bluuebunny/crossref_metadata_2025_split huggingface dataset:
General anesthesia with S-ketamine improves the early recovery and cognitive function in patients undergoing modified radical mastectomy: a prospective randomized controlled trial
Authors: Zhang Junxia , Jia Danting , Li Wenbin , Li Xiaohui , Ma Qian , Chen Xuexin 
Published: June 2023

Abstract
Background
Postoperative cognitive dysfunction (POCD) is a common postoperative disorder that is frequently observed after general anesthesia, which seriously threatens the quality of patients’ life. Existing studies have demonstrated that S-ketamine plays an important role in improving neuroinflammation. This trial aimed to explore the effects of S-ketamine on quality of recovery and cognitive function in patients following modified radical mastectomy (MRM).

Methods
Ninety patients aged 45 to 70 years with ASA grades of I or II, who underwent MRM, were selected. Patients were randomly assigned to the S-ketamine or control group. In the S-ketamine group, patients were induced with S-ketamine instead of sufentanil and maintained with S-ketamine and remifentanil. In the control group, patients were induced with sufentanil and maintained with remifentanil. The primary outcome was the Mini-Mental State Examination (MMSE) and Quality of Recovery-15 (QoR-15) score. Secondary outcomes including visual analog scale (VAS) score, cumulative propofol and opioids consumption, post anesthesia care unit (PACU) recovery time, occurrence of remedial analgesia, postoperative nausea and vomiting (PONV), other adverse events, as well as patient satisfaction.

Results
The global QoR-15 scores at postoperative day 1 (POD1) were significantly higher in the S-ketamine group than in the control group (124 [119.5–128.0] vs. 119 [114.0–123.5], P = 0.002), with a median difference of 5 points (95% confidence interval [CI] [-8 to -2]). Similarly, the global QoR-15 scores at postoperative day 2 (POD2) in the S-ketamine group were significantly higher than in the control group (140.0 [133.0–145.0] vs. 132.0 [126.5–141.5], P = 0.004). In addition, among the five subcomponents of the 15-item scale, S-ketamine group had a higher score in terms of physical comfort, pain, and emotional state both at POD1 and POD2. In terms of MMSE score, S-ketamine could promote the recovery of postoperative cognitive function at POD1, but not at POD2. Furthermore, the consumption of opioids, VAS score, and remedial analgesia in the S-ketamine group decreased significantly.

Conclusions
Collectively, our findings support that general anesthesia with S-ketamine as a potential strategy showed high safety and could not only improve the quality of recovery mainly through improving pain, physical comfort, and emotional state but also promote the recovery of cognitive function on POD1 in patients undergoing MRM.

Trial registration
The study was registered in the Chinese Clinical Trial Registry (registration No:ChiCTR2200057226, Date of registration: 04/03/2022).
Evaluation of human T-cell leukemia virus in vitro diagnostics using plasma specimens collected in Japan
Authors: Kusagawa Shigeru , Kawana-Tachikawa Ai , Matsubayashi Keiji , Sobata Rieko , Hamaguchi Isao 
Published: June 2023

Abstract
Background
In vitro diagnostics (IVDs) for primary detection test/screening of human T-cell leukemia virus (HTLV) have recently been updated to new-generation products in Japan. In this study, the performance of these products was evaluated and discussed in terms of the usability of HTLV diagnosis in Japan.

Methods
The performance of 10 HTLV IVDs for primary detection test and confirmatory/discriminatory test was evaluated. Plasma specimens that had been declared ineligible for transfusion were provided by the Japanese Red Cross Blood Center.

Results
The diagnostic specificity of the IVDs was 100% (160/160). Six sandwich assays resulted in all HTLV-1/HTLV-positive specimens being positive (46/46). On the other hand, one sandwich assay, IVD under development 2 (UD2), resulted in one HTLV-1-positive and one HTLV-positive specimen being negative (44/46, 95.7%). One indirect assay, HISCL HTLV-1, could not detect one HTLV-positive specimen (45/46, 97.8%), but the updated product, UD1, correctly detected it (46/46, 100%). Serodia HTLV-I, based on a particle agglutination assay, resulted in 44 of the 46 positive specimens, but could not detect two specimens (44/46, 95.7%). ESPLINE HTLV-I/II, based on an immunochromatography assay (ICA), was able to diagnose all specimens as positive (46/46, 100%).

Conclusions
Six sandwich assays and an ICA demonstrated high diagnostic sensitivity and specificity and are recommended for use in HTLV diagnosis in conjunction with confirmatory/discriminatory test using the INNO-LIA HTLV-I/II Score.
E-cadherin expression in the tumor microenvironment of advanced epidermal growth factor receptor-mutant lung adenocarcinoma and the association with prognosis
Authors: Chang Yu-Ping , Huang Gong-Kai , Chen Yung-Che , Huang Kuo-Tung , Chen Yu-Mu , Lin Chiung-Yu , Huang Chao-Cheng , Lin Meng-Chih , Wang Chin-Chou 
Published: June 2023

Abstract
Background
The expression of programmed death-ligand 1 (PD-L1), tumor-infiltrating lymphocytes (TILs), E-cadherin, and vimentin in lung cancer tumor microenvironment is known to impact patient survival or response to therapy. The expression of these biomarkers may also differ between primary lung tumors and brain metastatic tumors. In this study, we investigated the interaction between these biomarkers in lung tumors with or without concomitant brain metastasis and the interaction with paired brain metastatic tumors.

Methods
The study included 48 patients with stage IV epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma. Sixteen of the forty-eight patients were diagnosed with brain metastasis, while the remaining thirty-two were not. All sixteen patients with brain metastasis had brain tumors. The expression of PD-L1, TILs (CD8+ T lymphocytes and FOXP3+ regulatory T lymphocytes), E-cadherin, and vimentin were evaluated using immunohistochemical (IHC) staining.

Results
Patients with brain metastasis exhibited a higher frequency of exon 19 deletion and uncommon EGFR mutations, a higher lung tumor vimentin score, worse progression-free survival (PFS), and overall survival (OS) than patients without brain metastasis. IHC staining showed no difference between paired lung and brain tumors. Patients with low PD-L1 expression had better PFS and OS. After multivariate analysis, higher body mass index, the presence of brain metastasis, bone metastasis, and uncommon EGFR mutations were correlated with worse PFS, while the presence of brain metastasis and high lung tumor E-cadherin score was associated with worse OS.

Conclusions
In patients with stage IV EGFR-mutant lung adenocarcinoma, high E-cadherin expression in the lung tumor might be associated with worse OS. Vimentin expression in the lung tumor was positively related to the risk of brain metastasis.
The association between serum albumin and depressive symptoms: a cross-sectional study of NHANES data during 2005–2018
Authors: Zhang Guimei , Li Shuna , Wang Sisi , Deng Fangyi , Sun Xizhe , Pan Jiyang 
Published: June 2023

Abstract
Aims
The association between serum albumin and depressive symptoms has been unclear in previous epidemiological studies. We explored whether serum albumin is associated with depressive symptoms based on the National Health and Nutrition Examination Survey (NHANES) data.

Methods
This cross-sectional study included 13,681 participants aged ≥ 20 years from the NHANES performed during 2005–2018, which produced nationally representative database. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Serum albumin concentration was measured using the bromocresol purple dye method, and participants were divided into quartiles of serum albumin concentrations. Weighted data were calculated according to analytical guidelines. Logistics regression and linear regression models were used to assess and quantify the association between serum albumin and depressive symptoms. Univariate and stratified analyses were also performed.

Results
There were 1551 (10.23%) adults (aged ≥ 20 years) with depressive symptoms among the 13,681. A negative association was found between serum albumin concentration and depressive symptoms. Compared with the lowest albumin quartile, the multivariate-adjusted effect size (95% confidence interval) for depressive symptoms of the fully adjusted model in the highest albumin quartile was 0.77 (0.60 to 0.99) and − 0.38 (− 0.66 to − 0.09) using logistics regression and linear regression models respectively. Current smoking status modified the association between serum albumin concentration and PHQ-9 scores (p for interaction = 0.033).

Conclusion
This cross-sectional study revealed that albumin concentration is significantly more likely to be a protective factor for depressive symptoms, with the association being more pronounced in non-smokers.
Impact assessment of e-trainings in occupational safety and health: a literature review
Authors: Barati Jozan Mohammad Mahdi , Ghorbani Babak Daneshvar , Khalid Md Saifuddin , Lotfata Aynaz , Tabesh Hamed 
Published: June 2023

Abstract
Background
Implementing workplace preventive interventions reduces occupational accidents and injuries, as well as the negative consequences of those accidents and injuries. Online occupational safety and health training is one of the most effective preventive interventions. This study aims to present current knowledge on e-training interventions, make recommendations on the flexibility, accessibility, and cost-effectiveness of online training, and identify research gaps and obstacles.

Method
All studies that addressed occupational safety and health e-training interventions designed to address worker injuries, accidents, and diseases were chosen from PubMed and Scopus until 2021. Two independent reviewers conducted the screening process for titles, abstracts, and full texts, and disagreements on the inclusion or exclusion of an article were resolved by consensus and, if necessary, by a third reviewer. The included articles were analyzed and synthesized using the constant comparative analysis method.

Result
The search identified 7,497 articles and 7,325 unique records. Following the title, abstract, and full-text screening, 25 studies met the review criteria. Of the 25 studies, 23 were conducted in developed and two in developing countries. The interventions were carried out on either the mobile platform, the website platform, or both. The study designs and the number of outcomes of the interventions varied significantly (multi-outcomes vs. single-outcome). Obesity, hypertension, neck/shoulder pain, office ergonomics issues, sedentary behaviors, heart disease, physical inactivity, dairy farm injuries, nutrition, respiratory problems, and diabetes were all addressed in the articles.

Conclusion
According to the findings of this literature study, e-trainings can significantly improve occupational safety and health. E-training is adaptable, affordable, and can increase workers’ knowledge and abilities, resulting in fewer workplace injuries and accidents. Furthermore, e-training platforms can assist businesses in tracking employee development and ensuring that training needs are completed. Overall, this analysis reveals that e-training has enormous promise in the field of occupational safety and health for both businesses and employees.
Defunctioning stoma in anterior resection for rectal cancer does not impact anastomotic leakage: a national population-based cohort study
Authors: Munshi Eihab , Lydrup Marie-Louise , Buchwald Pamela 
Published: June 2023

Abstract
Background
Anterior resection (AR) is considered the gold standard for curative cancer treatment in the middle and upper rectum. The goal of the sphincter-preserving procedure, such as AR, is vulnerable to anastomotic leak (AL) complications. Defunctioning stoma (DS) became the protective measure against AL. Often a defunctioning loop-ileostomy is used, which is associated with substantial morbidity. However, not much is known if the routine use of DS reduces the overall incidence of AL.

Methods
Elective patients subjected to AR in 2007–2009 and 2016-18 were recruited from the Swedish colorectal cancer registry (SCRCR). Patient characteristics, including DS status and occurrence of AL, were analyzed. In addition, independent risk factors for AL were investigated by multivariable regression.

Results
The statistical increase of DS from 71.6% in 2007–2009 to 76.7% in 2016–2018 did not impact the incidence of AL (9.2% and 8.2%), respectively. DLI was constructed in more than 35% of high-located tumors ≥ 11 cm from the anal verge. Multivariable analysis showed that male gender, ASA 3–4, BMI > 30 kg/m2, and neoadjuvant therapy were independent risk factors for AL.

Conclusion
Routine DS did not decrease overall AL after AR. A selective decision algorithm for DS construction is needed to protect from AL and mitigate DS morbidities.
Association of interleukin-8 polymorphism (+ 781 C/T) with the risk of oral Lichen Planus disease
Authors: Ghasemi Haniyeh , Mozaffari Hamid Reza , Kohsari Maryam , Hatami Masoud , Yari Kheirollah , Marabi Mohammad Hesam 
Published: June 2023

Abstract
Background
Oral Lichen Planus (OLP) is a chronic inflammatory mucosal disease. The pathogenesis of OLP is unknown. The Single Nucleotide Polymorphism (SNP) that occurs in the regulatory position + 781 could affect the expression of interleukin-8. This polymorphism is probably associated with increased serum levels of IL-8. The current study aimed to investigate the genotype and allele frequencies of IL-8( + 781 C/T) in OLP patients and whether it is associated with the severity of OLP disease in an Iranian population.

Methods
Three milliliters of saliva were taken from 100 patients with OLP and 100 healthy individuals who were matched in age and gender. After DNA extraction from saliva samples of patients and healthy individuals, the genotype of IL-8 at position + 781 is detected using the PCR-RFLP method. The results were analyzed using SPSS software.

Results
Frequency of C/C, T/C, and T/T genotypes at position IL-8 + 781 gene in the patient group were 47%, 41%, and 12%, respectively, and in the control group, were 37%, 42%, and 21%. The difference between the two groups regarding allele frequency distribution was statistically significant (χ2 = 3.86, p = 0.049, 95% CI = 0.44-1, OR = 0.66). Our results indicated the significantly higher frequency of the TT genotype in the erosive OLP compared to the nonerosive group (p = 0.03, OR = 0.89, 95% CI = 0.49–1.6).

Conclusion
This study depicted the difference in the frequency of SNP IL-8 + 781 C/T allele in the patient and control groups had a significant association with the risk of OLP. In addition, our data revealed that IL-8 + 781 C/T polymorphisms might be associated with the severity of OLP in the Iranian population.
ORIENTATE: automated machine learning classifiers for oral health prediction and research
Authors: Gomez-Rios Inmaculada , Egea-Lopez Esteban , Ortiz Ruiz Antonio José 
Published: June 2023

Abstract
Background
The application of data-driven methods is expected to play an increasingly important role in healthcare. However, a lack of personnel with the necessary skills to develop these models and interpret its output is preventing a wider adoption of these methods. To address this gap, we introduce and describe ORIENTATE, a software for automated application of machine learning classification algorithms by clinical practitioners lacking specific technical skills. ORIENTATE allows the selection of features and the target variable, then automatically generates a number of classification models and cross-validates them, finding the best model and evaluating it. It also implements a custom feature selection algorithm for systematic searches of the best combination of predictors for a given target variable. Finally, it outputs a comprehensive report with graphs that facilitates the explanation of the classification model results, using global interpretation methods, and an interface for the prediction of new input samples. Feature relevance and interaction plots provided by ORIENTATE allow to use it for statistical inference, which can replace and/or complement classical statistical studies.

Results
Its application to a dataset with healthy and special health care needs (SHCN) children, treated under deep sedation, was discussed as case study. On the example dataset, despite its small size, the feature selection algorithm found a set of features able to predict the need for a second sedation with a f1 score of 0.83 and a ROC (AUC) of 0.92. Eight predictive factors for both populations were found and ordered by the relevance assigned to them by the model. A discussion of how to derive inferences from the relevance and interaction plots and a comparison with a classical study is also provided.

Conclusions
ORIENTATE automatically finds suitable features and generates accurate classifiers which can be used in preventive tasks. In addition, researchers without specific skills on data methods can use it for the application of machine learning classification and as a complement to classical studies for inferential analysis of features. In the case study, a high prediction accuracy for a second sedation in SHCN children was achieved. The analysis of the relevance of the features showed that the number of teeth with pulpar treatments at the first sedation is a predictive factor for a second sedation.
Spatial distribution and factors influencing modern contraceptive practice among tribal married women in India: evidence from National Family Health Survey 5 (2019–2021)
Authors: Panda Sushree Nibedita , Barik Manish , Acharya Ardhendu Sekhar , Kanungo Srikanta , Pati Sanghamitra 
Published: June 2023

Abstract
Background
The unmet need for family planning has been a public health concern in developing countries, especially in the south-east region. In India, the expanding roles of women has led to a growing need for family planning and contraception. However, tribal women still struggle with reproductive and sexual health issues. Unfortunately, most tribal women are not informed about the potential health risks associated with contraceptive use, as service providers often neglect to provide this information. As a result, tribal women often suffer in silence, which can lead to serious health problems. Thus, the present study aimed to understand the patterns and factors associated with modern contraceptive usage as well as the district level variation in usage among tribal married women.

Methods
We included 91,976 tribal married women participants aged 15 to 49 years from National Family Health Survey 5 conducted during the years 2019 to 2021. Descriptive statistics were used to compute the prevalence of modern contraceptive usage along with 95% confidence interval (CI) as a measure of uncertainty. The association between various socio-demographic predictors and modern contraceptive usage were assessed by multivariable logistic regression and presented as an adjusted odds ratio (AOR).

Results
The overall prevalence of modern contraceptive practices was found to be 53% among tribal married women, which was below the national average. Sterilization was the most preferred method of modern contraceptive, whereas injectables were the least preferred method. More than 80% of the married women get the family planning information from the public health facility and health workers. Districts of eastern and north-eastern states have comparatively less modern contraceptive prevalence than central and southern states. Age, education, parity and access to media were significantly associated with the use of modern methods of contraception.

Conclusion
Improving contraceptive use and reducing unmet needs for contraception among tribal women requires sustained efforts from healthcare workers, including Information Education and Communication (IEC) through mass media to raise awareness. A tailored family planning strategy is crucial to address the specific needs of tribal women at both the local and national levels, with adequate resources and monitoring for impact with this India can achieve Total Fertility Rate (TFR) 2.1 among tribals.
Educational strategies in the health professions to mitigate cognitive and implicit bias impact on decision making: a scoping review
Authors: Thompson John , Bujalka Helena , McKeever Stephen , Lipscomb Adrienne , Moore Sonya , Hill Nicole , Kinney Sharon , Cham Kwang Meng , Martin Joanne , Bowers Patrick , Gerdtz Marie 
Published: June 2023

Abstract
Background
Cognitive and implicit biases negatively impact clinicians’ decision-making capacity and can have devastating consequences for safe, effective, and equitable healthcare provision. Internationally, health care clinicians play a critical role in identifying and overcoming these biases. To be workforce ready, it is important that educators proactively prepare all pre-registration healthcare students for real world practice. However, it is unknown how and to what extent health professional educators incorporate bias training into curricula. To address this gap, this scoping review aims to explore what approaches to teaching cognitive and implicit bias, for entry to practice students, have been studied, and what are the evidence gaps that remain.

Methods
This scoping review was guided by the Joanna Briggs Institute (JBI) methodology. Databases were searched in May 2022 and included CINAHL, Cochrane, JBI, Medline, ERIC, Embase, and PsycINFO. The Population, Concept and Context framework was used to guide keyword and index terms used for search criteria and data extraction by two independent reviewers. Quantitative and qualitative studies published in English exploring pedagogical approaches and/or educational techniques, strategies, teaching tools to reduce the influence of bias in health clinicians' decision making were sought to be included in this review. Results are presented numerically and thematically in a table accompanied by a narrative summary.

Results
Of the 732 articles identified, 13 met the aim of this study. Most publications originated from the United States (n=9). Educational practice in medicine accounted for most studies (n=8), followed by nursing and midwifery (n=2). A guiding philosophy or conceptual framework for content development was not indicated in most papers. Educational content was mainly provided via face-to-face (lecture/tutorial) delivery (n=10). Reflection was the most common strategy used for assessment of learning (n=6). Cognitive biases were mainly taught in a single session (n=5); implicit biases were taught via a mix of single (n=4) and multiple sessions (n=4).

Conclusions
A range of pedagogical strategies were employed; most commonly, these were face-to-face, class-based activities such as lectures and tutorials. Assessments of student learning were primarily based on tests and personal reflection. There was limited use of real-world settings to educate students about or build skills in biases and their mitigation. There may be a valuable opportunity in exploring approaches to building these skills in the real-world settings that will be the workplaces of our future healthcare workers.