cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.29320751
title: Opioid-free anaesthesia to reduce postoperative nausea and vomiting after lower extremity wound surgery: a randomised double-blind crossover trial

description: Postoperative nausea and vomiting (PONV) are common complications after surgery. Opioid use is a significant risk factor. We utilised a crossover design to test this hypothesis in the same individuals that opioid-free anaesthesia (OFA) compared with opioid-inclusive anaesthesia reduces PONV. This randomised double-blind crossover trial included adult patients undergoing two surgical procedures for lower extremity wounds under general anaesthesia. Each patient received both OFA (i.v. lidocaine, esketamine, dexmedetomidine and propofol) and opioid-inclusive anaesthesia (sufentanil and propofol); which came first was determined by randomisation. The primary outcome was the incidence of PONV during the first 48 h postoperatively. Secondary outcomes were the severity of PONV, use of rescue antiemetics, postoperative pain, need for rescue analgesia, adverse events, time to extubation, and length of recovery room stay. Sixty-six patients completed this study (mean age 53 years, 36% female). The median washout period was 9 days. Compared with opioid-inclusive anaesthesia, OFA reduced the incidence of PONV 0–48 h postoperatively (5% vs. 23%, odds ratio [OR] = 0.13, 95% CI: 0.03–0.55, <i>p</i> = 0.006), which remained significant in the prespecified adjusted analysis (OR = 0.06, 95% CI: 0.01–0.32, <i>p</i> = 0.001). OFA also led to a reduced severity of PONV, a lower rate of hypotension, and a longer time to extubation. Postoperative pain and other outcomes were similar between the two anaesthetic techniques. This crossover trial demonstrates that OFA reduced PONV following lower extremity wound surgery, providing compelling evidence for the administration of OFA to enhance perioperative care. ChiCTR2200061511 (https://www.chictr.org.cn).
DOI: 10.6084/m9.figshare.29320751.v1
title: Opioid-free anaesthesia to reduce postoperative nausea and vomiting after lower extremity wound surgery: a randomised double-blind crossover trial

description: Postoperative nausea and vomiting (PONV) are common complications after surgery. Opioid use is a significant risk factor. We utilised a crossover design to test this hypothesis in the same individuals that opioid-free anaesthesia (OFA) compared with opioid-inclusive anaesthesia reduces PONV. This randomised double-blind crossover trial included adult patients undergoing two surgical procedures for lower extremity wounds under general anaesthesia. Each patient received both OFA (i.v. lidocaine, esketamine, dexmedetomidine and propofol) and opioid-inclusive anaesthesia (sufentanil and propofol); which came first was determined by randomisation. The primary outcome was the incidence of PONV during the first 48 h postoperatively. Secondary outcomes were the severity of PONV, use of rescue antiemetics, postoperative pain, need for rescue analgesia, adverse events, time to extubation, and length of recovery room stay. Sixty-six patients completed this study (mean age 53 years, 36% female). The median washout period was 9 days. Compared with opioid-inclusive anaesthesia, OFA reduced the incidence of PONV 0–48 h postoperatively (5% vs. 23%, odds ratio [OR] = 0.13, 95% CI: 0.03–0.55, <i>p</i> = 0.006), which remained significant in the prespecified adjusted analysis (OR = 0.06, 95% CI: 0.01–0.32, <i>p</i> = 0.001). OFA also led to a reduced severity of PONV, a lower rate of hypotension, and a longer time to extubation. Postoperative pain and other outcomes were similar between the two anaesthetic techniques. This crossover trial demonstrates that OFA reduced PONV following lower extremity wound surgery, providing compelling evidence for the administration of OFA to enhance perioperative care. ChiCTR2200061511 (https://www.chictr.org.cn).
DOI: 10.6084/m9.figshare.28280889
title: High-dose glucocorticoid treatment vs. glucocorticoid replacement in immune checkpoint inhibitor associated hypophysitis (CORTICI): an open, randomised controlled trial

description: One of the most severe endocrine side effects of immune checkpoint inhibitors (ICI) is hypophysitis leading to adrenal insufficiency. Recovery is rare, although it has been reported after high-dose glucocorticoid treatment. This is the first randomised study to evaluate whether hormonal recovery differs in patients treated with high-dose glucocorticoids versus glucocorticoid replacement therapy. In this single-centre, open, randomised controlled study, patients with ICI associated hypophysitis were randomised 1:1 to high-dose glucocorticoid treatment (1 mg/kg of prednisolone for two weeks, followed by tapering until week 7 and a switch to hydrocortisone 20 mg total daily dose in week 8) or glucocorticoid replacement therapy (hydrocortisone 20 mg total daily dose) over 8 weeks. The primary outcome was the frequency of hormonal axes recovery. Between 17th April 2019 and 16th September 2022, 18 out of the 20 randomised patients finished the trial; eight completed high-dose, 10 glucocorticoid replacement. Nine patients presented with hyponatraemia, two had typical changes on MRI, 12 had isolated adrenal insufficiency, and six had an additional hormone deficiency. None of the patients in neither group experienced a recovery in adrenal function. One patient in each group showed amelioration of hypogonadism. There was a significant, unfavourable treatment effect of high-dose treatment on HbA1c (mean treatment effect 5.16, 95% confidence interval 0.31 to 10.02, <i>p</i> = 0.039). High-dose glucocorticoid treatment was not effective in restoring adrenal function and leads to adverse effects on glucose metabolism. We therefore do not recommend its use for the treatment of ICI associated hypophysitis, except for compressive symptoms.
DOI: 10.6084/m9.figshare.28280889.v1
title: High-dose glucocorticoid treatment vs. glucocorticoid replacement in immune checkpoint inhibitor associated hypophysitis (CORTICI): an open, randomised controlled trial

description: One of the most severe endocrine side effects of immune checkpoint inhibitors (ICI) is hypophysitis leading to adrenal insufficiency. Recovery is rare, although it has been reported after high-dose glucocorticoid treatment. This is the first randomised study to evaluate whether hormonal recovery differs in patients treated with high-dose glucocorticoids versus glucocorticoid replacement therapy. In this single-centre, open, randomised controlled study, patients with ICI associated hypophysitis were randomised 1:1 to high-dose glucocorticoid treatment (1 mg/kg of prednisolone for two weeks, followed by tapering until week 7 and a switch to hydrocortisone 20 mg total daily dose in week 8) or glucocorticoid replacement therapy (hydrocortisone 20 mg total daily dose) over 8 weeks. The primary outcome was the frequency of hormonal axes recovery. Between 17th April 2019 and 16th September 2022, 18 out of the 20 randomised patients finished the trial; eight completed high-dose, 10 glucocorticoid replacement. Nine patients presented with hyponatraemia, two had typical changes on MRI, 12 had isolated adrenal insufficiency, and six had an additional hormone deficiency. None of the patients in neither group experienced a recovery in adrenal function. One patient in each group showed amelioration of hypogonadism. There was a significant, unfavourable treatment effect of high-dose treatment on HbA1c (mean treatment effect 5.16, 95% confidence interval 0.31 to 10.02, <i>p</i> = 0.039). High-dose glucocorticoid treatment was not effective in restoring adrenal function and leads to adverse effects on glucose metabolism. We therefore do not recommend its use for the treatment of ICI associated hypophysitis, except for compressive symptoms.
DOI: 10.6084/m9.figshare.30667043
title: The lung immune prognostic index as a predictive biomarker in urological malignancies undergoing immune checkpoint inhibitor therapy

description: We conducted a meta-analysis to evaluate the prognostic utility of the Lung Immune Prognostic Index (LIPI) in patients with urological malignancies treated with immune checkpoint inhibitors (ICIs). We systematically searched PubMed, the Cochrane Library, and EMBASE up to March 3, 2025. Clinical outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). Study quality was assessed using the Newcastle-Ottawa Scale (NOS), with a threshold score ≥6 defining high-quality studies. This meta-analysis incorporated seven studies comprising 2498 patients. Our findings demonstrated that patients with good LIPI index exhibited significantly prolonged OS (good vs. intermediate: HR = 0.51, 95% CI 0.42–0.62, <i>p</i> &lt; 0.001; good vs. poor: HR = 0.15, 95% CI 0.11–0.20, <i>p</i> &lt; 0.001; good vs. Intermediate and poor: HR = 0.48, 95% CI 0.38–0.61, <i>p</i> &lt; 0.001). The data further showed that patients with good LIPI index exhibited significantly prolonged PFS; (good vs. intermediate: HR = 0.66, 95% CI 0.57–0.76, <i>p</i> &lt; 0.001; good vs. poor: HR = 0.23, 95% CI 0.14–0.37, <i>p</i> &lt; 0.001; good vs. Intermediate and poor: HR = 0.73, 95% CI 0.66–0.81, <i>p</i> &lt; 0.001). Additionally, we found that the good LIPI index correlated with higher ORR (good vs. intermediate: OR = 1.50, 95% CI: 0.98–2.28, <i>p</i> = 0.061; good vs. poor: OR = 1.96, 95% CI: 1.01–3.83, <i>p</i> = 0.047). The good LIPI index correlated with higher DCR (good vs. intermediate: OR = 2.15, 95% CI: 1.53–3.01, <i>p</i> &lt; 0.001; good vs. poor: OR = 5.08, 95% CI: 2.85–9.05, <i>p</i> &lt; 0.001). No publication bias existed, and sensitivity analysis confirmed stable results. The LIPI emerges as a valuable prognostic biomarker in patients with urological malignancies treated with ICIs therapy.
DOI: 10.6084/m9.figshare.30667043.v1
title: The lung immune prognostic index as a predictive biomarker in urological malignancies undergoing immune checkpoint inhibitor therapy

description: We conducted a meta-analysis to evaluate the prognostic utility of the Lung Immune Prognostic Index (LIPI) in patients with urological malignancies treated with immune checkpoint inhibitors (ICIs). We systematically searched PubMed, the Cochrane Library, and EMBASE up to March 3, 2025. Clinical outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). Study quality was assessed using the Newcastle-Ottawa Scale (NOS), with a threshold score ≥6 defining high-quality studies. This meta-analysis incorporated seven studies comprising 2498 patients. Our findings demonstrated that patients with good LIPI index exhibited significantly prolonged OS (good vs. intermediate: HR = 0.51, 95% CI 0.42–0.62, <i>p</i> &lt; 0.001; good vs. poor: HR = 0.15, 95% CI 0.11–0.20, <i>p</i> &lt; 0.001; good vs. Intermediate and poor: HR = 0.48, 95% CI 0.38–0.61, <i>p</i> &lt; 0.001). The data further showed that patients with good LIPI index exhibited significantly prolonged PFS; (good vs. intermediate: HR = 0.66, 95% CI 0.57–0.76, <i>p</i> &lt; 0.001; good vs. poor: HR = 0.23, 95% CI 0.14–0.37, <i>p</i> &lt; 0.001; good vs. Intermediate and poor: HR = 0.73, 95% CI 0.66–0.81, <i>p</i> &lt; 0.001). Additionally, we found that the good LIPI index correlated with higher ORR (good vs. intermediate: OR = 1.50, 95% CI: 0.98–2.28, <i>p</i> = 0.061; good vs. poor: OR = 1.96, 95% CI: 1.01–3.83, <i>p</i> = 0.047). The good LIPI index correlated with higher DCR (good vs. intermediate: OR = 2.15, 95% CI: 1.53–3.01, <i>p</i> &lt; 0.001; good vs. poor: OR = 5.08, 95% CI: 2.85–9.05, <i>p</i> &lt; 0.001). No publication bias existed, and sensitivity analysis confirmed stable results. The LIPI emerges as a valuable prognostic biomarker in patients with urological malignancies treated with ICIs therapy.
DOI: 10.6084/m9.figshare.29484037
title: Development and validation of a nomogram for predicting the risk of cognitive impairment among chronic obstructive pulmonary diseases

description: Cognitive impairment has been proven to have a significant impact on the overall quality of life among chronic obstructive pulmonary disease (COPD). Using a reliable and convenient method to identify the high-risk population of cognitive impairment may help to improve the prognosis of COPD patients. The aim of this study is to develop a nomogram for predicting cognitive impairment for COPD patients. The convenience sampling method was employed to select COPD patients for investigation. The dataset was randomly partitioned into a development subset and a validation subset. Univariate and multiple logistic regression analyses were performed on the development dataset to ascertain risk factors for cognitive impairment and to establish a nomogram to forecast the likelihood of cognitive dysfunction in COPD patients. This model was evaluated thorough discrimination, calibration, and decision curve. Age, education level, regular exercise habits, participation in intellectual activities, FEV1/FVC, and serum albumin were significant contributing factors to cognitive impairment risk. A nomogram model for predicting cognitive impairment in COPD patients was developed based on these factors. The designed model demonstrates excellent predictive performance. The designed model can identify patients at high risk of cognitive impairment, providing empirical evidence for precise treatment and management of cognitive impairment in COPD patients. The occurrence of cognitive impairment among COPD patients is considerable and can be impacted by a range of factors. In addition to traditional factors, serum albumin serves as a protective factor against cognitive impairment in COPD patients.A simplified nomogram model encompassing age, education level, regular exercise habits, participation in intellectual activities, FEV<sub>1</sub>/FVC, and serum albumin can effectively predict the probability of cognitive impairment in COPD patients. The occurrence of cognitive impairment among COPD patients is considerable and can be impacted by a range of factors. In addition to traditional factors, serum albumin serves as a protective factor against cognitive impairment in COPD patients. A simplified nomogram model encompassing age, education level, regular exercise habits, participation in intellectual activities, FEV<sub>1</sub>/FVC, and serum albumin can effectively predict the probability of cognitive impairment in COPD patients.
DOI: 10.6084/m9.figshare.29484037.v1
title: Development and validation of a nomogram for predicting the risk of cognitive impairment among chronic obstructive pulmonary diseases

description: Cognitive impairment has been proven to have a significant impact on the overall quality of life among chronic obstructive pulmonary disease (COPD). Using a reliable and convenient method to identify the high-risk population of cognitive impairment may help to improve the prognosis of COPD patients. The aim of this study is to develop a nomogram for predicting cognitive impairment for COPD patients. The convenience sampling method was employed to select COPD patients for investigation. The dataset was randomly partitioned into a development subset and a validation subset. Univariate and multiple logistic regression analyses were performed on the development dataset to ascertain risk factors for cognitive impairment and to establish a nomogram to forecast the likelihood of cognitive dysfunction in COPD patients. This model was evaluated thorough discrimination, calibration, and decision curve. Age, education level, regular exercise habits, participation in intellectual activities, FEV1/FVC, and serum albumin were significant contributing factors to cognitive impairment risk. A nomogram model for predicting cognitive impairment in COPD patients was developed based on these factors. The designed model demonstrates excellent predictive performance. The designed model can identify patients at high risk of cognitive impairment, providing empirical evidence for precise treatment and management of cognitive impairment in COPD patients. The occurrence of cognitive impairment among COPD patients is considerable and can be impacted by a range of factors. In addition to traditional factors, serum albumin serves as a protective factor against cognitive impairment in COPD patients.A simplified nomogram model encompassing age, education level, regular exercise habits, participation in intellectual activities, FEV<sub>1</sub>/FVC, and serum albumin can effectively predict the probability of cognitive impairment in COPD patients. The occurrence of cognitive impairment among COPD patients is considerable and can be impacted by a range of factors. In addition to traditional factors, serum albumin serves as a protective factor against cognitive impairment in COPD patients. A simplified nomogram model encompassing age, education level, regular exercise habits, participation in intellectual activities, FEV<sub>1</sub>/FVC, and serum albumin can effectively predict the probability of cognitive impairment in COPD patients.
DOI: 10.6084/m9.figshare.30122363
title: The impact of diet and lifestyle-related oxidative stress on asthma outcomes: a longitudinal NHANES analysis

description: Oxidative stress is known to play a key role in the progression of asthma. The Oxidative Balance Score (OBS), derived from an analysis of diet and lifestyle choices, provides a measure of the body’s oxidative stress levels. This study aims to investigate the clinical relevance of OBS in asthma. The study included National Health and Nutrition Examination Survey (NHANES) data from 10,038 individuals between the years 2007 and 2018. We assessed associations of asthma prevalence with the OBS, Dietary Oxidative Balance Score (DOBS), and Lifestyle Oxidative Balance Score (LOBS) using logistic regression and restricted cubic spline (RCS) analyses. Lung function was evaluated through correlation analysis. The Cox proportional hazards models were employed to assess all-cause and cardiovascular-specific mortality by OBS components. Subgroup and interaction analyses were conducted to examine heterogeneity and to validate the findings. After adjusting for confounders, higher OBS [OR = 0.98 (0.97, 0.99), <i>p</i> = 0.003], DOBS [OR = 0.99 (0.97, 0.99), <i>p</i> = 0.016], and LOBS [OR = 0.91 (0.87, 0.96), <i>p</i> &lt; 0.001] were inversely associated with asthma prevalence. A nonlinear relationship was observed between OBS and asthma prevalence (p-for-nonlinear = 0.028). OBS showed positive correlations with lung function parameters, including FEV<sub>1</sub> (<i>r</i> = 0.12, <i>p</i> &lt; 0.001) and FEF<sub>25-75%</sub> (<i>r</i> = 0.06, <i>p</i> &lt; 0.001). Additionally, higher OBS was associated with reduced risks of all-cause mortality [HR = 0.92 (0.89, 0.96), <i>p</i> &lt; 0.001] and cardiovascular mortality [HR = 0.86 (0.80, 0.93), <i>p</i> &lt; 0.001] in asthma individuals. Our findings suggest that an antioxidant-rich diet and lifestyle may lower the risk of developing asthma and improve the prognosis for individuals with asthma. The Oxidative Balance Score (OBS), Dietary Oxidative Balance Score (DOBS), and Lifestyle Oxidative Balance Score (LOBS) were negatively correlated with asthma prevalence.OBS exhibited a negative association with all-cause and cardiovascular mortality in asthma.An antioxidant-rich diet and lifestyle may lower the risk of developing asthma and improve the prognosis for individuals with asthma. The Oxidative Balance Score (OBS), Dietary Oxidative Balance Score (DOBS), and Lifestyle Oxidative Balance Score (LOBS) were negatively correlated with asthma prevalence. OBS exhibited a negative association with all-cause and cardiovascular mortality in asthma. An antioxidant-rich diet and lifestyle may lower the risk of developing asthma and improve the prognosis for individuals with asthma.
DOI: 10.6084/m9.figshare.30122363.v1
title: The impact of diet and lifestyle-related oxidative stress on asthma outcomes: a longitudinal NHANES analysis

description: Oxidative stress is known to play a key role in the progression of asthma. The Oxidative Balance Score (OBS), derived from an analysis of diet and lifestyle choices, provides a measure of the body’s oxidative stress levels. This study aims to investigate the clinical relevance of OBS in asthma. The study included National Health and Nutrition Examination Survey (NHANES) data from 10,038 individuals between the years 2007 and 2018. We assessed associations of asthma prevalence with the OBS, Dietary Oxidative Balance Score (DOBS), and Lifestyle Oxidative Balance Score (LOBS) using logistic regression and restricted cubic spline (RCS) analyses. Lung function was evaluated through correlation analysis. The Cox proportional hazards models were employed to assess all-cause and cardiovascular-specific mortality by OBS components. Subgroup and interaction analyses were conducted to examine heterogeneity and to validate the findings. After adjusting for confounders, higher OBS [OR = 0.98 (0.97, 0.99), <i>p</i> = 0.003], DOBS [OR = 0.99 (0.97, 0.99), <i>p</i> = 0.016], and LOBS [OR = 0.91 (0.87, 0.96), <i>p</i> &lt; 0.001] were inversely associated with asthma prevalence. A nonlinear relationship was observed between OBS and asthma prevalence (p-for-nonlinear = 0.028). OBS showed positive correlations with lung function parameters, including FEV<sub>1</sub> (<i>r</i> = 0.12, <i>p</i> &lt; 0.001) and FEF<sub>25-75%</sub> (<i>r</i> = 0.06, <i>p</i> &lt; 0.001). Additionally, higher OBS was associated with reduced risks of all-cause mortality [HR = 0.92 (0.89, 0.96), <i>p</i> &lt; 0.001] and cardiovascular mortality [HR = 0.86 (0.80, 0.93), <i>p</i> &lt; 0.001] in asthma individuals. Our findings suggest that an antioxidant-rich diet and lifestyle may lower the risk of developing asthma and improve the prognosis for individuals with asthma. The Oxidative Balance Score (OBS), Dietary Oxidative Balance Score (DOBS), and Lifestyle Oxidative Balance Score (LOBS) were negatively correlated with asthma prevalence.OBS exhibited a negative association with all-cause and cardiovascular mortality in asthma.An antioxidant-rich diet and lifestyle may lower the risk of developing asthma and improve the prognosis for individuals with asthma. The Oxidative Balance Score (OBS), Dietary Oxidative Balance Score (DOBS), and Lifestyle Oxidative Balance Score (LOBS) were negatively correlated with asthma prevalence. OBS exhibited a negative association with all-cause and cardiovascular mortality in asthma. An antioxidant-rich diet and lifestyle may lower the risk of developing asthma and improve the prognosis for individuals with asthma.