bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrawound vancomycin application after spinal surgery: a propensity score–matched cohort analysis
Authors: Vakayil Victor , Atkinson Jeremiah , Puram Vikram , Glover James J. , Harmon James V. , Statz Catherine L. , Polly David W. , Bulander Robert E. 
Published: March 2021

OBJECTIVE
Surgical site infection (SSI) following spine surgery is associated with increased morbidity and healthcare costs. In an effort to reduce SSI rates, the application of intrawound vancomycin powder has gained popularity. However, there is limited high-quality evidence to support the safety and efficacy of this practice. The authors sought to determine if intrawound application of vancomycin powder improves 90-day overall SSI rates.

METHODS
The authors performed a retrospective, vancomycin exposure–matched cohort study at a single tertiary care hospital over 21 months. They included all patients undergoing elective spinal surgery and stratified the patients into two groups: those who received intrawound vancomycin powder application and those who received no application of vancomycin powder. The primary outcome of interest was the 90-day overall SSI rate. Secondary outcomes included rates of superficial SSI, deep SSI, wound disruption, and a post hoc analysis of the microbiology and minimum inhibitory concentrations. Baseline patient demographics, clinical presentation, comorbidities, perioperative factors, and 90-day postoperative outcomes were manually abstracted from patient charts. To mitigate bias, we performed 1:1 matching after calculating propensity scores and identified 1 patient from the no-vancomycin cohort for each patient in the vancomycin cohort.

RESULTS
A total of 997 patients met our inclusion criteria (473 patients receiving vancomycin and 524 patients not receiving vancomycin). Propensity score matching produced 221 matched pairs. Risk-adjusted analysis demonstrated similar overall SSI rates between the groups (OR 1.9, p = 0.329). On unadjusted analysis, the overall 90-day SSI rate was greater in the vancomycin group (n = 10 [4.5%]) than in the no-vancomycin group (n = 5 [2.3%]) (p < 0.001), as were the superficial SSI rate (7 [3.2%] vs 4 [1.8%], p < 0.001), deep SSI rate (3 [1.4%] vs 1 [0.5%], p < 0.001), and wound disruption rate (5 [2.3%] vs 1 [0.5%], p < 0.001). No cultured isolate demonstrated vancomycin resistance.

CONCLUSIONS
The authors observed no difference in SSI rates after the intrawound application of vancomycin powder during spine surgery. Vancomycin use did not contribute to antimicrobial resistance; however, it may select out gram-negative bacteria and increase rates of wound disruption.
Risk Factors for Central and Lateral Lymph Node Metastases in Patients With Papillary Thyroid Micro-Carcinoma: Retrospective Analysis on 484 Cases
Authors: Huang Yijie , Yin Ying , Zhou Wenyi 
Published: March 2021

BackgroundPapillary thyroid micro-carcinoma (PTMC) is defined as a tumor with a larger diameter ≤1 cm which has an indolent course and satisfying prognosis. However, the incidence of lymph node metastasis of PTMC cannot be ignored. The aim of this study was to assess the incidence of lymph node metastasis in PTMC patients, as well as to evaluate the risk factors for both central lymph node metastases (CLNM) and lateral lymph node metastases (LLNM).MethodsPatients who underwent thyroidectomy from January 2017 to October 2020, and pathologically diagnosed with PTMC were enrolled in our study and their medical records were collected and analyzed.ResultsA total of 484 PTMC patients were included. The incidence of central and lateral lymph node metastasis was 49.6% and 9.1%, respectively. Multivariate analysis demonstrated as independent risk factors for CLNM male sex, age &lt;40 years, largest tumor size ≥5 mm and bilaterality. Extrathyroidal extension, presence of CLNM, number of CLNM ≥5 were strong indicators for LLNM.ConclusionThe incidence of lymph node metastases in PTMC is non-negligible. The identification of potential risk factors for CLNM and LLNM would help tailor individual surgical interventions for patients with PTMC.
Immune-Related Adverse Events and Their Association With the Effectiveness of PD-1/PD-L1 Inhibitors in Non-Small Cell Lung Cancer: A Real-World Study From China
Authors: Chen Xiaoling , Nie Jun , Dai Ling , Hu Weiheng , Zhang Jie , Han Jindi , Ma Xiangjuan , Tian Guangming , Han Sen , Wu Di , Wang Yang , Long Jieran , Zhang Ziran , Fang Jian 
Published: March 2021

BackgroundProgrammed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors are increasingly used in China, but no real-world data are available about the immune-related adverse events (irAEs). This real-world retrospective study aimed to assess the safety and effectiveness of PD-1/PD-L1 inhibitors in patients with non-small cell lung cancer (NSCLC) and to analyze the association between irAEs and effectiveness.MethodsThis was a retrospective study of the clinical data of patients with NSCLC treated with PD-1/PD-L1 inhibitors from August 2016 to November 2019 at Beijing Cancer Hospital. The patients were divided into the irAE or non-irAE groups. Overall adverse events, the impact of irAE on tumor response, and the association of irAEs with effectiveness were evaluated.ResultsOne hundred and ninety-one patients were included, including 70 (36.6%) patients in the irAE group and 121 (63.4%) patients in the non-irAE group. AE, grades 3–5 AEs, and irAE occurred in 107 (56.0%), 24 (12.6%), and 70 (36.6%) of the patients, respectively. The objective response rate (ORR) and disease control rate (DCR) were higher in the irAE group compared with the non-irAE group (42.0% vs. 25.8%, P=0.038; 91.9% vs. 70.8%, P=0.002). Multivariable analyses identified that irAE were associated with progression-free survival (HR=0.62, 95%CI: 0.43–0.91; P=0.015), but not with overall survival (HR=0.76, 95%CI: 0.44–1.28; P=0.299).ConclusionIn NSCLC treated with PD-1/PD-L1 inhibitors, patients with irAEs showed improved effectiveness over patients without irAEs. Future studies of anti-PD-1/PD-L1 immunotherapy should explore this association and the underlying biological mechanisms of efficacy.
Evaluating the Accuracy of Breast Cancer and Molecular Subtype Diagnosis by Ultrasound Image Deep Learning Model
Authors: Zhang Xianyu , Li Hui , Wang Chaoyun , Cheng Wen , Zhu Yuntao , Li Dapeng , Jing Hui , Li Shu , Hou Jiahui , Li Jiaying , Li Yingpu , Zhao Yashuang , Mo Hongwei , Pang Da 
Published: March 2021

Background: Breast ultrasound is the first choice for breast tumor diagnosis in China, but the Breast Imaging Reporting and Data System (BI-RADS) categorization routinely used in the clinic often leads to unnecessary biopsy. Radiologists have no ability to predict molecular subtypes with important pathological information that can guide clinical treatment.Materials and Methods: This retrospective study collected breast ultrasound images from two hospitals and formed training, test and external test sets after strict selection, which included 2,822, 707, and 210 ultrasound images, respectively. An optimized deep learning model (DLM) was constructed with the training set, and the performance was verified in both the test set and the external test set. Diagnostic results were compared with the BI-RADS categorization determined by radiologists. We divided breast cancer into different molecular subtypes according to hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) expression. The ability to predict molecular subtypes using the DLM was confirmed in the test set.Results: In the test set, with pathological results as the gold standard, the accuracy, sensitivity and specificity were 85.6, 98.7, and 63.1%, respectively, according to the BI-RADS categorization. The same set achieved an accuracy, sensitivity, and specificity of 89.7, 91.3, and 86.9%, respectively, when using the DLM. For the test set, the area under the curve (AUC) was 0.96. For the external test set, the AUC was 0.90. The diagnostic accuracy was 92.86% with the DLM in BI-RADS 4a patients. Approximately 70.76% of the cases were judged as benign tumors. Unnecessary biopsy was theoretically reduced by 67.86%. However, the false negative rate was 10.4%. A good prediction effect was shown for the molecular subtypes of breast cancer with the DLM. The AUC were 0.864, 0.811, and 0.837 for the triple-negative subtype, HER2 (+) subtype and HR (+) subtype predictions, respectively.Conclusion: This study showed that the DLM was highly accurate in recognizing breast tumors from ultrasound images. Thus, the DLM can greatly reduce the incidence of unnecessary biopsy, especially for patients with BI-RADS 4a. In addition, the predictive ability of this model for molecular subtypes was satisfactory,which has specific clinical application value.
RETRACTED: The Association of COVID-19 Pandemic Stress With Health-Related Quality of Life in the Kingdom of Saudi Arabia: A Cross-Sectional Analytical Study
Authors: Hawash Manal Mohammed , Alhazmi Amani Hamad , Wafik Wagida , Muzammil Khursheed , Mushfiq Sakeena , Ahmed Hala Awad 
Published: March 2021

Background: There is a global disaster since WHO declared Covid-19 as a pandemic. With the increase in cases &amp; mortality rate, various health issues viz., stress, mental disorders and altered health-related quality of life have been noted as a result of pandemic and lockdowns. This study aimed to assess the association of COVID-19 pandemic stress with health-related quality of life in the Kingdom of Saudi Arabia.Methodology: It was a cross-sectional analytical study. Subjects included 878 citizens and residents of Saudi Arabia aged 18 years and above. Convenience, non-probability sampling technique was used. A web-based, self-administered, electronic questionnaire in Arabic language having three sections; Sociodemographic &amp; clinical profile, Standard PSS-10, and Standard SF-12 was used as the study tool and distributed through various social media means. The study period was of 2 months. Data were analyzed using SPS version 25. Descriptive statistics, Pearson's correlation coefficient, independent sample t-test and the one-way analysis of variance (ANOVA) were employed for suitable statistical analysis.Results: Almost two-thirds of the subjects were between the age of 18 to &lt; 40 and majority (74.1%) being females. Majority (83.0%) reported as having no chronic diseases, and 69.5% had no contact history with COVID-19 cases. The mean of MCS &amp; PCS was (32.34 ± 25.30) &amp; (41.65 ± 11.82), respectively. Majority (67.6%) had a moderate level of COVID-19 stress. A significant negative relationship between total stress scores and HRQOL domains was observed.Conclusion: Majority subjects had a moderate level of stress related to COVID-19 lockdown. Stress during COVID-19 has a significant negative association with both physical and mental HRQOL in which MCS was significantly lower than PCS. It is recommended to evaluate the effectiveness of stress management program and follow a holistic approach.
Mucoactive therapy for impaired respiratory function in children with acute bronchitis
Authors: Ovcharenko L. S. , Vertehel A. A. , Andrienko T. G. , Samokhin I. V. , Kryazhev A. V. , Timoshina O. V. 
Published: March 2021

Purpose of the study. Increasing the efficiency and safety of therapy of the bronchi secretoryevacuation disorders in acute bronchitis with impaired respiratory function in children by using a medication with minimal effect on the cardiovascular system.
Materials and methods. The study included 60 children aged 6 to 11 years, suffering from acute bronchitis for 1–2 days. Formed 2 groups of observation (30 children in each group): 1st group (main) – children receiving phytopreparation for 10 days in the complex therapy of the bronchi secretory-evacuation disorders in acute bronchitis with impaired function of external respiration; 2-nd group (comparison) – children receiving ambroxol. The dynamics of the severity of bronchitis was assessed according to the BSS scale (0–20 points).
Results. The clinical symptoms of acute bronchitis according to the BSS scale were significantly faster and more effective in the group of children taking the herbal remedy already on the 4-th day of therapy. In the group of patients taking phytopreparation, there was an improvement in objective indicators of respiratory function according to spirography data. In children of the 1st group, the period of recovery is accompanied by the normalization of indicators of the functioning of the autonomic nervous system and the predominance of eutonia against the background of a decrease in the number of registrations of parasympathicotonia.
Conclusions. Treatment of acute bronchitis in children using a phytopreparation normalizes the indices of autonomic regulation and functioning of the cardiovascular system, which contributes to a faster and more effective relief of clinical symptoms with the restoration of the function of external respiration.
MELESTARIKAN BUDAYA TULIS NUSANTARA: Kajian tentang Aksara Lontara
Authors: Ahmad Abdul Aziz 
Published: March 2021

The conservation of Indonesian Traditional Script is less seriously done. Therefore it needs to be encouraged especially for the traditional scripts because they are one of the national assets which need to be developed and kept. Lontara, traditional script in Indonesia, is the one which is still exist in use in South Sulawesi, although it is restricted in small areas. The term Lontara means history and science, and the second meaning is something written, or an article. Lontara script is also well known as Bugis Script or Makassar Script, but people prefer saying it as Lontara Script. The effort to introduce the Lontara is done in the following ways firstly by introducing the use and the benefit of the script. People are usually not interested to something because they do not know it. Secondly, it is done by reading and writing. Thirdly is by promoting the people to use it in daily written communication. Fourth is by using it in a publication, or written media, because this script needs to be spread out through a latest modern technology. Fifth is showing the Lontara to the people in a form of Artistic Craft, or paintings. Keywords: script, lontara, traditional, communication, publication.
Highly Stretchable, Adhesive, Biocompatible, and Antibacterial Hydrogel Dressings for Wound Healing
Authors: Yang Zifeng , Huang Rongkang , Zheng Bingna , Guo Wentai , Li Chuangkun , He Wenyi , Wei Yingqi , Du Yang , Wang Huaiming , Wu Dingcai , Wang Hui 
Published: March 2021

AbstractTreatment of wounds in special areas is challenging due to inevitable movements and difficult fixation. Common cotton gauze suffers from incomplete joint surface coverage, confinement of joint movement, lack of antibacterial function, and frequent replacements. Hydrogels have been considered as good candidates for wound dressing because of their good flexibility and biocompatibility. Nevertheless, the adhesive, mechanical, and antibacterial properties of conventional hydrogels are not satisfactory. Herein, cationic polyelectrolyte brushes grafted from bacterial cellulose (BC) nanofibers are introduced into polydopamine/polyacrylamide hydrogels. The 1D polymer brushes have rigid BC backbones to enhance mechanical property of hydrogels, realizing high tensile strength (21–51 kPa), large tensile strain (899–1047%), and ideal compressive property. Positively charged quaternary ammonium groups of tethered polymer brushes provide long‐lasting antibacterial property to hydrogels and promote crawling and proliferation of negatively charged epidermis cells. Moreover, the hydrogels are rich in catechol groups and capable of adhering to various surfaces, meeting adhesive demand of large movement for special areas. With the above merits, the hydrogels demonstrate less inflammatory response and faster healing speed for in vivo wound healing on rats. Therefore, the multifunctional hydrogels show stable covering, little displacement, long‐lasting antibacteria, and fast wound healing, demonstrating promise in wound dressing.
A novel program to enhance pediatric emergency medicine training in Thailand
Authors: Burns Beech , Bailey Jessica , Hartenstein Melinda , Sullivan Danielle , Burns Erin , Lin Amber , Chan Daniela , Plainkum Parit , Techapaitoon Surangkana , Pandee Uthen , Ma O. John 
Published: March 2021

AbstractBackgroundIn Thailand, there are few pediatric emergency medicine (PEM) fellowship‐trained providers, and emergency departments (EDs) are staffed by pediatricians and emergency physicians. Our pediatric ED collaborated with Thailand's largest private hospital system to develop a training program designed to improve emergency care for children.ObjectiveThe objective was to develop, implement, and assess the efficacy of a curriculum to improve PEM care by emergency providers in a Thai health system.MethodsWe conducted a prospective study from January 2018 to July 2019. After an initial needs assessment, we developed a curriculum with 22 modules, divided into basic and advanced courses. Each course began with baseline testing, consisting of written tests and several simulated cases led by physician–nurse teams. Each course was administered longitudinally through electronic modules over 6 months, with in‐person shadowing and skills workshops at the course midpoint, culminating in final summative examinations and repeat simulation testing.ResultsOn written examination scores for the basic course, physicians (n = 5) improved by 37.6% (95% confidence interval [CI] = 29.8% to 45.4%, p < 0.001), while nurses (n = 5) improved by 55.7% (95% CI = 45.8% to 65.6%, p < 0.001). For simulation testing among physician–nurse dyads, performance improved by 19.5% (95% CI = 3.9% to 35.1%, p = 0.004) for critical action items and by 3.0 points (95% CI = 2.3 to 3.7, p < 0.001) on a 16‐point teamwork scale. For the advanced course, physicians improved on the written examination by 36.9% (95% CI = 29.2% to 44.7%, p < 0.001) and nurses by 50.6 (95% CI = 47.3% to 54.0%, p < 0.001). For simulation testing, performance improved from 22.2% (95% CI = 8.2% to 35.6%, p < 0.001) for critical actions and 1.3 points (95% CI = 0.2 to 2.2, p = 0.005) on teamwork measures.ConclusionsWe designed an interdisciplinary curriculum and successfully trained Thai physicians and nurses to improve PEM knowledge and teamwork.
Using Edpuzzle to improve student experience and performance in the biochemistry laboratory
Authors: Shelby Shameka J. , Fralish Zachary D. 
Published: March 2021

AbstractStudent preparation has been shown to be of appreciable importance to student success in laboratory components of science courses. To promote student engagement prior to each laboratory session, technique and content videos, online assessments, and additional methods aiming to decrease cognitive load have been put into effect. Edpuzzle allows for instructors to effectively combine all of these components on a free, user‐friendly, cloud‐based platform. To improve student experience and performance in the introductory Biochemistry laboratory, Edpuzzle videos were incorporated into the curriculum. Ten videos were created and assigned to students on the platform. The platform allowed students to view the videos at their own pace and provided immediate feedback from assessments embedded within the videos. Student perceptions of Edpuzzle were favorable and the platform helped to promote student engagement in the material prior to the laboratory session which resulted in improvements in the Biochemistry lab experience. Edpuzzle has shown to be a highly effective tool for student engagement in the Biochemistry laboratory and can be utilized in other undergraduate laboratories as a replacement for existing pre‐laboratory preparation methods.
Selectively Probing Neurochemicals in Living Animals with Electrochemical Systems
Authors: Jin Ying , Li Xin , Jiang Ying 
Published: March 2021

AbstractNeurochemicals are essential molecules presented in the central nervous system that are primarily involved in neural activity and signaling. Neurochemical abnormalities resulted from genetic or environmental changes can lead to several behavioral and neurological disorders, including Alzheimer's and Parkinson's diseases. It is therefore imperative to employ detection systems of the optimal selectivity and spatio‐temporal resolution to ascertain the specific molecular basis particular to the pathological process. Electrochemical systems featuring excellent temporal‐spatial resolution and designable electrode interface are arguably the most versatile and widely used approaches for sensing of neurochemicals in living brain environment. Nevertheless, there are still many challenges that must be addressed to enable highly selective, sensitive, and stable in vivo electrochemical sensors and facilitate their development for emerging applications ranging from early diagnosis of brain diseases to designing potential curative treatments. Here, we provide a brief overview of the application of electrochemical sensors and biosensors in the analysis of neurochemicals in living animals. In particular, we highlight recent advances in modulating the physicochemical properties of electrode that can lead to in vivo sensors with exceptional selectivity. In addition, future trends of highly selective in vivo electrochemical systems are prospected.
Polydopamine‐Mediated Surface Functionalization of Exosomes
Authors: Wang Chenyu , Kimura Kenta , Li Jincai , Richardson Joseph J. , Naito Mitsuru , Miyata Kanjiro , Ichiki Takanori , Ejima Hirotaka 
Published: March 2021

AbstractExosomes are cell‐derived extracellular vesicles that hold promise for diagnosis and therapy. The surface characteristics of exosomes dictate their biological fate and are therefore important for various applications, however surface modification strategies are generally either limited in scope or require complex equipment or experimental procedures. Herein, we employ a simple and fast method to control the surface properties of exosomes via polydopamine coating. Specifically, the polydopamine coating allowed for tailorable functionalization via secondary reactions, which opens exciting avenues for the application of exosomes.
Ultrasound examination of the equine acute abdomen
Authors: Manso‐Díaz Gabriel 
Published: March 2021

Background: Abdominal pain is one of the most common causes of emergency in equine practice. The origin of these clinical signs is wide ranging; therefore, the treatment and prognosis can vary significantly. The use of imaging modalities, especially ultrasonography, for the diagnosis of abdominal diseases in horses has become widely available and currently plays a crucial role in the diagnostic work‐up of colic.Aim of the article: This article describes the use of ultrasound for assessing the equine abdomen and guides the equine practitioner on the diagnostic features of the most common diseases that can cause colic in horses.