bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of anesthesia clerkship for medical students on timings in surgical cases: An observational study.
Authors: Saetang Mantana , Chatmongkolchart Sunisa , Kunapaisal Thitikan , Yongsata Dararat , Saelim Kantaros 
Published: July 2023

Abstract
Background: The anesthesia clerkship is one of several specialties which medical students learn in the operating room. Learning from the clerkship in the operating room may affect patient care and starting time for surgical cases. We hypothesized actual time spent teaching the medical student affects the starting time surgical cases more than residents and student nurse anesthetists.
Methods: This prospective study was conducted between April-July 2022. We included the patients with American Society of Anesthesiologist status I-III, underwent elective Obstetric-Gynecologic surgery/ General surgery. We examined actual time spent teaching in these cases between the fifth-year medical student, anesthesiology residents, and student nurse anesthetists by using ANOVA comparison. The actual time spent teaching were defined as Anesthesia Release Time, Anesthesia-Controlled Time, Anesthetic Preparation Time, and Anesthetic Procedure Time.
Results: 111 procedures were performed (33.3% 5th year medical students, 33.3% residents, and 33.3% student nurse anesthetist). Our study examined statistically significant increased time spent in the 5th year medical student group when compared with resident group and student nurse anesthetist: Anesthesia Release Time spent more prolong than that in residents group (5.486 minutes, p=0.0015), and student nurse anesthetists (4.973 minutes, p=0.0038), Anesthesia-Controlled Time spent longer than residents and student nurse anesthetists (11.243 minutes (p <0.001) and 3.27 minutes (p= 0.067), respectively), and Anesthetic Procedure Time spent longer than that in residents and student nurse anesthetists (4.027 minutes (p = 0.0015), and 2.7297 minutes (p= 0.03), respectively). The scale for difficulty of case induction in the 5th year medical student group was higher than that of the other groups (p < 0.001). However, the number of successful of procedures were not statistically significant difference between the groups. Also, intraoperative and 24-hour postoperative complications were not significantly different between the groups (p=0.371, p=0.385, respectively).
Conclusions: We examined the presence of 5th-year medical students contributed to a prolonged case time, the overall impact did not appear to be clinically significant. However, teaching undergraduate medical education to 5th-year medical students remains the key roles of teaching hospitals and does not contribute significantly to a reduction in operating theatre output in this clinical setting.
Trial registration: TCTR20220418006
Who is your prenatal care provider? An algorithm to identify the predominant prenatal care provider with claims data.
Authors: Deng Songyuan , Renaud Samantha , Bennett Kevin 
Published: July 2023

Abstract
Background: Using claims data to identify a predominant prenatal care (PNC) provider is not always straightforward, but it is essential for assessing access, cost, and outcomes. Previous algorithms applied plurality (providing the most visits) and majority (providing majority of visits) to identify the predominant provider in primary care setting, but they lacked visit sequence information. This study proposes an algorithm that includes both PNC frequency and sequence information to identify the predominant provider and estimates the percentage of identified predominant providers. Additionally, differences in travel distances to the predominant and nearest provider are compared.
Method: The dataset used for this study consisted of 108,441 live births and 2,155,076 associated claims from the 2015-2018 South Carolina Medicaid. Analysis focused on patients who were continuously enrolled throughout their pregnancy and had any PNC visit, resulting in 32,609 pregnancies. PNC visits were identified with diagnosis and procedure codes and specialty within the estimated gestational age.
To classify PNC providers, seven subgroups were created based on PNC frequency and sequence information. Our algorithm was developed by considering both the frequency and sequence information. Percentage of identified predominant providers was reported. Chi-square tests were conducted to assess whether the probability of being identified as a predominant provider for a specific subgroup differed from that of the reference group (who provided majority of all PNC). Paired t-tests were used to examine differences in travel distance.
Results: Pregnancies in the sample had an average of 7.86 PNC visits. Fewer than 30% of the sample had an exclusive provider. By applying PNC frequency information, a predominant provider can be identified for 81% of pregnancies. After adding sequential information, a predominant provider can be identified for 92% of pregnancies. Distance was significantly longer for pregnant women traveling to the identified predominant provider (an average of 5 miles) than to the nearest provider.
Conclusions: Inclusion of PNC sequential information in the algorithm has increased the proportion of identifiable predominant providers by 11%. Applying this algorithm reveals a longer distance for pregnant women travelling to their predominant provider than to the nearest provider. (1)
Determining the Optimal Tank Size for Rooftop Rainwater Harvesting in Jordan: An Evaluation of Potential
Authors: Jaradat Anas , Özkök Enes 
Published: July 2023

Abstract

This study aimed to assess the potential of rainwater harvesting from rooftops in Jordan, recognizing its significance in mitigating water scarcity. Using the Ripple Method and Water Balance Model, data on daily rainfall rates and total rooftop area were collected and analyzed for each of Jordan’s 12 governorates to estimate the potential benefits and identify specific regions with high potential. The study found that Jordan has a total potential for rooftop rainwater harvesting estimated at 23.74 Mm3/year, with Irbid and Amman having the highest potential for water harvesting, with estimated potentials of 7.754 Mm3/year and 8.453 Mm3/year, respectively. Moreover, the optimal tank sizes for storing rainwater that would be used only to flush toilets were determined to be 2.7 Mm3 and 2 Mm3 per household in Ajlun and Irbid Governorates, respectively. These findings may provide valuable insights for policymakers, water resource managers, and communities interested in sustainable water management strategies.
Regulation of FUS ubiquitination and localization by HFM1 is essential for oocyte meiosis prophase I progression in mice
Authors: Pu Danhua , Zhong Chenyi , Wang Huiyuan , Yuan Xiong , He Yuheng , Cong Jing , Yang Rui , Ma Wenjie , Gao Li , Gao Chao , Cui Yu-gui , Wu Jie , Tan Rongrong 
Published: July 2023

Abstract
Helicase for meiosis 1 (HFM1), a putative DNA helicase expressed in germ-line cells, has been reported to be closely associated with premature ovarian insufficiency (POI). However, the underlying molecular mechanism has not been elucidated. The aim of this study was to investigate the function of HFM1 in the first meiotic prophase of mouse oocytes. In our study, we found that the deficiency of HFM1 resulted in increased apoptosis and depletion of oocytes in mice. Interestingly, the oocytes were arrested in the first meiotic prophase in the pachytene stage. In addition, impaired DNA double-strand break repair and impaired synapsis were observed in the absence of HFM1. Further investigation revealed that knockout of HFM1 promoted ubiquitination and degradation of FUS protein mediated by FBXW11. Additionally, the depletion of HFM1 altered the intranuclear localization of FUS and regulated meiotic- and oocyte development-related genes in oocytes by regulating the expression of BRCA1. These findings uncovered the critical role of HFM1 in orchestrating the regulation of DNA double-strand break repair and synapsis to ensure meiosis procession and primordial follicle formation, which provided clues for pathogenesis of POI.
“We just don't have the resources”: Supervisor perspectives on introducing workplace-based assessments into medical specialist training in South Africa, a qualitative study
Authors: Ras Tasleem , Jenkins Louis , Lazarus Colin , Rensburg Jean Janse van , Cooke Richard , Senkubuge Flavia , Dlova Abegail , Singaram Veena , Daitz Emma , Buch Eric , Green-Thompson Lionel , Burch Vanessa 
Published: July 2023

Abstract
Background
There have been some significant international shifts in the education of medical specialists over the past few years. These include the adoption of competency based medical education (CBME), increasing utilisation of workplace-based assessment (WBA), and the incorporation of WBA into systems of programmatic assessment in the context of CBME. Continuous assessment of workplace performance following an iterative standardized in‐service process has the potential to bring assessment of clinical competence from an artificial context into the real world of clinical medicine, without compromising patient safety. To date, insufficient exploration of WBA practices, experiences, perceptions, and aspirations in healthcare have been undertaken in South Africa or Africa. The aim of this study was to identify social factors that could contribute to WBA implementation from the perspective of medical consultants. This entailed describing knowledge of perceived barriers and enabling factors to WBA.
Methods
This was a cross-sectional observational study, using a mixed methods, self-administered online questionnaire to collect data from participants. We report the qualitative data here.
Results
The barriers to enabling WBA were: 1) lack of resources at in the health care facilities where registrars are trained; 2) the need for training of the trainers/assessors; 3) the effects of bias and favoritism in training and assessment of WBA; 4) subjectivity in assessment as problematic; 5) lack of standardization /agreement of Entrustable Professional Activities (EPAs); 6) the need for all stakeholders (consultants, university administration, HR etc.) to buy-in to WBA; 7) and the need for adequate technological support. Enablers were 1) existing opportunities for implementing WBA; 2) stakeholder support and buy-in; 3) agile technology; 4) a well-regulated and monitored environment; 5) resources; 6) standardization; 7) and training.
Conclusions
Participants demonstrated impressive levels of insight into their respective working environments, producing an extensive list of barriers and enablers. Despite significant structural and social barriers, this cohort perceives the impending implementation of WBA to be a positive development in registrar training in South Africa. Future research should explore the outlining of WBA programmes, training for WBA, and the implementation of WBA pilot projects, and include registrar perspectives.
Solidification mechanism of heavy metal of red mud-based engineered cementitious composites
Authors: Li Zhaofeng , Zhang Chen , Gao Yifan , Zhang Jian , Wang Chuan 
Published: July 2023

Abstract

In this paper, the occurrence form and leaching characteristics of heavy metals in red mud were clarified, the solidification mechanism of heavy metals by the hydration products and solidification agents was explored. The results show that the contents of heavy metals in red mud from high to low are Cr, Pb, Ni, Cu, As and Cd, which are 754 mg/kg, 78.2 mg/kg, 41.8 mg/kg, 33.2 mg/kg, 15.0 mg/kg and 0.77 mg/kg respectively. The potential ecological hazard level is moderate. The occurrence form of heavy metals in red mud-based cementitious materials gradually changes from effective state to stable state with the increase of curing age. When the curing age is 120 days, the curing rate tends to be stable, and the curing rates of As, Cu, Ni, Cd, Cr, Pb reach 99.91%, 97.62%, 97.02%, 96.83%, 95.91%, 91.11% respectively. The lifting effect of three heavy metal curing agents is: 5A zeolite < fly ash < attapulgite. The optimum heavy metal curing agent is attapulgite with a content of 6%. When the curing period is 28 days, the curing rate of heavy metal element Pb reaches 99.74%, and the curing rate of Cr reaches 99.40%, increased by 8.86% and 4.28% respectively. The results can realize the green and safe application of red mud based cementitious materials.
Two cephalic screws combined compression proximal-femur intramedullary nailing internal fixation versus long-stemmed cemented bipolar hemiarthroplasty for treating intertrochanteric fractures in Patients 75 Years and Older: a retrospective study
Authors: Deng Yan , Zhou Xiang-ping , Sun Bin , Li Guo-hui , Tong Zuo-Ming 
Published: July 2023

Abstract

Background: As the population continues to age, the occurrence of intertrochanteric femoral fractures (IFF) has been steadily increasing. Presently, the primary surgical treatment modality for this condition is intramedullary nailing fixation. However, primary cemented hemiarthroplasty is being considered a viable treatment option. The main aims of this investigation were to evaluate and draw comparisons between the clinical outcomes, ambulatory ability, overall survival, and all-cause mortality between two cephalic screws combined compression proximal-femur intramedullary nailing internal fixation (IF) and long-stemmed cemented bipolar hemiarthroplasty (LCHA) treatment of IFF in patients aged 75 years and older. The secondary objective was investigating relative independent risk factors contributing to postoperative all-cause mortality.
Methods: A retrospective analysis was conducted on 251 elderly patients (≥ 75 years) with IFF who underwent IF or LCHA between January 2018 and October 2022. We employed generalized estimating equations along with univariate and multivariate analyses to examine the impact of various surgical interventions and other pertinent factors on postoperative ambulatory ability and all-cause mortality outcomes. Associations between sex, age, number of comorbidities, aspartate aminotransferase (AST) levels, total blood transfusions, and mortality were analysed using Cox proportional hazards models.
Results: The analysis included a cohort of 120 patients from the IF group and 121 patients from the LCHA group. Statistically significant differences were not observed in the clinical outcomes, ambulatory ability, overall survival, or all-cause mortality after surgical treatment between the groups receiving IF and LCHA (p > 0.05).Nevertheless, among patients (age ≥ 85 years),the IF group demonstrated a lower rate of all-cause mortality compared to the LCHA group (p < 0.05). The older the patient, the greater the number of preoperative comorbidities and amount of perioperative transfusion; a lower preoperative AST level was associated with a higher risk of postoperative death (p < 0.05).
Conclusions: The results imply that the choice of IF or LCHA treatment for elderly patients with IFF aged 75 years or older may need to be tailored to the number of preoperative comorbidities, sex, age, preoperative AST level, and cost-effectiveness.
Safe and promising outcomes of in-hospital preoperative rehabilitation for coronary artery bypass grafting after an acute coronary syndrome
Authors: Nakamura Ken , Arai Shusuke , Kobayashi Kimihiro , Nakai Shingo , Sho Ri , Ishizawa Ai , Watanabe Daisuke , Hirooka Shuto , Ohba Eiichi , Mizumoto Masahiro , Kuroda Yoshinori , Kim Cholsu , Uchino Hideaki , Shimanuki Takao , Uchida Tetsuro 
Published: July 2023

Abstract
Objective:
In patients with stable hemodynamic status after an acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) after preoperative investigations can provide outcomes comparable to those of emergency surgery. However, no established guidelines exist regarding the preparation period before surgery. We report the results of the use of an inpatient cardiac rehabilitation program followed by CABG after an ACS to improve post-operative deconditioning and prognosis after discharge.
Methods: From 2005 to 2017, 471 patients underwent either isolated or combined CABG at our institution, and of those, the 393 who received isolated CABG were included in the analysis. Twenty-seven patients (6.9%) were admitted with ACS and underwent preoperative rehabilitation before undergoing CABG, with a subsequent review of surgical morbidity and mortality rates. Propensity score matching yielded a cohort of 26 patients who underwent preoperative rehabilitation (group A) and 26 controls (group B). Preoperative characteristics were similar between groups.
Results: The completion rate of the rehabilitation program was 96.3%. All programs were conducted with inpatients, with an average length of stay of 23 ± 12 days. All patients completed in-bed exercises, and 85% completed out-of-bed exercises. The 30-day postoperative mortality was 0% in both groups A and B, and the rate of postoperative major adverse cardiac or cerebrovascular events at 12 months did not differ significantly between groups (7.7% vs 3.9%, respectively; p=1.0). The duration of mechanical ventilation (1.3 ± 0.3 vs 1.5 ± 0.3 days, respectively; p=0.633), length of intensive care unit stay (4.4 ± 2.1 vs 4.8 ± 2.3 days, respectively; p=0.584) and length of hospital stay (25 ± 13 vs 22 ± 9 days, respectively; p=0.378) did not differ significantly between groups.
Conclusions:
No complications of preoperative rehabilitation were observed, suggesting that it is an acceptable option for patients who experience ACS and undergo CABG.
Mechanically strong, self‐healing and pH‐responsive lignocellulose nanofibril‐based hydrogels towards drug delivery applications
Authors: Cheng Gege , Wang Shuangju , Li Wenwen , Zhou Xin , Jiang Yan , Liu Xiuyu , Huang Qin 
Published: July 2023

Abstract
Employing lignocellulosic nanofibers (LCNF) with natural, high specific mechanical performance and abundant functional groups to design a hydrogel as a drug-sustained release carrier, which conforms to the concept of green and sustainable development. Herein, we facilely extracted carboxylated lignocellulose nanofibrils (CLCNF) from bagasse via a deep eutectic solvent (DES) and mechanical defibrillation-based strategy. The CLCNF crosslinked with poly(vinyl alcohol) (PVA) to obtain a nanocomposite hydrogel (PVA/CLCNF/B) whereupon the mechanical strength and drug release behavior were improved in the process. Consequently, the lignocellulose nanocomposite hydrogel presented a high compression modulus (3.92 MPa) and significant sustained‐release effect with a release rate of 80.73% after 36 h. TH delivery behavior of the PVA/CLCNF/B composite hydrogel could be controlled by acidic pH conditions. The TH release kinetics of PVA/CLCNF/B hydrogel in different phosphate buffer saline (PBS) followed the Korsmeyer‐Peppas model better, and the release of TH through the Fickian diffusion mechanism. Importantly, the vitro cytotoxicity tests showed PVA/CLCNF/B hydrogel had good biocompatibility. Overall, adding CLCNF to hydrogel may present great potential in drug release and therapy as a drug delivery carrier.
Etiology of lower respiratory tract in pneumonia based on metagenomic next-generation sequencing: a retrospective study
Authors: Wang Jin-zhu , Yuan Ding , Yang Xiang-hong , Sun Chang-hua , Hou Lin-lin , Zhang Yan , Gao Yanxia 
Published: July 2023

Abstract

The purpose of this study was to explore the ability of metagenomic next-generation sequencing (mNGS) to detect pathogens in lower respiratory tract of patients with pulmonary infection. A retrospective study was conducted on 112 patients with pulmonary infection admitted to the First Affiliated Hospital of Zhengzhou University from April 30th 2018 to June 30th 2020. Sputum and pharyngeal swabs were collected from all patients, and bronchoalveolar lavage fluid (BALF) was collected during bronchoalveolar lavage. Respiratory tract pathogenic microorganisms were detected by routine methods (bacterial smear, PCR, culture, etc.), and BALF pathogenic microorganisms were detected by mNGS. The average age of the patients was 53.0 years old and 94.6% (106/112) of the patients obtained the results of pathogenic microorganisms. The overall detection rate of pathogenic microorganisms by mNGS was significantly higher than that of conventional methods (93.7% vs. 33.1%,P<0.05). mNGS detected bacteria in 75.0% (84/112) of patients, while conventional methods detected bacteria in only 28.6% (32/112) of all patients. The most commonly detected bacteria were Acinetobacter baumannii (19.6%), Klebsiella pneumoniae (17.9%), Pseudomonas aeruginosa (14.3%), Staphylococcus faecium (12.5%), Enterococcus faecium (12.5%) and Haemophilus parainfluenzae (11.6%). Fungi were detected by mNGS in 29.5% (33/112) of patients, including 23 cases of Candida albicans (20.5%), 18 cases of Pneumocystis carinii (16.1%), and 10 cases of Aspergillus (8.9%). Conventional methods detected fungi only in 7.1% (8/112) of patients. The detection rate of virus by mNGS was significantly higher than that by conventional methods (43.8% vs.0.9%,P<0.05). The most commonly detected viruses were EBV (15.2%), CMV (13.4%), circovirus (8.9%), human coronavirus (4.5%) and rhinovirus (4.5%). The results of Kappa analysis showed that the consistency of the two methods was poor (P= 0.276), only 32.1% (36/112) of patients were positive for both methods, and 5.4% (6/112) of patients were negative for both methods. mNGS shows great advantages in the detection of pathogenic microorganisms in patients with pulmonary infection. For those with poor therapeutic effect, mNGS detection can obtain etiological basis as far as possible, which is helpful to achieve accurate anti-infective treatment.
High thrombospondin 1 expression is associated with aging and poor prognosis in patients with acute myeloid leukemia
Authors: Chen Guojie , Dou Xiaofeng , Wang Ling , Chen Jianjun , Xu Shuo , Lin Mei , Shi Wenyu 
Published: July 2023

Abstract

Acute myeloid leukemia is a heterogeneous disease with high morbidity and mortality under current treatment strategies. We screened the key gene thrombospondin 1 by analyzing The Cancer Genome Atlas and Gene Expression Omnibus databases using a bioinformatics approach and further analyzed it using clinical data from The Cancer Genome Atlas database. For validation, we collected bone marrow samples from 20 patients with acute myeloid leukemia and 10 healthy controls. Quantitative polymerase chain reaction and enzyme-linked immunosorbent assay were conducted to quantify the platelet-reactive thrombospondin 1 mRNA and protein expression. Then, we analyzed the different levels in patients and controls using clinical data. We discovered that thrombospondin 1 expression is upregulated in patients with acute myeloid leukemia, and high thrombospondin 1 expression is associated with age and poor prognosis. Thus, as an age-related factor, thrombospondin 1 may be a potential factor in the prognostic prediction of patients with acute myeloid leukemia.