bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metachronous port site, muscular and subcutaneous metastases from a gastric adenocarcinoma: a case report and review of articles
Authors: Fukui Yasuhiro , Kubo Naoshi , Sakurai Katsunobu , Tamamori Yutaka , Maeda Kiyoshi , Ohira Masaichi 
Published: May 2021

AbstractBackgroundPort site metastasis (PSM) after curative gastrectomy for gastric cancer and muscular metastasis from gastric cancer are rare manifestations. Similarly, subcutaneous metastasis from gastric cancer is rare, and muscular and subcutaneous metastases are associated with poor prognosis. We report a case of long-term survival in a patient who underwent curative resection of gastric cancer and repeated recurrence of port site, muscular and subcutaneous metastases from gastric cancer, treated by resection.Case presentationA 75-year-old man was diagnosed with gastric cancer and referred to our department. Upper endoscopy demonstrated a 5-cm circumferential ulcerated lesion at the cardia. Biopsy findings showed a poorly differentiated tubular adenocarcinoma. He underwent laparoscopic total gastrectomy with lymph node dissection, and pathologic examination revealed a moderately differentiated tubular adenocarcinoma stage T4aN1M0 and IIIA according to the UICC (Union for International Cancer Control) classification. He refused adjuvant chemotherapy and was only carefully observed. Twenty-three months after the primary gastrectomy, computed tomography (CT) revealed an irregular mass near the port site wounds. Then the patient underwent mass resection, and the pathological diagnosis was consistent with metastatic adenocarcinoma, located in the subcutaneous tissue at the port site wounds. Thirteen months after the second surgery, CT revealed an enhanced mass in the abdominal wall. Positron emission tomography (PET) CT showed an elevated uptake in the rectus abdominis muscle and a standardized uptake value (SUV) of 3.1. The patient underwent another mass resection, and the pathological diagnosis was consistent with metastatic adenocarcinoma in the rectus abdominis muscle. Thirty-five months after the third surgery, CT revealed a mass in the left gluteal subcutaneous region. Furthermore, PET-CT revealed a 35-mm mass with an elevated SUV of 9.6. Another mass resection procedure was performed, and the pathological diagnosis was consistent with metastatic adenocarcinoma in the subcutaneous tissue. Since tumor cells were present at the resection margin, additional radiation therapy was performed. The patient has survived 78 months after primary gastrectomy.ConclusionThe prognosis of muscular and subcutaneous metastases from gastric cancer is poor. However, if the metastatic tumor is solitary, surgical excision could be a feasible treatment option and might prolong survival.
Serial computed tomography findings of Coronavirus disease 2019 (COVID-19) pneumonia treated with favipiravir and steroid therapy: report of 11 cases
Authors: Irizato Naoki , Matsuura Hiroshi , Okada Atsuya , Ueda Ken , Yamamura Hitoshi 
Published: May 2021

Abstract
Background
This study evaluated the time course of computed tomography (CT) findings of patients with COVID-19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy.

Results
Eleven patients with severe COVID-19 pneumonia were included. CT findings assessed at the three time points showed that all patients had ground-glass opacities (GGO) and consolidation and mixed pattern at intubation. Consolidation and mixed pattern disappeared in most of the patients whereas GGO persisted in all patients at 1-month follow-up. In addition to GGO, a subpleural line and bronchus distortion and bronchial dilatation were frequent findings. The degree of resolution of GGO varied depending on each patient. The GGO score correlated significantly with the time from symptoms onset to initiation of steroid therapy (ρ = 0.707, p = 0.015).

Conclusions
At 1-month follow-up after discharge, non-GGO lesions were absorbed almost completely, and GGO were a predominant CT manifestation. Starting steroid therapy earlier after onset of symptoms in severe COVID-19 pneumonia may reduce the extent of GGO at 1-month follow-up.
k-Zumkeller labeling of super subdivision of some graphs
Authors: Basher M. 
Published: May 2021

AbstractA simple graph $$G=(V,E)$$

G
=
(
V
,
E
)

is said to be k-Zumkeller graph if there is an injective function f from the vertices of G to the natural numbers N such that when each edge $$xy\in E$$

x
y
∈
E

is assigned the label f(x)f(y), the resulting edge labels are k distinct Zumkeller numbers. In this paper, we show that the super subdivision of path, cycle, comb, ladder, crown, circular ladder, planar grid and prism are k-Zumkeller graphs.
Butterfly optimizer-assisted optimal integration of REDG units in hybrid AC/DC distribution micro-grids based on minimum operational area
Authors: Injeti Satish Kumar 
Published: May 2021

AbstractThis paper presents the impact of optimal location and sizing of renewable and non-renewable-based distributed generators in the AC/DC micro-grid system using the latest optimizer called butterfly optimization algorithm with an aim to minimize power loss. Generally, hybrid AC/DC micro-grids systems are modeled by separating AC and DC feeders with the help of high-power converters (HPC).AC grids sustained by substation and DC grids are maintained by their individual DG units. While planning of DGs in the hybrid AC/DC systems, the power loss incurred by HPCs is not considered avoiding complexity by many authors. In this paper, the sizing of DGs is determined by the operational area required by the type of DG technology as one variable and all possible candidate buses in the respective zones of AC/DC micro-grid system are another variable with due consideration of HPC losses in AC/DC micro-grid system. A hybrid AC/DC MG system is developed by classifying the existing benchmark 33-bus and 69-bus radial distribution systems into various AC/DC zones. To evaluate the proposed approach, it is implemented on aforementioned micro-grid systems and the obtained results are verified with other existing approaches in the literature. The results proved that the proposed approach is better than the other approaches in technical aspects.
Facilitating the Search for Partners on Matching Platforms
Authors: Kanoria Yash , Saban Daniela 
Published: May 2021

Two-sided matching platforms can control and optimize over many aspects of the search for partners. To understand how matching platforms should be designed, we introduce a dynamic two-sided search model with strategic agents who must bear a cost to discover their value for each potential partner and can do so nonsimultaneously. We characterize evolutionarily stable stationary equilibria and find that, in many settings, the platform can mitigate wasted search effort by imposing suitable restrictions on agents. In unbalanced markets, the platform should force the short side of the market to initiate contact with potential partners, by disallowing the long side from doing so. This allows the agents on the long side to exercise more choice in equilibrium. When agents are vertically differentiated, the platform can significantly improve welfare even in the limit of vanishing screening costs by forcing the shorter side of the market to propose and by hiding information about the quality of potential partners. Furthermore, a Pareto improvement in welfare is possible in this limit. This paper was accepted by Baris Ata, stochastic models and simulation.
Mental health assessment and triage in an ambulance clinical contact centre
Authors: Briggs Hannah , Clarke Stephen , Rees Nigel 
Published: May 2021

Background: With increasing numbers of emergency calls to ambulance services, exploration of the triage and management of mental health calls is valuable, given their volume and duration. Studies have explored these calls from patient and practitioner perspectives, but few have considered the perspective of the practitioners assessing patients over the phone in terms of clinical capability. Aim: This study aimed to explore the thoughts, feelings and educational requirements of paramedics and nurses working on emergency medical services clinical desks, focusing on mental health-related calls and the triage tools used. Methods: A service evaluation was conducted. A questionnaire was developed and distributed to 41 staff on clinical desks at the Welsh Ambulance Service Trust's (WAST) clinical contact centres in June 2019. Quantitative data was analysed using descriptive statistics and qualitative data by thematic analysis. Findings: Out of the 41 employees, 26 (63%) responded. Low levels of confidence were reported in managing mental health calls, along with inadequate detail in the mental health elements of their triage algorithm and deficiencies in referral pathways. Conclusion: Given the volume and complexity of mental health calls to ambulance services, more attention should be paid to the education and training of clinical desk professionals and the decision support tools available in WAST and other ambulance services. Further research is required with a larger sample size over multiple ambulance services.
Long-term patient-related quality of life after fracture-related infections of the long bones
Authors: Walter Nike , Rupp Markus , Hierl Katja , Pfeifer Christian , Kerschbaum Maximilian , Hinterberger Thilo , Alt Volker 
Published: May 2021

Aims We aimed to evaluate the long-term impact of fracture-related infection (FRI) on patients’ physical health and psychological wellbeing. For this purpose, quality of life after successful surgical treatment of FRIs of long bones was assessed. Methods A total of 37 patients treated between November 2009 and March 2019, with achieved eradication of infection and stable bone consolidation after long bone FRI, were included. Quality of life was evaluated with the EuroQol five-dimension questionnaire (EQ-5D) and German Short-Form 36 (SF-36) outcome instruments as well as with an International Classification of Diseases of the World Health Organization (ICD)-10 based symptom rating (ISR) and compared to normative data. Results With a mean follow-up of 4.19 years (SD 2.7) after the last surgery, the mean SF-36 score was 40.1 (SD 14.6) regarding the physical health component and 48.7 (SD 5.1) regarding the mental health component, compared to German normative values of 48.4 (SD 9.2) (p < 0.001) and 50.9 (SD 8.8) (p = 0.143). The mean EQ-5D index reached 0.76 (SD 0.27) with a mean EQ-5D visual analogue scale (VAS) rating of 65.7 (SD 22.7) compared to reference scores of 0.88 (p < 0.001) and 72.9 (p < 0.001). Mean scores of the ISR did not reveal significant psychological symptom burden, while an individual analysis showed moderate to severe impairments in 21.6% (n = 8) of the patients. Conclusion Even a mean 4.2 years (SD 2.7) after surgically successful treatment of FRI of long bones, patients report significantly lower quality of life in comparison to normative data. Future clinical studies on FRIs should focus on patient-related outcome measures enabling best possible shared treatment decision-making. Prevention methods and interdisciplinary approaches should be implemented to improve the overall quality of life of FRI patients. Cite this article: Bone Joint Res 2021;10(5):321–327.
HOW TO OBTAIN A GLOBAL REFERENCE THRESHOLD IN AHP/ANP
Authors: Garuti Claudio 
Published: May 2021

This paper has two main objectives. The first objective is to provide a mathematically grounded technique to construct local and global thresholds using the well-known rate of change method. The next objective, which is secondary, is to show the relevance and possibilities of applying the AHP/ANP in absolute measurement (AM) compared to the relative measurement (RM) mode, which is currently widely used in the AHP/ANP community. The ability to construct a global threshold would help increase the use of AHP/ANP in the AM mode (rating mode) in the AHP/ANP community. Therefore, if the first specific objective is achieved, it would facilitate reaching the second, more general objective.

For this purpose, a real-life example based on the construction of a multi-criteria index and threshold will be described. The index measures the degree of lag of a neighborhood through the Urban and Social Deterioration Index (USDI) based on an AHP risks model. The global threshold represents the tolerable lag value for the specific neighborhood. The difference or gap between the neighborhood’s current status (actual USDI value) and this threshold represents the level of neighborhood deterioration that must be addressed to close the gap from a social and urban standpoint. The global threshold value is a composition of 45 terminal criteria with their own local threshold that must be evaluated for the specific neighborhood. This example is the most recent in a large list of AHP applications in AM mode in vastly different decision making fields, such as risk disaster assessment, environmental assessment, the problem of medical diagnoses, social responsibility problems, BOCR analysis for the evolution of nuclear energy in Chile in the next 20 years and many others. (See list of projects in Appendix).
Optimized response of the AlGaN/GaN heterostructure with asymmetric gratings at oblique incidence in the terahertz regime
Authors: Cao Lei , Xia Huiting , Jia Shanshan , Yin Zhengya 
Published: May 2021

The performance of terahertz (THz) detectors based on two-dimensional electron gas (2DEG) with the aid of a subwavelength gratings coupler depends critically on the amplitude difference of an electric field with positive and negative scattering orders. An efficient method was proposed to enhance the current response of the AlGaN/GaN material in the frequency range from 0 to 5 THz under oblique incidence of THz radiation with asymmetric gratings, where the optimal incidence angle exists. The case of symmetric gratings was also studied for comparison. The results will be useful for the theoretical and experimental optimization of grating-assisted THz detectors without electrical bias.
Compact diode-pumped CW and Q-switched 2.8 µm Er:YLF laser
Authors: Švejkar Richard , Šulc Jan , Němec Michal , Jelínková Helena 
Published: May 2021

This paper presents a compact diode-pumped continuous-wave Er:YLF laser emitting radiation at 2.8 µm with output power 2.9 W and slope efficiency 26.2%. Moreover, the

Q

-switching regime was successfully tested with a Fe:ZnSe polycrystal used as a modulator. Passive

Q

-switching results in the shortest pulse duration of 21 ns with repetition rate 50 kHz and peak power 252 W.
High-power continuous-wave mid-infrared difference-frequency generation
in the presence of thermal effects
Authors: Chaitanya Kumar S. , Sukeert  , Ebrahim-Zadeh M. 
Published: May 2021

We report performance studies of high-power, continuous-wave (cw), mid-infrared (mid-IR) difference-frequency generation (DFG) in MgO:PPLN at 2262 nm based on a narrowband Yb-fiber laser as pump and a Tm-fiber laser as signal source. Using a 50-mm-long crystal, we generate as much as 3.84 W of DFG output power at a single-pass conversion efficiency up to 0.57%/W, with a passive power stability better than 0.53% rms and passive spectral stability better than 0.01% over 1 h. The DFG beam also exhibits excellent spatial beam quality in

T
E
M

00

mode profile with

M
2

<

1.2

, and a beam pointing stability better than 16 µrad over

>

1

h

. Simulations based on focused Gaussian beam theory provide an accurate estimate of the generated DFG output power and confirm thermal effects. Detailed thermal analysis indicates the role of linear absorption at the interacting wavelengths in local heating within the focal volume of the MgO:PPLN crystal. To the best of our knowledge, this is the highest cw DFG output power and conversion efficiency achieved in bulk MgO:PPLN in the mid-IR.
Race and other sociodemographic categories are differentially linked to multiple dimensions of interpersonal-level discrimination: Implications for intersectional, health research
Authors: Beatty Moody Danielle L. , Waldstein Shari R. , Leibel Daniel K. , Hoggard Lori S. , Gee Gilbert C. , Ashe Jason J. , Brondolo Elizabeth , Al-Najjar Elias , Evans Michele K. , Zonderman Alan B. 
Published: May 2021

ObjectivesTo examine whether intersections of race with other key sociodemographic categories contribute to variations in multiple dimensions of race- and non-race-related, interpersonal-level discrimination and burden in urban-dwelling African Americans and Whites.MethodsData from 2,958 participants aged 30–64 in the population-based Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used to estimate up to four-way interactions of race, age, gender, and poverty status with reports of racial and everyday discrimination, discrimination across multiple social statuses, and related lifetime discrimination burden in multiple regression models.ResultsWe observed that: 1) African Americans experienced all forms of discrimination more frequently than Whites, but this finding was qualified by interactions of race with age, gender, and/or poverty status; 2) older African Americans, particularly African American men, and African American men living in poverty reported the greatest lifetime discrimination burden; 3) older African Americans reported greater racial discrimination and greater frequency of multiple social status-based discrimination than younger African Americans; 4) African American men reported greater racial and everyday discrimination and a greater frequency of social status discrimination than African American women; and, 5) White women reported greater frequency of discrimination than White men. Allp’s < .05.ConclusionsWithin African Americans, older, male individuals with lower SES experienced greater racial, lifetime, and multiple social status-based discrimination, but this pattern was not observed in Whites. Among Whites, women reported greater frequency of discrimination across multiple social statuses and other factors (i.e., gender, income, appearance, and health status) than men. Efforts to reduce discrimination-related health disparities should concurrently assess dimensions of interpersonal-level discrimination across multiple sociodemographic categories, while simultaneously considering the broader socioecological context shaping these factors.
Accuracy of autorefraction in an adult Indian population
Authors: Kumar Rajesh S. , Moe Caitlin A. , Kumar Deepak , Rackenchath Mahalakshmi V. , A. V. Sathi Devi , Nagaraj Sriharsha , Wittberg Dionna M. , Stamper Robert L. , Keenan Jeremy D. 
Published: May 2021

Purpose
Autorefractors allow non-specialists to quickly assess refractive error, and thus could be a useful component of large-scale vision screening programs. In order to better characterize the role of autorefraction for public health outreach programs in resource-limited settings, the diagnostic accuracy of two autorefractors was assessed relative to subjective refraction in an adult Indian population.

Methods
An optometrist refracted a series of patients aged ≥50 years at an eye clinic in Bangalore, India using the Nidek ARK-900 autorefractor first, followed by the 3nethra Royal autorefractor, and then subjective refraction. The diagnostic accuracy of each autorefractor for myopia, hyperopia, and astigmatism was assessed using subjective refraction as the reference standard, and measures of agreement between refractions were calculated.

Results
A total of 197 eyes in 104 individuals (mean age 63 ± 8 years, 52% female) were evaluated. Both autorefractors produced spherical equivalent estimates that were on average more hyperopic than subjective refraction, with a measurement bias of +0.16 D (95%CI +0.09 to +0.23D) for Nidek and +0.42 D (95%CI +0.28 to +0.54D) for 3nethra. When comparing pairs of measurements from autorefraction and subjective refraction, the limits of agreement were approximately ±1D for the Nidek autorefractor and ±1.75D for the 3Nethra autorefractor. The sensitivity and specificity of detecting ≥1 diopter of myopia were 94.6% (95%CI 86.8–100%) and 92.5% (95%CI 88.9–97.5%) for the Nidek, and 89.2% (95%CI 66.7–97.4) and 77.5% (95%CI 71.2–99.4%) for the 3Nethra. The accuracy of each autorefractor increased at greater levels of refractive error.

Conclusions
The sensitivity and specificity of the Nidek autorefractor for diagnosing refractive error among adults ≥50 years in an urban Indian clinic was sufficient for screening for visually significant refractive errors, although the relatively wide limits of agreement suggest that subjective refinement of the eyeglasses prescription would still be necessary.
The effects of 0.9% saline versus Plasma-Lyte 148 on renal function as assessed by creatinine concentration in patients undergoing major surgery: A single-centre double-blinded cluster crossover trial
Authors: Weinberg Laurence , Li Michael Hua-Gen , Churilov Leonid , Macgregor Christopher , Garrett Kent , Eyles Jade , Bellomo Rinaldo 
Published: May 2021

Objectives
Saline and Plasma-Lyte have different physiochemical contents; consequently, they may differently affect patients’ renal function. We compared the effects of fluid therapy with 0.9% saline and with Plasma-Lyte 148 on renal function as assessed by creatinine concentration among patients undergoing major surgery.

Methods
We conducted a prospective, double-blinded cluster crossover trial comparing the effects of the two fluids on major surgery patients. The primary aim was to establish the pilot feasibility, safety and preliminary efficacy evidence base for a large interventional trial to establish whether saline or Plasma-Lyte is the preferred crystalloid fluid for managing major surgery patients. The primary efficacy outcome was the proportion of patients with changes in renal function as assessed by creatinine concentration during their index hospital admission. We used changes in creatinine to define acute kidney injury (AKI) according to the RIFLE criteria.

Results
The study was feasible with 100% patient and clinician acceptance. There were no deviations from the trial protocol. After screening, we allocated 602 patients to saline and 458 to Plasma-Lyte. The median (IQR) volume of intraoperative fluid received was 2000 mL (1000:2000) in both groups. Forty-nine saline patients (8.1%) and 49 Plasma-Lyte patients (10.7%) developed a postoperative AKI (adjusted incidence rate ratio [aIRR]: 1.34; 95% CI: 0.93–1.95; p = 0.120). No differences were observed in the development of postoperative complications (aIRR: 0.98; 95% CI: 0.89–1.08) or the severity of the worst complication (aIRR: 1.00; 95% CI: 0.78–1.30). The median (IQR) length of hospital stay was six days (3:11) for the saline group and five days (3:10) for the Plasma-Lyte group (aIRR: 0.85; 95% CI: 0.73–0.98). There were no serious adverse events relating to the trial fluids, nor were there fluid crossover or contamination events.

Conclusions
The study design was feasible to support a future follow-up larger clinical trial. Patients treated with saline did not demonstrate an increased incidence of postoperative AKI (defined as changes in creatinine) compared to those treated with Plasma-Lyte. Our findings imply that clinicians can reasonably use either solution intraoperatively for adult patients undergoing major surgery.

Trial registration
Registry: Australian New Zealand Clinical Trials Registry; ACTRN12613001042730; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364988.