bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of tranexamic acid in patients undergoing thoracic surgery: a systematic review and PRISMA-compliant meta-analysis
Authors: Gao Bin , Liu Yang , Yao Yun-tai ,   the Evidence in Cardiovascular Anesthesia (EICA) Group
Published: April 2024

Abstract
Objectives
Perioperative bleeding poses a significant issue during thoracic surgery. Tranexamic acid (TXA) is one of the most commonly used antifibrinolytic agents for surgical patients. The purpose of the current study was designed to investigate the efficacy and safety of TXA in patients undergoing thoracic surgery.

Methods
An extensive search of PubMed, Web of Science (WOS), Cochrane Library (trials), Embase, OVID, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP electronic databases was performed to identify studies published between the inception of these databases and March 2023. The primary outcomes included perioperative blood loss and blood transfusions. Secondary outcomes of interest included the length of stay (LOS) in hospital and the incidence of thromboembolic events. Weighted mean differences (WMDs) or odds ratios (OR) with 95% confidence intervals (CI) were used to determine treatment effects for continuous and dichotomous variables, respectively.

Results
Five qualified studies including 307 thoracic surgical patients were included in the current study. Among them, 65 patients were randomly allocated to the group receiving TXA administration (the TXA group); the other 142 patients were assigned to the group not receiving TXA administration (the control group). TXA significantly reduced the quantity of hemorrhage in the postoperative period (postoperative 12h: WMD = -81.90 ml; 95% CI: -139.55 to -24.26; P = 0.005; postoperative 24h: WMD = -97.44 ml; 95% CI: -121.44 to -73.44; P< 0.00001); The intraoperative blood transfusion volume (WMD = -0.54 units; 95% CI: -1.06 to -0.03; P = 0.04); LOS in hospital (WMD = -0.6 days; 95% CI: -1.04 to -0.16; P = 0.008); And there was no postoperative thromboembolic event reported in the included studies.

Conclusions
The present study demonstrated that TXA significantly decreased blood loss within 12 and 24 hours postoperatively. A qualitative review did not identify elevated risks of safety outcomes such as thromboembolic events. It also suggested that TXA administration was associated with shorter LOS in hospital as compared to control. To validate this further, additional well-planned and adequately powered randomized studies are necessary.
Radiotherapy combined with anti-PD-1 and TKI for primary cardiac angiosarcoma considering the joint assessment of TLSs and PD-L1: a case report
Authors: Deng Shuzhe , Yang Xinxin , He Lin , Zhang Qian , Zhao Chunbo , Meng Hongxue 
Published: April 2024

Abstract
Background
Primary cardiac angiosarcoma(PCA) has a low incidence rate and poor prognosis. Currently, no unified clinical treatment standards are available.

Case presentation
We report the case of a 48-year-old man presenting chest tightness, breathlessness, and dyspnea. Imaging and postoperative histopathologic studies confirmed PCA and that the tumor had invaded the entire right atrium. The patient developed progressive disease (PD) during postoperative radiotherapy. We used immunotherapy combined with targeted therapy based on the results of molecular profile and evaluation of tertiary lymphoid structures (TLSs) and programmed cell death-ligand 1 (PD-L1). After treatment, the metastatic lymph nodes of the patient were reduced to a certain extent, indicating that combination therapy was effective.

Conclusion
To the best of our knowledge, this is the first report of radiotherapy combined with anti-PD-1 and tyrosine kinase inhibitors(TKI) for PCA. In addition, this is the first report on immunotherapy for PCA based on new evaluation methods, including TLSs, PD-L1, and genomic profile.
Genotype-phenotype associations in microtia: a systematic review
Authors: Wahdini Siti Isya , Idamatussilmi Fina , Pramanasari Rachmaniar , Prawoto Almas Nur , Wungu Citrawati Dyah Kencono , Putri Indri Lakhsmi , Gunadi  
Published: April 2024

Abstract
Background
Microtia is a congenital ear malformation that can occur as isolated microtia or as part of a syndrome. The etiology is currently poorly understood, although there is strong evidence that genetics has a role in the occurrence of microtia. This systematic review aimed to determine the genes involved and the abnormalities in microtia patients' head and neck regions.

Methods
We used seven search engines to search all known literature on the genetic and phenotypic variables associated with the development or outcome of microtia. The identified publications were screened and selected based on inclusion and exclusion criteria and assessed for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tools. We found 40 papers in this systematic review with phenotypic data in microtia involving 1459 patients and 30 articles containing genetic data involved in microtia.

Result
The most common accompanying phenotype of all microtia patients was external ear canal atresia, while the most common head and neck abnormalities were the auricular, mental, and oral regions. The most common syndrome found was craniofacial microsomia syndrome. In the syndromic microtia group, the most common genes were TCOF1 (43.75%), SIX2 (4.69%), and HSPA9 (4.69%), while in the non-syndromic microtia group, the most frequently found gene was GSC exon 2 (25%), FANCB (16.67%), HOXA2 (8.33%), GSC exon 3 (8.33%), MARS1 (8.33%), and CDT1 (8.33%).

Conclusions
Our systematic review shows some genes involved in the microtia development, including TCOF1, SIX2, HSPA9, GSC exon 2, FANCB, HOXA2, GSC exon 3, MARS1, and CDT1 genes. We also reveal a genotype-phenotype association in microtia. In addition, further studies with more complete and comprehensive data are needed, including patients with complete data on syndromes, phenotypes, and genotypes.
Pre-operative plasma VEGF-C levels portend recurrence in epithelial ovarian cancer patients and is a bankable prognostic marker even in the initial assessment of a patient
Authors: Bhaskari J. , Bhagat Rahul , Shilpa V. , Premalata C.S. , Krishnamoorthy Lakshmi 
Published: April 2024

Abstract
Purpose
Our explorative study assessed a panel of molecules for their association with epithelial ovarian carcinomas and their prognostic implications. The panel included tissue expression of VEGF-C, COX-2, Ki-67 and eNOS alongside plasma levels of VEGF-C and nitric oxide.

Methods
130 cases were enrolled in the study. Plasma levels were quantified by ELISA and tissue expressions were scored by immunohistochemistry. The Chi square and Fischer’s exact test were applied to examine the impact of markers on clinicopathological factors. Non-parametric Spearman’s rank correlation test was applied to define the association among test factors.

Results
Plasma VEGF-C levels and COX-2 tissue expression strongly predicted recurrence and poor prognosis (< 0.001). Tissue Ki-67 was strongly indicative of late-stage disease (< 0.001). The aforementioned markers significantly associated with clinicopathological factors. Nuclear staining of VEGF-C was intriguing and was observed to correlate with high grade-stage malignancies, highly elevated plasma VEGF-C, and with recurrence. eNOS tissue expression showed no significant impact while nitric oxide associated positively with ascites levels. Tissue expression of VEGF-C did not associate significantly with poor prognosis although the expression was highly upregulated in most of the cases.

Conclusion
Plasma VEGF-C holds immense promise as a prognostic marker and the nuclear staining of VEGF-C seems to have some significant implication in molecular carcinogenesis and is a novel finding that commands further robust scrutiny. We present a first such study that assesses a set of biomarkers for prognostic implications in clinical management of epithelial ovarian carcinomas in a pan-Indian (Asian) population.
Effects of cognitive behavioural therapy and bright light therapy for insomnia in youths with eveningness: study protocol for a randomised controlled trial
Authors: Li Shirley Xin , Cheung Forrest Tin Wai , Chan Ngan Yin , Chan Joey Wing Yan , Zhang Jihui , Li Albert Martin , Espie Colin A. , Gradisar Michael , Wing Yun-Kwok 
Published: April 2024

Abstract
Background
Insomnia and eveningness are common and often comorbid conditions in youths. While cognitive behavioural therapy for insomnia (CBT-I) has been suggested as a promising intervention, it remains unclear whether it is sufficient to also address circadian issues in youths. In addition, despite that light has been shown to be effective in phase-shifting one’s circadian rhythm, there has been limited data on the effects of bright light therapy and its combination with CBT-I on sleep and circadian outcomes in youths. The current protocol outlines a randomised controlled trial that examines the efficacy of CBT-I and CBT-I plus bright light therapy (BLT) in reducing insomnia severity, improving mood symptoms and daytime functioning (e.g. sleepiness, fatigue, cognitive function), and improving subjective and objective sleep and circadian measures compared to a waitlist control group.

Methods
We will carry out a randomised controlled trial (RCT) with 150 youths aged 12–24 who meet the criteria of insomnia and eveningness. Participants will be randomised into one of three groups: CBT-I with bright light therapy, CBT-I with placebo light, and waitlist control. Six sessions of CBT-I will be delivered in a group format, while participants will be currently asked to use a portable light device for 30 min daily immediately after awakening throughout the intervention period for bright light therapy. The CBT-I with light therapy group will receive bright constant green light (506 lx) while the CBT-I with placebo light group will receive the modified light device with the LEDs emitting less than 10 lx. All participants will be assessed at baseline and post-treatment, while the two active treatment groups will be additionally followed up at 1 month and 6 months post-intervention. The primary outcome will be insomnia severity, as measured by the Insomnia Severity Index. Secondary outcomes include self-reported mood, circadian, daytime functioning, and quality of life measures, as well as sleep parameters derived from actigraphy and sleep diary and neurocognitive assessments. Objective measures of the circadian phase using dim-light melatonin onset assessment and sleep parameters using polysomnography will also be included as the secondary outcomes.

Discussion
This study will be the first RCT to directly compare the effects of CBT-I and BLT in youths with insomnia and eveningness. Findings from the study will provide evidence to inform the clinical management of insomnia problems and eveningness in youths.

Trial registration
ClinicalTrials.gov NCT04256915. Registered on 5 February 2020.
Human figure detection in Han portrait stone images via enhanced YOLO-v5
Authors: Zhang Junjie , Zhang Yuchen , Liu Jindong , Lan Yuxuan , Zhang Tianxiang 
Published: April 2024

Abstract
The unearthed Han Dynasty portrait stones are an important part of China’s ancient artistic heritage, and detecting human images in these stones is a critical prerequisite for studying their artistic value. However, high-precision target detection techniques often result in a large number of parameters, making them unsuitable for portable devices. In this work, we propose a new human image target detection model based on an enhanced YOLO-v5. We discovered that the complex backgrounds, dense group targets, and significant scale variations of targets within large scenes in portrait stones present significant challenges for human target image detection. Therefore, we first incorporated the SPD-Conv convolution and Coordinate Attention self-attention mechanism modules into the YOLO-v5 architecture, aiming to enhance the model’s recognition precision for small target images within Han portrait stones and strengthen its resistance to background disturbances. Moreover, we introduce DIoU NMS and Alpha-IoU Loss to improve the detector’s performance in dense target scenarios, reducing the omission of densely packed objects. Finally, the experimental results from our collected dataset of Han Dynasty stone figure images demonstrate that our method achieves fast convergence and high recognition accuracy. This approach can be better applied to the target detection tasks of special character images in complex backgrounds.
A comprehensive optimization mathematical model for wind solar energy storage complementary distribution network based on multi-regulatory devices under the background of renewable energy integration
Authors: Zhou Ke , Zhang Biyun , Jin Qingren , Bai Hao , Yang Weichen , Liu Tong 
Published: April 2024

AbstractIn the context of global energy transformation and sustainable development, integrating and utilizing renewable energy effectively have become the key to the power system advancement. However, the integration of wind and photovoltaic power generation equipment also leads to power fluctuations in the distribution network. The research focuses on the multifaceted challenges of optimizing the operation of distribution networks. It explores the operation and control methods of active distribution networks based on energy storage and reactive power compensation equipment. The stable operation of the distribution network is analyzed under the conditions of wind and photovoltaic integration, with a particular focus on precise regulation to address the limitations of existing methods. Afterwards, the study proposes an improvement plan that combines on load tap changer transformers and reactive power compensation equipment to solve complex power balance problems through second-order cone programming relaxation method. The results of numerical analysis show that the constructed mathematical model maintains a stable voltage of 1 to 1.1 pu at distribution network nodes within 24 h. Especially during peak hours from 15:00 to 24:00, it remains normal without any abnormal fluctuations when the control equipment is not added. These results confirm that precise regulation of multiple devices ensures voltage stability and avoids low or high voltage issues.
Why Biological Evolution Should Inspire Worship
Authors: Finlay Graeme 
Published: April 2024

The theory of biological evolution has often provoked disagreement, which has frequently been divisive and counterproductive. At other times this scientific paradigm has been discussed with an apologetic intent, to explain why the science of biology and the theology of creation cannot be seen to be mutually exclusive. This paper urges Christians to move decisively to a third type of discourse. The new field of comparative genetics has provided conclusive evidence that biological evolution has given rise to the diversity of living forms, including human beings. Consequently, Christians should, with confidence, gladly accept the evolutionary paradigm and look upon evolution as a divinely ordained historical process that develops through random (stochastic, free) process, but that leads to a divinely purposed consummation. As a result, biological history in its freedom but directedness to God’s final purposes should elicit wonder. People who have come to faith in the God revealed redemptively in Jesus should uninhibitedly offer adoration and praise for evolutionary fruitfulness. Worship should characterise the human response to biological history.[1]

[1] In appreciation of Professor Tom McLeish FRS, scientist, teacher, theologian.
Developing a ‘national module’ for nurses considering a career in general practice: addressing the workforce crisis in primary care
Authors: Lewis Robin 
Published: April 2024

The age profile of GPNs means that the pool of experienced GPNs available to recruit is rapidly shrinking. This article looks at potential solutions to the workforce crisis affecting practice nursing If the predicted workforce crisis in primary care is to be avoided, there is a clear need to increase the number of student nurses considering a career in general practice. Initiatives such as the NHS England national module, described here, are integral to this process. Of the HEIs nationally that responded to a tender from NHS England, SHU was one of seven HEIs awarded a contract to deliver the module. The SHU module uses a blended approach to learning and provides learners with an insight into general practice and the role of the general practice nurse. It is unique in that it is delivered in partnership with the South Yorkshire Primary Care Workforce and Training Hub and is designed to create a workforce ‘pipeline’ of new graduate nurses who will be equipped to access a regional career pathway for general practice nurses.
Hydroxyapatite ceramic-coated femoral components in younger patients followed up for 27 to 32 years
Authors: Upadhyay Piyush K. , Shah Nirav , Kumar Vishal , Mirza Saqeb B. 
Published: April 2024

AimsThis study reports the results of 38 total hip arthroplasties (THAs) in 33 patients aged less than 50 years, using the JRI Furlong hydroxyapatite ceramic (HAC)-coated femoral component.MethodsWe describe the survival, radiological, and functional outcomes of 33 patients (38 THAs) at a mean follow-up of 27 years (25 to 32) between 1988 and 2018.ResultsOf the surviving 30 patients (34 THAs), there were four periprosthetic fractures: one underwent femoral revision after 21 years, two had surgical fixation as the stem was deemed stable, and one was treated nonoperatively due to the patient’s comorbidities. The periprosthetic fracture patients showed radiological evidence of change in bone stock around the femoral stem, which may have contributed to the fractures; this was reflected in change of the canal flare index at the proximal femur. Two patients (two hips) were lost to follow-up. Using aseptic loosening as the endpoint, 16 patients (18 hips; 48%) needed acetabular revision. None of the femoral components were revised for aseptic loosening, demonstrating 100% survival. The estimate of the cumulative proportion surviving for revisions due to any cause was 0.97 (standard error 0.03).ConclusionIn young patients with high demands, the Furlong HAC-coated femoral component gives excellent long-term results.Cite this article: Bone Jt Open 2024;5(4):286–293.
Health Professionals’ knowledge and practice on basic life support and its predicting factors in Ethiopia: Systematic review and meta-analysis
Authors: Asferie Worku Necho , Kefale Demewoz , Kassaw Amare , Ayele Amare Simegn , Nibret Gedefaye , Tesfahun Yohannes , Shimels Hailemeskel Habitamu , Demis Solomon , Zeleke Shegaw , Aytenew Tigabu Munye 
Published: April 2024

Background
Basic Life Support (BLS) is a sequence of care provided to patients who are experiencing respiratory arrest, cardiac arrest, or airway obstruction. Its main purpose is to maintain the airway, breathing, and circulation through CPR. This review aimed to estimate the pooled prevalence of Health Professionals’ knowledge and practice on basic life support in Ethiopia.

Method
Eligible primary studies were accessed from international database (PubMed, Google Scholar, Hinari databases) and grey literatures found in online repositories. The required data were extracted from those studies and exported to Stata 17 for analysis. A weighted inverse-variance random-effects model and Der Simonian-Laird estimation method were used to compute the overall pooled prevalence of Health Professional’s knowledge, practice of basic life support and its predictors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger’s test.

Result
A total of 5,258 Health Professionals were included from 11 studies. The pooled prevalence of knowledge and practice outcomes on basic life support in Ethiopia were 47.6 (95% CI: 29.899, 65.300, I2: 99.21%) and 44.42 (95% CI: 16.42, 72.41, I2: 99.69) respectively. Educational status of the Professional’s was significantly associated with knowledge outcome. Those who had degree and above were 1.9 times (AOR: 1.90 (1.24, 2.56)) more likely knowledgeable on basic life support than under degree.

Conclusion
The overall pooled estimates of Health Professionals knowledge and practice on basic life support was considerably low. The educational status of the Health Professionals was significantly associated with knowledge outcome. The Health Professionals and responsible stakeholders should focus on the basic life support at Health Institutions. The professionals should advance their knowledge and skill on basic life support for the patients.
Vitreous hyper-reflective dots and the macular thickness after cataract surgery
Authors: Predović Jurica , Bosnar Damir , Marković Leon , Ćurić Ana , Bračić Josipa , Georgi Thomas , List Wolfgang , Glatz Wilfried , Ivastinovic Domagoj 
Published: April 2024

Purpose
To assess the association between vitreous hyper-reflective dots (VHD) and the macular thickness changes following uneventful phacoemulsification.

Methods
In this prospective cohort study optical coherence tomography (OCT) examinations were performed preoperatively and 1 week, 1 month and 3 months postoperatively in patients undergoing cataract surgery. OCT images were analyzed for retinal central subfield thickness (CST) and preretinal VHDs. Surgeries were recorded for the assessment of lens fragments in the space of Berger.

Results
111 eyes of 97 patient were enrolled of whom 69 (62.2%) were female. VHDs were seen in 25 eyes (22.5%) at week 1; in 21 eyes (18.9%) at month 1 and in 3 eyes (2.7%) at month 3. In all eyes with VHDs retro-capsular lens fragments were visible immediately after phacoemulsification. The number of VHDs significantly decreased over the postoperative period. There was a moderate correlation between the number of VHDs and CST at 1 month (r = 0.426, p<0.001). In eyes with VHD the CST averaged 238.8±17.6 μm (214–266) at 1 week; 276.1±63.5 μm (231–481) at 1 month and 285.1±122.3 μm (227–785) at 3 months. In eyes with no detectable VHDs CST averaged 235.9±23.3 μm (192–311) at 1 week; 240.1±21.6 μm (200–288) at 1 month and 242.2±21.3 μm (205–289) at 3 months. Although the differences among the assessment points were relatively low, there was a significant difference in general (p<0.001, Friedman test).

Conclusion
In conclusion, VHDs seem to cause macular thickening throughout the postoperative course. The origin of VHDs is still unknown; however, they presumably represent lens fragments that provoke subclinical inflammation.