bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of morning/afternoon surgeries on the early postoperative sleep quality of patients undergoing general anesthesia
Authors: Hou Haitao , Wu Shujing , Qiu Yuxue , Song Fenxiang , Deng Liqin 
Published: September 2022

Abstract
Objective
This study aimed to investigate the effects of morning and afternoon surgeries on the early postoperative sleep function in patients undergoing general anesthesia.

Methods
Fifty nine patients, aged 18–60 years, American society of anaesthesiologists (ASA) grade I or II, Body mass index of 18.5–28 kg/m2, undergoing laparoscopic myomectomy under total intravenous anesthesia, were included in the study. These patients were divided into two groups according to the start time of anesthesia: morning surgery group (group A, 8:00–12:00) and afternoon surgery group (group P, 14:00–18:00). The sleep conditions of the two groups of patients were evaluated by the Athens Insomnia Scale (AIS) one day before and one day after the operation. A total score of > 6 was regarded as postoperative sleep disturbance. The incidences of sleep disturbance one day after the operation in two groups were compared. The bispectral Index assessed the patient’s total sleep duration, sleep efficiency, and overall quality of sleep from 21:00 to 6:00 on the first night after surgery. Plasma concentrations of melatonin and cortisol at 6:00 am 1 day before surgery, 1 day after surgery were measured by ELISA, and rapid random blood glucose was measured.

Results
The total AIS score, overall quality of sleep, total sleep duration, and final awakening earlier than desired scores of the two groups of patients on the first night after surgery were significantly increased compared with preoperative scores (P < 0.01). In group P, the sleep induction and the physical and mental functioning during the day scores increased significantly after surgery compared with preoperative scores (P < 0.05). The postoperative AIS scores in group P increased significantly compared with those in group A (P < 0.01). The incidence of postoperative sleep disturbances (70.0%) in group P was significantly higher than that in group A (37.9%) (P < 0.05). Compared with group A, the total sleep duration under BIS monitoring in group P was significantly shorter, the sleep efficiency and the overall quality of sleep was significantly reduced (P < 0.01). Compared with those in group A, the level of melatonin on 1 d after surgery in group P was significantly decreased, and the level of cortisol in group P was significantly increased. There were no significant differences between the two groups in the levels of postoperative blood glucose and pain.

Conclusion
Both morning and afternoon surgeries have significant impacts on the sleep function in patients undergoing general anesthesia, while afternoon surgery has a more serious impact on sleep function.

Trial registration
ClinicalTrials, NCT04103528. Registered 24 September 2019—Retrospectively registered, http://www.ClinicalTrials.gov/ NCT04103528.
Comparing suction rates of novel DuCanto catheter against Yankauer and standard suction catheter using liquids of different viscosity—a technical simulation
Authors: Finke Simon-Richard , Schroeder Daniel C. , Ecker Hannes , Böttiger Bernd W. , Herff Holger , Wetsch Wolfgang A. 
Published: September 2022

Abstract
Purpose
Aspiration is a feared complication that may occur during airway management, and can significantly contribute to morbidity and mortality. Availability of a suctioning device with a suction catheter capable of clearing the airway is mandatory for airway management. However, suction performance may be significantly different amongst different suction catheters. The aim of this study was to compare suction rates of a standard 14 Ch suction catheter (SC), a Yankauer catheter (Y) and a DuCanto catheter (DC) using 4 fluids with different viscosity.

Methods
In this simulation trial, 4 preparations with standardized viscosity were prepared using a Xanthane-based medical fluid thickener. Lowest viscosity was achieved using tap water without thickener, syrup-like viscosity was achieved by adding 10 g per liter tap water, honey-like viscosity was achieved by adding 20 g per liter, and a pudding-like viscosity was achieved by adding 30 g of thickening powder per liter tap water. Each preparation was suctioned for 15 s with the three different suctioning devices. Measurements were repeated four times. The amount of removed preparation by suctioning was measured using a tared scale.

Results
Suction rates for water were 580 ± 34 mg for SC, 888 ± 5 mg for Y and 1087 ± 15 for DC; for syrup-like viscosity it was 383 ± 34(SC) vs. 661 ± 64(Y) vs. 935 ± 42(DC); for honey-like viscosity it was 191 ± 21(SC) vs. 426 ± 34(Y) vs. 590 ± 68(DC); and for pudding-like viscosity 74 ± 13(SC) vs. 164 ± 6(Y) vs. 211 ± 8(DC).

Conclusion
Suctioning liquids of different viscosity, the new DuCanto catheter was more effective than the Yankauer catheter that was more effective than a standard suctioning catheter. The relative superiority of the DuCanto was highest in fluids with high viscosity.
Effect of metformin on left ventricular mass and functional parameters in non-diabetic patients: a meta-analysis of randomized clinical trials
Authors: Kamel Ahmed M. , Sabry Nirmeen , Farid Samar 
Published: September 2022

Abstract
Background
Left ventricular hypertrophy is a common finding in patients with ischemic heart disease and is associated with mortality in patients with cardiovascular disease (CVD). Metformin, an antidiabetic drug, has been shown to reduce oxidative stress and left ventricular mass index (LVMI) in animal hypertrophy models. We summarized evidence regarding the effect of metformin on LVMI and LVEF.

Methods
Electronic databases were searched for randomized clinical trials (RCTs) that used metformin in non-diabetic patients with or without pre-existing CVD. The standardized mean change using change score standardization (SMCC) was calculated for each study. The random-effects model was used to pool the SMCC across studies. Meta-regression analysis was used to assess the association of heart failure (HF), metformin dose, and duration with the SMCC.

Results
Data synthesis from nine RCTs (754 patients) showed that metformin use resulted in higher reduction in LVMI after 12 months (SMCC = −0.63, 95% CI − 1.23; − 0.04, p = 0.04) and an overall higher reduction in LVMI (SMCC = −0.5, 95% CI − 0.84; − 0.16, p < 0.01). These values equate to absolute values of 11.3 (95% CI 22.1–0.72) and 8.97 (95% CI 15.06–2.87) g/m2, respectively. The overall improvement in LVEF was also higher in metformin users after excluding one outlier (SMCC = 0.26, 95% CI 0.03–0.49, P = 0.03) which translates to a higher absolute improvement of 2.99% (95% CI 0.34; 5.63). Subgroup analysis revealed a favorable effect for metformin on LVEF in patients who received > 1000 mg/day (SMCC = 0.28, 95% CI 0.04; 0.52, P = 0.04), and patients with HF (SMCC = 0.23; 95% CI 0.1; 0.36; P = 0.004). These values translate to a higher increase of 2.64% and 3.21%, respectively.

Conclusion
Results suggest a favorable effect for metformin on LVMI and LVEF in patients with or without pre-existing CVD. Additional trials are needed to address the long-term effect of metformin.
Registration The study was registered on the PROSPERO database with the registration number CRD42021239368 (https://www.crd.york.ac.uk/prospero).
The value of time-dependent risk predictions in a screening context - a comprehensive simulation analysis validated on German cancer registry data
Authors: Voelkel Vinzenz , Draeger Teresa , van Mossel Sietse , Siesling Sabine , Koffijberg Hendrik 
Published: September 2022

AbstractBackgroundRisk-prediction tools allow classifying individuals into risk groups based on risk thresholds. Such risk categorization is often used to inform screening schemes by offering screening only to individuals at increased risk of harmful events. Adding information concerning an individual’s risk development over time would allow assessing not just who to screen but also when to screen. This paper illustrates the value of personalised, time-dependent risk predictions to optimize risk-based screening schemes.MethodsIn a simulation analysis, two different time-dependent risk-based screening approaches are compared to another risk-based, but time-independent approach regarding their impact on screening efficiency. For this purpose, 81 scenarios featuring 5000 patients with five consecutive annual risk estimations for a hypothetical diseaseDare simulated, using different parameters to model disease progression and risk distribution. This simulation analysis is validated using a real-world clinical case study based on German breast cancer patients and the INFLUENCE-nomogram for locoregional breast cancer recurrence.ResultsIf individual risk estimations were used to personalise screening for a disease D aiming at detecting a 90% of curable cases, more than 20% of screening examinations could be avoided relative to a conventional uninformed approach, depending on the simulated scenario. Whereas an individual but time-independent approach is associated with acceptable saving potentials in case of a relatively homogenous risk distribution, the time-dependent approaches are superior when the complexity of a scenario increases. With slowly progressing diseases, risk-accumulation over time needs to be considered to achieve the highest screening efficiency on population level, for rapidly progressing diseases, an interval-specific approach is superior. The possible benefits of time-dependent risk-based screening were confirmed in the real-world clinical case study.ConclusionsAppropriate approaches to use time-dependent risk predictions may considerably enhance screening efficiency on individual and population level. Therefore, predicting risk development over time should be supported by future prediction tools and be incorporated in decision algorithms.
Conclusiveness, linguistic characteristics and readability of Cochrane plain language summaries of intervention reviews: a cross-sectional study
Authors: Banić Aleksandra , Fidahić Mahir , Šuto Jelena , Roje Rea , Vuka Ivana , Puljak Livia , Buljan Ivan 
Published: September 2022

Abstract
Background
One of the most important formats to disseminate the evidence in health to different populations are Cochrane Plain Language Summaries (PLSs). PLSs should be written in a simplified language, easily understandable and providing clear message for the consumer. The aim of this study was to examine the extent to which PLSs are customized for lay persons, specifically by providing conclusive, comprehensible, and readable messages.

Methods
The study analyzed Cochrane PLSs of interventional studies (N = 4360) in the English language published from 1995 to 2019. We categorized the conclusiveness into one of the following categories: “positive”, “positive inconclusive”, “no evidence”, “no opinion”, “negative”, “negative inconclusive”, “unclear”, “equal”, “equal inconclusive”. Language characteristics were analyzed using Linguistic Inquiry and Word Count (LIWC) software. The level of readability was measured by SMOG (Simple Measure of Gobbledygook) index, indicating the number of years of education required to read the text. For each PLS, we also collected the following data: Cochrane Review Network, year of publication and number of authors.

Results
Most of the PLSs (80%) did not have a conclusive message. In 53% PLSs there was no concluding opinion about the studied intervention or the conclusion was unclear. The most frequent conclusiveness category was “no opinion” (30%), and its frequency increased over time. The conclusiveness categories were similarly dispersed across Cochrane Networks. PLSs were written in an objective style, with high levels of analytical tone and clout above neutral, but a lower relation to authenticity and tone. The median number of years of non-specific education needed to read the PLSs was 14.9 (IQR 13.8 to 16.1), indicating that the person needs almost 15 years of general education to read the content with ease.

Conclusion
Most of the Cochrane PLSs provided no concluding opinion or unclear conclusion regarding the effects of analyzed intervention. Analysis of readability indicated that they may be difficult to read for the lay population without medical education. Our results indicate that PLSs may not be so plain, and that the writing of Cochrane PLSs requires more effort. Tools used in this study could improve PLSs and make them better suited for lay audiences.
Stenting of the pancreatic duct in the early phase of acute pancreatitis: a retrospective study
Authors: Yao Weijie , Wang Genwang , Wang Qi , Wang Feng , Wang Zuoquan , Wang Zuozheng 
Published: September 2022

Abstract
Background
The effectiveness of pancreatic duct (PD) stenting in the early stages of acute pancreatitis (AP) remains controversial. This study aimed to investigate the efficacy and safety of PD stenting in the early stages of AP.

Methods
This is a retrospective cohort study. The clinical data of 131 patients with AP from 2018 to 2019 were analysed and divided into two groups: the study group (n = 46, PD stenting) and the control group (n = 85, standard treatment).

Results
There was a statistically significant reduction in pain relief, oral refeeding, hospitalization, and intensive care unit (ICU) stay in the study group compared with that of the control group (P < 0.05). There were no significant differences in the incidence of complications between the two groups. Further multivariate analysis of risk factors for new-onset organ failure showed that the control group (odds ratio [OR] (95% confidence interval [CI]): 6.533 (1.104–70.181)) and a higher level of haematocrit (HCT) at admission (HCT > 46.1%, OR (95%CI): 8.728 (1.264–116.767)) were independent risk factors.

Conclusions
In the early phase of AP, PD stenting has the potential to reduce pain relief time, oral refeeding time, ICU stay time, and overall hospital stay time. This finding highlights a new route for the treatment of AP.
The effect of the inclusion of trunk-strengthening exercises to a multimodal exercise program on physical activity levels and psychological functioning in older adults: secondary data analysis of a randomized controlled trial
Authors: Shahtahmassebi Behnaz , Hatton Jacinta , Hebert Jeffrey J. , Hecimovich Mark , Correia Helen , Fairchild Timothy J. 
Published: September 2022

AbstractBackgroundEngaging in multimodal exercise program helps mitigate age-related decrements by improving muscle size, muscle strength, balance, and physical function. The addition of trunk-strengthening within the exercise program has been shown to significantly improve physical functioning outcomes. Whether these improvements result in improved psychological outcomes associated with increased physical activity levels requires further investigation. We sought to explore whether the inclusion of trunk-strengthening exercises to a multimodal exercise program improves objectively measured physical activity levels and self-reported psychological functioning in older adults.MethodWe conducted a secondary analysis within a single-blinded parallel-group randomized controlled trial. Sixty-four healthy older (≥ 60 years) adults were randomly allocated to a 12-week walking and balance exercise program with (n = 32) or without (n = 32) inclusion of trunk strengthening exercises. Each program involved 12 weeks of exercise training, followed by a 6-week walking-only program (identified as detraining). Primary outcome measures for this secondary analysis were physical activity (accelerometry), perceived fear-of-falling, and symptoms of anxiety and depression.ResultsFollowing the 12-week exercise program, no significant between-group differences were observed for physical activity, sedentary behaviour, fear-of-falling, or symptoms of anxiety or depression. Significant within-group improvements (adjusted mean difference [95%CI]; percentage) were observed in moderate-intensity physical activity (6.29 [1.58, 11.00] min/day; + 26.3%) and total number of steps per min/day (0.81 [0.29 to 1.33] numbers or + 16.3%) in trunk-strengthening exercise group by week 12. With respect to within-group changes, participants in the walking-balance exercise group increased their moderate-to-vigorous physical activity (MVPA) (4.81 [0.06 to 9.56] min/day; + 23.5%) and reported reduction in symptoms of depression (-0.26 [-0.49 to -0.04] points or -49%) after 12 weeks of the exercise program. The exercise-induced increases in physical activity levels in the trunk-strengthening exercise group were abolished 6-weeks post-program completion. While improvements in physical activity levels were sustained in the walking-balance exercise group after detraining phase (walking only).ConclusionsThe inclusion of trunk strengthening to a walking-balance exercise program did not lead to statistically significant between-group improvements in physical activity levels or psychological outcomes in this cohort following completion of the 12-week exercise program.Trial registrationAustralian and New Zealand Clinical Trials Registry (ACTRN12613001176752), registered on 28/10/2013.
Effect of insomnia in the major depressive disorder
Authors: Xu Guohong , Li Xiaoling , Xu Caixia , Xie Guojun , Liang Jiaquan 
Published: September 2022

Abstract
Background
People with sleep problems are more likely to have mental disorders. This study aimed to assess the effect of insomnia on the prognosis of patients with major depressive disorder (MDD).

Methods
We divided the patients into three groups according to the Insomnia Severity Index (ISI) scores. In addition, we compared the results of the Hamilton Depression Scale (HAMD) and Symptom Checklist-90 (SCL-90) scores. We evaluated the effect of insomnia at the 2nd, 4th, and 8th-week follow-up on the prognosis of MDD.

Results
Fifty-five patients between 19 and 58 years old, with a diagnosis of MDD via the Structured Clinical Interview for the Diagnostic and Statistical Manual-5 (DSM-5). The ISI scores of the moderate and severe group decreased significantly (P < 0.05) in the 2nd week compared to the baseline. The HAMD scores in all groups improved significantly in the 2nd week.

Conclusions
This study was inspired to assess insomnia as a comorbid disorder for patients with MDD, which may bring poor treatment consequences.
Power spectral analysis of heart rate variability is useful as a screening tool for detecting sympathetic and parasympathetic nervous dysfunctions in Parkinson’s disease
Authors: Miyagi Tomo , Yamazato Masanobu , Nakamura Takuto , Tokashiki Takashi , Namihira Yukihiro , Kokuba Kazuhito , Ishihara Satoshi , Sakima Hirokuni , Ohya Yusuke 
Published: September 2022

Abstract
Background
Parkinson’s disease (PD) is a progressive neurodegenerative disorder that causes motor symptoms and autonomic dysfunction. However, autonomic function tests commonly performed in PD can only evaluate either the sympathetic or parasympathetic nervous system. Therefore, the purpose of this pilot study is to investigate whether power spectral analysis of heart rate variability could detect both sympathetic and parasympathetic nervous dysfunctions in patients with PD.

Methods
Seventeen patients with PD and 11 healthy control subjects underwent electrocardiogram recording for the spectral analysis of heart rate variability to obtain values of low-frequency (LF) (0.04–0.15 Hz) and high-frequency (HF) (0.15–0.4 Hz) powers. Moreover, we examined the coefficient of variation of R–R intervals (CVRR) as a parameter of parasympathetic function in all participants and performed 123I-metaiodobenzylguanidine scintigraphy to measure the heart-to-mediastinum ratio as a parameter of cardiac sympathetic innervation in patients with PD.

Results
The median age of control subjects and PD patients was 63 and 66 years old, respectively. The median Hoehn and Yahr scale of PD patients was stage 2. The values of resting LF and HF powers widely varied. The median values of resting LF powers of control subjects and PD patients and those of HF powers were 169 and 70 ms2, 279 and 65 ms2, respectively, the difference was statistically insignificant. Approximately 41% of patients with PD had values below the first quartile of resting LF powers (< 58 ms2) or HF powers (< 50 ms2); however, no control subject had such low values. Positive correlations were found between resting LF powers and heart-to-mediastinum ratios of 123I-metaiodobenzylguanidine uptake (r = 0.6) and between resting HF powers and CVRRs (r = 0.7). The resting LF power was also associated with CVRRs and constipation. Furthermore, a positive correlation was observed between resting LF powers and resting HF powers in patients with PD (r = 0.8).

Conclusions
The power spectral analysis of heart rate variability may be useful as a screening tool for detecting autonomic dysfunctions by detecting low resting LF and HF powers in patients with PD. Sympathetic and parasympathetic nerves may be concurrently damaged in patients with PD.
Evaluation of the epidemiologic, clinical, radiologic, and treatment methods of patients with subacute and chronic meningitis
Authors: Bineshfar Niloufar , Rezaei Ali , Mirahmadi Alireza , Shokouhi Shervin , Gharehbagh Farid Javandoust , Haghighi Mehrdad , Harandi Ali Amini , Shojaei Maziar , Ramezani Mahtab , Zoghi Anahita , Gharagozli Kourosh , Lotfollahi Legha , Darazam Ilad Alavi 
Published: September 2022

Abstract
Background
Meningitis is known as a meningeal inflammation accompanied by pleocytosis in the cerebrospinal fluid (CSF), and can be classified into acute, subacute, and chronic meningitis based on symptoms duration of ≤ 5 days, ≥ 5 days and ≥ 4 weeks, respectively. Subacute and chronic meningitis are caused mainly by indolent infectious agents and noninfectious causes such as autoimmune, and neoplastic. In this study, we investigated the characteristics, diagnosis, and treatment of subacute and chronic meningitis.

Methods
We extracted the medical records of patients with chronic and subacute meningitis who were referred to three tertiary centers from Jun 2011 to Jun 2021. Initially, 2050 cases of meningitis were screened, and then 79 patients were included in the study.

Results
Headache (87.3%), nausea and vomiting (74.7%), fever (56.4%), and visual impairments (55.7%) were the most prevalent symptoms. The most common signs were nuchal rigidity (45.3%), altered mental status (26.9%), and papillary edema (37.5%). Brain computed tomography (CT) was normal in 68.6% of the patients while 22.9% of the cases had hydrocephalus. Brain magnetic resonance imaging (MRI) was normal in 60.0% of the patients. The most common abnormal MRI findings were leptomeningeal enhancement (16.0%) and hydrocephalus (16.0%). We had a 44.3% definite diagnosis with bacterial (n:25, 31.6%) and neoplastic (n:8, 10.1%) being the most prevalent etiologies. Mycobacterium tuberculosis (60%) and Brucella spp. (12%) were the most prevalent bacterial pathogens.

Conclusions
The most common etiologies include infectious, neoplastic, and immunologic. Due to insidious presentation and uncommon etiologies, establishing a proper diagnosis, and providing timely targeted treatment for patients with subacute and chronic meningitis remains a challenge for clinicians.