tbuckley/cabot-search huggingface dataset:
Association between frailty and acute kidney injury after cardiac surgery: unraveling the moderation effect of body fat through an international, retrospective, multi-cohort study
Authors: Yun-Xiao Bai, Zi-Hao Wang, Yong Lv, Jie Liu, Zhen-Zhen Xu, Yi-Qi Feng, Guo-Yang Liu, Ping Yin, Yan-Ting Wang, Nian-Guo Dong, Qing-Ping Wu
Journal: International Journal of Surgery (2024)

Background: Acute kidney injury (AKI) is a common and serious complication after cardiac surgery that significantly affects patient outcomes. Given the limited treatment options available, identifying modifiable risk factors is critical. Frailty and obesity, two heterogeneous physiological states, have significant implications for identifying and preventing AKI. Our study investigated the interplay among frailty, body composition, and AKI risk after cardiac surgery to inform patient management strategies. Material and Methods: This retrospective cohort study included three international cohorts. Primary analysis was conducted in adult patients who underwent cardiac surgery between 2014 and 2019 at Wuhan XX Hospital, China. We tested the generalizability of our findings with data from two independent international cohorts, the Medical Information Mart for Intensive Care IV (MIMIC-IV) and the eICU Collaborative Research Database. Frailty was assessed using a clinical lab-based frailty index (FI-LAB), while total body fat percentage (BF%) was calculated based on a formula accounting for BMI, sex, and age. Logistic regression models were used to analyze the associations between frailty, body fat, and AKI, adjusting for pertinent covariates. Results: A total of 8785 patients across three international cohorts were included in the study. In the primary analysis of 3,569 patients from Wuhan XX Hospital, moderate and severe frailty were associated with an increased AKI risk after cardiac surgery. Moreover, a nonlinear relationship was observed between body fat percentage and AKI risk. When stratified by the degree of frailty, lower body fat correlated with a decreased incidence of AKI. Extended analyses using the MIMIC-IV and eICU cohorts (n=3,951 and n=1,265, respectively) validated these findings and demonstrated that a lower total BF% was associated with decreased AKI incidence. Moderation analysis revealed that the effect of frailty on AKI risk was moderated by the body fat percentage. Sensitivity analyses demonstrated results consistent with the main analyses. Conclusion: Higher degrees of frailty were associated with an elevated risk of AKI following cardiac surgery, and total BF% moderated this relationship. This research underscores the significance of integrating frailty and body fat assessments into routine cardiovascular care to identify high-risk patients for AKI and implement personalized interventions to improve patient outcomes.
Effect of carbon nanoparticle suspension injection versus indocyanine green tracer in guiding lymph node dissection during radical gastrectomy (FUTURE-01): a randomized clinical trial
Authors: Yuan Tian, Yue Pang, Peigang Yang, Shuo Guo, Wenqian Ma, Honghai Guo, Yang Liu, Ze Zhang, Pingan Ding, Tao Zheng, Yong Li, Liqiao Fan, Zhidong Zhang, Dong Wang, Xuefeng Zhao, Bibo Tan, Yu Liu, Qun Zhao
Journal: International Journal of Surgery (2024)

Background: Carbon nanoparticle suspension injection (CNSI) and indocyanine green (ICG) have both been applied intraoperatively to facilitate lymphatic mapping and postoperatively to sort lymph nodes (LNs) in gastric cancer patients. However, no study has compared the two tracers in gastric cancer patients. Materials and Methods: This prospective randomized controlled trial was conducted from January 2022 to March 2023. Patients with potentially resectable gastric cancer (cT1-4a N0/+ M0) were randomized to the CNSI or ICG group. Results: This study enrolled 96 patients. Ninety patients were in the modified intention-to-treat population, including 46 patients (32 males and 14 females; mean [SD] age, 57.4 [9.4] years) in the CNSI group and 44 patients (31 males and 13 females; mean [SD] age, 60.8 [8.8] years) in the ICG group. The mean (SD) number of retrieved LNs was 69.8 (21.9) and 53.6 (17.2) in the CNSI and ICG groups, respectively ( P &lt;0.001). The mean (SD) number of retrieved micro-LNs was 19.9 (13.3) and 11.6 (9.9) in the CNSI and ICG groups, respectively ( P =0.001). The mean (SD) number of metastatic LNs was 8.1 (11.9) and 5.2 (9.2) in the CNSI and ICG groups, respectively ( P =0.19). Conclusions: Compared with ICG, CNSI can increase the number of LNs detected, especially micro-LNs. Both tracers have high diagnostic value for detecting metastatic LNs. CNSI-guided lymphography may be a superior method for improving the accuracy of LN dissection.
The potential roles of pelvic lymph node dissection in patients with prostate cancer: obtaining deeper understandings based on current clinical evidence
Authors: Jie Yang, Ting Peng, Hang Xu, Yujiao He, Qiang Wei, Hongbo Dong
Journal: International Journal of Surgery (2024)

Yang, Jie; Peng, Ting; Xu, Hang; He, Yujiao; Wei, Qiang; Dong, Hongbo Author Information
Advances in the use of microsurgery in neurogenic tumors: a bibliometric and visualization analysis
Authors: Zixin Luo, Xinyue Song, Duoqin Huang, Kang Zou, Li Xiao
Journal: International Journal of Surgery (2024)

aThe First Clinical Medical College, Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, the people's Republic of China bDepartment of Critical Care Medicine, the First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, the People's Republic of China cDepartment of Rehabilitation Medicine, the First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, the people's Republic of China Republic of China Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: First Affiliated Hospital of Gannan Medical University, CHINA. E-mail: [email protected] (K. Zou); . E-mail: [email protected] (L Xiao). This is an open access article distributed under the Creative Commons Attribution-ShareAlike License 4.0, which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-sa/4.0/
Interim analysis of short-term outcomes after laparoscopic spleen-preserving distal pancreatectomy with or without preservation of splenic vessels: a randomised controlled trial
Authors: Qiangxing Chen, Yangzhi Fu, Yongbin Li, He Cai, Xin Wang, Zhong Wu, Lingwei Meng, Man Zhang, Zixin Chen, Jingwen Jiang, Ke Cheng, Jun Li, Dian Zhang, Yu Cai, Jiaying You, Yunqiang Cai, Bing Peng
Journal: International Journal of Surgery (2024)

Background: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) is a widely adopted surgical approach for benign and low-grade malignant neoplasms of the distal pancreas. The Kimura and Warshaw techniques represent two principal strategies, yet it still needs to be determined which one is superior. Our investigation aimed to evaluate the clinical outcomes associated with each technique. Materials and Methods: This single-center, parallel-group, patient-blinded randomized controlled trial (RCT) was conducted at the XXXXX University. Stratified block randomization was utilized to enroll 114 patients starting in March 2022, with an interim analysis of short-term outcomes scheduled after 45%-50% of participant enrollment. Patients were randomized to receive LSPDP via either the Kimura or Warshaw technique. The primary endpoint was intraoperative blood loss, while secondary endpoints included a range of outcomes from composite outcome to quality of life, as quantified by the EQ-5D-5L. Results: From March 2022 to November 2023, 53 patients were randomly allocated to the Kimura (n=25) or Warshaw (n=28) groups for LSPDP. Baseline characteristics and postoperative outcomes were similar between the groups, such as pancreatic fistula incidence, EQ-5D-5L index scores, and delayed gastric emptying rates. Per-protocol (PP) analysis revealed that the Kimura group experienced significantly less blood loss (52.5±51.6 mL vs. 91.7±113.5 mL, P =0.007) and a reduced rate of composite outcome (23.8% vs. 56.7%, P =0.019), but incurred higher costs in the Warshaw group (¥56,227.4±¥7,027.0 vs. ¥63,513.8±¥12,944.5, P =0.013). Splenic infarction rates were higher in the Warshaw group, though not statistically significant (ITT: 39.3% vs. 12.5%, P =0.058; PP: 36.7% vs. 14.3%, P =0.113), without necessitating intervention. Neither group experienced postpancreatectomy haemorrhage, 90-day mortality, or ICU admissions, and all postoperative complications were mild (Clavien-Dindo Grade &lt;III). Conclusions: The 90-day interim analysis postoperatively indicates that both Kimura and Warshaw techniques for LSPDP are safe and viable. The Kimura technique, however, confers superior in terms of reduced intraoperative blood loss and fewer complications, alongside lower costs.
Amplifying Chinese physicians’ emphasis on patients’ psychological states beyond urologic diagnoses with ChatGPT—A multi-center cross-sectional study
Authors: Lei Peng, Rui Liang, Anguo Zhao, Ruonan Sun, Fulin Yi, Jianye Zhong, Rongkang Li, Shimao Zhu, Shaohua Zhang, Song Wu
Journal: International Journal of Surgery (2024)

Background: Artificial intelligence (AI) technologies, particularly large language models (LLMs), have been widely employed by the medical community. In addressing the intricacies of urology, ChatGPT offers a novel possibility to aid in clinical decision-making. This study aimed to investigate the decision-making ability of LLMs in solving complex urology-related problems and assess their effectiveness in providing psychological support to patients with urological disorders. Materials and methods: This study evaluated the clinical and psychological support capabilities of ChatGPT 3.5 and 4.0 in the field of urology. A total of 69 clinical and 30 psychological questions were posed to the AI models, and both urologists and psychologists evaluated their response. As a control, clinicians from Chinese medical institutions responded to closed-book conditions. Statistical analyses were conducted separately for each subgroup. Results: In multiple-choice tests covering diverse urological topics, ChatGPT 4.0 was performed comparably to the physician group, with no significant overall score difference. Subgroup analyses revealed variable performance based on disease type and physician experience, with ChatGPT 4.0 generally outperforming ChatGPT 3.5 and exhibiting competitive results against physicians. When assessing the psychological support capabilities of AI, it is evident that ChatGPT 4.0 outperforms ChatGPT 3.5 across all urology-related psychological problems. Conclusions: The performance of LLMs in dealing with standardized clinical problems and providing psychological support has certain advantages over clinicians. AI stands out as a promising tool for potential clinical aid.
Long-term outcomes of extensive thoracoabdominal aortic aneurysm repair utilizing normothermic iliac perfusion: A retrospective cohort study with 10-year single-center experience
Authors: Luchen Wang, Yanxiang Liu, Haoyu Gao, Mingxin Xie, Bowen Zhang, Sangyu Zhou, Xiangyang Qian, Cuntao Yu, Xiaogang Sun
Journal: International Journal of Surgery (2024)

Background: Normothermic iliac perfusion has been increasingly utilized for TAAA repair; however, the long-term outcomes in large samples are lacking. This study was designed to assesses the perioperative and long-term results of thoracoabdominal aortic repair using normothermic iliac perfusion. Methods: We retrospectively analyzed 156 patients having Crawford extent II or III thoracoabdominal aortic aneurysm replacement with normothermic iliac perfusion from 2012 to 2022. Primary endpoints were composite adverse events and long-term survival, which encompassed 30-day mortality, persistent stroke, persistent paraplegia, and acute renal failure needing continuous dialysis. The cohort was divided into two subgroups based on the use of selective visceral and cold renal perfusion techniques. Results: The combined adverse event rate was 14.1%. Specific rates were: 30-day mortality (4.5%), persistent stroke (1.9%), persistent paraplegia (4.5%), and renal failure requiring persistent dialysis (3.2%). The median follow-up time was 67 months. Overall survival rates at 1, 3, 5, 7, and 10 years were 91.6%, 90.0%, 85.4%, 77.6%, and 69.7%, respectively. Subgroup analysis showed the visceral and renal perfusion group had a significantly reduced adverse event incidence compared to the nonperfusion group (6.5% vs. 19.1%, P =0.026). Multivariable logistic regression analysis confirmed selective visceral and cold renal perfusion techniques as protective factors against postoperative adverse events (OR 0.30, 95%CI 0.09-0.94; P =0.038). Multivariable Cox regression analysis identified age ≥50 years (HR 2.63, 95%CI 1.10-6.27; P =0.029) and NYHA grade ≥III (HR: 3.20, 95% CI: 1.04-9.87; P =0.043) as independent risk factors predicting overall survival. Conclusions: Normothermic iliac perfusion is a feasible option for thoracoabdominal aortic repair with cost benefits and simpler management, and selective visceral and cold renal perfusion techniques may further improve its safety and effectiveness. However, enhanced vigilance and meticulous care are essential, particularly for elderly patients and those with cardiac insufficiency.
Assessing the global burden of mesothelioma: trends, socioeconomic influences, and asbestos exposure: a retrospective cohort study
Authors: Ziran Zhao, Jiagen Li, Fengwei Tan, Qi Xue, Shugeng Gao, Jie He
Journal: International Journal of Surgery (2024)

Introduction: Mesothelioma is an uncommon type of cancer which has received little attention. This study aims to evaluate the global disease burden; trends of mesothelioma by age, sex, and geographic locations; and its risk factors on the population level. Methods: The Global Cancer Observatory in 2022 and 2019 Global Burden of Disease were accessed for mesothelioma incidence and its risk factors worldwide. Multivariable linear regression analyses was conducted to explore the associations between mesothelioma incidence and key predictors including Human Development Index (HDI), Gross Domestic Product (GDP) per capita, and occupational asbestos exposure, adjusting for age and sex across global regions. Results: This study identified 30,870 global cases of mesothelioma in 2022, with a higher age-standardized incidence rate (ASR) in males (0.25 per 100,000) compared to females (0.39 per 100,000). Geographical analysis indicated the highest disease burden in Northern Europe, with particular prevalence in more developed regions. The incidence was also significantly associated with higher Human Development Index (HDI), with a beta coefficient of 0.133 overall, and Gross Domestic Product (GDP) per capita, with a beta coefficient of 0.101. These socioeconomic factors exhibited stronger associations in the elderly population, especially with HDI (β=0.512) and GDP (β=0.389), than in adults. Additionally, occupational exposure to asbestos remained a significant risk factor across all groups, except for the younger adult population, with an overall beta of 0.122 for incidence. The temporal trend analysis revealed a general decrease in mesothelioma incidence, particularly in the 15-49 years age group. Conclusions: The analysis indicates a higher mesothelioma incidence in males and in developed regions, with marked disparities noted particularly in Northern Europe. Significant correlations with socioeconomic indicators—HDI and GDP—and occupational asbestos exposure were identified, particularly affecting the elderly. Despite a decline in global incidence, especially among younger individuals, persistent cases in females highlight the need for continued public health measures addressing both occupational and environmental exposures.
Reoperation for ipsilateral local recurrence following prior nephron-sparing surgery: innovative surgical insights from a high-volume urological center with cross-sectional study
Authors: Wenming Ma, Wenlong Xu, Jialin Meng, Lei Chen, Sheng Tai, Cheng Yang, Jinhu Chen, Haoqiang Shi, Chaozhao Liang
Journal: International Journal of Surgery (2024)
Trends in all-cause and cause-specific mortality by BMI levels in England, 2004–2019: a population-based primary care records study
Authors: Marisa K Sophiea, Francesco Zaccardi, Yiling J Cheng, Eszter P Vamos, Naomi Holman, Edward W Gregg
Journal: The Lancet Regional Health - Europe (2024)

In the UK, obesity rates are rising concurrently with declining mortality rates. Yet, there is limited research on the shifts of mortality trends and the impact of obesity-related mortality. In this study, we examine mortality trends and the cause-specific proportional composition of deaths by body mass index.
Baseline Cardiac Parameters as Biomarkers of Radiation Cardiotoxicity in Lung Cancer
Authors: Gerard M. Walls, Nicola Hill, Michael McMahon, Brian óg Kearney, Conor McCann, Peter McKavanagh, Valentina Giacometti, Aidan J. Cole, Suneil Jain, Conor K. McGarry, Karl Butterworth, Jonathan McAleese, Mark Harbinson, Gerard G. Hanna
Journal: JACC CardioOncology (2024)

Radiation-induced cardiotoxicity poses a significant challenge in lung cancer management because of the close anatomical proximity of the heart to the lungs, compounded by a high prevalence of cardiovascular risk factors among patients.
Deep Inspiration Breath Hold in Left-Sided Breast Radiotherapy
Authors: Sara-Lise Busschaert, Eva Kimpe, Thierry Gevaert, Mark De Ridder, Koen Putman
Journal: JACC CardioOncology (2024)

Deep inspiration breath hold (DIBH) is an effective technique for reducing heart exposure during radiotherapy for left-sided breast cancer. Despite its benefits, cost considerations and its impact on workflow remain significant barriers to widespread adoption. This study aimed to assess the cost-effectiveness of DIBH and compare its operational, financial, and clinical outcomes with free breathing (FB) in breast cancer treatment. Treatment plans for 100 patients with left-sided breast cancer were generated using both DIBH and FB techniques. Dosimetric data, including the average mean heart dose, were calculated for each technique and used to estimate the cardiotoxicity of radiotherapy. A state-transition microsimulation model based on SCORE2 (Systematic Coronary Risk Evaluation) algorithms projected the effects of DIBH on cardiovascular outcomes and quality-adjusted life-years (QALYs). Costs were calculated from a provider perspective using time-driven activity-based costing, applying a willingness-to-pay threshold of €40,000 for cost-effectiveness assessment. A discrete event simulation model assessed the impacts of DIBH vs FB on throughput and waiting times in the radiotherapy workflow. In the base case scenario, DIBH was associated with an absolute risk reduction of 1.72% (95% CI: 1.67%-1.76%) in total cardiovascular events and 0.69% (95% CI: 0.67%-0.72%) in fatal cardiovascular events over 20 years. Additionally, DIBH was estimated to provide an incremental 0.04 QALYs (95% CI: 0.05-0.05) per left-sided breast cancer patient over the same time period. However, DIBH increased treatment times, reducing maximum achievable throughput by 12.48% (95% CI: 12.36%-12.75%) and increasing costs by €617 per left-sided breast cancer patient (95% CI: €615-€619). The incremental cost-effectiveness ratio was €14,023 per QALY. Despite time investments, DIBH is cost-effective in the Belgian population. The growing adoption of DIBH may benefit long-term cardiovascular health in breast cancer survivors.
Mediterranean Diet Is Associated With Lower All-Cause and Cardiovascular Mortality Among Long-Term Cancer Survivors
Authors: Marialaura Bonaccio, Augusto Di Castelnuovo, Simona Costanzo, Emilia Ruggiero, Simona Esposito, Teresa Panzera, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello
Journal: JACC CardioOncology (2024)
Clonal Hematopoiesis Is Associated With Cardiomyopathy During Solid Tumor Therapy
Authors: Etienne Leveille, Rachel Jaber Chehayeb, Carlos Matute-Martinez, Nathan W. Chen, Ritujith Jayakrishnan, Anthos Christofides, Derrick Lin, Yunju Im, Giulia Biancon, Jennifer VanOudenhove, Stephanie Halene, Jennifer M. Kwan
Journal: JACC CardioOncology (2024)
Less focus on symptom scales in psychiatric trials: it is time to ensure research equality between psychiatry and other medical specialities
Authors: Sophie Juul, Faiza Siddiqui, Pascal Faltermeier, Johanne Juul Petersen, Caroline Barkholt Kamp, Rikke Hermann Jakobsen, Lehana Thabane, Joanna Moncrieff, Mark Horowitz, Zainab Samaan, Michael Pascal Hengartner, Lawrence Mbuagbaw, Markus Harboe Olsen, Christian Gluud, Janus Christian Jakobsen
Journal: The Lancet Regional Health - Europe (2024)
Circulating tumor cells with increasing aneuploidy predict inferior prognosis and therapeutic resistance in small cell lung cancer
Authors: Zhongpeng Xie, Yanxia Wang, Tingfei Chen, Wei Fan, Lihong Wei, Bixia Liu, Xiaohua Situ, Qinru Zhan, Tongze Fu, Tian Tian, Shuhua Li, Qiong He, Jianwen Zhou, Huipin Wang, Juan Du, Hsian-Rong Tseng, Yiyan Lei, Ke-Jing Tang, Zunfu Ke
Journal: Drug Resistance Updates (2024)
Clinical validation of the novel fluorescent glomerular filtration rate tracer agent relmapirazin (MB-102)
Authors: Richard B. Dorshow, Martin P. Debreczeny, Stuart L. Goldstein, Jeng-Jong Shieh
Journal: Kidney International (2024)

The fluorescent compound relmapirazin has been rationally designed for use in point-of-care measurement of glomerular filtration rate (GFR), with attributes including negligible protein binding, negligible metabolites in vivo, negligible tubular secretion, and excellent chemical and photo stability. Twenty-four nonclinical assays were performed in accordance with FDA requirements yielding negligible toxicology concerns. Here, a clinical study was performed to validate relmapirazin as a GFR tracer in patients by comparison to iohexol. This was evaluated in 120 adults at three clinical sites with eGFR values ranging from normal to Stage 4 chronic kidney disease. Relmapirazin and iohexol were administered intravenously in consecutive boluses to each subject and serial blood samples obtained over the subsequent 12 hours. Plasma concentrations were measured and the corresponding plasma GFR for each agent was determined using a standard two-compartment pharmacokinetic assessment. Urine from each subject was collected for the entire 12-hour study period to measure the amount of administered dose appearing in the urine. A near perfect linear regression correlation was observed between the GFRs measured by these two tracers (r