bluuebunny/crossref_metadata_2025 huggingface dataset:
Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series
Authors: Putra Agustian Winarno , Indrasari Sagung Rai , Herdini Camelia , Yudistira Danu
Published: July 2024

Background Arteriovenous malformations (AVMs) in the head and neck pose a challenge in their management due to their local aggressiveness and high recurrence risk. This study aimed to analyze literature on head and neck AVM recurrence post-treatment and identify the most effective strategy with a lower recurrence rate. Objectives To analyse existing literature on the recurrence of head and neck AVMs following treatment. Our goal was to identify the most effective treatment option with a lower recurrence rate. Methods We conducted a thorough literature search using PubMed, ScienceDirect, and Scopus, from year 2000 to the present. Our analysis focused on key endpoints, specifically the recurrence rates of head and neck AVMs following various treatment approaches. Results Out of the initial pool of 108 screened articles, a total of 83 patients were deemed suitable for inclusion in the literature review. The reviewed articles demonstrated that appropriate diagnostic tests were documented in 95% of the included studies. Among the patients, 37.3% had previously undergone interventions and were currently dealing with regrowth masses. Notably, 56.6% of patients underwent a combined approach involving both endovascular and surgical methods, while 25.3% opted for a surgical-only approach, and only 18.1% pursued an endovascular-only approach. The studies showed a promising curing rate of AVMs, with a success rate of 94%, albeit with a complication rate of 32.5%. The average follow-up duration for all patients was 26 months, with a standard deviation of 20.5 months. Out of the 83 patients, 5 experienced recurrence, with single-modality approach. Interestingly, no patients who received a multi-modality of treatments experienced recurrence or regrowth of the AVM mass within the follow up period. Conclusion The multi-modality approach outperformed single-modality treatments in preventing AVM recurrence. These findings highlight the importance of a comprehensive and multidisciplinary approach in the management of these complex vascular anomalies. PROSPERO: CRD42023490871 registered on 17/12/2023
A scoping review on what constitutes a good research culture
Authors: Blatch-Jones Amanda Jane , Lakin Kay , Thomas Sarah
Published: July 2024

Background

The crisis in research culture is well documented, covering issues such as a tendency for quantity over quality, unhealthy competitive environments, and assessment based on publications, journal prestige and funding. In response, research institutions need to assess their own practices to promote and advocate for change in the current research ecosystem. The purpose of the scoping review was to explore ‘What does the evidence say about the ‘problem’ with ‘poor’ research culture, what are the benefits of ‘good’ research culture, and what does ‘good’ look like?’

Aims

To examine the peer-reviewed and grey literature to explore the interplay between research culture, open research, career paths, recognition and rewards, and equality, diversity, and inclusion, as part of a larger programme of activity for a research institution.

Methods

A scoping review was undertaken. Six databases were searched along with grey literature. Eligible literature had relevance to academic research institutions, addressed research culture, and were published between January 2017 to May 2022. Evidence was mapped and themed to specific categories. The search strategy, screening and analysis took place between April-May 2022.

Results

1666 titles and abstracts, and 924 full text articles were assessed for eligibility. Of these, 253 articles met the eligibility criteria for inclusion. A purposive sampling of relevant websites was drawn from to complement the review, resulting in 102 records included in the review. Key areas for consideration were identified across the four themes of job security, wellbeing and equality of opportunity, teamwork and interdisciplinary, and research quality and accountability.

Conclusions

There are opportunities for research institutions to improve their own practice, however institutional solutions cannot act in isolation. Research institutions and research funders need to work together to build a more sustainable and inclusive research culture that is diverse in nature and supports individuals’ well-being, career progression and performance.
Quantitative assessment of the lipiodol staining after transarterial chemoembolization for hepatocellular carcinoma: can it predict tumor recurrence?
Authors: Wattanasatesiri Tunyarat , Faimetta Patcha , Angthong Wirana
Published: July 2024

Background The degree of intratumoral lipiodol staining after conventional transarterial chemoembolization (cTACE) has the potential to predict tumor responses and disease prognosis. This study is aimed at evaluating the correlation between the lipiodol retention of the tumor with a complete response after cTACE and tumor recurrence by quantitative assessment. Methods From January 2013 to September 2023, every patient receiving cTACE for HCC was recognized. Inclusion criteria were patients with ≤6 HCCs and sizes 1-6 cm, with at least one tumor obtaining a complete response after cTACE, and available baseline and follow-up CT studies. Tumoral, cTACE procedural, and lipiodol staining parameters were analyzed. Using univariate and multivariate analysis, significant factors associated with tumor recurrence were identified. ROC curve analysis was used to identify the optimal cutoff point for the statistically significant factors, predicting tumor recurrence. Results The final population included 39 patients with 63 HCCs. Tumor recurrence was detected in 18/63 (28.6%) at a mean of 27.8 months. On univariate analysis, the incidence of tumor recurrence significantly increased with increased tumor size (p = 0.007), an inhomogeneous lipiodol staining pattern (p<0.001), a low minimum lipiodol radiodensity (p = 0.012), and a high lipiodol washout rate (p = 0.046). On multivariate analysis, an inhomogeneous lipiodol staining pattern (p<0.001) and a high lipiodol washout rate (p = 0.012) were significant predictors for tumor recurrence. On ROC analysis, a lipiodol washout rate of greater than 6.44 HU/month was related to tumor recurrence (sensitivity 83%, specificity 51%). Conclusions Inhomogeneous lipiodol staining pattern and lipiodol washout rate of >6.44 HU/month were predictors for recurrence of HCC after a complete response after cTACE. These correlations may provide useful guidance for subsequent imaging surveillance and treatment approaches.
Living systematic review and meta-analysis of plasma-concentrations of antipsychotic drugs in carriers and non-carriers of variant CYP450 genotypes: Living systematic review protocol
Authors: Milosavljević Filip , Leucht Stefan
Published: July 2024

Introduction Carriers of variant alleles of genes that encode liver CYP450 and UGT enzymes may experience abnormal plasma levels of antipsychotics and, consequently, worse efficacy or tolerability. Although pharmacogenomics is a rapidly developing field, current guidelines often rely on limited, underpowered evidence. We have previously demonstrated that meta-analysis is a viable strategy for overcoming this problem. Here, we propose a project that will expand our previous work and create a living systematic review and meta-analysis of drug plasma level differences between carriers and non-carriers of variant genotype-predicted phenotypes for every pharmacokinetic drug-gene interaction relevant to commonly used antipsychotic drugs. Protocol First, a baseline systematic review and meta-analysis will be conducted by searching for observational pharmacogenomics-pharmacokinetic studies. Data on dose-adjusted drug plasma levels will be extracted, and participants will be grouped based on their genotype for each drug-gene pair separately. Differences in plasma drug levels between different phenotypes will be compared using a random-effect ratio-of-means meta-analysis. The risk of bias will be assessed using ROBINS-I, and the certainty of evidence will be assessed using GRADE. Following the establishment of baseline results, the literature search will be re-run at least once every six months, and the baseline data will be updated and re-evaluated as new evidence is published. A freely available website will be designated to present up-to-date results and conclusions. Discussion This systematic review will provide evidence-based results that are continuously updated with evidence as it emerges in the rapidly developing field of pharmacogenomics. These results may help psychiatrists in their decision-making, as clinicians are becoming increasingly aware of the patients’ genetic data as testing becomes more widespread and cheaper. In addition, the results may serve as a scientific basis for the development of evidence-based pharmacogenomics algorithms for personalized dosing of antipsychotics to mitigate potentially harmful drug-gene interactions.
Characteristic min-polynomial of a triangular and diagonal strictly double R-astic matrices
Authors: Siswanto Siswanto , Al Maghribi Sahmura Maula
Published: July 2024

Background Determinant and characteristic polynomials are important concepts related to square matrices. Due to the absence of additive inverse in max-plus algebra, the determinant of a matrix over max-plus algebra can be represented by a permanent. In addition, there are several types of square matrices over max-plus algebra, including triangular and diagonal strictly double ℝ -astic matrices. A special formula has been devised to determine the permanent and characteristic max-polynomial of those matrices. Another algebraic structure that is isomorphic with max-plus algebra is min-plus algebra. Methods Min-plus algebra is the algebraic structure of triple ( ℝ ε ′ , ⊕ ′ , ⊗ ) . Furthermore, square matrices over min plus algebra are defined by the set of matrices sized n × n , the entries of which are the elements of ℝ ε ′ . Because these two algebraic structures are isomorphic, the permanent and characteristic min-polynomial can also be determined for each square matrix over min-plus algebra, as well as the types of matrices. Results In this paper, we find out the special formulas for determining the permanent and characteristic min-polynomial of the triangular matrix and the diagonal strictly double ℝ -astic matrix. Conclusions We show that the formula for determining the characteristic min-polynomial of the two matrices is the same, for each triangular matrix and strictly double ℝ -astic matrix A , χ A ( x ) = ⨁ r = 0 , 1 , … , n ′ δ n − r ⊗ n r .
A systematic review on Artificial Intelligence applied to predictive cardiovascular risk analysis in liver transplantation
Authors: Hirani Netra , Chatterjee Parag
Published: July 2024

Liver transplantation is the ultimate therapeutic option for patients with end-stage liver disease. The clinical management of transplant patients significantly impacts their prognosis, with outcomes influenced by multiple interacting variables. Cardiovascular complications count as a leading cause of both short-term and long-term morbidity and mortality in liver transplant recipients. In this respect, accurate risk assessment and stratification are crucial for optimizing clinical outcomes. Modern artificial intelligence (AI) techniques have significant potential for early risk prediction, providing comprehensive risk assessments in both diagnosed cohorts and early clinical phase patients. This systematic review examines the state of the art in AI applications for predicting cardiovascular risks in liver transplantation, identifying current issues, challenges, and future research directions. We reviewed articles from digital repositories such as PubMed, IEEE Xplore, and ScienceDirect published between 2000 and 2023, using keywords including artificial intelligence, machine learning, cardiovascular, and liver transplantation. Our analysis revealed a diverse range of machine learning algorithms used in this domain. Despite the potential, only 12 papers met the criteria for adequate topic coverage, highlighting a scarcity of research at this intersection. Key challenges include integrating diverse datasets, isolating cardiovascular effects amid multifaceted influences, ensuring data quality and quantity, and the issues to extrapolate machine learning models to day-to-day clinical practice. Nevertheless, leveraging AI for risk prediction in liver transplantation could significantly enhance patient management and resource optimization, indicating a shift towards more personalized and effective medical practices.
The fifth international hackathon for developing computational cloud-based tools and resources for pan-structural variation and genomics
Authors: Deb Sontosh K , Kalra Divya , Kubica Jędrzej , Stricker Erik , Truong Van Q. , Zeng Qiandong , Fiscus Christopher J. , Agustinho Daniel Paiva , Alexander Adam , Arciniega-Sanchez Marlon , Bosseau Lorianne , Brueffer Christian , Canal Astrid , Daw Joyjit , Enoma David , Diaz-Cuevas Alison , Diesh Colin , Doolittle-Hall Janet M. , Fernandez-Luna Luis , Han Tina , Höps Wolfram , Huang Peiming Peter , Huang Tony , Izydorczyk Michal Bogumil , Jaryani Farhang , Kesharwani Rupesh K. , Khan Shaheerah , Majidian Sina , Malakar Ayan , Mangolini Tania Girão , Modha Sejal , Moldes Mauricio , Mondal Rajarshi , Nahid Abdullah Al , Poon Chi-Lam , Sagayaradj Sagayamary , Sanio Philippe , Sepulveda-Morales Tania , Shahzaib Muhammad , Raza Muhammad Sohail , Tat Trinh , Thota Ishaan , Yaman Umran , Yeung Jason , Yu Qiyi , Zheng Xinchang , Mahmoud Medhat , Sedlazeck Fritz J. , Busby Ben
Published: July 2024

Background The goal of the Fifth Annual Baylor College of Medicine & DNAnexus Structural Variation Hackathon was to push forward the research on structural variants (SVs) by rapidly developing and deploying open-source software. The event took place in-person and virtually in August 2023, when 49 scientists from 14 countries and 8 U.S. states collaboratively worked on projects to address critical gaps in the field of genomics. The hackathon projects concentrated on developing bioinformatic workflows for the following challenges: RNA transcriptome comparison, simulation of mosaic variations, metagenomics, Mendelian variation, SVs in plant genomics, and assembly vs. mapping SV calling comparisons. Methods As a starting point we used publicly available data from state-of-the-art long- and short-read sequencing technologies. The workflows developed during the hackathon incorporated open-source software, as well as scripts written using Bash and Python. Moreover, we leveraged the advantages of Docker and Snakemake for workflow automation. Results The results of the hackathon consists of six prototype bioinformatic workflows that use open-source software for SV research. We made the workflows scalable and modular for usability and reproducibility. Furthermore, we tested the workflows on example public data to show that the workflows can work. The code and the data produced during the event have been made publicly available on GitHub (https://github.com/collaborativebioinformatics) to reproduce and built upon in the future. Conclusions The following sections describe the motivation, lessons learned, and software produced by teams during the hackathon. Here, we describe in detail the objectives, value propositions, implementation, and use cases for our workflows. In summary, the article reports the advancements in the development of software for SV detection made during the hackathon.
Laryngeal nerves in the cadaveric neck and its relevance to neck surgery- A descriptive study
Authors: Dass Prameela M , Rai Ashwin R , Pai Mangala M , V Muralimanju B , Chettiar Ganesh K , Rai Rajalakshmi
Published: July 2024

Background Because of its close relationship with vessels that supply the thyroid gland, it is necessary to understand and document the course of the laryngeal nerves to prevent accidental damage. Otherwise it can lead to weakness in vocal cord function if ligated along with the arteries during thyroidectomy or other surgical procedures. The aim of our study was to examine and document the origin, relationship, and branching patterns of the laryngeal nerves on the side of the neck. Method The present cross sectional anatomical study was conducted on 64 dissected necks of formalin-fixed cadavers that were utilized for undergraduate teaching purposes. Different parameters were measured in the neck along with the relationship between the laryngeal nerves and their accompanying arteries. Results We observed usual and unusual course of laryngeal nerves along with some variations. Some of the novel findings were an internal laryngeal nerve piercing the thyroid cartilage lamina and an external laryngeal nerve communicating with the superior cervical ganglion. Conclusion The present study observed anatomical variations in the course of the laryngeal nerves, which are relevant for clinical practice. The potential risks of damage to these laryngeal nerves during various surgical procedures make it necessary to review and compile its relationship with the surrounding structures.
Comparative hemodynamics of ATTR and AL amyloidosis with exercise-induced pulmonary hypertension: A retrospective analysis
Authors: Albulushi Arif , Al-Busaidi Amna , Al-Lawatia Kumayl , Al-Rawahi Thuraiya , Al-Zadjali Matlooba
Published: July 2024

Background Cardiac amyloidosis, characterized by the deposition of amyloid proteins in the heart tissue, presents in two main types: transthyretin (ATTR) and light-chain (AL) amyloidosis. The hemodynamic response to exercise and the relationship with pulmonary hypertension (PH) in these patients is not well understood. Methods This retrospective study analyzed 100 patients diagnosed with either ATTR or AL amyloidosis. We assessed the prevalence of PH at rest and its induction during exercise stress tests. Hemodynamic parameters were measured to identify differences in the cardiac response to exercise between the two subtypes. Results A higher prevalence of PH was noted in the ATTR group compared to the AL group. Exercise stress tests induced significant PH, particularly in the ATTR subgroup. Subtle yet clinically relevant hemodynamic differences were observed between the amyloidosis subtypes. Conclusions Our findings suggest that the amyloidosis subtype is an important factor in the management of PH. There is a need for tailored clinical approaches to address the distinct pathophysiological mechanisms in ATTR and AL amyloidosis. This study contributes to a better understanding of the hemodynamic changes during exercise in cardiac amyloidosis and underscores the importance of subtype-specific management strategies.
Expert Consensus Methods In The Humanities - An Exploration of their Potential
Authors: Rulkens Charlotte C.S. , Peels Rik , Mokkink Lidwine B. , Haven Tamarinde , Bouter Lex
Published: July 2024

Background Expert consensus methods are regularly used in natural, social, and life sciences. This article explores the potential of applying these methods more frequently in humanities research. Methods The authors reviewed literature and applied the philosophical methods of conceptual analysis and conceptual engineering. Results This article identifies and describes six main elements of expert consensus methods. It also provides an overview of the different types of expert consensus methods regularly used in the natural, social, and life sciences: Delphi studies, nominal groups, consensus conferences, and Glaser’s state of the art method. Subsequently, each of these types is illustrated by an example from the sciences. The article also presents the potential of and objections to the application of expert consensus methods there. It gives four examples of expert consensus methods that were applied in humanities research, also presented in line with the six elements. Conclusions The comparisons and categorization show that, as in the natural, social, and life sciences, expert consensus methods in the humanities can in some instances potentially accelerate the epistemic process and enhance transparency, replicability, diversity, and fair processes. Nevertheless, expert consensus methods need to be fine-tuned to do justice to the unique nature and approaches of the humanities and therefore further research is needed.
Only severe Injuries are effectively reduced by muscles' injury prevention protocols in football players: A systematic review
Authors: Moncer Rihab , Ghanmi Marwa , Chebil Dhekra , Bhiri Sana , Belhadj Youssef Iheb , Kacem Amani , Salah Sana , Mtaouaa Sahbi , Frigui Sinen , Ouannes walid , Jemni Sonia
Published: July 2024

Background Muscle injuries are the most frequent in football and may lead to the end of a player’s career. Many studies have evaluated the effectiveness of prevention programs for all injury types. Few studies have evaluated the effects of exercise on muscle injuries. Methods A documentary search was conducted in October 2022 from three databases: Medline via its PubMed interface, Google Scholar, and COCHRANE databases. We only included original articles published between October 2012 and October 2022 with a high level of evidence. The research was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. The target population consisted of professional and semi-professional footballers. The intervention in question was structured injury preventive protocols, including specific training or pre-established protocols such as the FIFA 11+ program, compared to each other or with regular training sessions. The main outcomes were the incidence rates of muscle injuries and severe injury in each group, as well as the time loss to injury. Results Seven randomized controlled trials with a high level of evidence confirmed using the PEDRO scale were included. There were 3815 male professional football players. There was heterogeneity in the age, hours of exposure, and duration of the intervention. The prevention protocols used were FIFA 11+, bounding exercises, NHE, and stretching exercises. Structured exercises significantly reduce the severity of muscle injury and, consequently, time loss to injury. Discussion Despite the diversity of prevention programs, teams still lack standardized programs. Structured exercises, such as FIFA 11+ and bounding exercises, which combine strengthening, body kinesthesic awareness, and neuromuscular control, reduce the incidence and severity of muscle injury. FIFA 11+ is the first and most complete structured program, but lacks some exercises, such as adductor strengthening. Conclusion This review showed the interest in structured exercises in reducing severity and time loss to injury in professional football players. Registration This review was registered on 8/17/2023 in the International Prospective Register of Systematic Reviews under the reference code CRD42023452202.
Paying reviewers and regulating the number of papers may help fix the peer-review process
Authors: L. Seghier Mohamed
Published: July 2024

The exponential increase in the number of submissions, further accelerated by generative AI, and the decline in the availability of experts are burdening the peer review process. This has led to high unethical desk rejection rates, a growing appeal for the publication of unreviewed preprints, and a worrying proliferation of predatory journals. The idea of monetarily compensating peer reviewers has been around for many years; maybe, it is time to take it seriously as one way to save the peer review process. Here, I argue that paying reviewers, when done in a fair and transparent way, is a viable solution. Like the case of professional language editors, part-time or full-time professional reviewers, managed by universities or for-profit companies, can be an integral part of modern peer review. Being a professional reviewer could be financially attractive to retired senior researchers and to researchers who enjoy evaluating papers but are not motivated to do so for free. Moreover, not all produced research needs to go through peer review, and thus persuading researchers to limit submissions to their most novel and useful research could also help bring submission volumes to manageable levels. Overall, this paper reckons that the problem is not the peer review process per se but rather its function within an academic ecosystem dominated by an unhealthy culture of ‘publish or perish’. Instead of reforming the peer review process, academia has to look for better science dissemination schemes that promote collaboration over competition, engagement over judgement, and research quality and sustainability over quantity.
A Study about Perceptions of Kimono among College Students and Kimono Enthusiasts: Is It Difficult to Move in a Kimono?
Authors: Miyashiro Kozue , Sasaki Kazuya , Ishikawa Tomoharu , Mori Hiroshi
Published: July 2024

Background Kimono is being reevaluated for its sustainability aspects, such as having fewer offcuts in the production process due to its structural differences from Western-style clothes and its high reusability due to the adaptability to individuals’ body shapes. On the other hand, once a common attire for daily wear in Japan, kimono has transitioned to being worn only on special events and the kimono-related industry has also shrunk. To stimulate demand for kimono, it is essential to familiarize younger generations with its potential as daily wear. Methods A questionnaire survey on perceptions of kimono was conducted among two groups in Japan: 211 college students and 50 kimono enthusiasts. The questionnaire included demographic questions and psychometric scales, primarily focusing on their kimono experiences, challenges associated with wearing kimono, their perceptions of kimono and Western-style clothes, and their attitudes towards kimono. Results The results revealed that a majority of students had worn kimono before, though they found it difficult to move while wearing it. In contrast, kimono enthusiasts evaluated it as easier to move, hard to become disheveled, and casual. They also rated the ease of wearing Western-style clothes lower compared to students, and this tendency intensified with the length of enthusiast experience. Furthermore, the findings indicated that enthusiasts regarded the kimono more as daily wear compared to students, while still deriving enjoyment from it as formal attire in special events. Conclusions These results suggest that the cognition that Western-style clothes are easy to move and kimono is not may change with experiences. Therefore, providing opportunities for people in Japan to acquire how to wear kimono in comfortable ways possibly impacts their perceptions of kimono.
Digital well-being in children and youth: Protocol for a comprehensive systematic review of reviews on interventions of problematic digital technology use
Authors: Shi Jing , Tan Jerome Jie Ming , Ong Hwee En , Aljuboori Dahlia , Alomairah Saud , Colder Carras Michelle , Thrul Johannes
Published: July 2024

Background Digital technologies proliferate in many people’s lives around the world with over 65% of these technology users being online. Children and youth are among the most prominent adopters of digital technologies in forms such as video gaming, social media, and online shopping. Problematic use of digital technologies can lead to poorer school/work performance, neglect of self-care skills, and comorbidities with other mental health issues. However, when used non-problematically, digital technology can also contribute to improving health and well-being. With the abundance of literature published, many reviews have sought to collate literature on treatment and interventions for children and youth with varying results. Thus, our proposed systematic review aims to synthesize current systematic reviews and meta-analyses on interventions and treatment of problematic digital technology use in children and youth (up to 25 years old). Methods As part of a three-paper series, a systematic search was completed in PsycINFO, Web of Science, and PubMed databases. Grey literature databases of the World Health Organization (IRIS database) and ClinicalTrials.gov were also searched. Furthermore, hand-searching of reference lists was also conducted. Title and abstract screening, followed by full-text screening, were completed by at least two independent reviewers. For this review, the extractions and the quality of selected reviews will be assessed using AMSTAR 2.0 by two authors independently and reviewed by two additional authors. Results Results will be presented in narrative and tabular form. The results of this study are expected to offer insights into the populations of children and youth studied, treatments/interventions provided, outcomes, results, limitations, and conclusions of literature from the past five years. Feasibility and generalizability of the reviews will also be discussed. Conclusions Methodological strengths and weaknesses of reviewed studies will point to gaps in knowledge and can be used to inform future areas of policy and research.
The effect of the COVID-19 pandemic on emergency maternal and under-five referrals in Sierra Leone: A cohort study
Authors: Kamara Jonta , Moses Francis , Thekkur Pruthu , Kamara Ibrahim Franklyn , Ashubwe Jacklyne , Wurie Aminata B. , Kamara Rugiatu Z. , Youkee Daniel , Samura Sorie , Bangura Thaimu , Nuwagira Innocent , Zachariah Rony , Sesay Tom , Kenneh Sartie
Published: July 2024

Background In Sierra Leone, the National Emergency Medical Services (NEMS) was designed to facilitate maternal and under-five referrals. During the COVID-19 pandemic, health facilities were repurposed and mobility restrictions were introduced, and this might have negatively influenced access to care. Thus, we compared utilization, timeliness and outcomes of referrals between the pre-COVID-19 and COVID-19 periods. Methods This was a cohort study using routinely collected data by the NEMS. There were 65 weeks in the pre-COVID-19 period (week one of January 2019 to week three of March 2020) and 91 weeks in the COVID-19 period (week four of March 2020 to week four of December 2021). We compared weekly referrals and the duration from initiating the NEMS for a referral to the patient reaching the receiving facility (prehospital delay) using the Mann–Whitney U test. Chi-squared tests were used to compare the mode of transportation and referral outcomes. Results Compared to the pre-COVID-19 period, there was significant decrease during the COVID-19 period in the median number of weekly maternal referrals (277 to 205), under-five referrals (177 to 104) and transfers on NEMS ambulances (348 to 269). The prehospital delays increased during the COVID-19 period for both maternal (72 to 86 minutes) and under-five (75 to 90 minutes) referrals (p<0.001). The percentage of NEMS ambulance transfers for maternal referrals was similar in both periods (90%), but for under-five referrals this decreased between the pre-COVID-19 (72%) and COVID-19 (68%) periods. In both periods, maternal (98%) and under-five (96%) referrals were successfully admitted to the receiving facilities. Conclusions The performance of the NEMS system in terms of referrals reaching the receiving health facilities was maintained during the pandemic. However, there is a need to sustain the current performance of the NEMS system while making more efforts to increase utilization and reduce delays during outbreaks/pandemics.
Biofeedback therapy using Cerebri for the prevention of migraine attacks in adults with episodic migraine (BioCer): a randomized, wait-list controlled trial – the study protocol
Authors: Poole Amalie Christine , Stubberud Anker , Simpson Melanie , Øie Lise Rystad , Skalstad Einar Tobias Vassbø , Bjørk Marte-Helene , Kristoffersen Espen Saxhaug , Vetvik Kjersti Grøtta , Olsen Alexander , Larsen Iben Cornelia Keim , Linde Mattias , Tronvik Erling Andreas , Meisingset Tore Wergeland
Published: July 2024

Introduction Biofeedback is a non-pharmacological treatment option valued for its minimal risk of adverse events and offers a safe alternative for individuals seeking preventive care for migraine. Despite level A evidence for migraine prevention, biofeedback treatment is still unavailable to most patients. We developed a novel medical device (Cerebri) for multimodal biofeedback treatment that omits the need for healthcare personnel involvement. Cerebri consists of a smartphone application (app) and two wireless sensors. Unique in its approach, the Cerebri app seamlessly integrates three biofeedback modalities – heart rate variability, temperature, and electromyography – making it a comprehensive, therapist-independent solution for non-pharmacological migraine management. Methods Biofeedback therapy using Cerebri for the prevention of migraine attacks in adults with episodic migraine (The BioCer study) was an open-label, randomized, waitlist-controlled, multicenter trial. This study investigated the safety and efficacy of daily home-based biofeedback sessions using the Cerebri device. A total of 286 participants will be randomized to either a 12-week intervention arm or waitlist control arm. The primary outcome was the change in the mean number of migraine days from baseline to the last 28-day period during the treatment phase in the treatment group compared with the control group. The primary outcome variable was prospectively collected through daily eDiary entries. Ethics and Dissemination Approval from the ethics committee and competent authorities was obtained prior to study initiation. Participation was voluntary and informed and written consent was obtained prior to inclusion. The results of this trial will be published in peer-reviewed international medical journals and communicated to patients and healthcare personnel through the relevant channels. Trial registration numbers EUDAMED: CIV-NO-22-08-040446 REK (Regional Committees for Medical and Health Research Ethics): 502734 Date of approval 2022-10-14 Trial registration: NCT05616741, 2022-11-15, https://clinicaltrials.gov/study/NCT05616741
Planet activeness: a new concept to enhance the accuracy of Astromet weather forecast.
Authors: Ga Dheebakaran , S Kokilavani , Patil Santosh Ganapati , T Sankar , K Rathika , S Arul Prasath , B Balamurali , N.K. Sathyamoorthy
Published: July 2024

Background Astrometeorology is an ancient science, that deals the relationship between planet position and weather events. Several Indian studies proved that Astrometeorology could be a complementary method to improve numerical weather forecast accuracy. Since 2011, Tamil Nadu Agricultural University is conducting astrometeorological research and devised a novel concept “Planet Activeness Chart”. The principle is that “planets’ influence on a location’s weather varies throughout the day and may be negative, inactive, active, highly active and rule depending on their angle to that location”. Most existing astromet studies used planetary position to predict the occurrence of weather events (yes/no) but failed to capture intensity of the event. The “Planet Activeness Concept” could address this limitation and enhance forecast usability. Methods A study was carried out from 2018 to 2021 with six years data (2011-16) to verify the “Planet activeness” on hourly rainfall and windspeed events in Tamil Nadu. The frequency of planet activeness for a weather event was calculated by dividing the number of times a planet was in the selected activeness during a specific event category by the total number of events. Results The results indicated that negative state of the Sun, active status of the Saturn, Uranus, Venus and Moon were positively associated with rainfall intensity. The windy planet Mercury and Neptune at active state, the Sun and Saturn at rule state, Venus and Uranus at negative state, Jupiter at highly active state had significant influence on the increased wind speed. Conclusion Applying the planet activeness concept with azimuth could enhance the accuracy and usability of Astrometeorological forecasts. This study establishes a mathematical relationship between planet activeness and weather as a first step to understand the science behind this relationship. It is suggested to study different combination of planet activeness during a weather event for more insights.
Identifying the role of Phytomolecules in the management of liver diseases by modulating NRF2 pathway: A Scoping Review Protocol
Authors: Mili Ajay , Rajkhowa Priyobrat , Nandakumar Krishnadas , Lobo Richard
Published: July 2024

Background The Liver is a vital organ in the human body, which plays a crucial role in various physiological processes. Oxidative stress is a critical factor in the pathogenesis and progression of various liver diseases, contributing to cellular damage and dysfunction. The Liver is particularly vulnerable to the harmful effects of reactive oxygen species when the balance between their production and the body’s antioxidant defense mechanisms is disrupted. The nuclear factor erythroid 2-related factor 2 (NRF2) pathway has emerged as a promising therapeutic target for liver diseases due to its pivotal role in cellular defense against oxidative stress and inflammation. Plants have always been a source of drugs which has been used to treat various pharmacological disorders and most of its activity is due to its potential as an antioxidant. However, the specific mechanisms by which they interact with the NRF2 pathway and confer protection against liver diseases remain inadequately elucidated. Therefore, this scoping review aims to identify and analyze the existing literature pertaining to the relationship between Phytomolecules, which can modulate NRF2 and protect against liver diseases. Methods The proposed scoping review will follow the steps given by “Arksey and O’Malley and Levac et al”. Electronic databases (PubMed/MEDLINE, Embase, etc.) will be searched for recent relevant studies. A predefined criterion for the inclusion and exclusion of studies will be independently adopted by two reviewers. The review will be presented as per the “Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Review (PRISMA-ScR)” guidelines. Conclusion The scoping review finding is expected to help understanding the role of Phytomolecules in preventing liver diseases by modulating the NRF2 pathway. Ultimately, this review will serve as a foundational step toward developing targeted interventions to improve liver health outcomes and reduce the global burden of liver diseases.
Deciphering the significance of neutrophil to lymphocyte and monocyte to lymphocyte ratios in tuberculosis: A case-control study from southern India
Authors: Bakshi Poorva , Nayak Rakshatha , Rai Sharada , Jayasheelan Shikha
Published: July 2024

Background Diagnosis of tuberculosis (TB) in resource-limited countries relies primarily on bacteriological confirmation using Ziehl-Neelsen (ZN) stain or culture. However, this method has low sensitivity due to suboptimal sampling and techniques. Neutrophils, monocytes, and lymphocytes are crucial in the pathogenesis of granulomatous inflammation and immune reactions. We investigated the usefulness of the haematological parameters and their ratios, like the Neutrophil to Lymphocyte ratio (NLR) and Monocyte to Lymphocyte ratio (MLR), for diagnosing tuberculosis. Methods We retrospectively grouped 114 patients with fever into those diagnosed with TB and control groups. We obtained their haematological data and calculated their derived ratios. The ratios obtained from the two groups were compared. Their sensitivity and specificity were calculated. Results Haematological parameters like MLR were higher in TB patients than in the control group. Although NLR was not significantly increased, MLR was significantly increased with p values <0.05. These tests had low sensitivity but high specificity. Conclusion Serum NLR and MLR emerge as valuable tools in TB diagnosis. Their simplicity and cost-effectiveness render them particularly suitable for screening and recurrence monitoring in rural and remote settings, thereby mitigating loss to follow-up.
The Relationship Between Mental Health and Periodontal Disease: Insights from NHANES Data
Authors: AlJoghaiman Eman
Published: July 2024

Introduction and aim Periodontal disease, initiated by dental biofilm and influenced by various local and systemic factors, includes stress as a potential contributor to its progression. Despite associations with severe forms like acute necrotizing ulcerative gingivitis, a comprehensive large-sample study linking stress to periodontal disease is lacking. This study aims to investigate the relationship between mental health and periodontal disease. Materials and Methods Leveraging data from the National Health and Nutrition Examination Survey (NHANES), relevant information was extracted. Mental health was the exposure variable, and periodontal disease, assessed through indices following Eke et al.'s definition, served as the outcome. Covariates impacting periodontal disease were considered, and demographic and disease status analyses employed the Rao-Scott chi-squared test. A logistic regression model assessed mental health's impact on periodontal disease. Results Logistic regression indicated higher odds of periodontal disease among individuals feeling bad about themselves for more than half of the day (OR 1.170, 95% CI 0.533-2.474), though statistical significance was not reached. Periodontitis prevalence significantly varied based on marital status, with 6.6% of married and 10.8% of unmarried subjects affected. Notably, a statistically significant difference in periodontitis prevalence existed between subjects with health insurance (8.3%) and those without (16.5%). Conclusion Within study limitations, it is concluded that no significant difference exists in periodontal status between individuals with compromised mental health and those without. The findings underscore potential associations between mental health, marital status, and access to health insurance with periodontal disease.
Impact on postoperative complications of combined prehabilitation targeting co-existing smoking, malnutrition, obesity, alcohol drinking, and physical inactivity: a systematic review and meta-analysis of randomised trials
Authors: Lydom Line N , Jensen Sofie Anne-Marie S , Lauridsen Susanne V , Rasmussen Mette , Christensen Robin , Joensen Ulla N , Rosenberg Jacob , Tønnesen Hanne
Published: July 2024

Background This study aimed to compare the effect on postoperative complications of prehabilitation targeting predefined co-existing risky lifestyle factors with usual preoperative routines in surgical patients. Methods This systematic review followed the PRISMA 2020 guideline and the protocol (CRD42022282611). Five databases were searched from inception to November 7, 2022 for randomised controlled trials on prehabilitation targeting ≥2 predefined risky lifestyles compared with usual preoperative routines. Risky lifestyles included Smoking, Nutrition (malnutrition and/or BMI>25), risky Alcohol intake, and Physical inactivity (SNAP). Primary outcome was postoperative complications ≤30 days. Cochrane’s risk-of-bias tool 2 was used and meta-analyses were conducted. GRADE was used to assess certainty of evidence. Results The search resulted in 20,862 records. At full-text screening, only two (120 participants) of 24 identified trials on combined SNAP intervention had ≥2 predefined risk factors and were included. One (n=110) on intensive physical and brief nutritional intervention to frail patients with colorectal cancer resection reported complication rates of 45% in both groups (relative risk (RR) 1.00, 95% CI 0.66 to 1.51). The other study (n=10, subgroup) on intensive alcohol and smoking intervention in patients with bladder cancer undergoing radical cystectomy, reported complications in 3/7 vs 3/3 participants (RR 0.50, 95% CI 0.21 to 1.19). The meta-analysis estimated a RR of 0.79 (95% CI 0.41 to 1.51, I2 51%). Conclusion Two small of the 24 trials on prehabilitation targeted co-existing and predefined risky SNAP factors and the effect on postoperative complications is very uncertain. Future prehabilitation research involving patient needs is warranted.
Natural agents that are neuroprotective against mitochondria: a bibliometric-based research mapping 1998–2024, from cells to mitochondria
Authors: YURISALDI SALEH ARMAN , Yogi Saputra Dwi Arwandi
Published: July 2024

Introduction Mitochondria are cell organelles that function as the cell’s main power plant, producing ATP, the main energy molecule in cells. Mitochondria play an important role in the context of neuroprotection, and mitochondrial function has been implicated in various neurodegenerative diseases, including Alzheimer’s, Parkinson’s, and amyotrophic lateral sclerosis (ALS). Recent research in the field of neuroprotection has focused on the development of therapies that target mitochondria. Natural ingredients have long been used in traditional medicine and show potential as neuroprotective agents. Methods In this work, a literature review methodology is employed to gather data from the Scopus database using the keywords natural agents, herb*, neuroprotective, and mitochondria. The data were analyzed using Biblioshiny and VOSviewer software to produce visualizations and bibliometric maps. We conducted quantitative and qualitative analyses. Results The research trend found are documents by year, most global cited document, most relevant sources, A factorial map illustrating the leading contributors of papers, documents by author, documents by country or territory, documents by subject area, network visualization, overlay visualization of scopus database using vosviewer, density visualization, thematic map, thematic evolution, cluster analysis, qualitative analysis, and word cloud. Conclusions Natural Agent Neurotropik is a natural substance that influences the brain’s nervous system and peripheral nervous system, enhancing cognition, mood, and brain function. Derived from herbs, spices, and herbal products, it has advantages over other natural agents in energy production, brain biogenesis, and neuroprotection.