bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-port-plus-one robot-assisted laparoscopic modified Lich-Gregoir direct nipple ureteral extravesical reimplantation in children with a primary obstructive megaureter
Authors: He Yufeng , Lin Shan , Xu Xinru , He Shaohua , Xu Huihuang , You Guangxu , Chen Jianglong , Xu Di 
Published: November 2023

PurposeTo introduce a new technique of single-port-plus-one robotic laparoscopic-modified Lich-Gregoir direct nipple ureteral extravesical reimplantation and ascertain its validity in the treatment of pediatric primary obstructive megaureter.MethodsBetween January 2021 and November 2021, we retrospectively analyzed the clinical data of 12 children with primary obstructive megaureter who were admitted to the Department of Pediatric Surgery of Fujian Provincial Hospital. All 12 children were treated with single-port-plus-one robotic laparoscopic Lich-Gregoir direct nipple ureteral extravesical reimplantation. Five of them were female and seven were male, including nine cases were simple obstructive type, while the remaining three cases were obstructive with reflux type. The mean age of the children was 17.33 ± 6.99 (10–36) months and the mean follow-up time was 14.16 ± 1.75 (12–17) months. Changes in preoperative and first-year postoperative parameters were compared.ResultsThe mean operative time for all 12 children was 123.58 ± 10.85 (110–145) min, with a mean internal operative time of 101.42 ± 0.85 (90–120) min, a mean operative bleeding time of 2.42 ± 0.67 (2–4) ml, and a mean hematuria duration of 16.08 ± 1.44 (14–19) h. The mean indwelling catheterization time was 2.25 ± 0.45 (2–3) days and the mean hospitalization time was 3.83 ± 0.39 (3–4) days. At the postoperative first year, the ureteral diameter, calyceal diameter, and anterior–posterior renal pelvic diameter were found to be significantly smaller than at the preoperative period (18.83 ± 3.21 mm vs. 6.83 ± 1.27 mm, 13.99 ± 3.58 mm vs. 3.5 ± 2.90 mm, and 34.92 ± 4.25 mm vs. 10.08 ± 1.88 mm, P &lt; 0.001). There was a significant increase in renal cortical thickness and the percentage of differential renal function (3.63 ± 1.66 mm vs. 5.67 ± 1.88 mm, 33.75 ± 2.77 mm vs. 37.50 ± 1.31 mm, P &lt; 0.001). The resolution rate of obstruction was 100% and no child developed DeNovo vesicoureteral reflux.ConclusionThe technique of modified Lich-Gregoir direct nipple ureteral extravesical reimplantation can help maintain the physiological direction of the ureter and at the same time enhance the effectiveness of antirefluxing in robotic surgery. The design of a single-port-plus-one wound can produce a cosmetic appearance by concentrating and hiding the wound around the umbilicus. This modified reimplantation procedure has the potential to become a promising technique in the robot-assisted treatment of primary obstructive megaureter.
Predictors of positive outcomes from ‘Early Intervention in Psychosis’: protocol for a national retrospective cohort study
Authors: Williams Ryan , Penington Ed , Gupta Veenu , Tsiachristas Apostolos , French Paul , Lennox Belinda , Bottle Alex , Crawford Mike J. 
Published: November 2023

BackgroundPsychotic disorders are severe and prevalent mental health conditions associated with long-term disability, reduced quality of life, and substantial economic costs. Early Intervention in Psychosis (EIP) services aim to provide timely and comprehensive treatment for psychotic disorders, and EIP service input is associated with improved outcomes. However, there is limited understanding of the specific components of EIP care that contribute to these improvements. There is significant nationwide variability in the commissioning and delivery of EIP, with individuals receiving different packages of components from different services. In this study, we seek to explore associations between EIP components and clinically significant outcomes, in order to understand the mechanisms underlying improved psychosis care.MethodsThis national retrospective cohort study will utilize data from the 2019 National Clinical Audit of Psychosis (NCAP), examining the care received by 10,560 individuals treated by EIP services in England. Exposure data from the NCAP, capturing the components of care delivered by EIP services, will be linked with outcome data from routine NHS Digital datasets over a three-year follow-up period. This will be the first study to use this method to examine this population in England. The primary outcomes will be surrogate measures of relapse of psychosis (hospital admission and referral to community-based crisis intervention services). Secondary outcomes include duration of admissions, emergency hospital attendances, episodes of detention under the Mental Health Act, and all-cause mortality. We will use multilevel regression to examine associations between exposures and outcome events. We will handle missing data using appropriate imputation techniques.DiscussionThis study aims to provide valuable insights into the long-term effects of variations in EIP service delivery. The study involves a large, diverse cohort including individuals treated by every EIP service in England. While there are limitations inherent in the observational nature of the study, any associations identified will be of great relevance to clinicians, researchers, and policymakers seeking to optimize EIP care. The results will enable more targeted treatment planning, resource allocation, and potential innovations in EIP care, ultimately leading to improved prognoses for people experiencing psychosis.
Indoor air bacterial load and antibiotic susceptibility pattern of isolates at Adare General Hospital in Hawassa, Ethiopia
Authors: Atalay Yibeltal Assefa , Mengistie Embialle , Tolcha Alemu , Birhan Belete , Asmare Getachew , Gebeyehu Natnael Atnafu , Gelaw Kelemu Abebe 
Published: November 2023

BackgroundAir is the agent of pathogenic microbes that cause significant problems in the hospital environment. Multidrug resistance poses a major therapeutic challenge to these airborne microorganisms in hospital indoor environments.Method and materialsThis study was conducted at Adare General Hospital in Hawassa City, Sidama, Ethiopia. A cross-sectional study was conducted. The proportional allocation method was used to select the sampled 50 rooms from the total available rooms in each category of wards and staff offices. A total of 100 indoor air samples were collected using settle plates in all units twice a day, morning (9:00–4:00 a.m.) and afternoon (3:00–4:00 p.m.). The types and number of colonies were determined in the laboratory, and the pathogenic bacteria were isolated by appropriate bacteriological techniques. Antimicrobial susceptibility testing was performed on Mueller-Hinton agar for each potentially pathogenic bacterium isolated. For each bacterium, a total of 12 antibiotics were tested using the Kirby-Bauer disk diffusion method. The test organism was adjusted to McFarland turbidity standards of 0.5. Data were entered and analyzed using the SPSS version 25 window. Descriptive analysis and one-way analysis of variance were performed.ResultsThe indoor air bacterial load of Adare General Hospital was found in the range between 210 and 3,224 CFU/m3. The highest indoor air bacterial load was identified from the gynecology ward with a mean of 2,542.5CFU/m3 at p &lt; 0.05. From 100 indoor air samples, a total of 116 bacterial pathogen isolates were obtained. Gram-positive isolates predominated at 72.4%, of which 37.1% were Staphylococcus aureus, 26.7% were coagulase-negative Staphylococci, and the rest 8.6% were Streptococcus pyogenes. The isolation of pathogenic bacteria Staphylococcus aureus and coagulase-negative Staphylococci showed a high level of resistance to ampicillin.ConclusionA high bacterial load was found in the study area as compared to different indoor air biological standards. Staphylococcus aureus and coagulase-negative Staphylococci were the isolated predominant bacteria. Attention should be given to preventing and minimizing those environmental factors that favor the multiplication of bacteria in the indoor environment of a hospital for the safe health of patients, visitors, and staff.
Measure what matters: considerations for outcome measurement of care coordination for children with neurodevelopmental disabilities and medical complexity
Authors: Materula Dércia , Currie Genevieve , Jia Xiao Yang , Finlay Brittany , Richard Catherine , Yohemas Meridith , Lachuk Gina , Estes Myka , Dewan Tammie , MacEachern Sarah , Gall Nadine , Gibbard Ben , Zwicker Jennifer D. 
Published: November 2023

IntroductionCare Coordination (CC) is a significant intervention to enhance family’s capacity in caring for children with neurodevelopmental disability and medical complexity (NDD-MC). CC assists with integration of medical and behavioral care and services, partnerships with medical and community-based supports, and access to medical, behavioral, and educational supports and services. Although there is some consensus on the principles that characterize optimal CC for children with NDD-MC, challenges remain in measuring and quantifying the impacts of CC related to these principles. Two key challenges include: (1) identification of measures that capture CC impacts from the medical system, care provider, and family perspectives; and (2) recognition of the important community context outside of a hospital or clinical setting.MethodsThis study used a multilevel model variant of the triangulation mixed methods design to assess the impact of a CC project implemented in Alberta, Canada, on family quality of life, resource use, and care integration at the broader environmental and household levels. At the broader environmental level, we used linked administrative data. At the household level we used quantitative pre-post survey datasets, and aggregate findings from qualitative interviews to measure group-level impacts and an embedded multiple-case design to draw comparisons, capture the nuances of children with NDD-MC and their families, and expand on factors driving the high variability in outcome measures. Three theoretical propositions formed the basis of the analytical strategy for our case study evidence to explore factors affecting the high variability in outcome measures.DiscussionThis study expanded on the factors used to measure the outcomes of CC and adds to our understanding of how CC as an intervention impacts resource use, quality of life, and care integration of children with NDD-MC and their families. Given the heterogeneous nature of this population, evaluation studies that account for the variable and multi-level impacts of CC interventions are critical to inform practice, implementation, and policy of CC for children with NDD-MC.
Evaluation of pilot community art-based workshops designed for Ukrainian refugee children
Authors: Lukito Steve , Wenkert Michaela , Hryhorovych Inna , Opanasenko Svitlana , Timms Laura , Yule William , Ougrin Dennis 
Published: November 2023

ObjectivesApproximately 8 million Ukrainians have been displaced by the war in Ukraine and five million children had their education disrupted. Here, we report an evaluation of (1) the feasibility (i.e., recruitment), (2) the acceptability (i.e., attendance, participants' views) and (3) the influence of a pilot community art-based project on the well-being, health behaviour and socialisation of Ukrainian refugee children in London, UK.MethodsTwenty-two refugee children aged 4–14 years from St Mary's Ukrainian school in London took part in five weekly art workshop group sessions led by a team of volunteer independent artists based in a community art studio in West London in collaboration with Children and War UK. Analyses were conducted on measures of the children's psychological well-being, health behaviour, and socialisation; collected from participating children and their parents through the workshops.ResultsThe community art workshops received sufficient interest from parents during recruitment. Child participants and their parents expressed overwhelmingly positive views and high satisfaction towards the workshops and their activities. While the workshops were conducted without a control group, changes in psychological well-being and health behaviour and socialisation were in the expected direction. The workshops were associated with reduced impact of intrusive re-experiencing of traumatic events (p = .021), negative emotion (ps = .006–.043; rated by children and by their parents, respectively), and sleep disturbance (p = .015). Mood and motivational states increase relative to before activities within sessions (ps = .001–.023).ConclusionsThe artist-led workshops are a valuable community project associated with high satisfaction and potentially increased well-being in Ukrainian refugee children. A provision for a larger number of participants should be considered.
Clinical and histopathological correlation of oral malignancy and potentially malignant disorders based on a screening program at high-risk population in Tamil Nadu, India
Authors: Iyer Kiran , Kumar Madan , Kannan Ranganathan , Narayanan Aswath , Moothedath Muhamood , Khanagar Sanjeev Balappa , Bijai Laliytha Kumar 
Published: November 2023

BackgroundThere is a high incidence of oral cancer and oral potential malignant disorder observed in southeast Asian countries such as India. Our study aimed to assess the correlation between screening and histopathological diagnosis and to predict the specificity and sensitivity of chair-side/field-based assessment of the oral lesion.Materials and methodsA total of 40,852 subjects aged between 20 and 60 years were screened in the 1st phase of the study, suspected lesions were stained with toluidine blue (Manufactured by Otto Chemicals private limited, India) at two time points, those who stained positively during the two points were taken up for biopsy. Provisional diagnosis was later correlated with histopathological diagnosis.ResultsSubjects who underwent biopsy had a mean age of (49.01 ± 9.8 years), Leukoplakia (1.5%) was the most common lesion observed among tobacco users, interestingly it had the least correlation (39.6%) in diagnosis, Overall sensitivity (88%) and a positive predictive value (80%) was high for clinical diagnosis of OPMD in our study.ConclusionCorrelation of clinical and histopathological diagnosis observed in our study confirms higher yield of true positives while screening in remote and vulnerable populations, which would assure a better quality of life for these subjects.
Feasibility and safety of planned early discharge following laparotomy in gynecologic oncology with enhanced recovery protocol including opioid-sparing anesthesia
Authors: Kuznicki Michelle L. , Yasukawa Maya , Mallen Adrianne R. , Lam Clarissa , Eggers Erica , Regis Jefferson , Wells Ali , Todd Sarah L. , Robertson Sharon E. , Tanner Jean-Paul , Anderson Matthew L. , Rutherford Thomas J. 
Published: November 2023

ObjectiveThis study aims to evaluate the feasibility and safety of planned postoperative day 1 discharge (PPOD1) among patients who undergo laparotomy (XL) in the department of gynecology oncology utilizing a modified enhanced recovery after surgery (ERAS) protocol including opioid-sparing anesthesia (OSA) and defined discharge criteria.MethodsPatients undergoing XL and minimally invasive surgery (MIS) were enrolled in this prospective, observational cohort study after the departmental implementation of a modified ERAS protocol. The primary outcome was quality of life (QoL) using SF36, PROMIS GI, and ICIQ-FLUTS at baseline and 2- and 6-week postoperative visits. Statistical significance was assessed using the two-tailed Student's t-test and non-parametric Mann–Whitney two-sample test.ResultsOf the 141 subjects, no significant demographic differences were observed between the XL group and the MIS group. The majority of subjects, 84.7% (61), in the XL group had gynecologic malignancy [vs. MIS group; 21 (29.2%), p &lt; 0.001]. All patients tolerated OSA. The XL group required higher intraoperative opioids [7.1 ± 9.2 morphine milligram equivalents (MME) vs. 3.9 ± 6.9 MME, p = 0.02] and longer surgical time (114.2 ± 41 min vs. 96.8 ± 32.1 min, p = 0.006). No significant difference was noted in the opioid requirements at the immediate postoperative phase and the rest of the postoperative day (POD) 0 or POD 1. In the XL group, 69 patients (73.6%) were successfully discharged home on POD1. There was no increase in the PROMIS score at 2 and 6 weeks compared to the preoperative phase. The readmission rates within 30 days after surgery (XL 4.2% vs. MIS 1.4%, p = 0.62), rates of surgical site infection (XL 0% vs. MIS 2.8%, p = 0.24), and mean number of post-discharge phone calls (0 vs. 0, p = 0.41) were comparable between the two groups. Although QoL scores were significantly lower than baseline in four of the nine QoL domains at 2 weeks post-laparotomy, all except physical health recovered by the 6-week time point.ConclusionsPPOD1 is a safe and feasible strategy for XL performed in the gynecologic oncology department. PPOD1 did not increase opioid requirements, readmission rates compared to MIS, and patient-reported constipation and nausea/vomiting compared to the preoperative phase.
Chemosensitivity of three patient-derived primary cultures of canine pericardial mesothelioma by single-agent and combination treatment
Authors: Nabeta Rina , Kanaya Ami , Elbadawy Mohamed , Usui Tatsuya , Furuya Tetsuya , Suzuki Kazuhiko , Uchide Tsuyoshi 
Published: November 2023

IntroductionCanine mesothelioma is a rare malignant tumor that mostly affects body cavities, such as the pericardial and pleural cavities. Chemotherapy plays a crucial role in the treatment of canine mesotheliomas. We aimed to compare the antitumor effects of single-agent and combination chemotherapeutic agents on patient-derived primary cultures of canine pericardial mesothelioma established in this study. We planned to generate xenograft models for future studies.Material and methodsEffusion samples were collected from three dogs with histologically diagnosed pericardial mesothelioma and used for primary culture. Cultured cells were characterized by immunostaining for pan-cytokeratin AE1/AE3, vimentin, Wilms' tumor suppressor gene 1 (WT1), and cytokeratin 5 (CK5). To assess the tumorigenic properties of cells in the effusion and generate a xenograft model, the cell suspension was injected into a severe combined immunodeficient (SCID) mouse either subcutaneously (SC) or intraperitoneally (IP). Lastly, chemosensitivity of established primary cultures against four drugs, doxorubicin, vinorelbine, carboplatin, and gemcitabine, by single-agent treatment as well as combination treatment of carboplatin at a fixed concentration, either 10 or 100 μM, and gemcitabine at different concentrations ranging from 0–1000 μM was assessed by cell viability assay.ResultsPrimary cultures were successfully generated and characterized by dual positivity for AE1/AE3 and vimentin and positive staining for WT-1 and CK5, confirming the mesothelial origin of the cells. In the xenograft models, SC mouse developed a subcutaneous mass, whereas IP mouse developed multiple intraperitoneal nodules. The masses were histopathologically consistent with mesotheliomas. The chemosensitivity assay revealed that carboplatin had the highest anti-tumor effects among the four tested single-agent treatments. Furthermore, carboplatin at 100 μM combined with gemcitabine at clinically relevant doses demonstrated the augmented anti-tumor effects compared to single-agent treatment.Discussion and conclusionPrimary cultures and xenograft models generated in this study could be useful tools for in vitro and in vivo studies of canine mesothelioma. Carboplatin is a highly effective chemotherapeutic agent against canine mesothelioma when used as a sole agent and in combination with gemcitabine.
Donor-Derived Cell-Free DNA (dd-cfDNA) in Kidney Transplant Recipients With Indication Biopsy—Results of a Prospective Single-Center Trial
Authors: Benning Louise , Morath Christian , Fink Annette , Rudek Markus , Speer Claudius , Kälble Florian , Nusshag Christian , Beimler Jörg , Schwab Constantin , Waldherr Rüdiger , Zeier Martin , Süsal Caner , Tran Thuong Hien 
Published: November 2023

Donor-derived cell-free DNA (dd-cfDNA) identifies allograft injury and discriminates active rejection from no rejection. In this prospective study, 106 kidney transplant recipients with 108 clinically indicated biopsies were enrolled at Heidelberg University Hospital between November 2020 and December 2022 to validate the clinical value of dd-cfDNA in a cohort of German patients. dd-cfDNA was quantified at biopsy and correlated to histopathology. Additionally, dd-cfDNA was determined on days 7, 30, and 90 post-biopsy and analyzed for potential use to monitor response to anti-rejection treatment. dd-cfDNA levels were with a median (IQR) % of 2.00 (0.48–3.20) highest in patients with ABMR, followed by 0.92 (0.19–11.25) in patients with TCMR, 0.44 (0.20–1.10) in patients with borderline changes and 0.20 (0.11–0.53) in patients with no signs of rejection. The AUC for dd-cfDNA to discriminate any type of rejection including borderline changes from no rejection was at 0.72 (95% CI 0.62–0.83). In patients receiving anti-rejection treatment, dd-cfDNA levels significantly decreased during the 7, 30, and 90 days follow-up compared to levels at the time of biopsy (p = 0.006, p = 0.002, and p &lt; 0.001, respectively). In conclusion, dd-cfDNA significantly discriminates active rejection from no rejection. Decreasing dd-cfDNA following anti-rejection treatment may indicate response to therapy.Clinical Trial Registration: https://drks.de/search/de/trial/DRKS00023604, identifier DRKS00023604.
ECOLOGICAL STRUCTURE OF FLORA OF MEADOWS OF THE ROMENSKO-POLTAVSKY GEOBOTANICAL DISTRICT
Authors: Zhuk M. 
Published: November 2023

The article paper deals with the ecological structure of the meadows flora of the Romensko-Poltavsky geobotanical district. The identified species were analysed according to 12 ecological factors, which belong to two groups – edaphic and climatic. In the first group, the plants of meadow lands were studied according to 7 ecological factors, among which sub-mesophytes (174 species or 28,9%) and mesophytes (149 species or 24,8%) prevail in relation to soil water regime. In relation to the soil moisture variability, the dominance of two ecogroups was revealed, they are hemi-hydrocontrastophiles (227 species or 37,8%) and hemi-hydrocontrastophobes (226 species or 37,6%). In terms of soil acidity, sub-acidophytes (275 species or 45,8%) and neutrophiles(244 species or 40,6%) were identified. In relation to the soil salinity of the soil in the studied meadow, phytocoenoses semi-eutrophes (288 species or 48%) are leading. In terms of carbonate content in the soil, hemi-carbonatophobes (235 species or 39,1%) and acarbonatophiles(203 species or 37,8%) prevailed. Hemi-nitrophiles (297 species or 49,4%) prevail in terms of nitrogen content in the soil, and sub-aerophiles (305 species or 50,7%) in terms of soil aeration. The meadow plants of the Romensko-Poltavsky geobotanical district were studied according to5 ecological factors of the climatic group, among which the most prominent were sub-mesotherms (309 species or 51,4%) and sub-microtherms (240 species or 39,9%) in relation to the thermal regime. In terms of climate humidity, sub-aridophytes dominate (233 species or 38,8%). In terms of climate continentality, hemi-continental (258 species or 42,9%) and hemi-oceanic (207 species or 34,4%) are dominant. Sub-cryophytes are the most numerous in relation to the cryo-regime(302 species or 50,2%). In relation to light conditions, sub-heliophytes are represented by the largest number of species (493 species or 82%).