bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymph Node Ratio as a Predictor of Survival for Colon Cancer: A Systematic Review and Meta-Analysis
Authors: Ichhpuniani Simarpreet , McKechnie Tyler , Lee Jay , Biro Jeremy , Lee Yung , Park Lily , Doumouras Aristithes , Hong Dennis , Eskicioglu Cagla 
Published: November 2023

Background Lymph node ratio is the number of lymph nodes with evidence of metastases on pathological review compared to the total number of lymph nodes harvested during oncologic resection. Lymph node ratio is a proven predictor of long-term survival. These data have not been meta-analyzed to determine the prognosis associated with different lymph node ratio cut-offs in colon cancer. Methods Medline, Embase, and CENTRAL were systematically searched. Articles were included if they compared 5-year overall survival (OS) or disease-free survival (DFS) between different lymph node ratios for patients undergoing oncologic resection for stages I-III colon cancer. Pairwise meta-analyses using inverse variance random effects were performed. Results From 2587 citations, nine studies with 97,631 patients (female: 51.9%, median age: 61.65 years) were included. A lymph node ratio above .1 resulted in a 49% decrease in the odds of 5-year OS (2 studies; OR: 0.51, 95% CI: 0.49-.53, P < .00001). A lymph node ratio above .25 resulted in a 56% decrease in the odds of 5-year OS (3 studies; OR: 0.44, 95% CI: 0.43-.45, P < .00001). A lymph node ratio above .5 resulted in a 65% decrease in the odds of 5-year OS (3 studies; OR: 0.35, 95% CI: 0.33-.37, P < .00001). Conclusions Lymph node ratios from .1 to .5 are effective predictors of 5-year OS for colon cancer. There appears to be an inverse dose-response relationship between lymph node ratio and 5-year OS. Further study is required to determine whether there is an optimal lymph node ratio cut-off for prognostication and whether it can inform which patients may benefit from more aggressive adjuvant therapy and follow-up protocols.
Evaluating Clinical Outcomes of Laparoscopic Subtotal and Total Cholecystectomy for Complicated Acute Cholecystitis: A Systematic Review and Meta-Analysis
Authors: Martinez Brian , Breeding Tessa , Katz Joshua , Kostov Anthony , Santos Radleigh G. , Ibrahim Joseph , Elkbuli Adel 
Published: November 2023

Introduction This systematic review and meta-analysis aimed to compare clinical outcomes in patients with complicated acute cholecystitis undergoing laparoscopic total vs subtotal cholecystectomy. Methods This systematic review and meta-analysis was conducted according to PRISMA guidelines and queried PubMed, Embase, ProQuest, Google Scholar, and Cochrane databases from inception to May 2023. The primary outcome was complication rates including common bile duct injury, wound infection, reoperation, bile leak, retained stones, and subhepatic collection, whereas secondary outcomes were in-hospital mortality and hospital length of stay. Results A total of 7 studies with 135,233 cases were included for meta-analysis. Patients who underwent laparoscopic total cholecystectomy had a significantly lower risk of postoperative bile leaks (RR: .15; 95% CI: .03, .80) and subhepatic fluid collection (RR: 0.19; 95% CI: .06, .63) and were 2.94 times less likely to die compared to those who underwent subtotal cholecystectomy (RR .34; 95% CI: .15, .77). Patients who underwent subtotal cholecystectomy had significantly longer hospital length of stay (mean difference 1.0 days; 95% CI: .5 days, 1.4 days). Conclusions In adult patients presenting with complicated cholecystitis, management with laparoscopic subtotal cholecystectomy presents a unique complication profile with increased risk of postoperative bile leak and subhepatic fluid collection, in-hospital mortality, and longer hospital length-of-stay when used as an alternative approach to laparoscopic total cholecystectomy. Further research into the most appropriate clinical scenarios and patient populations for the use of the subtotal cholecystectomy approach may prove useful in improving its associated outcomes.
Nationwide Outcomes After Neoadjuvant Chemotherapy for Locally Advanced Sigmoid Colon Cancer—A Propensity Score-Matched Analysis
Authors: Kodia Karishma , Alnajar Ahmed , Huerta Carlos T. , Gupta Gaurav , Giri Bhuwan , Dosch Austin , Paluvoi Nivedh 
Published: November 2023

Background The role of neoadjuvant chemotherapy (NAC) in advanced sigmoid colon carcinoma remains to be further characterized. Rationale for NAC includes downstaging on final pathology and optimization of microscopically negative margins (R0 resection). We investigated rates of neoadjuvant chemotherapy use in advanced sigmoid colon cancer at academic cancer centers and assessed factors associated with likelihood of NAC administration. Methods The National Cancer Database was queried from 2004 to 2017 for patients with clinical T3 or T4, N0-2, M0 sigmoid colon cancer who underwent surgical resection. Those with neoadjuvant radiation or metastatic disease were excluded. The outcomes of patients who did and did not receive neoadjuvant chemotherapy were evaluated for this retrospective cohort study. Results There were 23,597 patients of whom 364 (1.5%) received NAC. More patients received NAC at academic (41%, P < .001) and high-volume centers (27%, P < .001). Patients with Medicare/Medicaid (39%) and private insurance (52%) were more likely to receive NAC ( P < .001). There was a significantly higher rate of N2 to N1 downstaging in the NAC group. Propensity-score matching demonstrated comprehensive community cancer programs (CCCP) were less likely to provide NAC (OR 0.4; 95% CI 0.23, 0.70, P < .001). There was no difference in survival ( P = .20), R0 resection ( P = .090), or 30-day readmission rates ( P = .30) in the NAC cohort compared to the non-NAC cohort. Conclusions Access to centers offering multi-disciplinary care with NAC prior to surgical resection is important. This care was associated with academic and high-volume centers and private or government-sponsored insurance. There was no difference in survival between NAC and non-NAC cohort.
Drivers of reverse corporatization in English local government: A longitudinal analysis
Authors: Andrews Rhys 
Published: November 2023

Local governments increasingly create and use corporate forms of organization to provide public services. While there is growing evidence on the factors influencing such corporatization, less is known about what leads some local governments to bring corporatized services back in-house. This paper investigates financial, socioeconomic, political and organizational drivers of reverse corporatization among 62 Arms-Length Management Organizations (ALMOs), wholly owned nonprofit organizations created by local governments in England to provide social housing services. Survival analysis for the period 2003–2019 suggests that reverse corporatization is more likely to occur in left-wing local governments and in those with more financial reserves, but is less likely if ALMOs have operated for a longer time and have a large board of directors. Points for practitioners Understanding of the drivers of reverse corporatization can help local politicians and public managers improve their decisions about the appropriate mode of delivery for local public services. This paper highlights that good fiscal health may be essential for efforts to bring corporatized service back in-house, but that well-established municipal corporations may be better left to continue operating. It is also important for policymakers to recognize the role that political ideology (and socioeconomic circumstances) can play in shaping a commitment to reversing corporatization.
A novel blinds control approach based on dynamic radiance and solar radiation energy prediction
Authors: Li Jianzhang , Zeng Xianhui 
Published: November 2023

Automatic shading devices are widely employed in office buildings to enhance daylight comfort and reduce electricity consumption. However, conventional blinds control methods rely heavily on numerous sensors to monitor indoor daylight conditions, posing challenges in implementing automated control systems. A novel blinds control approach based on dynamic radiance and solar radiation energy prediction is proposed to address this issue. Instead of relying on illumination sensors, the method utilizes the Bidirectional Scattering Distribution Function (BSDF) and a sky model-based three-phase approach to calculate indoor illumination. Artificial neural networks are employed to predict transmitted solar radiation energy, thereby minimizing energy consumption. Furthermore, the multiple criteria decision-making model is applied to determine the optimal angle for the blinds. Simulation experiments demonstrated that this approach achieved a significant reduction of approximately 17% in energy consumption compared to a fixed angle of 90° in the cooling season. And the average illumination of the indoor work plane can be effectively maintained at the recommended level, as ensures improving occupants’ comfort. Practical Application: The proposed blinds control approach has practical applications in building automation control systems. By effectively reducing building energy consumption, it offers an efficient alternative to traditional control methods. Notably, this approach minimizes reliance on sensors, making it a cost-effective and sustainable solution for optimizing building energy usage.
Catheter thrombectomy for basilar artery stroke immediately after insertion of durable left ventricular assist device
Authors: Gregory Vasiliki , Isath Ameesh , Bali Atul D. , Al-Mufti Fawaz , Levine Avi , Kai Masashi , Ohira Suguru 
Published: November 2023

Background: Acute ischemic stroke (AIS) following left ventricular assist device (LVAD) implantation is a serious complication associated with device morbidity. AIS development following LVAD placement typically presents between 6- and 24-months post implantation. Case/Results: We report a case of a 67-year-old male who initially presented with reduced ejection fraction and severe coronary vessel disease. Following coronary artery bypass graft surgery, the patient remained in a low output state necessitating placement of an LVAD device. Approximately 4.5 hours following LVAD implantation, a severe acute decrease in mental status revealed new development of ischemic stroke of the basilar artery, which was successfully treated in one pass with catheter endovascular thrombectomy. Conclusion: While embolic stroke management in these cases remains difficult as patients are usually anticoagulated, our case demonstrates the utilization of endovascular thrombectomy as a viable therapeutic option in the setting of an uncommon occurrence of embolic stroke in the hours following LVAD implantation.
Investigation of electrical, electromagnetic interference shielding and tensile properties of 3D-printed acrylonitrile butadiene styrene/carbon nanotube composites
Authors: Maleki Amir Hossein , Zolfaghari Abbas 
Published: November 2023

Conductive polymer composites (CPCs) are manufactured by compounding conductive particles with a polymer matrix. There are many applications where they are used, including light-weight applications requiring both electrical and heat conductivity. Carbon nanotubes (CNTs) have been accepted as common materials to accomplish this goal. As part of this research, a material extrusion additive manufacturing (AM) process was utilized to create nanocomposites by a 3D-printing technique. Multi-wall carbon nanotubes (MWCNTs) were mixed in 1, 3 and 6 wt fractions with acrylonitrile butadiene styrene (ABS) and extruded in filament form. Three-dimensionally printed specimens were used to evaluate electrical, electromagnetic interference shielding effectiveness (EMI SE) and tensile properties. The electrical conductivity of the material was 26 times greater than that of ABS. In the X-band of electromagnetic waves, EMI SE's reflected and absorbed portions increased respectively 4 and 16 times. The tensile strength and modulus were enhanced by 15% and 9%, respectively. On composite specimens, microwave heat treatment was applied. There is less void space between the rasters and layers, which helps improve tensile properties. Additionally, 3D-printed specimens were tested for melt flow rate (MFR) and dynamic mechanical behaviour. The nozzle has experienced some wear due to the intrinsic abrasive nature of CNTs.
Research on the mechanism of rail corrugation of steel spring floating slab track on metro
Authors: Li Xiang , Ren Zunsong , Yang Yanfeng , Zhao Shulin 
Published: November 2023

Steel spring floating slab track (SSFST) is an effective vibration and noise reduction measure, which is gradually used in urban rail transit in recent years. In order to better solve the problems of vibration noise and abnormal rail corrugation on metro lines, the dynamic model of vehicle-track system including metro vehicle and track structure is established by using the simulation software. The relationship between the passing frequency of vehicle and the vibration frequency of track structure, as well as the resonance characteristics of the elastic track structure are analyzed so as to obtain cause of rail corrugation on SSFST. The results show the following: (1) It is a more obvious resonance phenomenon between the inner rail and the floating slab at the vibration frequency of 116 and 161 Hz (R300 m), 262 Hz (R1000 m) and 320-387 Hz (R1500 m), and the simulation of rail corrugation wavelength is closer to field measured data. (2) Comparing the vibration frequency distribution of ordinary track and SSFST under the same curve radius, the rail corrugation is related to the natural vibration characteristics of track structure. (3) The vibration characteristics of the track structure and the periodic wear characteristics of the rail are the key factors for the formation of rail corrugation.
Increase in human immunodeficiency virus and syphilis prevalence and incidence among men who have sex with men, vietnam 2015 – 2020
Authors: Thanh Nguyen Ha Thi , Nguyen Ly Thuy , Thanh Hoang Ha Thi , Bui Duc Hoang , Thu Phan Huong Thi , Van Khuu Nghia , Hong Ngo Hanh Thi , Dang Duc Anh , Mirzazadeh Ali , McFarland Willi , Pham Thang Hong 
Published: November 2023

Introduction We assessed trends in HIV and syphilis prevalence, HIV incidence, related risk factors, and preventive behaviors among men who have sex with men (MSM) in Vietnam from 2015 to 2020. Methods Data originated from the HIV Sentinel Surveillance Plus system, which sampled MSM at venues and hotspots in seven of Vietnam’s 63 provinces in 2015, 2016, 2018, and 2020 ( N = 1100-1445 per year; ∼150-300 per province per year). Results HIV prevalence estimates increased from 6.6% (95% CI 4.5–9.6) in 2015 to 13.8% (95% CI 10.5-18.2, p = .001 for trend) in 2020 overall, and separately in An Giang, Can Tho, Hai Phong, and Khanh Hoa provinces but not in Ho Chi Minh City, Hanoi, or Kien Giang. Syphilis prevalence increased from 2.7% (95% CI 1.4-5.1) in 2015 to 12.6% (95% CI 8.7-18.0) in 2020 overall ( p < .001 for trend), and separately in An Giang, Can Tho, and Hai Phong provinces but not in Ho Chi Minh City or Kien Giang. We calculated time-at-risk from first anal sex to first HIV-positive or last HIV-negative test to estimate HIV incidence. Estimated HIV incidence suggested increasing rates of seroconversion from 1.36 per 100 person-years experienced by participants in 2015 to 2.61 per 100 person-years among participants in 2020 (hazard ratio per year 1.13, 95% CI 1.08-1.18, p < .001). There was a statistically significant increase in HIV testing, STI testing, and receipt of free condoms over the period ( p < .05 for trend), and a statistically significant decrease in amphetamine use ( p = .043 for trend). Conclusions Despite prevention efforts and improvements in some risk indicators, consecutive cross-sectional sampling results provide evidence of increasing incidence of HIV and syphilis among MSM in Vietnam, especially outside the major cities. Aggressive HIV prevention and treatment services can be expanded while conducting deeper investigations into the causes of these increases.
Effective management of patients with borderline personality disorder in a busy acute inpatient ward using dialectical behaviour therapy principles
Authors: Banjo Jumi , Madson Kathy , Hromis Sanya 
Published: November 2023

Objective The study aimed to highlight principles of Dialectical Behaviour Therapy (DBT) that can provide a framework in the management of patients with borderline personality disorder (BPD) and outline some guiding principles in the effective management of these patients on a busy acute inpatient ward. Conclusions The inpatient environment is often a place where invalidating experiences can occur. These include feeling ignored, misunderstood and where private experiences are trivialised or denied. Patients with BPD are extremely sensitive to these experiences and are likely to decompensate if strategies are not in place to facilitate a more validating experience during admission. The proposed guidelines are feasible to implement and support a cohesive treatment team and collaborative patient-centred care which is likely to improve patient outcomes.
‘A Constant Black Cloud’: The Emotional Impact of Informal Caregiving for Someone With a Lower-Grade Glioma
Authors: Rimmer Ben , Balla Michelle , Dutton Lizzie , Lewis Joanne , Burns Richéal , Gallagher Pamela , Williams Sophie , Araújo-Soares Vera , Finch Tracy , Sharp Linda 
Published: November 2023

Those closest to people with lower-grade gliomas (LGGs) often assume the role of informal caregiver (IC). The additional responsibilities mean ICs of people with cancer can experience adverse impacts on their own lives. We explored the emotional impact of informal caregiving for people with LGGs. This was a descriptive qualitative study within the multi-method Ways Ahead project. We conducted semi-structured interviews with individuals from the United Kingdom, who currently, or in the past 5 years, informally cared for someone with an LGG. Interviews encompassed experiences of emotional impact as a consequence of caregiving for someone with an LGG. Inductive thematic analysis was undertaken. We interviewed 19 ICs (mean age 54.6 years; 14 females, 5 males). Participants reported substantial emotional impact. Four themes and associated subthemes were generated: Emotional responses to the illness (e.g. feeling helpless), Emotional responses to the unknown (e.g. anxiety about future uncertainty), Emotional consequences of care recipient changes (e.g. challenges of changed relationship dynamics), and Emotional weight of the responsibility (e.g. feeling burnout). Emotional impact in one area often exacerbated impact in another (e.g. future uncertainty impacted feelings of helplessness). Participants detailed the factors that helped them manage the emotional impact (e.g. being resilient). ICs of people with LGGs can experience wide-ranging emotional responses to and impacts of the illness, uncertain prognosis, care recipient changes, and the toll of caregiving. Adjustment and resilience are key protective factors, though further consideration of ways to identify and fulfil the emotional support needs of ICs of people with LGGs is required.
Oral Cleft and Maternal History of Spontaneous Abortion: A Case-Control Study
Authors: Pereira Maria Carolina de Moraes , Silva Carolina Maia , Queiroz Thaís Bernardes de , Neves Lucimara Teixeira das 
Published: November 2023

To investigate and compare the occurrence of previous spontaneous abortion among mothers of children with nonsyndromic oral clefts (NSOC) and mothers of children without NSOC; to understand if previous spontaneous abortion could be a risk factor for the occurrence of NSOC in subsequent pregnancies. Case-control study. Nonsyndromic oral clefts is an important public health problem. In the context of investigating risk factors for the occurrence of this malformation, previous spontaneous abortion have been considered in the etiology at NSOC. There were 1004 participants. In the case group 502 mothers of children with NSOC, and in the control group 502 mothers of children without NSOC or any other malformation or syndrome. A standardized questionnaire was utilized to interview the maternal history of spontaneous abortion. The data were evaluated using descriptive statistics, and comparisons were performed using the Chi-square test, adopting a significance level of 5%. The prevalence of maternal history of spontaneous abortion was 16.3% in the case group and 15.9% in the control group. Comparing the groups there was no statistical difference (p-value = 0.93). Analyzing the occurrence of previous spontaneous abortion, separating the case group according to the type of cleft in the child, no statistical differences were observed when comparing these groups between them. Maternal history of spontaneous abortion was not associated with NSOC, not representing an independent risk factor for NSOC in the Brazilian population.
Establishment of a Prognostic Nomogram for Cancer-Specific Survival in Patients With Base-of-Tongue Squamous Cell Carcinoma: A Retrospective Study Based on the SEER Database
Authors: Lin Zi-Jun , Huang Liying , Lin Ying-Mei , Luo Renhui , Wang Shen-Chih , Lyu Jun , Shao Jun 
Published: November 2023

Background The aim of this retrospective study was to construct and clinically apply a nomogram for cancer-specific survival (CSS) in patients diagnosed with base-of-tongue squamous cell carcinoma (BOTSCC) to predict their survival prognosis. Methods We collected 8448 patients diagnosed with BOTSCC during 2004–2015 from the Surveillance, Epidemiology, and End Results (SEER) database and divided 30% and 70% of them into validation and training cohorts, respectively. We utilized backward stepwise regression in the Cox model to select variables. Predictive variables were subsequently identified from the variables selected above by using multivariate Cox regression. The new survival model was compared with the American Joint Committee on Cancer (AJCC) prognosis model using the following variables: calibration curve, time-dependent area under the receiver operating characteristic curve (AUC), concordance index (C-index), integrated discrimination improvement (IDI), decision-curve analysis (DCA), and net reclassification improvement (NRI). Results A nomogram was established for predicting the CSS probability in patients with BOTSCC. Factors including sex, race, age at diagnosis, marital status, radiotherapy status, chemotherapy status, TNM AJCC stage, surgery status, tumor size, and months from diagnosis to treatment were selected through multivariate Cox regression as independent predictors of CSS. Calibration plots indicated that the model we established had satisfactory calibration ability. The AUC, C-index, IDI, DCA, and NRI results illustrated that the nomogram performed explicit prognoses more accurately than did the AJCC system alone. Conclusion We identified the relevant factors affecting the survival of BOTSCC patients and analyzed the data on patients suffering from BOTSCC in the SEER database. These factors were used to construct a new nomogram to give clinical staff a more-visual prediction model for the 3-, 5-, and 8-year probabilities of CSS for patients newly diagnosed with BOTSCC, thereby aiding clinical decision making.