bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contribution of Thoron and Its Progeny to the Effective Dose by Inhalation in the Uranium-Thorium Bearing Regions of Mayo Kebbi and Guéra in Chad
Authors: Patale Ziebno , Guillaume Samuel Bineng , Kranrod Chutima , Modibo Oumar Bobbo , Didier Takoukam Soh Serge , Abba Hamadou Yerima , Omori Yasutaka , Hosoda Masahiro , Saïdou  , Paul Ekobena Henri , Tokonami Shinji 
Published: June 2024

Abstract
In recent years, technological developments and hypotheses made by some researchers have revealed that the effective inhalation dose from thoron and its progeny was underestimated. This study uses direct measurements to show the significant contribution of thoron progeny to the effective inhalation dose. To achieve this, radon-thoron discriminative detectors (RADUET) and thoron progeny monitors were used for the simultaneous measurement of radon, thoron, and thoron progeny in 150 selected houses in the townships of Bitkine, Mongo, Léré, and Pala in southern Chad. By solid-state detection, concentrations of radon, thoron, and thoron progeny were measured and associated effective doses evaluated. The mean concentrations of radon, thoron, and thoron progeny were 62 (1), 60 (2), and 7.6 (2.1) Bq m−3, respectively. These concentrations are above the corresponding global average values. The equilibrium factor of the thoron varied considerably from one municipality to another. The average total annual effective dose by inhalation was estimated to be 4.23 mSv. The contribution of thoron and its progeny to the total inhalation dose ranged from 5% to 86% with an average of 62%. Considering the above, public exposure to thoron and its associated progeny is a public health concern in a similar way to radon.
The prognostic value of visceral pleural infiltration in ≤3 cm nonsmall cell lung cancer presenting with ground glass opacity: an inverse probability of treatment weighting study
Authors: Yang Zhenyu , Li Yiming , Guo Chenglin , Xing Yikai , Liu Chengwu , Zhang Jian , Pu Qiang , Liu Lunxu 
Published: June 2024

Background:
Visceral pleural infiltration (VPI) has been identified as an important risk factor in nonsmall cell lung cancer (NSCLC) for many decades. However, for patients who present with ground glass opacity (GGO), the prognostic value of VPI is still elusive. The authors aimed to investigate whether the VPI is a significant prognostic factor in surgically resected ≤3 cm stage I NSCLC, who presented with GGO.

Materials and methods:
Patients with primary NSCLC who underwent surgical resection between December 2009 and December 2018 were collected. Stage I tumors that presented as GGO nodules with a tumor size of less than 3 cm were included and divided into two groups based on VPI status (positive and negative). Clinical, pathological, and prognostic data were prospectively collected and retrospectively reviewed. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics. Overall survival (OS) and recurrence-free survival (RFS) were analyzed using the Cox proportional hazards model and Kaplan–Meier method.

Results:
A total of 2043 patients were included in this study (VPIs were found in 196 patients). After IPTW weighting, all factors between the two groups were balanced. The median follow-up time was 67.3 months. According to the multivariable Cox models, the VPI was not a significant prognostic factor for OS (HR=2.00, 95% CI: 0.96–4.17; P=0.063), but was significant for RFS (HR=2.00, 95% CI: 1.12–3.55; P=0.019). In subgroup analysis, we found VPI was significant for OS (HR=3.17, 95% CI: 1.09–9.26, P=0.035) and RFS (HR=4.07, 95% CI: 1.76–9.40, P=0.001) in patients with a tumor size >1 cm and a consolidation to tumor ratio (CTR) >50%. For patients with a tumor size ≤1 cm or a CTR ≤50%, the VPI was not significant.

Conclusions:
VPI may be a significant risk factor for GGOs in NSCLC patients with a tumor size >1 cm and a CTR >50%. Further prospective studies conducted across multicenters with a larger sample size are needed.
Stellate ganglion block for visceral pain in elderly patients undergoing video-assisted thoracoscopic lung cancer surgery: a randomized, controlled trial
Authors: Xiang Xiao-bing , Wu Yang-yang , Fang Zheng , Tang Xiao , Wu Ying-li , Zhou Jun , Cheng Xin-qi 
Published: June 2024

Background:
Visceral pain occurs commonly following thoracic surgery, but an effective method to relieve visceral pain in thoracic surgery remains controversial. The authors test the effect of stellate ganglion blocks (SGB) on perioperative visceral pain following video-assisted thoracoscopic surgery (VATS).

Methods:
A prospective, randomized, controlled trial enrolled 77 elderly patients undergoing VATS. Patients were randomized to SGB followed by modified intercostal nerve block (Group S, n=37); or modified intercostal nerve block only (Group C, n=40). Remifentanil 0.02–0.2 μg·kg-1·min-1 was titrated to keep pain threshold index values between 40 and 65 and maintain mean arterial pressure or heart rate values around 20% of baseline values. Patient-controlled intravenous analgesia with sufentanil was used in the postoperative period. The co-primary outcomes were the perioperative cumulative opioid consumption and pain scores on movement at 24 h after surgery.

Results:
Compared with the control group, SGB greatly reduced the intraoperative remifentanil consumption [300.00 (235.00–450.00)μg versus 710.00 (500.00–915.00)μg; P<0.01], with no difference in cumulative sufentanil consumption to 48 h postsurgery. There was a statistically significant difference in pain scores on movement at 24 h between groups [4.00 (3.00–4.00) versus 4.00 (3.25–5.00); P=0.01]. Further exploratory analyses showed a significant difference in intrachest pain on movement at 24 h [3.00 (2.00–3.00) versus 3.00 (2.25–4.00); P=0.01]. No significant difference was observed in nausea/vomiting, time to pass flatus, and postoperative length of stay.

Conclusion:
Preoperative SGB for elderly patients could effectively blunt intraoperative visceral stress and reduce postoperative visceral pain extending 24 h after VATS. This initial finding deserves further investigation.
Mapping the blueprint of artificial blood vessels research: a bibliometric analysis
Authors: Pan Dikang , Wang Jingyu , Wang Hui , Wu Sensen , Guo Jianming , Guo Lianrui , Sun Li , Gu Yongquan 
Published: June 2024

Background:
Vascular diseases represent a significant cause of disability and death worldwide. The demand for artificial blood vessels is increasing due to the scarce supply of healthy autologous vessels. Nevertheless, the literature in this area remains sparse and inconclusive.

Methods:
Bibliometrics is the study of quantitative analysis of publications and their patterns. This study conducts a bibliometric analysis of publications on artificial blood vessels in the 21st century, examining performance distribution, research trajectories, the evolution of research hotspots, and the exploration of the knowledge base. This approach provides comprehensive insights into the knowledge structure of the field.

Results:
The search retrieved 2060 articles, showing a consistent rise in the publication volume and average annual citation frequency related to artificial blood vessels research. The United States is at the forefront of high-quality publications and international collaborations. Among academic institutions, Yale University is a leading contributor. The dominant disciplines within the artificial blood vessels sector include engineering, biomedical sciences, materials science, biomaterials science, and surgery, with surgery experiencing the most rapid expansion.

Conclusions:
This study is the inaugural effort to bibliometrically analyze and visualize the scholarly output in the domain of artificial blood vessels. It provides clinicians and researchers with a reliable synopsis of the field’s current state, offering a reference point for existing research and suggesting new avenues for future investigations.
Prevention and management of rebound pain after resolution of regional block: a systematic review
Authors: Admassie Belete Muluadam , Debas Simachew Amogne , Admass Biruk Adie 
Published: June 2024

Background:
An extreme pain known as rebound pain develops after regional blockage wears off. Patient, surgical, and anesthesia-related factors influence the occurrence and intensity of rebound pain. Prior to the peripheral nerve block (PNB) being resolved, multimodal therapy should use. The objective of this review was to explore rebound pain prevention and management following PNB resolution.

Methods:
We conducted a thorough search across Pub Med, Hinari, Google Scholar, and Cochrane review databases, utilizing relevant keywords and search parameters to identify studies meeting our inclusion criteria. These studies aimed to provide sufficient evidence regarding the prevention and management of rebound pain following the resolution of regional blocks. Duplicate entries were removed using Endnote software. Screening of the literature was performed using a rigorous appraisal checklist. The findings of this review are reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement.

Results:
Using an electronic search, 3526 items were found from databases and websites. After removing duplicates (n=500), 3026 articles remained. Of these, 2813 were excluded after going through their titles and abstracts. Of the 213 articles screened, 126 were removed for such reasons as ineligibility or similarity in objectives. Of the remaining 87 studies, 37 were excluded for such reasons as the inaccessibility of free full texts. Finally, 50 studies were included for review.

Conclusions and recommendation:
Proper patient education about rebound pain, combined with the utilization of multimodal systemic analgesia before the resolution of PNBs, perineural dexamethasone, and employing a combination of nerve blocks, has been demonstrated to decrease the incidence of rebound pain. Therefore, clinicians should aim to prevent and manage rebound pain by implementing perioperative multimodal strategies before the resolution of regional blocks.
Awareness of personal safety among frontline healthcare workers working in COVID ward of BPKIHS during COVID-19 pandemic: a cross-sectional study authors
Authors: Khadka Rama , Parajuli Pushpa , Mehta Ram Sharan , Mandal Gyanand , Shrestha Erina , Adhikari Pratik , Uprety Pratik 
Published: June 2024

Background:
Frontline healthcare workers are at higher risk for COVID-19 infection and due to lack of availability of adequate personal protective equipment (PPE), lack of knowledge and good practices results in more deaths each year due to occupational accidents and diseases.

Objective:
The aim of the study was to assess the awareness of personal safety, the association between the level of awareness with selected socio-demographic variables and to identify the correlation between knowledge and practice of personal safety.

Materials and methods:
A descriptive cross-sectional study design was conducted among 106 Frontline Healthcare workers who have worked in the COVID ward. The study was conducted between 7 August 2022 and June 2023. A convenient sampling technique was used for sample selection. A validated self-administered questionnaire was used to assess the awareness of personal safety. Descriptive statistics (mean, SD frequency and percentage) and inferential statistics (χ2 and Spearman’s correlation rank) were used for the data analysis.

Results:
Among the respondents, there were 38 doctors and 68 nurses. The majority of the respondents had a moderate level of knowledge (79.2%) and practice (52.8%) with a mean score of 13.52±2.10 and 14.51± 2.35, respectively. Doctors have slightly higher levels of knowledge (14.01±1.62) and practice (14.57±2.07) as compared to Nurses (13.19±2.27, 14.48±2.5), respectively. Knowledge was found to be associated with the education level and age of the respondents, and practice has a significant association with training/demonstration with a P value of less than 0.05. Knowledge and practice were found to have a partial positive correlation (r value of 0.27).

Conclusion:
This study concluded that those having higher levels of education had good levels of knowledge and those who have attended formal or informal training or demonstrations regarding personal safety had good practices regarding personal safety.
Laparoscopic partial splenectomy for a giant splenic pseudocyst with elevated CA19-9: a case report
Authors: Sun Yi , Yu Xiao-Feng , Yao Han , Chai Chen 
Published: June 2024

Introduction and importance:
Currently, there is a lack of reliable evidence on the management of splenic cysts, which are rare. Exploring the efficacy of laparoscopic partial splenectomy can aid in the accumulation of treatment-related evidence.

Case presentation:
Here, we report the case of a 31-year-old female who was diagnosed with a giant splenic cyst with elevated serum CA19-9 and subsequently underwent laparoscopic partial splenectomy.

Clinical discussion:
The effects of most treatment options for splenic cysts, including percutaneous aspiration and drainage, fenestration, and partial splenectomy, have not been confirmed by high-level evidence. With the development of minimally invasive surgery, laparoscopic partial splenectomy has drawn increasing attention. Additionally, the relationships between tumor markers and splenic cysts need to be further elucidated.

Conclusions:
Laparoscopic partial splenectomy might be recommended for patients with splenic cysts, especially when the cysts are not completely covered by the splenic parenchyma.
Heat-related illness
Authors: Gardner Justin , Caley Lindsey , Poche Matthew , Trammell Susannah 
Published: June 2024

Abstract:
This article concisely overviews heat-related illnesses, emphasizing their significant impact on public health. It explores the pathophysiology of conditions ranging from mild heat cramps to life-threatening heat stroke, highlighting key heat transfer mechanisms and the importance of environmental factors. Differential diagnosis considerations, prevention strategies, and nursing implications are discussed, underscoring the need for prompt recognition and intervention in managing these conditions.
Increased Pretransplant Inflammatory Biomarkers Predict Death With Function After Kidney Transplantation
Authors: Lorenz Elizabeth C. , Smith Byron H. , Liang Yun , Park Walter D. , Bentall Andrew J. , Dhala Atiya F. , Waterman Amy D. , Kennedy Cassie C. , Hickson LaTonya J. , Rule Andrew D. , Cheville Andrea L. , LeBrasseur Nathan K. , Stegall Mark D. 
Published: June 2024

Background.
Chronic systemic inflammation is associated with mortality in patients with chronic kidney disease, cardiovascular disease, and diabetes. The goal of this study was to examine the relationship between pretransplant inflammatory biomarkers (growth differentiation factor-15 [GDF-15], interleukin-6 [IL-6], soluble tumor necrosis factor receptor-1, monokine induced by gamma interferon/chemokine [C-X-C motif] ligand 9 [MIG/CXCL9], monocyte chemoattractant protein-1, soluble FAS, tumor necrosis factor-α, interleukin-15, and interleukin-1β) and death with function (DWF) after kidney transplantation (KT).

Methods.
We retrospectively measured inflammatory biomarker levels in serum collected up to 1 y before KT (time from blood draw to KT was 130 ± 110 d) in recipients transplanted between January 2006 and December 2018. Kaplan-Meier estimation, Cox regression, and Gradient Boosting Machine modeling were used to examine the relationship between inflammatory biomarkers and DWF.

Results.
Our cohort consisted of 1595 KT recipients, of whom 62.9% were male and 83.2% were non-Hispanic White. Over a mean follow-up of 7.4 ± 3.9 y, 21.2% of patients (n = 338) experienced DWF. Patients with the highest quartile levels of GDF-15 (>4766 pg/mL), IL-6 (>6.11 pg/mL), and MIG/CXCL9 (> 5835 pg/mL) had increased rates of DWF, and each predicted mortality independently of the others. When adjusted for clinical factors (age, diabetes, etc), the highest quartile levels of GDF-15 and IL-6 remained independently associated with DWF. Adding inflammatory markers to a clinical Cox model improved the C-statistic for DWF from 0.727 to 0.762 using a Gradient Boosting Machine modeling approach.

Conclusions.
These findings suggest that pre-KT serum concentrations of GDF-15, IL-6, and MIG/CXCL9 may help to risk stratify and manage patients undergoing KT and suggests that chronic inflammation may play a role in mortality in KT recipients.
Unveiling Spatial Immune Cell Profile in Kidney Allograft Rejections Using 36-plex Immunofluorescence Imaging
Authors: Hirai Toshihito , Kondo Ayano , Shimizu Tomokazu , Fukuda Hironori , Tokita Daisuke , Takagi Toshio , Mayer Aaron T. , Ishida Hideki 
Published: June 2024

Background.
Kidney allograft rejections are orchestrated by a variety of immune cells. Because of the complex histopathologic features, accurate pathological diagnosis poses challenges even for expert pathologists. The objective of this study was to unveil novel spatial indices associated with transplant rejection by using a spatial bioinformatic approach using 36-plex immunofluorescence image data.

Methods.
The image obtained from 11 T cell-mediated rejection (TCMR) and 12 antibody-mediated rejection (AMR) samples were segmented into 753 737 single cells using DeepCell’s Mesmer algorithm. These cells were categorized into 13 distinct cell types through unsupervised clustering based on their biomarker expression profiles. Cell neighborhood analysis allowed us to stratify kidney tissue into 8 distinct neighborhood components consisting of unique cell type enrichment profiles.

Results.
In contrast to TCMR samples, AMR samples exhibited a higher frequency of neighborhood components that were characterized by an enrichment of CD31+ endothelial cells. Although the overall frequency of CD68+ macrophages in AMR samples was not significantly high, CD68+ macrophages within endothelial cell-rich lesions exhibited a significantly higher frequency in AMR samples than TCMR samples. Furthermore, the frequency of interactions between CD31+ cells and CD68+ cells was significantly increased in AMR samples, implying the pivotal role of macrophages in AMR pathogenesis. Importantly, patients demonstrating a high frequency of CD31:CD68 interactions experienced significantly poorer outcomes in terms of chronic AMR progression.

Conclusions.
Collectively, these data indicate the potential of spatial bioinformatic as a valuable tool for aiding in pathological diagnosis and for uncovering new insights into the mechanisms underlying transplant rejection.
Pancreas Preservation: Hypothermic Oxygenated Perfusion to Improve Graft Reperfusion
Authors: Mesnard Benoit , Ogbemudia Etohan , Bruneau Sarah , Le Bas-Bernardet Stéphanie , Minault David , Hervouet Jeremy , Kervella Delphine , Masset Christophe , Cantarovich Diego , Rigaud Jérôme , Badet Lionel , Friend Peter , Ploeg Rutger , Blancho Gilles , Hunter James , Prudhomme Thomas , Branchereau Julien 
Published: June 2024

Background.
The clinical standard for pancreas preservation for transplantation is static cold storage (SCS). Oxygenation during preservation has been shown to be advantageous in clinical studies. This study evaluates the efficiency of different oxygenation modalities during hypothermic pancreas preservation.

Methods.
Thirty-two porcine pancreases were procured in a controlled donation after circulatory death model and were divided to be preserved in 8 groups: (1) SCS, (2) hypothermic machine perfusion (HMP), (3) hypothermic oxygenated machine perfusion (HOPE) with 21% oxygen, (4) HOPE and 100%, (5) SCS and oxygen carrier, M101, (6) HMP and M101, (7) HOPE 21% and M101, and (8) HOPE 100% and M101. All the groups underwent 24 h of hypothermic preservation, followed by 2 h of normothermic reperfusion. Oxygen partial pressures were assessed using parenchymal probes. Perfusion parameters, perfusate samples, and tissue biopsies were analyzed.

Results.
This study showed that HMP was linked to higher tissue oxygen partial pressures, lower succinate levels, and better reperfusion parameters. Furthermore, the addition of M101 to either SCS or HMP was associated with lower succinate and creatinine phosphokinase accumulation, suggesting a protective effect against ischemia.

Conclusions.
Our research has demonstrated the efficacy of machine perfusion in hypothermic conditions in providing oxygen to the pancreas during preservation and conditioning the pancreatic microvasculature for reperfusion during transplantation. Furthermore, the addition of M101 suggests a protective effect on the graft from ischemia.
Reducing insulin omission errors among patients with diabetes mellitus in general surgical wards: a best practice implementation project
Authors: Ng Sharlyn Jia Yi , Goh Mien Li 
Published: June 2024

ABSTRACT

Introduction and objectives:
Omission of insulin, a high-alert medication with one of the highest locally reported errors, could lead to severe hyperglycemia, which could result in coma or death if not treated timeously. This study aimed to identify, evaluate, and implement strategies to reduce the occurrence of insulin omission errors in diabetic adult patients requiring insulin.

Methods:
This project followed the JBI Evidence Implementation Framework and conducted context analysis, strategy implementation, and evaluation of outcomes according to evidence-based quality indicators. The JBI PACES and JBI GRiP situational analysis tools were used to support data collection and implementation planning. There was one evidence-based criterion and five sub-criteria, with a sample size of 22 patients.

Results:
There was increased compliance with best practices to reduce interruptions and distractions from baseline audit (50%) to follow-up audits 1 (45.4%) and 2 (31.8%), and no insulin omission incidences during the implementation period. In the post-implementation analysis, there were notable improvements in compliance with strategies related to nurses; however, reduced compliance was observed related to patients. Key barriers to implementation included patients still disturbing nurses despite the nurses wearing the medication vests and patients forgetting instructions not to disturb nurses during medication administration. Strategies to improve compliance included ensuring coverage in each cubicle during insulin preparation and administration, tending to patients’ needs prior to insulin administration, and use of posters as reminders.

Conclusions:
There was an overall increase in compliance with best practice to reduce interruptions and distractions and no insulin omission incidences related to interruptions and distractions during the implementation phase.

Spanish abstract:

http://links.lww.com/IJEBH/A219