Predictive model for prolonged hospital stay risk after gastric cancer surgery.

Background: Prolonged postoperative hospital stay following gastric cancer (GC) surgery is an important risk factor affecting patients' mood and increasing complications. We aimed to develop a nomogram to predict risk factors associated with prolonged postoperative length of stay (PLOS) in patients undergoing gastric cancer resection. Methods: Data were collected from 404 patients. The least absolute shrinkage and selection operator (LASSO) was used for variable screening, and a nomogram was designed. The nomogram performance was evaluated by the area under the receiver operating characteristic curve (AUC). The consistency between the predicted and actual values was evaluated via a calibration map, and the clinical application value was evaluated via decision curve analysis (DCA) and clinical impact curve analysis (CICA). Results: A total of 404 patients were included in this study. Among these patients, 287 were assigned to the training cohort, and 117 were assigned to the validation cohort. According to the PLOS quartile distance, 103 patients were defined as having prolonged PLOS. LASSO regression and logistic multivariate analysis revealed that 4 clinical characteristics, the neutrophil-lymphocyte ratio (NLR) on postoperative day one, the NLR on postoperative day three, the preoperative prognostic nutrition index and the first time anal exhaust was performed, were associated with the PLOS and were included in the construction of the nomogram. The AUC of the nomogram prediction model was 0.990 for the training set and 0.983 for the validation set. The calibration curve indicated good correlation between the predicted results and the actual results. The Hosmer-Lemeshow test revealed that the P values for the training and validation sets were 0.444 and 0.607, respectively, indicating that the model had good goodness of fit. The decision curve analysis and clinical impact curve of this model showed good clinical practicability for both cohorts. Conclusion: We explored the risk factors for prolonged PLOS in GC patients via the enhanced recovery after surgery (ERAS) program and developed a predictive model. The designed nomogram is expected to be an accurate and personalized tool for predicting the risk and prognosis of PLOS in GC patients via ERAS measures.

The Predictive and Prognostic Value of Percentage Change in Calf Circumference in Infants and Children During the First Week of Admission in the Pediatric Intensive Care Unit: A Prospective Cohort Study.

Calf circumference (CC) is an easy measure of muscle loss; yet, there are limited studies in children. We aimed to assess the viability of the first-week percent change in CC as a prognostic nutritional marker. Two MUAC (mid-upper arm circumference), CC, and weight measurements were carried out: one on the first day of admission and another on the seventh day. The differences and correlations between their percent changes were examined. The possible association between CC percent change and prolonged length of hospital stay (PLOS) and in-hospital mortality was assessed. Seventy participants were enrolled with a median age of 19.5 months. The median (interquartile range [IQR]) of CC percent change was 0.54 (5.5) with significant correlations between it and each of MUAC and weight percent change (ρ = 0.928, P = .001), (ρ = 0.902, P = .001), respectively. Calf circumference percent changes were significantly more negative in children with PLOS; (P = .004). These changes seem to be viable measures of nutritional status.

Research on the structure function recognition of PLOS.

Purpose: The present study explores and investigates the efficiency of deep learning models in identifying discourse structure and functional features and explores the potential application of natural language processing (NLP) techniques in text mining, information measurement, and scientific communication. Method: The PLOS literature series has been utilized to obtain full-text data, and four deep learning models, including BERT, RoBERTa, SciBERT, and SsciBERT, have been employed for structure-function recognition. Result: The experimental findings reveal that the SciBERT model performs outstandingly, surpassing the other models, with an F1 score. Additionally, the performance of different paragraph structures has been analyzed, and it has been found that the model performs well in paragraphs such as method and result. Conclusion: The study's outcomes suggest that deep learning models can recognize the structure and functional elements at the discourse level, particularly for scientific literature, where the SciBERT model performs remarkably. Moreover, the NLP techniques have extensive prospects in various fields, including text mining, information measurement, and scientific communication. By automatically parsing and identifying structural and functional information in text, the efficiency of literature management and retrieval can be improved, thereby expediting scientific research progress. Therefore, deep learning and NLP technologies hold significant value in scientific research.

Association between length of stay and postoperative survival in patients with lung cancer: a propensity score matching analysis based on National Cancer Database.

Background: Postoperative complications tend to result in prolonged hospitalization. The aim of this study was to investigate whether prolonged postoperative length of stay (LOS) can predict patient survival, particularly long-term survival. Methods: All patients undergoing lung cancer surgery between 2004 and 2015 were identified in the National Cancer Database (NCDB). The highest quintile of LOS (more than 8 days) was defined as prolonged length of stay (PLOS). We performed 1:1 propensity score matching (PSM) between the groups with and without PLOS (Non-PLOS). Excluding confounding factors, postoperative LOS was used as a surrogate for postoperative complications. Kaplan-Meier and Cox proportional hazards survival analyses were performed to analyze survival. Results: A total of 88,007 patients were identified. After matching, 18,585 patients were enrolled in the PLOS and Non-PLOS groups, respectively. Before and after matching, 30-day rehospitalization rate and 90-day mortality in the PLOS group were significantly higher than they were in the Non-PLOS group (P<0.001), indicating a potential worse short-term postoperative survival. After matching, the median survival of the PLOS group was significantly lower than that of the Non-PLOS group (53.2 vs. 63.5 months, P<0.0001). Multivariable analysis revealed that PLOS is independent negative predictor of overall survival [OS; hazard ratio (HR) =1.263, 95% confidence interval (CI): 1.227 to 1.301, P<0.001]. In addition, age (<70 or ≥70), gender, race, income, year of diagnosis, surgery type, pathological stage, and neoadjuvant therapy also were independent prognostic factors of postoperative survival for patients with lung cancer (all P<0.001). Conclusions: Postoperative LOS could be taken as the quantitative indicator of postoperative complications of lung cancer in NCDB. In this study, PLOS predicted worse short-term and long-term survival independent of other factors. Avoiding PLOS could be considered to benefit patient survival after lung cancer surgery.

Female Dynamics in Authorship of Scientific Publications in the Public Library of Science: A 10-year Bibliometric Analysis of Biomedical Research.

Women are generally underrepresented in science, technology, engineering, and mathematics (STEM). As scientific production reflects scholarly impact and participation in the scientific process, the number of journal publications forms a pertinent measure of academic productivity. This study examined the prevalence and evolution of female representation in prominent author positions across multidisciplinary biomedical research. Publications from seven exemplar cross-specialty journals of the Public Library of Science (PLoS Medicine, PLoS Biology, PLoS One, PLoS Computational Biology, PLoS Genetics, PLoS Pathogens, and PLoS Neglected Tropical Diseases) between January 2010 and December 2020 were extracted from Web of Science. Using Genderize.io, the gender of authors from their first names was estimated using a 75% threshold. The association between female prevalence in first and last authorship and journal was evaluated using a binary logistic regression, and odds ratios were estimated against a 50:50 reference on gender. In 266,739 publications, 43.3% of first authors and 26.7% of last authors were females. Across the ten-year period, female first authorship increased by 19.6% and last authorship by 3.2%. Among all journals, PLoS Neglected Tropical Diseases had the greatest total proportion of female first authors (45.7%) and PLoS Medicine of female last authors (32%), while PLoS Computational Biology had the lowest proportion in these categories (23.7% and 17.2%). First authors were less likely to be females in all PLoS journals (p < 0.05) except for PLoS Neglected Tropical Diseases (odds ratio: 0.84, 95% confidence interval: 0.71-1.00), where the odds of female authorship were not significantly different (p = 0.054). Last authors were not more likely to be females in all PLoS journals (p < 0.001). Overall, women still appear underrepresented as first authors in biomedical publications and their representation as last authors has severely lagged. Efforts towards gender equality in scholarly authorship will contribute to the representation of women in biomedical research and ensure that their potential is not lost.

Strategic job market-guided development of pharmacy bachelor's curriculum and its importance in maintaining the profession viability in the Middle Eastern countries: Colleges of pharmacy in the UAE as a model.

The Middle East has high youth population; however, it is challenged by uncertain economic situation. Higher education plays a crucial role in the development of nations by equipping generations with the knowledge and skill through cumulative curriculum development. Like other professions, pharmacy is a dynamic field of study where continuous improvements are required to keep the viability of the profession and endow future generations with up to date skills. This article describes a strategy for pharmacy curriculum development considering four layers. The strategy starts from the understanding of the current situation in a university, looking into national, international accreditations and job market. The strategy covers development from program to subject's level. The strategy is applied to pharmacy programs in the UAE. Upon analysis, several recommendations were obtained for curriculum improvements. At individual university level, there is a need to work on clinical oriented topics in the curriculum to fit with international accreditation and country's vision. Details on this can be taken form deeper analysis of job market and stakeholders in the UAE. On the national level, unifications of total credit hours for the degree across universities needs to be envisaged with limits on contact experiential hours. The strategy has the potential of extrapolating to other Middle Eastern countries.

Predicting prolonged postoperative length of stay risk in patients undergoing lumbar fusion surgery: Development and assessment of a novel predictive nomogram.

Objective: The purpose of this study was to develop and internally validate a prediction nomogram model in patients undergoing lumbar fusion surgery. Methods: A total of 310 patients undergoing lumbar fusion surgery were reviewed, and the median and quartile interval were used to describe postoperative length of stay (PLOS). Patients with PLOS > P75 were defined as prolonged PLOS. The least absolute shrinkage and selection operator (LASSO) regression was used to filter variables for building the prolonged PLOS risk model. Multivariable logistic regression analysis was applied to build a predictive model using the variables selected in the LASSO regression model. The area under the ROC curve (AUC) of the predicting model was calculated and significant test was performed. The Kappa consistency test between the predictive model and the actual diagnosis was performed. Discrimination, calibration, and the clinical usefulness of the predicting model were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was assessed using the bootstrapping validation. Results: According to the interquartile range of PLOS in a total of 310 patients, the PLOS of 235 patients was ≤P75 (7 days) (normal PLOS), and the PLOS of 75 patients was > P75 (prolonged PLOS). The LASSO selected predictors that were used to build the prediction nomogram included BMI, diabetes, hypertension, duration of surgery, duration of anesthesia, anesthesia type, intraoperative blood loss, sufentanil for postoperative analgesia, and postoperative complication. The model displayed good discrimination with an AUC value of 0.807 (95% CI: 0.758-0.849, P < 0.001), a Kappa value of 0.5186 (cutoff value, 0.2445, P < 0.001), and good calibration. A high C-index value of 0.776 could still be reached in the interval validation. Decision curve analysis showed that the prolonged PLOS nomogram was clinically useful when intervention was decided at the prolonged PLOS possibility threshold of 3%. Conclusions: This study developed a novel nomogram with a relatively good accuracy to help clinicians access the risk of prolonged PLOS in lumbar fusion surgery patients. By an estimate of individual risk, surgeons and anesthesiologists may shorten PLOS and accelerate postoperative recovery of lumbar fusion surgery through more accurate individualized treatment.

Preprint citation practice in PLOS.

The role of preprints in the scientific production and their part in citations have been growing over the past 10 years. In this paper we study preprint citations in several different aspects: the progression of preprint citations over time, their relative frequencies in relation to the IMRaD structure of articles, their distributions over time, per preprint database and per PLOS journal. We have processed the PLOS corpus that covers 7 journals and a total of about 240,000 articles up to January 2021, and produced a dataset of 8460 preprint citation contexts that cite 12 different preprint databases. Our results show that preprint citations are found with the highest frequency in the Method section of articles, though small variations exist with respect to journals. The PLOS Computational Biology journal stands out as it contains more than three times more preprint citations than any other PLOS journal. The relative parts of the different preprint databases are also examined. While ArXiv and bioRxiv are the most frequent citation sources, bioRxiv's disciplinary nature can be observed as it is the source of more than 70% of preprint citations in PLOS Biology, PLOS Genetics and PLOS Pathogens. We have also compared the lexical content of preprint citation contexts to the citation content to peer-reviewed publications. Finally, by performing a lexicometric analysis, we have shown that preprint citation contexts differ significantly from citation contexts of peer-reviewed publications. This confirms that authors make use of different lexical content when citing preprints compared to the rest of citations.

The Level of Program Learning Outcomes (PLOs) achievements among the Interns and Fresh graduates of the BDS program.

OBJECTIVES: Success of Dental Program depends on the students' performance measured in terms of Program Learning Outcomes (PLOs) achievement. The present study was carried out to evaluate the level of achievement of the PLOs among dental interns and fresh graduates as a direct measure for the success of the BDS program of the College of Dentistry, King Saud University. METHODS: An online survey instrument was used to seek the opinion of male and female dental interns and fresh graduates about the attainment of the PLOs distributed over 6 domains: patients' care, communication & interpersonal skills, professionalism, practice management, information management & critical thinking, and health promotion domains on a five-point Likert scale. The data were analyzed using Minitab Statistical Software version 15.1.31.0. Descriptive as well as Chi-Square statistics were calculated to determine the significance of the responses to the levels of PLOs achievement at 0.05 level of significance. RESULTS: Levels of achievement of PLOs under the 6 domains indicated a good standard of planning, delivery, and evaluation of the BDS program. On an overall average score basis, the achievement of PLOs under the Communication-Interpersonal Skills domain ranked as highest with a score of 4.22 ± 0.88 followed by Professionalism (4.18 ± 0.85), Practice Management (4.03 ± 0.93), Patient care (3.94 ± 0.84) and Information Management-Critical Thinking domain with a score of 3.68 ± 0.96. The lowest score was achieved under Health promotion domain with a score of 3.60 ± 0.93. Statistically, no significant differences were found based on the graduation years and gender of the respondents. CONCLUSION: The study revealed significant achievement of PLOs under all learning domains of the BDS curriculum taught at the College of Dentistry, King Saud University. However, achievement scores for Information Management, Critical Thinking, and Health Promotion domains require further improvement through reinforcement of the curriculum, updating of content, and teaching strategies.

Airway management techniques in head and neck cancer surgeries: a retrospective analysis.

BACKGROUND: The aim of this study was to conduct a retrospective analysis of modalities of airway management and its impact on patients undergoing head and neck cancer surgeries. MATERIALS AND METHODS: A retrospective review of the medical record of 500 patients operated from January 2008 to December 2013 was conducted at our institute. Patients were reviewed for a mode of airway management, a total length of post-operative hospital stay (PLOS), and incidence of elderly patients in the total number of head and neck cancer surgeries posted for various diagnostic and definitive treatments. RESULTS: Out of 500 patients, 462 patients (92.4%) underwent nasal intubation, of which 320 underwent fiberoptic (FO) intubation (64%), 7 underwent tracheotomies after completion of surgery (1.4%), and 3 underwent at the beginning of surgery (0.6%). The remaining 38 patients (7.6%) underwent oral intubation. CONCLUSION: Nasotracheal intubation using fiberoptic bronchoscopy is the most preferred technique for the management of a difficult airway. Efficient airway management during the perioperative period significantly reduces the post-operative length of hospital stay and morbidity.

Comparative analysis of PLoS ALMS and ALtmetrics scores and indications for assessing the academic level of individual articles / 中华医学图书情报杂志

Objective To comparatively analyze the the relationship between PLoS ALMs,Altmetrics score and the indications for assessing the academic level of individual articles and their efficiency for assessing the academic level of individual articles. Methods The relationship of the viewed, downloaded, discussed, recommended counts and frequency of citation with Altmetrics score, h index, academic track T and their efficiency for assessing a single pa-per were comparatively analyzed with PLoS Biology and PLoS Medicine as an example. Results The viewed, down-loaded and discussed papers were positively related with the frequency of citation and h index, the recommended papers were not related with the h index and academic track T, and the Altmetrics score was moderately related with the red, downloaded and discussed papers, and was weakly related with the frequency of citation. Conclusion PLoS ALMS is a multidimensional assessment. Only it is measured with several indications, can it demonstrate a work’s comprehensive strength.

The impact of complications on prolonged length of hospital stay after resection in colorectal cancer: A retrospective study of Taiwanese patients.

Objectives To assess the impact of minor, major and individual complications on prolonged length of hospital stay in patients with colorectal cancer (CRC) after surgery using multivariate models. Methods This was a retrospective review of data from patients who underwent surgery for stage I-III CRC at two medical centres in southern Taiwan between 2005-2010. Information was derived from four databases. Multivariate logistic regression methods were used to assess the impact of complications on prolonged length of stay (PLOS) and prolonged postoperative length of stay (PPOLOS). Results Of 1658 study patients, 251 (15.1%) experienced minor or major postsurgical complications during hospitalizations. Minor and major complications were significantly associated with PLOS (minor, odds ratio [OR] 3.59; major, OR 8.82) and with PPOLOS (minor, OR 5.55; major, OR 10.00). Intestinal obstruction, anastomosis leakage, abdominal abscess and bleeding produced the greatest impact. Conclusions Minor and major complications were stronger predictors of prolonged hospital stay than preoperative demographic and disease parameters. Compared with the PLOS model, the PPOLOS model better predicted risk of prolonged hospital stay. Optimal surgical and medical care have major roles in surgical CRC patients.

Papers published in PLoS One by hospitals in China / 中华医学图书情报杂志

Objective To study the reasons why PLoS One has set off an upsurge in China especially in hospitals, the academic level of papers published in PLoS One, and how to correctly judge the SCI-covered papers published by hospitals.Methods Papers published in PLoS One by hospitals in China were retrieved.The number of papers published in PLoS One by hospitals in China, the institutions that published the papers in PLoS One, and the num-ber of fund-supported papers were analyzed.Results A total of 9739 papers were published in PLoS One by hospitals in China from 2007 to October 2015, with an average cited frequency of 5.29.The majority of authors who published the papers were from affiliated hospitals of scientific research institutions and teaching hospitals of colleges and uni-versities.Of the 9739 papers, 87.78%were supported by funds from different foundations.Conclusion Nothing is strike about the academic level of papers published in PLoS One by hospitals in China with their average cited fre-quency lower than that (8.14) in our country.The SCI-covered papers published by hospitals should not be con-sidered as the only criterion in assessing the performances of staff in hospitals.

Papers published in PLoS One by Chinese authors engaged in scientific research / 中华医学图书情报杂志

Objective To analyze the characteristics of contributions and the reasons why Chinese authors engaged in scientific research favor to contribute their papers to PLoS One by comparing the papers published in PLoS One and its series by authors from China and other countries.Methods Papers published in PLoS One by Chinese au-thors engaged in scientific research were retrieved from Web of Science by setting the retrieval parameters and ana-lyzed.Results The number of papers published in PLoS One series by authors from China increased rapidly.The number of papers published in PLoS One was significantly larger than that published in other PLoS One series. Conclusion The scientific research scale is unceasingly expanded.Why the Chinese authors engaged in scientific research favor to contribute their papers to PLoS One are due to its attractive power and the guidance of scientific and technological evaluation management in China.

Analysis of Submission Information of Open Access Journal PLoS One / 中国医学伦理学

Based on the introduction and analysis about PLoS One, and its number of published papers, impact fac-tor, publishing period, manuscript employed, publication fee, auditing, requirement for paper etc. , this paper pointed out break the barriers of traditional publishing model from several aspects, create a new way of open access scholarly pub-lishing, promoted the fast communication of scientific research. As the author of China, can choose more PLoS One pub-lished as our scientific research platform, improve our position in the field of scientific research in the world.

ICG-liver test versus new biomarkers as prognostic markers for prolonged length of stay in critically ill patients - a prospective study of accuracy for prediction of length of stay in the ICU.

BACKGROUND: Prognostic abilities of medical parameters, which are scoring systems, measurements and biomarkers, are important for stratifying critically ill patients. Indocyanine green plasma disappearance (ICG-PDR) is an established clinical tool for the assessment of liver perfusion and function. Copeptin, MR-proANP and pro-ADM are biomarkers whose prognostic value is still unclear. The goal of this prospective study was to evaluate ICG-PDR, copeptin, MR-proANP and pro-ADM to predict prolonged length of stay (pLOS) in the ICU. METHODS: This study was conducted as a prospective single center study including 110 consecutively admitted ICU patients. Primary endpoint was prolonged length of stay (pLOS) in the ICU, defined as more than three days of stay there. RESULTS: ROC analysis showed an AUC of 0.73 for ICG-PDR, 0.70 for SAPS II, 0.65 for MR-proANP, 0.64 for pro-ADM and 0.54 for copeptin for pLOS in the ICU. CONCLUSIONS: The prediction of pLOS in the ICU might be better by means of ICG-PDR than with the new biomarkers copeptin, MR-proANP or pro-ADM. Nevertheless, there is more need for research to evaluate whether ICG-PDR is an overall prognostic marker for pLOS. TRIAL REGISTRATION: (ClinicalTrials.gov number, NCT01126554).

Trends in percutaneous nephrolithotomy use and outcomes in the United States.

PURPOSE: We investigated recent trends in the use and perioperative outcomes of percutaneous nephrolithotomy in the United States in a population based cohort. MATERIALS AND METHODS: We obtained the records of patients treated with percutaneous nephrolithotomy between 1999 and 2009 from the Nationwide Inpatient Sample (NIS). A weighted sample was used to estimate national utilization rates. Trends in age, comorbidity, perioperative complications and in-hospital mortality were analyzed. Temporal trends were quantified by the estimated annual percent change. We evaluated the association between patient and hospital characteristics, including complications, prolonged length of stay and in-hospital mortality, using logistic regression models adjusted for clustering. RESULTS: During 1999 to 2009, percutaneous nephrolithotomy use increased in men and women from 3.0/100,000 and 2.99/100,000 to 3.63/100,000 and 4.07/100,000, respectively. Women showed the largest increases in percutaneous nephrolithotomy use with an estimated annual percent change of 4.49% (95% CI 2.7-6.3, p <0.001) vs 2.90% (95% CI 1.5-4.3, p = 0.003) in men. Baseline comorbidity in patients undergoing percutaneous nephrolithotomy increased with time. Overall complications increased from 12.2% to 15.6% (p <0.001), while mortality remained stable at 0.0% to 0.4%. The transfusion rate was 4.0%. Sepsis increased from 1.2% to 2.4% of cases (p <0.001). Patients were at risk for complications if they were older, more ill and treated in more recent years. Age was significantly associated with increased odds of mortality. CONCLUSIONS: Percutaneous nephrolithotomy use in the United States has increased and females are now the majority gender. Although mortality remains low, rates of sepsis and overall complications have increased. Broad use of percutaneous nephrolithotomy, especially in older and more ill patients, may account for these changes.