bluuebunny/crossref_metadata_2025_split huggingface dataset:
The nodal positivity rate in breast pCR patients with initially, clinically node-negative breast cancer after neoadjuvant systemic therapy: A systematic review and meta-analysis
Authors: Ma Le , Chen Heyan , He Jianjun , Xie Peiling , Gao Pin , Li Yijun , Zhang Huimin , Fan Zhimin 
Published: March 2023

BackgroundThe axillary lymph node positive (ypN+) rate in patients with clinically node-negative (cN0) breast cancer who have achieved breast pathologic complete response (bpCR) after neoadjuvant systemic therapy (NST) is extremely low, and this population has the potential to be exempt from sentinel lymph node biopsy (SLNB). However, an overview of the ypN+ rate in this population for different breast cancer subtypes is lacking.ObjectiveTo provide the pooled ypN+ rate in cN0 patients who achieved bpCR after NST in different breast cancer subtypes defined by hormone receptor (HR) status and human epidermal growth factor receptor 2 (HER2) status.MethodsA systematic literature search was conducted in Embase and PubMed on July 20, 2022. Two authors independently selected studies that met the inclusion criteria and extracted all data. The pooled ypN+ rates for each subtype were calculated by a random-effects model using the Stata 16.0 metaprop command.ResultsThe pooled analysis of 9609 cN0 patients who achieved bpCR showed that the ypN+ rate was lowest for the HR+/HER2+ (0%) subtype, followed by HR+/HER2- (5.1%), HR-/HER2+ (0.6%), and HR-/HER2- (0.3%). Additionally, 6571 cT1-T2N0 patients who achieved bpCR had a pooled ypN+ rate of 0.6%, and the ypN+ rates for different subtypes were as follows: HR+/HER2+ (1.7%), HR+/HER2- (2.7%), HR-/HER2+ (0.1%), and HR-/HER2- (0.8%).ConclusionOur results suggested that cN0 patients who achieve bpCR may be exempt from axillary surgery in the HR+/HER2-, HR+/HER2+, and HR-/HER2- subtypes because of the extremely low probability of residual axillary lymph node disease. However, the safety of omitting axillary surgery needs to be further confirmed by prospective studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42022351739.
Hereditary pulmonary arterial hypertension burden in pediatrics: A single referral center experience
Authors: Ishizuka Maki , Zou Wenxin , Whalen Elise , Ely Erin , Coleman Ryan D. , Lopez-Terrada Dolores H. , Penny Daniel J. , Fan Yuxin , Varghese Nidhy P. 
Published: March 2023

IntroductionHereditary pulmonary arterial hypertension (HPAH) is a rare yet serious type of pulmonary arterial hypertension (PAH). The burden in the pediatric population remains high yet underreported. The objective of this study is to describe the distribution of mutations found on targeted PAH panel testing at a large pediatric referral center.MethodsChildren with PAH panel administered by the John Welsh Cardiovascular Diagnostic Laboratory at Texas Children's Hospital and Baylor College of Medicine in Houston, Texas between October 2012 to August 2021 were included into this study. Medical records were retrospectively reviewed for clinical correlation.ResultsSixty-six children with PAH underwent PAH genetic testing. Among those, 9 (14%) children were found to have pathogenic mutations, 16 (24%) children with variant of unknown significance and 41 (62%) children with polymorphism (classified as likely benign and benign). BMPR2 mutation was the most common pathogenic mutation, seen in 6 of the 9 children with detected mutations. Hemodynamic studies showed higher pulmonary vascular resistance among those with pathogenic mutations than those without (17.4 vs. 4.6 Wood units). All children with pathogenic mutations had severe PAH requiring triple therapy. There were tendencies for higher lung transplantation rate but lower mortality among those with pathogenic mutations.ConclusionsAbnormalities on genetic testing are not uncommon among children with PAH, although majority are of unclear significance. However, children with pathogenic mutations tended to present with more severe PAH requiring aggressive medical and surgical therapies. Genetic testing should be routinely considered due to consequences for treatment and prognostic implications. Larger scale population studies and registries are warranted to characterize the burden of HPAH in the pediatric population specifically.
Effects of rhubarb peony decoction combined with antibiotics in treating pediatric periappendiceal abscess
Authors: Lin Zhixiong , Zeng Huiping , Cai Shujie , Chen Fei , Wang Xiang , Wu Dianming , Liu Mingkun , Fang Yifan 
Published: March 2023

Background/purposeRhubarb peony decoction (RPD) is a formula of traditional Chinese medicine that has been widely used to treat intra-abdominal inflammatory diseases. To investigate the therapeutic efficacy of RPD in pediatric periappendiceal abscess, patients who received intravenous antibiotics alone were compared with those treated with intravenous antibiotics combined with RPD.MethodsA retrospective review of children with periappendiceal abscess who received conservative treatment in our hospital between January 2013 and April 2022 was performed. The patients were divided into an intravenous antibiotic group (the control group) and an intravenous antibiotic combined with RPD group (the intervention group). Interval appendectomy (IA) was generally performed 10–12 weeks after conservative treatment. The primary outcome was the cure rate of conservative treatment, while the secondary outcomes included the recurrence rate, days of total intravenous antibiotic use, length of hospital stay (LOS), postoperative complications, and liver injury caused by RPD.ResultsA total of 142 patients (77 girls and 65 boys) were included, 52 in the control group and 90 in the intervention group. The two groups were similar in demographic data and clinical characteristics (P &gt; 0.05). The mean total course of RPD in the intervention group was 11.82 days. The intervention group had a significantly higher cure rate than the control group (93.33% vs. 80.77%, P = 0.029), and the length of total intravenous antibiotic use (P = 0.150), LOS (P = 0.077), recurrence rate (9.52% vs. 4.76%, P = 0.439), as well as the operation time (P = 0.101), LOS (P = 0.572), and postoperative complications (P = 0.549) were not significantly different between the two groups when the patients received IA. No patient had a liver injury caused by RPD during the treatment.ConclusionIntravenous antibiotics combined with RPD demonstrated high effectiveness and safety for treating pediatric periappendiceal abscess.
Population pharmacokinetic analysis and dosing optimization of polymyxin B in critically ill patients
Authors: Liang Danhong , Liang Zhi , Deng Guoliang , Cen Anfen , Luo Dandan , Zhang Chen , Ni Suiqin 
Published: March 2023

Objectives: Since the global broadcast of multidrug-resistant gram-negative bacteria is accelerating, the use of Polymyxin B is sharply increasing, especially in critically ill patients. Unsatisfactory therapeutic effects were obtained because of the abnormal physiological function in critically ill patients. Therefore, the determination of optimal polymyxin B dosage becomes highly urgent. This study aimed to illustrate the polymyxin B pharmacokinetic characteristics by defining the influencing factors and optimizing the dosing regimens to achieve clinical effectiveness.Methods: Steady-state concentrations of polymyxin B from twenty-two critically ill patients were detected by a verified liquid chromatography-tandem mass spectrometry approach. The information on age, weight, serum creatinine, albumin levels, and Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score was also collected. The population PK parameters were calculated by the non-parametric adaptive grid method in Pmetrics software, and the pharmacokinetic/pharmacodynamics target attainment rate was determined by the Monte Carlo simulation method.Results: The central clearance and apparent volume of distribution for polymyxin B were lower in critically ill patients (1.24 ± 0.38 L h-1 and 16.64 ± 12.74 L, respectively). Moreover, albumin (ALB) levels can be used to explain the variability in clearance, and age can be used to describe the variability in the apparent volume of distribution. For maintaining clinical effectiveness and lowering toxicity, 75 mg q12 h is the recommended dosing regimen for most patients suffering from severe infections.Conclusion: This study has clearly defined that in critically ill patients, age and ALB levels are potentially important factors for the PK parameters of polymyxin B. Since older critically ill patients tend to have lower ALB levels, so higher dosages of polymyxin B are necessary for efficacy.
Suicidality and epilepsy: A systematic review and meta-analysis
Authors: Wang Haijiao , Zhang Yu , Tan Ge , Chen Deng , Fu Yaoqi , Liu Ling 
Published: March 2023

BackgroundWe aimed to evaluate the association between epilepsy and suicidality, including suicidal ideation, attempts and completed suicide.MethodsWe systematically searched PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov from 1946 to June 21, 2021 and assessed the quality of the studies using the Newcastle–Ottawa Scale. We calculated the pooled OR and the crude rate for suicidal ideation, suicide attempts and completed suicide in patients with epilepsy (PWE).ResultsWe screened 2,786 studies and included 88 articles with 1,178,401 PWE and 6,900,657 participants as controls. Search terms included epilepsy and suicide. The pooled rates of suicidal ideation, suicide attempts and completed suicide in PWE were 19.73% (95% CI: 17.00–22.62%), 5.96% (95% CI: 4.82–7.20%), and 0.24% (95% CI: 0.11–0.42%), respectively. Compared to the control group, PWE were at a significantly higher risk of total suicidality (pooled OR, 2.60; 95%: 2.13–3.18), including suicidal ideation (pooled OR, 2.70; 95% CI, 2.21–3.30), suicide attempts (pooled OR, 2.74; 95% CI, 2.08–3.61) and completed suicide (pooled OR, 2.36; 95% CI, 1.45–3.83). Subgroup analyses showed significant differences in the subgroups of the measurement of suicidality.ConclusionThe rate of suicidal ideation, suicide attempts and completed suicide in PWE were about 19.73, 5.96, and 0.24%. And there was an increased risk of suicidality in PWE especially temporal lobe epilepsy and drug-resistant epilepsy. Clinicians need to be aware of this risk in PWE with early identification and prevention at the time of diagnosis.Protocol Registration: PROSPERO CRD42021278220.
Association between mental health symptoms and behavioral performance in younger vs. older online workers
Authors: Mills-Finnerty Colleen , Staggs Halee , Hogoboom Nichole , Naparstek Sharon , Harvey Tiffany , Beaudreau Sherry A. , O’Hara Ruth 
Published: March 2023

BackgroundThe COVID-19 pandemic has been associated with increased rates of mental health problems, particularly in younger people.ObjectiveWe quantified mental health of online workers before and during the COVID-19 pandemic, and cognition during the early stages of the pandemic in 2020. A pre-registered data analysis plan was completed, testing the following three hypotheses: reward-related behaviors will remain intact as age increases; cognitive performance will decline with age; mood symptoms will worsen during the pandemic compared to before. We also conducted exploratory analyses including Bayesian computational modeling of latent cognitive parameters.MethodsSelf-report depression (Patient Health Questionnaire 8) and anxiety (General Anxiety Disorder 7) prevalence were compared from two samples of Amazon Mechanical Turk (MTurk) workers ages 18–76: pre-COVID 2018 (N = 799) and peri-COVID 2020 (N = 233). The peri-COVID sample also completed a browser-based neurocognitive test battery.ResultsWe found support for two out of three pre-registered hypotheses. Notably our hypothesis that mental health symptoms would increase in the peri-COVID sample compared to pre-COVID sample was not supported: both groups reported high mental health burden, especially younger online workers. Higher mental health symptoms were associated with negative impacts on cognitive performance (speed/accuracy tradeoffs) in the peri-COVID sample. We found support for two hypotheses: reaction time slows down with age in two of three attention tasks tested, whereas reward function and accuracy appear to be preserved with age.ConclusionThis study identified high mental health burden, particularly in younger online workers, and associated negative impacts on cognitive function.
Use of tobacco, nicotine and cannabis products among students in Switzerland
Authors: Affolter Jana , Rohland Eveline , Philippe Marc , Tal Kali , Auer Reto , Jakob Julian 
Published: March 2023

IntroductionMost people who smoke cigarettes begin in their teens and teens may also be attracted to new tobacco, nicotine, and cannabis products. We describe use prevalence among upper-secondary school students in Switzerland, including daily use, of tobacco, nicotine, and cannabis products.MethodsWe invited secondary school students (age 15 to 21) in two Swiss cantons to take an online survey between October 2021 and February 2022. The survey collected demographic information and asked how frequently they used tobacco products (cigarettes in commercial packages, self-rolled cigarettes, hookahs, pipes, cigars and cigarillos, tobacco heating systems, snus, snuff), non-tobacco nicotine products (nicotine pouches, e-cigarettes with and without nicotine), and cannabis products (smoking with and without tobacco, cannabis vaping). Answers were scored on a Likert scale (no use in past month, less than weekly, weekly but not daily, daily use, prefer not to say), then tabulated and reported as descriptive statistics.ResultsOf 32,614 students in the schools we contacted, 9,515 (29.2%) completed the survey; 49.5% identified as female and 48.4% as male; 9.5% were under 16, 47% were 16–17, 27.5% were 18–19, and 16% were over 19. Reported daily use was most frequent for tobacco cigarettes in commercial packages (14.2%), snus (4.1%) and cannabis smoking with tobacco (3.6%). Most participants (54.8%) reported they had used at least one product at least once within the last month.ConclusionStudents who used a product were most likely to smoke cigarettes, but many regularly used new tobacco, nicotine and cannabis products, though use frequency varies.
Rapid evidence review: Policy actions for the integration of public health and health care in the United States
Authors: Lin Jennifer S. , Webber Elizabeth M. , Bean Sarah I. , Martin Allea M. , Davies Melinda C. 
Published: March 2023

ObjectiveTo identify policy actions that may improve the interface of public health and health care in the United States.MethodsA rapid review of publicly-available documents informing the integration of public health and health care, and case examples reporting objective measures of success, with abstraction of policy actions, related considerations, and outcomes.ResultsAcross 109 documents, there were a number of recurrent themes related to policy actions and considerations to facilitate integration during peace time and during public health emergencies. The themes could be grouped into the need for adequate and dedicated funding; mandates and shared governance for integration; joint leadership that has the authority/ability to mobilize shared assets; adequately staffed and skilled workforces in both sectors with mutual awareness of shared functions; shared health information systems with modernized data and IT capabilities for both data collection and dissemination of information; engagement with multiple stakeholders in the community to be maximally inclusive; and robust communication strategies and training across partners and with the public.ConclusionWhile the evidence does not support a hierarchy of policies on strengthening the interface of public health and health care, recurrent policy themes can inform where to focus efforts.
Correlation analysis of anthropometric indices and type 2 diabetes mellitus in residents aged 60 years and older
Authors: Feng Xiaoyan , Wang Junyi , Wang Shupei , Wang Zhihao , Wu Shan , Wei Yuan , Li Lvrong , Shen Tianran , Chen Qingsong 
Published: March 2023

Background and purposeIn recent years, the incidence of obesity in people aged 60 and over has increased significantly, and abdominal obesity has been recognized as an independent risk factor for diabetes. Aging causes physiologic decline in multiple body systems, leading to changes in obesity indicators such as BMI. At present, the relationship between abdominal obesity markers and Diabetes mellitus (DM) in people aged 60 years and older remains unclear. Therefore, it is necessary to study the correlation between anthropometric indices and diabetes and explore potential predictors.MethodsThe basic demographic information of participants aged 60 and above in Zhongshan City in 2020 was collected. Physical parameters, blood glucose and other biochemical indices were measured comprehensively. Binary logistic regression analysis was used to explore the relationship between abdominal obesity indicators [Waist circumference, Neck Circumference, Waist-to-hip ratio, Chinese Visceral Obesity Index (CVAI), and visceral obesity index] and diabetes mellitus. ROC characteristic curve was used to analyze the predictive ability of abdominal obesity indicators to DM, and the non-restrictive cubic spline graph was used to visualize the screened obesity indicators and diabetes risk.ResultsAmong 9,519 participants, the prevalence of diabetes was 15.5%. Compared with low CVAI, High CVAI level was significantly associated with increased prevalence of DM in males and females (all p &lt; 0.05), in males (OR, 2.226; 95%CI: 1.128–4.395), females (OR, 1.645; 95%CI: 1.013–2.669). After adjusting for potential confounding factors, there were gender differences between neck circumference and the prevalence of DM, and above-normal neck circumference in males was significantly associated with increased prevalence of DM (OR, 1.381; 95% CI: 1.091–1.747) (p &lt; 0.05).ConclusionAmong these anthropometric indices, CVAI is consistent with the features of fat distribution in older individuals and shows superior discriminative power as a potential predictor of DM, compared to traditional anthropometric parameters.
Jaringan Saraf Tiruan Menggunakan Metode Backpropagation untuk Prediksi Curah Hujan
Authors: Tamaji Tamaji , Utama Yoga Alif Kurnia , Sidharta Josie 
Published: March 2023

Hujan yakni sangat sulit untuk di prediksi. Banyak faktor yang dapat mempengaruhi di mulainya hujan mulai dari suhu, kelembapan, curah hujan dan intensitas sinar matahari. Apalagi ditambah dengan distorsi cuaca contohnya el nino & la nina bahwa menyebabkan periode hujan yang bertambah lama daripada biasanya. Padahal curah hujan yang sangat tinggi, menyebabkan bencana seperti banjir dan lain lainnya. Di karenakan hal tersebut sangat penting sekali dalam memprediksi hujan yang akan terjadi di suatu tempat sehingga diharapkan dapat sebagai antisipasi terhadap bencana banjir yang akan terjadi. Penelitian ini menggunakan JST (jaringan saraf tiruan) menggunakan metode pendekatan backpropagation dalam prakiraan curah hujan. Data input yang digunakan untuk melatih jaringan syaraf tiruan ini adalan data dari BKMG tentang curah hujan periode tiap bulan selama 2015-2019. Berdasarkan hasil data uji yang telah dilakukan, MSE pada keluaran jaringan syaraf tiruan sebesar 0.089161. Dari output ini bisa diambil garis lurus bahwa jaringan saraf tiruan menggunakan pendekatan metode backpropagation bisa digunakan untuk memprediksi curah hujan yang akan mendatang.
Kata kunci : Backpropagation, Curah Hujan, Prediksi, Jaringan Syaraf Tiruan.
Lugar, observação participante, turismo e trabalhadoras do sexo em Havana: uma proposta metodológica de investigação
Authors: Da Gama Hélio Fernando Lôbo Nogueira 
Published: March 2023

O objetivo é a metodologia da pesquisa sobre um impacto social do turismo no lugar havanero, as trabalhadoras do sexo, criminalizadas como prostitutas/jineteras. A epistemologia da fenomenologia de Husserl e dialética de Kosik enseja uma observação participante como metodologia de inserção no tecido social como “turista”/pesquisador, em busca dos sentidos que se estabelecem nas abordagens “não-autorizadas” dos autóctones e da relação entre essência/totalidade do fenômeno. A hipótese: tal percurso na investigação sociológica do fenômeno social turismo é legitimo enquanto escolha teórico-metodológicas. Potencializa o seu desenvolvimento contínuo como estratégia de aproximação e inquirição em quaisquer contextos geopolíticos e socioeconômicos. É essencial a relação do conceito de lugar com o da observação participante como método e técnica de pesquisa condizentes. Numa perspectiva histórica e teórica traço a conjuntura na qual Cuba se abriu como destino turístico internacional. Dados etnográficos colhidos com inspiração fenomenológica, especialmente sobre o sentido dos atores sociais que me concederam entrevistas em profundidade, são relatados a partir de suas narrativas. Como o método dialético continua quando o fenomenológico termina, as contextualizei histórica e geopoliticamente em busca de inferir generalizações. Faço a inserção de dados da atual conjuntura, buscando reforçar a necessidade do desenvolvimento da metodologia empreendida em Sociologia do Turismo.
Фізична підготовленість юних спортсменів у джиу-джитсу на початковому етапі спортивної спеціалізації (динаміка і вплив на спортивний результат)
Authors: Kravchk T.M. , Ogar G.O. , Dvorjanskiy A.A. 
Published: March 2023

Мета - дослідити динаміку розвитку рухових здібностей юних спортсменів й визначити вплив фізичної підготовленості на спортивний результат на початковому етапі спортивної спеціалізації у джиу-джитсу. Учасники дослідження. В дослідженні взяли участь 16 юних спортсменів, вік 10-11 років, стаж занять боротьбою 6-10 місяців. Всі досліджувані займались у одній групі тричі на тиждень по дві академічні години. Методи дослідження: аналіз науково-методичних джерел, педагогічні спостереження, педагогічне тестування, методи математичної статистики. Результати. У результаті дослідження було доведено позитивний вплив занять бразильським джиу-джитсу на гармонійний розвиток рухових здібностей хлопчиків середнього шкільного віку. Через специфіку змагальної діяльності й особливості навчально-тренувального процесу в джиу-джитсу найбільш виражена позитивна динаміка спостерігається при дослідженні динаміки розвитку спритності, гнучкості й силових здібностей м’язів верхнього плечового поясу і рук. Порівняння фізичної підготовленості груп «лідерів» і «аутсайдерів» показали, що на початковому етапі в джиу-джитсу суттєве значення має рівень розвитку базової фізичної підготовленості. Саме представники групи «лідерів», які були більш успішними у змаганнях, виявилися краще фізично підготовленими, за усіма досліджуваними показниками. Висновки. Заняття джиу-джитсу сприяють гармонійному розвитку рухових здібностей дітей середнього шкільного віку. Рівень розвитку рухових здібностей юних спортсменів в джиу-джитсу на початковому етапі спортивної спеціалізації суттєво впливає на спортивний результат. Найбільш значущими, за впливом на спортивні досягнення в джиу-джитсу, є гнучкість, спритність і силові здібності м’язів рук і верхнього плечового поясу.