bluuebunny/crossref_metadata_2025 huggingface dataset:
Autorrepresentación de escritores-investigadores: dos casos de crónicas periodísticas argentinas entre la ficción y la no ficción en el comienzo del siglo XXI
Authors: Ramallo. Carolina
Published: February 2024

El artículo analiza de forma comparada dos modos de autorrepresentación de escritores investigadores de crónicas periodísticas argentinas leídas por la crítica literaria como narraciones documentales. Trabajamos con el modo en que la figura del escritor investigador funciona en El interior. La primera Argentina de Martín Caparrós (2009) y Cuando me muera quiero que me toquen cumbia (2007) y Si me querés quereme transa (2010) de Cristian Alarcón, ya que ofrecen dos maneras distintas de tratar el contacto con la otredad, la distancia cultural y las jerarquías sociales, pero fundamentalmente porque nos permiten analizar el modo en que la escritura de crónicas articula procedimientos de ficción y no ficción explorando los límites y alcances de la representación literaria. La metodología de trabajo que orientó esta investigación recoge los aportes de la teoría literaria, la crítica cultural y el análisis textual, de modo tal que abordamos la problemática de la delimitación del estatuto ficcional de los textos produciendo una lectura de procedimientos a la luz de reflexiones teóricas que nos permitan, simultáneamente, analizar las fuentes y producir un conocimiento nuevo sobre el objeto estudiado.
Processing and Applications of Shape Memory Alloys
Authors: Datta Sudipto , Jain Nipun , Waidi Yusif Olatunji , Barua Ranjit
Published: February 2024

SMA (shape memory alloys) materials are a kind of smart material that undergoes shape changes with respect to temperature variations. In this chapter, the authors focus on the microstructure, classifications, fabrication, and future applications of these materials in brief. They discuss the four main types of SMA processing techniques, which include mechanical, thermomechanical, powder metallurgy, and melting route. Finally, its applications in various fields like transportation, civil structures, robotics, aerospace, automation, and medical fields will be briefly discussed.
The Evolving Landscape of Micro-Learning
Authors: Das Sima , Manna Monojit , Modak Subrata
Published: February 2024

Micro learning has emerged as a transformative approach to learning and development, presenting short, focused, and engaging learning modules tailored to the needs of modern learners. This study delves into the evolving landscape of micro learning trends, challenges, and opportunities to understand how this innovative method is shaping education, training, and personal development. Through a comprehensive literature review, data collection, and analysis, the research identifies emerging trends in micro learning, showcasing the integration of cutting-edge technologies such as artificial intelligence,
Effectiveness of Gamification in Facilitating Microlearning for Gen Z
Authors: Savithri M. , Philip Shynu , Sharma Tanya , Singh Nitish Kumar
Published: February 2024

This chapter offers a thorough examination of the uses, advantages, and difficulties of gamification in higher education. In contrast to game-based learning, gamification uses specific game features to improve the learning experience. This chapter investigates the use of gamification to engage and inspire Generation Z (Gen Z) pupils with the goal of enhancing their academic performance. It underlines the necessity for game development that increases motivation and engagement in educational settings and highlights the measurement of student progress based on completed activities. Effective instructional approaches are crucial in a time where there is a constant stream of information and people have short attention spans. A promising approach to overcoming these difficulties in both online and offline education utilizing ICT technologies is offered as gamified microlearning, which combines microlearning and games.
Impact of Attitude on Job Performance of Teachers in South Asian Higher Educational Institutions
Authors: Asthana Ashok , Sinha Anand Prasad , Srivastava Swati
Published: February 2024

The development of a region/nation largely depends on the quality of education provided as education is a powerful tool having potential to bring socio economic, technological development to a society. To strengthen the educational system of a country/region, the teacher, teaching standards, and supporting infrastructure should be prompt. The main objective of this study is to carry out a systematic investigation to find out the inter relationship between attitude and job. The outcome of the chapter highlights a positive correlation/impact of attitude on respective performance (job performance) of teachers. Also the demographic factors like age, qualification, and experience impact the job performance in positive directions. The inputs from the chapter will help the higher educational institutions to frame strategies and policies to strengthen, develop, and innovate the higher educational infrastructure and system.
Preservice Teachers' Implementation of Academic Language After Engaging in Literature Circles
Authors: Jackson Virginie , Cone Neporcha
Published: February 2024

This chapter highlights the ways in which preservice teachers incorporate culturally responsive literacy lessons by integrating academic language supports while working with elementary-school students after engaging in multicultural literature circles. The authors sought to prepare teacher candidates for the demands of today's classrooms by using literature circles—a small group of individuals who gather to discuss and analyze a specific piece of literature, fostering collaborative exploration and understanding of the text—that were culturally responsive and incorporated academic language supports as a teaching strategy. Twenty-five junior year teacher candidates were evaluated during a semester-long literacy methods course conducted in southeastern, United States. The findings highlight the importance of supporting preservice teachers as they cultivate the ability to foster learning in culturally and linguistically diverse students.
Activism in Academic Writing in the Arts
Authors: Salayo Juland Dayo
Published: February 2024

This qualitative content analysis (QCA) of art research aims to determine how academic writing manifests activism and develops critical writing pedagogy. Supported by the Freirean ideology of critical pedagogy and art activism, analysis shows that art researchers' activism is built through their connection with social realities and role identification necessary to construct concrete plans and actions addressing those inequalities and oppressive practices. Ultimately, art could serve as a form and platform for social change. Achieving these becomes instrumental in constructing a solid concept of critical writing pedagogy, specifically characterized by transformative and sustainable writing practices. The results further proved that romanticized activism may occur in a pedagogical radicalization necessary to define activism as a meaningful engagement with change.
The Impacts of a Redefined HEI Image Model on Postgraduate International Students' Satisfaction in Malaysia
Authors: Manzoor Shamima Raihan , Chong Siong Choy , Al-Mahmud Abdullah , Asmawi Arnifa
Published: February 2024

The influx of international students has moved beyond the Global North towards the Global South in countries like China, Malaysia, Singapore, and Hong Kong as they pursue strategies to become an international education hub in Asia. This massive competition among higher education institutions (HEIs) worldwide necessitates revisiting the existing image models to understand their heightened impacts on student satisfaction for both retaining existing students and attracting new ones. This study attempts to do so by gathering responses from 200 international postgraduate students from two renowned universities in Malaysia. The redefined HEI image model based on postgraduate international students shows that all of its three dimensions have a positive significant impact on students' satisfaction and decision-making. The outcomes of importance-performance map analysis (IPMA) have yielded the results of PLS-SEM both at the construct and indicator levels toward building more socially responsible HEIs as a service industry to boost student satisfaction in both regular and uncertain times.
Metabolic Syndrome and Lifestyle Factors in Patients with Schizophrenia: A Cross-Sectional Hospital-Based Study
Authors: Kantipudi Suvarna Jyothi , Jayachandran Samyukta , Sathianathan Ramanathan
Published: February 2024

Background:

Patients with schizophrenia are more likely to develop cardiovascular diseases such as myocardial infarction and stroke which result in premature deaths. The increased prevalence of these risk factors can be attributed to several reasons such as physical inactivity, poor diet, substance use, and treatment with second-generation antipsychotics. There is a paucity of studies on metabolic syndrome and its association with lifestyle risk factors in Low and Middle Income Countries (LAMIC) nations.

Aims:

This study aimed to estimate the prevalence of metabolic syndrome as per the National Cholesterol Education Program Adult Treatment Panel III criteria and to assess association in relation to sociodemographic, clinical, and lifestyle-related variables.

Methods:

A cross-sectional study design was employed. All consecutive patients with the Diagnostic and Statistical Manual of Mental Disorders-5 diagnosis of schizophrenia in the age group of 18–65 years were enrolled in the study after obtaining written informed consent. Statistical analysis was done using the software SPSS version 20. The demographic and clinical data are presented in frequencies, mean, and standard deviation. The Chi-square test was used to assess the significance of associations between categorical variables.

Results:

The prevalence of metabolic syndrome is 41% in patients with schizophrenia in urban hospital settings. Majority of patients reported low-moderate intensity physical activity, low fiber intake, and high fat intake. This study had shown a positive association of metabolic syndrome with female gender after adjusting other variables found in univariate analysis.

Conclusions:

The burden of cardiometabolic risk factors in patients with schizophrenia is quite high. There is a need for early screening and effective intervention to decrease morbidity and mortality in patients with schizophrenia.
Assessment of peel bond strength between two facial prosthetic materials after surface treatment methods: In vitro study
Authors: Ahmed Ali Saad , Kamil Saif Saad , Arab Luma Nasrat
Published: February 2024

Aim:

The bonding between acrylic resin to silicone liners in maxillofacial devices is vital for the maintenance of prosthetic parts. This study aims to provide insights into the effectiveness of different surface treatments in enhancing the bond between materials used in maxillofacial prosthetics, which is crucial to ensure both quality and durability in prosthetic applications.

Materials and Methods:

This in vitro study involves the fabrication of 30 specimens, with each specimen involving an acrylic part bonded to a silicone part. Each specimen measures 75 mm in length, 10 mm in width, and 6 mm in thickness. These dimensions are controlled and standardized for consistency. The study includes a total of 30 specimens, which represent the sample size, and it is divided into three groups (ethyl acetate, aluminum oxide sandblasting, and silicon carbide [SiC] paper), with each group having 10. Subsequently, the peel bonding strength was tested using a universal testing machine. All data were analyzed by one-way analysis of variance and Tukey’s post hoc tests at a level of α = 0.05.

Results:

Surface-treated specimens with ethyl acetate had the highest peel strength (PS) values (3.4138) followed by those treated with aluminum oxide sandblasting (2.3204) and SiC paper (1.8153), respectively.

Conclusions:

Surface treatment showed a varying impact on the PS of different materials. The ethyl acetate group benefited the most from the treatment, the sandblasting group experienced a moderate improvement, and the SiC group had the least improvement in peel bond strength.
Orthodontic patient’s perspectives, attitudes, and readiness toward teleorthodontics
Authors: Siti Nasir H , Nur Md Hasidin A , Azlini Ismail
Published: February 2024

Aim:

To evaluate the perspective, attitude, and readiness of orthodontic patients toward teleorthodontics.

Materials and Methods:

This prospective study was conducted at an orthodontic specialist clinic, Kulliyyah of Dentistry, Kuantan Pahang, Malaysia, involving all 46 orthodontic patients requiring active orthodontic treatment from February to July 2021. Patients were offered four options of online consultation: telephone call, virtual meeting, WhatsApp messaging, and a combination of all three methods. An online survey was distributed after the online consultations to assess patients’ perspectives, attitudes, and readiness toward teleorthodontics. Descriptive statistics were used to summarize the demographic data. Mann–Whitney U test and Kruskal–Wallis test were used to compare the patient’s perspectives, attitudes, and readiness toward teleorthodontics based on their demographic background. A Spearman’s correlation coefficient looked at the linear relationship between the perspective, attitude, and readiness toward teleorthodontics practice.

Results:

About 82.4% agreed that teleorthodontics was convenient. About 82% agreed that teleorthodontics should be practiced during the pandemic and 72% agreed that it should be practiced after the pandemic. About 89.1% agreed that teleorthodontics bring benefits during the pandemic, and 74% agreed that teleorthodontics might bring benefits after the pandemic. No significant difference was found between sociodemographic background with the total scores of patients’ perspectives, readiness, and attitude toward teleorthodontics.

Conclusions:

The majority of the patients showed good perspective, attitude, and readiness toward teleorthodontics. Teleorthodontics on certain clinical procedures can be implemented postpandemic to reduce in-office orthodontic visits.
Adhesion strength of orthodontic brackets to provisional crowns: A systematic review
Authors: Alharbi Fahad
Published: February 2024

Aim:

This systematic review assessed the shear bond strength of orthodontic brackets bonded to temporary crowns. The study followed PRISMA guidelines and the Cochrane Guidelines for Systematic Reviews, with a registered protocol (PROSPERO: CRD42023447478).

Materials and Methods:

in vitro studies were included, while animal studies, case reports, and abstracts were excluded. A comprehensive search strategy was implemented in multiple databases and supplemented with manual searches. Two independent reviewers screened studies, and data were extracted using a standardized form. Risk of bias was assessed using the RoBDEMAT tool. Meta-analysis was performed using random-effects models.

Results:

Out of 514 identified records, 21 studies were included. Various surface conditioning methods, adhesives, and brackets were used. Shear bond strength ranged from 0.03 to 22.54 MPa. Most studies had a risk of bias due to inadequate reporting. Significant heterogeneity was observed and outliers were removed.

Conclusions:

This review highlights the importance of combining chemical and mechanical surface treatments for bonding orthodontic brackets to provisional crowns. However, further research with rigorous methodology is required to establish more conclusive findings.
Comparison of Cerebral Blood Circulation of Fetuses with Congenital Heart Disease with Healthy Fetuses
Authors: Patir Muserref Gamze , Guven Emine Seda Guvendag , Albayrak Mehmet , Guven Suleyman
Published: February 2024

Background:

The effect of congenital cardiac malformation on fetal cerebral circulation has not been well known. This study aimed to compare the cerebral blood circulation of fetuses with congenital heart disease (CHD) with healthy fetuses.

Methods:

This prospective cohort study included 37 pregnant women who presented to the gynecology and obstetrics department of department of Farabi Hospital, Faculty of Medicine, Karadeniz Technical University for anomaly screening in the second trimester. The women were divided into two groups as those with fetuses having CHD and healthy fetuses. Middle cerebral artery (MCA), peak systolic velocity (PSV), pulsatility index (PI), resistivity index (RI), systole/diastole (S/D) ratio, and MCA transverse section diameter (mm) were recorded for each fetus.

Results:

The most common CHDs were truncus arteriosus and hypoplastic left heart syndrome. The mean MCA PSV, resistivity index, and MDCA vessel diameter values were statistically significantly higher in the study group compared with fetuses without CHDs. The mean PI and systole/diastole ratio were statistically significantly lower in the study group than in the control group.

Conclusion:

This study reported that MCA PSV, RI, and vessel diameter were significantly higher and the S/D ratio and PI were significantly lower in fetuses with CHD compared to the healthy fetuses.
Age Estimation Using Machine Learning Algorithms with Parameters Obtained from X-ray Images of the Calcaneus
Authors: Ciftci R , Secgin Y , Oner Z , Toy S , Oner S
Published: February 2024

ABSTRACT

Background:

Determination of bone age is a critical issue for forensics, surgery, and basic sciences.

Aim:

This study aims to estimate age with high accuracy and precision using Machine Learning (ML) algorithms with parameters obtained from calcaneus x-ray images of healthy individuals.

Method:

The study was carried out by retrospectively examining the foot X-ray images of 341 people aged 18-65 years. Maximum width of the calcaneus (MW), body width (BW), maximum length (MAXL), minimum length (MINL), facies articularis cuboidea height (FACH), maximum height (MAXH), and tuber calcanei width (TKW) parameters were measured from the images. The measurements were then grouped as 20-45 years of age, 46-64 years of age, 65 and older, and age estimation was made by using these at the input of ML models.

Results:

As a result of the ML input of the measurements obtained, a 0.85 Accuracy (Acc) rate was obtained with the Extra Tree Classifier algorithm. The accuracy rate of other algorithms was found to vary between 0.78 and 0.82. The contribution of parameters to the overall result was evaluated by using the shapley additive explanations (SHAP) analyzer of Random Forest algorithm and the MAXH parameter was found to have the highest contribution in age estimation.

Conclusions:

As a result of our study, calcaneus bone was found to have high accuracy and precision in age estimations.
Outcomes of in-hospital cardiac arrests during and after office hours in a single tertiary centre in Singapore
Authors: Tien Jong-Chie Claudia , Ching Yi Hao Edgarton , Tan Hui Li , Lee Jun Jie , Leong Kah Lai Carrie
Published: February 2024

Introduction:

In-hospital cardiac arrest (IHCA) is a significant healthcare burden with a paucity of data in Singapore. Various factors, including time of cardiac arrest, affect survival from acute resuscitation.

Methods:

This was a retrospective cohort study that evaluated the characteristics of patients who sustained an IHCA, including the Cardiac Arrest Survival Post Resuscitation In-hospital (CASPRI) scores, and the impact of arrest time in 220 consecutive cardiac arrests occurring in a tertiary hospital. The primary outcome was rate of return of spontaneous circulation (ROSC) post-IHCA, and the secondary outcome was 90-day survival.

Results:

The ROSC rate among patients with IHCA out of and during office hours was 69.5% and 75.4%, respectively (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.39–1.42). There were no statistically significant differences between the CASPRI scores of both groups. After adjusted analysis, the OR of ROSC post-IHCA out of office hours as compared to that during office hours was 0.78 (95% CI 0.39–1.53). The 90-day survival rate of patients who had an IHCA out of and during office hours was 25.7% and 34.6%, respectively (OR 0.65, 95% CI 0.32–1.34). The adjusted OR of 90-day survival was 0.66 (0.28–1.59).

Conclusion:

The results of this observational study did not show an association between the timing of cardiac arrest and the rate of ROSC or 90-day survival.
Actuality and underlying mechanisms of systemic immune-inflammation index and geriatric nutritional risk index prognostic value in hepatocellular carcinoma
Authors: Tchilikidi Konstantin Y
Published: February 2024

This editorial contains comments on the article “Correlation between preoperative systemic immune inflammation index, nutritional risk index, and prognosis of radical resection of liver cancer” in a recent issue of the World Journal of Gastrointestinal Surgery . It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immune-inflammation index (SII) and geriatric nutritional risk index (GNRI) prediction features valuable. There are few publications on both SII and GNRI together in hepatocellular carcinoma (HCC) and patient prognosis after radical surgery. Neutrophils release cytokines, chemokines, and enzymes, degrade extracellular matrix, reduce cell adhesion, and create conditions for tumor cell invasion. Neutrophils promote the adhesion of tumor cells to endothelial cells, through physical anchoring. That results in the migration of tumor cells. Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs. Platelets can form a protective film on the surface of tumor cells. This allows avoiding blood flow damage as well as immune system attack. It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness. High SII is also associated with macro- and microvascular invasion and increased numbers of circulating tumor cells. A high GNRI was associated with significantly better progression-free and overall survival. HCC patients are a very special population that requires increased attention. SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings. The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features. Those features provide tumor nutrition, growth, and distribution throughout the body, such as vascular invasion. On the other hand, they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings. The article is of considerable interest. It would be helpful to continue the study follow-up to 2 years and longer. External validation of the data is needed.
Mutational landscape of TP53 and CDH1 in gastric cancer
Authors: Cai Hong-Qiao , Zhang Li-Yue , Fu Li-Ming , Xu Bin , Jiao Yan
Published: February 2024

In this editorial we comment on an article published in a recent issue of the World J Gastrointest Surg . A common gene mutation in gastric cancer (GC) is the TP53 mutation. As a tumor suppressor gene, TP53 is implicated in more than half of all tumor occurrences. TP53 gene mutations in GC tissue may be related with clinical pathological aspects. The TP53 mutation arose late in the progression of GC and aided in the final switch to malignancy. CDH1 encodes E-cadherin, which is involved in cell-to-cell adhesion, epithelial structure maintenance, cell polarity, differentiation, and intracellular signaling pathway modulation. CDH1 mutations and functional loss can result in diffuse GC, and CDH1 mutations can serve as independent prognostic indicators for poor prognosis. GC patients can benefit from genetic counseling and testing for CDH1 mutations. Demethylation therapy may assist to postpone the onset and progression of GC. The investigation of TP53 and CDH1 gene mutations in GC allows for the investigation of the relationship between these two gene mutations, as well as providing some basis for evaluating the prognosis of GC patients.
Overview of ectopic pancreas
Authors: Li Chang-Fei , Li Qiu-Ru , Bai Miao , Lv Yuan-Shi , Jiao Yan
Published: February 2024

This editorial discusses the article written by Zheng et al that was published in the latest edition of the World Journal of Gastrointestinal Surgery . Our primary focus is on the causes, location, diagnosis, histological classification, and therapy of ectopic pancreas. Ectopic pancreas refers to the presence of pancreatic tissue that is situated in a location outside its usual anatomical placement, and is not connected to the normal pancreas in terms of blood supply or anatomical structure. Currently, the embryological origin of ectopic pancreas remains uncertain. The most prevalent form of ectopic pancreatic is gastric ectopic pancreas. Endoscopic ultrasonography examination can visualize the morphological characteristics of the ectopic pancreatic lesion and pinpoint its anatomical location. The histological categorization of ectopic pancreas evolves. Endoscopic treatment has been widely advocated in ectopic pancreas.
Classification of anatomical morphology of cystic duct and its association with gallstone
Authors: Zhu Jia-Hai , Zhao Song-Ling , Kang Qiang , Zhu Ya , Liu Li-Xin , Zou Hao
Published: February 2024

BACKGROUND

Gallstones are common lesions that often require surgical intervention. Laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstones. Preoperatively, the anatomical morphology of the cystic duct (CD), needs to be accurately recognized, especially when anatomical variations occur in the CD, which is otherwise prone to bile duct injury. However, at present, there is no optimal classification system for CD morphology applicable in clinical practice, and the relationship between anatomical variations in CDs and gallstones remains to be explored.

AIM

To create a more comprehensive clinically applicable classification of the morphology of CD and to explore the correlations between anatomic variants of CD and gallstones.

METHODS

A total of 300 patients were retrospectively enrolled from October 2021 to January 2022. The patients were divided into two groups: The gallstone group and the nongallstone group. Relevant clinical data and anatomical data of the CD based on magnetic resonance cholangiopancreatography (MRCP) were collected and analyzed to propose a morphological classification system of the CD and to explore its relationship with gallstones. Multivariate analysis was performed using logistic regression analyses to identify the independent risk factors using variables that were significant in the univariate analysis.

RESULTS

Of the 300 patients enrolled in this study, 200 (66.7%) had gallstones. The mean age was 48.10 ± 13.30 years, 142 (47.3%) were male, and 158 (52.7%) were female. A total of 55.7% of the patients had a body mass index (BMI) ≥ 24 kg/m2. Based on the MRCP, the CD anatomical typology is divided into four types: Type I: Linear, type II: n-shaped, type III: S-shaped, and type IV: W-shaped. Univariate analysis revealed differences between the gallstone and nongallstone groups in relation to sex, BMI, cholesterol, triglycerides, morphology of CD, site of CD insertion into the extrahepatic bile duct, length of CD, and angle between the common hepatic duct and CD. According to the multivariate analysis, female, BMI (≥ 24 kg/m2), and CD morphology [n-shaped: Odds ratio (OR) = 10.97, 95% confidence interval (95%CI): 5.22-23.07, P < 0.001; S-shaped: OR = 4.43, 95%CI: 1.64-11.95, P = 0.003; W-shaped: OR = 7.74, 95%CI: 1.88-31.78, P = 0.005] were significantly associated with gallstones.

CONCLUSION

The present study details the morphological variation in the CD and confirms that CD tortuosity is an independent risk factor for gallstones.
Will partial splenic embolization followed by splenectomy increase intraoperative bleeding?
Authors: Huang Long , Li Qing-Lin , Yu Qing-Sheng , Peng Hui , Zhen Zhou , Shen Yi , Zhang Qi
Published: February 2024

BACKGROUND

Partial splenic embolization (PSE) has been suggested as an alternative to splenectomy in the treatment of hypersplenism. However, some patients may experience recurrence of hypersplenism after PSE and require splenectomy. Currently, there is a lack of evidence-based medical support regarding whether preoperative PSE followed by splenectomy can reduce the incidence of complications.

AIM

To investigate the safety and therapeutic efficacy of preoperative PSE followed by splenectomy in patients with cirrhosis and hypersplenism.

METHODS

Between January 2010 and December 2021, 321 consecutive patients with cirrhosis and hypersplenism underwent splenectomy at our department. Based on whether PSE was performed prior to splenectomy, the patients were divided into two groups: PSE group (n = 40) and non-PSE group (n = 281). Patient characteristics, postoperative complications, and follow-up data were compared between groups. Propensity score matching (PSM) was conducted, and univariable and multivariable analyses were used to establish a nomogram predictive model for intraoperative bleeding (IB). The receiver operating characteristic curve, Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis (DCA) were employed to evaluate the differentiation, calibration, and clinical performance of the model.

RESULTS

After PSM, the non-PSE group showed significant reductions in hospital stay, intraoperative blood loss, and operation time (all P = 0.00). Multivariate analysis revealed that spleen length, portal vein diameter, splenic vein diameter, and history of PSE were independent predictive factors for IB. A nomogram predictive model of IB was constructed, and DCA demonstrated the clinical utility of this model. Both groups exhibited similar results in terms of overall survival during the follow-up period.

CONCLUSION

Preoperative PSE followed by splenectomy may increase the incidence of IB and a nomogram-based prediction model can predict the occurrence of IB.
Machine learning-based radiomics score improves prognostic prediction accuracy of stage II/III gastric cancer: A multi-cohort study
Authors: Xiang Ying-Hao , Mou Huan , Qu Bo , Sun Hui-Rong
Published: February 2024

BACKGROUND

Although accurately evaluating the overall survival (OS) of gastric cancer patients remains difficult, radiomics is considered an important option for studying prognosis.

AIM

To develop a robust and unbiased biomarker for predicting OS using machine learning and computed tomography (CT) image radiomics.

METHODS

This study included 181 stage II/III gastric cancer patients, 141 from Lichuan People's Hospital, and 40 from the Cancer Imaging Archive (TCIA). Primary tumors in the preoperative unenhanced CT images were outlined as regions of interest (ROI), and approximately 1700 radiomics features were extracted from each ROI. The skeletal muscle index (SMI) and skeletal muscle density (SMD) were measured using CT images from the lower margin of the third lumbar vertebra. Using the least absolute shrinkage and selection operator regression with 5-fold cross-validation, 36 radiomics features were identified as important predictors, and the OS-associated CT image radiomics score (OACRS) was calculated for each patient using these important predictors.

RESULTS

Patients with a high OACRS had a poorer prognosis than those with a low OACRS score (P < 0.05) and those in the TCIA cohort. Univariate and multivariate analyses revealed that OACRS was a risk factor [RR = 3.023 (1.896-4.365), P < 0.001] independent of SMI, SMD, and pathological features. Moreover, OACRS outperformed SMI and SMD and could improve OS prediction (P < 0.05).

CONCLUSION

A novel biomarker based on machine learning and radiomics was developed that exhibited exceptional OS discrimination potential.
Risk stratification in gastric cancer lung metastasis: Utilizing an overall survival nomogram and comparing it with previous staging
Authors: Chen Zhi-Ren , Yang Mei-Fang , Xie Zhi-Yuan , Wang Pei-An , Zhang Liang , Huang Ze-Hua , Luo Yao
Published: February 2024

BACKGROUND

Gastric cancer (GC) is prevalent and aggressive, especially when patients have distant lung metastases, which often places patients into advanced stages. By identifying prognostic variables for lung metastasis in GC patients, it may be possible to construct a good prediction model for both overall survival (OS) and the cumulative incidence prediction (CIP) plot of the tumour.

AIM

To investigate the predictors of GC with lung metastasis (GCLM) to produce nomograms for OS and generate CIP by using cancer-specific survival (CSS) data.

METHODS

Data from January 2000 to December 2020 involving 1652 patients with GCLM were obtained from the Surveillance, epidemiology, and end results program database. The major observational endpoint was OS; hence, patients were separated into training and validation groups. Correlation analysis determined various connections. Univariate and multivariate Cox analyses validated the independent predictive factors. Nomogram distinction and calibration were performed with the time-dependent area under the curve (AUC) and calibration curves. To evaluate the accuracy and clinical usefulness of the nomograms, decision curve analysis (DCA) was performed. The clinical utility of the novel prognostic model was compared to that of the 7th edition of the American Joint Committee on Cancer (AJCC) staging system by utilizing Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI). Finally, the OS prognostic model and Cox-AJCC risk stratification model modified for the AJCC system were compared.

RESULTS

For the purpose of creating the OS nomogram, a CIP plot based on CSS was generated. Cox multivariate regression analysis identified eleven significant prognostic factors (P < 0.05) related to liver metastasis, bone metastasis, primary site, surgery, regional surgery, treatment sequence, chemotherapy, radiotherapy, positive lymph node count, N staging, and time from diagnosis to treatment. It was clear from the DCA (net benefit > 0), time-dependent ROC curve (training/validation set AUC > 0.7), and calibration curve (reliability slope closer to 45 degrees) results that the OS nomogram demonstrated a high level of predictive efficiency. The OS prediction model (New Model AUC = 0.83) also performed much better than the old Cox-AJCC model (AUC difference between the new model and the old model greater than 0) in terms of risk stratification (P < 0.0001) and verification using the IDI and NRI.

CONCLUSION

The OS nomogram for GCLM successfully predicts 1- and 3-year OS. Moreover, this approach can help to appropriately classify patients into high-risk and low-risk groups, thereby guiding treatment.
Systemic inflammatory response index is a predictor of prognosis in gastric cancer patients: Retrospective cohort and meta-analysis
Authors: Ren Jing-Yao , Xu Meng , Niu Xiang-Dong , Ma Shi-Xun , Jiao Ya-Jun , Wang Da , Yu Miao , Cai Hui
Published: February 2024

BACKGROUND

The systemic inflammatory response index (SIRI) has been demonstrated to make a significant difference in assessing the prognosis of patients with different solid neoplasms. However, research is needed to ascertain the accuracy and reliability of applying the SIRI to patients who undergo robotic radical gastric cancer surgery.

AIM

To validate the applicability of the SIRI in assessing the survival of gastric cancer patients and evaluate the clinical contribution of preoperative SIRI levels to predicting long-term tumor outcomes in patients, who received robotic radical gastric cancer surgery.

METHODS

Initially, an exhaustive retrieval was performed in the PubMed, the Cochrane Library, EMBASE, Web of Science, and Scopus databases to identify relevant studies. Subsequently, a meta-analysis was executed on 6 cohort studies identifying the value of the SIRI in assessing the survival of gastric cancer patients. Additionally, the clinical data of 161 patients undergoing robotic radical gastric cancer surgery were retrospectively analyzed to evaluate their clinicopathological characteristics and relevant laboratory indicators. The association between preoperative SIRI levels and 5-year overall survival (OS) and disease-free survival (DFS) was assessed.

RESULTS

The findings demonstrated an extensive connection between SIRI values and the outcome of patients with gastric cancer. Preoperative SIRI levels were identified as an independent hazard feature for both OS and DFS among those who received robotic surgery for gastric cancer. SIRI levels in gastric cancer patients were observed to be associated with the presence of comorbidities, T-stage, carcinoembryonic antigen levels, the development of early serious postoperative complications, and the rate of lymph node metastasis.

CONCLUSION

SIRI values are correlated with adverse in the gastric cancer population and have the potential to be utilized in predicting long-term oncological survival in patients who undergo robotic radical gastric cancer surgery.
Development of a clinical nomogram for prediction of response to neoadjuvant chemotherapy in patients with advanced gastric cancer
Authors: Liu Bing , Xu Yu-Jie , Chu Feng-Ran , Sun Guang , Zhao Guo-Dong , Wang Sheng-Zhong
Published: February 2024

BACKGROUND

The efficacy of neoadjuvant chemotherapy (NAC) in advanced gastric cancer (GC) is still a controversial issue.

AIM

To find factors associated with chemosensitivity to NAC treatment and to provide the optimal therapeutic strategies for GC patients receiving NAC.

METHODS

The clinical information was collected from 230 GC patients who received NAC treatment at the Central South University Xiangya School of Medicine Affiliated Haikou Hospital from January 2016 to December 2020. Least absolute shrinkage and selection operator logistic regression analysis was used to find the possible predictors. A nomogram model was employed to predict the response to NAC.

RESULTS

In total 230 patients were finally included in this study, including 154 males (67.0%) and 76 females (33.0%). The mean age was (59.37 ± 10.60) years, ranging from 24 years to 80 years. According to the tumor regression grade standard, there were 95 cases in the obvious response group (grade 0 or grade 1) and 135 cases in the poor response group (grade 2 or grade 3). The obvious response rate was 41.3%. Least absolute shrinkage and selection operator analysis showed that four risk factors significantly related to the efficacy of NAC were tumor location (P < 0.001), histological differentiation (P = 0.001), clinical T stage (P = 0.008), and carbohydrate antigen 724 (P = 0.008). The C-index for the prediction nomogram was 0.806. The calibration curve revealed that the predicted value exhibited good agreement with the actual value. Decision curve analysis showed that the nomogram had a good value in clinical application.

CONCLUSION

A nomogram combining tumor location, histological differentiation, clinical T stage, and carbohydrate antigen 724 showed satisfactory predictive power to the response of NAC and can be used by gastrointestinal surgeons to determine the optimal treatment strategies for advanced GC patients.
Preoperative neutrophil-to-lymphocyte ratio predicts symptomatic anastomotic leakage in elderly colon cancer patients: Multicenter propensity score-matched analysis
Authors: Wang Chao-Yang , Li Xiao-Long , Ma Xiao-Long , Yang Xiong-Fei , Liu Yong-Yong , Yu Yong-Jiang
Published: February 2024

BACKGROUND

The neutrophil-to-lymphocyte ratio (NLR), a composite inflammatory biomarker, is associated with the prognosis in patients with colorectal tumors. However, whether the NLR can be used as a predictor of symptomatic postoperative anastomotic leakage (AL) in elderly patients with colon cancer is unclear.

AIM

To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer.

METHODS

Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed. Receiver operating characteristic curve analysis was performed to determine the best predictive cutoff value for the NLR. Twenty-two covariates were matched using a 1:1 propensity score matching method, and univariate and multivariate logistic regression analyses were used to determine risk factors for the development of postoperative AL.

RESULTS

Of the 577 patients included, 36 (6.2%) had symptomatic AL. The optimal cutoff value of the NLR for predicting AL was 2.66. After propensity score matching, the incidence of AL was significantly greater in the ≥ 2.66 NLR subgroup than in the < 2.66 NLR subgroup (11.5% vs 2.5%; P = 0.012). Univariate logistic regression analysis revealed statistically significant correlations between blood transfusion intraoperatively and within 2 d postoperatively, preoperative albumin concentration, preoperative prognostic nutritional index, and preoperative NLR and AL occurrence (P < 0.05); multivariate logistic regression analysis revealed that an NLR ≥ 2.66 [odds ratio (OR) = 5.51; 95% confidence interval (CI): 1.50-20.26; P = 0.010] and blood transfusion intraoperatively and within 2 d postoperatively (OR = 2.52; 95%CI: 0.88-7.25; P = 0.049) were risk factors for the occurrence of symptomatic AL.

CONCLUSION

A preoperative NLR ≥ 2.66 and blood transfusion intraoperatively and within 2 d postoperatively are associated with a higher incidence of postoperative symptomatic AL in elderly patients with colon cancer. The preoperative NLR has predictive value for postoperative symptomatic AL after elective surgery in elderly patients with colon cancer.
Development of a new Cox model for predicting long-term survival in hepatitis cirrhosis patients underwent transjugular intrahepatic portosystemic shunts
Authors: Lv Yi-Fan , Zhu Bing , Meng Ming-Ming , Wu Yi-Fan , Dong Cheng-Bin , Zhang Yu , Liu Bo-Wen , You Shao-Li , Lv Sa , Yang Yong-Ping , Liu Fu-Quan
Published: February 2024

BACKGROUND

Transjugular intrahepatic portosystemic shunt (TIPS) placement is a procedure that can effectively treat complications of portal hypertension, such as variceal bleeding and refractory ascites. However, there have been no specific studies on predicting long-term survival after TIPS placement.

AIM

To establish a model to predict long-term survival in patients with hepatitis cirrhosis after TIPS.

METHODS

A retrospective analysis was conducted on a cohort of 224 patients who underwent TIPS implantation. Through univariate and multivariate Cox regression analyses, various factors were examined for their ability to predict survival at 6 years after TIPS. Consequently, a composite score was formulated, encompassing the indication, shunt reasonability, portal venous pressure gradient (PPG) after TIPS, percentage decrease in portal venous pressure (PVP), indocyanine green retention rate at 15 min (ICGR15) and total bilirubin (Tbil) level. Furthermore, the performance of the newly developed Cox (NDC) model was evaluated in an internal validation cohort and compared with that of a series of existing models.

RESULTS

The indication (variceal bleeding or ascites), shunt reasonability (reasonable or unreasonable), ICGR15, postoperative PPG, percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS placement. The NDC model incorporated these parameters and successfully identified patients at high risk, exhibiting a notably elevated mortality rate following the TIPS procedure, as observed in both the training and validation cohorts. Additionally, in terms of predicting the long-term survival rate, the performance of the NDC model was significantly better than that of the other four models [Child-Pugh, model for end-stage liver disease (MELD), MELD-sodium and the Freiburg index of post-TIPS survival].

CONCLUSION

The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis, help identify high-risk patients and guide follow-up management after TIPS implantation.
"Five steps four quadrants" modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in laparoscopic pancreaticoduodenectomy
Authors: Hu Xiao-Si , Wang Yong , Pan Hong-Tao , Zhu Chao , Chen Shi-Lei , Liu Hui-Chun , Pang Qing , Jin Hao
Published: February 2024

BACKGROUND

Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment, the feasibility and safety of this approach for laparoscopic pancreaticoduodenectomy (LPD) require further clinical evaluation and investigation.

AIM

To explore the application value of the "five steps four quadrants" modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.

METHODS

A total of 52 patients who underwent LPD via the "five steps four quadrants" modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively. The patients' body mass index (BMI), preoperative laboratory indices, intraoperative variables and postoperative complications were recorded. The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.

RESULTS

Among the 52 patients, 36 were males and 16 were females, and the average age was 62.2 ± 11.0 years. There were 26 patients with pancreatic head cancer, 16 patients with periampullary cancer, and 10 patients with distal bile duct cancer. The BMI was 22.3 ± 3.3 kg/m², and the median total bilirubin (TBIL) concentration was 57.7 (16.0-155.7) µmol/L. All patients successfully underwent the "five steps four quadrants" modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage. Correlation analysis revealed significant associations between preoperative BMI (r = 0.3581, P = 0.0091), TBIL level (r = 0.2988, P = 0.0341), prothrombin time (r = 0.3018, P = 0.0297) and lymph node dissection time. Moreover, dissection time was significantly correlated with intraoperative blood loss (r = 0.7744, P < 0.0001). Further stratified analysis demonstrated that patients with a preoperative BMI ≥ 21.9 kg/m² and a TIBL concentration ≥ 57.7 μmol/L had significantly longer lymph node dissection times (both P < 0.05).

CONCLUSION

The "five steps four quadrants" modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD. This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve; thus, it is worthy of further clinical promotion and application.