bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of continuous intercostal nerve block vs. single shot on analgesic outcomes and hospital stays in minimally invasive direct coronary artery bypass surgery: a retrospective cohort study
Authors: Yao Youxiu , Xu Mao 
Published: March 2022

Abstract
Background
Minimally invasive direct coronary artery bypass (MIDCAB) grafting surgery is accompanied by severe pain. Although continuous intercostal nerve block (CINB) has become one of the multimodal analgesic techniques in single port thoracoscopic surgery, its effects on MIDCAB are unclear. The purpose of this study was to compare the effects of CINB and single shot on analgesic outcomes and hospital stays in patients undergoing MIDCAB in a real-world setting.

Methods
A retrospective cohort study was carried out at Peking University Third Hospital, China. Two hundred and sixteen patients undergoing MIDCAB were divided into two groups: a CINB group and a single block (SI) group. The primary outcome was postoperative maximal visual analog scale (VAS); secondary outcomes included the number of patients with maximal VAS ≤ 3, the demand for and consumed doses of pethidine and tramadol, and the length of intensive care unit (ICU) and hospital stays. The above data and the area under the VAS curve in the 70 h after extubation for the two subgroups (No. of grafts = 1) were also compared.

Results
The maximum VAS was lower in the CINB group, and there were more cases with maximum VAS ≤ 3 in the CINB group: CINB 52 (40%) vs. SI 17 (20%), P = 0.002. The percentage of cases requiring tramadol and pethidine was less in CINB, P = 0.001. Among all patients, drug doses were significantly lower in the CINB group [tramadol: CINB 0 (0–100) mg vs. SI 100 (0–225) mg, P = 0.0001; pethidine: CINB 0 (0–25) mg vs. SI 25 (0–50) mg, P = 0.0004]. Further subgroup analysis showed that the area under the VAS curve in CINB was smaller: 28.05 in CINB vs. 30.41 in SI, P = 0.002. Finally, the length of ICU stay was shorter in CINB than in SI: 20.5 (11.3–26.0) h vs. 22.0 (19.0–45.0) h, P = 0.011.

Conclusions
CINB is associated with decreased demand for rescue analgesics and shorter length of ICU stay when compared to single shot intercostal nerve block. Additional randomized controlled trial (RCT) is needed to support these findings.
Predictors of pre-hospital vs. hospital mortality due to road traffic injuries in an Iranian population: results from Tabriz integrated road traffic injury registry
Authors: Homayoun Sadeghi-Bazargani , Milad Jamali-Dolatabad , Mina Golestani , Parvin Sarbakhsh 
Published: March 2022

AbstractBackgroundRoad Traffic Injuries (RTIs) is considered as one of the main health challenges and causes of mortality, worldwide and especially in Iran. Predicting the place where RTIs-related death takes place is vital in decreasing this type of mortality. The purpose of the present study was to identify the predictors of RTI fatalities with respect to the place of death (hospital vs. pre-hospital) during the recent decade in East Azerbaijan Province, Iran.MethodsOverall, 7347 RTI fatalities were retrieved from the road traffic injuries registry which is supported by the Forensic Medicine Organization in East Azerbaijan. Among these cases, 2758(37.5%)) were hospital deaths. The registered variables of these cases were analysed using bivariate and multiple logistic regression (STATA version 15).ResultsOut of 7347 deaths, 5862 (79.8%) were men and the rest were women 1485 (20.2%).The mean age was 40.3 (SD = 20.8). Of the total number of cases, 2758 (37.5%) died in hospital death and the rest 4589 (62.5) were pre-hospital death. According to the results of the present study, inter-city RTI (OR = 1.7, CI 95% = (1.5–2)) and RTIs inside the city of Tabriz (OR = 1.4, CI 95% = (1.2–1.6)) increases the chance of hospitals death. In addition, having a heavy counterpart vehicle compared to no counterpart vehicle decreased the chances of hospitals death (OR = 0.46, CI 95% = (0.39–0.55)) while motorcycle or bike counterpart vehicle compared to no counterpart vehicle increased the chances of hospital death (OR = 2.26, CI 95% = (1.59–3.22)). Also the users of the motorcycle or bike vehicle compared to the pedestrians increased the chances of hospital death (OR = 1.43, CI 95% = (1.19–1.71)) while any the other vehicle users compared to the pedestrians have significantly lower chances for hospital death. Other factors that increased hospitals death were transferring injured people by ambulance (OR = 1.3, CI 95% = (1.1–1.6)) and being elderly (OR = 1.5, CI 95% = (1.2–1.7)). Moreover, it was found that the annual trend of change in hospital death is strongly affected by the above-identified factors.ConclusionsThe effective predictors in hospital death were RTI location, type of counterpart vehicle, used vehicles and lighting condition. The identified factors related to the location of deaths by RTI can be divided into the RTI severity-related factors as well as factors related to the services quality and speed of delivery. According to the present results, through professional training of people in the field and providing immediate assistance in RTIs pre-hospital mortality can be significantly prevented.
Prognostic role of multiparameter MRI and radiomics in progression of advanced unresectable hepatocellular carcinoma following combined transcatheter arterial chemoembolization and lenvatinib therapy
Authors: Luo Junpeng , Huang Zhimei , Wang Murong , Li Tian , Huang Jinhua 
Published: March 2022

Abstract
Background
Current study aims to determine the prognostic value of Multiparameter MRI after combined Lenvatinib and TACE therapy in patients with advanced unresectable hepatocellular carcinoma (HCC).

Methods
A total of 61 HCC patients with pre-treatment Multiparameter MRI in Sun Yat-sen University Cancer Center from January 2019 to March 2021 were recruited in the current study. All patients received combined Lenvatinib and TACE treatment. Potential clinical and imaging risk factors for disease progression were analyzed using Cox regression model. Each patient extracts signs from the following 7 sequences: T1WI, T1WI arterial phase, T1WI portal phase, T1WI delay phase, T2WI, DWI (b = 800), ADC.1782 quantitative 3D radiomic features were extracted for each sequence, A random forest algorithm is used to select the first 20 features by feature importance. 7 logit regression-based prediction model was built for seven sequences based on the selected features and fivefold cross validation was used to evaluate the performance of each model.

Results
CR, PR, SD were reported in 14 (23.0%), 35 (57.4%) and 7 (11.5%) patients, respectively. In multivariate analysis, tumor number (hazard ratio, HR = 4.64, 95% CI 1.03–20.88), and arterial phase intensity enhancement (HR = 0.24, 95% CI 0.09–0.64; P = 0.004) emerged as independent risk factors for disease progression. In addition to clinical factors, the radiomics signature enhanced the accuracy of the clinical model in predicting disease progression, with an AUC of 0.71, a sensitivity of 0.99%, and a specificity of 0.95.

Conclusion
Radiomic signatures derived from pretreatment MRIs could predict response to combined Lenvatinib and TACE therapy. Furthermore, it can increase the accuracy of a combined model for predicting disease progression. In order to improve clinical outcomes, clinicians may use this to select an optimal treatment strategy and develop a personalized monitoring protocol.
Prevalence of constipation and use of laxatives, and association with risk factors among older patients during hospitalization: a cross sectional study
Authors: Konradsen Hanne , Lundberg Veronica , Florin Jan , Boström Anne-Marie 
Published: March 2022

Abstract
Background
Many older patients experience constipation as a bothersome symptom with a negative impact on quality of life. During hospitalization, the focus is often on the reason for admission with the risk that other health problems are not prioritized. The aim of the study was to describe the prevalence of constipation and use of laxatives among older hospitalized patients and to investigate the associations with demographic factors, risk assessments and prescribed medications.

Methods
A descriptive retrospective cross-sectional study design was used. This study enrolled patients aged 65 years or older admitted to a geriatric department. Data from electronic health records regarding constipation, demographics, risk assessments, medical diagnoses, prescribed medications and length of stay were extracted. Constipation was assessed using ICD- 10 diagnosis, documented signs and symptoms of constipation, and prescribed laxatives. Data was analyzed using descriptive and comparative analyses, including logistic regression.

Results
In total, 6% of the patients had an ICD-10 diagnosis of constipation, 65% had signs and symptoms of constipation, and 60% had been prescribed laxatives. Only 5% of the patients had constipation documented according to ICD-10, signs and symptoms, and prescribed laxatives. Signs and symptoms of constipation were associated with prescribed opioids (OR = 2.254) and longer length of stay (OR = 1.063). Being prescribed laxatives was associated with longer length of stay (OR = 1.109), prescribed opioids (OR = 2.154), and older age (OR = 1.030).

Conclusions
The prevalence of constipation varies depending on the methods used to identify the condition. There was a discrepancy between the documentation of constipation in relation to sign and symptoms, ICD-10 diagnosis and prescribed laxatives. The documentation of constipation was not consistent for the three methods of assessment.
The prevalence of liver abnormalities in humans due to Schistosoma japonicum by ultrasonography in China: a meta-analysis
Authors: Gu Man-Man , Sun Meng-Tao , Zhang Jie-Ying , Yu Qiu-Fu , Lu Da-Bing 
Published: March 2022

Abstract
Background
Schistosoma japonicum was once one of the most severe parasitic diseases in China. After 70 years of national schistosomiasis control programmes, the prevalence and associated morbidity of the infection have been reduced to a much lower level. However, due to the low sensitivity of the current detection approaches, many minor infections in humans could not be identified and ultimately develop chronic injuries with liver abnormalities, a specific ‘network’ echogenic pattern under ultrasonography. Therefore, as more people take part in physical examinations, we performed this meta-analysis to estimate the overall prevalence of schistosomiasis-associated liver abnormalities in China.

Methods
The publications were searched systematically across five electronic databases. All eligible studies were assessed with quality evaluation forms. Heterogeneity of studies was determined using the I2 and Q tests. A random effects or fixed effects model was employed based on heterogeneity results. The pooled prevalence and its 95% confidence intervals were calculated with the Freeman-Tukey double arcsine transformation. All analyses were conducted using R with the “meta” package. The protocol registration number was CRD42021232982.

Results
A total of 19 relevant articles, including 21 studies, were included. The average score of study quality was 6.4 (total score 7), indicating high quality of all included studies. A total of 268, 247 persons were included, and 43, 917 persons were diagnosed with schistosomiasis liver abnormalities by ultrasonography. High degrees of heterogeneity existed among all studies or within subgroups. The overall pooled prevalence was 18.64% (95% CI: 11.88–26.50%). The estimate significantly increased over time and varied among provinces, with the highest in Shanghai and the lowest in Sichuan. The estimate in people aged 60 years or older was significantly higher than that in people of all ages. No significant difference was seen when based on study areas (urban or rural areas) or gender.

Conclusion
The long-term burden of schistosomiasis in China remains large, as nearly one-fifth of the examined persons were diagnosed with schistosomiasis liver abnormalities. The pooled prevalence was associated with regions or age groups. Such may have a high reference value in the exact calculation of the disease burden and can be helpful for policy makers in prioritizing public health.
High cortisol levels are associated with oxidative stress and mortality in maintenance hemodialysis patients
Authors: Kim Juhee , Yun Kyu-sang , Cho Ajin , Kim Do Hyoung , Lee Young-Ki , Choi Myung-Jin , Kim Seok-hyung , Kim Hyunsuk , Yoon Jong-Woo , Park Hayne C. 
Published: March 2022

Abstract
Background
Chronic stimulation of the mineralocorticoid receptor has been suggested as one of the potential causes of cardiovascular events and death in patients with end-stage renal disease. This observational cohort study was performed to demonstrate that serum cortisol might be a predictive marker for patient mortality and to evaluate its association with oxidized low-density lipoprotein (oxLDL) in hemodialysis (HD) patients.

Methods
Patients receiving HD three times a week were screened for enrollment at two institutions. Baseline cortisol levels were measured before each HD session, and the patients were divided into two groups according to the median value of serum cortisol before analysis. The baseline characteristics and laboratory values of the high and low cortisol groups were compared. Serum cortisol, adrenocorticotropic hormone, renin, aldosterone, and oxLDL were measured in 52 patients to evaluate the effect of oxidative stress on serum cortisol levels.

Results
A total of 133 HD patients were enrolled in this cohort study. Compared to the patients with low serum cortisol levels, the patients with high serum cortisol levels (baseline cortisol ≥ 10 μg/dL) showed higher rates of cardiovascular disease (59.7% vs. 39.4%, P=0.019) and left ventricular systolic dysfunction (LVSD) (25.9% vs. 8.0%, P=0.016). The patients in the high cortisol group demonstrated higher all-cause mortality than those in the low cortisol group. The serum cortisol level was an independent risk factor for patient mortality (hazard ratio 1.234, 95% confidence interval 1.022-1.49, P=0.029). Among the 52 patients with oxLDL measurements, oxLDL was an independent risk factor for elevated serum cortisol levels (Exp(B) 1.114, P=0.013) and LVSD (Exp(B) 12.308, P=0.045). However, plasma aldosterone levels did not affect serum cortisol levels.

Conclusions
Serum cortisol is a useful predictive marker for all-cause death among patients receiving HD. OxLDL is an independent marker for elevated serum cortisol among HD patients.
Comparison of clinical features and pregnancy outcomes in early- and late-onset preeclampsia with HELLP syndrome: a 10-year retrospective study from a tertiary hospital and referral center in China
Authors: Li Boya , Yang Huixia 
Published: March 2022

Abstract
Background
Early-onset preeclampsia (EO-PE) and late-onset preeclampsia (LO-PE) are different subtypes of preeclampsia. We conducted this study to analyze the similarities and differences in the clinical features and pregnancy outcomes in EO- and LO-PE with HELLP syndrome.

Methods
This was a retrospective study in a tertiary hospital. Eighty-three parturients with HELLP syndrome were allocated into two groups based on the timing of preeclampsia onset: EO-PE with HELLP (n = 47) and LO-PE with HELLP (n = 36).

Results
In total, 31.9% and 63.9% of women in the EO-PE with HELLP and LO-PE with HELLP groups, respectively, were asymptomatic at diagnosis (P = 0.004, OR = 0.265 (0.106–0.662)). Headache or visual symptoms were more frequent in the EO-PE group than in the LO-PE group (48.9% vs. 25%, P = 0.026, OR = 0.348 (0.135–0.896)). Women in the EO-PE with HELLP group had higher SBP and DBP than those in the LO-PE with HELLP group. Laboratory tests, including platelets, liver function, and hemolysis, which are the main indicators for the diagnosis of HELLP syndrome, showed almost no significant differences between the two groups, with kidney function being the only difference observed. Women in the EO-PE with HELLP group had higher Scr than those in the LO-PE with HELLP group. The degree of proteinuria was higher in the EO-PE group than in the LO-PE with HELLP group. The incidence of severe maternal complications was significantly higher in the EO-PE group than in the LO-PE with HELLP group (25.5% vs. 5.6%, P = 0.016, OR = 0.172 (0.036–0.824)). In total, 57.4% and 8.3% of neonates in the EO-PE and LO-PE with HELLP groups were admitted to the NICU, and the difference was statistically significant, even after adjustment for the delivery week (P = 0.009, OR = 0.830 (0.729–0.944)). Postpartum HELLP syndrome was more common in the LO-PE group than in the EO-PE group (30.6% vs. 4.3%, P = 0.001, OR = 9.9 (2.031–48.256)).

Conclusions
Compared with LO-PE with HELLP patients, EO-PE with HELLP patients have more obvious kidney damage, higher blood pressure and a higher risk of adverse maternal and neonatal outcomes. Patients with LO-PE need to be alerted to the occurrence of HELLP syndrome after delivery.
Normative data and repeatability for macular ganglion cell layer thickness in healthy Swedish children using swept source optical coherence tomography
Authors: Wolf Philip , Larsson Eva , Åkerblom Hanna 
Published: March 2022

Abstract
Background
Optical coherent tomography (OCT) technology is evolving with improved resolution and accuracy in segmentation between different cell layers in the retina. The ganglion cell layer in the macula region is a window to see what is happening in the visual pathways and a macula OCT is an examination that most children tolerate. This makes updated normative data necessary since variables may differ between different OCT devices and normative data for children is often not presented.
The aim of this study was to develop normative data for macular ganglion cell layer thickness in children, measured with swept source OCT, and investigate the repeatability between measurements.

Methods
Healthy Swedish children between 4 and 16 years old, with normal refraction, spherical equivalent mean:1.13 (sd:0.66) dioptre and normal visual acuity Logmar, mean: 0,015 (sd:0,05), were examined with swept source OCT. Macula OCT was performed three times in both eyes and the different retinal layers were evaluated.

Results
Fifty-eight children were screened for inclusion. Fifty-five children were included in the study, 24 boys and 31 girls. Mean age was 8.9 years. Results from right eyes was analysed. The mean average thickness of macular ganglion cell layer thickness, retinal nerve fibre layer/ganglion cell layer boundary to inner plexiform layer/inner nuclear layer boundary, was 68.0 μm (sd:4.0, range:58-77). There was no correlation with sex or age. Fifty-three children manage to complete two, and 41 children three acceptable measurement and the mean coefficient of variation was low.

Conclusion
The ganglion cell layer thickness differs according to which OCT device that is used, and the population examined. This makes normative data essential to accurately interpret results. Swept source OCT of the macula have excellent repeatability and the examination well tolerated in most children making it an investigation useful for diagnosing and following diseases in the optic pathways.
Traditional Chinese-Hong Kong version of Forgotten Joint Score-12 (FJS-12) for patients with osteoarthritis of the knee underwent joint replacement surgery: cross-cultural and sub-cultural adaptation, and validation
Authors: Ho Kevin Ki-Wai , Chau Wai-Wang , Lau Lawrence Chun-Man , Ong Michael Tim-Yun 
Published: March 2022

AbstractBackgroundA patient-reported outcome (PRO) tool which reflects the outcomes of patients underwent total knee arthroplasty (TKA) are important to be “ceiling effect free” which commonly used PRO tools face. Forgotten joint score-12 (FJS-12) has been proved to reduce or even free from ceiling effect. FJS-12 has been translated to different languages. The objectives of this study are to validate FJS-12 in Traditional Chinese-Hong Kong language and look for the goodness of FJS-12 still exist in this language adapted FJS-12 version.MethodsFJS-12 was administered to 75 patients whose majority was obese underwent TKA between September 2019 and March 2020. Patients completed 3 sets of questionnaires (FJS-12, Oxford Knee Score (OKS), and Numeric Rating Scale (NRS)) twice, 2 weeks apart. Reliability, internal consistency, responsiveness, test–retest agreement and discriminant validity were evaluated.ResultsReliability of FJS-12 showed moderate to excellent internal consistency (Cronbach’sα = 0.870). Test–retest reliability of FJS-12 was good (ICC = 0.769). Bland–Altman plot showed good test–retest agreement. Construct validity in terms of correlations between FJS-12 and OKS, and FJS-12 and NRS were moderate at baseline (Pearson’s coefficientr = 0.598) and good at follow-up (r = 0.879). Smallest detectable change (Responsiveness) was higher than MIC. Floor effect was none observed, and ceiling effect was low. Discriminant validity was found to have no significance. BMI (obesity) did not affect FJS-12 outcomes.ConclusionsThe Traditional Chinese-Hong Kong version of FJS-12 showed good test–retest reliability, validity, responsiveness, BMI non-specific, with no floor and low ceiling effects for patients who underwent TKA. Sub-culture differences in individual PRO tools should be considered in certain ethnicities and languages.
Ligamentous injury-induced ankle instability causing posttraumatic osteoarthritis in a mouse model
Authors: Li Junkun , Chen Zhi , Cheng Yu , Gao Chao , Li Jiaxin , Gu Xiaohui , He Fan , Luo Zongping , Yang Huilin , Zhang Hongtao , Yu Jia 
Published: March 2022

Abstract
Background
This study aims to explore the relationship between surgically-induced ankle instability and posttraumatic osteoarthritis (PTOA) in a mouse model, and to provide reference for clinical practice.

Results
Ligamentectomy was performed on 24 eight-week-old male C57BL/6 J mice, which were divided into three groups. Both the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) were severed in the CFL + ATFL group, while only the CFL was removed in the CFL group. The SHAM group was set as the blank control group. A wheel-running device was used to accelerate the development of ankle osteoarthritis (OA). Balance measurement, footprint analysis, and histological analysis were used to assess the degree of ankle instability and OA. According to the balance test results, the CFL + ATFL group demonstrated the highest number of slips and the longest crossing beam time at 8 weeks postoperatively. The results of gait analysis exhibited that the CFL + ATFL group had the most significant asymmetry in stride length, stance length, and foot base width compared to the CFL and SHAM groups. The OARSI score of the CFL + ATFL group (16.7 ± 2.18) was also much higher than those of the CFL group (5.1 ± 0.96) and the SHAM group (1.6 ± 1.14).

Conclusion
Based on the mouse model, the findings indicate that severe ankle instability has nearly three times the chance to develop into ankle OA compared to moderate ankle instability.