COVID-19 has altered how individuals interact with natural environments. Numerous studies have investigated the effects of such environments on health. However, how natural environments influenced ...individuals' physiological and mental health during various stages of the COVID-19 pandemic remains unclear. Therefore, we conducted this study to investigate the effects of natural environments on individuals' physiological and mental health during different stages of the pandemic; we also identified factors that mediated these effects. Overall, we evaluated the importance of natural environments during challenging times. This study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The pandemic period was divided into three stages on the basis of severity: pandemic (March 2020 – February 2022), easing (February 2022–September 2022), and post-acute COVID pandemic (September 2022 - present). An initial pool of 3018 studies was narrowed down to a final sample of 73 studies. During the pandemic stage, individuals frequenting public green spaces exhibited improved well-being, reduced stress levels, and a sense of nature deprivation. Private green spaces played crucial roles in maintaining health during the pandemic stage. Highquality window views were associated with improved well-being and reduced depression. During the easing stage, the environmental quality of public green spaces influenced individuals' perceived safety and sense of belonging. And coastal areas were the preferred natural destinations in this stage. During the post-acute COVID pandemic stage, individuals acknowledged the importance of natural environments in maintaining physiological and mental health as they gradually returned to prepandemic normalcy. In conclusion, the COVID-19 pandemic highlighted humanity's reliance on nature. Therefore, sufficient urban spaces should be dedicated to preservation of natural environments to mitigate negative emotions arising from prolonged indoor stays.
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•During the pandemic, the quality of window views is associated with well-being and depression.•Spending time outside in nature eased the stress from the pandemic.•Coastal areas were the preferred natural destinations in the easing stage.•After the pandemic, public health awareness increased regarding the importance of nature to human health.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Post-operative pain and bleeding are the main complications following hemorrhoidal surgery. This study aimed to investigate whether an absorbable gelatin sponge is a superior hemostatic and analgesic ...agent compared to gauze soaked in epinephrine for post-hemorrhoidal surgery care. A retrospective study was conducted using data from a single institute. Data were collected from the electronic medical record database and outpatient patient questionnaire archive. The study encompassed 143 patients who received gauze soaked in epinephrine as the hemostatic agent after hemorrhoidal surgery and 148 patients who received an absorbable gelatin sponge. Most patients underwent stapled hemorrhoidopexy, with 119 (83.2%) in epinephrine group and 118 (79.7%) in gelatin sponge group. The primary outcome measurements were postoperative pain score, oral analgesic dosage and complications. Patients in the absorbable gelatin sponge group reported significantly lower pain scores from 8 h after their hemorrhoidal surgery (postoperative day 0) through postoperative day 2. The average pain scores in the absorbable gelatin sponge group and gauze soaked in epinephrine group were 5.3 ± 3.2 and 6.2 ± 3.2 (p = 0.03) on postoperative 8 h; 4.7 ± 3.0 and 5.8 ± 2.9 (p ≤ 0.01) on postoperative day one; and 4.4 ± 2.8 and 5.3 ± 2.9 (p = 0.01) on postoperative day two, respectively. There were no significant differences in postoperative recovery or complication rates between the two groups. Our study revealed that absorbable gelatin sponges provide more effective pain relief to patients during the initial postoperative days after hemorrhoidal surgery, without any adverse impact on patient outcomes. Consequently, absorbable gelatin sponges are recommended as a replacement for gauze soaked in epinephrine following hemorrhoidal surgery.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Stapled hemorrhoidopexy has a few advantages such as less postoperative pain and faster recovery compared with conventional hemorrhoidectomy. There are two major devices used for stapled ...hemorrhoidopexy, PPH stapler (Ethicon EndoSurgery) and DST stapler (Covidien). This study was conducted to investigate the postoperative outcomes among patients with grade III and IV hemorrhoids who underwent hemorrhoidopexy with either of these two devices. A total of 242 consecutive patients underwent stapled hemorrhoidopexy with either PPH stapler (110 patients) or DST stapler (132 patients) at a single center in 2017. We performed a retrospective case-control study to compare the short-term postoperative outcomes and the complications between these two groups. After matching the cases in terms of age, gender, and the grade of hemorrhoids, there were 100 patients in each group (PPH versus DST). There were no significant differences in the postoperative visual analog scale (VAS) score and analgesic usage. Among complications, the incidence of anorectal stricture was significantly higher in the DST group (p = 0.02). Evaluation of the mucosal specimen showed that the total surface area, the muscle/mucosa ratio and the surface area of the muscle were also significantly higher in the DST group (p = 0.03). Further analysis of the DST group demonstrated that patients with anorectal stricture after surgery are younger than patients without anorectal stricture, and higher muscle/mucosa ratio (p = 0.03) and a higher surface area of the muscle (p = 0.03) also measured in the surgical specimen. The two devices provide similar outcomes of postoperative recovery. Patients who underwent DST stapled hemorrhoidopexy had a higher incidence rate of stricture, larger area of muscle excision, and higher muscle/mucosa ratio in the surgical specimen. Further investigation is warranted for a better understanding of the correlation between muscle excision and anorectal stricture.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Abstract
The right and left side of the colon derived from the midgut and hindgut, respectively. Previous studies have reported different characteristics of right-sided colon cancer (RCC) and ...left-sided colon cancer (LCC), but oncological outcomes remain unclear. This study compared the outcomes of RCC and LCC. This retrospective study included 1017 patients who received curative colectomy for stage I-III colon cancer at a single institute between August 2008 and December 2019. Overall survival (OS) and time to recurrence (TTR) were analyzed as outcome measurements. No significant difference in the OS or TTR of patients with RCC and LCC were observed. In subgroup analysis, RCC was associated with shorter TTR than LCC in stage II colon cancer (HR 2.36, 95% confidence interval 1.24–4.48,
p
< 0.01). Multivariate analysis demonstrated that right sidedness, R1 resection, low body mass index (BMI) and adjuvant chemotherapy were independent factors for poor prognosis for stage II colon cancer. Low BMI, perineural invasion, higher T stage and N2 stage were independent factors for poor prognosis for stage III colon cancer. The results were confirmed by multivariate analysis after propensity score matching. Our study revealed that RCC was an independent risk factor for recurrence in stage II colon cancer.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Oxide semiconductors have been considered one of the most promising candidates for flexible electronics applications owing to their low process temperatures and good reliability. However, the low ...mobility of p-type oxide semiconductors limits the performance of flexible oxide-TFT-based CMOS technology. In this study, p-type SnO x :Ni thin films were deposited by reactive rf magnetron co-sputtering, a technique compatible with the current industrial semiconductor manufacturing technology, from Sn and Ni targets. As the Ni-gun power increased, the distribution of Ni in the SnO x :Ni thin film changed from a more uniform dispersion to nanoclusters, resulting in the crystalline phase transition of SnO x :Ni from <inline-formula> <tex-math notation="LaTeX">\alpha </tex-math></inline-formula>-SnO (110)-dominant polycrystalline to amorphous and then to <inline-formula> <tex-math notation="LaTeX">\alpha </tex-math></inline-formula>-SnO (101)-dominant polycrystalline. A high-mobility inverted-staggered p-type SnO x :Ni TFT was then fabricated on a glass substrate with a maximum process temperature of 225°C, which is compatible with flexible polymeric substrates. The TFT fabricated at an optimal Ni-gun power of 42 W exhibited an impressive field-effect mobility of 11 cm 2 V −1 s −1 and on current of <inline-formula> <tex-math notation="LaTeX">35.2 ~\mu \text{A} </tex-math></inline-formula> per channel width-to-length ratio; these values are comparable to those of a typical n-type oxide TFT. These results should contribute toward flexible oxide-TFT-based CMOS technology.
Background
Totally implantable venous access ports (TIVAP) have been widely used in cancer patients for many years. The early infection (within 30 days after TIVAP implantation) rate of TIVAP ...accounts for about one-third of all TIVAP infections, and early infection often causes port removal and affects subsequent cancer treatment. This study investigated the incidence and risk factors for early and late infection after TIVAP implantation.
Methods
From January 2013 to December 2018, all adult cancer patients who received TIVAP implantation in Taipei Medical University Shuang-Ho Hospital were reviewed. We evaluated the incidence of TIVAP-related infection, patient characteristics, and bacteriologic data. Univariable analysis and multiple logistic regression analysis were used to evaluate the risk factors of TIVAP-related infection.
Results
A total of 3001 TIVAPs were implanted in 2897 patients, and the median follow-up time was 424 days (range: 1–2492 days), achieving a combined total of 1,648,731 catheter days. Thirty-one patients (1.0%) had early infection and 167 (5.6%) patients had late infection. In multivariate analysis, TIVAP combined with other surgeries (
p
= 0.03) and inpatient setting (
p
< 0.001) was the risk factor of early infection, and TIVAP combined with other surgeries (
p
= 0.007), hematological cancer (
p
= 0.03), and inpatient setting (
p
< 0.001) was the risk factor of late infection.
Conclusion
Inpatient TIVAP implantation and TIVAP implantation combined with other surgeries are associated with high rates of TIVAP-related early and late infections.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Colorectal cancer is one of the most frequently diagnosed forms of cancer, and it is associated with several common symptoms and signs such as rectal bleeding, altered bowel habits, abdominal pain, ...anemia, and unintentional weight loss. Sciatica, a debilitating condition in which the patient experiences paresthesia and pain in the dermatome of associated lumbosacral nerve roots or sciatic nerve distribution, is not considered one of these. Here we present a case of colorectal cancer manifesting symptoms of sciatica alone.
A 68-year-old male presented with progressive lower back pain radiating to his left thigh and calf over L5/S1 dermatome. Sciatica was suspected and initially underwent conservative treatment with analgesics. However, the symptoms progressed and MRI revealed an epidural abscess surprisingly. Surgical debridement was performed and pus culture isolated Streptococcus gallolyticus. Based on the strong association of S. gallolyticus with colorectal cancer, the presence of this pathogen prompted further tumor evaluation, even in the absence of the typical symptoms and signs. This investigation ultimately leads to the diagnosis of sigmoid adenocarcinoma.
Although rare, sciatica caused by S. gallolyticus infection of the spinal epidural space may serve as the initial presentation of colorectal cancer. Physicians should be aware of the strong association between S. gallolyticus and colorectal cancer. Based on what we currently know about the condition; a thorough systematic assessment of occult neoplasia for patients with S. gallolyticus infection is recommended.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Total mesorectal excision (TME) is the standard surgical principle in the treatment of rectal cancer. However, in recent years, there has been an increasing debate about how to obtain better results ...in circumferential margin (CRM) and distal margins of the surgical specimen. The CRM and distal margin involvement rates have been linked to local recurrence and disease-free survival rates. In this study, we compared three surgical techniques for the treatment of lower rectal cancer.
From July 2008 to April 2018, we identified consecutive patients with lower rectal cancer who underwent TME. According to the surgical technique, we divided the patients into three groups: transanal TME (TaTME), laparoscopic TME (LaTME), and open TME (OpTME).
A total of 126 patients underwent TME; 39, 64 and 23 patients underwent TaTME, LaTME, and OpTME respectively. Tumor location was lower in the TaTME group than the other groups (p < 0.01). TaTME resulted in longer operation time than the other two groups (p < 0.01). In pathological outcomes, no patients with a CRM <1 mm were observed in the TaTME group compared with five (7.8%) and three patients (13.0%) with CRM <1 mm in the LaTME and OpTME group respectively (p = 0.035). Patients in the TaTME and LaTME groups also had a better disease-free survival than OpTME group (p < 0.01).
TaTME provides surgeons with a novel and effective method to treat lower rectal cancer. In the short-term outcomes, TaTME achieved better pathological results and disease free survival than OpTME but not significantly superior to LaTME. Further studies are necessary to evaluate the long-term oncological results.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Numerous factors can influence bowel movement recovery and anastomotic healing in colorectal surgery, and poor healing can lead to severe complications and increased medical expenses. Collagen patch ...cover (CPC) is a promising biomaterial that has been demonstrated to be safe in animal models and has been successfully applied in various surgical procedures in humans. This study.
A retrospective review of medical records from July 2020 to June 2022 was conducted to identify consecutive patients who underwent laparoscopic colectomy. Patients who received CPC at the anastomotic site were assigned to the collagen group, whereas those who did not receive CPC were assigned to the control group.
Data from 241 patients (collagen group, 109; control group, 132) were analyzed. Relative to the control group, the collagen group exhibited a faster recovery of bowel function, including an earlier onset of first flatus (2.93 days vs. 3.43 days, p < 0.01), first defecation (3.73 days vs. 4.18 days, p = 0.01), and oral intake (4.30 days vs. 4.68 days, p = 0.04). CPC use was also associated with lower use of postoperative intravenous analgesics. The complication rates in the two groups did not differ significantly.
CPCs can be safely and easily applied to the anastomotic site during laparoscopic colectomy, and can accelerate bowel movement recovery. Further studies on the effectiveness of CPCs in colorectal surgery involving larger sample sizes are required.
ClinicalTrials.gov registration number: NCT05831956 (26/04/2023).
Colorectal cancer (CRC) is the third most common type of cancer worldwide, and distant metastasis is frequently noted at diagnosis or follow-up. Notably, some patients with CRC can present with ...distant organ metastasis without any nodal involvement, which was defined as direct distant organ metastasis (DDOM). In this study, we evaluated the prognostic significance of DDOM for patients with CRC.
This study included 325 patients who had undergone primary colorectal cancer resection between August 2008 and December 2021. The patients with and without DDOM were compared (Kaplan–Meier analysis) in terms of overall survival (OS) and time to recurrence. Furthermore, the patients’ clinicopathological risk factors and protective factors were analyzed (multivariate Cox proportional hazards model).
Of the 325 patients, 65 (20%) had DDOM (Direct+ group) and 260 (80%) did not (Direct− group). The Kaplan–Meier analysis revealed that OS was significantly better in the Direct+ group than in the Direct− group (p < 0.01). A subgroup analysis by CRC stage was performed; for the patients with non-stage-IV CRC, the rate of OS was significantly higher in the Direct+ group than in the Direct− group (p = 0.02). However, DDOM did not affect the OS of the patients with stage IV CRC. The multivariate analysis indicated DDOM, left colon tumor location, and postoperative adjuvant chemotherapy were significant protective factors for disease-related mortality in the patients with non-stage-IV CRC; by contrast, body mass index, curative resection, and postoperative adjuvant chemotherapy were identified to be significant protective factors in the patients with stage IV CRC.
DDOM appears to be significantly associated with improved OS in patients with non-stage-IV CRC but not in those with stage IV CRC. Furthermore, the time to cancer recurrence may not vary significantly between patients with DDOM and those without it.
•Direct distant organ metastasis (DDOM) in colorectal cancer (CRC) patients, occurring without lymph noda involvement, is identified in 20% of cases.•DDOM is associated with significantly improved overall survival (OS) in non-stage-IV CRC patients.•DDOM in non-stage-IV CRC patients had lower incidence rates of lymphovascular and perineural invasion, coupled with higher rate of complete resection of metastatic tumor.•In stage IV CRC patients, DDOM does not influence OS and time to recurrence.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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