bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis
Authors: Wang Changgang , Feng Haoran , Zhu Xiaoning , Song Zijia , Li You , Shi Yiqing , Jiang Yimei , Chen Xianze , Zhang Tao , Zhao Ren , Liu Kun 
Published: January 2022

BackgroundRecently, enhanced recovery after surgery (ERAS) has been widely used in the perioperative management of colorectal cancer (CRC). This study aimed to evaluate the safety and feasibility of ERAS combined with single-incision laparoscopic surgery (SILS) in CRC surgery.MethodsThis was a retrospective study of patients with CRC who underwent surgery between April 2018 and April 2020 in Ruijin Hospital(North), Shanghai Jiaotong University School of Medicine. The patients were divided into three groups: group A (n=138), patients who underwent traditional multiport laparoscopic colectomy with conventional perioperative management; group B (n=63), patients who underwent SILS; and group C (n=51), patients who underwent SILS with ERAS.ResultsOverall, 252 participants were included in the retrospective study. The median operation time (min) in group B and group C was shorter than that in group A (group A 134.0 ± 42.5; group B 117 ± 38.9; group C 111.7 ± 35.4, p=0.004). The estimated surgical blood loss (ml) was lower in groups B and C than in group A (group A 165.1 ± 142.2; group B 122.0 ± 79.4; group C 105.2 ± 55.8, p=0.011). The length of surgical incision (cm) was shorter in groups B and C than in group A (group A 7.34 ± 1.05; group B 5.60 ± 0.80; group C 5.28 ± 0.52, p&lt;0.001). The time before first flatus (hours) in group C was shorter than in groups A and B (group A 61.85 ± 21.14; group B 58.30 ± 20.08; group C 42.06 ± 23.72; p&lt;0.001). The days prior to the administration of free oral fluids in group C was shorter than in groups A and B (group A 4.79 ± 1.28; group B 4.67 ± 1.11; group C 2.62 ± 0.64; p&lt;0.001). The days of prior solid diet was less in group C than in groups A and B (group A 7.22 ± 3.87; group B 7.08 ± 3.18; group C 5.75 ± 1.70; p=0.027). The postoperative length of stay (LOS) was less in group C compared with that in groups A and B (group A 9.46 ± 4.84 days; group B 9.52 ± 7.45 days; group C 7.20 ± 2.37 days; p=0.023). The visual analog scale (VAS) scores on day 0, 1, and 2 in groups B and C were lower than those in group A (day 0, p&lt;0.001; day 1, p&lt;0.001; day 2, p=0.002), while the VAS score on day 3 showed no differences in the three groups (group A 1.29 ± 1.38; group B 0.98 ± 1.24; group C 0.75 ± 0.64, p=0.018).ConclusionThe findings suggest that SILS combined with ERAS may be a feasible and safe procedure for CRC surgery because it provides favorable cosmetic results, early dietary resumption, shorter hospital stays, and appropriate control of postoperative pain without increases in complications or readmission rates compared to conventional perioperative care with SILS or conventional laparoscopic surgery(CLS) of CRC. Further prospective randomized controlled studies are needed to enhance evidence-based medical evidence.
Volume of Disease as a Predictor for Clinical Outcomes in Patients With Melanoma Brain Metastases Treated With Stereotactic Radiosurgery and Immune Checkpoint Therapy
Authors: Burke Aidan M. , Carrasquilla Michael , Jean Walter C. , Collins Brian T. , Anaizi Amjad N. , Atkins Michael B. , Gibney Geoffrey T. , Collins Sean P. 
Published: January 2022

Purpose/ObjectivesClinical trials of anti-Programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein (CTLA-4) therapies have demonstrated a clinical benefit with low rates of neurologic adverse events in patients with melanoma brain metastases (MBMs). While the combined effect of these immunotherapies (ITs) and stereotactic radiosurgery (SRS) has yielded impressive results with regard to local control (LC) and overall survival (OS), it has also been associated with increased rates of radiation necrosis (RN) compared to historical series of SRS alone. We retrospectively reviewed patients treated with IT in combination with SRS to report on predictors of clinical outcomes.Materials and MethodsPatients were included if they had MBMs treated with SRS within 1 year of receiving anti-PD-1 and/or CTLA-4 therapy. Clinical outcomes including OS, LC, intracranial death (ID), and RN were correlated with type and timing of IT with SRS, radiation dose, total volume, and size and number of lesions treated.ResultsTwenty-nine patients with 171 MBMs were treated between May 2012 and May 2018. Patients had a median of 5 lesions treated (median volume of 6.5 cm3) over a median of 2 courses of SRS. The median dose was 21 Gy. Most patients were treated with ipilimumab (n = 13) or nivolumab-ipilimumab (n = 10). Most patients underwent SRS concurrently or within 3 months of receiving immunotherapy (n = 21). Two-year OS and LC were 54.4% and 85.5%, respectively. In addition, 14% of patients developed RN; however, only 4.7% of the total treated lesions developed RN. The median time to development of RN was 9.5 months. Patients with an aggregate tumor volume &gt;6.5 cm3 were found to be at increased risk of ID (p = 0.05) and RN (p = 0.03). There was no difference in OS, ID, or RN with regard to type of IT, timing of SRS and IT, number of SRS courses, SRS dose, or number of cumulative lesions treated.ConclusionsIn our series, patients treated with SRS and IT for MBMs had excellent rates of OS and LC; however, patients with an aggregate tumor volume &gt;6.5 cm3 were found to be at increased risk of ID and RN. Given the efficacy of combined anti-PD-1/CTLA-4 therapy for MBM management, further study of optimal selection criteria for the addition of SRS is warranted.
Pattern of Time-to-Surgery in Patients With Breast Cancer at Different Stages of the COVID-19 Pandemic
Authors: Chen Ruixian , Yang Jiqiao , Zhao Xin , Fu Zhoukai , Wang Zhu , Qiu Changjian , Wu Yunhao , Yang Ruoning , Liu Weijing , Huang Ya , Chen Jie 
Published: January 2022

BackgroundThe management of cancer surgeries is under unprecedented challenges during the COVID-19 pandemic, and the breast cancer patients may face a time-delay in the treatment. This retrospective study aimed to present the pattern of time-to-surgery (TTS) and analyze the features of breast cancer patients under the different stages of the COVID-19 pandemic.MethodsPatients who received surgeries for breast cancers at West China Hospital between February 15, 2020 and April 30, 2020 (the outbreak and post-peak stages), and between March 10, 2021 and May 25, 2021 (the normalization stage) were included. TTS was calculated as the time interval between the pathological diagnosis and surgical treatment of breast cancer patients. And the pandemic was divided into three stages based on the time when the patients were pathologically diagnosed and the severity of pandemic at that time point. TTS, demographic and clinicopathological features were collected from medical records.ResultsA total of 367 patients were included. As for demographic features, it demonstrated statistically significant differences in insurance type (p&lt;0.001) and regular screening (p&lt;0.001), as well as age (p=0.013) and menstrual status (p=0.004). As for clinicopathological features, axillary involvement (p=0.019) was a factor that differed among three stages. The overall TTS was 23.56 ± 21.39 days. TTS for patients who were diagnosed during the outbreak of COVID-19 were longer than those diagnosed during pandemic post-peak and normalization stage (p&lt;0.001). Pandemic stage (p&lt;0.001) and excision biopsy before surgery (OR, 6.459; 95% CI, 2.225-18.755; p=0.001) were markedly correlated with the TTS of patients.ConclusionsTTS of breast cancer patients significantly varied in different stages of the COVID-19 pandemic. And breast cancer patients’ daily lives and disease treatments were affected by the pandemic in many aspects, such as health insurance access, physical screening and change of therapeutic schedules. As the time-delay may cause negative influences on patients’ disease, we should minimize the occurrence of such time-delay. It is vital to come up with comprehensive measures to deal with unexpected situations in case the pandemic occurs.
Clinical Characteristics and the Risk Factors of Hepatic Injury in 221 Children With Infectious Mononucleosis
Authors: Zhang Chao , Cui Shu , Mao Guoshun , Li Guitao 
Published: January 2022

Background: Infectious mononucleosis caused by Epstein-Barr Virus infection is a common acute infectious disease in children. About 40–80% of children with infectious mononucleosis have hepatic injury, and hepatic failure is one of the main causes of death in patients with fatal infectious mononucleosis. Identifying the demographics, presenting clinical characteristics and the risk factors of hepatic injury in infectious mononucleosis children are helpful to remind clinicians which patients are prone to have hepatic damage.Methods: A descriptive, cross-sectional study with a 31-month retrospective review was performed on all infectious mononucleosis children hospitalized in the pediatric department of Fuyang People's Hospital. Demographic data, presenting features, radiology imaging, clinical and laboratory parameters, and clinical outcomes of infectious mononucleosis children were collected.Results: Two-hundred twenty-one infectious mononucleosis inpatients were enrolled, and 43.9% (97/221) patients were considered to have a hepatic injury (defined as alanine amino transaminase &gt; 40 U/L). Compared with patients without hepatic injury, hepatic injury patients were marked with a significantly higher percentage of hepatomegaly (31 vs. 49%), splenomegaly (58 vs. 81%) and palpebral edema (47 vs. 63%), higher age (3.05 ± 2.12 vs. 3.84 ± 2.44), hospitalization days (6.85 ± 2.64 vs. 8.08 ± 2.83), leukocyte (14.24 ± 5.32 vs. 18.53 ± 8.63), lymphocytes (9.48 ± 4.49 vs. 13.80 ± 7.47), the proportion of atypical lymphocytes (0.12 ± 0.07 vs. 0.15 ± 0.08) and aspartate aminotransferase (33.71 ± 10.94 vs. 107.82 ± 93.52). The results of correlation analysis and multiple linear regression analysis indicated that age (OR = 1.185; 95% CI = 1.035–1.357, p = 0.014), female (OR = 2.002, 95% CI: 0.261–0.955, p = 0.036) and splenomegaly (OR = 2.171, 95% CI: 1.018–4.628, p = 0.045) were independent risk factors of hepatic injury.Conclusions: In this study, the hepatic injury was associated with gender, age, and splenomegaly, which improved our understanding of risk factors about hepatic injury among infectious mononucleosis children.
Hospital Admissions for Respiratory Tract Infections in Children Aged 0–5 Years for 2017/2023
Authors: Methi Fredrik , Størdal Ketil , Telle Kjetil , Larsen Vilde Bergstad , Magnusson Karin 
Published: January 2022

Aim: To compare hospital admissions across common respiratory tract infections (RTI) in 2017-21, and project possible hospital admissions for the RTIs among children aged 0–12 months and 1-5 years in 2022 and 2023.Methods: In 644 885 children aged 0–12 months and 1–5 years, we plotted the observed monthly number of RTI admissions [upper- and lower RTI, influenza, respiratory syncytial virus (RSV), and COVID-19] from January 1st, 2017 until October 31st, 2021. We also plotted the number of RTI admissions with a need for respiratory support. We used the observed data to project four different scenarios of RTI admissions for the rest of 2021 until 2023, with different impacts on hospital wards: (1) “Business as usual,” (2) “Continuous lockdown,” (3) “Children's immunity debt,” and (4) “Maternal and child immunity debt.”Results: By October 31st, 2021, the number of simultaneous RTI admissions had exceeded the numbers usually observed at the typical season peak in January, i.e., ~900. Based on our observed data and assuming that children and their mothers (who transfer antibodies to the very youngest) have not been exposed to RTI over the last one and a half years, our scenarios suggest that hospitals should be prepared to handle two to three times as many RTI admissions, and two to three times as many RTI admissions requiring respiratory support among 0–5-year-olds as normal, from November 2021 to April 2022.Conclusion: Scenarios with immunity debt suggest that pediatric hospital wards and policy makers should plan for extended capacity.
The Relation of Accelerometer-Measured Physical Activity and Serum Uric Acid Using the National Health and Nutrition Survey (NHANES) 2003–2004
Authors: Smith Isaac D. , Ross Leanna M. , Gabaldon Josi R. , Holdgate Nicholas , Pieper Carl F. , Ning Tony C. , Kraus William E. , Huffman Kim M. 
Published: January 2022

Objective: Gout is a crystal-induced inflammatory arthritis caused by elevated uric acid. Physical activity has the potential to reduce serum uric acid (SUA), thus improving the disease burden of gout. In this study, we examined the association of objectively-measured physical activity and SUA.Methods: A cross-sectional study was conducted using survey, laboratory, and accelerometer data from the 2003–2004 National Health and Nutrition Examination Survey (NHANES). SUA concentrations (mg/dL) were obtained during an initial exam, and then physical activity (kCal/day) was measured with 7 days of ActiGraph accelerometry in participants (n = 3,475) representative of the ambulatory, non-institutionalized US civilian population. Regression, including restricted cubic splines, was used to assess the relation of physical activity and SUA in bivariate and adjusted models. Covariates included age, gender, race/ethnicity, alcohol use, body mass index, renal function, and urate-lowering therapy.Results: In the bivariate model, physical activity was correlated with SUA concentrations and included a non-linear component (p &lt; 0.01). In the adjusted model, linear splines were employed with a node at the SUA nadir of 5.37mg/dL; this occurred at 703 kCal/day of physical activity. The association of physical activity and SUA was negative from 0 to 703 kCal/day (p = 0.07) and positive &gt;703 kCal/day (p &lt; 0.01 for the change in slope).Conclusion: Physical activity and SUA are associated in a non-linear fashion, with a minimum estimated SUA at 703 kCal/day of objectively-measured physical activity. These findings raise intriguing questions about the use of physical activity as a potential adjunctive therapy in patients with gout, and further interventional studies are needed to elucidate the effects of moderate intensity exercise on SUA concentrations.
Resident and early-career family physicians’ focused practice choices in Canada: a qualitative study
Authors: Kabir Monisha , Randall Ellen , Mitra Goldis , Lavergne M Ruth , Scott Ian , Snadden David , Jones Lori , Goldsmith Laurie J , Marshall Emily G , Grudniewicz Agnes 
Published: January 2022

BackgroundFocused practice within family medicine may be increasing globally, but there is limited research on the factors contributing to decisions to focus practice.AimTo examine the factors influencing resident and early-career family physician choices of focused practice across three Canadian provinces.Design and settingA subset of qualitative interview data were analysed from a study across British Columbia, Ontario, and Nova Scotia, Canada.MethodIncluded in the analysis were a total of 22 resident family physicians and 38 early-career family physicians in their first 10 years of practice who intend to or currently practise in a focused area. Comparisons were made for participant types, provinces, and the degree of focused practice, while identifying themes related to factors influencing the pursuit of focused practice.ResultsThree key themes were identified of factors contributing to choices of focused practice: self-preservation within the current structure of the healthcare system; support from colleagues; and training experiences in medical school and/or residency. Minor themes included: alignment of practice with skills, personal values, or ability to derive professional satisfaction; personal lived experiences; and having many attractive opportunities for focused practice.ConclusionBoth groups of participants unanimously viewed focused practice as a way to circumvent the burnout or exhaustion they associated with comprehensive practice in the current structure of the healthcare system. This finding, in addition to other influential factors, was consistent across the three provinces. More research is needed to understand the implications of resident and early-career family physician choices of focused practice within the physician workforce.
Pengembangan Sistem Penyediaan Air Bersih dengan Metode Appropriate Technology di Kelurahan Mekar Sari Kecamatan Rambutan Pemko Tebing Tinggi
Authors: Isranuri Ikhwansyah , Sitohang Nur Asnah 
Published: January 2022

Planning for a clean water supply system is a community service program carried out by USU in collaboration with the Dinas Pemberdayaan Masyarakat dan Desa(PMD) of the Pemko Tebing Tinggi. The problem encountered is the unavailability of clean water. This condition can interfere with people's daily activities such as the need for households. The clean water supply system that is implemented is the application of appropriate technology in the sense that it is easy to operate and all components are easy to care for by the public. The purpose of this activity is to provide clean water that meets health requirements, namely colorless, tasteless and odorless. This system is also planned to provide clean water for the next few years. The projection of population growth is also a consideration, which is calculated based on the average population growth data. Based on the Indonesian National Standard (SNI), the need for clean water for a population with a population of 300 households with the household category is 120 liters per person per day, so the water requirement is 1.67 liters/second. The source of water is obtained by digging 15 meters deep by installing 15 concrete rings with a diameter of 80 cm and a height of 100 cm. Then a pump is installed to suck water and then it is pumped into a poly tank (capacity 2100 liters) storage tank which is located at a height of 5-6 meters. Before flowing from the tank to the pipe, the water is filtered using a filter. For this purpose, a piping installation complete with a valve and a float is designed to automatically close the pipe when the tank is full. The result of water from this system is clean water and suitable for consumption by residents.
Pengaruh Hypnopressure terhadap Produksi Air Susu Ibu (ASI) dan Kepercayaan Diri Menyusui
Authors: Anuhgera Diah Evawanna , Sembiring Elsaria 
Published: January 2022

Breastfeeding is an obligation that must be given to babies during their growth period. Consistent breast milk production and confidence to breastfeed are very necessary for the success of exclusive breastfeeding. Hypnopressure is one method that can increaseand maintain breastmilk production and breastfeeding confidence. The purpose of this project is to analyze the effect of hypnopressure on breast milk production and breastfeeding confidence. This study uses Quasy Eksperimental with Pretest dan Posttest Controlled Group Design. There were 28 postpartum mothers who were divided into two groups and taken with simple random sampling. Production of breast milk was measured by electric breast pump and breastfeeding sel efficacy was measured Breastfeeding Self Efficacy Scale (BSES). Data were analyzed using paired and unpaired t-test. Primary outcomes of this study will be effect of the intervention on breastmilk production and breastfeeding confidence. We conclude that hypnopressure could improve breastmilk production (p=0.00) and breasfeeding confidence (p=0.00) and breastfeeding confidence (p=0.00). Result of this greater understanding about increase breast milk production and confidence which influence the success of breastfeeding by hypnopressure then be useful targets for midwife intervention in post partum.
Cross-Scale Synthesis of Organic High-k Semiconductors Based on Spiro-Gridized Nanopolymers
Authors: Lin Dongqing , Zhang Wenhua , Yin Hang , Hu Haixia , Li Yang , Zhang He , Wang Le , Xie Xinmiao , Hu Hongkai , Yan Yongxia , Ling Haifeng , Liu Jin’an , Qian Yue , Tang Lei , Wang Yongxia , Dong Chaoyang , Xie Linghai , Zhang Hao , Wang Shasha , Wei Ying , Guo Xuefeng , Lu Dan , Huang Wei 
Published: January 2022

High dielectric constants in organic semiconductors have been identified as a central challenge for the improvement in not only piezoelectric, pyroelectric, and ferroelectric effects but also photoelectric conversion efficiency in OPVs, carrier mobility in OFETs, and charge density in charge-trapping memories. Herein, we report an ultralong persistence length (

l

p

≈
41

nm) effect of spiro-fused organic nanopolymers on dielectric properties, together with excitonic and charge carrier behaviors. The state-of-the-art nanopolymers, namely, nanopolyspirogrids (NPSGs), are synthesized via the simple cross-scale Friedel-Crafts polygridization of A
2
B
2
-type nanomonomers. The high dielectric constant (

k
=
8.43

) of NPSG is firstly achieved by locking spiro-polygridization effect that results in the enhancement of dipole polarization. When doping into a polystyrene-based dielectric layer, such a high-

k

feature of NPSG increases the field-effect carrier mobility from 0.20 to 0.90 cm
2
V
-1
s
-1
in pentacene OFET devices. Meanwhile, amorphous NPSG film exhibits an ultralow energy disorder (<50 meV) for an excellent zero-field hole mobility of

3.94
×

10

−
3

c

m

2

V

−
1

s

−
1

, surpassing most of the amorphous

π

-conjugated polymers. Organic nanopolymers with high dielectric constants open a new way to break through the bottleneck of efficiency and multifunctionality in the blueprint of the fourth-generation semiconductors.
Studi Longitudinal Pada Analisis Data Gula Darah Pasien Diabetes melalui Principal Component Analysis
Authors: Islamiyati Anna , Sahriman Sitti , Oktoni Sakinah 
Published: January 2022

Multicollinearity is a relationship or correlation between predictor variables. Multicollinearity can also occur in longitudinal data, which is a combination of cross-section data and time-series data. The impact of multicollinearity causes the influence of the predictor variable on the response variable to be insignificant, the least-squares estimator, and the error to be sensitive to changes in the data. Therefore, the procedure to overcome multicollinearity uses the principal component analysis method. This study aims to model PCA longitudinal data regression with a fixed-effect model that is applied to blood sugar data of diabetic patients with a time span of January 2019 to July 2019 at Ibnu Sina Hospital Makassar City. The results of this study indicate that there are two main components formed from PCA longitudinal data regression modelling with a fixed-effect model. Obtained variable values are systolic blood pressure of -0.007, diastolic blood pressure of -0,016, the body temperature of -0.098, and platelets of 0.005 which affect blood sugar in patients with diabetes.