bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the effectiveness and safety of UAS in the treatment of upper urinary tract stones with flexible ureteroscopy lithotripsy: a meta-analysis and systematic review
Authors: Guo Wei , Li Zeyan , Yan Keqiang , Fang Zhiqing , Fan Yidong 
Published: June 2023

Abstract
Objective To investigate the effectiveness and safety of ureteral access sheaths (UAS) in flexible ureteroscopic lithotripsy of upper urinary tract stones through a comprehensive systematic review and meta-analysis.Methods We conducted a meta-analysis and systematic review of the UAS in flexible ureteroscopy lithotripsy on April 12, 2023 (PROSPERO ID : CRD42022368459). The main outcomes of the meta-analysis included stone-free rate (SFR), intra and post-operation complications, hospitalization duration, and operation time.Results Twenty-one studies with 11335 patients satisfied the inclusion criteria. The results showed that compared with the UAS group, the non-UAS group had a higher stone-free rate(SFR) (OR = 0.76, 95%CI 0.60–0.95, P = 0.01) and shorter operation time(MD = 11.21, 95% CI 5.66–16.76, P < 0.00001), but no significant difference in postoperative complications(OR = 1.20, 95% CI 0.79–1.82, P = 0.38), intraoperative complications(OR = 1.20, 95%CI 0.85–1.70, P = 0.57), and hospitalization duration (MD = -0.03, 95%CI -0.30-0.24, P = 0.84).Conclusion Our findings indicate that UAS usage results in unfavorable surgical outcomes with no benefit in preventing surgical complications. Therefore, we recommend re-evaluating the usage of UAS as a surgical aid in patients with large stones.
Adjustment Characteristics in COVID-19 Crisis: A Case of Thai Undergraduate Students
Authors: Phimsri Chanita , Srisawa Niwat 
Published: June 2023

Abstract
Background
The outbreak of the COVID-19 crisis has forced humans to adapt to changes in many areas. Thus, adjustment characteristics in the COVID-19 crisis differ from adjustment characteristics in normal situations. This study aimed to study the adjustment characteristics in the COVID-19 crisis of undergraduate students and to develop adjustment characteristics the in COVID-19 crisis of undergraduate student scale.
Methods
Mixed-method research was used. In qualitative research, researchers reviewed literature about the impacts of the COVID-19 crisis and the characteristics of well adjustment to develop definitions of adjustment characteristics in the COVID-19 crisis of undergraduate students. Next, the definitions were considered appropriate by psychological professionals. In quantitative research, the definitions of adjustment characteristics in COVID-19 crisis of undergraduate students were used to develop items for the questionnaire. They analyzed the component of adjustment characteristics by confirmatory factor analysis. Then, developed adjustment characteristics in the COVID-19 crisis of undergraduate student scale, and analyzed test quality by Item Response Theory.
Results
A qualitative study shows that there were four main impacts of the COVID-19 crisis included academic impact, emotional impact, social impact, and technological impact. According to the impacts of the COVID-19, adjustment characteristics in the COVID-19 crisis of undergraduate students consist of four dimensions: academic adjustment, emotional adjustment, social adjustment, and technological adjustment. Psychological professionals agreed. In quantitative studies, A confirmatory factor analysis of the factor structure indicated that the model fit and adjustment characteristics in the COVID-19 crisis of undergraduate student scale include four subscales, and 35 quality items.
Conclusions
Adjustment characteristics in the COVID-19 crisis of undergraduate students consist of four components: academic adjustment, emotional adjustment, social adjustment, and technological adjustment.
Association between health literacy and satisfaction with health care among parents of long-term ill children: a cross-sectional study
Authors: Selezneva Ekaterina , Hallström Inger Kristensson , Vilhjalmsson Runar 
Published: June 2023

Abstract
Background: Inadequate health literacy has been shown to impact patient satisfaction with health care, a frequently used measure of health care quality. Low parental satisfaction with paediatric care can lead to lower compliance with prescribed medication and treatment and thus worsen the child's health outcomes. This study explored the relationship between the health literacy of parents of long-term ill children and parents’ satisfaction with the health care, and whether this relationship varied by the introduction of an eHealth device.
Methods: This cross-sectional study was based on the data collected in a larger clinical study from questionnaires filled out by 77 parents of chronically ill children admitted to neonatal and specialized surgery departments in southern Sweden between August 2019 and June 2020.
Statistical analysis was performed using Mann Whitney and Kruskal-Wallis nonparametric tests, Spearman's rank correlation and multivariate logistic regression.
Results: A substantial and statistically significant correlation was observed between parental health literacy and almost all dimensions of parental satisfaction, with the highest correlation between health literacy and satisfaction with information (r=0.476, p<0.001). Health literacy was a significant independent predictor of high satisfaction with information and technical skills, and high overall satisfaction. An eHealth communication device moderated the relationship between health literacy and satisfaction with communication.
Conclusion: The study indicates that health literacy is among important predictors of parents’ satisfaction with health care. Health services should be sensitive to variations in parental health literacy and should tailor information and communication to parental needs to secure the best health outcomes for chronically sick children. Further studies are needed to evaluate the clinical benefits of assessing parental health literacy for child health outcomes.
Trial registration: ClinicalTrials.gov identifier: NCT04150120.
Patients' perceptions and performance of informing relatives: A qualitative study within a trial on healthcare-assisted risk disclosure (DIRECT)
Authors: von Salomé Jenny , Nääs Charlotta , Rosén Anna 
Published: June 2023

Abstract
Current clinical practice encourages patients with hereditary cancer to inform their at-risk relatives (ARR). A Swedish multicentre randomised controlled trial - DIRECT- evaluates whether direct letters from healthcare to ARR (intervention) affects the proportion being reached compared with patient-mediated disclosure only (control). We conducted 17 semi-structured interviews on how DIRECT participants perceived and performed risk communication with ARR. Using reflexive thematic analysis, we found that participation in DIRECT played a minor role in the patients’ experience of genetic counselling and risk disclosure. No integrity-related issues were reported by patients offered disclosure support, and most accepted letters to all ARR. Risk communication was perceived as important and both groups disclosed to all close relatives themselves. However, patients’ views on their duty to inform distant relatives was unpredictable, and a variety of approaches were used, including contacting all ARR, engaging the family, vaguely relying on others to inform, and not disclosing at all. Most patients limited their responsibility to the disclosure, although others wanted relatives to get tested or provided them with continuous information before ending their mission. We also identified some confusion about implication of test results, who needed information, and who was responsible for informing ARR. These misunderstandings possibly affected the risk communication. This study gives insight how direct letters interacts with family-mediated risk disclosure. The healthcare-assisted offer could be an option to convey information to more distant relatives, but the effectiveness of such intervention needs evaluation. Results from DIRECT will be available in 2025.
Improvements in orthostatic tolerance with physical training are augmented with heat acclimation; a randomised controlled trial
Authors: Parsons Iain , Snape Daniel , Stacey Michael J , Barlow Matthew , O’Hara John , Gall Nick , Chowienczyk Phil , Wainwright Barney , Woods David R 
Published: June 2023

Abstract
Introduction
Heat adaptation is protective against heat illness however its role in heat syncope, due to reflex mechanisms, has not been conclusively established. The aim of this study was to evaluate if heat acclimation (HA) was protective against heat syncope and to ascertain underlying physiological mechanisms.
Method
20 (15 males, 5 females) endurance trained cyclists were randomised to either 8 days of mixed active and passive HA (HEAT) or temperate exercise (CONTROL). Prior to, and following, the interventions participants underwent a head up tilt (HUT) with graded lower body negative pressure (LBNP) continued until presyncope with measurement of cardiovascular parameters. Heat stress testing was performed to determine physiological and perceptual measures of HA.
Results
There was a significant increase in orthostatic tolerance (OT), as measured by HUT/LBNP, in the HEAT group (pre-intervention; 28 ± 9 mins, post-intervention; 40 ± 7 mins) compared to CONTROL (pre-intervention; 30 ± 8 mins, post-intervention; 33 ± 5 mins) (p = 0.0116). Heat acclimation resulted in a significantly reduced peak and mean rectal and skin temperature (p < 0.0141), peak heat rate (p < 0.0033), thermal comfort (p < 0.0411) and rating of perceived exertion (p < 0.0251). There was a significantly increased plasma volume (PV) in the HEAT group in comparison to CONTROL (p = 0.0293).
Discussion
Heat adaptation causes improvements in OT and is likely to be beneficial in patients with heat exacerbated reflex syncope. Heat acclimation mediated PV expansion is the likely predominant physiological mechanism underlying improved OT.
Relationship between occupational and physical activity with varicocele
Authors: Ghorbani Hamidreza , Ghorbani Mohammad , Rahmanipour Elham , Rafeemanesh Ehsan , Ghodsi Alireza , Jarahi Lida , Sangani Ehsan Jalali , Mirzaei Mohammad , Sadrian Seyed Hassan , Mehri Ali , Amiri Masoumeh 
Published: June 2023

Abstract
Background Varicocele is the most common correctable cause of infertility in males.
Objectives: This study is designed to evaluate the correlation between occupational and physical activities with 6 incidence and severity of varicocele.
Methods: This cross-sectional study was performed on patients with varicocele in a tertiary referral center in Iran. The International Physical Activity Score Questionnaire (IPAQ) was utilized to evaluate physical activity. Furthermore, the occupational status was assessed using 10 a standard checklist created by an occupational medicine specialist.
Results: 169 patients with a mean age of 29.1 ± 7.3 years were enrolled. Grade 1 varicocele was found in 49.7% of the patients, followed by grade 2 (47.9%), and grade 3 (2.4%). There was no association between varicocele grade and fertility status, diabetes, hypertension, and smoking. 14 There was a significant difference in patients' varicocele grade between low, moderate, and high15 intensity occupations, indicating that the majority of patients with low and moderate-intensity occupations had grade 1 varicocele, whereas most of the patients with high-intensity occupations had grade 2 varicocele. There was a negative correlation between varicocele grade and exercise. 18 On the other hand, there were positive correlations between varicocele grade and squatting, pulling 19 objects, and climbing stairs.
Conclusion: The intensity of occupational activity was associated with the severity of varicocele, and patients with high-intensity occupations had higher grades of varicocele. Physical activities such as squatting, pulling objects, and climbing stairs increase the grade of varicocele, while exercise reduces the grade of varicocele.
Study on the relationship between permeability coefficient and porosity, the confining and osmotic pressure of attapulgite-modified loess
Authors: Zhang Zhengrui , Pishro Ahad Amini , Zhang Lili , Ma Xuejiao , Matlan Siti Jahara , Taha Nazaruddin Abdul , Pishro Mojdeh Amini 
Published: June 2023

Abstract
This study investigated attapulgite-modified loess as an efficient and cost-effective method for creating an impermeable liner for landfills in regions with scarce clay resources. Laboratory permeability tests were conducted using a flexible wall permeameter to determine the permeability of compacted loess and attapulgite mixtures under varying osmotic conditions. The relationship between the permeability coefficient, attapulgite dosage, radial pressure, and osmotic pressure was analyzed. Nuclear magnetic resonance and scanning electron microscopy were also used to observe the microstructure of the modified loess. The results showed that attapulgite dosage significantly reduced the permeability coefficient, but the effect became limited when the content surpassed 10%. The decrease of the permeability coefficient of the modified loess is mainly due to the filling of pores between the loess by attapulgite, which makes the pore size and throat size of the modified loess smaller. The modified loess displayed a sheet structure that contributed to an increased permeability coefficient due to increased radial pressure. This study provides valuable insights into using attapulgite-modified loess as a material for landfill lining in regions with scarce clay resources.
The Lymphovascular Invasion and Neutrophil-to-lymphocyte Ratio Increase the Prognostic Value of the Basal Model in UTUC Patients after Radical Nephroureterectomy
Authors: Ye Jianjun , Wang Qihao , Chen Zeyu , Wang Xingyuan , Zhang Chichen , Han Ping , Wei Qiang , Bao Yige 
Published: June 2023

Abstract

Objective To determine the prognostic value of lymphovascular invasion (LVI), neutrophil-to-lymphocyte ratio (NLR) and their combination for predicting oncological outcomes in upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU). Materials and methods Data from 581 UTUC patients who underwent RNU at our institution from May 2003 to June 2019 were retrospectively analyzed. The predictive value on the endpoints of interest, including overall survival (OS), cancer-specific survival (CSS) and metastasis-free survival (MFS), was assessed by Kaplan‒Meier curves and the Cox proportional hazard model. The receiver operating characteristic (ROC) curve was computed to evaluate the predictive ability. Results Patients in the LVI-positive group or NLR-high group had a significantly worse OS, CSS and MFS than those in the LVI-negative group or NLR-low group. LVI-positive and NLR-high coexistence was an independent risk factor for OS, CSS and MFS in multivariate analyses (HR 2.28, 95% CI 1.52–3.44; HR 2.56, 95% CI 1.63–4.01; HR 1.83, 95% CI 1.09–3.06, respectively). Furthermore, adding LVI and NLR to the basal model, consisting of tumor stage, grade and lymph node metastasis, improved the ability to predict the survival outcomes of UTUC patients in ROC analysis. Conclusion LVI, NLR and their combination were all independent risk factors for OS, CSS and MFS in UTUC patients after RNU. Adding LVI and NLR into the basal model enhanced the prognostic prediction ability throughout the follow-up period. It might be a feasible and promising tool for risk stratification and individualized treatment.
Comparison of four value sets derived using different TTO and DCE approaches: Application to the new region-specific PBM, AP-7D
Authors: Shiroiwa Takeru , Murata Tatsunori , Morii Yasuhiro , Hoshino Eri , Fukuda Takashi 
Published: June 2023

Abstract
Background
AP-7D is a newly developed preference-based measure (PBM) in East and Southeast Asia. However, no value set has been established yet. Comparison of the characteristics of value sets obtained by different methods is necessary to consider the most appropriate methodology for valuation survey of AP-7D.
Method
We surveyed the general population’s preference of AP-7D health states by four valuation methods (a) composite time trade-off (cTTO); (b) simple discrete choice experiment (DCE); (c) DCE with duration; and (d) ternary DCE. In Japan, we collected approximately 1,000 samples for cTTO tasks through a face-to-face survey and 2,500 samples for each of the three DCE tasks. Respondents were selected through quota sampling based on the sex and age. The cTTO data were analyzed using a linear mixed and tobit model; the DCE data were analyzed using a simple and panel conditional logit model. Where the results of the analysis showed inconsistencies, a constrained model was used.
Results
Since all the unconstrained models, except simple DCE, showed one or more inconsistencies, the constrained model was used for the analyses. The minimum values for the models were as follows: TTO model, -0.101; simple DCE model, -0.106; DCE with duration model, -0.706; ternary DCE model, -0.306. The score for the DCE with the duration model was much lower than that for the other models. Although the value sets for AP-7D differed among the four valuation methods, the ternary DCE model showed intermediate characteristics between those of the cTTO and DCE with duration models. As compared with to EQ-5D-5L, the distributions of all the scores on the Japanese AP-7D moved to the left. Although “Energy” was one of the domains with the least influence on the AP-7D score in all four models, “Burden to others” had the largest impact on the preferences.
Conclusion
We constructed four value sets using different TTO and DCE methods. Our findings are expected not only to contribute to the development of AP-7D, but also other preference-based measures.
A Dietary Pattern of Frequent Plant-based Foods Intake Reduced the Associated Risks for Atopic Dermatitis Exacerbation: Insights from The Singapore/Malaysia Cross-sectional Genetics Epidemiology Cohort
Authors: LIM Jun Jie , REGINALD Kavita , SAY Yee-How , LIU Mei Hui , CHEW Fook Tim 
Published: June 2023

Abstract
Background
The prevalence of atopic dermatitis (AD) has been increasing in recent years, especially in Asia. There is growing evidence to suggest the importance of dietary patterns in the development and management of AD. Here, we seek to understand how certain dietary patterns in a Singapore/Malaysia population are associated with various risks of AD development and exacerbation.
Methods
A standardized questionnaire following the International Study of Asthma and Allergies in Childhood (ISAAC) guidelines was investigator-administered to a clinically and epidemiology well-defined allergic cohort of 13,561 young Chinese adults aged 19–22. Information on their sociodemographic, lifestyle, dietary habits, and personal and family medical atopic histories were obtained. Allergic sensitization was assessed by a skin prick test to mite allergens. Spearman’s rank-order correlation was used to assess the correlation between the intake frequencies of 16 food types. Dietary patterns were identified using principal component analysis. Four corresponding dietary scores were derived to examine the association of identified dietary patterns with atopy and AD exacerbations through a multivariable logistic regression that controlled for age, gender, parental eczema, BMI, and lifestyle factors.
Results
The correlation is the strongest between the intake of butter and margarine (R = 0.65). We identified four dietary patterns, “high-calorie foods”, “plant-based foods”, “meat and rice”, and “probiotics, milk and eggs”, and accounted for 47.4% of the variance. Among these patterns, moderate-to-high intake of “plant-based foods” conferred a protective association for chronic (Adjusted odds ratio (AOR): 0.706; 95% confidence interval (CI): 0.589–0.847; p < 0.001) and moderate-to-severe AD (AOR: 0.756; 95% CI: 0.638–0.897; p < 0.01). “Meat and rice” and “probiotics, milk and eggs” were not significantly associated with AD exacerbation. While frequent adherence to “high-calorie foods” increased the associated risks for ever AD and moderate-to-severe AD, having a higher adherence to “plant-based foods” diminished the overall associated risks.
Conclusions
Frequent adherence to “plant-based foods” was associated with reduced risks for AD exacerbation in young Chinese adults from Singapore/Malaysia. This provides the initial evidence to support the association between dietary factors and AD. Further research is needed to better understand the pathomechanisms underlying diet and AD exacerbations.
Modified early intensive and treat-and-extend regimen of anti-vascular endothelial growth factor for diabetic macular edema in Taiwan
Authors: Chou Jui-Feng , Wu Jian-Sheng , Chen Yi-Ling , Chen San-Ni 
Published: June 2023

Abstract
Given the rising prevalence of patients with diabetes and increasing treatment burden for patients with vision-threatening diabetic macular edema (DME), we aimed to explore the efficacy of modified early intensive and treat-and-extend regimen of anti-vascular endothelial growth factor (VEGF) therapy under the Taiwan National Insurance Bureau reimbursement policy. We obtained data on 69 eyes treated with initial 4-monthly intravitreal injections of aflibercept or ranibizumab, plus individualized treat-and-extend regimen. At 12 months, the mean (SD) change in LogMAR best corrected visual acuity from baseline was − 0.28 (0.31) in all eyes, while that in the aflibercept and ranibizumab groups were − 0.30 (0.34) and − 0.25 (0.28), respectively. Central retinal thickness decreased by 137.2 (122.4) in all eyes, 138.1 (134.2) in the aflibercept group, and 136.2 (110.9) in the ranibizumab group. Additionally, the aflibercept group had a lower mean number of injections than the ranibizumab group (8.5 vs. 8.7). The last extended dosing interval of > 12 weeks was 31.0% and 16.7% of the eyes in the aflibercept and ranibizumab groups, respectively. The modified anti-VEGF regimens effectively managed DME in terms of functional and anatomical outcomes, and efficiently reduced the healthcare burden by reducing the number of injections and extending treatment intervals within 12 months.
Transbronchial Lymph Node Forceps Biopsy as a Novel Tool in Diagnosis of Mediastinal Lymphadenopathy
Authors: Al-Halfawy Ahmed , Hussein Sabah , Ashur Wafaa , El-Hendawi Ali , Hussein Sara 
Published: June 2023

Abstract
Background
Differential diagnosis of mediastinal lymphadenopathy is an issue of debate. Lymph nodes may be enlarged due to variety of inflammatory, infectious, malignant reasons. Hence, it is important to establish diagnosis. Transbronchial lymph node forceps biopsy provides adequate tissue for lung cancer staging purposes, several pathologies, such as granulomatous diseases and lymphoma, that may require histologic assessment for better diagnostic definition. This study evaluated the safety and feasibility of the transbronchial forceps biopsy as a new tool for diagnosis of mediastinal lymph nodes.
Methods
The study included 18 patients with confirmed mediastinal lymphadenopathy who were admitted in Chest Department, Cairo University, in collaboration with Pathology Department during the period from December 2019 to December 2020. All patient were subjected to flexible video bronchoscopy for conventional transbronchial needle aspiration (C-TBNA) and transbronchial forceps biopsy from the enlarged mediastinal lymph node (LN-TBFB). Biopsies were sent for histopathology examination.
Results
C-TBNA was diagnostic in 71.4% of sarcoidosis cases, 42.9% of malignant cases, and was not diagnostic in TB cases. Sensitivity of C-TBNA is: 61.1%. However, LN-TBFB was diagnostic in 100% of sarcoidosis and TB cases and in 85.7% of malignant cases. Sensitivity of LN-TBFB was 94.4%
Conclusion
lymph node transbronchial forceps biopsy (LN-TBFB) was found to be safe and effective in the diagnosis of mediastinal lymphadenopathy. We strongly advocate the use of minimally invasive techniques for diagnosing pathologically enlarged mediastinal lymph node.