bluuebunny/crossref_metadata_2025_split huggingface dataset:
Difficulties That Lead to Conversion in Laparoscopic Cholecystectomy
Authors: Kamruzzaman Md , Rahman Md Shahidur , Khan Abdul Kader , Afrin Sadia 
Published: July 2024

Background: Cholelithiasis is one of the most common surgical problems throughout the world. Earlier, the prevailing treatment of symptomatic Cholelithiasis was an open cholecystectomy which is almost replaced by laparoscopic cholecystectomy. Although occasionaly switch to open cholecystectomy may require during the procedure which is known as conversion in laparoscopic cholecystectomy. Many factors contribute to the conversion which is not a sign of surgeon's failure rather is a sign of surgeon’s good surgical judgment. Our objectives are to find out the factors which are associated with conversion and thus reduce conversion rate, preoperative preparation and counseling the patient for conversion in laparoscopic cholecystectomy.
Methods: This was a hospital based retrospective study, carried out in department of hepatobiliary & pancreatic surgery department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January 2008 to December 2009. A total no of 50 cases were included in our study which were converted to open cholecystectomy. Cases were collected from the hospital medical records which were retrieved and analyzed.
Result: A total no of 768 laparoscopic cholecystectomies were attempted during the study period. Out of which 50 cases were converted to open cholecystectomy. Thus the conversion rate was 6.5%. Among these the reasons for conversion in both genders were dense adhesion in 22 (2.86%), aberrant anatomy in 10 (1.3%), empyema gall bladder in 4 (0.52%), per operative findings of choledocholithiasis in 3 (0.39%), suspicion of common bile duct injury in 3 (0.39%), others causes of conversion included uncontrolled bleeding 3 (0.39%), thick fibrosed gall bladder 2 (0.26%), accidental bowel injury 2 (0.26%), Type-I choledochal cyst 1 (0.13%) cases.
Conclusion: various factors are related to conversion in laparoscopic cholecystectomy. But due to improvement of learning curve, good quality operative equipment, now a day’s laparoscopic cholecystectomy is safe method of treatment for gall stone diseases with very low conversion rate.
J Bangladesh Coll Phys Surg 2024; 42: 235-240
Ciclo hemoterápico: Interferências no descarte de hemocomponentes sanguíneos e suas implicações
Authors: Santos Brunna Nayara da Graça , Oliveira Myllena Camilla Souza Gomes de , Silva Ana Paula Barreto Prata , Teles Weber de Santana , Silva Max Cruz da , Andrade Mariamália Newton , Andrade Ádamo Newton Marinho , Oliveira Fernanda Kelly Fraga , Carmo Francisca Evane Celestino do 
Published: July 2024

O ciclo do sangue culmina na formação de hemocomponentes e inicia-se desde a captação do doador, triagem, coleta, produção, análises sorológicas e imunohematológicas, armazenamento, distribuição e transfusão sanguínea. O descarte de hemocomponentes propriamente dito pode ocorrer durante cada etapa desse ciclo e não necessariamente apenas no seu fim. Isso dependerá dos interferentes ocorridos em determinada fase e da intercorrência adquirida nela. Este estudo trata-se de uma revisão narrativa da literatura, de caráter descritivo e exploratório, tem por objetivo avaliar as interferências relacionadas ao descarte de hemocomponentes durante o ciclo hemoterápico: por motivos sorológicos, erros vinculados à coleta e à produção e as causas subjacentes para tal prática. Os critérios de inclusão abrangeram os descartes de hemocomponentes por sorologia positiva, erros de coleta e de produção, e como critério de exclusão, nos artigos analisados, foram desconsiderados descartes por motivos vinculados a interrupção da transfusão na agência transfusional e descartes por contingência. Dentre as variáveis de descarte de hemocomponentes destacam-se a hemólise, dificuldade de punção venosa, fluxo lento e interrompido, volume excedente ou insuficiente, resultados de sorologia positivos, lipemia, esverdeamento de plasma, icterícia, contaminação por hemácias e vencimento. Os hemocomponentes mais descartados mediante os estudos analisados foram o concentrado de plaquetas (CP) e o plasma fresco congelado (PFC). Considerando esses os motivos de descarte analisados, é necessário reduzi-los durante a cadeia transfusional, a fim de gerenciar os estoques de hemocomponentes, para que se possa fornecê-los em prol da proteção e saúde dos receptores.
PROPOSTAS DIDÁTICAS PARA O ENSINO DE GEOGRAFIA:
Authors: Cano Fernando Camillo Santos 
Published: July 2024

A presente pesquisa objetivou desenvolver quatro sequências didáticas sobre o conteúdo Atmosfera para o ensino de geografia. As sequências didáticas foram capazes de propiciar ações para tornar mais significativa a aprendizagem dos alunos, sendo elas constituídas pelo arcabouço teórico-científico do educador, sua tomada de decisão em relação às estratégias metodológicas e a participação dos alunos em sala de aula. Na maioria das vezes, as formas tradicionais de ensino fazem com que os alunos não consigam superar seus obstáculos ou dificuldades específicas de aprendizagem, tornando o ensino engessado. Para o desenvolvimento das sequências didáticas da presente pesquisa foram utilizadas diferentes estratégias metodológicas, tais como: a exposição de imagens, jogo, mapa conceitual, música e vídeo. No que tange à temática abordada, o conteúdo de Atmosfera é propício à disseminação de imagens e diferentes recursos audiovisuais, facilitando o desenvolvimento das práticas criativas. Porém, os livros didáticos continuam reproduzindo formas tradicionais de ensino, dificultando a construção de uma nova forma de aprendizagem. A importância do estudo da Atmosfera na geografia escolar é orientar os alunos quanto aos fenômenos hodiernos, além de entender como ela se constitui e como ela pode alterar nosso cotidiano. Dessa forma, faz-se necessário destacar que a paisagem, o lugar e o espaço geográfico são os conceitos geográficos estruturantes da análise da atmosfera terrestre. Como demonstrado na presente pesquisa, a utilização de estratégias metodológicas alternativas é fonte motivadora para os alunos aprenderem e suprirem possíveis dificuldades, uma vez que aos alunos são apresentadas novas formas de estudo, bem como transmissão do conhecimento. É importante que o educador tenha a capacidade de planejar diferentes estratégias e diversificá-las quando se trata de ensino-aprendizagem dentro do âmbito da geografia escolar.
ANÁLISE QUALITATIVA DA LOCALIZAÇÃO DA ETE EM ITUMBIARA – GO
Authors: Reginaldo Pereira Leonardo , Guerra Ferreira Campos Ana Flávia , Coutinho Maciel Mendes Gabriel , Ridan Pires de Melo Suiaine 
Published: July 2024

Uma das áreas contempladas pelo saneamento básico é a coleta e, posteriormente, o tratamento de esgoto, o qual na maioria dos municípios brasileiros é feito em estações de tratamento de esgoto, chamada de ETE. Um dos tipos de tratamento adotado nas estações é o tratamento anaeróbio, que apresenta uma característica importante: a emissão de gases odorantes, como, por exemplo, o gás sulfídrico, o que acontece na cidade de Itumbiara, em Goiás. Esses odores podem ser percebidos até um determinado raio de influência a partir da estação, causando incômodo para a população. O crescimento da população nas proximidades da estação e a direção de propagação do vento são fatores que podem favorecer a susceptibilidade ao efeito do gás sulfídrico nos habitantes. Posto isto, esse artigo teve por objetivo realizar uma abordagem qualitativa tendo como foco o local da ETE, analisando a presença de áreas urbanizadas e os impactos causados pelo gás sulfídrico na circunvizinhança, baseando-se em um raio de influência. Na metodologia, foi utilizado um software para elaboração de mapas e obtenção de imagens de satélite, além de literaturas para obtenção do raio de influência e de fonte específica para adotar a direção do vento. Como resultados, obteve-se que há uma expansão urbana que direciona-se para o entorno da ETE, além de que os ventos predominantes impactam na propagação dos odores para locais onde há presença de habitantes. Conclui-se então que existem construções dentro do raio de influência da ETE, que estão suscetíveis à atuação do gás sulfídrico.
Standardization of an antimicrobial resistance surveillance network through data management
Authors: Kim Hyunji , Park Jeong Su , Kim Dokyun , Kim Hee Jung , Shin Jeong Hwan , Kim Young Ah , Uh Young , Kim Soo Hyun , Shin Jong Hee , Jeong Seok Hoon , Park Kyoung Un 
Published: July 2024

IntroductionThe rapid spread of COVID-19 worldwide within 2 months demonstrated the vulnerability of the world’s population to infectious diseases. In 2015, the Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched to combat antimicrobial resistance (AMR). However, there has been no comprehensive assessment of the decade-long global battle against AMR based on GLASS data.MethodsSouth Korea established Kor-GLASS (Korean-GLASS) to proactively monitor data quality and enable international collaborations. A unique feature of Kor-GLASS is the quality control center (QCC), which uses network hubs and ensures standardized, high-quality data through interlaboratory proficiency testing (IPT) and external quality assessment (EQA). In addition, the QCC multifaceted endeavors for integrated data quality management.ResultsSince 2020, high-quality AMR data have indicated fluctuating antibiotic resistance rates in South Korea. This trend does not align with the decrease in antibiotic usage seen in humans but coincides with non-human antibiotic sales, indicating a need for greater monitoring of non-human antibiotic resistance. Comprehensive and robust management taking account of the intricate interplay among humans, animals, and the environment is essential. Kor-GLASS has been expanded into a “One Health” multiagency collaborative initiative.DiscussionAlthough a standardized solution is not suitable for all countries, it must align with the local context and international standards. A centralized top-down management structure such as that of the QCC is essential to ensure continuous data quality coordination. Sustained efforts and surveillance systems are crucial for monitoring and managing AMR and safeguarding human health.
Provision of digital devices and internet connectivity to improve synchronous telemedicine access in the U.S.: a systematic scoping review
Authors: Bell Joshua , Gottlieb Laura M. , Lyles Courtney R. , Nguyen Oanh Kieu , Ackerman Sara L. , De Marchis Emilia H. 
Published: July 2024

IntroductionThe COVID-19 pandemic led to a dramatic increase in telemedicine use for direct patient care. Inequities in device/internet access can limit the extent to which patients can engage with telemedicine care and exacerbate health disparities. In this review, we examined existing literature on interventions designed to improve patient telemedicine access by providing digital devices including tablets, smartphones, and computers and/or internet connectivity.MethodsIn this systematic scoping review, we searched four databases for peer-reviewed studies published 1/1/2000–10/19/2021 that described healthcare interventions that provided patients with devices and/or internet connectivity and reported outcomes related to telemedicine access and/or usage. Data extraction elements included: study population, setting, intervention design, details on device/connectivity provision, and outcomes evaluated.ResultsTwelve articles reflecting seven unique interventions met inclusion criteria. Ten articles examined telemedicine utilization (83%) and reported improved patient show rates/utilization. Seven articles examined patient satisfaction with the interventions (58%) and reported positive experiences. Fewer articles examined health outcomes (17%; 2/12) though these also demonstrated positive results. Across included studies, study quality was low. There were no controlled trials, and the most rigorously designed studies (n = 4) involved pre/post-intervention assessments.DiscussionFindings from this review indicate that providing material technology supports to patients can facilitate telemedicine access, is acceptable to patients and clinicians, and can contribute to improved health outcomes. The low number and quality of existing studies limits the strength of this evidence. Future research should explore interventions that can increase equitable access to telemedicine services.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=183442, identifier, PROSPERO: CRD42020183442.
Secondary school students’ perspectives on supports for overcoming school attendance problems: a qualitative case study in Germany
Authors: Enderle Chiara , Kreitz-Sandberg Susanne , Backlund Åsa , Isaksson Joakim , Fredriksson Ulf , Ricking Heinrich 
Published: July 2024

IntroductionSchool attendance problems (SAPs) affect both the education and development of young learners. There is a need to better understand what supports are needed to overcome and prevent SAPs from students’ perspectives. The aim of the current study is to explore students’ perspectives on what challenges they faced, and what they perceived as helpful in overcoming attendance challenges on their pathways towards completing their education.MethodWe conducted interviews with students (n = 9) in a local comprehensive school (Stadtteilschule) in the city-state Hamburg in Germany. Students were in their final year before obtaining a certificate that qualifies them for possible admission to post-secondary education. Data was analyzed using qualitative content analysis.ResultsFindings show that students experienced complex challenges to school attendance that were associated with emotional distress, negative school experiences, and reduced well-being. Our findings point to common protective mechanisms in students’ perceptions of what helped them overcome SAPs. The key drivers of school attendance are located within students and their social contexts, including personal resilience, supportive relationships at school, and the social environment.DiscussionBased on students’ views, we present a model that illustrates the interconnectedness of perceived challenges and supports in the function of risk and protective factors moving across ecological systems in the development of SAPs. We highlight how these areas can guide prevention and intervention to support students in successfully completing their education and transitioning into multiple post-secondary pathways.
The value of the platelet/high-density lipoprotein cholesterol ratio in predicting depression and its cardiovascular disease mortality: a population-based observational study
Authors: Zhang Huifeng , Xu Ying , Xu Yaying 
Published: July 2024

BackgroundCardiovascular disease (CVD) and depression have a bidirectional association, with inflammation and metabolic factors being common important triggers for both conditions. However, as a novel inflammatory and metabolic marker, platelet-to-HDL-C ratio (PHR) has not been established in relation to depression and cardiovascular disease.Materials and methodsParticipants aged 20 years and older were included in the 2005–2018 NHANES database. PHR was calculated as the ratio of platelet count (1000 cells/μL) to HDL-C (mmol/L). The Patient Health Questionnaire (PHQ-9) was used to diagnose depression, with a cutoff value of 10. Weighted logistic regression analysis and restricted cubic spline (RCS) analysis were employed to examine the association between PHR and depression-related features. Additionally, weighted COX regression and RCS were used to analyze the association of PHR with CVD mortality in patients with depression. Receiver operating characteristic curves were used to assess whether PHR had an advantage over HDL-C in predicting depression. Finally, the mediating role of PHR in the latest cardiovascular health indicator Life’s Essential 8 and depression was explored.ResultsA total of 26,970 eligible participants were included, including 2,308 individuals with depression, representing approximately 160 million U.S. adults when weighted. After full adjustment, we estimated that the odds ratio (OR) of depression associated with a per standard deviation (SD) increase in PHR was 1.06 (95% CI: 1.01–1.12, P=0.03). The restricted cubic spline (RCS) analysis indicated a linear association (Nonlinear P=0.113). When PHR was divided into four groups based on quartiles and included in the model after full adjustment for depression risk factors, participants in quartile 2, quartile 3, and quartile 4 of PHR showed a trend of increasing risk of depression compared to the lowest quartile group (P trend=0.01). In addition, weighted COX regression and RCS revealed that a per SD increase in PHR was associated with a higher risk of CVD mortality among patients with depression (HR: 1.38, 95% CI: 1.05–1.81, P=0.02, Nonlinear P=0.400). Subgroup analyses showed that current alcohol consumption enhanced the association between PHR and depression (P for interaction=0.017). Furthermore, the areas under the ROC curves (AUC) were 0.556 (95% CI, 0.544–0.568; P &lt; 0.001) for PHR and 0.536 (95% CI, 0.524–0.549; P &lt; 0.001) for HDL-C (PDeLong = 0.025). Finally, mediation analysis indicated that PHR was an intermediate mechanism between LE8 and depression (mediation proportion=5.02%, P=0.02).ConclusionIn U.S. adults, an increase in PHR linearly increases the risk of depression and CVD mortality among individuals with depression. Additionally, PHR has a better predictive advantage for depression compared to HDL-C. Furthermore, PHR significantly mediates the association between LE8 scores and depression.
Genetically predicted small dense low-density lipoprotein cholesterol and ischemic stroke subtype: multivariable Mendelian randomization study
Authors: Yu Xiao , Shen Guangxun , Zhang Yan , Cui Cancan , Zha Yining , Li Pingan , Li Lihong , Wang Xu , Nan Guangxian 
Published: July 2024

PurposeSmall dense low-density lipoprotein cholesterol (S-LDL-C) has been suggested as a particularly atherogenic factor for ischemic stroke (IS) in observational studies, but the causality regarding the etiological subtype remains unclear. This study aims to explore the causal effects of small dense low-density lipoprotein cholesterol (S-LDL-C), medium (M-LDL-C) and large (L-LDL-C) subfractions on the lifetime risk of ischemic stroke (IS) and main subtypes using two-sample Mendelian randomization (TSMR) design.MethodsWe identified genetic instruments for S-LDL-C, M-LDL-C and L-LDL-C from a genome-wide association study of 115 082 UK Biobank participants. Summary-level data for genetic association of any ischemic stroke (AIS), large artery stroke (LAS), small vessel stroke (SVS) and cardioembolic stroke (CES) were obtained from MEGASTROKE consortium. Accounting for the pleiotropic effects of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C), we conducted multivariable TSMR analysis.ResultsIn univariable TSMR, we found a causal association between genetically predicted S-LDL-C and LAS (IVW-FE: odds ratio (OR) = 1.481, 95% confidence interval (CI): 1.117–1.963, P = 0.006, q = 0.076) but not AIS, SVS or CES. No causal effects were observed for M-LDL-C or L-LDL-C in terms of AIS and IS subtype. In multivariable analysis, the causal association between S-LDL-C and LAS remained significant (IVE-MRE: OR = 1.329, 95% CI: 1.106–1.597, P = 0.002).ConclusionsFindings supported a causal association between S-LDL-C and LAS. Further studies are warranted to elucidate the underlying mechanism and clinical benefit of targeting S-LDL-C.
The effect of hyperuricemia and its interaction with hypertension towards chronic kidney disease in patients with type 2 diabetes: evidence from a cross- sectional study in Eastern China
Authors: Chen Xiang-yu , Lu Feng , Zhang Jie , Xu Chun-xiao , Du Xiao-fu , Liang Ming-bin , Chen Li-jin , Zhong Jie-ming 
Published: July 2024

ObjectivesThis study aimed to explore the synergistic interaction effect between hyperuricemia and hypertension towards chronic kidney disease in patients with type 2 diabetes.MethodsThis research originates from a cross-sectional study performed in Zhejiang Province, Eastern China, between March and November 2018. The correlation between serum uric acid levels and the risk of chronic kidney disease was assessed using a restricted cubic spline model. An unconditional multivariable logistic regression model, along with an interaction table, was utilized to explore the potential interaction effect of hyperuricemia and hypertension towards chronic kidney disease.Results1,756 patients with type 2 diabetes were included in this study, the prevalence of chronic kidney disease (CKD) was 27.62% in this population. A U-shaped non-linear pattern emerged correlating serum uric acid (SUA) levels and CKD risk, indicating that both low and high SUA levels were linked to an increased CKD risk. This risk achieved its lowest point (nadir) at SUA approximately equals to 285μmol/L (p for trend &lt;0.05). Once adjustments for age, gender, education level, abnormal fasting plasma glucose (FPG), abnormal hemoglobin A1c (HbA1c), abnormal total cholesterol (TC), abnormal high-density lipoprotein cholesterol (HDL-C), alcohol consumption and duration of diabetes were factored in, it was found that patients with both hyperuricemia and hypertension demonstrated a 5.42-fold (95% CI: 3.72–7.90) increased CKD risk compared to the reference group. The additive interaction between hyperuricemia and hypertension was statistically significant, as manifested by the following values: a relative excess risk due to interaction (RERI) of 2.57 (95% CI: 0.71–4.71), an attributable proportion due to interaction (AP) of 0.47 (95% CI: 0.14–0.64), and a synergy index (SI) of 2.39 (95% CI: 1.24–4.58). In contrast, there was no significant interaction effect in multiplicative scale.ConclusionHyperuricemia and hypertension may contribute additively to CKD, beyond their isolated impacts. Evaluating the risk of CKD in type 2 diabetes patients necessitates considering this potential interaction.