bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk and prediction of multiple primary malignancies after early gastric cancer
Authors: Chen Na , Shi Lei , Ge Jian , Jia Ruzhen , Jiang Junmei 
Published: July 2023

BackgroundPatients with early gastric cancer have increased risk of developing multiple primary malignancies (MPM) due to improved survival rates. The purpose of this study was to evaluate the clinicopathological features of MPM and to generate a useful tool for predicting the development of MPM after early gastric cancer.MethodsWe selected 1025 early gastric cancer patients with complete medical records for a retrospective analysis. The Cox proportional risk regression model was used to analyze the independent risk factors for the development of MPM in early gastric cancer. RStudio software was used to compare the OS of early gastric cancer patients with and without MPM, and a nomogram was established to predict the probability of MPM 1-, 2-, 3-year after early gastric cancer. The predictive effectiveness of the nomogram was evaluated by the C-index and calibration curve. Decision curve analysis (DCA) measured the applicability of the nomogram to clinical practice.ResultsOf the 1025 patients with early gastric cancer, 66 patients (6.4%) had 69 primary cancers other than early gastric cancer. They had a median follow-up of 41 months, and their cumulative incidence of MPM was 4.9%, 5.4% and 5.9% after 1-, 2-, and 3- year, respectively. Oesophageal cancer was the most frequently detected MPM, followed by lung and colorectal cancers. Male (p=0.038), age ≥65 years (p=0.003), smoking history (p=0.036), and lymph node metastasis (p=0.013) were independent risk factors for MPM in patients with early gastric cancer. Patients with early gastric cancer with MPM had a worse OS prognosis than patients with early gastric cancer without MPM (p&lt;0.001). The internally validated nomogram predicted the probability of developing MPM after early gastric cancer (C index= 0.697). The calibration chart showed that the predicted probability of MPM in early gastric cancer was similar to the observed result, and the DCA showed strong clinical practicability.ConclusionAfter the diagnosis and treatment of early gastric cancer, we should be alert to the possibility of MPM and perform regular and careful monitoring.
A novel classifier combining G protein-coupled receptors and the tumor microenvironment is associated with survival status in glioblastoma
Authors: Guo Chunyu , Yu Cong , Gao Weizhen , Ren Dabin , Zhang Yisong , Zheng Ping 
Published: July 2023

Background: Numerous studies have highlighted the crucial role of G protein-coupled receptors (GPCRs) in tumor microenvironment (TME) remodeling and their correlation with tumor progression. However, the association between GPCRs and the TME in glioblastoma (GBM) remains largely unexplored.Methods: In this study, we investigated the expression profile of GPCRs in GBM using integrated data from single-cell RNA sequencing and bulk sequencing. Surgical samples obtained from meningioma and GBM patients underwent single-cell RNA sequencing to examine GPCR levels and cell-cell interactions. Tumor microenvironment (TME) score is calculated by the infiltrated immune cells with CIBERSORT.Results: Our findings revealed a predominantly increased expression of GPCRs in GBM, and demonstrated that the classification of GPCRs and TME is an independent risk factor in GBM. Patients with high GPCR expression in the tumor tissue and low TME score exhibited the worst outcomes, suggesting a potentially aggressive tumor phenotype. On the other hand, patients with low GPCR expression in the tumor tissue and high TME score showed significantly better outcomes, indicating a potentially more favorable tumor microenvironment. Furthermore, the study found that T cells with high GPCR levels displayed extensive cell-cell connections with other tumor and immune cells in the single cell RNA analysis, indicating their potential involvement in immune escape.Conclusion: In conclusion, GPCRs in combination with TME classification can serve as prognostic markers for GBM. GPCRs play an essential role in tumor progression and the TME in GBM.
Aspirin reduces the mortality risk of sepsis-associated acute kidney injury: an observational study using the MIMIC IV database
Authors: Chen Sining , Li Shishi , Kuang Chaoying , Zhong Yuzhen , Yang Zhiqian , Yang Yan , Liu Fanna 
Published: July 2023

Introduction: Sepsis-associated acute kidney injury (SA-AKI) is a complication of sepsis and is characterized by high mortality. Aspirin affects cyclooxygenases which play a significant role in inflammation, hemostasis, and immunological regulation. Sepsis is an uncontrolled inflammatory and procoagulant response to a pathogen, but aspirin can inhibit platelet function to attenuate the inflammatory response, thus improving outcomes. Several studies have generated contradictory evidence regarding the effect of aspirin on patients with sepsis-associated acute kidney injury (SA-AKI). We conducted an analysis of the MIMIC IV database to investigate the correlation between aspirin utilization and the outcomes of patients with SA-AKI, as well as to determine the most effective dosage for aspirin therapy.Materials and methods: SA-AKI patients’ clinical data were extracted from MIMIC-IV2.1. Propensity score matching was applied to balance the baseline characteristics between the aspirin group and the non-user group. Subsequently, the relationship between aspirin and patient death was analyzed by Kaplan-Meier method and Cox proportional hazard regression models.Results: 12,091 patients with SA-AKI were extracted from the MIMIC IV database. In the propensity score-matched sample of 7,694 individuals, lower 90-day mortality risks were observed in the aspirin group compared to the non-users group (adjusted HR: 0.722; 95%CI: 0.666, 0.783) by multivariable cox proportional hazards analysis. In addition, the Kaplan-Meier survival curves indicated a superior 90-day survival rate for aspirin users compared to non-users (the log-rank test p-value was 0.001). And the median survival time of patients receiving aspirin treatment was significantly longer than those not receiving (46.47 days vs. 24.26 days). In the aspirin group, the average ICU stay length was shorter than non-users group. (5.19 days vs. 5.58 days, p = 0.006). There was no significant association between aspirin and an increased risk of gastrointestinal hemorrhage (p = 0.144).Conclusion: Aspirin might reduce the average ICU stay duration and the 30-day or 90-day mortality risks of SA-AKI patients. No statistically significant difference in the risk of gastrointestinal hemorrhage was found between the aspirin group and the control group.
Cryptotanshinone affects HFL-1 cells proliferation by inhibiting cytokines secretion in RAW264.7 cells and ameliorates inflammation and fibrosis in newborn rats with hyperoxia induced lung injury
Authors: Ma Mengmeng , Bao Tianping , Li Jingyan , Cao Linxia , Yu Bingrui , Hu Jingjing , Cheng Huaiping , Tian Zhaofang 
Published: July 2023

Objective: Bronchopulmonary dysplasia (BPD) is a common complication of prematurity and has no specific treatment option. Moreover, inflammation and fibrosis play a vital role in the development of BPD. Thus, this study aimed to explore the role of the anti-inflammatory and anti-fibrotic drug cryptotanshinone (CTS) in the treatment of inflammation and fibrosis in BPD.Methods:In vivo, Sprague–Dawley rats (male) were divided into air, hyperoxia and CTS groups with different dose interventions (7.5, 15, and 30 mg/kg). A BPD rat model was induced by continuous inhalation of hyperoxia (95%) for 7 days, during which different doses of CTS were injected intraperitoneally. Furthermore, histological examination, hydroxyproline content measurement, Western blot and real-time quantitative polymerase chain reaction were used to detect the levels of inflammation and fibrosis in the tissues. RAW264.7 cells exposed to 95% oxygen were collected and co-cultured with fibroblasts to determine the expression levels of α-SMA, collagen-Ⅰ and MMPs. The levels of pro-inflammatory cytokines such as TNF-α, IL-6 and pro-fibrotic factor TGF-β1 in the supernatants were measured using enzyme-linked immunosorbent assay.Results: Haematoxylin and eosin staining revealed that CTS reduced the inflammatory response in rat lungs. Masson staining revealed that CTS alleviated the level of pulmonary fibrosis. CTS also reduced the levels of TNF-α, IL-6 and TGF-β1 along with the expression of the fibrosis marker α-SMA in lung tissue. Similarly, in vitro analysis revealed that CTS decreased the levels of TNF-α, IL-6 and TGF-β1 expressed in RAW 264.7 cells, and reduced α-SMA, collagen-Ⅰ, MMPs concentrations in HFL-1 cells co-cultured with the supernatant of RAW264.7 cells after hyperoxia.Conclusion: CTS can attenuate the hyperoxia-induced inflammatory response and the level of fibrosis by regulating the levels of inflammatory factors and fibrotic factor TGF-β1 expressed by macrophages, thereby highlighting the therapeutic potential of CTS in the treatment of BPD.
Job satisfaction of village doctors in a rural-oriented tuition-waived medical education program in China
Authors: Jin Renmin , Chen Yan 
Published: July 2023

IntroductionTo address health inequity and relieve shortage of rural doctors, China initiated Rural-oriented Tuition-waived Medical Education (RTME) to train doctors in rural areas for free since 2010. Little is known about job satisfaction of this particular group of rural doctors.MethodsJob Satisfaction Questionnaires for Village Doctors were distributed to 240 village doctors with RTME program in China, and 40 received in-depth semi-structured interviews. Descriptive analysis, chi-square test, univariate and multivariate logistic regressions in SPSS23.0 were conducted, and thematic analysis was applied to interviews.ResultsJob satisfaction rate of village doctors with RTME program was 56.50%. Full understanding of RTME policy, recognition of rural medical work, relevance of RTME curriculum with present job, education background, rural origin and renumeration were positively correlated with job satisfaction. Preferential policies of RTME program, relaxing working atmosphere, more promotion opportunity, and easier access to higher technical titles were the key factors to retain rural doctors.ConclusionOur findings may interest healthcare authorities, medical colleges and primary healthcare establishments. Studying the job satisfaction of village doctors in China may also be beneficial in developing community and rural health services, and provide valuable insights into the training and retention of primary healthcare providers in other countries.
Burden and patient characteristics associated with repeat consultation for unscheduled care within 30 days in primary care: a retrospective case control study with implications for aging and public health
Authors: Richard Valentin , Bouazzi Leila , Richard Clément , Sanchez Stéphane 
Published: July 2023

IntroductionRepeated consultations in primary care represent a significant burden on healthcare services. Characterizing the patients who repeatedly attend ambulatory care would enhance our understanding of the healthcare needs of this population, with a view to providing appropriate services. The aim of this study was therefore to identify the factors associated with repeated consultation in unscheduled care. Our secondary aim was to explore the specific profile of patients aged &gt;65 years.MethodsA retrospective case–control study comparing re-consultation within 30 days at a primary care facility versus non-reconsulting patients, defined as those who did not reconsult within 30 days, among patients consulting over a period of 1 year (1 January to 31 December 2019). Data was collected for a random sample of 5,059 consultations. Patients and controls were matched for age ± 5 years, and sex.ResultsThe main factors associated with repeat consultation were an initial consultation late at night (midnight to 6.00 am; OR 1.31, 95%CI 1.20–1.44), and psychological disorders as the main diagnosis (OR 1.33, 95%CI 1.20–1.48). Conversely, consulting at the weekend was associated with a lower likelihood of repeat consultation (OR 0.82, 95% 0.85–0.91).Conclusion30-day reconsultations were significantly more frequent after late night consultation. This could be used as an indicator of the quality of care to assess performance of general practice teams with implications for improving overall health of an aging population.
A Study on Role of Health Care Management Streams
Authors: Perumal S , Dhanasekaran S 
Published: July 2023

Health care is the maintenance or improvement of health care via the prevention, diagnosis, treatment, amelioration, or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health care professionals and allied health care fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions are all part of health care. It includes work done in providing primary care, secondary care, and tertiary care, as well as in public healthcare. Access to health care may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health care policies. Providing health care services means “the timely use of personal health care services to achieve the best possible health care outcomes. A limitation to health care services affects negatively the use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). An efficient health care system can contribute to a significant part of a country’s economy, development, and industrialization. Health care is conventionally regarded as an important determinant in promoting the general physical and mental health care and well-being of people around the world, An example of this was the worldwide eradication of smallpox in 1980, declared by the WHO as the first disease in human history to be eliminated by deliberate health care interventions.
El diseño universal del aprendizaje y su importancia en la educación pública ecuatoriana
Authors: Maldonado Alarcón Sandra , Esteves-Fajardo Zila Isabel 
Published: July 2023

El objetivo general de la presente investigación fue describir el diseño universal del aprendizaje y su importancia en la educación pública ecuatoriana. Con apoyo metodológico de tipo documental descriptivo y un diseño bibliográfico, la investigación se construyó desde una perspectiva cuantitativa, lo que posibilitó el recorrido por el tema investigado. Con la ayuda del método de análisis de contenido, que se utilizó a lo largo de toda la investigación, fue posible estudiar los datos recopilados. Se empleó como instrumento de investigación, la ficha o guía de análisis documental, lo que contribuyó a extraer las ideas y contrastarlas, de artículos arbitrados y tesis, entre otros. Se concluye que, la promoción de nuevas estrategias en el proceso de enseñanza aprendizaje en la educación pública, constituye un reto de gestión pública en materia educativa en la cual deben participar los padres de familia, escuela, estudiantes y comunidad, para mejorar las políticas de inclusión.
Cambios faciales por exodoncias de primeros premolares maxilares, maloclusiones Clase II subdivisión 1: Revisión narrativa
Authors: Iñiguez-Zúñiga Gabriela Isabel , Campoverde-Torres Cristian Hernán 
Published: July 2023

La maloclusión clase II subdivisión 1 se puede corregir con diferentes tipos de tratamiento como: ortopedia, ortodoncia correctiva con extracciones, sin extracciones, y cirugía ortognática. Uno de los tratamientos son las extracciones de primeros premolares maxilares; este tratamiento consiste en corregir la maloclusión a través de movimientos dentoalveolares. El objetivo de esta revisión narrativa es analizar la evidencia científica disponible sobre los cambios del perfil facial por exodoncias de primeros premolares maxilares en la maloclusión Clase II subdivisión 1 tratados con ortodoncia. Se realizó una revisión narrativa por vía electrónica a través de los buscadores: PubMed, Google académico, Springer y Cochrane Library, con términos como: maloclusión Clase II subdivisión 1, tratamiento, extracción primer premolar, rostro. Cuando se realizan extracciones, ambos labios se retraen, presentado más disminución en la protrusión del labio superior, lo que da lugar a cambios en el perfil facial.
Gestión administrativa motor de sostenibilidad de los emprendimientos ecuatorianos
Authors: Vásquez-Erazo Edwin Joselito , Estupiñán-Tello Diego Enrique , Vásquez-Álvarez Juan Sebastian 
Published: July 2023

Se plantea como objetivo desarrollar estrategias que minimicen el fracaso y aporten a la sostenibilidad de los emprendimientos ecuatorianos, teniendo como base el paradigma positivista, con enfoque cuantitativo, diseño experimental, transaccional, correlacional, la población corresponde a 70 emprendimientos, de diferentes ciudades del Ecuador, en sectores de bienes de consumo, comercio y servicios, a quienes se les aplicó una encuesta, donde se identificaron los factores que inciden en el fracaso de las mismas y como logra su sostenibilidad, los resultados obtenidos indican que el 25,7% de los emprendimientos fracasan por desconocimiento del mercado, el 21,4% por inadecuada gestión administrativa, el 24,3% excesiva competencia, el 32,8% por falta de financiamiento, de acuerdo al GEM Ecuador 2020, el 42% de emprendimientos fracasan antes de cumplir tres años, finalmente, se evidencia la necesidad de implementar estrategias para la sostenibilidad de los negocios.
Efectividad de la intrusión molar superior con mini implantes para corregir la mordida abierta anterior
Authors: Urgilés-Calle Prissila Estefanía , Lima-Illescas Miriam Verónica 
Published: July 2023

Los ortodoncistas consideran la mordida abierta anterior un verdadero desafío, debido a la interacción de varios factores etiológicos (genéticos, dentales, esqueléticos, funcionales). Es importante determinar el mejor tratamiento para esta patología, hoy en día existen varias técnicas para lograr la intrusión molar superior entre las que se destacan los mini implantes por ser una técnica sencilla y accesible para todo paciente, el objetivo de esta revisión de tipo descriptiva, fue conocer la efectividad de la intrusión del molar maxilar en la corrección de la mordida abierta anterior mediante mini implantes. Finalmente los estudios coinciden que los mini implantes son una técnica efectiva, más estable y menos traumática que se emplea con facilidad para corregir la mordida abierta anterior, mediante la intrusión de molares superiores. El éxito del tratamiento depende del diagnóstico y plan de tratamiento para lograr una corrección exitosa y estable a largo plazo.
Efectos adversos periodontales del tratamiento ortodóntico con alineadores transparentes removibles versus aparatología fija convencional
Authors: Cabrera-Pazos Gabriel Eduardo , Guerrero-Alvarado Danny Esteban 
Published: July 2023

RESUMEN
La enfermedad periodontal se encuentra más instituida en pacientes con uso de aparatología fija ortodóntica. Para ello es de suma importancia conocer los diferentes movimientos y problemas que se pueden desarrollar durante el tratamiento de ortodoncia para de esta manera poder entender la capacidad que tienen los mismos sobre los órganos dentales y las estructuras adyacentes a ellos, de igual manera reconocer a los elementos de riesgo que pueden producir la enfermedad periodontal (EP). Luego de la búsqueda bibliográfica se definieron 25 artículos de relevancia para este estudio, en esta revisión se intentó identificar los efectos adversos entre enfermedad periodontal y el tratamiento de ortodoncia con aparatología fija y removible. La mayor parte de autores concluyen en que indistintamente el tipo de aparatología utilizada en el tratamiento ortodóntico va a tener un efecto indeseable sobre la salud periodontal, siendo la aparatología removible la opción más indicada en pacientes comprometidos periodontalmente.
Refleksi Scenario Planning "Menang" dalam Pelaksanaan Reforma Agraria di Provinsi Jawa Barat
Authors: Darmawan Dalu Agung , Mahasari Jamaluddin , Soetarto Endriatmo , Asnawi Yudha Heryawan , Sukmawati Anggraini 
Published: July 2023

Tujuan penelitian ini adalah untuk mengetahui Refleksi <em>Scenario Planning</em> "MENANG" dalam Pelaksanaan Reforma Agraria di Provinsi Jawa Barat.<strong> </strong> Jenis penilitian ini adalah kualitatif meskipun sebagian data yang dikumpulkan berasal dari data-data sekunder. Di tataran metodologis dasar kajian ini menggunakan pendekatan etnografi, atau dalam istilah etnometodologi dikenal sebagai refleksivitas (reflexivite). Lebih jauh sebagai praktik sosial refleksivitas adalah bstakeholders) tercipta dan bermakna.atas praksis RA dengan segala kelindannya. Dalam hal ini dengan skenario pendasaran Planning, Monitoring, Evaluation, Normative, Accelaration, Network, Gainful (MENANG), peneliti dan tineliti (para pihak) berikhtiar menerawang ulang sejauhmanakah praksis RA telah mampu tumbuh dan merangkai Kebijakan <em>Land Use</em>, <em>Land Tenure</em>, Land Value dan <em>Land Development</em> dalam tata kelola pertanahan (yang berkelanjutan) di Provinsi Jawa Barat. Sementara itu kelembagaan GTRA yang dalam hal ini yang bersifat fungsional, bukan struktural, dalam kiprahnya sering terkendala dalam kewenangan, dalam perolehan dukungan penganggaran, dan tentu saja dalam eksekusi kebijakan RA di Jawa Barat. Ajuan saran dari kajian ini ialah implementasi RA di lapangan (Provinsi Jawa Barat dalam hal ini) akan semakin efektif jika Pemeriah membentuk badan khusus yang bersifat struktural di aras pusat yang memiliki kewenangan penuh atas pelaksanaan RA sehingga akan dapat meminimalisir kesenjangan dan peluang terjadinya distorsi kebijakan, yaitu antara idealita dengan praksis empirik di lapangan.
Convolutional Wavelet Neural Network Based Non-Intrusive Load Monitoring for Next Generation Shipboard Power Systems
Authors: Senemmar Soroush , Zhang Jie 
Published: July 2023

<p>In this study, a non-intrusive load monitoring (NILM) framework is developed for next generation shipboard power systems (SPS) based on a discrete wavelet transform (DWT) and a convolutional neural network (CNN). We have applied the developed NILM method to a four-zone medium voltage direct current (MVDC) SPS to evaluate the effectiveness of the proposed method. Each zone of the MVDC SPS consists of multiple components, such as propulsion load, pulsed load, high ramp rate load, cooling load, and hotel load. The current signals from the main generators are the main inputs to the proposed NILM model. The current signals are first processed with a discrete wavelet transform to create a coefficient matrix that reflects the status of all the components in each zone. Then, a multi-class classification problem is formulated and solved using a CNN model to monitor the load statuses in real time. The results of case studies show that the developed wavelet-CNN based NILM model can (i) accurately monitor the status of all components with a total accuracy of over 98%, (ii) identify unique pulsed loads with a total accuracy of over 99%, and (iii) sustain the functionality of load monitoring under extreme events such as cyber/physical attacks. </p>