bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subtotal cholecystectomy: is it a safe option for difficult gall bladders?
Authors: Ibrahim R , Abdalkoddus M , Mahendran B , Mownah OA , Nawara H , Aroori S 
Published: May 2023

Introduction Subtotal cholecystectomy (STC) is an alternative to total cholecystectomy (TC) in patients with severe inflammation/adhesions around the hepatocystic triangle. This study aimed to evaluate the safety profile of STC. Methods We retrospectively reviewed all patients who had STC at our unit between February 2009 and August 2019. STC was divided into two types, reconstituting (R-STC) and fenestrating (F-STC), depending on whether the gall bladder remnant was closed or left open. Patients who had cholecystectomy for gall bladder malignancy or as part of another operation were excluded from the study. Results A total of 5,664 patients underwent cholecystectomy during the study period. Of these, 97 (1.7%) underwent STC. The laparoscopic to open conversion rate was high at 48.8% (47 cases), as was the overall postoperative complication rate (45.4%, 44 cases). No patient suffered iatrogenic bile duct injury. Nineteen patients (19.6%) suffered postoperative bile leak. This was significantly higher in patients who had STC in the acute setting (41% vs 13% for elective STC cases; p=0.04). There was no significant difference in rate of bile leak or other complications between R-STC and F-STC types. The 90-day readmission rate was 8.2% (8 cases). No mortalities were recorded within 90 days post STC. Conclusions STC seems to be an effective technique to avoid bile duct injury in difficult cholecystectomy cases. However, the perioperative morbidity associated with STC is relatively high. Surgeons should be aware of the risks of STC and take appropriate steps to minimise them.
Screening for malnutrition in emergency laparotomy patients: a comparison of three tools
Authors: O’Connor T , MacKenzie L , Clarke RW , Bradburn M , Wilson TR , Lee MJ 
Published: May 2023

IntroductionMalnourished patients undergoing emergency laparotomy are at risk of significant morbidity. The optimum screening tool to identify such patients in practice and research is yet to be determined. This study aims to compare the performance of three nutrition risk tools in predicting time without enteral nutrition in this population.MethodsA prospective cohort study (NCT04696367) was conducted across two sites, recruiting patients undergoing National Emergency Laparotomy Audit eligible procedures. Data collected included demographics, diagnosis, procedure and outcomes. Nutrition risk was assessed using three tools: Malnutrition Universal Screening Tool (MUST) score, Nutritional Risk Index (NRI) and Nutritional Risk Score 2002 (NRS-2002). Complications were assessed with the Comprehensive Complication Index. Quality of life was measured at baseline and 5 days postsurgery using EQ-5D-5L.ResultsA total of 59 patients were recruited. Median age was 69 years. Of the 59 participants, 23 were judged high risk using MUST score, 13 using NRS and 8 using NRI. Median time to restart enteral intake was 7 days (interquartile range 7–14). Time without intake was correlated with increasing score using MUST (r=0.463, p<0.001) and NRS-2002 (r=0.296, p=0.03) but not NRI (r=−0.121, p=0.38). High-risk nutritional groups also had increased length of hospital stay, but not complication scores.ConclusionsPatients undergoing emergency laparotomy spend a prolonged time without enteral nutrition. Although all nutritional tools demonstrated some propensity to identify patients at higher risk of needing nutritional support, their performance was variable. Nevertheless, some may be useful in future clinical studies.
Medicolegal claims in general surgery: a 10-year retrospective review of claims against the NHS in England
Authors: Magowan D , Evans M , Burton L , Smith L 
Published: May 2023

Introduction Every year 12,000 medicolegal claims are brought against the NHS in England at a cost of £8 billion—6.7% of the NHS England budget. In 1,000 of these claims the primary speciality is General Surgery. The aims of this paper were to examine 10 years of claims against General Surgery Departments in NHS England, identify the common causes and injuries, review the associated cost and suggest strategies for improvement. Methods Data regarding medicolegal claims made against NHS General Surgical Departments in England from 2010 to 2020 were obtained from the Clinical Negligence Scheme for Trusts. A retrospective review was undertaken to examine the number of claims, cost of claims closed with and without damages, primary causes and primary injuries. Results A total of 10,027 claims were made between 2010 and 2020. Of these, 9,377 were closed in that time, with cost totalling £851,558,930. Of claims closed, an average of 608 per year were closed with damages and 329 without damages. Claims with damages resulted in more than forty-five times greater cost per claim compared with those closed without damages. Overall, cost increased by over 50% between 2010 and 2020. Common causes included ‘failure/delay in treatment’, ‘intraoperative problems’ and ‘failure/delay in diagnosis’. Common injuries included ‘additional/unnecessary operation(s)’, ‘unnecessary pain’, ‘fatality’ and ‘bowel damage/dysfunction’. Conclusion Medicolegal expenditure represents a serious concern for the NHS, worsening each year. This retrospective review highlights the rising cost along with the most common causes and primary injuries. Action is required at every level of the NHS to improve surgical care, consent and communication with our patients, and by doing so minimise poor outcomes and their resultant medicolegal consequences.
Directional atherectomy combined with drug-coated balloon angioplasty for superficial femoral arteriosclerosis obliterans
Authors: Su Z , Li Y , Wang C , Guo J , Guo L , Gu Y 
Published: May 2023

Introduction This study is an analysis of the therapeutic effects of directional atherectomy combined with drug-coated balloon angioplasty (DA+DCB) in treating superficial femoral arteriosclerosis obliterans. Methods Patients in our hospital with superficial femoral arteriosclerosis obliterans who received DA+DCB during the period June 2016 to February 2019 were identified retrospectively. Preoperative demographics, operative details and postoperative follow-up outcomes were analysed statistically. Results Between June 2016 and February 2019, 48 patients were enrolled in this retrospective study. The average age of the patients was 66.85 ± 11.28 years; 83.3% of the patients were male. During the procedure, flow-limiting dissection occurred frequently (9/48 patients) and there were six bailout stent implantations owing to flow-limiting dissections. The incidence rate of target artery thrombosis was 4.2% (2/48). There was no vessel perforation, embolism or operation-related death. The technical success rate was estimated at 100%. The mean ankle–brachial index of the patients was 0.54 ± 0.28 before the operation and 0.93 ± 0.13 before discharge (p < 0.0001). The mean follow-up time was 19.6 ± 9.0 months. The primary patency rate was 89.4%, 82.4% and 76.5% at 12, 24 and 36 months. The freedom from target lesion revascularisation (TLR) was 97.9%, 93.8% and 84.4% at 12, 24 and 36 months. Conclusion The use of DA+DCB showed good clinical benefit for superficial femoral arteriosclerosis obliterans, which had good primary patency and freedom from TLR. Multicentre randomised controlled trials with long-term follow-up are needed.
Group velocity of light in internal conical refraction
Authors: Wang Pengqian 
Published: May 2023

We calculated the group velocity of light in internal conical refraction in a biaxial crystal as a function of the direction of the electric displacement vector, or the vibration direction, of its carrier wave. Our method represents group velocity through the electromagnetic fields of light, rather than its wave normal or ray direction. The travel time of a light pulse traversing a parallel plate biaxial crystal in internal conical refraction is found to vary as a sinusoidal function of twice the vibration angle of the light wave. Our method distinguishes the four directions of the two optic axes in monoclinic and triclinic crystals. Numerical examples are given for KNbO3 at the wavelength of 400 nm, and for Sn2P2S6 at the wavelength of 550 nm.
PREventing Mild Idiopathic SCOliosis PROgression (PREMISCOPRO): A protocol for a randomized controlled trial comparing scoliosis-specific exercises with observation in mild idiopathic scoliosis
Authors: Diarbakerli Elias , Abbott Allan , Gerdhem Paul 
Published: May 2023

Background
Idiopathic scoliosis is the most common spinal deformity in children. Treatment strategies aim to halt progression of the curve. Mild scoliosis is in many cases observed or, in some cases, treated with scoliosis-specific exercises. More severe curves are treated mainly with a brace. The aim of this study is to investigate the effectiveness of scoliosis-specific exercises compared to observation in adolescents with mild idiopathic scoliosis.

Methods
Subjects. Previously untreated and skeletally immature children aged 9–15 years of age with idiopathic scoliosis (curve magnitude Cobb 15–24 degrees) will be included. A total of 90 subjects will be included to receive one of two possible interventions.
Interventions. Both groups will receive a physical activity prescription according to the World Health Organization recommendations. The intervention group will receive an additional active self-correction treatment strategy for curve correction and will have outpatient sessions once every two weeks for the first three months. They will be prescribed to do the exercises at least three times per week. The intervention will be performed until skeletal maturity or progression of the curve.
Outcome. The subjects will participate in the study until curve progression or until skeletal maturity (defined as less than 1 cm growth for six months). The primary outcome variable is failure of treatment, defined as progression of the Cobb angle more than 6 degrees on two consecutive x-rays compared to the baseline x-ray. Secondary outcome measures include patient-reported outcomes, clinical characteristics (i.e. angle of trunk rotation and trunk asymmetry) and number requiring brace treatment. Clinical follow-ups will be performed every six months and radiographs will be taken annually.

Discussion
This study will compare effectiveness of an active self-corrective exercise strategy in mild idiopathic scoliosis with observation in terms of halting curve progression.
A ZONA DE CONFORTO DA BUROCRACIA: GOVERNANÇA NO PROCESSO DE COMPRAS PÚBLICAS
Authors: Soares João Cláudio Araújo , Mota Flávio Perazzo Barbosa , Barboza Stephanie Ingrid Souza 
Published: May 2023

Dilema: Após assumir o cargo de Gestor de Compras na Universidade do Leste do Brasil (ULB), o gestor público Roberto, juntamente com estudantes do curso de Gestão Pública, se depara com o dilema de melhorar os processos do setor, tentando contribuir para uma governança mais adequada para as compras públicas.
Objetivo educacional: O caso permite desenvolver competências para interpretação dos conceitos gerais de burocracia, compras públicas, governança pública e gestão de riscos no setor público.
Contextualização: A trajetória de Roberto com os estudantes ocorre intermediada pelo professor Franco, enquanto estagiário docente da disciplina Organização, Sistemas e Métodos e estudante do curso de Mestrado em Gestão Pública na ULB. As preconcepções e desafios são apresentados sob o olhar de dentro do setor público.
Tema principal: O enfoque está na discussão sobre gestão de processos, governança e gestão de riscos, orientando a reflexão sobre as ações gerais necessárias e desafiadoras em termos de implementação no contexto da gestão pública.
Público: Recomenda-se a aplicação em nível de graduação do quarto semestre em diante ou pós-graduação lato sensu, nas disciplinas de Gestão de Licitações e Contratos e Governança Pública. É necessário que o discente tenha conhecimento e formação em disciplinas de Fundamentos de Administração e Gestão Pública, Organização, Sistemas e Métodos e Gestão de Pessoas no Setor Público.
Originalidade/valor: A situação real apresentada trabalha nuances inerentes às compras públicas, bem como permite compreender os conceitos teóricos subjacentes, para tentar implantá-los na prática. O que envolve a gestão de processos e compras públicas? Quais os conceitos centrais de governança e gestão de riscos? Como implantar?
A GESTÃO PÚBLICA DE ASSISTÊNCIA SOCIAL DO MUNICÍPIO DE JEREMOABO (BA) E O DESAFIO DA GOVERNANÇA POR MEIO DA GESTÃO MATRICIAL PARA RESULTADOS
Authors: CARNEIRO Liliane Mendes 
Published: May 2023

Este artigo incita uma reflexão sobre a gestão pública do Sistema Únicode Assistência Social, bem como expõe o desafio de implantar um projeto de mestrado profissional firmado numa proposta de governança por meio da Gestão Matricial para Resultados (GMR) no município de Jeremoabo (BA). Esse debate científico se estabelece no reconhecimento de que a assistência social, embora detenha um arcabouço jurídico que a legaliza, ainda tem na sua institucionalização e estruturação organizacional deficit e inadequações que conferem empecilhos à gestão do Sistema Único de Assistência Social (SUAS). A Gestão Matricial para Resultados tende a criar estratégias de superação que dotem a gestão pública de maior eficiência, eficácia e efetividade.
A MORTE DO DISCURSO GRÁFICO: A QUEBRA NA TRANSMIDIAÇÃO DA RETÓRICA VISUAL E O FIM DO RECONHECIMENTO DAS MARCAS IMPRESSAS NOS PRODUTOS JORNALÍSTICOS EM PLATAFORMAS DIGITAIS
Authors: Ebel Ivana Raquel 
Published: May 2023

A queda na tiragem e o fim de edições impressas de veículos tradicionaisde mídia colocam em xeque um patrimônio de imagem construído ao longo dos anos: o discurso gráfico. A transposição da mídia impressa para a web não soube transportar os valores de imagem para o mundo digital e a nova geração de leitores pouco sabe da aparência ou da estrutura dos veículos originais. O momento atual ainda é de intersecção, mas em pouco tempo o legado atrelado ao aspecto visual dos jornais estará perdido, distanciando o produto digital de tal maneira de suas origens impressas, que pouco restará além do nome para a identificação das marcas. Um experimento desenvolvido para os principais veículos impressos da Alemanha comprova essa dissociação visual dos produtos. Ao combinar as capas das edições impressas com a capa dos portais web, ficou claro que existe uma coesão de design entre os exemplares de um mesmo suporte tecnológico, mas a conexão entre o produto impresso e a web de um mesmo veículo não pode mais ser estabelecida levando em conta apenas os aspectos visuais. O discurso gráfico está morto.
AUTOAVALIAÇÃO PARA MELHORIA DO ACESSO E DA QUALIDADE NA ATENÇÃO BÁSICA: RELATO DE EXPERIÊNCIA DE UMA EQUIPE DA ESF DE ITAJAÍ
Authors: Maeyama Marcos Aurélio , CéBella Cruz Catarina , Tomelin Nayara Andressa , Castro Vítor Velho , Candeia Guilherme , Piazza Willian Franco , Veiga Mariana Vilela , Campos Viviane dos Santos , Bueno Jéssica Lüders , Costa Camila Bentes 
Published: May 2023

Com o objetivo de valorizar e qualificar a Atenção Básica, o Ministério daSaúde lança em 2012 o Programa de Melhoria do Acesso e da Qualidade na Atenção Básica (PMAQ), que é constituído por processos de autoavaliação, monitoramento, avaliação externa, educação permanente e apoio institucional. Para a etapa de autoavaliação, é disponibilizado o instrumento denominado Autoavaliação para Melhoria do Acesso e da Qualidade na Atenção Básica (AMAQ), que apresenta duas unidades de análise (gestão e equipe) com diversos padrões de qualidade para cada subdimensão avaliada. O objetivo deste trabalho foi relatar a etapa de autoavaliação de uma equipe de Saúde da Família. Dentre as subdimensões avaliadas, a “Educação Permanente e Qualificação das Equipes de Atenção Básica”, a “Atenção Integral” e o “Programa Saúde na Escola”, obtiveram classificação “satisfatório”. O pior resultado obtido foi para a subdimensão “Participação, controle social e satisfação do usuário”, com classificação “muito insatisfatório”. Já a subdimensão “Organização do processo de trabalho”, obteve a classificação “muito satisfatório”. Somando a média de desempenho das subdimensões, a equipe obteve classificação geral “satisfatório”. Ainda que o resultado tenha sido positivo, a equipe pactuou a construção de uma matriz de intervenção para todos os padrões de qualidade que apresentassem fragilidade. O instrumento da AMAQ retrata diversos aspectos que envolvem o trabalho na AB, sendo um potente dispositivo de reflexão e indutor de mudanças para melhoria dos indicadores de saúde no território. Nesse sentido, a institucionalização da avaliação é fundamental para que as equipes sistematicamente realizem reflexão sobre o próprio trabalho.
SOLIDÃO COLETIVA OU ISOLAMENTO INDIVIDUAL: OS PRÓS E CONTRAS DO ENREDAMENTO NA ALTA ERA DIGITAL
Authors: Valderramas Edgard Luiz Bernardes 
Published: May 2023

Na relação homem-máquina, percebe-se que o ponto de convergência entre osseres humanos e as máquinas ultrapassa o nível de abstração simplesmente pelo desfrute de recursos do primeiro em relação ao segundo, o que permite um entendimento “wineriano” desse conceito. É como se tratássemos o homem e a tecnologia como uma simbiose pura, um verdadeiro “homo computatrum” dos tempos modernos. O presente artigo, ao percorrer os domínios da tecnologia e a sua intersecção com a sociedade, busca trazer uma reflexão de como o enredamento está inserido no cotidiano das pessoas, definindo os atores destecenário e traçando uma relação entre o que é isolamento individual e o que é solidão coletiva, procurando refletir sobre as relações entre a sociedade atual e a utilização das novas e impressionantes tecnologias que estão sempre ao alcance das mãos.
Escola da Terra Capixaba
Authors: Oliveira Josiléia Curty de , Jadejiski Rainei Rodrigues , Baldotto Ozana Luzia Galvão , Foerste Erineu 
Published: May 2023

Este texto traz experiências formativas de professoras do campo do sul do estado do Espírito Santo que participaram do curso de Especialização em Educação do Campo – Escola da Terra Capixaba. As ações dessa formação continuada estiveram ligadas à atuação do grupo de pesquisa CNPq Culturas, Parcerias e Educação do Campo, da Universidade Federal do Espírito Santo, e foram referenciadas nos pressupostos da educação do campo, com foco na epistemologia da práxis como base para a construção de conhecimentos e de uma formação crítica e emancipadora. A metodologia do estudo se ancora nos pressupostos da pesquisa narrativa (auto)biográfica, tendo como colaboradoras as professoras que atuam nos anos iniciais do ensino fundamental. Os resultados revelam que o processo formativo possibilitou que as professoras repensassem a própria prática, tornando-as mais sensíveis à realidade dos estudantes campesinos e contribuindo para amenizar a lacuna dos estudos sobre educação do campo existente entre a formação inicial e a continuada.
Successful Reuse of a Donor Heart
Authors: Esmailian Gabriel , Chen Qiudong , Ramzy Danny , Kobashigawa Jon A. , Chikwe Joanna , Esmailian Fardad 
Published: May 2023

Abstract
At a time when transplantable organs are in a shortage, few cases have noted the reuse of donor hearts in a second recipient in an effort to expand the donor network. Here, we present a case in which an O Rh-positive donor heart was first transplanted into a B Rh-positive recipient and later successfully retransplanted into a second O Rh-positive recipient 10 days after the initial transplant at the same medical center. On postoperative day 1, the first recipient, a 21-year-old man with nonischemic cardiomyopathy, sustained a devastating cerebrovascular accident with progression to brain death. With preserved left ventricle and mildly depressed right ventricle function, the heart was allocated to the second recipient, a 63-year-old male patient with familial restrictive cardiomyopathy. The bicaval technique was used, and the total ischemic time was 100 minutes. His postoperative course was uncomplicated with no evidence of rejection on 3 endomyocardial biopsies. Follow-up transthoracic echocardiogram revealed a left ventricular ejection fraction of 60% to 70%. Seven months posttransplant, the second recipient was doing well with appropriate left and right ventricular function. With careful organ selection, short ischemic time, and proper postoperative care, retransplant of donor hearts may be an option for select patients in need of heart transplant.
SODA: A Set of Fast Oblivious Algorithms in Distributed Secure Data Analytics
Authors: Li Xiang , Sun Nuozhou , Luo Yunqian , Gao Mingyu 
Published: May 2023

Cloud systems are now a prevalent platform to host large-scale big-data analytics applications such as machine learning and relational database. However, data privacy remains as a critical concern for public cloud systems. Existing trusted hardware could provide an isolated execution domain on an untrusted platform, but also suffers from access-pattern-based side channels at various levels including memory, disks, and networking. Oblivious algorithms can address these vulnerabilities by hiding the program data access patterns. Unfortunately, current oblivious algorithms for data analytics are limited to single-machine execution, only support simple operations, and/or suffer from significant performance overheads due to the use of expensive global sort and excessive data padding.
In this work, we propose SODA, a set of efficient and oblivious algorithms for distributed data analytics operators, including filter, aggregate, and binary equi-join. To improve performance, SODA completely avoids the expensive oblivious global sort primitive, and minimizes the data padding overheads. SODA makes use of low-cost (pseudo-)random communication instead of expensive global sort to ensure uniform data traffic in oblivious filter and aggregate. It also adopts a novel two-level bin-packing approach in oblivious join to alleviate both input redistribution and join product skewness, thus minimizing necessary data padding. Compared to the state-of-the-art system, SODA not only extends the functionality but also improves the performance. It achieves 1.1× to 14.6× speedups on complex multi-operator data analytics workloads.
Harpin enhances antioxidant nutrient accumulation and decreases enzymatic browning in stored soybean sprouts
Authors: Tian Shan , Liang Bo , Li Tianshuai , Li Yueyue , Wang Qianjin , Liu Changlai 
Published: May 2023

Abstract
Enzymatic browning causes quality losses in the soybean sprout industry. Herein, the effects of harpin, a proteinaceous bacterial elicitor isolated from Erwinia amylovora, in regulating enzymatic browning and antioxidant nutrient accumulation in stored soybean sprout were investigated. Enhanced soybean sprout growth (evaluated by sprout length and fresh weight) occurred after spraying three times (0, 2, and 4 days after sowing) with 30 mg L−1 harpin during the growth stage. The decline in vitamin C and total phenolic contents and total antioxidant capacity (evaluated by Fe3+ reducing power) were attenuated by harpin during storage. Harpin increased phenylalanine ammonia-lyase, NADPH oxidase (NOX), superoxide dismutase, and catalase activities and inhibited polyphenol oxidase activity and enzymatic browning in soybean sprouts during storage. However, this harpin-promoted sprout growth, enhanced antioxidant accumulation and enzyme activity and improved sprout quality could be partly, but drastically, abolished using diphenyleneiodonium chloride, a specific inhibitor of NOX. Moreover, the mechanisms by which harpin influences antioxidant accumulation and enzymatic browning in soybean sprouts during storage were discussed from the perspective of NOX-mediated H2O2 signalling.