bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of site of occlusion in proximal splenic artery embolisation for blunt splenic trauma
Authors: Boscà-Ramon A. , Ratnam L. , Cavenagh T. , Chun J-Y , Morgan R. , Gonsalves M. , Das R. , Ameli-Renani S. , Pavlidis V. , Hawthorn B. , Ntagiantas N. , Mailli L. 
Published: August 2022

AbstractBackgroundProximal splenic artery embolisation (PSAE) can be performed in stable patients with Association for the Surgery of Trauma (AAST) grade III-V splenic injury. PSAE reduces splenic perfusion but maintains viability of the spleen and pancreas via the collateral circulation. The hypothesized ideal location is between the dorsal pancreatic artery (DPA) and great pancreatic artery (GPA). This study compares the outcomes resulting from PSAE embolisation in different locations along the splenic artery.Materials and methodsRetrospective review was performed of PSAE for blunt splenic trauma (2015–2020). Embolisation locations were divided into: Type I, proximal to DPA; Type II, DPA-GPA; Type III, distal to GPA. Fifty-eight patients underwent 59 PSAE: Type I (7); Type II (27); Type III (25). Data was collected on technical and clinical success, post-embolisation pancreatitis and splenic perfusion. Statistical significance was assessed using a chi-squared test.ResultsTechnical success was achieved in 100% of cases. Clinical success was 100% for Type I/II embolisation and 88% for Type III: one patient underwent reintervention and two had splenectomies for ongoing instability. Clinical success was significantly higher in Type II embolisation compared to Type III (p = 0.02). No episodes of pancreatitis occurred post-embolisation. Where post-procedural imaging was obtained, splenic perfusion remained 100% in Type I and II embolisation and 94% in Type III. Splenic perfusion was significantly higher in the theorized ideal Type II group compared to Type I and III combined (p = 0.01).ConclusionThe results support the proposed optimal embolisation location as being between the DPA and GPA.
Correlation between self-reported and questioned Epworth sleepiness scale results including polysomographic outcomes
Authors: Basak Hazan , Anadolu R. Yucel 
Published: August 2022

Abstract
Introduction
Obstructive sleep apnea (OSA) is characterized by a recurrent complete or partial obstruction in the upper airways accompanied by desaturation attacks and recurrent awakenings (arousal) during sleep and is associated with excessive sleepiness and poor quality of life. Excessive daytime sleepiness (EDS) has long been recognized as the most important symptom of OSA and Epworth sleepiness scale (ESS) is a simple, easy-to-understand, self-reported, validated scale used in the evaluation of patients with obstructive sleep apnea syndrome (OSAS).

Objective
Some researchers have reported that ESS has controversial results in evaluating OSAS due to the fact that it is based on self-reporting. It is known that ESS is a self-administered patient questionnaire, but it can also be administered by the doctor, and the information about the latter’s validity, reliability, and correlation with OSAS is limited. This study was conducted to compare the outcomes of ESS self-administered by the patient and administered by a doctor in patients with OSAS.

Methods
Ninety-three patients with OSAS symptoms, with polysomnography test results, and who were presented in a tertiary hospital in 2019 for snoring and apnea problems were included in this study. ESS, consisting of eight questions and used to measure daytime sleepiness in various situations on the basis of self-reporting, was used. Subsequently, ESS was repeated, but this time verbally administered by the doctor to the patient. ESS is a 4-point Likert-type scale scored with 0, 1, 2, and 3. Excessive daytime sleepiness is accepted in individuals with a total score of 11 or more. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) program.

Results
Of the patients who participated in this study, 57% (n = 53) were male and 43% (n = 40) were female. The average age of the patients was 48.1±9.71. The body mass index (BMI) average was 29.7±5.66 kg/m2, and the average neck circumference was 38.6±4.62 cm. The mean value of the completed ESS self-administered by the patient (ESSp) was calculated as 11.0±5.25 and that of the ESS administered by the doctor (ESSd) was 7.9±4.76. For the results, while daytime sleepiness was 35.5% in ESSd, it was 52.7% in ESSp. A positive correlation was found between the ESSd and ESSp values and BMI. A positive correlation was also found between the apnea-hypopnea index (AHI) and BMI.

Conclusions
The ESS administered by a doctor will yield more accurate data about the severity of OSAS than the ESS self-administered by the patient.
Krebs von den Lungen 6 (KL-6) levels in COVID-19 ICU patients are associated with mortality
Authors: Scarpati Giuliana , Baldassarre Daniela , Boffardi Massimo , Calabrese Vincenzo , De Robertis Edoardo , Lacava Graziella , Oliva Filomena , Pagliano Pasquale , Pascale Gabriele , Tripepi Giovanni L. , Piazza Ornella 
Published: August 2022

AbstractBackgroundKrebs von den Lungen 6 (KL-6) is a high-molecular-weight mucin-like glycoprotein, which is also known as MUC1. KL-6 is mainly produced by type 2 pneumocytes and bronchial epithelial cells, and, therefore, elevated circulating KL-6 levels may denote disorders of the alveolar epithelial lining.The objective of this study is to verify if KL-6 serum level might support ICU physicians in predicting mortality, risk stratifying and triaging severe COVID-19 patients.MethodsA retrospective cohort study, including all the COVID-19 patients who measured KL-6 serum values at least once during their ICU stay, was performed. The study sample, 122 patients, was divided in two groups, according to the median KL-6 value at ICU admission (median log-transformed KL-6 value: 6.73 U/ml; group A: KL-6 lower than the median and group B: KL-6 higher than the median).ResultsOne-hundred twenty-two ICU patients were included in this study. Mortality was higher in group B than in group A (80 versus 46%;p < 0.001); both linear and logistic multivariate analyses showed ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (P/F) significantly and inversely related to KL-6 values.ConclusionAt ICU admission, KL-6 serum level was significantly higher in the most hypoxic COVID-19 patients and independently associated with ICU mortality.
Association Between Anesthesia Provider Education and Carbon Footprint Related to the Use of Inhaled Halogenated Anesthetics
Authors: Chambrin Coralie , de Souza Sander , Gariel Claire , Chassard Dominique , Bouvet Lionel 
Published: August 2022

BACKGROUND:
Inhaled halogenated anesthetics are responsible for half of operating room total greenhouse gas emissions. Sustainable anesthesia groups were set up in 4 Lyon, France, university hospitals (Hospices Civils de Lyon) in January 2018 and have supported a specific information campaign about the carbon footprint related to the use of inhaled halogenated anesthetics in June 2019. We aimed to assess whether implementing such information campaigns was associated with a decrease in the carbon footprint related to inhaled halogenated anesthetics.

METHODS:
This retrospective cohort study was conducted from January 1, 2015, to February 29, 2020, in 4 hospitals of the Hospices Civils de Lyon in France. Information meetings on sustainable anesthesia practices were organized by sustainable anesthesia groups that were set up in January 2018. In addition, a specific information campaign about the carbon footprint related to inhaled halogenated anesthetics was conducted in June 2019; it was followed by a questionnaire to be completed online. The monthly purchase of sevoflurane, desflurane, and propofol was recorded, and the estimated monthly carbon footprint from desflurane- and sevoflurane-related perioperative emissions was calculated. The interrupted time-series data from January 2015 to February 2020 were analyzed by segmented regression, considering both interventions (setting up of the sustainable anesthesia groups and specific information campaign) in the analysis and adjusting for 2 confounding factors (seasonality of the data and number of general anesthesia uses).

RESULTS:
Among the 641 anesthesia providers from the study hospitals, 121 (19%) attended the information meetings about the carbon footprint of inhaled halogenated anesthetics, and 180 (28%) completed the questionnaire. The anesthetic activity from all 641 providers was considered in the analysis. After the sustainable anesthesia groups were set up, the carbon footprint of sevoflurane and desflurane started decreasing: the slope significantly changed (P < .01) and became significantly negative, from −0.27 (95% confidence interval [CI], −1.08 to 0.54) tons.month−1 to −14.16 (95% CI, −16.67 to −11.65) tons.month−1. After the specific information campaign, the carbon footprint kept decreasing, with a slope of −7.58 (95% CI, −13.74 to −1.41) tons.month−1 (P = .02), which was not significantly different from the previous period (P = .07).

CONCLUSIONS:
The setup of the sustainable anesthesia groups was associated with a dramatic reduction in the carbon footprint related to halogenated anesthetics. These results should encourage health care institutions to undertake information campaigns toward anesthesia providers so that they also take into account the environmental impact in the choice of anesthetic drugs, in addition to the benefits for the patient and economic concerns.
Potentially Inappropriate Medication Administration Is Associated With Adverse Postoperative Outcomes in Older Surgical Patients: A Retrospective Cohort Study
Authors: Burfeind Kevin G. , Zarnegarnia Yalda , Tekkali Praveen , O’Glasser Avital Y. , Quinn Joseph F. , Schenning Katie J. 
Published: August 2022

BACKGROUND:
The American Geriatrics Society (AGS) Beers Criteria is an explicit list of potentially inappropriate medications (PIMs) best avoided in adults ≥65 years of age. Cognitively impaired and frail surgical patients often experience poor outcomes after surgery, but the impacts of PIMs on these patients are unclear. Our objective was to assess whether perioperative PIM administration was associated with poor outcomes in geriatric surgical patients. We then evaluated the association between PIM administration and postoperative outcomes in subgroups of patients who were frail or cognitively impaired.

METHODS:
We performed a retrospective cohort study of patients ≥65 years of age who underwent elective inpatient surgery at a large academic medical center from February 2018 to January 2020. Edmonton Frail Scale and Mini-Cog screening tools were administered to all patients at their preoperative clinic visit. A Mini-Cog score of 0 to 2 was considered cognitive impairment, and frailty was defined by an Edmonton Frail Scale score of ≥8. Patients were divided into 2 groups depending on whether they received at least 1 PIM (PIM+), based on the 2019 AGS Beers Criteria, in the perioperative period or none (PIM−). We assessed the association of preoperative frailty, cognitive impairment, and perioperative PIM administration with the length of hospital stay and discharge disposition using multiple regression analyses adjusted for age, sex, ASA physical status, and intensive care unit (ICU) admission.

RESULTS:
Of the 1627 included patients (mean age, 73.7 years), 69.3% (n = 1128) received at least 1 PIM. A total of 12.7% of patients were frail, and 11.1% of patients were cognitively impaired; 64% of the frail patients and 58% of the cognitively impaired patients received at least 1 PIM. Perioperative PIM administration was associated with longer hospital stay after surgery (PIM−, 3.56 ± 5.2 vs PIM+, 4.93 ± 5.66 days; P < .001; 95% confidence interval [CI], 0.360–0.546). Frail patients who received PIMs had an average length of stay (LOS) that was nearly 2 days longer than frail patients who did not receive PIMs (PIM−, 4.48 ± 5.04 vs PIM+, 6.33 ± 5.89 days; P = .02). Multiple regression analysis revealed no significant association between PIM administration and proportion of patients discharged to a care facility (PIM+, 26.3% vs PIM−, 28.7%; P = .87; 95% CI, −0.046 to 0.054).

CONCLUSIONS:
Perioperative PIM administration was common in older surgical patients, including cognitively impaired and frail patients. PIM administration was associated with an increased hospital LOS, particularly in frail patients. There was no association found between PIM administration and discharge disposition.
Rapid cardiac thermal acclimation in wild anadromous Arctic char (Salvelinus alpinus)
Authors: Gilbert Matthew J. H. , Middleton Ella K. , Kanayok Kevin , Harris Les N. , Moore Jean-Sébastien , Farrell Anthony P. , Speers-Roesch Ben 
Published: August 2022

ABSTRACT
Migratory fishes commonly encounter large and rapid thermal variation, which has the potential to disrupt essential physiological functions. Thus, we acclimated wild, migratory Arctic char to 13°C (∼7°C above a summer average) for an ecologically relevant period (3 days) and measured maximum heart rate (ƒH,max) during acute warming to determine their ability to rapidly improve cardiac function at high temperatures. Arctic char exhibited rapid compensatory cardiac plasticity similar to past observations following prolonged warm acclimation: they reduced ƒH,max over intermediate temperatures (−8%), improved their ability to increase ƒH,max during warming (+10%), and increased (+1.3°C) the temperature at the onset of an arrhythmic heartbeat, a sign of cardiac failure. This rapid cardiac plasticity may help migrating fishes such as Arctic char mitigate short-term thermal challenges. Furthermore, by using mobile Arctic research infrastructure in a remote field location, the present study illustrates the potential for field-based, experimental physiology in such locations.
Covered stent placement for gastroduodenal artery stump hemorrhage after pancreaticoduodenectomy: long-term patency and risk factor of stent failure
Authors: Min Hooney , Yoon Chang Jin , Lee Jae Hwan , Choi Won Seok , Yeo Joon Bum , Yoon Yoo-Seok , Cho Jai Young , Lee Hae Won , Lee Jun Suh 
Published: August 2022

Objective: To evaluate the long-term outcomes of covered stent placement in patients with gastroduodenal artery (GDA) stump hemorrhage after pancreaticoduodenectomy (PD) and to identify risk factors of stent failure. Methods and materials: Covered stent was placed in total of 21 patients for GDA stump hemorrhage after PD from September 2012 to March 2021. Technical and clinical success, complications, and stent patency were retrospectively evaluated. Nine relevant variables were analyzed to determine risk factors for stent failure. Results: In 20 of 21 patients (95.2%), the GDA stump was completely excluded with covered stent placement. Immediate hemostasis was achieved in the 20 patients and rebleeding from jejunal artery occurred in one patient which was successfully embolized one day after the stent placement. There was no procedure-related complication or early mortality (<30 days). During follow-up period (median 655.5 days), stent thrombosis was found on CT in 10 patients (50.0%, 10/20) without any laboratory or CT abnormalities. One thrombosed stent migrated into the jejunum 20 months after placement. The six-month, one-year, and two-year stent patency were 81.9%, 52.9%, and 37.8%, respectively (median 620 days). The recurrence of primary malignancy was associated with stent failure (HR 5.70; 95% CI 1.18–27.76, p = 0.03). Conclusions: Covered stent placement is an effective and safe management of postoperative GDA stump hemorrhage. Stent failure occurred frequently (50%) but did not cause liver ischemia. Stent failure was associated with recurrence of primary malignancy. Advances in knowledge 1. Covered stent placement is an effective and safe management of postoperative GDA stump hemorrhage. 2. Stent failure occurred frequently (50%) but did not cause liver ischemia. 3. Stent failure was associated with recurrence of primary malignancy.
The spectrum of Self-directed learning perceptions among faculty members and students of Bolan University of Medical and Health Sciences
Authors: Mehboob Mukhtar 
Published: August 2022

Objectives: To analyze the perception of students and faculty regarding self-directed learning (SDL).
Methods: This mixed method study design (pragmatic) with both positivist and interpretive approaches was conducted on faculty members and students of Bolan Medical College Quetta from 1st April 2021 to 31st Aug 2021 on 246 medical and dental students and 12 faculty members. The research question was about the role of SDL in undergraduate medical students and faculty members. The inclusion criteria were any registered student and permanent faculty member, while exclusion criteria were any selected student and faculty member who not consented to participate in study. Data on self-directed learning instruments from medical students on 5 points Likert scale was collected by regular interval method and faculty members on an open narrative questionnaire by purposive sampling. The data were analyzed by the SPSS version 26, framework method of content analysis, and constant comparison technique.
Results: The mean age of students was 21.45 + 2.01 years. There were 114 males and 132 females (ratio 1: 1.15). The maximum mean score (4.35) is 91.1% followed by (4.32) 84.0% of students’ percept that SDL constantly improves & excels in learning and successes and failures inspire SDL. The minimum mean score (3.32) 49.2% revealed that students felt difficulty in arranging and controlling their learning time. The faculty perception that SDL leads to professional identity (confidence & self-identity), improved technical skill (better expression & enhanced cognition), professionalism (focused learning, effective reflection, time management & self-satisfaction), collaboration, communicator, and leadership qualities.
Conclusion: The students strongly believed that SDL will improve and excel but they need time management. Faculty members concluded that leadership, communication, collaboration, and professionalism are related to SDL.
doi: https://doi.org/10.12669/pjms.38.7.6517
How to cite this:Mehboob M. The spectrum of Self-directed learning perceptions among faculty members and students of Bolan University of Medical and Health Sciences. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.6517
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Association between the dysfunctions of the stomatognathic system and the disorders in the statics of the body
Authors: Odzimek Martyna 
Published: August 2022

INTRODUCTION The stomatognathic system is a group of tissues and organs consisting of: the mandible, teeth (upper and lower), two temporomandibular joints, muscles, ligaments and numerous vessels: nerve, blood and lymph. We define the body posture as an individual, individual feature of each person, which is expressed by the figure. A defect of posture or a disorder of the body statics is any anomaly from the correct posture that may be congenital or acquired.
OBJECTIVE The main aim of the study was to assess the relationship between dysfunctions of the stomatognathic system and disturbances in body statics. The research was conducted from January to February 2022 using the proprietary questionnaire, which was made available online (Google Forms).
RESULTS At least one symptom of body statics disorders was noticeable in 77 people from the group of people with problems within the stomatognathic system (88,51%). Only 10 people with disorders of the masticatory system motor system did not report any postural abnormalities (11,49%). The results of the research show that there is a statistically significant relationship between the occurrence of dysfunctions within the stomatognathic system and disturbances in body statics (x2 = 28,11 > x2 = 22,4570,001;6 - statistically significant relationship, rc = 0,304 - average strength of the relationship).
CONCLUSIONS The complexity of the issue shows that focusing on only one problem may not produce the measured therapeutic effects. Only comprehensive and properly planned treatment brings the maximum therapeutic effect.
Cognitive and psychomotor performance of Polish and Ukrainian drivers
Authors: Horoszkiewicz Krzysztof , Horoszkiewicz Bartosz 
Published: August 2022

Introduction. Recent years have seen a dynamic increase in people from eastern countries employed in Polish road transport.
The aim of the study was to compare the cognitive and psychomotor performance of Polish and Ukrainian drivers.

Material and Methods. The results of 336 male truck drivers aged between 22 and 64 years were analysed. There were 174 respondents in the Polish sample (M = 38.6 years; SD = 10.3) and 162 respondents in the Ukrainian sample (M = 36.8 years; SD = 8.3). The level of intellectual performance was assessed using the Raven's Matrix Test (TMS) and the Precision of Movement and Quick Thinking (PIM) Index. Psychomotor performance was verified using computer tests belonging to the SDP System.

Results. Ukrainian drivers, compared to Polish drivers, were characterised by analogous results in terms of cognitive processes and psychomotor performance. The mean scores of the Raven's test, PIM index and also coordination tests were comparable in both groups. A strong positive correlation was found between TMS and PIM.

Conclusions. 1. Drivers from Ukraine and Poland have similar intellectual and psychomotor abilities. 2. The PIM index correlates strongly positively with TMS and can be a reliable tool in intelligence screening. 3. The presented methods of the SDP System are not culturally loaded. Standardised scales addressed to the Polish driver population should be used to assess these areas in Ukrainian subjects.
Sensory quality of selected natural yoghurts available on the Polish market
Authors: Kiciak Agata , Orzycki Marcin , Staśkiewicz Wiktoria , Bielaszka Agnieszka , Kardas Marek 
Published: August 2022

Introduction: The fermented milk drinks include: yogurt, kefir, fermented milk, acidophilic milk, koumiss and new generation dairy products. The high nutrient content of yogurt is related to the composition of the milk it is made of. Aim: The aim of the study was to assess the sensory quality of selected natural yoghurts available on the Polish market.Material and methods: The research material consisted of 8 natural yoghurts available on the Polish market. Natural yoghurts were purchased in supermarkets in the Silesian Voivodeship. The intensity of the examined features (color, taste, smell, consistency, general appearance) was assessed using a proprietary card for evaluation on a five-point scale (5 - very good quality, 1 - disqualifying quality). Results: The results of the sensory evaluation using the 5-point method: The highest mean was obtained by the yoghurt code: 125 - 4.34 (± 0.47) and the worst by the respondents was the yogurt with the code: 596 - 3.54 (± 0.77). The results of the sensory evaluation carried out by the scheduling method: the highest scores were obtained for natural yoghurts with the codes 133 and 189.Conclusions: The evaluation of the sensory quality of selected natural yoghurts carried out using the five-point method showed that the highest overall score was obtained by yogurt containing: milk, powdered milk, milk proteins, calcium, live cultures of yoghurt fermentation bacteria, Lactobacillus acidophilus LA-5® i Bifidobacterium BB-12®.The evaluation carried out by the ranking method showed that yoghurts with the following compositions were best evaluated by the respondents: milk, milk proteins, live yoghurt bacteria cultures and milk, live bacteria cultures, selected lactic acid strains of Bifidobacterium BB-12®, 0% fat.The lowest score of respondents in the sensory evaluation with the use of both methods was obtained by natural yoghurt with the following composition: milk, live bacteria cultures.