bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between delta anion gap and hospital mortality for patients in cardiothoracic surgery recovery unit: a retrospective cohort study
Authors: Xie Kai , Zheng Chao , Wang Gao-Ming , Diao Yi-Fei , Luo Chao , Wang Ellen , Hu Li-Wen , Ren Zhi-Jian , Luo Jing , Ren Bin-Hui , Shen Yi 
Published: May 2022

Abstract
Backgrounds
High level of anion gap (AG) was associated with organic acidosis. This study aimed to explore the relationship between delta AG (ΔAG = AGmax − AGmin) during first 3 days after intensive care unit (ICU) admission and hospital mortality for patients admitted in the cardiothoracic surgery recovery unit (CSRU).

Methods
In this retrospective cohort study, we identified patients from the open access database called Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC III). A logistic regression model was established to predict hospital mortality by adjusting confounding factors using a stepwise backward elimination method. We conducted receiver operating characteristic (ROC) curves to compare the diagnostic performance of acid–base variables. Cox regression model and Kaplan Meier curve were applied to predict patients’ 90-day overall survival (OS).

Results
A total of 2,860 patients were identified. ΔAG was an independent predictive factor of hospital mortality (OR = 1.24 per 1 mEq/L increase, 95% CI: 1.11–1.39, p < 0.001). The area under curve (AUC) values of ΔAG suggested a good diagnostic accuracy (AUC = 0.769). We established the following formula to estimate patients’ hospital mortality: Logit(P) = − 15.69 + 0.21ΔAG + 0.13age-0.21BE + 2.69AKF. After calculating Youden index, patients with ΔAG ≥ 7 was considered at high risk (OR = 4.23, 95% CI: 1.22–14.63, p = 0.023). Kaplan Meier curve demonstrated that patients with ΔAG ≥ 7 had a poorer 90-day OS (Adjusted HR = 3.20, 95% CI: 1.81–5.65, p < 0.001).

Conclusion
ΔAG is a prognostic factor of hospital mortality and 90-day OS. More prospective studies are needed to verify and update our findings.
Analysis of risk factors for postoperative complications in non-small cell lung cancer: comparison with the Japanese National Clinical Database risk calculator
Authors: Motono Nozomu , Ishikawa Masahito , Iwai Shun , Yamagata Aika , Iijima Yoshihito , Uramoto Hidetaka 
Published: May 2022

Abstract
Background
Although the risk calculator of the National Clinical Database (RC-NCD) has been widely used to predict the occurrence of mortality and major morbidity in Japan, it has not been demonstrated whether a correlation between the calculated RC-NCD risk score and the actual occurrence of mortality and severe morbidity exists.

Methods
The clinical data of 585 patients who underwent pulmonary resection for non-small cell lung cancer were collected, and the risk factors for postoperative morbidity were analyzed to verify the validity of the RC-NCD.

Results
The coexistence of asthma (p = 0.02), nutrition lymphocyte ratio (p = 0.04), and pulmonary lobe (p < 0.01) were significant risk factors for postoperative morbidity in the present study, and the percent-predicted vital capacity (p < 0.01), pulmonary lobe (p = 0.03), and type of operative procedure (p = 0.01) were significant risk factors for severe postoperative morbidity. Furthermore, in patients received lobectomy, coexistence of asthma (p = 0.01) and pulmonary lobe (p < 0.01) were identified as significant risk factors for postoperative morbidity. Meanwhile, male sex (p = 0.01), high BMI (p < 0.01), low vital capacity (p = 0.04), and pulmonary lobe (p = 0.03) were identified as significant risk factors for severe postoperative morbidity.

Conclusions
Given that the pulmonary lobe was a significant risk factor for postoperative morbidity in patients received pulmonary resection and for severe postoperative morbidity in patients received lobectomy, the RC-NCD for postoperative morbidity needs to be modified according to high-risk lobes.
Trial registration: The Institutional Review Board of Kanazawa Medical University approved the protocol of this retrospective study (approval number: I392), and written informed consent was obtained from all patients.
Effect of radical lymphadenectomy in colorectal cancer with para-aortic lymph node metastasis: a systematic review and meta-analysis
Authors: Zhao Pengyue , Yang Xingpeng , Yan Yang , Yang Jiaqi , Li Songyan , Du Xiaohui 
Published: May 2022

Abstract
Background
Colorectal cancer (CRC) with para-aortic lymph node metastasis (PALNM) is an intractable clinical situation, and the role of radical lymphadenectomy in the treatment of CRC with PALNM is still controversial. The aim of the current system review and meta-analysis is to evaluate the clinical efficacy and safety of radical lymphadenectomy in CRC patients with PALAN.

Methods
We performed a systematic search of PubMed, Embase, Cochrane Library and other online databases up to 31 October 2021. The clinical data including overall survival and postoperative complications were screened and analyzed after data extraction. Odds ratios (ORs) were applied to analyze these dichotomous outcomes with a fixed effects model.

Results
A total of 7 available retrospective clinical studies involving 327 patients were finally included. CRC patients with PALNM who underwent radical lymphadenectomy showed significantly overall survival (OR: 6.80, 95% CI: 3.46–13.38, P < 0.01; I2 = 0%) when compared to those who did not receive radical lymphadenectomy. Moreover, in terms of postoperative complications (OR: 0.71, 95% CI: 0.35–1.44, P = 0.48; I2 = 0%), there was no statistical difference between radical lymphadenectomy treatment and control groups.

Conclusions
The radical lymphadenectomy treatment has showed the expected clinical efficacy in prolonging overall survival time of CRC patients with PALAN. Moreover, the preemptive radical lymphadenectomy could not cause additional postoperative complications.
Analysis of the risk factors for intraoperative acute diffuse brain swelling in patients with isolated traumatic acute subdural haematomas
Authors: Wu Ruhong , Liu Chunbo , Ma Tao , Jia Geng , Qin Huaping 
Published: May 2022

Abstract
Background
The purpose of this retrospective study was to investigate the risk factors for intraoperative acute diffuse brain swelling in patients with isolated traumatic acute subdural haematomas (ASDH).

Methods
A total of 256 patients who underwent decompressive craniectomy for isolated traumatic ASDH between April 2013 and December 2020 were included. We evaluated the risk factors for intraoperative acute diffuse brain swelling using a multivariate logistic regression analysis.

Results
The incidence of intraoperative acute diffuse brain swelling in patients with isolated traumatic ASDH was 21.88% (56/256). Dilated pupils (OR = 24.78), subarachnoid haemorrhage (OR = 2.41), and the time from injury to surgery (OR = 0.32) were independent risk factors for intraoperative acute diffuse brain swelling, while no independent associations were observed between these risk factors and sex, age, the mechanism of injury, the Glasgow Coma Scale score, site of haematoma, thickness of haematoma, midline shift and the status of the basal cistern, although the mechanism of injury, the Glasgow Coma Scale score and the status of the basal cistern were correlated with the incidence of intraoperative acute diffuse brain swelling in the univariate analyses.

Conclusions
This study identified the risk factors for intraoperative acute diffuse brain swelling in patients with isolated traumatic ASDH. An increased risk of intraoperative acute diffuse brain swelling occurs in patients with bilaterally dilated pupils, subarachnoid haemorrhage and a shorter time from injury to surgery. These findings should help neurosurgeons obtain information before surgery about intraoperative acute diffuse brain swelling in patients with isolated traumatic ASDH.
Comparison of clinical and radiological outcomes of local morselized bone grafts and structural iliac bone grafts in the treatment of lumbar tuberculosis with posterior-only surgery
Authors: Xu Shuang , Zhang Shuai , Wang Gaoju , Yang Jin , Song Yueming , Wang Qing 
Published: May 2022

Abstract
Background
Many surgeons have reported results similar to those of anterior debridement and bone grafting in treating spinal tuberculosis in the lumbar region using only a posterior approach. However, there is still no consensus regarding bone graft methods. This study aims to compare the clinical and radiological outcomes of morselized versus structural iliac bone grafts in the treatment of lumbar tuberculosis via one-stage posterior surgery.

Methods
A retrospective study was performed with 82 patients with lumbar tuberculosis who had undergone posterior-only debridement, bone grafting, and instrumentation between January 2014 and June 2018. Morselized bone grafts were used in 43 patients, whereas structural iliac bone grafts were used in 39 patients. The clinical data and imaging results of the patients were compared between the two groups to evaluate the clinical effects of the two types of grafts.

Results
The operation time, blood loss and hospital stay values in the morselized bone group were significantly lower than those in the structural iliac bone group (p < 0.05). No significant differences were observed with respect to erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Cobb angle, or improvement of neurological function between the two groups. The VAS pain scores for low back and leg pain decreased significantly after the operation (p < 0.05). However, postoperatively, the VAS score was higher in the structural iliac bone group than in the morselized bone group, and there was no significant difference at the last follow-up between the two groups (p > 0.05). Bone fusion was achieved in 41 patients (95%) in the morselized bone group and 38 patients (97%) in the structural iliac bone group. There was no significant difference between the fusion rates of the two groups (p > 0.05).

Conclusion
The two graft techniques achieved comparable clinical outcomes in lumbar spinal tuberculosis treatment. However, the morselized bone graft was more beneficial in terms of reducing surgical trauma and postoperative complications.
Tumor mutational burden presents limiting effects on predicting the efficacy of immune checkpoint inhibitors and prognostic assessment in adrenocortical carcinoma
Authors: Xu Fangshi , Guan Yibing , Zhang Peng , Xue Li , Ma Yubo , Gao Mei , Chong Tie , Ren Bin-Cheng 
Published: May 2022

Abstract
Background
Adrenocortical carcinoma (ACC) is a highly malignant urologic cancer and tends to metastasize. Although immune checkpoint inhibitors (ICIs) bring a glimmer of light to conquer ACC, only a fraction of patients have benefit from ICIs treatment. It is well known that tumor mutational burden (TMB) is closely associated with the efficacy and response rate of immunotherapy. However, its roles in ACC were not investigated.

Methods
Using somatic mutations data of 92 ACC samples in TCGA database, we calculated their TMB values by the ‘maftools’ package in R software (Ver 3.6.3). To explore the roles of TMB in ICIs therapy, we have addressed this issue from three perspectives. First, the effects of TMB levels on tumor immune microenvironment (TIM) were analyzed through CIBERSORT algorithm, ssGSEA method and TIMER web server. Second, we investigated the expressive correlations between TMB level and five pivotal immune checkpoints based on Pearson coefficient. Third, the difference in TIDE score between high- and low-TMB groups was compared. The prognostic value of TMB was also evaluated. Besides, GSEA was performed to determine the changes in the activities of signaling pathways caused by TMB.

Results
TMB values in ACC samples were not high. The average of total mutation counts in each sample was only 21.5. High TMB could lead metabolic reprogramming and poor survival outcomes. However, it was unable to affect the infiltration levels of lymphocytes, and failed to facilitate the activities of immune-related pathways. Regarding immune checkpoints (ICs), only PD-L1 upregulation could result in a good prognosis, and TMB level did not correlate with the expressions of other ICs except for LAG3. There was no significant difference in TIDE score between high- and low-TMB groups. Combining the present results and previous study, we speculated that inadequate stimulation for neoantigens formation, intrinsic immune-resistance and special genomic alterations were three possible reasons for TMB limiting functions in TIM and ICIs. Besides, TMB was toughly applied in clinical practice due to its high cost of determination and non-universal definition of high TMB.

Conclusions
TMB presents limiting effects on prediction for ICIs efficacy and prognostic assessment for ACC patients.
Color stability of hybrid ceramics exposed to beverages in different combinations
Authors: Yerliyurt Kaan , Sarıkaya Işıl 
Published: May 2022

Abstract
Background
The aim of this study is to evaluate the color stability of hybrid ceramics stored in different combinations of beverages that are routinely consumed.

Methods
The specimens were prepared with resin nano-ceramic (Lava Ultimate, 3M Espe, USA) and hybrid ceramic (Vita Enamic, Vita Zahnfabrik, Germany). The specimens were aged in a thermocycler machine for 10,000 cycles. They were stored in different combinations of beverages (water, tea, coke, coffee, red wine, pomegranate juice, and turnip juice) for 12 + 12 h. Surface roughness measurements were performed using a profilometer. The specimen colors were measured using a spectrophotometer. The color values (L-a-b) of the specimens and mean surface roughness values (Ra) were recorded at the end of the 1st (D1), 7th (D7), 14th (D14) and 28th (D28) d.

Results
When the solution groups were examined, significant color changes were observed in the Lava coffee-tea, Enamic coffee-tea, Lava coffee-wine, and Enamic coffee-wine groups compared with the other groups (p < 0.01). Except for the samples in the Lava coffee-wine 28th day (D28) and Enamic coffee-wine 28th day (D28) groups, more color changes were observed in the Lava samples than in the Enamic samples across all groups and periods.

Conclusion
Greater color changes (except for the samples stored in coffee-wine) were observed in the Lava samples than in the Enamic samples across all groups and periods. It was observed that the coffee-tea and coffee-wine beverage combinations produced the greatest color change in hybrid ceramics within the limitations of this study.
Mass media campaigns for the promotion of oral health: a scoping review
Authors: Goldberg Eileen , Eberhard Joerg , Bauman Adrian , Smith Ben J. 
Published: May 2022

Abstract
Background
Oral diseases are highly prevalent globally and are largely preventable. Individual and group-based education strategies have been dominant in oral health promotion efforts. Population-wide mass media campaigns have a potentially valuable role in improving oral health behaviours and related determinants. This review synthesises evidence from evaluations of these campaigns.

Methods
A systematic search of major databases was undertaken to identify peer-reviewed articles reporting the evaluation of mass reach (non-interpersonal) communication strategies to address common forms of oral disease (i.e., dental caries, periodontitis, gingivitis). Studies using all types of quantitative design, published in English between 1970 and 2020 were included. Data concerning campaign objectives, content, evaluation methods and findings were extracted.

Results
Eighteen studies were included from the 499 identified through searching, reporting the findings of 11 campaign evaluations. Two of these used controlled quasi-experimental designs, with the remainder using pre- and post-test (N = 5) or post-test only designs (N = 4). Message recall, as a measure of exposure, was reported in eight campaigns with short-term (≤ 8 weeks) recall ranging from 30 to 97%. Eight studies examined impacts upon oral health knowledge, with four of the five measuring this at baseline and follow-up reporting improvements. From the eight studies measuring oral health behaviours or use of preventative services, six that compared baseline and follow-up reported improvements (N = 2 in children, N = 4 in adults).

Conclusion
There are relatively few studies reporting the evaluation of mass media campaigns to promote oral health at the population level. Further, there is limited application of best-practice methods in campaign development, implementation and evaluation in this field. The available findings indicate promise in terms of achieving campaign recall and short-term improvements in oral health knowledge and behaviours.
Human papillomavirus vaccination related knowledge, and recommendations among healthcare providers in Southern China: a cross-sectional survey
Authors: Chen Siqi , Mei Chaofan , Huang Weikang , Liu Peiyi , Wang He , Lin Wei , Yuan Shixin , Wang Yueyun 
Published: May 2022

Abstract
Background
Little research has been conducted to explore variables associated with the healthcare providers’ (HCPs) understanding and recommendation of human papillomavirus vaccine (HPV) since the vaccine was approved for use in China.

Methods
A large-scale cross-sectional survey was conducted in southern China covering Guangdong, Guangxi, and Hainan provinces between April 2019 and October 2019. Firstly, descriptive analysis was used to access awareness, knowledge, barriers, and recommendations toward HPV vaccine among all participants. Multi-variable logistic regression was further applied to explore potential factors associated with awareness, acknowledgment of HPV vaccine, and recommendation behaviors toward HPV vaccine.

Results
2075 questionnaires were collected, and 2054 were included in the final analysis. In total, 77.9% of participants have heard of HPV vaccine and obtained sub-optimal HPV/HPV vaccine knowledge scores with a mean (SD) of 13.8 (3.5) out of a maximum score of 23. 68.1% HCPs reported that they have recommended HPV vaccine to others. Province and profession were the most significant characteristics associated with awareness, knowledge score, and recommendation behavior toward HPV vaccine. HCPs in Guangdong obtained a much better knowledge score [Mean (SD) = 15.5 (3.0)] and reported higher recommendation behavior (82.8%). Compare with HCPs from the Division of Expanded Program on Immunization (DEPI), Community Health Center (CHC), and obstetrician-gynecologists, other non-HPV closely related professions showed a less competent knowledge of HPV and HPV vaccine [Mean (SD) = 12.5 (3.0)] and lower frequency of recommendation behavior on vaccination (58.1%). The difference in HPV vaccine knowledge among different professions was concentrating on the items about clinical pathology of HPV and the practical aspects of HPV vaccine. Educational level and title were also closely associated with their knowledge of HPV and its vaccine. Besides, knowledge scores independently determined with recommendation behavior (OR = 1.18, 95% CI 1.13–1.23).

Conclusion
Knowledge level of HPV and HPV vaccine as well as recommendation behavior toward HPV vaccine were relatively lower in southern China and differed significantly between provinces. Profession-specific gaps on the knowledge level of HPV and HPV vaccine emphasized the need for targeted education and training to improve HCPs’ engagement in the promotion of the HPV vaccine.
Does the uterine microbiota affect the reproductive outcomes in women with recurrent implantation failures?
Authors: Keburiya Lela K. , Smolnikova Veronika Yu. , Priputnevich Tatiana V. , Muravieva Vera V. , Gordeev Alexey B. , Trofimov Dmitry Yu. , Shubina Ekaterina S. , Kochetkova Taisiya O. , Rogacheva Margarita S. , Kalinina Elena A. , Sukhikh Gennady T. 
Published: May 2022

Abstract
Background
Inefficiency of in vitro fertilization (IVF) programs can be caused by implantation failures. The uterine microbiota can influence the implantation process. However, it still remains unclear whether opportunistic microorganisms detected in the endometrium have a negative impact on the implantation success. The aim of our study was to evaluate the influence of the uterine microbiota on the embryo implantation success in patients undergoing assisted reproductive technologies.

Methods
The study included 130 women diagnosed with infertility. The patients were divided into three groups: group I included women with the first IVF attempt (n = 39); group II included patients with recurrent implantation failure following embryo transfer with ovarian stimulation (n = 27); group III consisted of women with recurrent implantation failure following frozen-thawed embryo transfer (n = 64). We performed microbiological examination of the embryo transfer catheter which was removed from the uterine cavity after embryo transfer; cervical discharge of all the patients was studied as well. Thirty patients were selected for metagenomic sequencing.

Results
The study showed that the uterine cavity is not free of microorganisms. A total of 44 species of microorganisms were detected: 26 species of opportunistic organisms and 18 species of commensals (14 species of lactobacilli and 4 species of bifidobacteria). Obligate anaerobic microorganisms and Gardnerella vaginalis were detected more frequently in group I compared to group III (strict anaerobes—15.4 and 1.6%; G. vaginalis—12.8 and 1.6%, respectively) (p < 0.05). However, this fact did not have a negative influence on the pregnancy rate: it was 51.3% in group I, it was 29.6% and 35.9% in women with recurrent implantation failures, respectively.

Conclusion
Opportunistic microorganisms which were revealed in low or moderate titers (103–105 CFU/ml) in the uterine cavity and cervical canal did not affect the pregnancy rate in the women in the study groups. The microflora of the uterine cavity and cervical canal differed in qualitative composition in 87.9% of patients, therefore, we can suggest that the uterine cavity may form its own microbiota. The microbiota of the uterine cavity is characterized by fewer species diversity compared to the microbiota of the cervical canal.