bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Tilt Improves Efficacy of CO2 Field-flooding in Minimally Invasive Cardiac Surgery
Authors: Vandenberghe Stijn , Singjeli Geni , Demertzis Stefanos 
Published: March 2022

Abstract
Objective: Space limitations during minimally invasive cardiac surgery impede consistent use of CO2 field-flooding. We compared different gas delivery methods, flow rates and the effect of patient inclination. Methods: A gastight model of MICS surgery with internal organs and right thoracotomy wound was created from a mannequin and equipped with a CO2 concentration sensor in the left ventricle. Maximum achievable CO2 concentration was compared for gas delivery via three commercial CO2 diffusors (CarbonMini, Temed, Andocor) and also via a trocar with side port. Gas flow rates of 1, 3, 5 and 8 liter per minute were tested. The model was placed either in supine position or with 20° oblique tilt. A simplified transparent model was also created and placed in an optical test bench to evaluate the gas cloud motions via real-time visualization.Results: The trocar consistently achieved higher CO2 concentrations inside the left ventricle. At 1 l/min, approximately 2.5 minutes were needed to fill the supine model to its maximum CO2 concentration, which was limited to a range of 48-82% in the left ventricle. At higher flow rates, filling time and concentration were significantly improved. In a tilted model, all devices and all flow rates generated on average 99% CO2 in the ventricle. Imaging revealed constant gas exchange via the main incision, with CO2 outflow via bottom and air inflow via the top of the incision. Conclusions: CO2 field flooding in minimally invasive cardiac surgery is highly effective if the patient is tilted. Else a flow rate of 5 l/min is recommended to achieve the same protection.
Long-term Outcomes of Anatomical Resection for Hepatocellular Carcinoma: a Propensity Score Matching Analysis
Authors: She Wong Hoi , Cheung Tan To , Tsang Simon H.Y. , Dai Wing Chiu , Chan Albert C.Y. , Lo Chung Mau 
Published: March 2022

Abstract
Objective: To compare anatomical resection (AR) and non-anatomical resection (NAR) in terms of postoperative outcomes and long-term survival in patients of hepatocellular carcinoma (HCC).Summary Background Data: HCC is a common cancer and studies of AR versus NAR for HCC had contradictory findings.Methods: Data of patients having AR or NAR for HCC in 2000-2015 were reviewed. Propensity-score matching (AR:NAR, 2:1) was performed to match the two groups in liver function and tumor number, size, and marker. The two matched groups were compared in terms of tumor characteristics, operative details, postoperative and oncological outcomes, and survival.Results: After matching, there were 382 patients in AR group and 191 patients in NAR group. AR group had fewer minor resections (p<0.001) and laparoscopic resections (11% vs 19.4%, p=0.006), more blood loss (0.565 vs 0.335 L, p<0.001) and transfusion (9.2% vs 3.7%, p<0.001), longer operations (353 vs 214 min, p<0.001) and hospitalization (p<0.001), more macrovascular involvement (4.2% vs 0%, p=0.004), fewer recurrences (p=0.003), longer disease-free period (52.9 vs 39.2 months, p=0.041), and better disease-free survival (p=0.012). The groups were comparable in complication and overall survival (p=0.377). On multivariate analysis, macrovascular involvement (HR 3.689, 95% CI 2.099-6.485, p<0.01) and NAR (HR 0.796, 95% CI 0.640-0.989, p=0.039) were independent risk factors for disease-free survival.Conclusions: For HCC, AR showed a benefit in disease-free survival but not overall survival, while NAR resulted in a better postoperative profile.
Acute pancreatitis in 60 Iranian children: do pediatricians follow the new guidelines in diagnosis and management of acute pancreatitis?
Authors: khiabani Mahsa soti , Mohammadi Mahya Sadat , Ghoreyshi Seyyed amirreza , Rohani Pejman , Alimadadi Hosein , Sohouli Mohammad Hassan 
Published: March 2022

Abstract
Background: the incidence of acute pancreatitis in children is increasingو but causes and diagnostic and therapeutic methods are different in different centers. The aim of this study was to investigate the common causes and routine diagnostic and therapeutic methods of acute pancreatitis in children in a pediatric gastrointestinal referral center and its compliance with existing guidelines. Methods: In this retrospective, cross-sectional study, a total of 60 children with a diagnosis of acute pancreatitis, were studied.Results: The most common causes of acute pancreatitis were systemic and metabolic diseases and medications. CT scan was performed for 36% of patients, but 31% of patients, for whom a CT scan was performed had no clear indication of CT scan. Only half of the patients received fluid 1.5 times their maintenance in the first 24 hours. Antibiotic therapy was performed for 48% of patients but medical indications for antibiotic treatment were found in only 34% of cases. During the COVID-19 pandemic, the relative incidence of acute pancreatitis was increased.Conclusions: In children with systemic and metabolic disease and using anticonvulsant drugs, it is important to consider the incidence of this disease. In clinical education, the risks of radiation due to unnecessary CT scans and inappropriate prescription of antibiotics need to be emphasized. More research should be done to study the association between COVID-19 and acute pancreatitis.
Patient-Reported Distress and Problems Among Elderly Patients with Hematological Malignancy in Korea
Authors: Park Sun-young , Kim Yoonjoo , Hong Hyunju 
Published: March 2022

Abstract
Purpose: Treatment for hematological malignancies (HMs) and functional decline associated with age can cause distress in elderly patients with HMs. However, information about the nature and effects of distress in this population is scarce. Therefore, this study examined the level of distress, its source, and the practical/familial/physical/emotional problems among elderly patients with HMs. Methods: We conducted a cross-sectional study of patients with HMs aged ≥ 65 years who visited an outpatient clinic at a tertiary medical center in Korea between November 2019 and March 2020. Patient-reported distress and problems were measured using the Distress Thermometer (DT) and 39‐item Problem List by the National Comprehensive Cancer Network. Descriptive statistics, χ2 test or Fisher’s exact test, and multivariate logistic regression analyses were conducted (N = 132). Results: In total, 62.1% of patients were had moderate to severe distress (DT score ≥ 4), experiencing an average of nine problems. Significant sources of distress on multivariate logistic analysis included problems with transportation, depression, and constipation, accounting for 47% of distress variance. Most patients had physical (97.0%) or emotional problems (79.5%). Among these, fatigue (60.6%), worry (59.8%), tingling (59.8%), getting around (47.0%), and memory/concentration (40.2%) were the most frequently reported problems. Conclusions: Elderly patients with HMs have a high burden of distress, which is affected by different sources, compared with patients with general cancer. Thus, in this population, assessment and management of distress need to be conducted considering the unique features of their source and burden. Further research on distress should consider the cancer type and population age.
Psychoeducational and Rehabilitation Interventions for Late Life Anxiety and Depression among the Older Adults at Geriatric Home
Authors: El-Fatah Wafaa Osman Abd , Elborie Haitham Osama 
Published: March 2022

Abstract
Background: The Decade of Healthy Ageing (2021–2030) seeks to reduce health inequities and improve the lives of older people. purpose of the study is to evaluate the effect of the psychoeducational and rehabilitation interventions for late-life anxiety and depression among older adults at geriatric homes, a quasi-experimental research design was performed on convenient sample consisting of 20 elderlies at Om-Kolsom geriatric home are in Helwan city, Egypt on May 2021.Results: There is a statistically significant improvement in depression and anxiety symptoms among the elderly who have been studied, and in total depression and anxiety levels in the post-intervention study compared with pre-intervention.Conclusions: At a geriatric home, psychoeducational and rehabilitation interventions are effective in reducing symptoms of depression and anxiety among the elderly.
Risk and Main Contributing Factors for Constipation in Patients with Gastrointestinal Cancer: A Multicenter Cross-Sectional Study in China
Authors: Ma Xiaoxiao , Lu Qian , Lu Yuhan , Li Xin 
Published: March 2022

Abstract
Background and objectives: The purpose of this study is to determine the risk of constipation and to identify the significant risk factors for constipation in patients with gastrointestinal cancer using the Chinese version of the Constipation Risk Assessment Scale (CRAS-C), as well as to explore the complementary constipation risk factors in patients with gastrointestinal cancer, to improve the specificity of the CRAS-C in this population, and finally to provide a theoretical basis for constipation prevention. Research design and methods: A cross-sectional study involving multiple centers was conducted. A total of 190 patients with gastrointestinal cancer completed surveys that included demographic information, defecation habits, and the CRAS-C. The mean, SD, median, maximum, minimum, frequency, and percentage were used as indicators for the constipation risk and significant risk factors. The t-test and Chi-square tests were used to analyze constipation indicators in patients with gastrointestinal cancer. Results: 190 patients were 58.92±12.07 years of age.The total CRAS-C mean (SD) score was 13.22 (4.69). 51 patients (26.8%) scored lower than 11, who were at the low risk level of constipation. 139 patients (73.2%) scored 11 or above, who were at the high risk level of constipation. The top 10 factors were insufficient liquid intake(81.1%), failure to consume bran products daily(78.9%), insufficient fiber intake(77.9%), antiemetics (74.7%), cytotoxic chemotherapy (52.6%), colorectal/abdominal diseases (42.6%), opioid analgesics (35.3%), opioid analgesics(26.8%), calcium channel blockers (16.3%), endocrine disorders (14.2%). Chi square test showed that constipating for most of the past 3 months, ascites and ECOG score were complementary constipation risk factors in gastrointestinal cancer patients. Conclusion: The findings indicate that most gastrointestinal cancer patients were at a high risk of constipation. There are also several complementary constipation risk factors and CRAS-C can be further revised in future studies to make it more specific in gastrointestinal cancer patients. Integrating CRAS into the pathway of constipation management, carrying out constipation risk screening for hospitalized cancer patients, building systematic constipation prevention plan based on risk assessment are important to reduce the incidence of constipation in patients with gastrointestinal cancer, and improve the quality of life.
Common Mental Disorders And Equity In Health Care Use: São Paulo-Capital Health Survey
Authors: Gianini Reinaldo José , Santos Gustavo Brito Venâncio dos , Salvestro Gabriel 
Published: March 2022

Abstract
Background: Common Mental Disorders (CMDs) compromise quality of life, thus generating socioeconomic costs. Objectives: To analyze equity regarding use of the services and health expenditures among individuals with CMDs, and their relationships with sociodemographic variables.Methodology: The data are from the 2015 São Paulo health survey, with application of SRQ-20. The participants have given their consent for their data to be used in this research.Results: The sample presented a CMD prevalence of 19.7% (95% CI=18.2%-21.4%). Higher CMD prevalence values were found among users of the public health services (PR=1.49; 95% CI=1.25-1.76) and in groups with ≥ 33 dollars of health expenditures in the last month (PR=1.28; 95% CI=1.08-1.52). For individuals with CMDs, the main variables associated with “used the public health system” and “health expenditure < 33 dollars” were lower schooling levels, lower per capita family income, and age < 60 years old. There was an inverse relationship between use of the Unified Health System (Sistema Único de Saúde, SUS) and health expenditure. ﻿Conclusion: Use of the SUS by people with CMDs follows the principle of equity in that it assists groups that are underprivileged in terms of schooling and family income, but not those over 60 years old.
Linking The North Atlantic Oscillation to Winter Precipitation Over The Western Himalaya Through Disturbances of The Subtropical Jet
Authors: Hunt Kieran , Zaz Sumira Nazir 
Published: March 2022

Abstract
Winter (December to March) precipitation is vital to the agriculture and water security of the Western Himalaya and is largely brought to the region by extratropical systems, known as western disturbances (WDs), which are embedded in the subtropical jet. In this study, using seventy years of data, it is shown that during positive phases of the North Atlantic Oscillation (NAO+), the subtropical jet is significantly more intense than during negative phases (NAO-). Accordingly, it is shown that the NAO significantly affects WD behaviour on interannual timescales: during NAO + periods, WDs are on average 20% more common and 7% more intense than during NAO- periods. This results in 40% more moisture flux entering the region and impinging on the Western Himalaya and an average increase in winter precipitation of 45% in NAO + compared to NAO-. Using empirical orthogonal function (EOF) analysis, North Atlantic variability is causally linked to precipitation over North India – latitudinal variation in the jet over the North Atlantic is linked to waviness downstream, whereas variation in its tilt over the North Atlantic is linked to its strength and shear downstream. These results are used to construct a simple linear model that can skilfully predict winter precipitation over north India at a lead time of one month.
Exploring Genetic Variability In Okra (Abelmoschus Sp.) Accessions Using Promoter Targeted CAAT Box-Derived Polymorphism (CBDP) And Start Codon Targeted (Scot) Markers
Authors: V. Puneeth P. , Lata Suman , Yadav R. K. , Wankhede Dhammaprakash P , Tomar B. S. , Choudary H. , Tomer Avinash , Bidaramali V. , Talukdar A. 
Published: March 2022

Abstract
Okra is a warm season vegetable with excellent nutritional, medicinal and industrial potential. Though it is an important vegetable crop but genetic maps and linkage groups are not defined due to the presence of a few polymorphic molecular markers. In this study, we have used CAAT box-derived polymorphism (CBDP) and start codon targeted (ScoT) markers to determine the genetic diversity and population structure of the wild and cultivated population of okra, a genetically orphan crop. Twenty-five CBDP and thirty-six ScoT markers were used on eighty-nine okra accessions to generate polymorphic bands and to analyze the genetic diversity. Out of the 61 primers used, 27 (20-CBDP and 7-ScoT) primers were amplified with clearly visible polymorphic bands. The band size range of CBDP primers was 350-1500bp and for ScoT primers, it was 200-3000bp.Nei’sgenetic diversity was 1.7 for CBDP and 0.13 for ScoT. AMOVA of both markers combined showed 17% and 83% variation among and within-population, respectively. A UPGMA hierarchical dendrogram based on Jaccard’s similarity was drawn for CBDP and ScoT clustered all the accessions into many clades, with significant clustering of cultivated accessions on one clade and wild populations on the other. Bayesian model STRUCTURE analysis of Abelomoschus populations based on CBDP and ScoT markers gave two (K =2) and four (K = 4) genetic structures, respectively, with small admixture. In all the parameters studied, CBDP markers outperformed the ScoT markers.
Does Renewable Energy Determine the Environmental Impacts of Economic Growth? New Evidence from PSTR Analysis
Authors: Aydin Celil , Cetintas Yagmur 
Published: March 2022

Abstract
This study investigates the relationship between environmental pollution and economic growth in the context of renewable energy in OECD countries using the panel smooth transition regression (PSTR) model for the 1995-2018 period. The study finds the value of the threshold variable, determined as the share of renewable energy use in total energy consumption, as 7.825%. In this context, economic growth affects the environment negatively and increases environmental pollution when the share of renewable energy use in energy consumption is below the threshold level. On the other hand, when it is above the threshold level, it reduces environmental pollution by affecting the environment positively. Therefore, the widespread use of renewable energy is a solution to reduce environmental pollution. Accordingly, it is very important for policy makers to both highlight and encourage renewable energy use. Furthermore, countries need to both invest in this area and focus on R&D to increase renewable energy production.
The Impact Of The Serotonin Transporter Gene Promoter DNA Methylation And Parenting Styles On Anorexia Nervosa
Authors: He Qianqian , Kang Qing , Yu Shunying , Peng Sufang , Chen Han , Lin Zhiguang , Xiao Zeping , Chen Jue 
Published: March 2022

Abstract
Purpose: The serotonin system and parenting styles have been reported to be involved in the pathogenesis of anorexia nervosa (AN). The study was aimed to explore the effect of the methylation of the promoter region of serotonin transporter gene (SLC6A4), also called 5-HTTLPR, parenting styles as well as their interaction on AN.Methods: 91 AN patients (ANs) and 87 healthy controls (HCs) were recruited, from whom 41 ANs and 40 HCs completed the environmental assessment. 5-HTTLPR methylation levels, clinical symptoms and environmental factors were assessed at baseline for all participants. 5-HTTLPR methylation was measured by MassArray methods and clinical symptoms were mainly evaluated by the EDE-Q6.0 scale. Environmental assessment is the parenting attitudes and behaviors used by the EMBU scale.Results: ANs had higher methylation at CpG 11, CpG 24.25, CpG 31.32 and CpG_mean than HCs (P=0.039, 0.042, 0.018, 0.001). Furthermore, it was the binge/purging subtype that revealed significant hypermethylation at CpG 24.25 and CpG_mean (P=0.027, 0.031). Both CpG11 methylation level and the parenting styles of refusal denial, overprotection for father were both positively correlated the EDEQ-6.0 scores in ANs (P=0.047, 0.018). Besides, their interaction analysis found, it was the overprotection, not the refusal denial for father that significantly associated with EDEQ-6.0 scores in ANs (P=0.030).Conclusions: Our study provided preliminary evidence that 5-HTTLPR DNA methylation at CpG11 and parenting styles of refusal denial, overprotection for father played vital roles in AN pathogenesis. Their interaction analysis indicated it was father’s overprotection that significantly associated with the clinical symptoms in ANs.
Barriers and Facilitators of a New Model of Stratified Exercise Therapy in Knee Osteoarthritis: A Qualitative Study
Authors: Knoop Jesper , de Joode Willemijn , Brandt Hella , Dekker Joost , Ostelo Raymond 
Published: March 2022

Abstract
Background. We developed a new model of stratified exercise therapy that distinguishes three knee osteoarthritis (OA) subgroups (‘high muscle strength subgroup’, ‘low muscle strength subgroup’, ‘obesity subgroup’), which are provided subgroup-specific exercise therapy (supplemented by a dietary intervention for the ‘obesity subgroup’). The present study aimed at exploring barriers and facilitators of this new model.Methods. Qualitative research design embedded within a cluster randomized controlled trial in a primary care setting. A random sample from the experimental arm were interviewed (i.e., 15 patients, 11 physiotherapists and 5 dieticians). Qualitative data from these semi-structured interviews were thematically analyzed according to the grounded theory approach, to identify barriers and facilitators.Results. We identified six themes. Two themes applied to the model in general, emphasizing the perceived added value and applicability of the model. Three themes specifically applied to a subgroup. For the ‘high muscle strength subgroup’, the low number of supervised sessions was perceived advantageous by some and hindering by others. The ‘low muscle strength subgroup’ treatment was considered mostly comparable with usual care, therefore easy to provide. For the ‘obesity subgroup’, the potential of combining exercise therapy with weight loss was generally acknowledged, but physiotherapists perceived obesity difficult to address, and both physiotherapists and dieticians reported a lack of interprofessional collaboration. A sixth theme addressed barriers of knee OA treatment in general, with lack of motivation as most prominent barrier.Conclusion. This qualitative study revealed a number of barriers and facilitators of effective application of our model. Addressing these barriers and facilitators may enhance the effectiveness of the model.Trial registrationThe Netherlands National Trial Register (NTR): NL7463 (date of registration: 8 January 2019)
Greek-Cypriot nurses and midwives attitudes, beliefs and knowledge on medical cannabis: A cross-sectional descriptive correlational study
Authors: Sokratous Sokratis , Kaikoushi Katerina , Mpouzika Meropi , Alexandrou George , Karanikola Maria 
Published: March 2022

Abstract
Background: There is a lack of evidence on the attitudes, knowledge and beliefs towards medical cannabis (MC) in healthcare professionals, nationally and internationally. Additionally, there is lack of knowledge, and clinical guidance on MC use among healthcare professionals. We aimed to explore the attitudes, beliefs and knowledge of nurses and midwives on MC use in Cyprus. Special focus was given on gender differences, age group, religion, family status and work experience. Methods: A descriptive, cross-sectional correlational study with internal comparisons was performed on nurses and midwives during the 26th Nurses and Midwives Congress in Cyprus. All active nurses and midwives from public and private sector of private and national healthcare services (n=526) were eligible to participate. Pearson chi-square test for group differences was employed. Descriptive and inferential statistics were assessed.Results: The sample consisted of 232 nurses and midwives (the response rate was 46.46%), while 28.9% of them were male and 71.1% were female (mean: 32.3 years, SD: 9.2, range: 21–70). The participants reported lack of knowledge on MC effectiveness in the majority of the disorders included in the questionnaire. Nevertheless, they reported that MC was acceptable for persistent muscle spam (28.9%), insomnia/sleeping disorders (26.7%), mental health conditions (28%) and terminal illness (20.3%). Male and unmarried participants more frequently reported cannabis use cannabis recreational purposes (p<0.01), and that they had a friend who used cannabis for recreational purposes (p<0.05). Moreover, the age group of 20-30 years, more frequently agreed that additional research on MC needs to be integrated into academic programs (p<0.05)Conclusions: Enrichment of nursing curricula with theoretical and clinical/ laboratory courses in MC, during their studies, and during their employment in clinical settings is proposed. Additional interventions to decrease recreational cannabis use among Cypriot nurses and midwives should be considered based on gender and age.