bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost saving in implementing ERAS protocol in emergency abdominal surgery
Authors: Bisagni Pietro , D’Abrosca Vera , Tripodi Vincenzo , Armao Francesca Teodora , Longhi Marco , Russo Gianluca , Ballabio Michele 
Published: February 2024

Abstract
Introduction
ERAS (Enhanced Recovery After Surgery) protocol is now proposed as the standard of care in elective major abdominal surgery. Implementation of the ERAS protocol in emergency setting has been proposed but his economic impact has not been investigated. Aim of this study was to evaluate the cost saving of implementing ERAS in abdominal emergency surgery in a single institution.

Methods
A group of 80 consecutive patients treated by ERAS protocol for gastrointestinal emergency surgery in 2021 was compared with an analogue group of 75 consecutive patients treated by the same surgery the year before implementation of ERAS protocol. Adhesion to postoperative items, length of stay, morbidity and mortality were recorded. Cost saving analysis was performed.

Results
50% Adhesion to postoperative items was reached on day 2 in the ERAS group in mean. Laparoscopic approach was 40 vs 12% in ERAS and control group respectively (p ,002). Length of stay was shorter in ERAS group by 3 days (9 vs 12 days p ,002). Morbidity and mortality rate were similar in both groups. The ERAS group had a mean cost saving of 1022,78 € per patient.

Conclusions
ERAS protocol implementation in the abdominal emergency setting is cost effective resulting in a significant shorter length of stay and cost saving per patient.
The association between hepatitis B virus and semen quality: a systematic review and meta-analysis
Authors: Xu Yuting , Gan Kai , Hou Liqing , Wang Huawei , Cai June , Liu Liu , Wen Wen , Rao Meng , Tang Li 
Published: February 2024

Abstract
Background
Some studies have suggested that hepatitis B virus (HBV) infection had a negative association with semen quality, but the conclusions have been inconsistent. The purpose of our study was to systematically assess the association between HBV infection and semen parameters.

Methods
We searched electronic databases for studies published from January 1980 to August 2023. Eleven studies were included in the analysis. Primary outcomes were semen volume, sperm concentration, sperm morphology, sperm motility and sperm progressive motility. We also conducted a subgroup analysis between China and other countries.

Result
Compared with the semen quality of HBV-negative men, HBV infection had a negative association with semen volume (MD: −0.20 mL, 95%CI: −0.32 to − 0.09, P = 0.0004), sperm concentration (MD: −4.46 × 106/mL, 95%CI: −7.09 to − 1.84, P = 0.0009), sperm morphology (MD: −2.49%, 95%CI: −4.35 to − 0.64, P = 0.008), sperm motility (MD: −6.85%, 95%CI: −11.53 to − 2.18, P = 0.004), and sperm progressive motility (MD: −6.63%, 95%CI: −10.24 to − 3.02, P = 0.0003). However, HBV infection had no significant association with total sperm count (MD: −31.50 × 106, 95%CI: −74.11 to 11.10, P = 0.15). The association between HBV and semen quality were inconsistent between the subgroups.

Conclusion
HBV infection had a negative association with sperm concentration, motility, morphology, and semen volume. However, The association between HBV and total sperm count remain unclear. This metaanalysis suggests that we should pay attention to the adverse effect of HBV on sperm quality, and several studies have reported the relevant mechanisms. But due to the significant heterogeneity among studies on some semen parameters, further large and well-designed researches are needed before introducing clinical management recommendations.
Lesson learned from assessing teachers’ and students’ perspectives regarding the quality of e-learning in medical education during the pandemic: a mixed-methods study
Authors: Zarifsanaiey Nahid , Farrokhi Majid Reza , karimian Zahra , hoseini Sara , chahartangi farshid , Shahraki Hadi Raeisi 
Published: February 2024

AbstractBackgroundThe evaluation of e-learning systems ensures the provision of quality training. The goal was to identify the perspectives of teachers and students on e-learning in medical education during the COVID-19 pandemic at Shiraz University of Medical Sciences (SUMS), Iran.MethodsThis study utilized a convergent mixed methods research design with a two-phase approach to collect and analyze data between June and August 2022. In the first stage, a cross-sectional descriptive study was conducted to evaluate the quality of e-learning systems from the perspective of 400 students. In the second stage, semi-structured interviews were conducted with 10 virtual education professors and 10 student representatives to identify the strengths, weaknesses, opportunities, and threats of virtual education. A validated questionnaire was administered to assess the quality of the e-learning system, and data were analyzed using SPSS-21. Qualitative data were subjected to content analysis.ResultsOur findings revealed that the student support system, the course structure, and the infrastructure and technology subscales’ mean scores were significantly higher than the average level (P < 0.001). However, the professors’ methods of teaching and learning strategies were unsatisfactory. The results of the present study showed that the evaluation mean score was significantly higher among, younger, female, and undergraduate students. Virtual education has strengths and weaknesses, and innovative approaches are needed to enhance student engagement. The lack of appropriate infrastructure and virtual teaching tools for teachers and students is a significant challenge that needs to be addressed. Blended learning is effective in medical education, and the shift from teacher-centered to learner-centered teaching approaches is an opportunity to explore innovative teaching approaches.ConclusionFrom the perspective of students, the quality of eLearning systems at the universities was moderate. Virtual education offers both benefits and drawbacks, and there is a requirement for innovative solutions to enhance student engagement and lessen boredom.
Identifying, categorising, and mapping actors involved in resilience in healthcare: a qualitative stakeholder analysis
Authors: Guise Veslemøy , Chambers Mary , Lyng Hilda Bø , Haraldseid-Driftland Cecilie , Schibevaag Lene , Fagerdal Birte , Dombestein Heidi , Ree Eline , Wiig Siri 
Published: February 2024

Abstract
Background
Resilience in healthcare is the capacity to adapt to challenges and changes to maintain high-quality care across system levels. While healthcare system stakeholders such as patients, informal carers, healthcare professionals and service managers have all come to be acknowledged as important co-creators of resilient healthcare, our knowledge and understanding of who, how, and in which contexts different stakeholders come to facilitate and support resilience is still lacking. This study addresses gaps in the research by conducting a stakeholder analysis to identify and categorise the stakeholders that are key to facilitating and sustaining resilience in healthcare, and to investigate stakeholder relationships relevant for the enactment of resilient healthcare systems.

Methods
The stakeholder analysis was conducted using a sample of 19 empirical research projects. A narrative summary was written for 14 of the projects, based on publicly available material. In addition, 16 individual interviews were undertaken with researchers from the same sample of 19 projects. The 16 interview transcripts and 14 narratives made up the data material of the study. Application of stakeholder analysis methods was done in three steps: a) identification of stakeholders; b) differentiation and categorisation of stakeholders using an interest/influence grid; and c) investigation and mapping of stakeholder relationships using an actor-linkage matrix.

Results
Identified stakeholders were Patients, Family Carers, Healthcare Professionals, Ward/Unit Managers, Service or Case Managers, Regulatory Investigators, Policy Makers, and Other Service Providers. All identified stakeholders were categorised as either ‘Subjects’, ‘Players’, or ‘Context Setters’ according to their level of interest in and influence on resilient healthcare. Stakeholder relationships were mapped according to the degree and type of contact between the various groups of stakeholders involved in facilitating resilient healthcare, ranging from ‘Not linked’ to ‘Fully linked’.

Conclusion
Family carers and healthcare professionals were found to be the most active groups of stakeholders in the enactment of healthcare system resilience. Patients, managers, and policy makers also contribute to resilience to various degrees. Relationships between stakeholder groups are largely characterised by communication and coordination, in addition to formal collaborations where diverse actors work together to achieve common goals.
Validation of human immunodeficiency virus diagnosis codes among women enrollees of a U.S. health plan
Authors: Pocobelli Gaia , Oliver Malia , Albertson-Junkans Ladia , Gundersen Gabrielle , Kamineni Aruna 
Published: February 2024

Abstract
Background
Efficiently identifying patients with human immunodeficiency virus (HIV) using administrative health care data (e.g., claims) can facilitate research on their quality of care and health outcomes. No prior study has validated the use of only ICD-10-CM HIV diagnosis codes to identify patients with HIV.

Methods
We validated HIV diagnosis codes among women enrolled in a large U.S. integrated health care system during 2010–2020. We examined HIV diagnosis code-based algorithms that varied by type, frequency, and timing of the codes in patients’ claims data. We calculated the positive predictive values (PPVs) and 95% confidence intervals (CIs) of the algorithms using a medical record-confirmed diagnosis of HIV as the gold standard.

Results
A total of 272 women with ≥ 1 HIV diagnosis code in the administrative claims data were identified and medical records were reviewed for all 272 women. The PPV of an algorithm classifying women as having HIV as of the first HIV diagnosis code during the observation period was 80.5% (95% CI: 75.4–84.8%), and it was 93.9% (95% CI: 90.0-96.3%) as of the second. Little additional increase in PPV was observed when a third code was required. The PPV of an algorithm based on ICD-10-CM-era codes was similar to one based on ICD-9-CM-era codes.

Conclusion
If the accuracy measure of greatest interest is PPV, our findings suggest that use of ≥ 2 HIV diagnosis codes to identify patients with HIV may perform well. However, health care coding practices may vary across settings, which may impact generalizability of our results.
Development of regional pharmacy intravenous admixture services data reporting and analysis platform for enhanced quality control ability
Authors: Tian Shaowu , Xie Genyu , Xu Fan , Zhang Jun 
Published: February 2024

Abstract
Background
Pharmacy intravenous admixture service (PIVAS) center has emerged as an important department of hospitals as it can improve occupational protection and ensure the safety and effectiveness of intravenous infusions. However, there is little research on the standardized capability and risk evaluation of PIVAS by using modern information technology. In this research, we established Regional Pharmacy Intravenous Admixture Services Data Reporting and Analysis Platform (RPDRAP) to improve quality control ability for PIVAS management. RPDRAP including evaluation matrix for quality control monitoring. The construction of platform is based on guidelines for the Construction and Management of PIVAS and management specifications of PIVAS in China.

Methods
RPDRAP was established in 2018. This platform comprises a data collection system and a data analysis system. The data collection system consists of 67 data items. Data collection relied on online platforms through data acquisition module. The collected data were analyzed using a model with 20 indicators within the data analysis system. Fifteen hospitals, public comprehensive healthcare facilities with more than 500 beds, participated in the platform’s application evaluation.

Results
The study revealed significant differences in PIVAS total score, supervisors, and workload between 2020 and 2022. The platform’s application results demonstrated improvements in personnel management, work efficiency, and infection control within these PIVAS. Although statistical significance was observed in only 8 out of the 25 items, most of the scores showed an increase, with a small portion remaining unchanged and no decline in scores.

Conclusions
This platform can be recommended for PIVAS homogeneous and regional efficient management. The use of this platform not only improves the quality control ability of PIVAS but also enables the management department to quickly grasp the current situation and characteristics of each PIVAS through standardized data collection and analysis.
Management of pain in cancer patients— lessons from practices during the COVID-19: a qualitative study of cancer care providers’ perspectives
Authors: Cornall Georgina , Zhao Emma , Luckett Tim , Erciyas Ertugrul , Monck David , Glare Paul , Wang Andy , Lee Yi-Ching 
Published: February 2024

Abstract
Background
The ongoing COVID-19 pandemic has impacted health systems globally and affected managing many chronic conditions, including cancer. This study aimed to explore the perceptions of multi-disciplinary cancer care providers on how cancer pain management was affected by the COVID-19 pandemic.

Methods
Participants were eligible if they were cancer care providers of any specialty and discipline from two tertiary hospitals in Australia. Data were collected using semi-structured interviews to explore cancer care providers’ perspectives on cancer pain management within COVID-19. Thematic analysis of interview transcripts used an integrated approach that started with inductive coding before coding deductively against a behaviour framework called the COM-B Model, which proposes that ‘capability’, ‘motivation’ and ‘opportunity’ are requisites for any behaviour.

Results
Twenty-three providers participated. Five themes were developed and interpreted from the analysis of data, namely: “Telehealth enables remote access to cancer pain management but also created a digital divide”, “Access to cancer pain management in the community is compromised due to the pandemic”, “COVID-19 negatively impacts hospital resource allocation”, “Patients were required to trade off cancer pain management against other health priorities” and “Hospital restrictions result in decreased social and psychological support for patients with cancer pain”.

Conclusions
The landscape of cancer pain management in the Australian health system underwent substantial shifts during the COVID-19 pandemic, with lasting impacts. Cancer care providers perceived the pandemic to have significant adverse effects on pain management across multiple levels, with repercussions for patients experiencing cancer-related pain. A more adaptive health system model needs to be established in the future to accommodate vulnerable cancer patients.
Sero-epidemiological investigation on Toxoplasma gondii infection in Apennine wolf (Canis lupus italicus) and wild boar (Sus scrofa) in Italy
Authors: Dini Filippo Maria , Musto Carmela , De Nigris Vincenzo Maria , Bellinello Enrica , Sampieri Maria , Merialdi Giuseppe , Barca Lorella , Delogu Mauro , Galuppi Roberta 
Published: February 2024

Abstract
Background
The wild boar (Sus scrofa) and the Apennine wolf (Canis lupus italicus) are two wild species that have both increased their presence in the Italian territory, albeit in varying numbers. They can be occasionally found in peri-urban areas as well. Both of these species can serve as intermediate hosts for Toxoplasma gondii, as they can become infected either through the consumption of oocysts found in water, soil, or on vegetables, or through the ingestion of meat containing bradyzoites. Consequently, these animals can be regarded as key indicators of Toxoplasma presence in the wild or peri-urban environment. In our study, we examined a total of 174 wild boar meat juice and 128 wolf sera from Italy for the detection of T. gondii IgG using the indirect fluorescent antibody test (IFAT).

Results
The results showed that 40 (22.6%) of the wild boar meat juice and 34 (26.6%) of the wolf serum samples tested positive. Interestingly, there were no significant differences in seropositivity with respect to gender, age group, or the region of origin in both species.

Conclusions
Overall the results indicate a moderate exposure in both the species under investigation, highlighting the spread of T. gondii in sylvatic and periurban environments. The prevalence of T. gondii in wild boar is consistent with findings from other studies conducted in Europe. Our study, with a considerably larger sample size compared to the available research in European context, provides valuable data on the seroprevalence of T. gondii in wolves.
Super enhancer related gene ANP32B promotes the proliferation of acute myeloid leukemia by enhancing MYC through histone acetylation
Authors: Wan Xiaomei , Wang Jianwei , Fang Fang , Hu Yixin , Zhang Zimu , Tao Yanfang , Zhang Yongping , Yu Juanjuan , Wu Yumeng , Zhou Bi , Yin Hongli , Ma Li , Li Xiaolu , Zhuo Ran , Cheng Wei , Zhang Shuqi , Pan Jian , Lu Jun , Hu Shaoyan 
Published: February 2024

Abstract
Background
Acute myeloid leukemia (AML) is a malignancy of the hematopoietic system, and childhood AML accounts for about 20% of pediatric leukemia. ANP32B, an important nuclear protein associated with proliferation, has been found to regulate hematopoiesis and CML leukemogenesis by inhibiting p53 activity. However, recent study suggests that ANP32B exerts a suppressive effect on B-cell acute lymphoblastic leukemia (ALL) in mice by activating PU.1. Nevertheless, the precise underlying mechanism of ANP32B in AML remains elusive.

Results
Super enhancer related gene ANP32B was significantly upregulated in AML patients. The expression of ANP32B exhibited a negative correlation with overall survival. Knocking down ANP32B suppressed the proliferation of AML cell lines MV4-11 and Kasumi-1, along with downregulation of C-MYC expression. Additionally, it led to a significant decrease in H3K27ac levels in AML cell lines. In vivo experiments further demonstrated that ANP32B knockdown effectively inhibited tumor growth.

Conclusions
ANP32B plays a significant role in promoting tumor proliferation in AML. The downregulation of ANP32B induces cell cycle arrest and promotes apoptosis in AML cell lines. Mechanistic analysis suggests that ANP32B may epigenetically regulate the expression of MYC through histone H3K27 acetylation. ANP32B could serve as a prognostic biomarker and potential therapeutic target for AML patients.
Association of sugar intake from different sources with cardiovascular disease incidence in the prospective cohort of UK Biobank participants
Authors: Schaefer Sylva Mareike , Kaiser Anna , Eichner Gerrit , Fasshauer Mathias 
Published: February 2024

Abstract
Background
The relation between incident cardiovascular disease (CVD) and sugar might not only depend on the quantity consumed but also on its source. This study aims to assess the association between various sources of dietary sugars and CVD incidence in the prospective population-based UK Biobank cohort.

Methods
A total of 176,352 participants from the UK Biobank with at least one web-based dietary questionnaire (Oxford WebQ) for assessment of sugar intake were included in this study. Mean follow-up lasted 10.9 years (standard deviation 2.0), with 12,355 incident cases of CVD. To determine the association of free sugar (FS) and intrinsic sugar intake with incident CVD, hazard ratios (HR) were calculated using Cox proportional hazard regression models. FS intake from beverages and beverage subtypes, i.e., soda/fruit drinks, juice, milk-based drinks, and tea/coffee, as well as from solid foods and solids subtypes, i.e., treats, cereals, toppings, and sauces, was included as penalised cubic splines.

Results
FS intake showed a J-shaped relationship with CVD risk, reaching the lowest HR (HR-nadir) at 9 %E, while intrinsic sugars displayed a non-linear descending association, with the HR-nadir at 14 %E. FS in beverages demonstrated a significant linear relationship with CVD with the HR-nadir at 3 %E, while FS in solids exhibited a significant non-linear U-shaped relationship with the HR-nadir at 7 %E. Within the beverage subtypes, soda/fruit drinks displayed a linear relationship, as did to a lesser extent FS in milk-based drinks and tea/coffee. Juice, however, showed a significant U-shaped relationship with CVD risk. Among solid foods subtypes, FS in treats had a J-shaped relation with the HR-nadir at 5 %E, and FS in cereals showed a linear association. In comparison, FS in toppings and sauces exhibited a U-shaped pattern with HR-nadir at 3 %E and 0.5 %E, respectively. All major results remained similar in various sensitivity analyses and were more robust for ischemic heart disease compared to stroke.

Conclusions
Only some sources of FS exhibit a robust positive association with CVD incidence. Public health efforts aiming at the reduction of CVD risk should prioritise the reduction of sugary beverages with an emphasis on soda/fruit drinks.
Establishing non-fasting reference values for plasma lipids levels based on age, sex, and puberty stage in a French-Canadian pediatric population
Authors: Bouhour Sophie , Plantefève Rosalie , Gillet Virginie , Abolghasemi Armita , Bouchouirab Fatima Zahra , Baccarelli Andrea A. , Takser Larissa , Çaku Artuela 
Published: February 2024

Abstract
Background
Dyslipidemias, including familial hypercholesterolemia (FH), are a significant risk factor for cardiovascular diseases. FH is a genetic disorder resulting in elevated levels of low-density lipoprotein cholesterol (LDL-C) and an increased probability of early cardiovascular disorders. Heterozygous familial hypercholesterolemia (HeFH) is the most common form, affecting approximately 1 in 250 individuals worldwide, with a higher prevalence among the French-Canadian population. Childhood is a critical period for screening risk factors, but the recommendation for non-fasting screening remains controversial due to a lack of specific reference values for this state. This study aims to establish reference values for lipid levels in non-fasting children from Sherbrooke, Quebec, Canada, that will be specific for sex, age, and pubertal stages.

Methods
Blood samples and corresponding anthropometric data were collected from 356 healthy children aged from 6 to 13. They were categorized either into two age groups: Cohort 6–8 and Cohort 9–13, or into pubertal stages. Reference values, specifically the 2.5th, 5th, 10th, 50th, 90th, 95th, and 97.5th percentiles were determined using the CLSI C28-A3 guidelines.

Results
Lipid profiles did not significantly differ between sexes, except for higher levels of high-density lipoprotein (HDL-C) in boys within Cohort 6–8. HDL-C levels significantly increased, while LDL-C and non-HDL-C levels significantly decreased in both sexes with age. Non-fasting age- and pubertal stages-specific reference values were established.

Conclusion
This study established reference intervals for lipid markers in non-fasting state within the pediatric French-Canadian population. These findings could be used in dyslipidemia screening in daily practice.