bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the COVID pandemic on major abdominal cancer resections in Germany: a retrospective population-based cohort study
Authors: Uttinger Konstantin L. , Diers Johannes , Baum Philip , Hankir Mohammed , Germer Christoph-Thomas , Wiegering Armin 
Published: March 2023

Background:
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is estimated to have claimed more than 6 million lives globally since it started in 2019. Germany was exposed to two waves of coronavirus disease 2019 in 2020, one starting in April and the other in October. To ensure sufficient capacity for coronavirus disease 2019 patients in intensive care units, elective medical procedures were postponed. The fraction of major abdominal cancer resections affected by these measures remains unknown, and the most affected patient cohort has yet to be identified.

Methods:
This is a register-based, retrospective, nationwide cohort study of anonymized ‘diagnosis-related group’ billing data provided by the Federal Statistical Office in Germany. Cases were identified using diagnostic and procedural codes for major cancer resections. Population-adjusted cancer resection rates as the primary endpoint were compared at baseline (2012–2019) to those in 2020.

Results:
A change in resection rates for all analyzed entities (esophageal, gastric, liver, pancreatic, colon, rectum, and lung cancer) was observed from baseline to 2020. Total monthly oncological resections dropped by 7.4% (8.7% normalized to the annual German population, P=0.011). Changes ranged from +3.7% for pancreatic resections (P=0.277) to −19.4% for rectal resections (P<0.001). Reductions were higher during lockdown periods. During the first lockdown period (April–June), the overall drop was 14.3% (8.58 per 100 000 vs. 7.35 per 100 000, P<0.001). There was no catch-up effect during the summer months except for pancreatic cancer resections. In the second lockdown period, there was an overall drop of 17.3%. In subgroup analyses, the elderly were most affected by the reduction in resection rates. There was a significant negative correlation between regional SARS-CoV-2 incidences and resections rates. This correlation was strongest for rectal cancer resections (Spearman’s r: −0.425, P<0.001).

Conclusions:
The pandemic lockdowns had a major impact on the oncological surgical caseload in Germany in 2020. The elderly were most affected by the reduction. There was a clear correlation between SARS-CoV-2 incidences regionally and the reduction of surgical resection rates. In future pandemic circumstances, oncological surgery has to be prioritized with an extra focus on the most vulnerable patients.
Association between hospital surgical case volume and postoperative mortality in patients undergoing gastrectomy for gastric cancer: a systematic review and meta-analysis
Authors: Ning Fei-Long , Gu Wan-Jie , Zhao Zhe-Ming , Du Wan-Ying , Sun Min , Cao Shi-Yi , Zeng Yong-Ji , Abe Masanobu , Zhang Chun-Dong 
Published: March 2023

Background:
Postoperative mortality is an important indicator for evaluating surgical safety. Postoperative mortality is influenced by hospital volume; however, this association is not fully understood. This study aimed to investigate the volume–outcome association between the hospital surgical case volume for gastrectomies per year (hospital volume) and the risk of postoperative mortality in patients undergoing a gastrectomy for gastric cancer.

Methods:
Studies assessing the association between hospital volume and the postoperative mortality in patients who underwent gastrectomy for gastric cancer were searched for eligibility. Odds ratios were pooled for the highest versus lowest categories of hospital volume using a random-effects model. The volume–outcome association between hospital volume and the risk of postoperative mortality was analyzed. The study protocol was registered with Prospective Register of Systematic Reviews (PROSPERO).

Results:
Thirty studies including 586 993 participants were included. The risk of postgastrectomy mortality in patients with gastric cancer was 35% lower in hospitals with higher surgical case volumes than in their lower-volume counterparts (odds ratio: 0.65; 95% CI: 0.56–0.76; P<0.001). This relationship was consistent and robust in most subgroup analyses. Volume–outcome analysis found that the postgastrectomy mortality rate remained stable or was reduced after the hospital volume reached a plateau of 100 gastrectomy cases per year.

Conclusions:
The current findings suggest that a higher-volume hospital can reduce the risk of postgastrectomy mortality in patients with gastric cancer, and that greater than or equal to 100 gastrectomies for gastric cancer per year may be defined as a high hospital surgical case volume.
Measurement Approaches to Estimating Methadone Continuity in Opioid Use Disorder Care
Authors: Busch Alisa B. , Kennedy-Hendricks Alene , Schilling Cameron , Stuart Elizabeth A. , Hollander Mara , Meiselbach Mark K. , Barry Colleen L. , Huskamp Haiden A. , Eisenberg Matthew D. 
Published: March 2023

Background:
Long-term treatment with medications for opioid use disorder (OUD), including methadone, is lifesaving. There has been little examination of how to measure methadone continuity in claims data.

Objectives:
To develop an approach for measuring methadone continuity in claims data, and compare estimates of methadone versus buprenorphine continuity.

Research Design:
Observational cohort study using de-identified commercial claims from OptumLabs Data Warehouse (January 1, 2017–June 30, 2021).

Subjects:
Individuals diagnosed with OUD, ≥1 methadone or buprenorphine claim and ≥180 days continuous enrollment (N=29,633).

Measures:
OUD medication continuity: months with any use, days of continuous use, and proportion of days covered.

Results:
5.4% (N=1607) of the study cohort had any methadone use. Ninety-seven percent of methadone claims (N=160,537) were from procedure codes specifically used in opioid treatment programs. Place of service and primary diagnosis codes indicated that several methadone procedure codes were not used in outpatient OUD care. Methadone billing patterns indicated that estimating days-supply based solely on dates of service and/or procedure codes would yield inaccurate continuity results and that an approach incorporating the time between service dates was more appropriate. Among those using methadone, mean [s.d.] months with any use, days of continuous use, and proportion of days covered were 4.8 [1.8] months, 79.7 [73.4] days, and 0.64 [0.36]. For buprenorphine, the corresponding continuity estimates were 4.6 [1.9], 80.7 [70.0], and 0.73 [0.35].

Conclusions:
Estimating methadone continuity in claims data requires a different approach than that for medications largely delivered by prescription fills, highlighting the importance of consistency and transparency in measuring methadone continuity across studies.
Nursing Students' Self-rated Nurse Professional Competence at the End of an International Collaborative Education Program and Follow-up 1 Year Later
Authors: Xu Lijuan , Lou Yan , Willmer Mikaela , Engström Maria 
Published: March 2023

Background:
International collaborative programs and student active learning are encouraged; yet, little is known about them.

Purpose:
To compare nursing students' self-rated nurse professional competence (NPC) and general self-efficacy between those enrolled in an international collaborative program, which focused on student active learning, and those enrolled in a traditional lecture-based program at the end of graduation and 1 year later.

Methods:
This prospective comparative study distributed a questionnaire to 137 nursing students enrolled in the 2 bachelor-level programs at a university in southeastern China.

Results:
At the end of graduation, students enrolled in the international collaborative program reported higher scores for NPC factors, medical and technical care and general self-efficacy, than those enrolled in the traditional lecture-based program. One year later, they reported higher scores for total NPC, value-based nursing care, medical and technical care, care pedagogics, documentation and administration of nursing care, and general self-efficacy than others.

Conclusion:
This study found that the nursing students enrolled in the international collaborative program reported higher self-rated competence.
Handrim wheelchair propulsion technique in individuals with spinal cord injury with and without shoulder pain – a cross-sectional comparison
Authors: Braaksma Jelmer , Vegter Riemer J.K. , Leving Marika T. , van der Scheer Jan W. , Tepper Marga , Woldring Ferry A.B. , van der Woude Lucas H.V. , Houdijk Han , de Groot Sonja 
Published: March 2023

Abstract

Objective
To compare handrim wheelchair propulsion technique between individuals with spinal cord injury (SCI) with and without shoulder pain.

Design
A cross-sectional study including 38 experienced handrim wheelchair users with SCI. Participants were divided in a ‘shoulder pain’ (n = 15) and ‘no-shoulder pain’ (n = 23) group using the Local Musculoskeletal Discomfort scale. Kinetic and spatiotemporal aspects of handrim wheelchair propulsion during submaximal exercise on a motor-driven treadmill were analyzed. Data were collected using a measurement wheel instrumented with 3D force sensors.

Results
After correction for confounders (time since injury and body height), linear regression analyses showed the pain group had a 0.30 s (95% CI, -0.5 to -0.1) shorter cycle time, 0.22 s (95% CI, -0.4 to -0.1) shorter recovery time, 15.6° (95% CI, -27.4 to -3.8) smaller contact angle and 8% (95% CI, -15 to 0) lower variability in the work per push compared to the no-pain group. Other parameters did not differ between groups.

Conclusions
This study indicates that individuals with SCI who experience shoulder pain propel their handrim wheelchair kinematically different from individuals with SCI without shoulder pain. This difference in propulsion technique might be a pain-avoiding mechanism aimed at decreasing shoulder range of motion.
All-Cause and Cause-Specific Mortality in Parents After the Death of a Child in Taiwan: A Population-Based Cohort Study
Authors: Chen Ying-Yeh , Gunnell David , Wu Chia-Kai , Hu Ya-Hui , Lee Pei-Chen 
Published: March 2023

ABSTRACT

Objective
Research from Western countries suggests that there is an increase in mortality in parents bereaved by the death of a child. Few studies have investigated this issue in a non-Western context. We explored the impact of the death of a child on parental mortality in Taiwan.

Method
By linking population-based national registers, we followed the 2004–2014 birth cohort (N = 2,083,972) up until 2016. A total of 11,755 child deaths were identified. For each deceased child, four living children matched on age and sex were randomly selected; their parents were the comparison group. We used Cox proportional hazards regression models to compare the mortality risk of bereaved parents with the comparison group up until 2017.

Results
Overall mortality risk was increased in parents who experienced the death of a child; the risk was higher in bereaved mothers (adjusted hazard ratio = 4.91, 95% confidence interval = 3.96–6.09) than fathers (adjusted hazard ratio = 1.82, 95% confidence interval = 1.55–2.13). The risk did not differ according to the sex of the child, but parents whose children died of unexpected causes (i.e., suicide/accidents/violence) were at greater risk than those dying of other causes. Risk was higher when the child was older than 1 year at the time of death than for deaths before age 1 year.

Conclusions
Parents who lost a child were at increased mortality risk in this East Asian population. Special attention should be paid to the health of bereaved parents and explore the pathways leading to their risk.
A Gene-Acculturation Study of Obesity Among US Hispanic/Latinos: The Hispanic Community Health Study/Study of Latinos
Authors: Fernández-Rhodes Lindsay , McArdle Cristin E. , Rao Hridya , Wang Yujie , Martinez-Miller Erline E. , Ward Julia B. , Cai Jianwen , Sofer Tamar , Isasi Carmen R. , North Kari E. 
Published: March 2023

ABSTRACT

Objective
In the United States, Hispanic/Latino adults face a high burden of obesity; yet, not all individuals are equally affected, partly due in part to this ethnic group’s marked sociocultural diversity. We sought to analyze the modification of body mass index (BMI) genetic effects in Hispanic/Latino adults by their level of acculturation, a complex biosocial phenomenon that remains understudied.

Methods
Among 11,747 Hispanic/Latinos adults in the Hispanic Community Health Study/Study of Latinos aged 18 to 76 years from four urban communities (2008–2011), we a) tested our hypothesis that the effect of a genetic risk score (GRS) for increased BMI may be exacerbated by higher levels of acculturation and b) examined if GRS acculturation interactions varied by gender or Hispanic/Latino background group. All genetic modeling controlled for relatedness, age, gender, principal components of ancestry, center, and complex study design within a generalized estimated equation framework.

Results
We observed a GRS increase of 0.34 kg/m2 per risk allele in weighted mean BMI. The estimated main effect of GRS on BMI varied both across acculturation level and across gender. The difference between high and low acculturation ranged from 0.03 to 0.23 kg/m2 per risk allele, but varied across acculturation measure and gender.

Conclusions
These results suggest the presence of effect modification by acculturation, with stronger effects on BMI among highly acculturated individuals and female immigrants. Future studies of obesity in the Hispanic/Latino community should account for sociocultural environments and consider their intersection with gender to better target obesity interventions.
Evaluating the Efficacy of Topical Intranasal Fluorescein for Localizing CSF Rhinorrhea: A Systematic Review
Authors: Romeo Dominic , Ng Jinggang Jenny , Fritz Christian , De Ravin Emma , Suresh Neeraj , Harris Jacob , Rajasekaran Karthik 
Published: March 2023

Objective:
To assess existing literature on topical intranasal fluorescein (TINF) for the diagnosis and localization of nasal cerebrospinal fluid (CSF).

Study Design:
Systematic review.

Methods:
A 6-database literature search was conducted to identify articles providing insight into TINF for the diagnosis and treatment of sinonasal CSF leak. Demographic characteristics, technical details, efficacy, and safety data were extracted and analyzed. Methodological quality was assessed using Methodological Items for Non-Randomized Studies (MINORS) criteria.

Results:
All studies reported a diagnostic accuracy rate ≥96%. There were no major complications reported for any patient (n=99) with either 5% or 10% fluorescein use. The MINORS instrument of methodological quality indicated that the assessed studies were of moderate quality (7.29 out of a maximum score of 24).

Conclusion:
This systematic review indicates that TINF is an easy, safe, inexpensive, and sensitive approach for the diagnosis and treatment of sinonasal CSF leakage. For these reasons, it may be especially well suited for resource-limited clinical scenarios.
Practice and effect evaluation of early restrictive fluid resuscitation strategy in the nursing care of patients with sepsis in the emergency department: a retrospective cohort study
Authors: Hu Xiaqing , Zhang Jie , Wang Peipei , Dai Xin 
Published: March 2023

ABSTRACT

Objective:
To explore the practice and effect evaluation of the early restrictive fluid resuscitation strategy in the nursing care of patients with sepsis in the emergency department.

Methods:
A total of 239 sepsis patients, who were treated in the emergency department of our hospital from January to September 2020, were selected as the participants of this study, and a retrospective analysis was performed. According to different methods of fluid resuscitation, they were divided into an improved group and a control group. One hundred and twelve patients who received restrictive fluid resuscitation were in the improved group; another 127 patients who received adequate fluid resuscitation were in the control group. The ICU stay time, ventilator use time, and 28-day mortality rate of the two groups were observed. The hemodynamic indices, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, and complications of the two groups before and after treatment were compared.

Results:
After treatment, in the improved group, the APACHE II and SOFA scores were lower than in the control group, fluid replacement decreased, lactate clearance increased, ICU admission time shortened and the proportion of ventilator time to ICU admission time decreased. The incidence of acute respiratory distress syndrome (ARDS), cTn I and brain natriuretic peptic in the improved group were significantly lower than those in the control group. From the dimension within the group, the APACHE II score, SOFA score, heart rate and shock index were lower after treatment than before treatment in both the improved and control groups.

Conclusion:
Restricted fluid resuscitation can effectively alleviate the condition of emergency sepsis patients, improve hemodynamics, reduce the incidence of ARDS, and prevent patient deaths. It is worthy of clinical application.
Self-reported Xylazine Experiences: A Mixed Methods Study of Reddit Subscribers
Authors: Spadaro Anthony , O’Connor Karen , Lakamana Sahithi , Sarker Abeed , Wightman Rachel , Love Jennifer S , Perrone Jeanmarie 
Published: March 2023

AbstractObjectivesXylazine is an alpha-2 agonist increasingly prevalent in the illicit drug supply. Our objectives were to curate information about xylazine through social media from People Who Use Drugs (PWUDs). Specifically, we sought to answer the following: 1) what are the demographics of Reddit subscribers reporting exposure to xylazine? 2) is xylazine a desired additive? and 3) what adverse effects of xylazine are PWUDs experiencing?MethodsNatural Language Processing (NLP) was used to identify mentions of “xylazine” from posts by Reddit subscribers who also posted on drug-related subreddits. Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March 2022 to October 2022.Results76 posts mentioning xylazine were extracted via NLP from 765,616 posts by 16,131 Reddit subscribers (January 2018 to August 2021). People on Reddit described xylazine as an unwanted adulterant in their opioid supply. 61 participants completed the survey. Of those that disclosed their location, 25/50 (50%) participants reported locations in the Northeastern United States. The most common eoute of xylazine use was intranasal use (57%). 31/59 (53%) reported experiencing xylazine withdrawal. Frequent adverse events reported were prolonged sedation (81%) and increased skin wounds (43%).ConclusionsAmong respondents on these Reddit forums, xylazine appears to be an unwanted adulterant. PWUDs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This appeared to be more common in the Northeast.
Ubiquitous, B12-dependent virioplankton utilizing ribonucleotide triphosphate reductase demonstrate interseasonal dynamics and associate with a diverse range of bacterial hosts in the pelagic ocean
Authors: Wu Ling-Yi , Piedade Gonçalo J. , Moore Ryan M. , Harrison Amelia O. , Martins Ana M. , Bidle Kay D. , Polson Shawn W. , Sakowski Eric , Nissimov Jozef I. , Dums Jacob T. , Ferrell Barbra D. , Wommack K. Eric 
Published: March 2023

ABSTRACTThrough infection and lysis of their coexisting bacterial hosts, viruses impact the biogeochemical cycles sustaining globally significant pelagic oceanic ecosystems. Currently, little is known of the ecological interactions between lytic viruses and their bacterial hosts underlying these biogeochemical impacts at ecosystem scales. This study focused on populations of lytic viruses carrying the B12- dependent Class II monomeric ribonucleotide reductase (RNR) gene, ribonucleotide triphosphate reductase (RTPR), documenting seasonal changes in pelagic virioplankton and bacterioplankton using amplicon sequences of RTPR and the 16S rRNA gene, respectively. Amplicon sequence libraries were analyzed using compositional data analysis tools that account for the compositional nature of these data. Both virio- and bacterioplankton communities responded to environmental changes typically seen across seasonal cycles as well as shorter term upwelling–downwelling events. Defining RTPR-carrying viral populations according to major phylogenetic clades proved a more robust means of exploring virioplankton ecology than operational taxonomic units defined by percent sequence homology. Virioplankton RTPR populations showed positive associations with a broad phylogenetic diversity of bacterioplankton including dominant taxa within pelagic oceanic ecosystems such asProchlorococcusand SAR11. Temporal changes in RTPR-virioplankton, occurring as both free viruses and within infected cells, indicated possible viral–host pairs undergoing sustained infection and lysis cycles throughout the seasonal study. Phylogenetic relationships inferred from RTPR sequences mirrored ecological patterns in virio- and bacterioplankton populations demonstrating possible genome to phenome associations for an essential viral replication gene.
GPR4 knockout attenuates intestinal inflammation and forestalls the development of colitis-associated colorectal cancer in murine models
Authors: Marie Mona A. , Sanderlin Edward J. , Hoffman Alexander , Cashwell Kylie D. , Satturwar Swati , Hong Heng , Sun Ying , Yang Li V. 
Published: March 2023

AbstractGPR4 is a proton-sensing G protein-coupled receptor highly expressed in vascular endothelial cells and has been shown to potentiate intestinal inflammation in murine colitis models. Herein, we evaluated the proinflammatory role of GPR4 in the development of colitis-associated colorectal cancer (CAC) using the dextran sulfate sodium (DSS) and azoxymethane (AOM) mouse models in wild-type and GPR4 knockout mice. We found GPR4 contributed to chronic intestinal inflammation and heightened DSS/AOM-induced intestinal tumor burden. Tumor blood vessel density was markedly reduced in mice deficient in GPR4 which correlated with increased tumor necrosis and reduced tumor cell proliferation. These data demonstrate GPR4 ablation alleviates intestinal inflammation and reduces tumor angiogenesis, development, and progression in the AOM/DSS mouse model.Author summaryInflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, is a debilitating condition with chronic inflammation in the digestive tract. Patients with IBD are at higher risk of developing colitis-associated colorectal cancer (CAC), compared with the general population. The etiology of IBD is not well understood, but both genetic and environmental factors have been implicated. In this study, we investigated the role of the pH-sensing GPR4 receptor in colitis and CAC using the DSS and AOM induced mouse models. GPR4 knockout alleviated intestinal inflammation, reduced tumor angiogenesis, and impeded CAC development. Our data suggest that inhibition of GPR4 may be explored as a potential therapeutic approach for IBD treatment and CAC prevention.