bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robot-assisted laparoscopic staging compared to conventional laparoscopic staging and laparotomic staging in clinical early stage ovarian carcinoma
Authors: Bouter E.L.M. , Lok Christianne , Trum Hans 
Published: August 2022

Purpose of review
Robot-assisted laparoscopic staging (RALS) is increasingly used for staging epithelial ovarian cancer (EOC). Evidence of its safety is limited. The aim of this review is to compare the efficacy and safety of RALS in clinical early-stage EOC to conventional laparoscopy and laparotomy and to assess the level of evidence that is currently available to adopt this surgical technique.

Recent findings
Only retrospective studies comparing staging by minimally invasive surgery (MIS) to laparotomy are available. Both RALS and conventional laparoscopic staging shorten length of hospital stay (LHS, mean -2.9 days) and decrease estimated blood loss (EBL, mean -79 ml less) compared to laparotomy. Complication rates and number of lymph nodes collected are similar in all surgical staging techniques. Survival outcomes after staging by MIS cannot be compared to staging by laparotomy because of the lack of evidence but RALS is probably noninferior to conventional laparoscopic staging.

Summary
RALS probably improves perioperative outcomes in patients with clinical early stage EOC similar to conventional laparoscopic staging. Whether oncologic outcomes of RALS are comparable to open and conventional approaches is uncertain as there is only level C evidence and randomized controlled trials are urgently needed to confirm the current retrospective findings.
Advances in the treatment of light chain amyloidosis
Authors: Palladini Giovanni , Milani Paolo 
Published: August 2022

Purpose of review
After many years, the management of systemic light chain (AL) amyloidosis is entering the era of evidence-based medicine, with three recently published randomized clinical trials, a regimen (daratumumab, cyclophosphamide, bortezomib, and dexamethasone, daratumumab-CyBorD) labeled for upfront therapy, more clinical trials ongoing, and published guidelines. In this review, we discuss how current practice is changing based on this data.

Recent findings
Daratumumab-CyBorD grants unprecedentedly high rates of hematologic and organ response and became the novel standard-of-care in AL amyloidosis. The International Society of Amyloidosis and the European Hematology Association issued common guidelines for autologous stem cell transplant (ASCT) in this disease. Improved patient selection and effective induction regimens greatly reduced ASCT-related mortality. Venetoclax is emerging as a very effective option in patients harboring the common t(11;14) abnormality. Rapid and profound reduction of the amyloid free light chain can improve survival also at advanced stages.

Summary
Daratumumab-CyBorD is being integrated into the treatment flow-chart whereas the role of ASCT is being redefined. New approaches are being tested in clinical trials. Treatment of daratumumab-refractory patients and validation of criteria of hematologic progression to be used in clinical trials and in individual patient management are current areas of research.
The Contribution of Health Behaviors to Depression Risk Across Birth Cohorts
Authors: Gueltzow Maria , Bijlsma Maarten J. , van Lenthe Frank J. , Myrskylä Mikko 
Published: August 2022

Background:
More recent birth cohorts are at a higher depression risk than cohorts born in the early 20th century. We aimed to investigate to what extent changes in alcohol consumption, smoking, physical activity, and obesity contribute to these birth cohort variations.

Methods:
We analyzed panel data from US adults born 1916–1966 enrolled in the Health and Retirement Study (N = 163,760 person-years). We performed a counterfactual decomposition analysis by combining age-period-cohort models with g-computation. We thereby compared the predicted probability of elevated depressive symptoms (CES-D 8 score ≥3) in the natural course to a counterfactual scenario where all birth cohorts had the health behaviors of the 1945 birth cohort. We stratified analyses by sex and race-ethnicity.

Results:
We estimated that depression risk of the 1916–1949 and 1950–1966 birth cohort would be on average 2.0% (–2.3 to –1.7) and 0.5% (–0.9 to –0.1) higher with the alcohol consumption levels of the 1945 cohort. In the counterfactual with the 1945 BMI distribution, depression risk is on average 2.1% (1.8 to 2.4) higher for the 1916–1940 cohorts and 1.8% (–2.2 to –1.5) lower for the 1950–1966 cohorts. We find no cohort variations in depression risk for smoking and physical activity. The contribution of alcohol is more pronounced for Whites than for other race-ethnicity groups, and the contribution of BMI more pronounced for women than for men.

Conclusion:
Increased obesity levels were associated with exacerbated depression risk in recent birth cohorts in the United States, while drinking patterns only played a minor role.
Therapeutic Drug Monitoring and Dosage Adjustments of Immunosuppressive Drugs When Combined With Nirmatrelvir/Ritonavir in Patients With COVID-19
Authors: Lemaitre Florian , Budde Klemens , Van Gelder Teun , Bergan Stein , Lawson Roland , Noceti Ofelia , Venkataramanan Raman , Elens Laure , Moes Dirk Jan A. R. , Hesselink Dennis A. , Pawinski Tomasz , Johnson-Davis Kamisha L. , De Winter Brenda C. M. , Pattanaik Smita , Brunet Mercè , Masuda Satohiro , Langman Loralie J. 
Published: August 2022

Abstract:
Nirmatrelvir/ritonavir (Paxlovid) consists of a peptidomimetic inhibitor (nirmatrelvir) of the SARS-CoV-2 main protease and a pharmacokinetic enhancer (ritonavir). It is approved for the treatment of mild-to-moderate COVID-19. This combination of nirmatrelvir and ritonavir can mediate significant and complex drug–drug interactions (DDIs), primarily due to the ritonavir component. Indeed, ritonavir inhibits the metabolism of nirmatrelvir through cytochrome P450 3A (CYP3A) leading to higher plasma concentrations and a longer half-life of nirmatrelvir. Coadministration of nirmatrelvir/ritonavir with immunosuppressive drugs (ISDs) is particularly challenging given the major involvement of CYP3A in the metabolism of most of these drugs and their narrow therapeutic ranges. Exposure of ISDs will be drastically increased through the potent ritonavir-mediated inhibition of CYP3A, resulting in an increased risk of adverse drug reactions. Although a decrease in the dosage of ISDs can prevent toxicity, an inappropriate dosage regimen may also result in insufficient exposure and a risk of rejection. Here, we provide some general recommendations for therapeutic drug monitoring of ISDs and dosing recommendations when coadministered with nirmatrelvir/ritonavir. Particularly, tacrolimus should be discontinued, or patients should be given a microdose on day 1, whereas cyclosporine dosage should be reduced to 20% of the initial dosage during the antiviral treatment. Dosages of mammalian target of rapamycin inhibitors (m-TORis) should also be adjusted while dosages of mycophenolic acid and corticosteroids are expected to be less impacted.
Assessment of patient’s perception and knowledge towards anesthesia services at Dilla University Referral Hospital, South Ethiopia, 2021: a cross-sectional study
Authors: Hailu Seyoum , Girma Timsel , Regasa Teshome 
Published: August 2022

Background:
The poor community understanding of anesthesia professionals and their discipline has been a long-standing and obvious problem. Many studies have been done in the developed countries investigating public awareness of anesthetists but there are few publications from the developing countries including Ethiopia. Patients’ knowledge of anesthetists and their roles inside and outside the operation theatre is poor worldwide.

Objective:
This study is aimed to assess patients’ perception and knowledge of anesthesia service among patients admitted for surgery at Dilla University Referral Hospital (DURH), Southern Ethiopia, 2021.

Methods:
An institutional-based cross-sectional questionnaire survey was carried out on consecutive adult patients aged 18 years and above that had undergone surgery at DURH, conducted over four months. Data were presented using tables, and graphs and summarized by using dummy tables. After carefully analyzing the collected data, a conclusion was made with constructive recommendations.

Result:
A total of 396 patients were initially included in the study while 27 patients declined to participate with a 93% response rate. The mean age of participants was 39.5±14.9 years, and more than half of the respondents 225 (61%) were male. Regarding the type of surgery done 238 (64.6%) respondents were emergency the rest of 35.4% were elective surgery. Of 369 respondents, only 42% knew that anesthetist is the one who gives anesthesia and 38% knew that a doctor does.

Conclusion:
The perception of most patients is that anesthesia is all about “putting patients to sleep and waking them up.” There was poor knowledge of patients regarding the role of anesthetists beyond the confines of the operating theater. Therefore, there is a need for intensified public education on the importance of anesthesia and the diverse roles anesthetists play in ensuring holistic health care delivery.
Influential Factors for Selecting a Plastic Surgeon: A National Survey in Saudi Arabia
Authors: Al Qurashi Abdullah A. , Mortada Hatan , Abuthiyab Noorah , Al Zaid Nura , Aletani Tala , Arab Khalid 
Published: August 2022

Introduction:
Knowing what attracts cosmetic patients to a specific surgeon can help current cosmetic surgeons and aspiring ones improve themselves and better market their practice. Hence, this study aimed to investigate the influential factors when selecting an aesthetic surgeon for a cosmetic procedure in Saudi Arabia.

Methods:
This is a cross-sectional, nationwide study targeting the public from all regions of Saudi Arabia. The study was conducted between September 21 and October 29, 2021. The self-structured electronic survey was based on previously published studies and was revised by two academic plastic surgeons.

Results:
This study included a total of 7190 participants from all regions of Saudi Arabia. The most influential factor for choosing an aesthetic surgeon was the surgeon’s qualifications (39.9%), followed by friends and relatives’ advice (24%) and hospital/clinic environment (10.2%), while the number of social media followers was the least favorable factor (0.8%). Additionally, the most preferred aesthetic surgeon was a surgeon with international board certification (mean score, 4.17).

Conclusions:
This study showed that the most common factor for choosing an aesthetic surgeon was the surgeons’ qualifications. Thus, Saudi aesthetic surgeons and aspiring Saudi aesthetic surgeons must focus on obtaining high qualifications to attract more patients. Furthermore, an internationally board-certified surgeon is the most preferred surgeon for Saudi Arabian patients; thus, traveling abroad to world-renowned institutions is recommended.
Yogurt Technique for Descemet Membrane Endothelial Keratoplasty Graft Preparation: Early Clinical Outcomes
Authors: Moramarco Antonio , Romano Vito , Modugno Rocco Luigi , Coco Giulia , Viola Pietro , Fontana Luigi 
Published: August 2022

Purpose:
The aim of this study was to evaluate the efficacy and safety of the Yogurt technique for Descemet membrane endothelial keratoplasty (DMEK) graft preparation.

Methods:
This study included patients who underwent DMEK combined or not with phacoemulsification surgery using donor tissues prepared by a surgeon with the DMEK Tzamalis disposable punch at 2 referral hospitals between October 2019 and June 2021. Primary outcomes were duration of graft preparation, surgeon grading of graft quality, and endothelial cell density measured at 1 and 6 months after surgery. Secondary outcomes were best-corrected visual acuity (BCVA) measured at 1 and 6 months postoperatively and DMEK intraoperative and postoperative complications.

Results:
Forty-nine patients were included in this study. The mean DMEK graft preparation time was 7.2 ± 1.4 minutes. Donor grafts were rated good in 67.3% of cases (33 of 49), sufficient in 24.5% (12 of 49), and poor in 8.2% (4 of 49). Donor mean endothelial cell density was 2580 ± 155 preoperatively, which were reduced to 2269 ± 191 (P < 0.000) and 1697 ± 142 (P < 0.0001) at 1 and 6 months, respectively. No significant difference was found in graft preparation outcome (P = 0.543). The preoperative BCVA was 0.65 ± 0.44 logMAR, which improved to 0.31 ± 0.43 logMAR (P < 0.0001) and 0.12 ± 0.14 logMAR (P < 0.0001) at 1 and 6 months after surgery, respectively.

Conclusions:
This study shows that the DMEK Tzamalis punch can be used as an effective and safe method for DMEK graft preparation with a shallow learning curve that allows it to be successfully performed by relatively inexperienced surgeons.
Retrobulbar Injection of Amphotericin B in Patients With COVID-19 Associated Orbital Mucormycosis: A Systematic Review
Authors: Sharifi Ali , Akbari Zahra , Shafie’ei Mohammad , Nasiri Naser , Sharifi Meraj , Shafiei Mohadeseh , Zand Amin 
Published: August 2022

Purpose:
Following COVID-19 infection a rising count of rhino-orbito-cerebral mucormycosis is observed, requiring orbital exenteration, a disabling lifetime affecting surgery. One of the potential interventions for globe salvage in these patients is retrobulbar injections of amphotericin B. This study was conducted to review protocols, outcomes, and side effects of retrobulbar injection of amphotericin B in patients with COVID-19 associated rhino-orbito-cerebral mucormycosis (CAM).

Methods:
The PubMed, Scopus, Web of Science, and Embase databases were searched using a comprehensive string of relevant keywords. All English studies with the confirmed diagnosis of CAM infection were included. We excluded all studies in which retrobulbar injection of amphotericin B was not implemented in any of the patients or there was a lack of clarified and detailed data about this procedure among participants.

Results:
A total of 647 cases had a history of retrobulbar injection(s) of amphotericin B in 13 reviewed studies with 3,132 subjects of CAM. The most common protocol was the retrobulbar injection of 1 ml of 3.5 mg/ml liposomal amphotericin B for 3 doses daily or on alternate days. We discerned that the globe salvage rate was 95.0% in eyes with a history of retrobulbar injection(s). The total rate of orbital exenteration was 14.9%, regardless of the history of retrobulbar injection of the drug. Other outcomes of this intervention were vision salvage and reduced major ophthalmic complaints, including pain, swelling, chemosis, ptosis, and ophthalmoplegia. The side effects of this intervention were not serious, and most of them were transient. They included swelling at the injection site, restriction of ocular motilities, exacerbation of orbital inflammation, and even intensification of visual impairment in a few cases.

Conclusions:
Retrobulbar injection of amphotericin B should be considered a nearly safe and protective intervention against orbital exenteration in patients with CAM. It may also be effective in saving vision. Since the effectiveness of orbital exenteration in the survival of patients is not ascertained, retrobulbar injections can be considered an alternative intervention.
High Temperature and Its Association With Work-Related Injuries by Employment Status in South Korea, 2017–2018
Authors: Choi Bokyoung , Choi Hayon Michelle , Choi Youngeun , Kim Inah , Hwang Seungsik 
Published: August 2022

Objective
This study aimed to determine the association between maximum daily temperature and work-related injuries according to employment status in South Korea.

Methods
Data on workers’ compensation claims and daily maximum temperature between May 20 and September 10, 2017–2018, were collected and analyzed. The absolute temperature risk effect (ATR) was evaluated by comparing the risk effect at 2 temperatures (30°C vs 33°C) across all communities using 2-stage time-series analysis.

Results
The association between high temperatures and work-related injuries was statistically significant in the construction sector (ATR, 1.129; 95% confidence interval [CI], 1.010–1.261). In addition, the findings of this study also demonstrated a higher risk effect among nonpermanent workers (ATR, 1.109; 95% CI, 1.013–1.214) at 33°C versus 30°C when compared with permanent workers (ATR, 0.963; 95% CI, 0.891–1.041).

Conclusions
This study found a significant association between high temperatures and work-related injuries among nonpermanent workers in South Korea.
Evidence-based treatment recommendations for OTC management of chronic constipation
Authors: Rao Satish S.C. , Brenner Darren M. 
Published: August 2022

ABSTRACT
Chronic constipation is a common gastrointestinal condition, and most individuals self-treat with multiple over-the-counter (OTC) laxatives prior to consulting a health care provider. This brief report is a synopsis of an updated systematic review the authors conducted of published data on the efficacy and safety of OTC treatments to provide evidence-based recommendations. After applying the selection criteria, 41 randomized controlled clinical trials of ≥ 4-week duration were identified and analyzed. Standardized definitions of constipation were applied across these studies; however, definitions for stool frequency and consistency varied. Overall, the short- and long-term efficacy of polyethylene glycol-based preparations and senna were supported by good (grade A) evidence suggesting their use as first-line laxatives. Modest evidence (grade B) supported the use of other agents including the stimulants bisacodyl and sodium picosulfate, fiber, fruit-based laxatives, and magnesium oxide. Additional evidence from rigorously designed studies is needed to support the use of other options for chronic constipation. The OTC products studied were generally well tolerated with common adverse effects being abdominal pain, cramping, bloating, diarrhea, and nausea.
Polyunsaturated fatty acids and metabolic health: novel insights
Authors: Djuricic Ivana , Calder Philip C. 
Published: August 2022

Purpose of review
This review aims to discuss the potential roles of omega-3 (ω-3) and omega-6 (ω-6) polyunsaturated fatty acids (PUFAs) in the prevention and treatment of metabolic diseases, to provide the latest evidence from epidemiological and clinical studies, and to highlight novel insights into this field.

Recent findings
Higher dietary or circulating ω-3 PUFA levels are related to a lower risk of metabolic syndrome. Novel findings in obesity indicate higher proportions of ω-6 and ω-3 PUFAs, a modulated oxylipin profile and an altered transcriptome in subcutaneous white adipose tissue, that seem resistant to the effects of ω-3 PUFAs compared with what occurs in normal weight individuals. ω-3 PUFAs may improve the blood lipid profile and glycemic outcomes in patients with type 2 diabetes mellitus and reduce liver fat in nonalcoholic fatty liver disease (NAFLD); the findings of several recent meta-analyses support these effects. Genetic background affects inter-individual variability in the insulin sensitivity response to ω-3 PUFA supplementation. ω-3 PUFAs have prebiotic effects, altering the gut microbiota.

Summary
Although evidence for health benefits of ω-3 PUFAs is strong, recent findings suggest a more personalized approach to ω-3 PUFA intake for individuals at high risk for metabolic diseases.
Value of clinical tests in diagnosing anterior cruciate ligament injuries: A systematic review and meta-analysis
Authors: Huang Zhihao , Liu Zhihao , Fan Changfeng , Zou Miao , Chen Jiyan 
Published: August 2022

Objectives:
This study compared 4 clinical tests with reference to magnetic resonance imaging and arthroscopic visualization to comprehensively evaluate their diagnostic value for anterior cruciate ligament injuries.

Methods:
We systematically searched 10 electronic databases from January 1, 2010, to May 1, 2021. Two reviewers collected data in accordance with the Preferred Reporting Item for Systematic Reviews and Meta-Analyses 2020 guidelines. The quality of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. A meta-analysis was performed using Meta-Disc version 1.4 and Stata SE version 15.0.

Results:
Eighteen articles involving 2031 participants were included. The results of the meta-analysis showed that for the Lachman test, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio, area under the curve (AUC) of summary receiver operating characteristic (SROC), and Q* were 0.76 (95% CI, 0.73–0.78), 0.89 (95% CI, 0.87–0.91), 5.65 (95% CI, 4.05–7.86), 0.28 (95% CI, 0.23–0.36), 22.95 (95% CI, 14.34–36.72), 0.88, and 0.81, respectively. For the anterior drawer test, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio, AUC of SROC, and Q* were 0.64 (95% CI, 0.61–0.68), 0.87 (95% CI, 0.84–0.90), 3.57 (95% CI, 2.13–5.96), 0.44 (95% CI, 0.32–0.59), 8.77 (95% CI, 4.11–18.74), 0.85, and 0.78, respectively. For the pivot shift test, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio, AUC of SROC, and Q* were 0.59 (95% CI, 0.56–0.62), 0.97 (95% CI, 0.95–0.98), 13.99 (95% CI, 9.96–19.64), 0.44 (95% CI, 0.35–0.55), 29.46 (95% CI, 15.60–55.67), 0.98, and 0.94, respectively. For the lever sign test, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio, AUC of SROC, and Q* were 0.79 (95% CI, 0.75–0.83), 0.92 (95% CI, 0.87–0.95), 9.56 (95% CI, 2.76–33.17), 0.23 (95% CI, 0.12–0.46), 47.38 (95% CI, 8.68–258.70), 0.94, and 0.87, respectively.

Conclusions:
Existing evidence shows that these clinical tests have high diagnostic efficacy for anterior cruciate ligament injuries, and that every test has its own advantages and disadvantages. However, the above results should be validated through additional studies, considering the limited quality and quantity of our sample.