bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different-doses Nalmefene Combined with Hydromorphone Hydrochloride for Postoperative Analgesia After Colorectal Surgery: A Randomized Controlled Study
Authors: Wang Ye , Zhao Lin , Wu Meng , An Qi , Guo Qianqian , Fan Chunling , Guo Zhenggang 
Published: August 2023

Abstract
Background Hydromorphone hydrochloride has a satisfactory postoperative analgesic effect for patients with colorectal cancer but isaccompanied by a relatively high incidence of adverse events. Low-dose naloxone combined with opioids for patient-controlled analgesia (PCA) can reduce the incidence of drug-related adverse events. Nalmefene is a more selective opioid receptor antagonist than naloxone. We hypothesized that low-dose nalmefene combined with hydromorphone hydrochloride for PCA could enhance the analgesic effect and reduce the incidence of adverse events of hydromorphone hydrochloride.
Methods The research was designed as a randomized, double-blind, controlled study. Ninety-nine patients undergoing selective radical resection of colorectal cancer were enrolled and randomly divided into three groups. The postoperative analgesia plan was hydromorphone hydrochloride (0.15 mg/kg) added to 100 ml of normal saline for all groups, to which 2 μg/kg nalmefene was added in Group N1 and 0.5 μg/kg nalmefene was added in Group N2, Group C received hydromorphone hydrochloride only. The PCA was connected to the patient after the operation. The following data were recorded: the degree of pain (NRS score) at 1, 6, 12, 24 and 48 h after surgery; the occurrence of nausea, vomiting and pruritus; the total analgesic consumption of the PCA pump; the time to postoperative exhaust; the time to drainage tube extubation; and the overall length of hospital stay.
Results The NRS scores of Group N1 (2 μg/kg) were significantly lower than those of Group C (P = 0.25). Among the three groups, the NRS scores of Group N1 (2 μg/kg) were significantly lower than those of Group C at 12 h (P = 0.01) and 48 h (P = 0.01) post-operatively. Compared with 12 hours post-operatively, the NRS scores were lower at 24 hours post-operatively in Group N1 and Group C (P < 0.05), and significantly lower at 48 hours post-operatively in all three groups (P < 0.001). There was a significant difference in the incidence of pruritus among the three groups (P = 0.036).
Conclusions Nalmefene at a dosage of 2 μg/kg enhances the postoperative analgesic effect of hydromorphone hydrochloride and reduces the occurrence of postoperative pruritus.
Trial Registration: The trial was registered with the Chinese Clinical Trial Registry (Registration number: ChiCTR2000033520, date: 03/06/2020).
The manifestation of the lack of occupational health rights of food delivery riders and countermeasures: A case study of 405 riders in C City, J Province, China
Authors: Han Ye , Li Huan 
Published: August 2023

Abstract
Background: In the digital economy, the endogenous contradiction between “bundled labor relations” and “enhanced occupational risks” has led to higher work risks for food delivery riders and compromised their occupational health rights. In the context of the gradual improvement of civil society rights and the implementation of The Healthy China Strategy, how to protect the occupational health of delivery riders is an urgent problem in China at this stage.
Methods: A questionnaire survey was used to analyze labor safety protection, basic occupational health insurance, supplementary occupational health insurance, and risk-avoidance approaches of serious accidents within 405 delivery riders in C City, J Province, China, and to draw conclusions from this study.
Results: The occupational health protection system of food delivery riders is not yet sound, and their occupational health rights and interests are compromised. In terms of labor safety protection, the means based on clothing, equipment, and safety tips are superficial; in terms of basic occupational health insurance, the means based on work injury insurance and medical insurance are incomplete; in terms of supplemental protection, the method led by commercial accident insurance is lagging; in terms of risk-avoidance approaches of serious accidents, the function of mutual assistance from family is weakened.
Conclusion: Based on the principle of “from the surface to the core, from the part to the whole, from emergency to perfection and from self-assistance to mutual assistance”, a comprehensive occupational injury protection system based on social insurance, supplemented by commercial insurance and underwritten by family protection should be established for delivery riders.
Multi-rider Ridesharing Stable Matching Optimization
Authors: Ke Hua , Li Haoyang 
Published: August 2023

Abstract

The rapid growth of private car ownership has led to significant issues such as traffic congestion and environmental pollution. Ridesharing has emerged as a promising solution to alleviate the negative impacts associated with private car usage. This paper focuses on the stability of ridesharing systems and establishes a single-driver multiple-rider ridesharing matching model. To solve this model, a filtering algorithm for the pre-matching set and a fast-solving algorithm for stable matching scheme are proposed. Furthermore, we introduce the concept of a subsidy distance upper limit into the ridesharing system. Remarkably, our findings indicate that with a limit of 0.1km, the distance saved generated by the subsidy amounts to 560.5% of the total subsidy. To validate our approach, we simulate ridesharing demand data using real taxi data, and design computational experiments to prove the computational efficiency of the filtering algorithm and fast-solving algorithm. The impact of various parameters on ridesharing systems is also explored.
A 12-month, longitudinal, intervention study examining a tablet protein substitute preparation in the management of tyrosinemia.
Authors: Daly Anne , Evans Sharon , Pinto Alex , Ashmore Catherine , MacDonald Anita 
Published: August 2023

Abstract

Protein substitutes (PS) without tyrosine (Tyr) and phenylalanine (Phe), are an essential source of synthetic protein in the treatment of tyrosinemia (HT). In the UK, the only available protein substitutes for HT are Tyr/ Phe free amino acid liquid or powders or formulations based on glycomacropeptide (CGMP). A tablet Tyr/ Phe free amino acid supplement (AAT) has now been introduced. The aim of this two-part prospective, longitudinal intervention study was to assess the efficacy, acceptability, and tolerance of AAT in children aged > 8 years with HTI. Part 1: was a 28-day acceptability/ tolerance study, part 2, was a 12-month extension study examining efficacy of AAT. Anthropometry and blood Tyr/ Phe were assessed. All subjects were taking NTBC [2-(2-nitro-4-triflourothybenzoyl) cyclohexane-1, 3-dione] with a Tyr restricted diet. Eight subjects with HTI were recruited 4 boys, and 4 girls with a median age of 14.3y (range 10.4–17.3); 3 were Caucasian and 5 of Pakistani origin. The median (range) protein equivalent from PS was 60g/d (50–60), natural protein 20g/d (15–30), and NTBC 30 mg/d (25–80). No subjects were taking Phe supplements. Five (63%) subjects completed part 1, with 4 taking all their PS requirements as AAT. Subjects reported AAT were tasteless and had no odour. No adverse gastrointestinal symptoms were recorded, with two reporting improvements in abdominal discomfort. At 12 months, 4 subjects had a non-significant decrease in blood Tyr/ Phe compared to the 12 months pre-treatment. Median blood Tyr (µmol/ L) pre-intervention was 500 (320–590); and at 12 months, 450 (290–530). Median blood Phe (µmol/L) pre-intervention was 40 (30–40); and at 12 months 30 (30–50). Median height z scores remained unchanged, but there was a small decrease in weight z score (pre-study weight − 0.1 (-1.4 to1.1), 12 m -0.3 (-1.4 to 1.3) and BMI (pre- study BMI 0.2 (-2 to 1.4), and 12m, -0.1 (-2.5 to 1.5)). Conclusion: AAT were useful for some adolescents with HTI who struggled with the taste and volume of conventional powdered and liquid PS.
Simultaneous Anton, Balint, Anosognosia, and Hemianopsia From Bilateral Ischemic Infarct: A Case Report
Authors: Nichols Cory , Merritt Mckenzie , Janda Paul , Vickers Aroucha 
Published: August 2023

Abstract
Background: Gerstmann syndrome, Balint Syndrome, Homonymous Hemianopsia, and Anosognosia are all well explicated parieto-occipital pathologies commonly, though not exclusively associated with cerebral infarct. These syndromes have been previously described in the literature as occurring as sequelae of neurodegenerative dementias. As far as can be determined, the simultaneous occurrence of all four syndromes due to cerebral infarctions have not yet been reported in the scientific literature.
Case Presentation: A 55-year-old man with hypertension, dyslipidemia, atrial fibrillation, and medical noncompliance was found in the parking lot of his workplace confused and brought to the emergency room for altered mental status. Upon neurological evaluation, he was found to have signs of Gerstmann Syndrome, Balint Syndrome, Homonymous Hemianopsia, and Anosognosia. Neuroimaging revealed bilateral parietal occipital strokes suspected to be provoked by atrial fibrillation in the setting of anticoagulation noncompliance.
Conclusion: The patient’s bilateral parieto-occipital infarcts presented with simultaneous Gerstmann Syndrome, Balint Syndrome, Homonymous Hemianopsia, and Anosognosia that mimicked an acute encephalopathic state. Though each syndrome has been documented in the medical literature in isolation and occasionally in conjunction, there have been no documented cases of simultaneous spontaneous development of all four due to nearly symmetric vascular infarcts. These syndromes can be subtle yet cause devastating co-morbidities. As such, the authors aim to emphasize the need to implement visuospatial testing, an element often bypassed, as part of the acute stroke pathway for patients who may be eligible for thrombolytic therapy.
Biochemical Outcome in Metastatic Prostate Cancer Patients Following Prostate-Directed Radiotherapy
Authors: Ayoub Heba Maged , Zamzam Maha Lotfy , Elsayed Fifi Mostafa , Hassanin Ihab Mohammed , Elsemary Eman Essam 
Published: August 2023

Abstract
Background
The role of cytoreductive local radiotherapy (RT) in metastatic prostate cancer has recently been established. This study aimed to evaluate the biochemical outcome of local RT in metastatic prostate cancer.
Methods
This randomized controlled phase II study conducted at the Clinical Oncology Department, Suez Canal University Hospital. Eligible participants were de-novo or metachronous metastatic prostate cancer patients with Eastern Cooperative Oncology Group performance status of 0–2. Participants were randomized to receive either cytoreductive prostate-directed RT in addition to standard care or standard care alone. The conventional radiation schedule of 70 Gy/35 fractions or the hypofractionated schedule of 55 Gy/20 fractions were delivered. The primary endpoint was biochemical progression-free survival (BPFS), and secondary endpoints included clinical response, and overall survival (OS). Survival and post-hoc analyses were performed using Cox regression and the Kaplan-Meier method with the log-rank test.
Results
Between November 23, 2020, and November 21, 2022, 70 patients were enrolled in this study. Of them, 34 patients were assigned to the prostate radiotherapy group, and 29 patients were assigned to the control group. At a median follow-up of 12 months, the median BPFS has not been reached for the prostate radiotherapy group compared to 4.067 months for the control group (HR: 0.147, p < 0.001). Subgroup analysis showed that the median BPFS was statistically significantly correlated with low-volume (95% CI, 0.004 to 0.262, p = 0·001) and hormonal-sensitive metastatic disease (95% CI, 0.010 to 0.192, p < 0·001). The median OS was 16.33 months for the prostate-radiotherapy group compared to 11.33 months for the control group (HR: 0.313, p = 0.003).
Conclusion
Prostate-directed RT improved BPFS and OS in metastatic prostate cancer patients, particularly in those with low volume and hormonal-sensitive disease.
Trial Registration:
This trial is registered on (27/4/2023) with pactr.samrc.ac.za, PACTR202305854600529, URL: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25510
Remimazolam sedation for spinal anaesthesia surgery and its effect on perioperative cognitive function in elderly patients: a multicentre, placebo-controlled study
Authors: Kang Jia-min , Li Yuan-jie , Zong Lin-yue , Xu Ying , Qiao Dan , Zhang Wei-wei , Zhou Qi , Li Yan , Han Tao , Zhang Yue-ming , Yin Li-jun , Xu Jin , Wang Shou-shi , Yuan Yuan , Li Qing , Niu Kai-jun , Zheng Yu-xin , Zhang Lin-lin , Li Yi-ze , Yu Yong-hao 
Published: August 2023

Abstract

BACKGROUND
Remimazolam, a novel ultra-short-acting benzodiazepine, is a potential sedative for non-general anaesthesia surgery in the elderly. This study aimed to investigate the appropriate sedative dosage of remimazolam and its effects on perioperative cognitive function in elderly patients undergoing non-general anaesthesia surgery.
METHODS
This multicentre, placebo-controlled trial enrolled 330 elderly patients undergoing non-general anaesthesia procedures at eight centres in China from July 2021 to February 2022, with 238 ultimately completing the study. The primary endpoints were the dose of successful sedation with remimazolam and the changes in perioperative cognitive function. Adverse events were recorded to assess drug safety.
RESULTS
The induction dose of remimazolam for sedation in spinal anaesthesia in elderly patients was 5.38 mg (95% confidence interval [CI], 5.20 to 5.56), maintained at a rate of 0.223 mg·kg− 1·h− 1 (95% CI, 0.201 to 0.237) with no serious adverse effects. Compared with the saline group, there was no statistical difference in the Mini-Mental State Examination scores in the experimental group on Day2 morning (P : 0.886), Day2 afternoon (P : 0.864), and Day7 (P : 0.613), and no statistical difference in the Montreal Cognitive Assessment scores on Day2 morning (P : 0.687), Day2 afternoon (P : 0.827), and Day7 (P : 0.483).
CONCLUSIONS
Remimazolam besylate is an effective sedative drug during spinal anaesthesia in elderly patients, with a successful induction dose of 5.38 mg (95% CI, 5.20 to 5.56), maintained at a rate of 0.223 mg·kg− 1·h− 1 (95% CI, 0.201 to 0.237) and a good safety profile without altering the short-term postoperative cognitive function.
Impact of epidemic prevention measures on the incidence of HFMD during the COVID-19 epidemic period in Beijing
Authors: Zhao Hao , Dong Shuaibing , Wang Xiaoli , Yang Peng , Zhang Daitao , Wang Quanyi , Jia Lei , Huo Da 
Published: August 2023

Abstract
The non-pharmacological interventions during the COVID-19 epidemic period may also affected the incidence of other infectious diseases. This study used the autoregressive integrated moving average (ARIMA) model to predict the theoretical incidence of hand-foot-and-mouth disease (HFMD) in Beijing in 2020, then used the Wilcoxon-Mann-Whitney test to compare it with the actual value, in order to explore the impact of public health prevention measure on the incidence of HFMD during the COVID-19 epidemic period. Between January 2013 and December 2019, 210,101 cases of HFMD were reported in Beijing. The number of reported cases in Beijing in 2020 decreased by 92.7% compared to the average annual number of reported cases from 2013 to 2019. The optimal model (1,1,1) (1,1,1) 12 established in this study predicted the monthly incidence of HFMD in 2020, the model-fitting effect was good, the test results showing that there was a statistically significant difference between the predicted and actual number of HFMD cases in 2020. Epidemic prevention measures during the COVID-19 epidemic period had a great impact on the incidence of HFMD in Beijing.
ALDH1A1 confers resistance to RAF/MEK inhibitors in melanoma cells by maintaining stemness phenotype and activating PI3K/AKT signaling
Authors: Ciccone Valerio , Simonis Vittoria , Gaudio Cinzia Del , Cucini Claudio , Ziche Marina , Morbidelli Lucia , Donnini Sandra 
Published: August 2023

Abstract

The mitogen-activated protein kinase (MAPK) cascade is an intracellular signaling pathway involved in the regulation of proliferation and survival of melanoma cells. Several different mutations, involving BRAF or NRAS, exert an oncogenic effect by activating the MAPK pathway, resulting in a further increase in cellular proliferation. MEK inhibitor therapy in combination with a BRAF inhibitor is more effective and less toxic than treatment with a BRAF inhibitor alone, and has become the standard of care for tumors driven by BRAF or NRAS mutations. This study demonstrates that melanoma cells overexpressing aldehyde dehydrogenase 1A1 (ALDH1A1) displayed stem-like properties which was associated with resistance to vemurafenib and trametinib through the activation of PI3K/AKT signaling instead of MAPK axis. Inhibition of PI3K/AKT signaling rescued sensitivity to drugs. Consistently, pharmacological inhibition of ALDH1A1 activity downregulated the activation of AKT and enhanced responsiveness to vemurafenib and trametinib. We propose ALDH1A1 as a new potential target for treating MAPK inhibitor resistant melanoma.
The Prevalence of Developmental Defects of Enamel in People with Cystic Fibrosis: A Systematic Review
Authors: O’Leary Fiona , Coffey Niamh , Hayes Martina , Burke Francis , Harding Mairéad , Plant Barry 
Published: August 2023

Abstract
Background
Oral health impacts systemic health, individual well-being, and quality of life. It is important to identify both modifiable and non-modifiable risk factors that may impact oral health at an individual and a population level, doing so may aid public health and policy development, and promote targeted patient treatment strategies. Developmental defects both quantitative and qualitative can negatively impact oral health. Affected individuals may be more susceptible to dental caries, hypersensitivity premature tooth wear, erosion, and poor aesthetics. As part of a wider study assessing oral health in adults with cystic fibrosis currently underway in Cork University Dental School and hospital, it was decided to conduct a systematic review of available literature to assess the prevalence of enamel defects in people with cystic fibrosis.
Keywords
Cystic Fibrosis, Developmental Defects of Enamel, Oral Health, Public Health, Policy, Prevention.
Aims
To critically evaluate the literature to determine if the prevalence of developmental defects of enamel is higher in people with cystic fibrosis.
Methods
Data Sources: A systematic review of articles published in the English language from 1960 to 2023 was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) Statement. Three online databases were searched Embase, Scopus and Web of Science Core Collection. Studies that examined an association between cystic fibrosis and developmental defects of enamel were included in this systematic review.
Results
Ninety-one studies were identified following a search of online databases and bibliographies. Following application of inclusion and exclusion criteria, and screening by two examiners nine studies were deemed eligible for inclusion in the systematic review. Eight studies reported a higher prevalence of developmental defects of enamel in people with cystic fibrosis, although not all reported differences were statistically significant. One study reported no difference between the study and control group
Conclusions
The results of the systematic review indicate varying degrees of heterogeneity between studies. However, there is a consistent pattern that the prevalence of DDE is higher in people with cystic fibrosis compared to people without cystic fibrosis. The aetiology of developmental defect of enamel in people with cystic fibrosis has not been determined although genetic dysfunction, chronic systemic infections, and long-term antibiotic use are some of the theorised causes. This systematic review shows the paucity of information regarding the oral health of this vulnerable cohort and highlights the need for future studies to investigate if the disease process of cystic fibrosis is causative factor for developmental defects of enamel.
A Nationwide Survey and Piloting for Competency-based Training Program for Medical Radiation Therapists – Now and Beyond
Authors: Tu Chao-Yuan , Liu Cheng-Heng , Lu Szu-Huai , Huang Tzu-Jie , Wen Shu-Yu , Lin Wei-Jou , Tu Chun-Yuan , Huang Kuo-Ming , Yang Chih-Wei 
Published: August 2023

Abstract
Background
Competency-based medical education is an important development trend in the training of medical personnel worldwide nowadays. Started from 2019, the society of medical radiotherapist (RTTs) in Taiwan has established a competency framework through stringent consensus-based approach, whilst enhancing professional identify. Before proceeding to the next stages of the full-scale implementation of CBME, we used the milestone framework to investigate the self-assessments of RTTs at various training stages in Taiwan.
Methods
To evaluate trainee performance, a quantitative scale of medical radiation therapy learning milestones was developed for clinical faculty and trainees. According to their tenure, the data collected from each group was separated into three categories: PGY1 (y ≦ 1), PGY2 (1 < y ≦ 2), and graduate trainees (2 < y ≦ 3). We conducted independent t-tests, ANOVA and the Pearson correlation coefficient to analyze the differences and correlation of milestones between categories.
Results
A better understanding of the current mapping of competency levels across training programs was provided, as well as areas where both radiation trainees and instructors lacked confidence, particularly in interprofessional teamwork. Significant positive correlation (0.23–0.4, p < 0.05) were noted between self-assessments in every sub-competency and tenure using Pearson’s Correlation Coefficient. Among them, [Interprofessional teamwork], [Management of instrument error and malfunction], [Effective communication with other professions] and [Continuous improvement of professional skills] have the modest correlation coefficients (0.1 ≤ r ≤ 0.29), informing that these areas might be the priority of future training programs renovation.
Conclusions
Based on the milestone framework established by the stringent consensus-based approach, our study reveals the status of nationwide RTTs' self-reported competency levels. The results and experience can serve as a reference for future use of learning milestones, curriculum planning, and teaching evaluation in the medical radiotherapy field and other professions in Taiwan.