bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival Outcomes of Breast-Conserving Surgery Versus Mastectomy in Locally Advanced Breast Cancer Following Neoadjuvant Chemotherapy: A Meta-Analysis
Authors: Qin Rong , Yin Liang , Wang Deqian , Cao Xuan , Shaibu Zakari , Wang Xiangyang , Chen Peiqin , Sui Danjuan , Qiu Xiaoxi , Liu Dan 
Published: July 2024

Background Mastectomy (MT) and breast conservation surgery (BCS) are two common surgical options for the treatment of locally advanced breast cancer (LABC). Neoadjuvant chemotherapy (NACT) is frequently administered before surgery to shrink tumors and improve surgical outcomes. However, there is a lack of consensus on the optimal surgical approach after NACT and its impact on survival outcomes. Objective This meta-analysis aims to compare the survival outcomes between MT and BCS in patients treated with NACT. Method A PRISMA selection was used to identify studies across electronic database such as PubMed, and Cochrane Library from inception until 11th July, 2023. A total of 10 comparative studies involving a total of 5018 patients were included. Among them, 2898 patients underwent MT while 2120 underwent BCS after receiving NACT. The outcomes assessed were the 5-year overall survival (OS) and 5-year disease-free survival (DFS). The data from the included studies were pooled, and odds ratios (OR) with 95% confidence intervals (CI) were calculated to evaluate the differences between MT and BCS in terms of survival outcomes. Prospero: CRD42024496831. Result The meta-analysis revealed that patients who underwent MT after NACT had a higher 5-year OS compared to those who underwent BCS (OR 2.68, 95% CI [2.19-3.28; p < 0.00001]). Additionally, the 5-year DFS was significantly better for patients who underwent MT (OR 3.11, 95% CI [1.80-5.38; p < 0.0001]). Conclusion MT after NACT may be associated with better 5-year OS and DFS compared to BCS.
Control-matched octo/nonagenarian outcomes in acute basilar artery occlusions treated with mechanical thrombectomy—analysis of the PC-SEARCH thrombectomy registry
Authors: Mierzwa Adam T , Prologo-Richardson Paige , Kasab Sami Al , Nelson Ashley , Gutierrez Santiago Ortega , Vivanco-Suarez Juan , Farooqui Mudassir , Jadhav Ashutosh P , Desai Shashvat , Toth Gabor , Alrohimi Anas , Nguyen Thanh N , Klein Piers , Abdalkader Mohamad , Salahuddin Hisham , Wilseck Zachary , Pandey Aditya , Koduri Sravanthi , Vora Nirav , Aladamat Nameer , Gharaibeh Khaled , Afreen Ehad , Zaidi Syed , Jumaa Mouhammad 
Published: July 2024

Introduction Age is often used as a predictor in determining outcomes in large vessel occlusions treated with mechanical thrombectomy. However, limited data exist for octo/nonagenarian outcomes compared to younger individuals in acute basilar artery occlusions treated with thrombectomy. Methods Patient data were obtained from the PC-SEARCH Thrombectomy Registry which consists of 444 acute basilar artery occlusions treated with mechanical thrombectomy. Individuals were dichotomized based on age (>80 and ≤80 years old). Primary outcome was defined as modified Rankin Scale of 0–3 at 90 days. Logistic and multivariate regression, as well as control-matched analysis, were performed. Results There were 373 and 71 patients in the younger and older cohorts, respectively. Gender, ethnicity, smoking status, atrial fibrillation, and coronary artery disease were noted to be significantly different between cohorts. At 90 days, 178 (47.7%) and 23 (32.4%) patients achieved primary outcome at 90 days (p = 0.02), however, after controlling for potentially confounding factors this association lost significance (OR 0.50 95% CI 0.24–1.05; p = 0.07). There were 84 patients included in the control matched analysis and demonstrated no significant differences on multivariate analysis between cohorts (OR 0.68 95% CI 0.25–1.84; p = 0.45). Interpretation Octa/nonagenarians presenting with an acute basilar artery occlusion treated with mechanical thrombectomy can achieve acceptable rates of favorable functional outcomes compared to younger individuals with similar baseline demographic and stroke characteristics.
Hydroxytyrosol Ameliorates Busulfan-Induced Oligozoospermia in a Mouse Model
Authors: Ye Taowen , Ma Yumin , Dong Jin , Dong Yanli , Hui Jie , Wang Chengniu , Liu Yang , Wang Xiaorong 
Published: July 2024

Objective Hydroxytyrosol (HT), a polyphenolic component identified in olive oil and leaves, represents one of the most extensively investigated natural phenol due to its diverse beneficial biological properties. Recent studies have shown that HT exhibits protective effects on reproductive function and can improve sperm quality. However, the precise effect and underlying mechanism of HT on oligozoospermia remain unclear. This study aims to investigate the effect and mechanism of HT across varying concentrations on oligozoospermia. Methods Oligozoospermia was induced in ICR male mice via intraperitoneal injection of busulfan (BUS, 30 mg/kg). The mice were randomly categorized into five groups as Normal, BUS, HT 10 mg/kg, HT 30 mg/kg and HT 50 mg/kg. The efficacy of HT on oligozoospermia was assessed through sperm concentration and motility using a computer-assisted sperm analysis system. Testicular and epididymal histology was examined via hematoxylin-eosin staining, while cytoskeletal integrity was evaluated by immunofluorescence. Hormone levels, along with reactive oxygen species (ROS) and malondialdehyde (MDA) were examined by ELISA kits. Differentially expressed genes were identified through RNA sequencing, and the expression levels of key genes were validated by qPCR. Results The results indicated that HT (50 mg/kg) significantly increased sperm concentration, promoted morphological recovery of testicular tissue, heightened the levels of serum testosterone, follicle-stimulating hormone, luteinizing hormone, as well as decreased the accumulation of ROS and MDA in mice with oligozoospermia. RNA sequencing analysis and RT-qPCR results revealed that HT could restore spermatogenesis and ameliorate oligozoospermia by up-regulating genes related to cilium organization, microtubule-based movement, and spermatid differentiation and development. Conclusions HT demonstrates therapeutic efficacy against busulfan-induced oligozoospermia. The mechanism of HT on oligozoospermia may be related to its influence on cilium and microtubule-based movement, along with the differentiation and development of spermatids. HT shows potential as a prospective therapeutic intervention for the treatment of oligozoospermia.
Exploring the performance of bio-based PLA/PHB blends: A comprehensive analysis
Authors: Gao Luyao , D Drozdov Aleksey 
Published: July 2024

Poly(lactic acid) (PLA) is a bio-based linear aliphatic polyester that is broadly used in biomedical applications. A shortcoming of PLA is its brittleness and low toughness. Poly(hydroxybutyrate) (PHB) is a microbial bioprocessed and biodegradable polyester. To enhance toughness of PLA, it was melt-blended with PHB-based thermoplastic elastomer in various proportions by using a twin-screw extruder. Scanning electron microscope images reveal that PLA forms a continuous phase in PLA/PHB blends reinforced with inclusions of PHB. Fourier transform infrared spectroscopy measurements demonstrate strong intermolecular interactions between PLA and PHB chains. Differential scanning calorimeter thermogramms show that PHB reduces the glass transition temperature of PLA and affects its crystalline structure. When the mass fraction of PHB was 20, the glass transition temperature of the blend decreased to 33.9°C. Rheological measurements demonstrate that blending of PLA with PHB changes qualitatively the dependence of its viscosity on shear rate. Quasi-static (uniaxial tension) and dynamic (impact) tests confirm that blending of PLA with PHB results in a noticeable (by a factor of three) increase in its impact toughness and causes transition from the brittle to ductile regime of fracture. When the mass fraction of PHB was 40, the impact toughness reached to 0.40 kJ/m2, almost 3 times to neat PLA.
Policy Review of Preschool Education Legislation in China
Authors: Huang (黄瑾) Jin , Xiong (熊灿灿) Cancan 
Published: July 2024

Purpose This study reviews the development of preschool education legislation in China and analyzes its background, fundamental principles, and prospects. Design/Approach/Methods Interpretations of the newly published Preschool Education Law of the People's Republic of China (Draft) are highlighted to reveal the recent manifestations of the legislative development of preschool education in China. Findings In China, legislation pertaining to preschool education is based on an extensive practical foundation and solid policy basis embodying the fundamental principles of establishing government leadership, ensuring children's right to education, and upholding public welfare and inclusivity. Such legislation is conducive to the further exploration of key issues and significant relationships involved in the development of preschool education and marks a milestone in its modernization with Chinese characteristics. Originality/Value This paper's findings indicate that the Preschool Education Law of the People's Republic of China (Draft) demonstrates significant progress in the development of preschool education in China, but there are still key issues that need to be further explored.
The Chinese Origin of Xue (Learning)
Authors: Huang (黄晓珠) Xiaozhu 
Published: July 2024

Highlights The concept of xue (学) played a central role in Chinese education. Through the analysis of this key concept, we can further explain the internal differences between Chinese and Western educational cultures and systems. By mastering numerical divination techniques, shi (historians, 史) recast their role from that of sorcerers to that of civil officials. Such a shift laid the foundation necessary for xue to transform from a venue for military decision-making into a place for cultural and educational engagement after the Western Zhou Dynasty. In addition to shaping its core philosophical spirit, the origin of xue established its significance in traditional Chinese social and cultural contexts. It has contributed to the formation and transformation of the concept of de (virtue, 德) and continues to exert a great influence on contemporary Chinese education.
“No Less Than 4%”: A Policy Review of China's Fiscal Spending on Education, 2000–2020
Authors: Lu (陆伟) Wei 
Published: July 2024

Purpose This study aims to review the policy background of China's ever-growing fiscal spending on education and discusses the aggregate growth of its national fiscal spending on education and the responsible bodies involved. Design/Approach/Methods This study adopts policy analysis and descriptive statistics as its primary research methods. Findings Since 2012, China's national fiscal spending on education has accounted for no less than 4% of its gross domestic product for nine consecutive years. Additionally, over 80% of China's total education spending is underpinned by state finances, with the country boasting the largest education system in the world. While compulsory education accounts for approximately half of China's national fiscal spending on education, higher education reflects the highest budgetary education spending per student. Furthermore, China has been actively increasing its fiscal spending on pre-school education. Originality/Value The findings of this study have implications for understanding the status quo and changes in China's education spending.
Ignored Subjectivity in the Informational Panopticon: Restricted Classroom Interaction Under Technical Discipline
Authors: Chang (常亚慧) Yahui , Gao (高明苏) Mingsu , Yu (余旻) Min 
Published: July 2024

Purpose This article aims to provide a portrait of classroom interactions supported by information technology and discuss the complex impact of technical elements on teaching and the time–space distance of student subjectivity in a technology-dominated world. Design/Approach/Methods Based on Foucault's panopticism, this study examines a smart classroom in East Asia to observe classroom teaching and learning processes; conducts semi-structured interviews with teachers, students, parents, and other stakeholders; and analyzes the hidden mechanism of the smart classroom on interaction from the perspective of perceivers. Findings The smart classroom has the distinctive structural features of a Panopticon. Artificial intelligence, which coalesces cultural capital through technological authority, has a significant capital advantage over students, producing a false spectacle of efficient learning. Panoramic surveillance causes the “backstage” of students’ roles to be gradually consumed by the “front” and makes students exhibit “make-work” behavior. Refined information management mechanisms produce invisible digital walls that separate interactive groups, making it difficult for students to obtain sufficient information about the gestures and behaviors of their classmates to interact effectively. Originality/Value This study reveals the ignorance of human subjectivity in the orientation of instrumental rationality by understanding the expressions of witnesses.
PA-VSD Without MAPCA(s): Review of Long-Term Outcomes and Reinterventions
Authors: Stephens Elizabeth H. , Dearani Joseph A. , Miranda William R. , Anderson Jason H. 
Published: July 2024

Background Pulmonary atresia with ventricular septal defect without major aortopulmonary collateral arteries (MAPCAs) is an uncommon form of congenital heart disease. As more patients with congenital heart disease live to adulthood, the objective of this article was to review the long-term results of this specific population. Methods A review of the PubMed database was performed using pertinent key words (pulmonary atresia, tetralogy of Fallot, conduit, right ventricle-pulmonary artery) concentrating on studies from 1990-present and published in English. Most studies of pulmonary atresia-ventricular septal defect patients included those with and without MAPCAs. Analysis included examination of the entire cohort, consideration of the proportion of patients with MAPCAs, and any subgroup analysis of the patients without MAPCAs. Results Survival is approximately 80% at ten years and is improved with complete repair and larger pulmonary arteries. Some studies have found genetic syndromes and extracardiac anomalies to impact survival, while others have not. Incomplete repair has been shown to be associated with worse survival. Independent of initial management strategy, patients with pulmonary atresia and ventricular septal defects without MAPCAs require repeat intervention on the right ventricular outflow tract. Hypoplastic pulmonary arteries have been shown to be a risk factor for reintervention, and decreased conduit durability has been shown with younger age at implantation of conduit. Conclusions Long-term outcomes have improved for patients with pulmonary atresia-ventricular septal defect without MAPCAs, with complete repair and adequate pulmonary arteries favorable for survival. Long-term outcomes include reinterventions, both catheter-based and surgical, predominantly on the right ventricular outflow tract.
Common Arterial Trunk Repair at the Red Cross War Memorial Hospital, Cape Town: A 20-Year Review of Surgical Practice and Outcomes
Authors: Moodley A , Meyer HM , Salie S , Human P , Zühlke L J , Brooks A 
Published: July 2024

Background This study describes the 20-year experience of managing common arterial trunk (CAT) in a low-and-middle-income country and compares the early and medium-term outcomes following the transition from conduit to nonconduit repair at the Red Cross War Memorial Children's Hospital. Methods Single-center retrospective study of consecutive patients aged less than 18 years who underwent repair of CAT from January 1999 to December 2018 at the Red Cross War Memorial Children's Hospital. Patients with interrupted aortic arch or previous pulmonary artery banding were excluded. Results Fifty-four patients had CAT repair during the study period. Thirty-four (63.0%) patients had a conduit repair, and 20 (37.0%) patients had a nonconduit repair. There were two intraoperative deaths. Thirty-day in-hospital mortality was 22.2% (12/54). Overall, in-hospital mortality was 29.6% (16/54). Eight (21.1%) late mortalities were observed. The actuarial survival for the conduit group was 77.5%, 53.4%, and 44.5% at 6, 12, and 27 months, respectively, and the nonconduit group was 58.6% at six months. The overall freedom from reoperation between the conduit group and nonconduit group was 66.2% versus 86.5%, 66.2% versus 76.9%, and 29.8% versus 64.1% at 1, 2, and 8 years, respectively. Conclusions The outcomes following the transition to nonconduit repair for CAT in a low- and middle-income setting appear to be encouraging. There was no difference in mortality between conduit and nonconduit repairs, and importantly the results suggest a trend toward lower reintervention rates.
Comparison of Blalock-Taussig-Thomas Shunts With Patent Ductus Arteriosus Ligated Versus Left Open
Authors: Nasworthy Mandy W. , Roeser Mark , Frank Deborah , Vergales Jeffrey 
Published: July 2024

Background The optimal approach to patent ductus arteriosus management during systemic-to-pulmonary artery shunt placement is currently unknown. The purpose of this study is to examine the outcomes of variable strategies for patent ductus arteriosus management during Blalock-Taussig-Thomas shunt surgery. Methods A retrospective cohort study of infants who underwent shunt placement was performed, comparing those who had the ductus ligated with those who had the ductus left open. Indicators of low cardiac output syndrome, development of necrotizing enterocolitis, and secondary outcomes such as resuscitation events were examined. Results Thirty-six infants were included all of whom had their shunt placed via median sternotomy. Twenty infants had their ductus ligated at the time of the shunt, and they were compared with 16 infants whose ductus was left open. There was no statistical difference in preoperative baseline characteristics, including corrected gestational age, age in days, weight, mechanical ventilation, vasoactive use, heterotaxy, and gastrointestinal anomalies. There was also no statistical difference in postoperative indicators of low cardiac output, including urine production, total fluids given, renal injury, maximum lactate, and vasoactive-inotropic score. Three patients had postoperative renal injury, and all were in the ligated duct group. There was also no statistical difference in any secondary outcomes, including the development of necrotizing eneterocolitis, resuscitation events, reinterventions, length of intubation, total length of stay, and mortality. Conclusions This study provides evidence that variable management of the ductus during shunt placement does not significantly impact outcomes. Leaving the ductus open allows for a potential rescue source of pulmonary blood flow and does not appear to increase the risk of postoperative low cardiac output.
Examining implementation determinants of a culturally grounded, school-based prevention curriculum in rural Hawai‘i: A test development and validation study
Authors: Okamoto Scott K. , Okamura Kelsie H. , Marshall Sarah Momilani , Chin Steven Keone , Carson Adabelle B. , An Katlyn J. , Song Sarah D. , Saladino Paula Angela , Prado Guillermo , Kulis Stephen S. 
Published: July 2024

Background: This study examined the implementation determinants of a culturally grounded, school-based drug prevention curriculum in rural Hawai‘i. Test development and validation procedures were used to examine the impact of implementation barriers and facilitators of the curriculum in public or charter middle/intermediate schools on Hawai‘i Island. Method A five-phase, mixed-methods approach toward test development and validation was used. These phases included item generation (Phase 1), item refinement and selection (Phase 2), item reduction (Phase 3), reliability testing (Phase 4), and validity testing (Phase 5). Educational administrators, teachers, and staff employed by the Hawai‘i State Department of Education (HIDOE) participated in the study. Results Phases 1 and 2 yielded 50 implementation barriers and 27 implementation facilitators that were evaluated by 204 HIDOE administrators, teachers, and staff. Factor analysis of the barrier items indicated a four-factor solution: (1) Innovation Barriers, (2) HIDOE State-Level Barriers, (3) Teacher-Level Barriers, and (4) Administrator-Level Barriers. Mean comparisons indicated that several barrier and facilitator items differentiated teachers from administrators in the sample. Conclusions This study contributes to the implementation measurement literature, specifically in the areas of mental health and substance use. It also highlights the importance of addressing multiple contextual levels in the implementation of culturally focused prevention interventions. Plain Language Summary Title Examining Implementation Barriers and Facilitators for School-Based Prevention in Hawai‘i. Plain Language Summary Compared with other major ethnic groups, Native Hawaiian and Pacific Islander (NHPI) youth have substantially higher rates of substance use and higher adverse mental and physical health effects related to their use. Despite these disparities, educational and community-based practitioners have long struggled with implementing and sustaining promising substance use interventions for NHPI youth. This study contributes to our understanding of measuring implementation barriers and facilitators for substance use prevention for NHPI youth in rural school settings. It contributes to the field of health disparities and health equity promotion, by addressing calls for research to understand factors affecting successful implementation of prevention programs. This is critical toward achieving health equity for underrepresented and vulnerable populations, such as NHPI and rural youth.