bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of endotracheal tube size for pediatric patients from the length of the middle finger in comparison with standard age-based formula in South Indian population
Authors: Krishna Bhat Rama Rani , Kamlekar Ramya Lakshmi , Kulkarni Malavika 
Published: August 2023

Background:
Determining the appropriate size of an endotracheal tube (ETT) in infants and children remains a challenge for anesthesiologists. We conducted this study to assess the accuracy of middle finger length (MFL) in predicting the appropriate ETT size for pediatric patients in comparison with the age-based estimation and derive a formula based on MFL for the estimation of ETT size.

Materials and Methods:
In the study, South Indian children 1–10 years of age, requiring general anesthesia were intubated by consultant anesthesiologists based on their discretion with an appropriately sized ETT. Subsequently, the MFL of the children was measured and tracheal tube size calculated from the age-based formula was also noted. The actual size of the ETT inserted was compared with the MFL and age-based formula using Pearson's correlation.

Results:
In children between 1 and 10 years of age, the age-based formulae (ABF) was found to correlate with ETT estimated with the correlation coefficient (r = 0.885; P < 0.001) and MFL (r = 0.783 and P < 0.001). ABF showed a stronger correlation with the ETT inserted compared to the MFL, nevertheless, we were able to arrive at a formula to predict tracheal tube size based on MFL: ETT ID (mm) =1.1+ (0.7 × MFL [cm]).

Conclusion:
Although age-based Cole's and Motoyama's formulae are better predictors of pediatric ETT size, MFL can still be used to predict the tube size in cases when age and weight are unknown.
Demographic profile and clinical characteristics of surgical patients operated in COVID-19 operation theater in a tertiary care hospital
Authors: Bathla Sapna , Mehta Mahak , Das Akshaya Kumar , Mullick Parul , Meena Dharam Singh , Ganapathy Usha 
Published: August 2023

Background and Aim:
Surgical procedures in patients with COVID-19 disease are associated with increased perioperative morbidity and mortality. A retrospective study was conducted to evaluate the demographic and clinical data of surgical patients with suspected or confirmed COVID-19 disease.

Methods:
After taking hospital ethics committee approval, medical records of surgical patients operated during the period from May 2020 to November 2020 in a COVID-19-designated tertiary care hospital of northern India were assessed. The demographic data such as age, gender, associated comorbidities, type of surgery, intraoperative complications, and data on the postoperative status of the patients were collected and analyzed.

Results:
Ninety-four patients underwent surgical procedures during the study period. Out of all patients, 87.2% were females. The median age of patients was 28 years (range: 1 month–59 years). The emergency cesarean section was the most common surgery performed. The subarachnoid block was the most commonly used anesthesia technique. Out of 94 patients, 70 patients were confirmed COVID-19 positive, and 24 were suspected cases. Most of the patients were American Society of Anesthesiologists II (83%) and 43.6% of patients had comorbidities.

Conclusion:
The cesarean section was the most commonly performed surgical procedure. The most common anesthesia technique used was the subarachnoid block. The patients operated under subarachnoid block had a better prognosis and did not require intensive care unit stays in the postoperative period.
Study of platelet-derived growth factor receptor beta in bone marrow biopsy samples of patients with multiple myeloma
Authors: Musallam Ghada S.K.A. , Elkholy Rasha A. , Elgamal Basma M. , Ahmed Aisha A.A. 
Published: August 2023

Background
Multiple myeloma (MM) is a malignant neoplastic disease manifested by uncontrolled proliferation of plasma cells in the bone marrow, production of monoclonal immunoglobulins, and associated organ dysfunction. Platelet-derived growth factor receptor beta (PDGFR-β) has demonstrated an important role in angiogenesis and neoplastic diseases.

Aim
The aim of this work was to calculate the expression of PDGFR-β in bone marrow trephine biopsy samples of newly diagnosed patients with MM and its clinical significance.

Patients and methods
A total of 20 newly diagnosed patients with MM were enrolled in this study. The expression of PDGFR-β on plasma cells in bone marrow trephine biopsy samples was assessed by immunohistochemical staining.

Results
Our results showed a statistically significant increase in lactate dehydrogenase, beta 2 microglobulin, and clonal plasma cell percentage in bone marrow of patients with high PDGFR-β expression in comparison with patients with negative and intermediate PDGFR-β expression and statistical significant decrease in albumin and prognostic-free survival in patients with high PDGFR-β expression in comparison with patients with negative and intermediate PDGFR-β expression.

Conclusion
Patients with MM with high PDGFR-β expression had unfavorable prognosis in terms of prognostic-free survival and advanced disease stage compared with intermediate and low PDGFR-β expressions.
Palpebral fissure changes following horizontal recti muscles surgery
Authors: El Zahar Wafaa S. , Shafik Heba M. , Awara Amr M. , El Desouky Mohamed A. 
Published: August 2023

Background
Strabismus surgery is a 1-day operation. It can result in aligned eyes or nearly so (orthophoria) or overcorrection or undercorrection that may require further treatment or another surgery.

Aim
To assess alterations in vertical palpebral fissure height following horizontal recti muscle surgery (recession or resection) for the treatment of horizontal strabismus (esotropia or exotropia).

Patients and methods
A prospective interventional case series was carried out on 68 eyes of 41 patients with horizontal strabismus (exotropia or esotropia), comitant or incomitant (paralytic), who underwent surgical correction. Patients were subdivided into three groups: group I (n=50) underwent recession only, group II (n=10) underwent resection only, and group III (n=8) underwent recession and resection. All patients were subjected to preoperative, operative, and postoperative evaluations (palpebral fissure height and width measurement).

Results
Distant angle of exotropia was considerably lower in group I than group III (P2<0.019) but were insignificantly different between groups I and II and between groups II and III. Palpebral fissure at 6 months was considerably lower in group II than groups I and III (P=0.013 and 0.019, respectively).

Conclusion
Horizontal rectus muscles recession for horizontal strabismus causes vertical widening of palpebral fissure height, and also resection results in narrowing of vertical palpebral fissure height. The combination of horizontal rectus muscle recession and resection for horizontal strabismus results in vertical palpebral fissure height widening in half of eyes and vertical palpebral fissure height narrowing in a quarter of the eyes.
Effect of intraoperative single dose of dexamethasone on posttonsillectomy pain in children: a systematic review and meta-analysis
Authors: Sakr Mohamed A. , El-Guindy Ahmed S. , Khalefa Mohamed A. , Mandour Mahmoud F. 
Published: August 2023

Background
Tonsillectomy is one of the commonest operative techniques done universally. In spite of developments in anesthetic and operative procedures, posttonsillectomy pain remains a vital clinical problem. Posttonsillectomy pain is perhaps the consequence of muscle spasm caused by inflammation and irritation of the pharyngeal muscular structure. Postoperatively cases frequently have significant odynophagia, alteration of diet, and reduced activity. The recovery interval of kids frequently continues from 4 to 7 days, whereas adults might continue being symptomatic up to 2 weeks. The odynophagia may be sufficiently severe to control oral intakes, which in occasional cases can lead to dehydration needing admittance for intravenous fluids.

Aim
This work aimed to evaluate the consequence of intraoperative single dosage of dexamethasone on posttonsillectomy pains in kids and to verify its significance.

Patients and methods
A systematic review of presently accessible randomized controlled trials via a one-dose, intravenous corticoid throughout pediatric tonsillectomy has been done. Visual analog pain score information was obtained with reviewers blinded to findings.

Results
Seven randomized trials have been involved in posttonsillectomy pain analysis. A significant decrease in pain as determined by visual analog pain score on the first-day postoperatively was found.

Conclusions
A single, intraoperative dosage of dexamethasone can decrease posttonsillectomy pain on the first day postoperatively by a factor of 1 on a 10-point pain scale. As the adverse effects and price of dexamethasone dosage seem negligible, considerations of routine usage appear acceptable.
A Randomized Controlled Trial of Negative Pressure Wound Therapy to Reduce Colorectal Surgical Site Infection
Authors: Groot Gary , Dattani Sheev , Mondal Prosanta , Darbyshire Rhonda , Morin Carolyn , Ginther David N. , Pham Hong , Gill Jivanjot 
Published: August 2023

Background:
The rate of surgical site infection (SSI) in clean-contaminated wounds resulting from elective colorectal procedures ranges from 15 to 30%. Within the region considered in the study, the SSI rate is 20% despite the adoption of preventative measures.

Objective:
The objective of this study was to determine the effectiveness of prophylactic negative pressure wound therapy (NPWT) in reducing superficial SSIs in clean-contaminated wounds resulting from elective colorectal surgery to below 10%.

Design:
An unblinded randomized controlled trial was conducted.

Settings:
The study was conducted at two Canadian tertiary academic hospitals.

Patients and Methods:
Patients undergoing elective, non-emergent, clean-contaminated colorectal resection by both laparoscopic and open procedures were included. Participants were randomized to either standard surgical dressing (SSD) or NPWT over a closed incision.

Main Outcome Measures:
Incidence of superficial SSI on postoperative day 30.

Results:
The study closed early due to lack of accrual. From the planned group of 398 patients, 126 were randomly assigned to SSD (n = 61) or NPWT (n = 61). The analysis included 55 patients from the SSD group and 47 from the NPWT group. The mean age for the groups was 64.9 years (SSD) and 65.1 years (NPWT) with males comprising 52.7% (n = 29) and 44.7% (n = 21) of the populations, respectively. The results showed a clinically important but statistically non-significant difference between the two groups. The overall rate of SSI in the as-treated analysis was 14.7%, while it was slightly lower at 13.5% in the intent-to-treat (ITT) analysis. In both cases, there was a trend toward higher rates of SSI in the SSD, with the ITT analysis showing somewhat larger differences; however, in both the logistic regression models, the trends were non-significant.

Conclusion:
We present a randomized controlled trial of prophylactic NPWT following elective colorectal resection. The results indicated a clinically important reduction in the superficial SSI rate compared with standard surgical dressing. A more extensive randomized study is needed to clarify the effectiveness of NPWT to reduce wound infections in this patient population.

Limitations:
Neither patients nor clinicians were blinded to the treatment. The lack of recruitment introduced a type two statistical error, which led to a non-significant difference between the cases and controls.

Conflict of Interest:
None.
Prognostic Role of the Lymph Node Ratio in Colorectal Cancer
Authors: Derici Serhat Tolga , Ergenç Muhammer , Sücüllü İlker , Akin Mehmet Levhi 
Published: August 2023

Background:
Studies have been conducted to investigate more practical and useful parameters in determining the prognosis of patients with colorectal cancer (CRC), and some suggest that the lymph node ratio (LNR) may be useful in doing so, especially in patients with inadequate lymph node dissection.

Objectives:
We aimed to evaluate the effect of LNR (number of metastatic lymph nodes/number of total lymph nodes excised) on disease-free survival and overall survival rates in CRC.

Design:
A single-center retrospective cohort study.

Setting:
Tertiary care hospital.

Patients and Methods:
The clinical and pathological features of the patients were analyzed by dividing them into groups according to tumor localization; tumor, node, metastasis staging; and LNR. The Kaplan–Meier method and the log-rank test were used for survival analysis.

Sample Size:
A total of 479 patients with CRC who were operated on between September 1991 and December 2011 were included in this study. The LNR of 439 patients could be calculated, and analyses were according to these patient groups.

Main Outcome Measures:
The primary objective of this study was to determine the effect of LNR on disease-free survival and overall survival in CRC.

Results:
A total of 121 right-sided colon cancers, 202 left-sided colon cancers, and 156 rectal cancers were analyzed. The age of the patients ranged from 20 to 93 years, and the mean age was 66.8 (13.5) years. The cumulative 5-year survival rate was 48.5% in our patients with CRC. When analyzing the tumor, node, metastasis stages of the groups according to their LNRs, the results showed that as the rate of lymph node metastasis increases, so does the tumor stage parameter (P < 0.001). The overall survival and disease-free survival rates significantly decreased as LNR increased (P < 0.001).

Conclusion:
This study showed that LNR correlates well with the disease-free and overall survival rates. A higher LNR could indicate the aggressiveness of the tumor; therefore, LNR may be a predictor of the poor prognosis of CRC.

Limitations:
Some patients could not be followed-up and we could not evaluate complications because not all patients had data on postoperative complications. As a result, our study results may have been affected.

Conflict of Interest:
The authors have no conflict of interest to declare.
Trends of Minimally Invasive Surgery and Adequate Lymph Node Harvest in pT4 Colon Adenocarcinoma
Authors: Pacheco Felipe A. , Harris-Gendron Sarah 
Published: August 2023

Background:
Recent advances in minimally invasive surgery (MIS) have improved outcomes in colon cancer treatment. However, the use of MIS in pT4 colon cancer is controversial. Existing literature on lymph node retrieval in MIS compared to that in open surgery is inconsistent. Previous studies using the National Cancer Database from 2010 to 2014 and 2010 to 2016 found that MIS was associated with higher odds of adequate lymph node resection.

Objectives:
Using data from more recent years, this study seeks to compare lymph node resection between MIS and open surgery in pT4 colon cancer.

Design and Setting:
This retrospective cohort study was conducted using the National Cancer Database.

Patients and Methods:
Patients undergoing MIS or open surgery with lymph node harvest for pT4 colon cancer were included in this study. A trend analysis of surgical approach (MIS versus open and robotic versus laparoscopic) from 2010 to 2017 and a logistic regression model including multiple tumor characteristics and demographic variables for procedures between 2015 and 2017 were performed.

Main Outcome Measures:
The main outcome evaluated was the adequacy of lymph node retrieval.

Sample Size:
A total of 27319 patients were included.

Results:
This study showed a trend towards MIS and robotic surgery for pT4 colon cancer. In addition, it found that MIS for pT4 tumors have higher odds of achieving an adequate lymph node harvest than open surgery in recent years (2015–2017). The demographic factors associated with inadequate lymph node harvest include race and location of the facility (rural versus metro cities).

Conclusions:
The findings of this study suggest that colorectal surgery has shifted towards MIS, and specifically, robotic surgery for pT4 tumors. This approach has an oncological advantage of adequate lymph node harvest compared to open surgery.

Limitations:
Despite its advantages, this retrospective database study has inherent biases, such as confounding bias, selection bias, and coding errors in the database, as well as limited data available for analysis.

Conflict of interest:
The authors have no conflict of interest to declare.
Quantum limits of sub-Laplacians via joint spectral calculus
Authors: Letrouit Cyril 
Published: August 2023

We establish two results concerning the quantum limits (QLs) of some sub-Laplacians.
First, under a commutativity assumption on the vector fields involved in the definition of the sub-
Laplacian, we prove that it is possible to split any QL into several pieces which can be studied
separately, and which come from well-characterized parts of the associated sequence of eigenfunctions.
Secondly, building upon this result, we study in detail the QLs of a particular family of sub-
Laplacians defined on products of compact quotients of Heisenberg groups. We express the QLs
through a disintegration of measure result which follows from a natural spectral decomposition of
the sub-Laplacian in which harmonic oscillators appear.
Both results are based on the construction of an adequate elliptic operator commuting with the
sub-Laplacian, and on the associated joint spectral calculus. They illustrate the fact that, because of
the possible high degeneracies in the spectrum, the spectral theory of sub-Laplacians is very rich.
Optimal dwelling time prediction for package tour using K‐nearest neighbor classification algorithm
Authors: Wahyutama Aria Bisma , Hwang Mintae 
Published: August 2023

AbstractWe introduce a machine learning‐based web application to help travel agents plan a package tour schedule. K‐nearest neighbor (KNN) classification predicts the optimal tourists' dwelling time based on a variety of information to automatically generate a convenient tour schedule. A database collected in collaboration with an established travel agency is fed into the KNN algorithm implemented in the Python language, and the predicted dwelling times are sent to the web application via a RESTful application programming interface provided by the Flask framework. The web application displays a page in which the agents can configure the initial data and predict the optimal dwelling time and automatically update the tour schedule. After conducting a performance evaluation by simulating a scenario on a computer running the Windows operating system, the average response time was 1.762 s, and the prediction consistency was 100% over 100 iterations.
Distribution of Escherichia coli Pathotypes along an Urban–Rural Gradient in Ecuador
Authors: Montero Lorena , Smith Shanon M. , Jesser Kelsey J. , Paez Maritza , Ortega Estefanía , Peña-Gonzalez Angela , Soto-Girón Maria Juliana , Hatt Janet K. , Sánchez Xavier , Puebla Edison , Endara Pablo , Cevallos William , Konstantinidis Konstantinos T. , Trueba Gabriel , Levy Karen 
Published: August 2023

ABSTRACT.
Diarrheal diseases are a leading cause of mortality and morbidity in low- and middle-income countries. Diarrhea is associated with a wide array of etiological agents including bacterial, viral, and parasitic enteropathogens. Previous studies have captured between- but not within-country heterogeneities in enteropathogen prevalence and severity. We conducted a case-control study of diarrhea to understand how rates and outcomes of infection with diarrheagenic pathotypes of Escherichia coli vary across an urban–rural gradient in four sites in Ecuador. We found variability by site in enteropathogen prevalence and infection outcomes. Any pathogenic E. coli infection, coinfections, diffuse adherent E. coli (DAEC), enteroinvasive E. coli (EIEC), and rotavirus were significantly associated with acute diarrhea. DAEC was the most common pathotype overall and was more frequently associated with disease in urban areas. Enteropathogenic E. coli (EPEC) and enterotoxigenic E. coli (ETEC) were more common in rural areas. ETEC was only associated with diarrhea in one site. Phylogenetic analysis revealed that associations with disease were not driven by any single clonal complex. Higher levels of antibiotic resistance were detected in rural areas. Enteropathogen prevalence, virulence, and antibiotic resistance patterns vary substantially by site within Ecuador. The variations in E. coli pathotype prevalence and virulence in this study have important implications for control strategies by context and demonstrate the importance of capturing within-country differences in enteropathogen disease dynamics.
Effectiveness of POE Learning Model on Science Process Skills in Temperature and Heat of Elementary Students
Authors: Uriyah Novita , Supardi Zainul Arifin Imam , Suryanti  
Published: August 2023

This research aims to explain the effectiveness of the Predict-Observe-Explain (POE) learning model on elementary students' science process skills on temperature and heat material. This research was conducted on fifth-grade students at SDN Kalirungkut I/264. This research method is a quasi-experiment with a non-equivalent control group research design. The data was collected through test and non-test (observation) techniques. Based on the N-Gains score test, the score in the experimental group was 58.12697%, which is quite effective. Based on the analysis using effect size on experimental and control class students, it is known that the effect size value is 1.131611, which means that learning with the POE model on temperature and heat material has a high influence on students' science process skills. Based on the results of the research conducted, it can be concluded that the POE learning model is more effective than conventional learning of scientific process skills. This research will help students improve their fundamental scientific process skills using the POE model. In prior research, no one has tried to examine the topic of temperature and heat and no one has calculated the effectiveness of the POE model on science process skills using effect size.
ANALISIS JENIS MAKNA KONOTASI LIRIK LAGU PILIHAN LESTI KEJORA ALTERNATIF BAHAN AJAR
Authors: Aini Fania Siti Zachra Nur’ , Hidayati Panca Pertiwi , Suratiningsih Meity 
Published: August 2023

Menganalisis makna konotasi merupakan hal yang sulit dipelajari peserta didik, bahkan masih banyak peserta didik tidak mampu memaknai kata yang bermakna konotasi sebuah karya sastra khususnya puisi berupa lirik lagu.Ppenelitian ini bertujuan untuk mendeskripsikan makna konotasi dan jenis makna konotasi dalam diksi melalui analisis semantik pada 13 Lirik Lagu Pilihan Lesti Kejora serta untuk meningkatkan pemahaman dalam pembelajaran sastra yang erat kaitannya dengan penyusunan LKPD digunakan sebagai alternatif bahan ajar sastra kelas X di SMA. Penulis menganalisis data kemudian mendeskripsikan secara naratif merupakan penelitian kualitatif deskriptif. Hasil penelitian menunjukkan bahwa sering menggunakan konotasi tinggi dan ramah untuk menyatakan kata yang memiliki nilai rasa baik dengan makna dikiaskan melalui konotasi tinggi dan ramah. Jenis makna konotasi dalam diksi yang ditemukan meliputi konotasi tinggi, ramah, tidak pantas, tidak enak, keras dan nonsens dengan total keseluruhan jenis makna konotasi dalam diksi ialah 236 data. Berdasarkan hasil uji coba LKPD kepada dua orang pendidik serta diujicobakan kepada sepuluh peserta didik, diantaranya satu peserta didik memperoleh nilai kategori cukup, enam peserta didik memperoleh nilai kategori baik, dan tiga peserta didik memperoleh nilai kategori sangat baik. Oleh karena itu, hasil analisis tersebut dapat dijadikan sebagai alternatif bahan ajar sastra dalam bentuk LKPD kelas X di SMA.
Kata kunci: jenis makna konotasi, lirik lagu, bahan ajar