bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential Value of Cerebrospinal Fluid Progranulin in the Identification of Postoperative Delirium in Geriatrics Patients Undergoing Knee Replacement: The Perioperative Neurocognitive Disorder and Biomarker LifestylE Study
Authors: Wang Bin , Sun Xiujie , Wang Jiahan , Deng Xiyuan , Lin Yanan , Liu Fanghao , Dong Rui , Lin Xu , Bi Yanlin 
Published: January 2022

Objective: The aim of this study was to investigate whether progranulin (PGRN) levels in cerebrospinal fluid (CSF) were associated with postoperative delirium (POD) in geriatric patients undergoing knee replacement.Method: A total of 600 Han Chinese patients aged 65–90 years and who underwent unilateral total knee arthroplasty were included in the Perioperative Neurocognitive Disorder And Biomarker LifestylE (PNDABLE) study from June 2020 to November 2020. All participants were assessed using the Confusion Assessment Method and the Memorial Delirium Assessment Scale on postoperative days 1–7 (or before discharge) by an anesthesiologist. CSF PGRN and CSF biomarkers of POD were measured by ELISA. We analyzed the risk and protective factors of POD using the multivariate logistic regression, and the associations between CSF PGRN and CSF biomarkers of POD using multiple linear regression. We also explored whether the influence of CSF PGRN on POD was mediated by POD core pathology in linear regression models.Results: Postoperative delirium incidence was 9.7% (53/545). There were significant differences in preoperative CSF PGRN between patients with POD and non-POD (NPOD). As for CSF biomarkers, CSF Aβ40, T-tau, and P-tau were risk factors for POD, while CSF PGRN, Aβ42, and Aβ42/Aβ40 were protective factors for POD, as shown by the multivariate logistic regression analysis. CSF PGRN was positively associated with CSF Aβ42 and was negatively associated with CSF Aβ40, T-tau, and P-tau in patients with POD. We found that the AUC was 0.795 (95% CI = 0.706, 0.867) for PGRN between POD and NPOD groups. We found the influence of CSF PGRN on POD was mediated by POD core pathology. The effect was considered partial mediation with the proportion of mediation varying from 44.92 to 62.07%.Conclusion: Cerebrospinal fluid PGRN may be a reasonably good prognostic factor for POD development. Overall, amyloid pathology and tau protein might partially mediate the influence of PGRN on POD.Clinical Trial Registration:www.clinicaltrials.gov, identifier ChiCTR2000033439.
Increasing Seaweed Consumption in the Netherlands and Portugal and the Consequences for the Intake of Iodine, Sodium, and Exposure to Chemical Contaminants: A Risk-Benefit Study
Authors: Vellinga Reina Elisabeth , Sam Matthijs , Verhagen Hans , Jakobsen Lea Sletting , Ravn-Haren Gitte , Sugimoto Minami , Torres Duarte , Katagiri Ryoko , Thu Beate Julie , Granby Kit , Hoekstra Jeljer , Temme Elisabeth Helena Maria 
Published: January 2022

Background: Seaweed has a high potential for nourishing the future planet. However, besides being beneficial, it also contains adverse components; this poses the question whether consumption of seaweed foods overall contributes beneficially or detrimentally to human health, and hence if their consumption should be promoted or restricted.Methods: This study evaluated the impact of substituting regular foods with seaweed foods in the diet, both in terms of nutritional quality (via iodine and sodium) and food safety (via arsenic, cadmium, lead, and mercury). Food consumption data from the Netherlands and Portugal (adults aged &gt;18 years) were used, in which 10% of the amounts of pasta, bacon, and lettuce consumed were replaced by seaweed-derived products made from kelp (Saccharina latissima). Using Monte Carlo Risk Assessment software (MCRA), long-term nutrient intake and exposure to contaminants were assessed. The results obtained for the Netherlands and Portugal were compared with data from Japan, a country that has a high natural consumption of seaweed.Results: This low-tier risk-benefit study reveals that an increased seaweed consumption (as assessed by the 10% replacement with seaweed products) has no consequences in terms of intake of sodium and exposure to cadmium, lead, and mercury, and the associated (absence of) adverse health aspects. The alternative scenario almost doubled the mean iodine intake in the Netherlands (to 300 μg/day) and Portugal (to 208 μg/day) and increased the average exposure to arsenic levels in the Netherlands (to 1.02 μg/kg bw/day) and Portugal (to 1.67 μg/kg bw/day).Conclusion: The intake of iodine and exposure to arsenic in the Netherland and Portugal were certainly higher due to the modeled increase of seaweed foods. If seaweed consumption increases close to the 10% substitution, the public health consequences thereof may trigger further research.
Effects of Intravenous Infusion of Lidocaine on Short-Term Outcomes and Survival in Patients Undergoing Surgery for Ovarian Cancer: A Retrospective Propensity Score Matching Study
Authors: Zhang Hao , Gu Jiahui , Qu Mengdi , Sun Zhirong , Huang Qihong , Cata Juan P. , Chen Wankun , Miao Changhong 
Published: January 2022

BackgroundIntravenous lidocaine has been shown to reduce opioid consumption and is associated with favourable outcomes after surgery. In this study, we explored whether intraoperative lidocaine reduces intraoperative opioid use and length of stay (LOS) and improves long-term survival after primary debulking surgery for ovarian cancer and explored the correlation between SCN9A expression and ovarian cancer prognosis.MethodsThis retrospective study included patients who underwent primary debulking surgery(PDS) for ovarian cancer from January 2015 to December 2018. The patients were divided into non-lidocaine and lidocaine [bolus injection of 1.5 mg/kg lidocaine at the induction of anaesthesia followed by a continuous infusion of 2 mg/(kg∙h) intraoperatively] groups. Intraoperative opioid consumption, the verbal numeric rating scale (VNRS) at rest and LOS were recorded. Propensity score matching was used to minimize bias, and disease-free survival (DFS) and overall survival (OS) were compared between the two groups.ResultsAfter propensity score matching(PSM), the demographics were not significantly different between the groups. The intraoperative sufentanil consumption in the lidocaine group was significantly lower than that in the non-lidocaine group (Mean: 35.6 μg vs. 43.2 μg, P=0.035). LOS was similar between the groups (12.0 days vs. 12.4 days, P=0.386). There was a significant difference in DFS between the groups (32.3% vs. 21.6%, P=0.015), and OS rates were significantly higher in the lidocaine group than in the non-lidocaine group (35.2% vs. 25.6%, P=0.042). Multivariate analysis indicated that intraoperative lidocaine infusion was associated with prolonged OS and DFS.ConclusionIntraoperative intravenous lidocaine infusion appears to be associated with improved OS and DFS in patients undergoing primary debulking surgery for ovarian cancer. Our study has the limitations of a retrospective review. Hence, our results should be confirmed by a prospective randomized controlled trial.
C-Reactive Protein Is an Indicator of the Immunosuppressive Microenvironment Fostered by Myeloid Cells in Hepatocellular Carcinoma
Authors: Wang Yongchun , Li Zhixiong , Huang Zhijie , Yu Xingjuan , Zheng Limin , Xu Jing 
Published: January 2022

BackgroundC-reactive protein (CRP) is a widely used marker of systemic inflammation and predicts poor clinical outcomes in patients with hepatocellular carcinoma (HCC); however, its significance in the local immune response at the tumor site is not clear.MethodsSerum CRP levels of 329 HCC patients were detected before resection. Paired paraffin-embedded tumor samples were used to quantify immune cell populations, such as CD11b+ myeloid cells, CD68+ macrophages (Mφs), CD15+ neutrophils, CD8+ T cells, and CD206+, CD204+, CD163+ and CD169+ Mφs, by immunohistochemistry. Enrichment scores for 34 types of immune cells based on transcriptome data from 24 HCC samples were calculated by xCell. Overall survival of patients was analyzed using the Kaplan-Meier method.ResultsSerum CRP levels were correlated with liver functions and tumor stages in patients with HCC. The densities of CD68+ tumor-associated macrophages (TAMs) and CD15+ tumor-associated neutrophils (TANs) were significantly higher in patients with elevated serum CRP levels than in those with low CRP levels (both p &lt; 0.0001). Further analysis of TAM subtypes revealed that serum CRP levels were associated with CD204+ and CD163+ Mφ densities (p &lt; 0.0001 and p = 0.0003, respectively). Moreover, transcriptome data showed that CRP expression was associated with the expression of myeloid cell infiltration-related genes in HCC tumors. The combination of serum CRP with TAMs or TANs in both the nontumor and intratumor regions could represent a powerful criterion for predicting patient prognoses.ConclusionSerum CRP could serve as an indicator of an immunosuppressive TME in HCC, which could be of potential clinical application for treatment strategies targeting the TME.
Augmented Reality to Assist Skin Paddle Harvesting in Osteomyocutaneous Fibular Flap Reconstructive Surgery: A Pilot Evaluation on a 3D-Printed Leg Phantom
Authors: Cercenelli Laura , Babini Federico , Badiali Giovanni , Battaglia Salvatore , Tarsitano Achille , Marchetti Claudio , Marcelli Emanuela 
Published: January 2022

BackgroundAugmented Reality (AR) represents an evolution of navigation-assisted surgery, providing surgeons with a virtual aid contextually merged with the real surgical field. We recently reported a case series of AR-assisted fibular flap harvesting for mandibular reconstruction. However, the registration accuracy between the real and the virtual content needs to be systematically evaluated before widely promoting this tool in clinical practice. In this paper, after description of the AR based protocol implemented for both tablet and HoloLens 2 smart glasses, we evaluated in a first test session the achievable registration accuracy with the two display solutions, and in a second test session the success rate in executing the AR-guided skin paddle incision task on a 3D printed leg phantom.MethodsFrom a real computed tomography dataset, 3D virtual models of a human leg, including fibula, arteries and skin with planned paddle profile for harvesting, were obtained. All virtual models were imported into Unity software to develop a marker-less AR application suitable to be used both via tablet and via HoloLens 2 headset. The registration accuracy for both solutions was verified on a 3D printed leg phantom obtained from the virtual models, by repeatedly applying the tracking function and computing pose deviations between the AR-projected virtual skin paddle profile and the real one transferred to the phantom via a CAD/CAM cutting guide. The success rate in completing the AR-guided task of skin paddle harvesting was evaluated using CAD/CAM templates positioned on the phantom model surface.ResultsOn average, the marker-less AR protocol showed comparable registration errors (ranging within 1-5 mm) for tablet-based and HoloLens-based solution. Registration accuracy seems to be quite sensitive to ambient light conditions. We found a good success rate in completing the AR-guided task within an error margin of 4 mm (97% and 100% for tablet and HoloLens, respectively). All subjects reported greater usability and ergonomics for HoloLens 2 solution.ConclusionsResults revealed that the proposed marker-less AR based protocol may guarantee a registration error within 1-5 mm for assisting skin paddle harvesting in the clinical setting. Optimal lightening conditions and further improvement of marker-less tracking technologies have the potential to increase the efficiency and precision of this AR-assisted reconstructive surgery.
Urine Biomarkers Combined With Ultrasound for the Diagnosis of Obstruction in Pediatric Hydronephrosis
Authors: Kazlauskas Vytis , Bilius Vytautas , Jakutis Virginijus , Komiagiene Renata , Burnyte Birute , Verkauskas Gilvydas 
Published: January 2022

Introduction: To establish the efficacy of ultrasound (US) combined with urine biomarkers in differentiating patients who require surgical management from those who do not, avoiding invasive investigations.Materials and Methods: From February 2019 to February 2021, all pediatric patients who presented with hydronephrosis were selected for the study. All renal units (RU) were evaluated by US, and fresh frozen voided urine samples were collected at the time of inclusion. Hydronephrosis grade was evaluated by the Society for Fetal Urology (SFU) and an alternative grading system (AGS). Patients who had high-grade hydronephrosis on US were referred to renal scan (RS) or intervention, when there was an increase of dilatation in subsequent follow-up images. Fresh frozen urine from the control group with no history of renal diseases and no renal anomalies on US was collected. We compared differences of US parameters combined with urine biomarkers between surgically and non-surgically managed patients and between the groups of patients when they were stratified by different RS findings and analyzed whether urinary biomarkers give any additional value to US. Instead of the anterior–posterior diameter (APD), we used its ratio with mid-parenchymal thickness. The additional efficacy of biomarkers to US was calculated when the US component was derived to a cumulative APD/mid-parenchymal ratio.Results: Sixty-four patients with hydronephrosis were prospectively included in the study accounting for a total of 81 patient visits and 162 RUs evaluated. A control group of 26 patients was collected. The mean age at inclusion in the hydronephrosis group was 43.7(±45.5) months, and a mean age in a control group was 61.2(±41.3) months. The cumulative APD/mid-parenchymal ratio combined with urinary albumin, β2 microglobulin (β2-M), and urinary neutrophil gelatinase-associated lipocalcin may have a better performance in the prediction of surgical intervention than the cumulative APD/mid-parenchymal ratio alone (p = 0.1). The best performance to detect the increased tissue transit time and obstructive curve on RS was demonstrated by the β2-M creatinine ratio. An increased cumulative APD/mid-parenchymal ratio with biomarkers together had a fairly good sensitivity and specificity for detection of DRF &lt; 40%.Conclusions: According to our data, the APD/mid-parenchymal ratio alone has good efficacy in prediction of surgery and abnormal RS findings especially when combined with urine biomarkers.
Transient Early Fine Motor Abnormalities in Infants Born to COVID-19 Mothers Are Associated With Placental Hypoxia and Ischemia
Authors: Liu Huan-Yu , Guo Juanjuan , Zeng Chang , Cao Yuming , Ran Ruoxi , Wu Tiancheng , Yang Guifang , Zhao Dongchi , Yang Pu , Yu Xuechen , Zhang Wei , Liu Song-Mei , Zhang Yuanzhen 
Published: January 2022

Background: Long-term effects of Coronavirus Disease 2019 (COVID-19) on infants born to infected mothers are not clear. Fine motor skills are crucial for the development of infant emotional regulation, learning ability and social skills.Methods: Clinical information of 100 infants born to 98 mothers (COVID-19 n = 31, non-COVID-19 n = 67) were collected. Infants were follow-up up to 9 months post-partum. The placental tissues were examined for SARS-CoV-2 infection, pathological changes, cytokines, and mtDNA content.Results: Decreased placental oxygen and nutrient transport capacity were found in infected pregnant women. Increased IL-2, IL-6, TNF-α, and IFN-γ were detected in trophoblast cells and maternal blood of COVID-19 placentas. Elevated early fine motor abnormal-ities and increased serum TNI (troponin I) levels at delivery were observed in infants born to mothers with COVID-19. Increased abnormal mitochondria and elevated mtDNA content were found in the placentas from infected mothers. The placental mtDNA content of three infants with abnormal DDST were increased by 4, 7, and 10%, respectively, compared to the mean of the COVID-19 group. The Maternal Vascular Malperfusion (MVM), elevated cytokines and increased placental mtDNA content in mothers with COVID-19 might be associated with transient early fine motor abnormalities in infants. These abnormalities are only temporary, and they could be corrected by daily training.Conclusions: Babies born to COVID-19 mothers with mild symptoms appeared to have little or no excess long-term risks of abnormal physical and neurobehavioral development as compared with the infants delivered by non-COVID-19 mothers.
Implementation of the Comprehensive Unit-Based Safety Program to Improve Infection Prevention and Control Practices in Four Neonatal Intensive Care Units in Pune, India
Authors: Johnson Julia , Latif Asad , Randive Bharat , Kadam Abhay , Rajput Uday , Kinikar Aarti , Malshe Nandini , Lalwani Sanjay , Parikh Tushar B. , Vaidya Umesh , Malwade Sudhir , Agarkhedkar Sharad , Curless Melanie S. , Coffin Susan E. , Smith Rachel M. , Westercamp Matthew , Colantuoni Elizabeth , Robinson Matthew L. , Mave Vidya , Gupta Amita , Manabe Yukari C. , Milstone Aaron M. 
Published: January 2022

Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices.Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to improve IPC practices in three focus areas: hand hygiene, aseptic technique for invasive procedures, and medication and intravenous fluid preparation and administration. Sites received training in CUSP methodology, formed multidisciplinary teams, and selected interventions for each focus area. Process measures included fidelity to CUSP, hand hygiene compliance, and central line insertion checklist completion. Outcome measures included the rate of healthcare-associated bloodstream infection (HA-BSI), all-cause mortality, patient safety culture, and workload.Results: A total of 144 healthcare workers and administrators completed CUSP training. All sites conducted at least 75% of monthly meetings. Hand hygiene compliance odds increased 6% per month [odds ratio (OR) 1.06 (95% CI 1.03–1.10)]. Providers completed insertion checklists for 68% of neonates with a central line; 83% of checklists were fully completed. All-cause mortality and HA-BSI rate did not change significantly after CUSP implementation. Patient safety culture domains with greatest improvement were management support for patient safety (+7.6%), teamwork within units (+5.3%), and organizational learning—continuous improvement (+4.7%). Overall workload increased from a mean score of 46.28 ± 16.97 at baseline to 65.07 ± 19.05 at follow-up (p &lt; 0.0001).Conclusion: CUSP implementation increased hand hygiene compliance, successful implementation of a central line insertion checklist, and improvements in safety culture in four Indian NICUs. This multimodal strategy is a promising framework for low- and middle-income country healthcare facilities to reduce HAI risk in neonates.
Long-Term Influence of Incidental Emotions on the Emotional Judgment of Neutral Faces
Authors: Nudelman Marta F. , Portugal Liana C. L. , Mocaiber Izabela , David Isabel A. , Rodolpho Beatriz S. , Pereira Mirtes G. , Oliveira Leticia de 
Published: January 2022

Background:Evidence indicates that the processing of facial stimuli may be influenced by incidental factors, and these influences are particularly powerful when facial expressions are ambiguous, such as neutral faces. However, limited research investigated whether emotional contextual information presented in a preceding and unrelated experiment could be pervasively carried over to another experiment to modulate neutral face processing.Objective:The present study aims to investigate whether an emotional text presented in a first experiment could generate negative emotion toward neutral faces in a second experiment unrelated to the previous experiment.Methods:Ninety-nine students (all women) were randomly assigned to read and evaluate a negative text (negative context) or a neutral text (neutral text) in the first experiment. In the subsequent second experiment, the participants performed the following two tasks: (1) an attentional task in which neutral faces were presented as distractors and (2) a task involving the emotional judgment of neutral faces.Results:The results show that compared to the neutral context, in the negative context, the participants rated more faces as negative. No significant result was found in the attentional task.Conclusion:Our study demonstrates that incidental emotional information available in a previous experiment can increase participants’ propensity to interpret neutral faces as more negative when emotional information is directly evaluated. Therefore, the present study adds important evidence to the literature suggesting that our behavior and actions are modulated by previous information in an incidental or low perceived way similar to what occurs in everyday life, thereby modulating our judgments and emotions.
Occupational Exposure Assessment and Seroprevalence of Brucella Specific Antibodies Among Veterinarians in the Northern Palestine
Authors: Alzuheir Ibrahim , Al Zabadi Hamzeh , Abu Helal Muhammed 
Published: January 2022

Background: Brucellosis is one of the most popular zoonosis in the world caused by bacteria belonging to the genus Brucella. The disease is considered an occupational risk to persons dealing with animals and animal products. Brucellosis is endemic in livestock in Palestine. Yet, few studies investigated human brucellosis in Palestine. We aimed to estimate Brucella seropositivity among veterinary healthcare professionals in Northern Palestine, and to assess the associated risk factors.Methods: A cross-sectional study was conducted in four governorates in the Northern West Bank (Jenin, Nablus, Qalqylia, and Tulkarm). A sample of 100 veterinarians was collected. Participants were interviewed using a structured questionnaire to assess risk factors. Blood samples were collected to be screened for the presence of anti-Brucella IgG using the Enzyme-Linked Immunosorbent Assay (ELISA).Results: The seroprevalence of Brucellosis by ELISA was 76%. Risk factors included working in the public sector, dealing with animals' vaccination, longer period of exposure, and advancing in age.Conclusions: Brucellosis is a high-risk occupational disease among veterinarians. Its prevalence rate among veterinary healthcare workers in the Northern West Bank, Palestine was very high compared to neighboring countries and internationally.
Rancangan Blended Learning Berbasis Storytelling Pada Pembelajaran Agama dan Moral untuk PAUD Kristen di Surakarta
Authors: Efi Nurwindayani  , Pantan Frans , Marbun Purim 
Published: January 2022

Abstract: The purpose of this study was to develop a blended learning design based on a special storytelling method for religious and moral learning in PAUD Kristen Surakarta. This study uses a qualitative method with a level 1 research and development model covering the stages of needs analysis, design, and design validation by experts and practitioners. The final result of this research is the finding of a blended learning design based on the storytelling method in religious and moral learning in PAUD Kristen Surakarta. The design has been conceptually validated by experts and practitioners.
Keywords: Blended Learning, Storytelling, Religious and Moral Learning
Abstrak: Tujuan penelitian ini adalah mengembangkan sebuah rancangan blended learning berbasis metode storytelling khusus pada pembelajaran agama dan moral di PAUD Kristen Surakarta. Penelitian ini menggunakan metode kualitatif dengan model penelitian dan pengembangan level 1 meliputi tahap analisis kebutuhan, membuat rancangan, dan validasi rancangan oleh ahli dan praktisi. Hasil akhir penelitian ini adalah temuan yaitu rancangan blended learning berbasis metode storytelling pada pembelajaran agama dan moral di PAUD Kristen Surakarta. Rancangan telah tervalidasi secara konseptual oleh ahli dan praktisi. Kata Kunci: Blended Learning, Storytelling, Pembelajaran Agama dan Moral