bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pragmatic Non-Randomized Trial of Prehabilitation Prior to Cancer Surgery: Study Protocol and COVID-19-Related Adaptations
Authors: Santa Mina Daniel , Sellers Daniel , Au Darren , Alibhai Shabbir M. H. , Clarke Hance , Cuthbertson Brian H. , Darling Gail , El Danab Alaa , Govindarajan Anand , Ladha Karim , Matthew Andrew G. , McCluskey Stuart , Ng Karen A. , Quereshy Fayez , Karkouti Keyvan , Randall Ian M. 
Published: March 2021

BackgroundExperimental data highlight the potential benefits and health system cost savings related to surgical prehabilitation; however, adequately powered randomized controlled trial (RCT) data remain nascent. Emerging prehabilitation services may be informed by early RCT data but can be limited in informing real-world program development. Pragmatic trials emphasize external validity and generalizability to understand and advise intervention development and implementation in clinical settings. This paper presents the methodology of a pragmatic prehabilitation trial to complement emerging phase III clinical trials and inform implementation strategies.MethodsThis is a pilot pragmatic clinical trial conducted in a large academic hospital in Toronto, Ontario, Canada to assess feasibility of clinical implementation and derive estimates of effectiveness. Feasibility data include program referral rates, enrolment and attrition, intervention adherence and safety, participant satisfaction, and barriers and facilitators to programming. The study aims to receive 150 eligible referrals for adult, English-speaking, preoperative oncology patients with an identified indication for prehabilitation (e.g., frailty, deconditioning, malnutrition, psychological distress). Study participants undergo a baseline assessment and shared-decision making regarding the intervention setting: either facility-based prehabilitation or home-based prehabilitation. In both scenarios, participants receive an individualized exercise prescription, stress-reduction psychological support, nutrition counseling, and protein supplementation, and if appropriate, smoking cessation program referrals. Secondary objectives include estimating intervention effects at the week prior to surgery and 30 and 90 days postoperatively. Outcomes include surgical complications, postoperative length of stay, mortality, hospital readmissions, physical fitness, psychological well-being, and quality of life. Data from participants who decline the intervention but consent for research-related access to health records will serve as comparators. The COVID-19 pandemic required the introduction of a ‘virtual program’ using only telephone or internet-based communication for screening, assessments, or intervention was introduced.ConclusionThis pragmatic trial will provide evidence on the feasibility and viability of prehabilitation services delivered under usual clinical conditions. Study amendments due to the COVID-19 pandemic are presented as strategies to maintain prehabilitation research and services to potentially mitigate the consequences of extended surgery wait times.
Use of 68Ga-PSMA-11 and 18F-FDG PET-CT Dual-Tracer to Differentiate Between Lymph Node Metastases and Ganglia
Authors: Shi Yiping , Xu Lian , Zhu Yinjie , Wang Yining , Chen Ruohua , Liu Jianjun 
Published: March 2021

PurposeDifferentiating lymph node metastases (LNM) from peripheral ganglia by physiological prostate-specific membrane antigen (PSMA) uptake is challenging. Two tracers (68Ga-PSMA-11 and 18F-fluorodeoxyglucose [FDG]) metabolic uptake patterns were evaluated by positron emission tomography-computed tomography (PET-CT), searching for differences that could tell ganglia from LNM.MethodsDual 68Ga-PSMA-11 and 18F-FDG PET-CT data of 138 prostate cancer patients acquired from June 2018 to December 2019 were retrospectively evaluated. Ganglia and LNM with PSMA-11 uptake above local background were analyzed by the location and PSMA-11-PET and FDG-PET maximum standardized uptake value (SUVmax).ResultsPSMA-11-positive ganglia (n = 381) and LNM (n = 83) were identified in 138 and 58 patients, respectively. The LNM SUVmax of PSMA-11-PET (16.4 ± 14.8 vs 2.3 ± 0.7, P &lt; 0.001) and FDG-PET (3.3 ± 3.2 vs 1.5 ± 0.5, P &lt; 0.001) were higher than in ganglia. The probabilities of being an LNM in the low-potential (PSMA-11-PET SUVmax of &lt;4.1 and FDG-PET SUVmax of &lt;2.05), moderate-potential (PSMA-11-PET SUVmax of &gt;4.1 and FDG-PET SUVmax of &lt;2.05, or PSMA-11-PET SUVmax of &lt;4.1 and FDG-PET SUVmax of &gt;2.05), and high-potential (PSMA-11-PET SUVmax of &gt;4.1 and FDG-PET SUVmax of &gt;2.05) groups were 0.9% (3/334), 44.6% (37/83), and 91.5% (43/47), respectively (P &lt; 0.001). The cervical and coeliac ganglia had higher PSMA-11 and FDG uptake than the sacral ganglia (P &lt; 0.001 for all). LNM PSMA-11 and FDG uptake was similar in these three locations.ConclusionThe FDG-PET and PSMA-11-PET SUVmax, especially when combined, could well differentiate LNM from ganglia. The tracers uptake differed between cervical/coeliac and sacral ganglia, so the lesion location should be considered during image assessment.
Risk of Second Primary Malignancies Based on the Histological Subtypes of Colorectal Cancer
Authors: Wu Meijuan , Huang Mengxi , He Chenglong , Chen Cheng , Li Huiyu , Wang Jing , Liu Mengyan , Fu Gongbo , Lei Zengjie , Chu Xiaoyuan 
Published: March 2021

Background: Previous studies have revealed an increased risk of second primary malignancies (SPMs) after colorectal cancer (CRC); however, no previous investigation has quantified differences in the risk of SPMs based on the histological subtypes of first primary CRC.Methods: Patients diagnosed with first primary CRC between 2000 and 2011 were identified from the Surveillance, Epidemiology, and End Results cancer registries. The patients were divided into three cohorts: classical adenocarcinoma (CA), mucinous adenocarcinoma (MA), and signet-ring cell carcinoma (SRCC). Standardized incidence ratios were calculated to assess the risk of SPMs among the patients.Results: Overall risk of SPMs was significantly higher among patients with three histological subtypes of CRC than in the general population. The risk of esophagus cancer was significantly increased in SRCC. The risk of small intestine, colon and rectum, and corpus uteri cancers was high in three histological subtypes, with the highest risk observed in SRCC, followed by MA. Increased risks of second stomach, uterus, urinary bladder, kidney, and thyroid cancers were only observed in CA patients, while increased risk of second renal pelvis cancer was limited to MA patients. Furthermore, the high overall risk of SPMs in CA patients persisted regardless of clinicopathological factors. After surgery combined with chemotherapy treatment, CA patients were more prone to developing second small intestine, colon and rectum cancers than those treated with surgery only. A lower second prostate cancer risk was observed in rectal CA patients treated with surgery combined with radiotherapy than in patients treated with surgery only.Conclusion: The present study revealed that the risk of developing SPMs after CRC varied based on the histological subtypes of the first primary CRC. Although the mechanisms underlying the observed patterns of SPM risk remain unknown, the study provided insights into future cancer surveillance based on the histological subtypes of CRC.
Cell Population Data (CPD) for Early Recognition of Sepsis and Septic Shock in Children: A Pilot Study
Authors: Biban Paolo , Teggi Martina , Gaffuri Marcella , Santuz Pierantonio , Onorato Diletta , Carpenè Giovanni , Gregori Dario , Lippi Giuseppe 
Published: March 2021

Objectives: Innovative Cell Population Data (CPD) have been used as early biomarkers for diagnosing sepsis in adults. We assessed the usefulness of CPD in pediatric patients with sepsis/septic shock, in terms of early recognition and outcome prediction. We revised 54 patients (0–15 y) admitted to our Pediatric Intensive Care Unit (PICU) for sepsis/septic shock during a 4-year period. Twenty-eight patients were excluded, 26 septic patients were enrolled (G1). Forty children admitted for elective surgery served as controls (G2). Data on five selected CPD parameters, namely neutrophils fluorescence intensity (NE-SFL), monocytes cells complexity (MO-X), monocytes fluorescence intensity (MO-Y), monocytes complexity and width of dispersion of events measured (MO-WX), and monocytes cells size and width dispersion (MO-WZ), were obtained at time of PICU admission (t0) by a hematological analyzer (Sysmex XN 9000®). As the primary outcome we evaluated the relevance of CPD for diagnosing sepsis/septic shock on PICU admission. Furthermore, we investigated if CPD at t0 were correlated with C-reactive protein (CRP), patient survival, or complicated sepsis course.Results: On PICU admission (t0), NE-SFL, MO-WX, and MO-Y were higher in sepsis/septic shock patients compared to controls. NE-SFL values were correlated with CRP values in G1 patients (r = 0.83). None of the five CPD parameters was correlated with survival or complicated sepsis course.Conclusion: We found higher values of NE-SFL, MO-WX, and MO-Y in children with sepsis/septic shock upon PICU admission. These parameters may be a promising adjunct for early sepsis diagnosis in pediatric populations. Larger, prospective studies are needed to confirm our preliminary observations.
The Diversity of the Intestinal Flora Disturbed After Feeding Intolerance Recovery in Preterm Twins
Authors: Li Ying , Jia Chunhong , Lin Xiaojun , Lin Lili , Li Lizhen , Fan Xi , Huang Xiaoxia , Xu Zhanyuan , Wang Huixin , Wu Fan , Liu Guosheng 
Published: March 2021

Background: Feeding intolerance (FI) is a common condition in premature infants that results in growth retardation and even necrotizing enterocolitis. The gut microbiome is linked to FI occurrence; however, the outcome after FI recovery is unclear.Methods: Fecal samples were collected from 11 pairs of premature twins/triplets for 16S rRNA gene sequencing. Initial fecal samples were collected shortly after admission, and then every other week until 7 weeks or discharge.Results: After FI recovery, there was no significant difference in the β-diversity of the intestinal flora between the FI group and the feeding tolerance (FT) group. By contrast, there was a significant difference in the β-diversity. Proteobacteria was the predominant phylum in the microbiome of the FI group, whereas Firmicutes was the predominant phylum in the microbiome of the FT group. The predominant bacteria with LDA &gt;4 between the two groups at 13–15 days after birth, 19–28 days after birth, and at discharge were different, with the proportions of Bacillus, Clostridium butyricum, and Clostridium being highest in the FT group and Firmicutes, unidentified_Clostridiales, and Proteobacteria being highest in the FI group. Similarly, there were significant differences in the relative abundances of KEGG pathways, such as fatty acid metabolism, DNA repair and recombination proteins, energy metabolism, and amino acid metabolism, between the two groups (P &lt; 0.01).Conclusions: There was a significant difference in diversity of the intestinal flora after feeding intolerance recovery. Feeding intolerance may disturb the succession of the intestinal bacterial community.
Effectiveness of a Virtual Exercise Program During COVID-19 Confinement on Blood Pressure Control in Healthy Pregnant Women
Authors: Silva-Jose Cristina , Sánchez-Polán Miguel , Diaz-Blanco Ángeles , Coterón Javier , Barakat Ruben , Refoyo Ignacio 
Published: March 2021

BackgroundThe situation caused by COVID-19 has led to movement restrictions for the majority of the population due to the confinement established by the health authorities. This new situation has changed people’s habits and significantly affected the pregnant population. Decreased exercise and increased psychophysical stress are associated with excessive weight gain, diabetes, and gestational cardiovascular complications that affect the mother, fetus, and newborn. Recent research shows that the dynamics of maternal blood pressure is one of the most important control factors during pregnancy. Thus, prevention of these type of pathologies through interventions without maternal-fetal risks is important.ObjectivesTo examine the influence of a virtual exercise program on maternal blood pressure during pregnancy.Materials and MethodsA randomized clinical trial design was used (NCT04563065). Data from 72 pregnant women without obstetric contraindications under confinement conditions in the Madrid area were collected. Women were randomly assigned to the intervention (IG) or control group (CG). They previously signed informed consent forms. A moderate exercise program was performed as an intervention from 8–10 to 38–39 weeks of pregnancy. Systolic (SBP) and diastolic (DBP) maternal blood pressure were measured during the first, second and third trimesters of pregnancy, as well as before and immediately after delivery in both study groups.ResultsNo differences in systolic and diastolic blood pressure during the first, second and third trimesters were found between groups. Significant differences in SBP were found immediately before delivery (IG = 119.83 ± 10.16 vs. CG = 125.6 ± 10.91; p = 0.047) and immediately after delivery (IG = 115.00 ± 11.18 vs. CG = 122.24 ± 15.71; p = 0.045).ConclusionsResults show lower SBP values for the IG during delivery than CG. A virtual exercise program throughout pregnancy during COVID-19 confinement can help to control systolic blood pressure before and immediately after delivery in healthy pregnant women.
Anxiety and Its Associated Factors During the Initial Phase of the COVID-19 Pandemic in Indonesia
Authors: Anindyajati Gina , Wiguna Tjhin , Murtani Belinda Julivia , Christian Hans , Wigantara Ngurah Agung , Putra Anggi Aviandri , Hanafi Enjeline , Minayati Kusuma , Ismail Raden Irawati , Kaligis Fransiska , Savitri Ary I. , Uiterwaal Cuno S. P. M. , Diatri Hervita 
Published: March 2021

Introduction: Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus which has not been identified previously in humans. The disease leads to respiratory problems, systemic disorders, and death. To stop the virus transmission, physical distancing was strongly implemented, including working and school from home (WFH &amp; SFH). The limitation altered daily routines and needs advanced to adapt. Many have felt uncomfortable and this could have triggered anxiety symptoms. This study aimed to evaluate the proportion of significant anxiety symptoms and its association with COVID-19-related situations in an Indonesian context during the initial months of the pandemic.Methods: An online community survey was distributed through social media and communication platforms, mainly WhatsApp, targeting people &gt;18 years old in Indonesia. Anxiety symptoms were assessed using Generalized Anxiety Disorder-7 (Indonesian Version). Demographical data and information on social situation related to the COVID-19 pandemic were collected. The proportion of clinically significant anxiety symptoms was calculated and the association with demographic and social factors was assessed using chi square test (χ2) and logistic regression for multivariate analysis.Results: Out of 1215 subjects that completed the survey, 20.2% (n = 245) exhibited significant anxiety symptoms. Several factors, such as age (AOR = 0.933 CI 95% = 0.907–0.96), sex (AOR = 1.612 CI 95% = 1.097–2.369), medical workers (AOR = 0.209 CI 95% = 0.061–0.721), suspected case of COVID-19 (AOR = 1.786 CI 95% = 1.001–3.186), satisfaction level of family support (AOR = 3.052 CI 95% = 1.883–4.946), and satisfaction level of co-workers (AOR = 2.523 CI 95% = 1.395–4.562), were associated with anxiety.Conclusion: One out of five Indonesian people could have suffered from anxiety during the COVID-19 pandemic. The riskiest group being young females, people who had suspected cases of COVID-19, and those with less satisfying social support. Nevertheless, health workers were found to have a lesser risk of developing anxiety. Accessible information and healthcare, social connection, supportive environment, and mental health surveillance are important to prevent bigger psychiatric problems post-pandemic.
“It’s all About the Colors:” How do Mexico City Youth Perceive Cigarette Pack Design
Authors: Grilo Graziele , Lagasse Lisa P. , Cohen Joanna E. , Moran Meghan B. , Reynales-Shigematsu Luz Myriam , Smith Katherine C. 
Published: March 2021

Objectives: Cigarette packs are relevant to branding strategies, designed to appeal to specific groups. There is little research on how pack features increase product appeal among key constituents such as youth in low- and middle-income countries.Methods: We conducted 10 focus group discussions (FGDs) with adolescents and 5 FGDs with young adult smokers in Mexico City, separated by age, gender, smoking, and socioeconomic status. Participants separated 23 cigarette packs into “appealing” and “unappealing” groups, and were asked to explain their decisions, describing the features that supported their views. FGDs were video-recorded, transcribed in Spanish, translated into English, and subjected to thematic analysis.Results: Pack groupings did not differ greatly across FGDs; bold, contrasting colors and elements communicating flavor and promotion increased cigarette pack appeal and desire to try. Participants perceived packs with these features to be used by and designed for youth, like themselves.Conclusion: Our findings reinforce the importance of packaging design in attracting new consumers and maintaining current ones. Mexico should consider stronger tobacco advertising policies that include packaging color and depiction of flavor to reduce product appeal.
Effectiveness and perceptions of using templates in long-term condition reviews: a systematic synthesis of quantitative and qualitative studies
Authors: Morrissey Mary , Shepherd Elizabeth , Kinley Emma , McClatchey Kirstie , Pinnock Hilary 
Published: March 2021

BackgroundReview templates are commonly used in long-term condition (LTC) consultations to standardise care for patients and promote consistent data recording. However, templates may affect interactions during the review and, potentially, inhibit patient-centred care.AimTo systematically review the literature about the impact that LTC review templates have on process and health outcomes, and the views of health professionals and patients on using review templates in consultations.Design and settingParallel qualitative and quantitative systematic reviews.MethodFollowing Cochrane methodology, nine databases were searched (1995–2019; updated July 2020) for clinical trials and qualitative studies of LTC templates in healthcare settings. Duplicate selection, risk-of-bias assessment, and data extraction were performed. The quantitative and qualitative analyses were conducted in parallel, and findings synthesised narratively.ResultsIn total, 12 qualitative and 14 quantitative studies were included (two studies reported both qualitative and quantitative data, and were included in both analyses). Review templates were well used, but the only study to assess health outcomes showed no effect. Templates can improve documentation of key measures and act as a reminder tool; however, they can restrict the review process, and risk health professionals’ agendas being prioritised over those of patients. Templates may also limit opportunities to discuss individuals’ concerns about living with their condition and act as a barrier to providing patient-centred care.ConclusionFuture research should evaluate health, as well as process, outcomes. The potential benefits of templates in improving documentation should be balanced against concerns that ‘tick boxes’ may override patient agendas, unless templates are designed to promote patient-centred care.
Guest Editors’ Note
Authors: Mitralexis Sotiris , Steiris Georgios 
Published: March 2021

We are most thankful to Forum Philosophicum, and its Editor-in-Chief Marcin Podbielski, for the invitation to act as guest editors in a special issue dedicated to looking at Maximus the Confessor from a philosophical perspective—by which we mean both the philosophical efflorescence of Maximus’ thought per se, approached within its historical context, and the attempt to find Maximian solutions to contemporary philosophical problems or to engage Maximus’ thought in dialogue with modern philosophy. In many ways, this special issue is a sister volume to the book Maximus the Confessor as a European Philosopher (Eugene: Cascade / Wipf & Stock, forthcoming later in 2016). Both form parts of a sustained attempt at highlighting Maximus the Confessor’s relevance for philosophical inquiry, without denying the explicitly theological nature of his thought in doing so. Believing that there is much philosophical fecundity in this approach, we remain with the hope that it will be continued.
PENGARUH PEMBERIAN TABLET BESI DALAM MENINGKATKAN KADAR HEMOGLOBIN REMAJA UMUR PUTRI DI SEKOLAH MENENGAH ATAS LAHAT
Authors: Haryanti Eka , Kamesworo Kamesworo - , Maksuk Maksuk - 
Published: March 2021

ABSTRAK
Latar belakang: Penyebab utama yang dapat menimbulkan anemia pada wanita yaitu terjadinya kehilangan darah saat menstruasi dan kurangnya zat gizi dalam pembentukan darah misalnya zat besi, protein, asam folat dan B12. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian tablet Fe dalam peningkatan kadar Hb pada remaja usia 15-18 tahun di SMAN 3 Lahat.
Metode: Jenis penelitian ini adalah kuantitatif dengan desain Quasy Eksperiment One Group Pretest Postest. Sampel diambil menggunakan purposive sampling sebanyak 46 responden. Alat ukur yang digunakan adalah Hb meter.
Hasil: Hasil penelitian menunjukan sebelum pemberian tablet Fe didapatkan bahwa dari 46 responden, yaitu sebanyak 11 responden (24%) mengalami anemia. Pada pengukuran setelah pemberian tablet Fe dari 46 responden terdapat 5 responden (10.9%) mengalami anemia. Uji Test Dependent menunjukan hasil signifkan (p = 0,001). Hal ini menunjukan ada pengaruh pemberian tablet Fe dalam peningkatan kadar Hb pada remaja usia 15-18 tahun.
Kesimpulan: Sesudah pemberian Tablet Fe menggunakan uji T maka didapatkan (P value = 0.001), dimana P value lebih kecil dari 0.05 artinya ada perbedaan yang signifikan antara pemberian Tablet Fe terhadap kadar Hb remaja putri di SMAN 3 Lahat.
Kata Kunci: Anemia, tablet Fe, remaja

ABSTRACT
Background:The main causes that can cause anemia in women are blood loss during menstruation and lack of nutrients in the formation of blood such as iron, protein, folic acid and B12. This study aims to determine the effect of giving Fe Tablets in increasing Hb levels in adolescents aged 15-18 years at Senior High School 3 (SMAN 3 ) of Lahat.
Method:This type of research is quantitative with the design of Quasy Experiment One Group Pretest Postest. Samples were taken using purposive sampling as many as 46 respondents. The measuring instrument used is the Hb meter.
Results: The results showed that before giving Fe tablets, it was found that of 46 respondents, 11 respondents (24%) had anemia. In the measurement after giving Fe tablets from 46 respondents there were 5 respondents (10.9%) having anemia. Test Dependent Test showed significant results (p = 0.001). This shows that there is an effect of giving Fe tablets in increasing Hb levels in adolescents aged 15-18 years.
Conclusion:After giving Fe Tablet using the T test, it was obtained (P value = 0.001), where P value is less than 0.05, it means that there is a significant difference between Fe tablet administration on Hb levels of girls in Senior High School 3 (SMAN 3) of Lahat
Keywords:Anemia, Fe tablets,