bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Surgical Delays on Short- and Long-Term Survival Among Colon Cancer Patients
Authors: Lo Brian D. , Caturegli Giorgio , Stem Miloslawa , Biju Kevin , Safar Bashar , Efron Jonathan E. , Rajput Ashwani , Atallah Chady 
Published: October 2021

Background The purpose of this study was to assess the impact of surgical delays on short- and long-term survival among colon cancer patients. Methods Adult patients undergoing surgery for stage I, II, or III colon cancer were identified from the National Cancer Database (2010-2016). After categorization by wait times from diagnosis to surgery (<1 week, 1-3 weeks, 3-6 weeks, 6-9 weeks, 9-12 weeks, and >12 weeks), 30-day mortality, 90-day mortality, and 5-year overall survival were compared between patients both overall and after stratification by pathological disease stage. Results Among 187 394 colon cancer patients, 24.2% waited <1 week, 30.5% waited 1-3 weeks, 29.0% waited 3-6 weeks, 9.7% waited 6-9 weeks, 3.3% waited 9-12 weeks, and 3.3% waited >12 weeks for surgery. Patients undergoing surgery 3-6 weeks after colon cancer diagnosis exhibited the best 30-day mortality (1.3%), 90-day mortality (2.3%), and 5-year overall survival (71.8%) ( P < .001 for all). After risk-adjusting for confounders, all wait times beyond 6 weeks were associated with worse 5-year overall survival (6-9 weeks: HR 1.10, 95% CI 1.06-1.15; 9-12 weeks: HR 1.25, 95% CI 1.18-1.33; >12 weeks: HR 1.43, 95% CI 1.35-1.52; P < .001 for all). Subgroup analysis after stratification by disease stage demonstrated that patients with stage III colon cancer were able to wait up to 9 weeks before exhibiting worse 5-year overall survival, compared to 6 weeks for patients with stage I or II disease. Conclusions Colon cancer patients should undergo surgery 3-6 weeks after diagnosis, as all surgical delays beyond 6 weeks were associated with worse 30-day mortality, 90-day mortality, and 5-year overall survival.
Positive mental health framework of transdiagnostic protective factors in elucidating the association between adverse childhood experiences and severe mental disorders
Authors: Liu Jianlin , Abdin Edimansyah , Vaingankar Janhavi Ajit , Lim Matthew Sheng Mian , Verma Swapna , Tang Charmaine , Shafie Saleha , Shahwan Shazana , Subramaniam Mythily 
Published: October 2021

Objectives: Transdiagnostic risk factors—disrupted processes common to psychopathology—link adverse childhood experiences to severe mental disorders (i.e. major depressive disorder, bipolar disorder, and schizophrenia spectrum disorders); however, transdiagnostic protective factors are understudied. The present study investigated the association between a positive mental health framework of protective intra- and interpersonal resources and severe mental disorders in individuals with adverse childhood experiences. We hypothesized that (1) individuals with adverse childhood experiences will experience more severe mental disorders and poorer intra- and interpersonal resources than those without adverse childhood experiences; (2) intrapersonal (e.g. general coping) and interpersonal resources (e.g. emotional support) will interact to predict severe mental disorders. Methods: A total of 1929 adults participated in this population-based study. Participants were assessed for adverse childhood experiences, severe mental disorders, and intra- and interpersonal resources (general coping, general affect, emotional support, interpersonal skills, spirituality, and personal growth and autonomy) via structured interviews and self-reports. Results: As hypothesized, individuals with adverse childhood experiences (62.6%) experienced more severe mental disorders and poorer intra- and interpersonal resources than those without adverse childhood experiences. Among those with adverse childhood experiences, emotional support interacted with general coping and general affect to predict severe mental disorders; general coping and general affect were negatively associated with severe mental disorders at high (+1 SD) and low (−1 SD) emotional support, respectively. Conclusions: The present study identified interactions between specific intrapersonal (i.e. general coping and general affect) and interpersonal resources (i.e. emotional support); knowing among whom and when to intervene are essential for optimal treatment of adverse childhood experiences and severe mental disorders.
Introducing a digital tool for sustainability impact assessments within the German Federal Government: A neo-institutional perspective
Authors: Wanckel Camilla 
Published: October 2021

This study examines the institutionalization of information technologies for policy formulation by investigating the case of eNAP. The digital tool was introduced in the spring of 2018 with the aim of supporting and improving sustainability impact assessments (SIAs) within the German Federal Government. Applying a neo-institutional perspective, this study shows how a tool like eNAP is embedded into prevailing regulative, normative, and cultural–cognitive structures. Findings from 10 semi-structured interviews indicate that the application of eNAP varies according to intra-ministerial coordination practices and portfolio-specific information-processing schemata. Overall, the tool serves to translate the abstract regulation to conduct an SIA, as well as to translate the vague norm of “sustainability” into a concrete assessment requirement, thereby helping increase policy officials’ awareness of sustainability goals. However, consistent with previous studies, great importance is not attached to SIAs in policy formulation, and prevailing norms and routines make the implementation of eNAP to increase the use of evidence or in-depth considerations of policy alternatives and their consequences unlikely. Points for practitioners Information and communication technologies (ICTs) provide new opportunities to support ex-ante policy evaluations. Practitioners enforcing ICTs for impact assessments should take a comprehensive perspective on the institutional context because both formal organizational structures and implicit expectations, habits and routines affect how policy officials use these tools. Technology alone does not improve policy evaluations, and a misfit between regulative, normative and cultural–cognitive institutional elements can lead to merely symbolic displays of impact assessments through the means of digital tools.
Comparison of intravesical adjuvant therapy in bladder cancer with two different maintenance regimens of mitomycin and BCG
Authors: Gupta Sandeep , Dutta Avisek , Pal Dilip Kumar 
Published: October 2021

Objective: To compare recurrence rate and side effects with two different maintenance regimens of postoperative intravesical therapy with mitomycin and BCG in T1 bladder cancer. Methods: Eighty were enrolled in this study and all received immediate post operative mitomycin. They were then allocated to two groups of 40, one group receiving intravesicle BCG and other a combination BCG and Mitomycin. They were followed up to a period of 2 years. Result: Two year recurrence rate after transurethral resection of bladder tumour with high grade T1 disease in the Combination group is low (20%) as compared to the BCG group (37.5%). Conclusion: Two year recurrences reduced with use of intravesical Mitomycin during maintenance in the combination group which though not statistically significant favours the trial with combination therapy in future studies. Side effect profile did not worsen with combination of Mitomycin and BCG.
Accelerated aging and characterization of HDPE pin type insulators (15 kV)
Authors: Erbetta Cynthia DC , Silva Maria Elisa SR , Freitas Roberto FS , Sousa Ricardo G 
Published: October 2021

The study of the behavior of polymeric material used for insulators in the electrical system is extremely important in order to evaluate their lifetime as well as their performance when exposed to different environmental conditions. In the present work, the behavior of high-density polyethylene (HDPE) pin type insulators (15 kV), under accelerated aging conditions, was studied. Samples were exposed to aging, for 200 h, 1000 h, and 2000 h, in accelerated weathering chambers, according to two different methods. In Method 1, the parameters were established based on natural aging in location conditions, and in Method 2, ASTM G155 standard parameters were used. All samples were characterized by rheometry, Fourier-transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC). The accelerated aging conditions, used in Methods 1 and 2, affected the aging of HDPE pin type insulators samples differently, the changes being more intense in Method 1.
Effective elimination of high-dose methotrexate by repeated hemodiafiltration and high-flux hemodialysis in patients with acute kidney injury
Authors: Sakran Razan , Milo Gai , Jabareen Ali , Artul Tareq , Haim Nissim , Litvak Michael , Ringelstein-Harlev Shimrit , Horowitz Nethanel , Efrati Edna , Assady Suheir , Kurnik Daniel 
Published: October 2021

Introduction Acute kidney injury (AKI) after high dose methotrexate (HD-MTX) is associated with delayed MTX-excretion and life-threatening toxicity. Glucapridase, the recommended therapy, is expensive and not always available. Case series We describe 3 cases (69, 67, 73 years) with diffuse large B-cell lymphoma who developed AKI and early-onset severely delayed MTX elimination after HD-MTX. MTX serum concentrations were 101 and 69 μmol/L at 24 h after administration in two patients and 34 μmol/L at 32 h in the third. Management and outcome Since glucarpidase was unavailable, we performed daily high-flux hemodialysis (HF-HD) or online hemodiafiltration (HDF) sessions (median duration, 6 h). The median serum MTX elimination half-life during HDF/HF-HD sessions was similar in all patients (median, 4.4 h; IQR, 3.8–5.3 h), but serum MTX concentrations rebounded after each dialysis by a median of 40% of the trough concentrations. The three patients underwent multiple dialysis sessions, until MTX serum concentrations remained sufficiently low to be neutralized by leucovorin. Only 1 patient developed severe pancytopenia, and renal function normalized in all patients after 3–6 weeks. Discussion In conclusion, when glucarpidase is unavailable or delayed, early, repeated and prolonged HDF/HF-HD effectively enhance MTX elimination and prevent toxicity in patients with AKI and severely delayed MTX elimination after HD-MTX.
Effect of placement angle, diameter, length and bone density on the pull-out strength of orthodontic mini-implants: An in vitro study
Authors: Mohan Santosh , Srinivasan Dilip , Arumugam Edeinton , Devasahayam Davis , Kannan Ravi 
Published: October 2021

Objective: To evaluate the effect of the placement angle, diameter, length and bone density on the mechanical stability of orthodontic mini-implants by measuring their pull-out strengths. Design: A total of 120 mini-implants of four different dimensions made from titanium were used. They measured 1.3 × 6.0mm, 1.3 × 8.0 mm, 1.5 × 6.0 mm and 1.5 × 8.0 mm. Synthetic polyurethane bone blocks (Saw Bones, USA) in two different densities were used. Setting: Each size of mini-implant was inserted equidistantly into synthetic bone blocks of two different densities, in three different insertion angles of 30°, 60° and 90°. This resulted in 24 test groups with five mini-implants allocated to each group. Methods: The pull-out strength was measured using an Instron Universal Testing Machine exerting a vertical force parallel to the long axis of the mini-implant until removal or failure occurred. Peak load at failure of the mini-implant was recorded in kN. Results: Showed that mini-implants placed at an insertion angle of 30° offered least resistance to pull-out. Mini-implants 6.0 mm in length showed less pull-out strength compared to the longer 8.0-mm mini-implants. Mini-implants 1.3 mm in diameter provided similar pull-out values as 1.5-mm mini-implants. Bone densities of 0.20 g/cc and 0.32 g/cc did not affect the pull-out strength of mini-implants. Conclusion: From the study, it was concluded that a logical choice of mini-implant dimension and prudent use of placement technique can help achieve the treatment goals with a reduced hazard of mini-implant failure.
Effect of interval compared to continuous exercise training on physiological responses in patients with chronic respiratory diseases: A systematic review and meta-analysis
Authors: Alexiou Charikleia , Ward Lesley , Hume Emily , Armstrong Matthew , Wilkinson Mick , Vogiatzis Ioannis 
Published: October 2021

Background Current evidence suggests that interval exercise training (IET) and continuous exercise training (CET) produce comparable benefits in exercise capacity, cardiorespiratory fitness and symptoms in patients with chronic obstructive pulmonary disease (COPD). However, the effects of these modalities have only been reviewed in patients with COPD. This meta-analysis compares the effectiveness of IET versus CET on exercise capacity, cardiorespiratory fitness and exertional symptoms in patients with chronic respiratory diseases (CRDs). Methods: PubMed, CINHAL, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Nursing and Allied health were searched for randomised controlled trials from inception to September 2020. Eligible studies included the comparison between IET and CET, reporting measures of exercise capacity, cardiorespiratory fitness and symptoms in individuals with CRDs. Results: Thirteen randomised control trials (530 patients with CRDs) with fair to good quality on the PEDro scale were included. Eleven studies involved n = 446 patients with COPD, one involved n = 24 patients with cystic fibrosis (CF) and one n = 60 lung transplantation (LT) candidates. IET resulted in greater improvements in peak work rate (WRpeak) (2.40 W, 95% CI: 0.83 to 3.97 W; p = 0.003) and lower exercise-induced dyspnoea (−0.47, 95% CI: −0.86 to 0.09; p = 0.02) compared to CET; however, these improvements did not exceed the minimal important difference for these outcomes. No significant differences in peak values for oxygen uptake (VO2peak), heart rate (HRpeak), minute ventilation (VEpeak), lactate threshold (LAT) and leg discomfort were found between the interventions. Conclusions: IET is superior to CET in improving exercise capacity and exercise-induced dyspnoea sensations in patients with CRDs; however, the extent of the clinical benefit is not considered clinically meaningful.
Systematic Review of Health Organization Guidelines Following the AMSSM 2019 Youth Early Sport Specialization Summit
Authors:   AMSSM Collaborative Research Network Youth Early Sport Specialization Summit, Herman Daniel C. , Nelson Vicki R. , Montalvo Alicia M. , Myer Greg D. , Brenner Joel S. , DiFiori John P. , Jayanthi Neeru A. , Marshall Stephen W. , Kliethermes Stephanie A. , Beutler Anthony I. , Tenforde Adam S. 
Published: October 2021

Context: Youth sport specialization may place young athletes at increased risk for negative impacts to their physical and/or psychological health. In response to these health concerns, several health organizations have created guidelines and position statements to guide parents and practitioners toward best practices for management of the young athlete. Objective: To systematically review and synthesize current organizations’ recommendations and guidelines regarding youth sport specialization. Data Sources: English-language articles from January 1, 2000, to December 31, 2018, in the NCBI Pubmed, Embase, Cochrane, CINAHL, and SPORTDiscus databases. Study Selection: Articles that reported on recommendations or interventions by health organizations or health representatives of sports organizations. A total of 56 articles were assessed, with 11 meeting inclusion eligibility criteria. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Two investigators independently identified all recommendations within the results that fit within a 15-item framework encompassing 4 domains: Psychological Development/Approach, Physical Development/Load, Facilities and Resources, and Timing and Monitoring of Specialization. Results: Recommendations across organizations were primarily clustered in the Physical Development/Load (43%), Facilities and Resources (48%), and Sport Specialization (55%) domains. In contrast, the Psychological Development/Approach domain had fewer recommendations (20%). The most common recommendations endorsed concepts: “Monitor athlete well-being,” “Youth athletes need access to well-trained, quality coaches,” “Multi-sport participation,” “Limit early organized participation and/or training,” and “Parents require awareness of training, coaching, and best practices.” The level of evidence provided to support a given recommendation varied significantly. The level of detail and the consistency of terms used throughout the results were typically low. Recommendations were frequently made without reference to potential outcome measures or specific strategies that could be used for practical implementation in the community. Conclusion: There was broad representation of different aspects of specialization but limited consistency between health organization guidelines. Adopting a framework for recommendations as used in this review could assist organizations in structuring future recommendations that are specific, measurable, and framed in a manner that will promote action in the youth sport community.
Benefit of continued noninvasive cardiac monitoring in geriatric trauma: A retrospective review of geriatric pelvis, hip, and femur fractures and analysis of cardiac events during immediate post-traumatic course
Authors: Curfman Karleigh R , Urias Daniel S , Simunich Thomas J , Dodson Byron D , Morrissey Shawna L 
Published: October 2021

Objective: The geriatric population suffers from a predisposition to cardiac events due to physiologic changes commonly associated with aging. The majority of the trauma population seen at our facility is within the geriatric population (greater than 65 years old). Therefore, this study was aimed to determine which of those preexisting factors were associated with an increased risk for developing cardiac event. By assessing those risks, we hoped to determine a timeline for the highest risk of cardiac event occurrence, in order to identify a safe period of when cardiac monitoring was indicated. Methods: A retrospective study performed over 6 months reviewing geriatric trauma patients with hip, pelvis, or femur fractures, n = 125. A list of predetermined risk factors including comorbidities, pathologies, laboratory values, electrocardiogram findings, and surgery was crossed with the patient’s records in order to identify factors for increased risk of cardiac event. Once patients who had documented cardiac events were identified, a temporal pattern of cardiac event occurrence was analyzed in order to determine a period when noninvasive cardiac monitoring should remain in place. Results: In 125 patients, 40 cardiac events occurred in 30 patients. The analyzed variables with statistically significant associations for having a cardiac event were comorbidities (p = 0.019), elevated body mass index (p = 0.001), abnormal initial phosphorus (p = 0.002), and an electrocardiogram finding of other than normal sinus rhythm (p = 0.020). Of the identified cardiac events, we found that by hospital day 3 68% of cardiac event had occurred, with 85% by hospital day 4, 95% by day 5, and 100% within the first 7 days of admission. Conclusion: Patient history of cardiac comorbidities, elevated body mass index, abnormal phosphorus, and abnormal electrocardiogram findings were found to be significant risk factors for cardiac event development in geriatric trauma. All recorded events in our study occurred within 7 days of the initial trauma.
Apoptotic M540 bodies present in human semen interfere with flow cytometry-assisted assessment of sperm DNA fragmentation and oxidation
Authors: Sadeghi Niloofar , Tavalaee Marziyeh , Kiani-Esfahani Abbas , Moazamian Aron , Gharagozloo Parviz , Aitken Robert J. , Drevet Joël R. , Nasr-Esfahani Mohammad Hossein 
Published: October 2021

Abstract
Background
The use of flow cytometry (FC) to evaluate sperm DNA fragmentation via deoxynucleotidyl transferase terminal fluorescein dUTP nick-end labeling (TUNEL) has shown inconsistencies compared with conventional fluorescent microscopic analyses. It has been hypothesized that the observed discrepancies could be attributed to the presence of apoptotic bodies that can be labeled with merocyanine 540, the so-called M540 bodies. In order to verify this hypothesis and determine the accuracy of our in-house FC-assisted evaluation of spermatozoa parameters, we used FC to evaluate both the fragmentation of sperm DNA using the TUNEL assay and the oxidation of sperm DNA using the 8-OHdG assay on semen samples with or without M540 bodies.

Results
We show that the presence of M540 bodies lead to underestimation of both the level of sperm DNA fragmentation and sperm DNA oxidation when using FC assisted detection systems. We also observed that this situation is particularly pertinent in semen samples classified as abnormal with respect to the routine WHO semen evaluation as they appear to contain more M540 bodies than normal samples.

Conclusions
We conclude that M540 bodies interfere with both FC-conducted assays designed to evaluate sperm nuclear/DNA integrity. Exclusion of these contaminants in unprepared semen samples should be performed in order to correctly appreciate the true level of sperm DNA/nuclear damage which is known to be a critical male factor for reproductive success.