bluuebunny/crossref_metadata_2025_split huggingface dataset:
Çocuklarda klinik olarak anlamlı üst gastrointestinal sistem kanama için risk faktörleri
Authors: AYDEMİR Yusuf , ULUKAPI Hasan , BARIŞ Zeren 
Published: May 2020

Giriş ve Amaç: Üst gastrointestinal sistem kanaması çocukluk çağında çoğunlukla hafif olmakla birlikte, hayatı tehdit eden ciddi kanama şeklinde de görülebilmektedir. Bu çalışmada klinik olarak anlamlı üst gastrointestinal sistem kanamasına işaret eden bulguların ve risk faktörlerinin belirlenmesi amaçlandı.
Gereç ve Yöntem: Çalışmaya üst gastrointestinal sistem kanaması tanısı alan, 0-18 yaş aralığında çocuklar alındı. Tanı anındaki yaşı, cinsiyeti, kanama miktarı, hematemez, melena varlığı, başvuru anındaki yakınmaları, eşlik eden hastalıkları, kanamaya yatkınlık yaratan ilaç kullanımı, vital bulguları, kapiller dolum zamanı ve sistemik fizik muayene bulguları kaydedildi. Laboratuvar tetkiklerinden hemogram, biyokimya, koagülasyon testleri, endoskopik işlem bulguları, eritrosit transfüzyonu sayısı, uygulanan medikal ve/veya endoskopik tedaviler, acilde ya da serviste izlemleri ve kanama açısından konulan son tanısı kaydedildi. Sheffield skorlamasına göre 8 puan ve üzeri alanlar anlamlı üst gastrointestinal sistem kanaması olanlar olarak gruplandı, veriler gruplar arasında karşılaştırıldı.
Bulgular: Elli beş çocuk [29 (%52.7) kız, 26 (%47.3) erkek; ortalama tanı yaşı 8.4±5.4 yıl] çalışmaya alındı. Başvuru anında 22 hastada anemi, 20 hastada kan üre azotu yüksekliği, 14 hastada eritrosit sayısında düşüklük, 5 hastada hipoalbüminemi vardı. Anlamlı kanaması olan 17 hastada; melena (%76.5 vs. %21.1, p
El legado de las voces y los escritos: su valor como testimonio de la cultura escolar
Authors: Mayordomo Alejandro 
Published: May 2020

RESUMO
O artigo analisa as maneiras pelas quais as vozes e os escritos do passado, tanto os que chegaram até nós como os que ainda podemos obter de pessoas vivas, podem contribuir de maneira especial para o conhecimento e a interpretação da cultura escolar do passado. Defendemos que eles constituem um patrimonio histórico-educativo muito importante e valioso, que deve ser salvo e aproveitado. Através do mesmo são indicadas as potencialidades e os valores desses recursos, “egodocumentos”, e também seus problemas, bem como limitações e cautelas a serem consideradas pelo investigador. Em todo o trabalho se repassa e analisa diversos aspectos: o valor dos “testemunhos” como objeto de interpretação; o sentido e as contribuições da “memoria” e de seus quadros sociais; a relação significativa que se establece entre memoria e “emoção”, uma vinculação que nos permite captar e revelar “vivencias” de práticas escolares. O artigo termina oferecendo um conjunto sintético, de desafios e caminhos de pesquisa e estudo, que aponta esse campo como sugestivo e necessário, o que nos permitirá não apenas conhecimento descritivo, mas também “personalizar” os protagonistas, contextualizando-os em sua comunidade sociopolítica.
Patrimônio-Educativo. Egodocumentos. Cultura escolar.
Extraskeletal Para-articular Osteochondroma of the Ankle Joint in a Child
Authors: Kawakami Yohei , Hara Hitomi , Kawamoto Teruya , Niikura Takahiro , Kuroda Ryosuke , Akisue Toshihiro 
Published: May 2020

Case:
We present a rare case of extraskeletal para-articular osteochondroma (ESPAOC) in the ankle of a 9-year-old boy, which was causing pain and limiting the range of motion of the ankle joint. The lesion might have also contributed to the deformity of the medial aspect of the talus. Total resection resolved all of the symptoms, with no recurrence at 1-year postoperatively.

Conclusion:
Operative excision should be considered when ESPAOC directly restricts ankle motion because it can lead to chronic pain and joint degeneration if left untreated.
The pattern of life events preceding suicide among the elderly in rural China: a national case-control psychological autopsy study
Authors: Mo Qiqing , Wang Guojun , Jia Cunxian , Niu Lu , Zhou Liang , Ma Zhenyu 
Published: May 2020

Abstract
Background: There is a lack of evidence of life events prior to suicide and associated with an increasing suicide risk for Chinese rural elderly. The aim of this study was to identify the pattern of life events which precede suicide among the elderly in a Chinese culture context. Methods: A total of 12 counties were randomly selected using two-stage stratified cluster sampling method. 242 suicide cases aged 60 years and older were collected from these counties from February 2014 to September 2015. 242 living controls were matched by age, gender, and location. Data in current study were collected through face-to-face interviews by psychological autopsy method. The 46-item Life Event Scale for the Elderly was used to measure the life events before suicide/interviews. Results: Approximately 99.6% of suicides and 88.4% of controls experienced at least one type of life event. The suicide elderly experienced more long-term life events than recent life events. The top three most frequent life events were being diagnosed with chronic disease, hospitalization, and being diagnosed with terminal illness for suicide elderly. More female suicides experienced the death of spouse, while more males experienced hospitalization, diagnosed with terminal illness and suffered family poverty. Experienced at least one type of life events, had unstable marital status, physical diseases and mental disorders were the probability-changing factors for suicide.Conclusions: Life events were common for the rural elderly, especially long-term life events. The experience of any type of life events is the probability-changing factor for suicide. More attention should be paid to the rural elderly who experienced more long- term life events and experienced health related life events.
Reliability of Optic Disc Edema Area in Estimating the Severity of Papilledema in Patients with POEMS Syndrome
Authors: Liu Ling-shan , Zhang Xiao , Zhao Hao , Gao Xue-min , Zhou Dao-bin , Dai Rongping , Li Jian 
Published: May 2020

Abstract
Background: Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome is a rare paraneoplastic syndrome involving multisystem. Optic disc edema (ODE) is the most common ocular manifestation in patients with POEMS syndrome and serves as an independent prognostic factor. However, parameters previously used to estimate its severity were inconvenient and costly. This study was designed to bring forward a novel and practical parameter, optic disc edema area, to evaluate ODE in patients with this disease and applied it to assess effectiveness of lenalidomide combined with dexamethasone in respect of ODE.Results: Forty-one treatment-naive patients with POEMS syndrome were enrolled in this single-center prospective study and treated with lenalidomide combined with dexamethasone. They received ocular examination to determine optic disc edema (ODE) area and other optic manifestations. Meanwhile, serum VEGF was measured before and after treatment. Among 41 enrolled patients, 38 received complete ocular examinations, and 25 of which had ODE at initial visit. Binocular mean ODE area of patients with ODE was significantly related to ODE grade (r = 0.620, p = 0.003) and peripapillary retinal thickness (r = 0.760, p < 0.001) before treatment. Serum VEGF was significantly higher in patients with ODE than their counterparts (p = 0.025) and positively correlated with binocular mean ODE area (r = 0.460, p = 0.036). After treatment, ODE area, along with serum VEGF, decreased markedly (p < 0.001).Conclusion: ODE area was a reliable index to evaluate ODE severity and could precisely reflect ODE improvement through systemic treatment. Additionally, it was related to serum VEGF, a key factor in disease pathogenesis, suggesting its potential as an indicator of the overall severity of this disease.Trial registration: Clinicaltrials, NCT01816620. Registered March 22 2013, https://clinicaltrials.gov/ct2/show/NCT01816620.
Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-centre cohort study of 33 patients
Authors: Zhong Weiyang , Liang Xinjie , Luo Xiaoji , Huang Tianji , Quan Zhengxue 
Published: May 2020

Abstract
Background: The study aimed to investigate the complications rate of and risk factors for unplanned reoperation among elderly patients who underwent posterior lumbar fusion (PLF) for degenerative lumbar spondylolisthesis (DLS).Methods: A total of 1100 DLS patients who were older than 60 years were reviewed from January 2006 to December 2016; 33 patients underwent unplanned reoperations and were analysed and divided into two groups (group A: posterolateral fusion, 650 patients; group B: intervertebral fusion, 450 patients). Sex, body mass index (BMI), radiographic data and clinical outcome data were analysed to evaluate the complications rate of and the risk factors for unplanned reoperations.Results: A total of 33 patients underwent unplanned reoperations (3%). The patients were followed for an average of 4.20±2.25 years (group A) and 4.32±2.54 years (group B) without a significant difference. Significant differences were found in mean age, levels of involvement, hospital stay, surgery time, and blood loss between the groups. The causes of unplanned operation were wound infection, screw misplacement, neurological deficit, nonunion, and screw fracture, which were significant except for wound infection between the groups. Higher BMI (obesity), diabetes mellitus (DM), more bleeding and sex (female) were risk factors for complications. Cases of screw misplacement, neurological deficit, nonunion and screw fracture in group A were more significant than those in group B.Conclusion: Patients with higher BMI, DM, older age, posterolateral fusion, and female sex predicted a higher incidence of unplanned reoperations. Spine surgeons may need to pay more attention to their preoperative training and to improving surgical techniques that could reduce the reoperation rate.
Rolling Press Enables Electrospun Fibers Based Binder-Free Electrodes with High Stability for Lithium Ion Batteries
Authors: Zhao Yun , Kang Yuqiong , Deng Changjian , Liu Xinyi , Liang Zheng , Li Tao , Hu Quan 
Published: May 2020

Abstract
With the demand for higher energy density and smaller size lithium-ion batteries (LIBs), the development of high specific capacity active materials and the reduction of the usage of inactive materials are the main directions. Herein, a universal method is developed for binder-free electrodes for excellent stable LIBs by rolling the electrospun membrane directly onto the commercial current collector. The rolling process only makes the fiber web denser without changing the fiber structure, and the fiber web still maintains a porous structure. This strategy significantly improves the structural stability of the membrane compared to the direct carbonized electrospun membrane. Moreover, this method is suitable for a variety of polymerizable adhesive polymers, and each polymer can be composited with different polymers, inorganic salts, etc. The electrode prepared by this method can be stably cycled for more than 2000 cycles at a current density of 2500 mA g -1 . This study provides a cost-effective and versatile strategy to design the LIB electrode with high energy density and stability for experimental research and practical application.
Can virtual reality improve traditional anatomy educational programmes?A mixed-method study on the use of a 3D skull model
Authors: Chen Shi , Zhu Jiawei , Cheng Cheng , Pan Zhouxian , Liu Lingshan , Du Jianhua , Shen Xinhua , Shen Zhen , Zhu Huijuan , Liu Jihai , Yang Hua , Ma Chao , Pan Hui 
Published: May 2020

Abstract
Background: Realistic, portable, and scalable lectures, cadaveric models, 2D atlases and computer simulations are being combined more frequently for teaching anatomy, resulting in major increases in user satisfaction. However, while digital simulations may be more portable, interesting, or motivating than traditional teaching tools, it is unclear whether they are superior in terms of student learning. This paper presents a study in which the educational effectiveness of a virtual reality (VR) skull model is compared with that of cadaveric skulls and atlases. The purpose of this study was to compare the results of teaching with VR with those of traditional teaching methods by administering objective questionnaires and perception surveys. Methods: A mixed-method study with 73 medical students was carried out with three different groups: the VR skull (N=25), cadaveric skull (N=25) and atlas (N=23) groups. Anatomical structures were taught through an introductory lecture and model-based learning. All students completed the pre- and post-intervention tests, which were composed of a theory test and an identification test. Results: The participants in all three groups had significantly higher total scores on the post-intervention test than on the pre-intervention test; the post-interview test score in the VR group was not statistically significantly higher than those of the other groups (VR: 30 [22-33.5], cadaver: 26 [20-31.5], atlas: 28[20-33]; p=0.571). The participants in the VR and cadaver groups provided more positive feedback on their learning models than the atlas group (VR: 26 [19-30], cadaver: 25 [19.5-29.5], atlas: 12 [9-20]; p<0.0001).Conclusions: The VR skull model was equally efficient as the cadaver skull and atlas in terms of enabling students to learn anatomy. In addition, VR can aid participants in understanding complex anatomy structures with a higher level of motivation and mild adverse effects.
Risk Screening of Obstructive Sleep Apnea Syndrome by Body Profiles via Random Forests Model
Authors: Tsai Cheng-Yu , Liu Wen-Te , Lin Yin-Tzu , Lin Shang-Yang , Majumdar Arnab , Houghton Robert , Wu Dean , Lee Hsin-Chien , Wu Cheng-Jung , Li Lok Yee Joyce , Juang Jer-Nan , Tsai Yi-Shan , Hsu Shin-Mei , Lo Chen-Chen , Lo Kang , Chen You-Rong , Lin Feng-Ching 
Published: May 2020

Abstract
Background

Obstructive Sleep Apnea Syndrome (OSAS) is a major global health concern and is typically diagnosed by in-lab polysomnography (PSG). This examination though has high medical manpower costs and alternative portable methods have further limitations. This paper develops a new model for screening the risk of OSAS in different age groups and gender by using body profiles. The effects of body profiles for different subgroups in sleep stage alteration and OSAS severity are also investigated.
Methods

The data is derived from 6614 Han-Taiwanese subjects who have previously undergone PSG in order to assess the severity of OSAS in the sleep center of Taipei Medical University Shuang-Ho Hospital between March 2015 and October 2019. Characteristics of subjects, including age, gender, body mass index (BMI), neck circumference, and waist circumference, were obtained from a questionnaire. Pearson regression was used to evaluate the correlations between body profiles and sleep stages as well as sleep disorder indexes. To develop an age and gender independent model, random forests (RF), which is an ensemble learning method with high explainability, were trained by the four groups by gender and age (older or younger than 50 years old) with ratios of 70% (training dataset) and 30% (testing dataset), respectively. Prediction performance was evaluated by sensitivity, specificity and accuracy. Variable importance was assessed by averaging the impurity decrease to account for the effect of different factors.
Results

Results indicate that high BMI, neck circumference and waist circumference decreased the duration of slow-wave sleep and increased the sleep disorder indices and the percentage of wake and N1. Additionally, screening models for different gender and age utilizing anthropometric features as predictors via RF were established and demonstrated to have high accuracy (75.63% for younger males, 74.72% for elder males, 78.81% for younger females, and 72.10% for elder females). Feature importance indicated that waist circumference was the highest contributing factor in females and elder males, whereas the BMI was the highest contribution in younger males.
Conclusions

The authors recommend the use of the prediction models for those with Han-Taiwanese craniofacial features.
Comparing nutrients and volatiles among different tomato varieties
Authors: Cheng Guoting , Chang Peipei , El-Sappah Ahmed H. , Zhang Yan , Liang Yan 
Published: May 2020

Abstract
Background: Flavor is an important quality of tomato fruit. The improvement of flavor attracts more and more attention. This study aimed to explore the differences in the concentrations of nutrients and volatiles between red and pink colors of tomatoes fruit, including cherry tomato (S. lycopersicum var. cerasiforme Mill) and large-fruited tomato (S. lycopersicum), respectively. Methods: Soluble sugar, titratable acids, and volatile organic compounds, were detected using gas chromatography-mass spectrometry. Hedonism score and odor activity value were used to evaluate the taste and odor intensity of tomato fruit. The membership function method was used to comprehensively evaluate the fruit flavor. Results: It was found that the levels of aldehydes, ketones, esters, and phenols were significantly higher in pink tomato than in red tomato. The concentrations of ascorbic acid, soluble solids, fructose, glucose, citric acid, and carotenoid-derived volatiles were significantly greater in cherry tomato than in large-fruited tomato. However, Phe-derived and Ile/Leu-derived volatiles were significantly higher in pink large-fruited tomato and red cherry tomato. The fatty and irritant odors were stronger in pink tomato than in red tomato, and cherry tomato had better overall taste than large-fruited tomato. The sweetness and sweetness/acidity ratio were significantly higher in pink cherry tomato than other categories of tomatoes. Conclusion: The concentrations of volatiles varied greatly between pink and red tomatoes, and the levels of nutrients varied greatly between cherry and large-fruited tomatoes. This study can provide reference for tomato flavor quality improvement breeding.
Effectiveness of the self-retrieval basketing technique for stone extraction during flexible ureteroscopy for urolithiasis
Authors: Anan Go , Komatsu Kenji , Hatakeyama Shingo , Iwamura Hiromichi , Kohada Yuki , Mikami Jotaro , Ito Jun , Kaiho Yasuhiro , Shimbo Masaki , Endo Fumiyasu , Yoneyama Takahiro , Hashimoto Yasuhiro , Ohyama Chikara , Hattori Kazunori , Sato Makoto 
Published: May 2020

Abstract
Background

To assess the safety and effectiveness of using the self-retrieval basketing technique by solo surgeon as a method for stone extraction during flexible ureteroscopy (f-URS) for urolithiasis.
Methods

This retrospective study enrolled patients with urinary calculus who underwent f-URS at two institutions in Japan between September 2014 and November 2019. A total of 100 cases were performed by one experienced surgeon using the self-retrieval basketing technique. With this approach, the f-URS apparatus was manipulated with the nondominant hand and the basket catheter was manipulated with the dominant hand. The self-retrieval basketing technique employed two parts—specifically, a “front catch” and “side catch” to gather fragmented stones visible in the front and side of the ureteroscopic view, respectively. We retrospectively examined perioperative results, complications, and the stone free rate (with “stone-free” defined as ≤ 2 mm with kidney ureter bladder (KUB) 1 month after f-URS) to estimate the safety and effectiveness for comparison with results of the conventional retrieval basketing technique.
Results

Among our study population, the median stone size was 14 mm and the median operative time was 80 minutes. A stone free status was achieved in 87 patients (87%). The median stone fragmentation time was 16 minutes and the stone retrieval time was 32 minutes. All included cases were completed with the self-retrieval basketing technique. Complications related to stone retrieval were identified in two cases (2%); the degree of ureter injury being Clavien grade IIIa. There were no intraoperative complications such as heavy hematuria not to detect ureteral mucosa.
Conclusions

The self-retrieval basketing technique is safe and effective for the extraction of stone fragments during f-URS for urolithiasis. The self-retrieval basketing technique does not require assistance for basketing; therefore, f-URS with active retrieval basketing could be completed by solo surgeon.
Improving the Use of Healthcare Resources in Canadian Hospitals: The Impact of a Reintegration Unit in Expanding Acute Care Capacity and Resource Use in Sunnybrook Health Sciences Centre
Authors: Cheng Ivy , Baker G. Ross , Carew Debra , Landau Stacy , Walko Debra , Li Wendy , Ma Yan Yan 
Published: May 2020

Abstract
Background: Alternate level of care (ALC) patients are those who reside in acute hospital beds but can be managed in non-hospital settings. They contribute to high occupancy levels in Canadian hospitals. Between 2017-18, Ontario spent 1.1 billion dollars on hospitalized patients waiting for alternate level of care (ALC) beds. To improve value for care, Ontario Ministry of Health (MOHLTC) invested into reintegration units which are designed to transfer ALC patients out of hospital and transition them back into the community or long-term care (LTC). Given today’s healthcare budget pressures, it is unclear if reactivation units are feasible. In 2018, the MOHLTC funded a reintegration unit, Pine Villa with an operational partner, Sunnybrook Hospital and community service providers (SPRINT Senior Care, LOFT) in Toronto, Ontario. The objective was to determine averted costs for ALC-patients and impact on Sunnybrook patient flow-through if ALC-patient Pine Villa transfers occurred on the day of ALC readiness. Methods: Retrospective, observational analysis of Sunnybrook ALC-patients discharged to Pine Villa between January 9, 2018 to February 4, 2019. From the healthcare payer’s perspective (MOHTLC), cost analysis was modelled for ALC patients designated for 1) LTC and 2) home with supports. Avoided costs at time of ALC readiness were determined by case-costing. Averted hospital ALC days were established. Results: If ALC patients were transferred to Pine Villa at time of ALC readiness for LTC, the healthcare system could have averted 5.4 million dollars from Sunnybrook. If the patients were transferred for home, 2.3 million dollars could have been averted. Both models increased acute Sunnybrook Hospital capacity by 34 beds. Conclusion: There is a business case supporting reintegration units if ALC-patients are discharged from the hospital on the day of ALC-readiness.