate , Trigg Jason , Wesseling Tim , Parashar Surita , McLinden Taylor , Sereda Paul , McDougall Patrick , Moher Matthew , Montaner Julio S G , Hogg Robert , Barrios Rolando 
Published: February 2025

Objective:
We characterized sociodemographic and behavioural factors associated with mortality among people living with HIV (PLWH) in British Columbia (BC), Canada.

Design:
We used purposive sampling to recruit a representative cohort of PLWH aged ≥19 years from January 2016-September 2018. Participants completed a survey and consented to link their data with the BC Vital Statistics Agency, where deaths were recorded.

Methods:
We conducted bivariate analyses to compare characteristics between participants who died with those alive as of September 2021. We used multivariable Cox proportional hazards models to examine factors associated with mortality.

Results:
As of September 2021, 71 (11.0%) of 644 participants died. The most common specified cause of death was due to overdose (n = 14, 19.7%). A higher proportion of individuals who died had been incarcerated (52.1% vs. 33.3%; p = 0.002), reported recent homelessness (28.2% vs. 12.6%; p < 0.001) and recent injection drug use (32.4% vs. 19.0%; p = 0.009), compared to those alive at the end of follow-up. Age ≥60 (adjusted hazard ratio [aHR] 3.80, 95% CI 1.55–9.34), and experiencing homelessness in the last 12 months prior to enrolment (aHR 2.01, 95% CI 1.18–3.61) were associated with an increased hazard of death, while identifying as gay or lesbian (aHR 0.42, 95% CI 0.23–0.77), and having greater social support (aHR 0.88 per 10-unit score increase, 95% CI 0.81–0.96) were protective.

Conclusions:
Over six years of follow-up, more than 10% of our cohort died, with overdose being the most commonly reported cause of death. PLWH with higher social support however had a lower risk of death in BC.
Mentorship in Academic Surgery: Revisiting the Essence of Faculty Development
Authors: Carlson Eric R , Britt LD 
Published: February 2025

Summary:
Mentorship is one essential element of faculty development that is traditionally described as a relationship between a senior individual who serves as the mentor for a mentee who is a less experienced individual. Permitting the mentee to select the mentor as a form of informal pairing; providing structured training for mentors and mentees; conducting frequent, in-person sessions; and financially and academically recognizing the mentoring activities will be of mutual benefit to mentors and mentees alike, and beneficial to the organization that the mentors and mentees serve. Mentorship represents a discipline distinct from coaching and sponsorship. Mentoring is an intense, holistic, and long-term professional relationship that transforms the mentor and mentee, as well as the organization in which the interaction occurs. Coaching is a focused, short- or long-term professional interaction that is directed at specific goals and objectives that are established by the coachee. Sponsoring represents active support by the sponsor with significant influence and access to resources and who is advocating for the career advancement of the sponsee. All three exercises are of known value to permit academic development and academic advancement in faculty development constructs.