bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of laparoscopy-assisted gastrectomy versus open gastrectomy to long-term survival for early gastric cancer: an updated meta-analysis based on randomized controlled trials
Authors: Zhai Zhao , Lou Shenghan , Zhu Ziyu , Cong Xiliang , Gao Jialiang , Han Bangling , Yin Xin , Zhang Yu , Xue Yingwei 
Published: June 2020

Abstract
BackgroundThere is a controversy for the therapeutic effect of laparoscopy-assisted gastrectomy (LADG) and open gastrectomy for a long time. The meta-analysis in this article evaluates and compares the effectiveness of these two treatments to patients' long-term survival.MethodWe searched MEDLINE (PubMed), EMBASE (Ovid) and the Cochrane Library and identified all qualified researches from January 2002 to January 2020. The statistic analysis is performed by Revman 5.3 and Version 3 Comprehensive Meta-analysis. Through the results, we compared the advantages and long-term survival of LADG and ODG.ResultAccording to the result of 8 randomized controlled trials which involves 2650 patients with early gastric cancer, compared with ODG, LAGD has longer surgery time (MD=78.11，95%CI=59.14-97.07，P＜0.00001), less blood loss (MD=-100.59，95%CI=-127.71--73.46，P＜0.00001), a shorter incision (MD=-12.25，95%CI=-13.18--11.31，P＜0.00001), shorter time to start the first time of flatus (MD=-0.66，95%CI=-1.01--0.32，P=0.0001), shorter hospital stay (MD=-0.94，95%CI=-1.66--0.22，P=0.01), and lower frequency of analgesic utilization (MD=-1.69，95%CI=-2.18--1.21，P＜0.00001). However, there is no statistical difference between ODG and LAGD on the number of harvested lymph nodes, time of the first meal, short-term surgical complications, cancer recurrence rate, and long-term survival rate.ConclusionAccording to the result of meta-analysis, compared with ODG, LADG has a significant advantage in blood loss in surgery, early rehabilitation, scar development, management of postoperative pain, etc. Meanwhile, LADG and ODG have the same performance on long-term survival. Therefore, we believe LADG is a safe and effective replacement of ODG for early gastric cancer.
Modeling and Simulation to Improve the Efficiency of Transportation Systems: A Tool for Decision Support
Authors: Suryani Erma , Hendrawan Rully Agus , Adipraja Philip Faster Eka , Indraswari Rarasmaya , Ahyudanari Ervina , Jauhari Achmad , Prambayanto Prasetyo 
Published: June 2020

Abstract
The authors have withdrawn this preprint due to author disagreement.
Development and Validation of a Nomogram to Predict Deteriorating Trajectory in Patients with COVID-19 Infection: A Population-Based Prospective Study
Authors: Chen Wei , Zhu Menglin , Li Jian , Pan Cuiping , Zhao Demian , Jin Yuting , Li Manxiu , Wu Shun , Feng Yaojun , Wang Tiejun 
Published: June 2020

Abstract
Background Most of the patients with COVID-19 infection are mild to moderate initially. However, there is no effective prediction for the patients to develop into severe or extremely severe. This study aims to develop an effective clinical prediction model.Methods A single-center, retrospective, observational study conducted. A nomogram was conducted based on the results of multivariate logistic regression analysis. Results A total of 483 patients diagnosed mild to moderate were included, among these patients 62 developed severe or extremely critical illness. Seven variables including hyperlipidemia, vomiting, diarrhea, lymphocyte, imaging and mentality were associated with deteriorating trajectory. The ROC curve showed that model was robust, for which the area under the curve of the training set and the validation set are 0.873 and 0.813.Conclusions For patients with mild to moderate COVID-19 infection, nomogram score can effectively predict the possibility of patients developing into severe or extremely critical.
Comparison of sagittal spinopelvic parameters in different types of double-level degenerative lumbar spondylolisthesis: a retrospective study
Authors: zhang guangzhi , Deng Yajun , He Xuegang , Ren Enhui , Wu Zuolong , Yang Fengguang , Yang Liang , Ma Zhanjun , Gao Yichen , Guo Xudong , Wang Yidian , Liu Mingqiang , Zhu Daxue , Kang Xuewen 
Published: June 2020

Abstract
Background

Degenerative lumber spondylolisthesis (DLS), a common orthopaedic disease causing low back pain, seriously affects daily life and work. Although sagittal spinopelvic parameters have been studied in single-level DLS patients, investigations into different types of double-level DLS are scarce. This study aims to analyse the demographic and radiological parameters of patients with different types of double-level DLS and compare their differences to provide a reference for guiding surgical treatment and restoring sagittal balance of DLS patients.
Methods

From January 2014 to January 2020, double-level DLS patients’ records were retrospectively reviewed and divided into three types: anterior, posterior, and combined; the anterior and combined types were studied. Two spin surgeons measured the sagittal spinopelvic parameters: C7 tilt, maximal thoracic kyphosis (TKmax), maximal lumbar lordosis (LLmax), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Following descriptive analysis, demographic and radiographic data were compared between the anterior and combined types.
Results

Patients in the anterior type group (n = 40) were older (67.68 ± 6.66 vs. 61.72 ± 10.06 years, P = 0.031), and the proportion of females were significantly higher (90% vs. 50%, P = 0.001) than the combined group (n = 18). Both groups had different levels of chronic lower back pain, but the incidence of radiating leg pain and neurogenic claudication was significantly higher in the anterior type. Owestry disability index and visual analogue scale lower back scores were also higher in the anterior type. In the anterior type, C7 tilt (7.14 ± 2.15 vs. 5.41 ± 2.28, P = 0.007), LLmax (50.02 ± 14.76 vs. 36.96 ± 14.56, P = 0.003), PI (68.28 ± 9.16 vs. 55.53 ± 14.19, P < 0.001), PT (28.68 ± 7.31 vs. 19.38 ± 4.70, P < 0.001), and PT/PI (42.45 ± 11.22 vs. 36.04 ± 9.87, P = 0.041) were significantly higher. In the anterior type, PI correlated significantly positively with LLmax (r = 0.59) and SS (r = 0.71). LLmax and SS (r = 0.65) had a positive correlation. PT/PI and SS (r = -0.77) had a negative correlation. In the combined type, PI correlated positively with LLmax (r = 0.61) and SS (r = 0.88), and PT/PI correlated negatively with SS (r = -0.81).
Conclusions

In patients with double-level DLS, the sagittal spinopelvic parameters differ between the anterior and combined types. PI and LLmax were significantly higher in the anterior type, resulting in compensation by forward flexion and pelvic retroversion. Spinal surgeons should focus on correcting sagittal deformities, relieving postoperative clinical symptoms, and improving quality of life during fusion surgery, which is proven to guarantee long-term surgical results.
Association between smoking and cancers among women: results from the FRiCaM multisite cohort study
Authors: Mezzoiuso Angelo Giosuè , Odone Anna , Signorelli Carlo , Russo Antonio Giampiero 
Published: June 2020

Abstract
BackgroundSmoking is one of the leading causes of death worldwide, and it is strongly associated with several human cancers. However, the differential effects of cigarette smoke on the development and progression of different types of cancer remain unclear, and related data are limited.MethodsIn this longitudinal cohort study conducted among 75,324 women aged 41–76 years, we aimed to evaluate the effect of exposure to tobacco smoke on cancer development. The participants completed a questionnaire assessing sociodemographic characteristics, anthropometric measures, health status, and lifestyle habits, including smoking and dietary habits; Cox proportional hazards regression modelling was used to evaluate the association between smoking and 21 different types of cancer.ResultsAfter a 15-year follow-up, 9,487 cases of cancer were identified through record linkage with the Cancer Registry of Milan. Smoking was found to be positively associated with all neoplasms, with a hazard ratio 1.10 (95% CI, 1.04–1.16); cancer of the oral cavity 2.63 (1.72–4.01]), oesophagus 3.09 (1.37–6.96), stomach 1.52 (1.10–2.11), pancreas 1.69 (1.29–2.21), larynx 34.81 (8.07-150.14), lung 8.48 (7.09–10.14), cervix uteri 2.51 (1.38–4.57), and bladder and urinary tract 5.67 ( 3.96–8.14); lymphoma 1.37 (1.03–1.83); and colorectal cancer 1.30 (1.11–1.51).ConclusionsOur results thus demonstrate how smoke exposure increases the risk of several types of cancer. Considering the increasing prevalence of smoking among women, our results highlight the need to prioritize the development of anti-smoking campaigns targeted at women in order to contrast the evident gender inequality with respect to healthcare.
A Preliminary Study on the Utility of Root® with SedLine® for Sleep Evaluation in Critically Ill Patients: Comparison With Polysomnography and the Richards−Campbell Sleep Questionnaire
Authors: Nagatomo Kanae , Sanui Masamitsu , Masuyama Tomoyuki , Iizuka Yusuke , Makino Jun , Shiotsuka Junji 
Published: June 2020

Abstract
Background To date, there has not been a practical evaluation of patient sleep in critical care units, where sleep disturbance is commonly found. This study aimed to validateฎ a portable electroencephalography monitor, as a sleep monitoring device, against polysomnography (PSG) for objective sleep evaluation and the Richards − Campbell Sleep Questionnaire (RCSQ) for subjective sleep quality in critically ill patients.Methods In this observational study, the sleep pattern of 10 adult patients staying in an ICU for at least 72 hours was evaluated for 24 hours using PSG and the Patient State Index (PSI) from SedLine. Additionally, their nighttime sleep was subjectively scored using the RCSQ to compare with the objective parameters.Results Sleep architecture from PSG showed an increase in light sleep and a prominent decrease in restorative sleep, despite preserved quantity of nocturnal sleep. Based on PSG results, PSI was distributed in accordance with sleep depth. Subjective quality of nocturnal sleep from the RCSQ was correlated with the PSI (r = -0.816, 95% confidence interval [CI]: -0.955 to -0.383), as well as with the nighttime stage N2 ratio from PSG alone (r = 0.741, 95% CI: 0.209 to 0.935) or combined with restorative sleep (r = 0.801, 95% CI: 0.347 to 0.951). The cutoff value of PSI to distinguish between the stage N1 and N2 was 67.0 (specificity, 0.641; sensitivity, 0.845 with area under curve [AUC] of 0.818).Conclusion SedLine is considered a feasible and valid instrument for sleep quality assessment in ICU patients.Trial registration: This investigation was part of an interventional trial registered with the University Hospital Medical Information Network Individual Clinical Trials Registry (UMIN-CTR000026350, http://www.umin.ac.jp/icdr/index-j.html) on March 1, 2017.
Technical Efficiency and Productivity of Tobacco Control Policies in 16 Selected OECD Countries: A Comparative Study Using Data Envelopment Analysis, 2008-2014
Authors: Lari Majid Safaei , Raei Behzad , Tehrani Pedram Nourizadeh , Takian Amirhossein 
Published: June 2020

Abstract
Background: To date, there is no synthesized evidence about the technical efficiency (TE) of cross-country tobacco control policies. This study aims to measure the efficiency and productivity of tobacco control policies across 16 selected countries of Organization for Economic Co-operation and Development (OECD) from 2008 to 2014.Method: We used data envelopment analysis (DEA). MPOWER is an acronym for a WHO proposed package consisting of six tobacco reduction interventions that can be adapted to present a commitment of the parties to a treaty labeled FCTC (Framework Convention on Tobacco Control).Taxation on tobacco products and pictorial warning labels were chosen as the inputs. Percentage of daily smokers’ population above 15 years old and the number of cigarettes used per smoker per day were output variables. Additionally, the Malmquist total factor productivity (TFP) was used to analyze the panel data and measure productivity change and technical efficiency changes over time.Results: The highest TE score (1.05) was attributed to Norway and the lowest (0.9175) belonged to the United Kingdom (UK). Technological change with a total average of 1.069 would imply that the technology and creativity have increased, while countries have been able to promote their creativity over the time period. Norway with the TFP score of 1.15 was the most productive country, while the UK and Turkey with the TFP scores of 0.95 and .098 respectively, were the least productive countries in the implementation of the MPOWER policies.Conclusion: Most OECD countries have productively implemented MPOWER policies. Such productive performances are the results of the strong pivotal pictorial warnings. Consequently, the policy of plain packaging seems to hamper the MPOWER policies. Taxation on tobacco products were relatively weak and inefficient.
Regulation on BCAAs catabolism pathway plays the key role in cyclophosphamide-induced leucopenia BALB/c mice after the treatment of a typical Traditional Chinese Medicine of Lvjiao Buxue Granules
Authors: Tian Jun-sheng , Zhao Hui-liang , Wang Qi , Xiang Huan , Xu Xiang-ping , Huang Sheng , Yan Dong-lan , Qin Xue-mei 
Published: June 2020

Abstract
Background: Cyclophosphamide is a common tumor chemotherapy drug used to treat various cancers, but the resulting immunosuppression leads to leukopenia, which is a serious limiting factor in clinical application. Therefore, the introduction of immunomodulators as adjuvant therapy may help to reduce the hematological side effects of cyclophosphamide. Lvjiao Buxue Granules has been widely used in clinical treatment of gynecological diseases such as anemia and irregular menstruation, and recently, it has been found to increase the role of white blood cells, but its mechanism of action is still unclear. In this research, we applied the 1H-NMR metabolomics approach to characterize metabolites in cyclophosphamide-induced leucopenia mice spleen, so as to fully understand the metabolic processes of leucopenia and improve the leukocyte function of Lvjiao Buxue Granules.Methods: Cyclophosphamide was used to establish the leucopenia mice with cancer chemotherapy and the content of white blood cells, red blood cells, hemoglobin, platelets, and other routine blood indexes were measured. The changes of endogenous metabolites in spleen analyzed by 1H-NMR metabolomics technique were investigated the regulation effect of LBG in mice with leukopenia. Afterward, the chemical components-targets-differential metabolites network of Lvjiao Buxue Granules was constructed by the use of biological targets network, thus leucopenia-relevant metabolism pathways were dissected. Results: The blood routine parameters and organ indexes levels of leucopenia mice with cancer chemotherapy were improved by Lvjiao Buxue Granules. The metabolomic study revealed that 15 endogenous metabolites in mice spleen were considered as potential biomarkers of Lvjiao Buxue Granules for its protective effect. Integrated analysis of metabolomics and biological targets network indicated that Lvjiao Buxue Granules exerted the leukocyte elevation activity by inhibiting the branched-chain amino acids (BCAAs) degradation pathway and increasing the levels of valine, leucine and isoleucine. Conclusion: Lvjiao Buxue Granules exert obvious efficacy on the mice model of leucopenia, which could be improved by regulating the branched-chain amino acid degradation pathway and the levels of valine, leucine and isoleucine.
Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture
Authors: Jin Sheng-Yu , Jin Jing-Yao , Kim Woo-Jong , Yoon Taek-Rim , Park Kyung-Soon 
Published: June 2020

Abstract
Background Failed treatment of subtrochanteric fractures commonly leads to pain, limping, and poor function. Cementless total hip arthroplasty (THA) could be an option as a salvage procedure in such cases. This study was to evaluate the clinical and radiological results and complications of this treatment in our hospital. Method Eighteen cementless THAs for failed treatment of subtrochanteric fractures were performed at our institution between January 2001 to December 2017. There were eleven males and seven females, and the average age was 74 years (range 57.0-89.0). Eight patients were previously operated with an intramedullary nail, six patients were treated with a dynamic hip screw, two patients were treated with an angled blade plate, one patient was treated with a proximal femur locking plate, and one patient was treated with a dynamic compression plate. Results The mean follow-up was 5.2 years (range 2.2-10.8). The mean duration of the operation was 98.0 minutes (standard deviation [SD],15.4; range 70-135). The mean total blood loss was 992.2 mL (SD,171.2; range 640-1260 mL), and the amount of transfusion was 2.2 units (SD, 0.8, range 1-4). The mean Harris hip score (HHS) was 38.2 (SD, 9.3; range, 24-56) preoperatively and 85.4 (SD, 4.9; range, 79-92) at the last follow-up. Compared to the patients treated with plate-screws, those treated with an intramedullary nail had significantly shorter surgical duration, fewer blood transfusions, and less intraoperative blood loss. Kaplan-Meier survivorship with an endpoint of revision was 94.4% (95% confidence interval 72.7-99.9) at five years. Conclusion Cementless THA is one of the acceptable procedures for failed treatment of the subtrochanteric fracture with fewer complications.
Determinants of Private Investment Contracts in the Basic Sanitation Sector: Evidence for Developing Countries
Authors: Borges Dianifer Leal , Fernandez Rodrigo Nobre , Shikida Cláudio Djissey , Costa Luciana de Andrade 
Published: June 2020

Abstract
Investment in infrastructure is a key factor for improving the quality of life of the population and, consequently, for the economic development of nations. In this context, the universalization of water and sanitation services is of great importance due mainly to their impact on public health. Based on the work of Yehoue et al. (2006) and Sharma (2012), this article studies the determinants of the number of private investment contracts for the basic sanitation sector. In the empirical analysis, with a panel of developing countries during the years 2003-2016, we use the following counting estimators to study the number of contracts in the sector: Negative, Poisson, Negative Binomial, and Zero Inflated negative binomial with corrected Vuong (ZINBCV). The results show that the channels of the macroeconomic environment, foreign investment and the political environment are the main determinants in the formulation of new contracts in the basic sanitation sector.
Effects of Preoperative Oral Carbohydrate on Cirrhotic Patients Under Endoscopic Therapy with Anesthesia: A Randomized Controlled Trial
Authors: Wang Yan , Tu Yichun , Liu Zhenglv , Li Hui , Chen Hongtan , Cheng Baoli , Fang Xiangming 
Published: June 2020

Abstract
Background: Preoperative fasting is a major cause of perioperative discomfort in patients. Addressing this problem by preoperative oral carbohydrate (POC) has been recommended as an important element of the enhanced recovery after surgery (ERAS) protocol, but its effect on cirrhotic patients who tend to show abnormalities in gastric emptying function has not yet been clarified. Our study aims to investigate the influence of POC on gastric empting and preoperative well-being in cirrhotic patients. Methods: A prospective, randomized and controlled study of cirrhotic patients with gastroesophageal varices scheduled for elective endoscopic therapy under intravenous anesthesia was conducted. 180 patients were enrolled in this study. Patients were divided into three groups: those not supplement with carbohydrate for 8h prior to endoscopic therapy (Control group), those given a carbohydrate beverage 2h (2h group) or 4h (4h group) prior to endoscopy. Gastric emptying was evaluated by gastric sonography score and collecting gastric content aspirated endoscopically before anesthesia. Stresses caused by examination associated fasting were evaluated by visual analogue scale (VAS) scores for six parameters (thirst, hunger, mouth dryness, nausea, vomit and weakness) preoperatively. Hemodynamic changes, peristole and postoperative complications were also recorded. Results: Before anesthesia, gastric sonography score was similar among three groups. In addition, no patient had residual gastric volume more than 1.5ml/kg in control and 4h group, but six patients (11%) reached a residual gastric volume of more than 1.5ml/kg in 2h group. Moreover, compared with control fasting, VAS scores for six parameters (thirst, hunger, mouth dryness, nausea, vomiting and fatigue) in 2h group and for three parameters (thirst, hunger and mouth dryness) in 4h group were both significantly lower. Gastric peristaltic score and operation score before operation, postoperative complication, lengths of hospital stay and in-hospital expense were not significantly different among three groups.Conclusions: For the first time, we demonstrate that avoiding preoperative fasting with oral carbohydrates given 4h prior to anesthesia can improve preoperative well-being feelings, without enhancing the risk of aspiration and regurgitation in cirrhotic patients. Our study adds knowledge for preoperative fasting guidelines in anesthesia for cirrhotic patients. Trial registration: This trial was registered at Clinicaltrials.gov under the number ChiCTR2000032394.
Caring For Children With Congenital Heart Diseases: Economic Burden Of Pre-Surgical Treatment On Nigerian Families
Authors: Duru Chika Onyinyechi , OKPOKOWURUK Frances SAM , ADESINA ADEDOTUN DANIEL DANIEL , WORGU GLORY OVUNDA , ADENIJI FOLUKE OLUKEMI , Aliyu Ibrahim 
Published: June 2020

Abstract
Background Congenital Heart Disease (CHD) places an enormous economic burden on families of affected children in Nigeria. This study sought to determine the healthcare costs of pre-surgical management of CHD and describe its effects on the family’s income.Methods Using a semi-structured interviewer-administered questionnaire, family income, type of CHD, co-morbidity, healthcare payment mechanism and healthcare cost were investigated among 121 families with CHD children. Indicators of Catastrophic Health Expenditure (CHE); healthcare spending in excess of 10% family income were calculated. Factors associated with increased healthcare spending in CHD management were explored using the Kruskal Wallis test of significance.Results Of the 121 parents interviewed, about 80% paid for healthcare using out-of-pocket payment mechanism. Mean annual total cost of healthcare was ₦87,951± ₦120,213 ($244.31± $333.92) with direct medical care accounting for 81.0% of this total annual cost. Mean annual consultation, medication, investigation and admission cost were ₦5,515 ($15.32), ₦57,882 ($160.78), ₦30,462 ($84.62) and ₦87,789 ($243.86) respectively. Mean estimated annual indirect cost was ₦19,233 ± ₦31,722 ($53.42 ± $88.12). Incidence of CHE was 35.5% while catastrophic overshoot and mean positive overshoot attributable to CHD healthcare cost were 6.5% and 32.9% of family income respectively. Healthcare cost was significantly higher in families of children with co-morbidities (p = 0.016) and those who suffered financial catastrophe (p = 0.001). Health insurance did not significantly reduce healthcare spending among the insured.Conclusion The economic burden of pre-surgical management of children with CHD is high in Nigeria. There is the need to scale up the inclusion of CHD under the National health insurance scheme.