bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel nomogram for adult primary perihilar cholangiocarcinoma and considerations concerning lymph node dissection
Authors: Zhang Qi , Liu Zehan , Liu Shuangqing , Wang Ming , Li Xinye , Xun Jing , Wang Xiangyu , Yang Qin , Wang Ximo , Zhang Dapeng 
Published: January 2023

ObjectiveTo construct a reliable nomogram available online to predict the postoperative survival of patients with perihilar cholangiocarcinoma.MethodsData from 1808 patients diagnosed with perihilar cholangiocarcinoma between 2004 and 2015 were extracted from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database. They were randomly divided into training and validation sets. The nomogram was established by machine learning and Cox model. The discriminant ability and prediction accuracy of the nomogram were evaluated by concordance index (C-index), receiver operator characteristic (ROC) curve and calibration curve. Kaplan-Meier curves show the prognostic value of the associated risk factors and classification system.ResultsMachine learning and multivariate Cox risk regression model showed that sex, age, tumor differentiation, primary tumor stage(T), lymph node metastasis(N), TNM stage, surgery, radiation, chemotherapy, lymph node dissection were associated with the prognosis of perihilar cholangiocarcinoma patients relevant factors (P &lt; 0.05). A novel nomogram was established. The calibration plots, C-index and ROC curve for predictions of the 1-, 3-, and 5-year OS were in excellent agreement. In patients with stage T1 and N0 perihilar cholangiocarcinoma, the prognosis of ≥4 lymph nodes dissected was better than that of 1- 3 lymph nodes dissected (P &lt; 0.01).ConclusionThe nomogram prognostic prediction model can provide a reference for evaluating the prognosis and survival rate of patients with perihilar cholangiocarcinoma. Patients with stage T1 and N0 perihilar cholangiocarcinoma have more benefits by increasing the number of lymph node dissection.
Selective use of pancreatic duct occlusion during pancreaticoduodenectomy in patients with a small-size duct and atrophic parenchyma in the distal pancreas: A retrospective study
Authors: Chen Guangbin , Yin Jie , Chen Qun , Wei Jishu , Zhang Kai , Meng Lingdong , Lu Yichao , Wu Pengfei , Cai Baobao , Lu Zipeng , Miao Yi , Jiang Kuirong 
Published: January 2023

BackgroundDespite the advancements in surgical techniques, postoperative pancreatic fistula (POPF) remains a potentially life-threatening complication of pancreaticoduodenectomy (PD). Pancreatic duct occlusion (PDO) without anastomosis has also been proposed to alleviate the clinical consequences of POPF in selected patients after PD.ObjectivesTo assess the safety and effectiveness of PDO with mechanical closure after PD in patients with an atrophic pancreatic body-tail and a small pancreatic duct.MethodsWe retrospectively identified two female and two male patients from April 2019 to October 2020 through preoperative computed tomography of the abdomen. Among them, three patients underwent PDO with mechanical closure after PD, and one underwent PDO after pylorus-preserving PD. In addition, patients' medical records and medium-and long-term follow-up data were analyzed.ResultsPostoperative histological examination revealed a solid pseudopapillary tumor in two patients, pancreatic ductal adenocarcinoma in one patient, and chronic pancreatitis with pancreatic duct stones in one patient. However, none of the patients developed biochemical or clinically relevant POPF, with no postpancreatectomy hemorrhage, biliary leakage, delayed gastric emptying, intra-abdominal abscess, or chyle leakage. Among the four patients, three developed new-onset diabetes mellitus, and one had impaired glucose tolerance. Furthermore, three patients received pancreatic enzyme supplementation at a dose of 90,000 Ph. Eur. units/d, and one was prescribed a higher dose of 120,000 Ph. Eur. units/d.ConclusionsPDO with mechanical closure is an alternative approach for patients with an atrophic pancreatic body-tail and a small pancreatic duct after PD. Therefore, further evidence should evaluate the potential benefits of selective PDO in these patients.
Full-endoscopic uniportal retropharyngeal odontoidectomy: A preliminary case report
Authors: Ye Jichao , Liu Bin , Li Jinteng , Zheng Guan , Duan Kaidi , Gao Liangbin , Zhang Chunyan , Huang Jingwen , Tang Yong 
Published: January 2023

Summary of background dataOdontoidectomy aims to decompress the medulla oblongata and is usually performed through the classical transoral approach, which affects oropharynx and accompanied with high rate of complications comprising swallowing and respiratory tract. We have developed a minimal invasive method via a standard cervical anterior approach: full-endoscopic trans-cervical odontoidectomy, which provides an alternative access for the resection of odontoid process and medulla oblongata decompression without traversing potentially contaminated cavities.MethodsFrom 2018 to 2020, three patients with either odontoid process lesion or basilar invagination underwent full-endoscopic uniportal trans-cervical odontoidectomy with/without combining the posterior instrumentation. With fluoroscopic guidance, a uniportal endoscope sleeve was placed inside of the odontoid process; then odontoid process was gradually resected from the inside to outside under endoscopic monitoring. Postoperative images and clinical data were collected during post-op follow-up.ResultPatients were soon extubated after surgery when patients wake up from general anesthesia. There were no severely perioperative complications, especially dysphagia and airway obstruction, and the symptoms and neurological function was improved immediately after surgery. The final pathology of one patient with odontoid osteolytic lesion was confirmed as plasmacytoma. The postoperative CT scans proved that the range of odontoid process resection was consistent with the preoperative expectation.ConclusionIn summary, our proposed endoscopic trans-cervical odontoidectomy provides a valid choice for non-oral approach, which would reduce postoperative approach related complications and accelerate postoperative recovery.
Epidural esketamine and morphine for postoperative analgesia after caesarean delivery: A pilot study
Authors: Tang Ju , Zheng Zhiguo , Ran Qijun , Zhao Feng , Wang Yao , Hu Feng , Yang Chao , Tan Xiaoyong 
Published: January 2023

ObjectiveThe aim of this study was to determine whether the addition of esketamine to morphine would improve postoperative analgesia after cesarean section.MethodsParturients who planned for a cesarean delivery using combined spinal–epidural anesthesia with a request for postoperative anesthesia were randomly divided into four groups (A, B, C, and D). When the surgery was completed, the parturients in groups A, B, C, and D were administered 2 mg morphine, 0.25 mg/kg of esketamine, 0.25 mg/kg of esketamine plus 2 mg morphine hydrochloride, and 0.25 mg/kg of esketamine plus 1 mg morphine through the epidural catheters, respectively. The postoperative pain at rest, pain with movement, the number of rescue analgesics, and adverse effects were evaluated for 48 h after cesarean delivery.ResultsA total of 119 parturients were included in this study, including 30 cases in group A, 30 cases in group B, 30 cases in group C, and 29 cases in group D. All visual analog scale (VAS) scores at rest and with movement were much lower in group C as compared with those in group A and group B (P &lt; 0.05). Moreover, VAS scores at rest were also lower in Group C than in group D for 24 h (P &lt; 0.05). Corresponding to the low pain scores, parturients in group C also required less rescue analgesia as compared with the other three groups (P = 0.021 for C vs. A, P &lt; 0.001 for C vs. B, and P &lt; 0.001 for C vs. D). There were no statistically significant differences between the four study groups with regard to the incidence of adverse events (P &gt; 0.05).ConclusionsThe addition of esketamine to morphine improved postoperative analgesia after cesarean section without increasing the incidence of adverse events.
Associations of Household Solid Fuel Use With Falls and Fall-Related Injuries in Middle-Aged and Older Population in China: A Cohort Study
Authors: Ming Xing , Guo Ruixiao , Liu Mengli , He Xiaoman , Guo Feifei , Gao Shengli 
Published: January 2023

Objective: This study evaluated the associations of solid fuels with incidence of falls and fall-related injuries.Methods: Data were taken from wave 1∼4 of the China Health and Retirement Longitudinal Study, including 15,651 participants aged 45 years and older. Modified Poisson regression was used to examine the associations of solid fuels with falls and fall-related injuries.Results: Modified Poisson regression analysis showed that solid fuels users for cooking had an increasing incidence of falls and fall-related injuries, with RR of 1.211 (95% CI: 1.124, 1.305) and 1.248 (95% CI: 1.107, 1.408); for heating had an incidence, with RR of 1.178 (95% CI: 1.062, 1.306) and 1.134 (95% CI: 0.963, 1.335); combined for cooking and heating, with RR of 1.247 (95% CI: 1.105, 1.408) and 1.185 (95% CI: 0.982, 1.431).Conclusion: Our study suggests that solid fuel use is associated with a higher incidence of falls and fall-related injuries among adults aged 45 years and older in China. It is necessary to restrict solid fuel use to reduce household air pollution and make stronger environmental protection policies to improve household environment.
Antifungal Activities of Compounds Produced by Newly Isolated Acrocarpospora Strains
Authors: Cheng Ming-Jen , Chen Jih-Jung , Wu Ming-Der , Leu Jyh-Yih , Tseng Min 
Published: January 2023

In our continued search for bioactive metabolites from cultures of rare Actinobacteria resources from all over Taiwan and various natural ecological environments, an active antimicrobial strain of Acrocarpospora punica 04107M was collected in Taitung County in Taiwan and prepared from soil. The bioassay-guided fractionation of the BuOH extract of a culture broth from A. punica 04107M led to the isolation of five previously undescribed compounds: Acrocarposporins A–E (Compounds 1–5). All the constituents were confirmed by HRESIMS and 1D- and 2D-NMR spectroscopy. Their antifungal activity was also evaluated. Our results showed that four constituents (Compounds 1, 2, 4, and 5) possessed mild antifungal activity against Aspergillus niger, Penicillium italicum, Candida albicans, and Saccharomyces cerevisiae. It is worth mentioning that the chemical composition of Acrocarpospora punica 04107M has never been studied. This is the first report on diterpenoid metabolites from the genus Acrocarpospora.
Biodiversity of Phototrophs and Culturable Fungi in Gobustan Caves
Authors: Mazina Svetlana Evgenievna , Gasanova Tatiana Vladimirovna , Kozlova Ekaterina Vitalievna , Popkova Anna Vladimirovna , Fedorov Anton Sergeevich , Bukharina Irina Leonidovna , Pashkova Anna Sergeevna , Larionov Maxim Viktorovich , Abdullayev Rahman Rahim oglu , Isaev Vugar Urfat oglu 
Published: January 2023

Unique natural objects, such as the caves of the Gobustan National Historical and Artistic Preserve, are also of great cultural and historical value due to rock art and sites of ancient people. A favorable microclimate makes these habitats convenient for colonization by microbiota, including phototrophs. In arid regions with intense seasonal fluctuations of microclimatic parameters, the conditions for survival are the least favorable; therefore, it becomes especially important to determine the composition of communities that are the most adapted to specific conditions. This work aimed to identify the biodiversity of communities of caves and grottoes of the Gobustan Reserve. The studies were carried out in July 2019. Samples were analyzed for cyanobacteria and algae by microscopy and cultivation methods, microfungi were isolated by soil dilution, and the fouling glass method was also used. In total, 29 taxa of cyanobacteria and algae, 18 taxa of fungi, and 3 species of mosses were identified. The studied habitats were dominated by the algae Chlorella vulgaris, Aphanocapsa sp., and Stichococcus bacillaris; the subdominants were Jaaginema subtilissimum, Leptolyngbya tenuis, Chlorococcum minutum, and Humidophila contenta. Microfungi had the highest occurrence of Aspergillus niger, Aureobasidium pullulans, Alternaria alternata, and Talaromyces ruber. It was noted that cyanobacteria dominated in morphologically differentiated biofilms and green algae on the rocks. The greatest number of microfungi was found in the aphotic zone and bryophyte tufts. The dominance of green algae is atypical for most caves of other regions and may be associated with intense lighting of habitats. The absence of protonema is a consequence of the aridity and low moisture content of the substrates.
Aprendizaje autónomo y actitudes hacia las matemáticas en estudiantes de contabilidad y finanzas de la Universidad de San Martín de Porres.
Authors: Farfán Pimentel Johnny Félix , Santiago López Carlos 
Published: January 2023

En el presente estudio se consideró determinar la relación entre el aprendizaje autónomo y las actitudes hacia las matemáticas en estudiantes de contabilidad y finanzas de la Universidad de San Martín de Porres. Respecto a la metodología del estudio, tuvo como diseño metodológico el enfoque cuantitativo a fin de brindar soluciones al problema de investigación, con diseño no experimental, de nivel básico y correlacional. La población estuvo conformada por 650 estudiantes de la escuela profesional de contabilidad y finanzas de la Universidad de San Martín de Porres. Por muestreo probabilístico, la muestra consistió en 242 estudiantes. Después del proceso estadístico Rho de Spearman, los resultados mostraron r = 0,280** y p valor = 0,000<0,05. Es decir, el aprendizaje autónomo y las actitudes hacia las matemáticas están relacionadas de manera directa y significativa en estudiantes de contabilidad y finanzas de la Universidad de San Martín de Porres. De tal forma que se llegó a aceptar la hipótesis alterna y rechazar la hipótesis nula.
Palabras clave: Aprendizaje autónomo, actitudes, matemáticas, educación superior.
Espaço, corpo e território: a interculturalidade na Universidade
Authors: Lago Sueli Bonfim , Da Silva Joelma Boaventura , Do Reis Leonardo Rangel 
Published: January 2023

O objetivo deste trabalho é suscitar provocações em torno de uma possível relação existente entre os conceitos de espaço, território e corpo na inclusão racial universitária brasileira. Privilegiou-se a abordagem qualitativa de natureza descritiva, utilizando-se de revisão de literatura e análise de dados estatísticos disponíveis em sites oficiais. A presente discussão incide sobre os conceitos de corpo, espaço e território em face da interculturalidade no ensino superior indígena. Observou-se que a universidade por sua capilaridade absorve um quantitativo significativo de discentes indígenas, mas necessita trabalhar a interculturalidade.
Atendimento Psicológico em Tempos de Pandemia
Authors: Carvalho Isadora Marques , Mendes Elzilaine Domingues 
Published: January 2023

O impacto catastrófico que a pandemia de Covid-19 provocou em todo o cenário internacional, inaugurou com a necessidade de isolamento social para contenção do vírus, uma nova modalidade de atendimento: o online. Utilizando o arcabouço da teoria psicanalítica, o presente trabalho objetivou estudar o novo delinear do atendimento psicológico em tempos de pandemia. Aferindo-se posteriormente, dados atualizados sobre os casos de morte e infecção pelo novo coronavírus e, o investigar da sua relação com o sofrimento psíquico do sujeito no que concerne as transformações no social e a irrupção traumática do habitual. Apresentando-se também, o método psicanalítico e a abordagem qualitativa aqui empregados, a fim de, analisar e interpretar as entrevistas realizadas remotamente com três psicólogas formadas e seus respectivos discursos, por meio das chamadas associação livre e escuta flutuante, com as quais a investigação dos fenômenos efetua-se como singular e inconsciente ao sujeito e ao meio. Evidenciando ao final, pela discussão e resultados obtidos no decorrer do estudo, que as intervenções em sua maioria se deram de forma síncrona em plataformas de videochamadas e/ou por ligações de voz e, que houve significativo acentuamento de vulnerabilidades sociais, econômicas e culturais. Sendo os principais desafios apontados no exercício da prática clínica, as instabilidades de conexão virtual, o estabelecimento de vínculos e a garantia de sigilo entre analista e analisando. Enunciando continuamente, as possibilidades por ela acordadas, desde a questão financeira à uma maior flexibilidade e praticidade em termos de agendamentos e deslocamentos. Concluindo-se que, a temática abordada carece de mais produções e pesquisas na área, devido à grande mudança do setting terapêutico e, pelo aumento de sua procura.
Análise do vício alimentar, estresse e de Depressão em pacientes pré e pós cirurgia bariátrica atendidos no ambulatório de endocrinologia e psicologia do hulw
Authors: Dos Santos Lucas Serqueira Brito 
Published: January 2023

Objetivo: Analisar a presença de vício alimentar, depressão e estresse em pacientes em tratamento conservador e em pacientes bariátricos bem como correlacionar as vaiáveis. Métodos: Pacientes maiores de 18 anos acompanhados pelo serviço de endocrinologia e psicologia do HULW foram submetidos à avaliação antropométrica e aplicações dos questionários de vício alimentar, depressão e estresse, A análise dos dados foi feita com teste-T, correlação de Spearman e Qui-quadrado. Resultados: Houve uma presença majoritariamente feminina no estudo com mais 80% em cada grupo. Pacientes do grupo bariátrico apresentaram índices menores de depressão e estresse e uma tendência à significância em menor número de sintomas de vício alimentar. Na análise geral foram encontradas correlações de vício alimentar com IMC e estresse além de depressão com IMC e estresse. Foi encontrada correlação positiva entre depressão e estresse em ambos os grupos, positiva entre depressão e IMC no grupo bariátrico e uma correlação negativa entre IMC e estresse no grupo conservador. Em relação ao diagnóstico de depressão e vício alimentar, pacientes do grupo bariátrico apresentaram menor prevalência de depressão e uma tendência a menor prevalência de pacientes com vício alimentar no mesmo grupo. Conclusão: Os pacientes do grupo bariátrico apresentaram índices menores de acometimento de depressão e estresse. Análises com foco no vício alimentar devem ser conduzidas para maior esclarecimento da questão. Portanto, esses achados sugerem que a cirurgia bariátrica possui influência positiva sobre os indicadores de estresse e depressão.
Deteksi Dini dan Upaya Pengendalian Diabetes Milletus dan Hipertensi di Posbindu Ngudi Waras Jaten Karanganyar
Authors: Hastutik Hastutik 
Published: January 2023

Penyakit degenaratif dapat terjadi akibat adanya perubahan sel-sel tubuh yang dapat mempengaruhi fungsi organ secara keseluruhan. Kesadaran dari masyarakat untuk melakukan deteksi dini adanya penyakit degeneratif perlu ditingkatkan. Hipertensi dan diabetes milletus merupakan penyakit degeneratif yang perlu diwaspadai dan dilakukan deteksi sebagai upaya pencegahan. Upaya pencegahan ini dapat dilakukan sebelum maupun sesudah seseorang terdiagnosa suatu penyakit. Tujuan dari pengabdian masyarakat ini adalah melakukan pemeriksaan tekanan darah dan glukosa darah di Posbindu Ngudi Waras sebagai salah satu upaya deteksi dini penyakit degeneratif. Peserta yang mengikuti kegiatan ini ada 35 orang, dari hasil pemeriksaan ditemukan ada 16 orang menderita tekanan darah tinggi dan 2 orang yang mempunyai kadar glukosa darah diatas normal. Hasil pemeriksaan tekanan darah dan kadar gula dalam darah secara berkala adalah teknik yang bisa dilakukan untuk deteksi penyakit degeneratif.
Wujudkan Generasi Milenial Bebas Stunting dengan Deteksi dan Intervensi Dini Status Gizi Remaja
Authors: Wigunantiningsih Ana , Anggraini Yeni , Sari Reni Puspita 
Published: January 2023

Stunting adalah kondisi gagal tumbuh pada balita karena kekurangan gizi kronis pada 1000 Hari Pertama Kehidupan (HPK). Hal ini salah satunya disebabkan oleh kualitas kesehatan anak-anak dan remaja yang kurang mendapatkan asupan gizi seimbang juga remaja putri yang mengalami anemia karena kekurangan zat besi. Sekarang banyak makanan kekinian tinggi gula dan lemak, tapi rendah serat dan ini disukai anak-anak dan remaja, padahal makanan tersebut dapat menyebabkan obesitas dan meningkatkan risiko Penyakit Tidak Menular (PTM). Kualitas kesehatan remaja menjadi kunci dalam mencegah stunting. Stunting merupakan permasalahan yang tidak bisa diselesaikan dengan satu cara, melainkan harus diselesaikan dari segala tingkatan, terutama dengan meningkatkan kualitas remaja putri yang kelak akan melahirkan generasi selanjutnya. Pengabdian masyarakat ini bertujuan untuk meningkatkan pengetahuan remaja putri tentang pemenuhan gizi dan indicator penilaian status gizi dengan penghitungan IMT (Indeks Massa Tubuh). Metode yang digunakan dalam kegiatan ini berupa ceramah diikuti dengan tanya jawab dan diakhiri dengan evaluasi secara lisan serta melakukan pengkategorian status gizi remaja putri berdasarkan penghitungan IMT. Hasil kegiatan didapatkan Siswi dengan status gizi normal sebesar 67,6%, kurus 20,6%, gemuk 8,8% dan kurus 3%.
Kata Kunci: Remaja, Stunting, Status Gizi
Krisis dalam Konflik
Authors: Andrini Ghita Fadhila 
Published: January 2023

Abstract
Yemen is one of the most volatile countries in the Middle East. The civil war that is taking place in Yemen has worsened the country's internal conditions with many threats to human security. Various threats to human security have become increasingly apparent since Operation Decisive Storm in 2015. This study aims to discuss the humanitarian condition in Yemen in 2015-2021 using the human security concept. The method used is qualitative with literature study data collection. The data obtained were collected and analysed using Atlas.ti software. The results showed that Yemen experienced insecurity in the seven dimensions of human security (economic, food, health, environment, personal, community, and political), which are interrelated. Various factors cause insecurity in Yemen, including attacks by weapons of war, limited access, and climate change. However, these causes arise because of the continuation of the war. Therefore, the cessation of war is the main thing that needs to be done to prevent a continuing threat.
Keywords: civil war, human security, humanitarian crisis, Yemen

Abstrak
Yaman merupakan salah satu negara dengan instabilitas tinggi di Timur Tengah. Perang saudara yang berlangsung di Yaman telah memperburuk kondisi dalam negeri negara tersebut dengan banyaknya ancaman terhadap keamanan manusia. Berbagai bentuk ancaman terhadap keamanan manusia semakin jelas terlihat sejak Operasi Badai yang Menentukan (Operation Decisive Storm) pada tahun 2015. Penelitian ini bertujuan untuk membahas kondisi kemanusiaan di Yaman pada tahun 2015-2021 dengan menggunakan konsep keamanan manusia. Metode yang digunakan adalah kualitatif dengan pengumpulan data studi literatur. Data yang diperoleh dikumpulkan dan dianalisis menggunakan perangkat lunak Atlas.ti. Hasil penelitian menunjukkan bahwa Yaman mengalami ketidakamanan pada ketujuh dimensi keamanan manusia (ekonomi, pangan, kesehatan, lingkungan, personal, komunitas, politik) yang saling berkaitan satu sama lainnya. Terdapat berbagai macam faktor yang menyebabkan ketidakamanan di Yaman, di antaranya adalah serangan senjata perang, keterbatasan akses, serta perubahan iklim. Akan tetapi, berbagai penyebab tersebut sejatinya muncul karena adanya keberlangsungan perang. Oleh karena itu, berhentinya perang menjadi hal utama yang perlu dilakukan untuk mencegah ancaman yang berkelanjutan.
Kata kunci: keamanan manusia, krisis kemanusiaan, perang saudara, Yaman