bluuebunny/crossref_metadata_2025 huggingface dataset:
Theoretically framing views of people who smoke in understanding what might work to support smoking cessation in coastal communities: adapting the TIDieR checklist to qualitative analysis for complex intervention development
Authors: Ward Emma , Varley Anna , Wright Melissa , Pope Ian , Notley Caitlin
Published: September 2024

Introduction

People living in coastal communities have some of the worst health outcomes in the UK, driven in part by high smoking rates. Deprived coastal communities include socially disadvantaged groups that struggle to access traditional stop smoking services. The study aimed to seek the views of people who smoke living in coastal communities, to assess the optimal smoking cessation intervention for this population. In addition, the Template for Intervention Description Replication (TIDieR) checklist was adapted as an analytical framework for qualitative data to inform intervention design.

Methods

Current or recent ex-smokers (n = 25) were recruited to participate in qualitative interviews from a range of community locations in a deprived English seaside town. A thematic analysis of the interview data was undertaken adapting the TIDieR framework. This analysis was triangulated with relevant literature and notes from stakeholder meetings and observations to map onto the TIDieR checklist to describe the optimal intervention.

Results

Barriers to quitting smoking in the target population included low motivation to quit, high anxiety/boredom, normalisation of smoking and widespread illicit tobacco use. There was broad support for combining behavioural support, e-cigarettes and financial incentives, with a strong preference for the intervention to be delivered opportunistically and locally within (non-healthcare) community settings, in a non-pressurising manner, ideally by a community worker specially trained to give stop smoking support.

Conclusions

An intensive community-based smoking cessation intervention was acceptable to the target population. Adapting the TIDieR checklist as a deductive qualitative analytical framework offered a systematic approach to intervention development. Combined with other intervention development activities, this ensured that the intervention design process was transparent and the proposed intervention was well defined. It is recommended that prior to intervention development researchers speak to members of the target population who may give valuable insight into the optimal intervention.
“The police came in white protective suits and with batons, it was pure disaster” – a multi-stakeholder perspective on infection control in reception centers for asylum seekers during the COVID-19 pandemic in Germany
Authors: Pacolli-Tabaku Latife , Führer Amand , Wahidie Diana , Trohl Ulrich , Yilmaz-Aslan Yüce , Brzoska Patrick
Published: September 2024

Background

The COVID-19 pandemic presented unprecedented challenges, particularly for vulnerable populations residing in confined settings such as refugee shelters: Physical distancing measures were challenging to implement in shelters due to shared rooms or communal use of kitchens and sanitary facilities, which increased the risk of infections. Meanwhile, individuals’ capabilities for individual protection strategies were severely impaired by the structure of the shelters. Consequently, shelters had the duty to develop and implement strategies for the prevention and handling of SARS-CoV-2 infections. The aim of this study was to explore the perspectives of refugees, NGO employees, and shelter directors regarding COVID-19-related measures in German refugee shelters. The study aimed to identify challenges and conflicts arising from implemented measures, as well as expectations for improved support during the pandemic.

Methods

Semi-structured and narrative interviews were conducted with 6 refugees, 6 facility managers, 12 NGO staff, and 2 social service agency staff from February to August 2022. Qualitative content analysis was employed to analyze the data, identifying overarching themes and codes.

Results

The study uncovered challenges and conflicts resulting from pandemic measures, particularly mass quarantine orders, within refugee shelters. Lack of transparency and ineffective communication worsened tensions, with refugees feeling distressed and anxious. The quarantine experience had a negative impact on refugees’ mental health, which was exacerbated by limited social interaction and leisure-time activities. Shelter managers encountered administrative challenges when implementing measures due to facility constraints and limited resources, while NGO employees encountered obstacles in providing immediate assistance due to legal regulations and a lack of cooperation from shelter managers.

Conclusions

The study highlights that shelters are problematic institutions from a public health perspective. It shows the importance of implementing customized pandemic interventions in refugee shelters that take account of the diverse needs and experiences of both refugee and staff. To achieve this, we recommend to establish an ethics committee and involve various stakeholders in decision-making processes. Additionally, enhancing information dissemination to promote transparency and public understanding of measures is crucial. These insights can help develop comprehensive and effective pandemic plans for refugee shelters, ensuring better preparedness for future public health crises.
Migration background and use of preventive healthcare services: Findings of the German Ageing Survey
Authors: Kameraj Arianit , König Hans-Helmut , Hajek André
Published: September 2024

Background

This study aimed to investigate the relationship between migration background and the utilization of preventive healthcare services.

Methods

Cross-sectional data from wave 5 in the year 2014, with a sample size of 7,684 individuals, were extracted from the nationally representative German Ageing Survey. The survey included community-dwelling individuals aged 40 years and above, with migration background serving as the primary independent variable. The outcomes measured included participation in cancer screenings, flu vaccinations, and routine health check-ups. Multiple logistic regressions were used to examine the association between migration background and preventive healthcare services.

Results

Regressions showed that the presence of a migration background with personal migration experience (compared with not having a migration background) was associated with a lower likelihood of using preventive healthcare services. More precisely, compared to individuals not having a migration background, individuals with a migration background and personal migration experience had a lower likelihood of routine health check-ups (OR = 0.76, 95% CI: 0.61 to 0.95), flu vaccinations (OR = 0.75, 95% CI: 0.59 to 0.95) and cancer screenings (OR = 0.71, 95% CI: 0.57 to 0.89). In contrast, there was no significant association between the presence of a migration background without personal migration experience (compared with not having a migration background) and the use of preventive healthcare services.

Conclusion

In conclusion, results showed differences between individuals without migration background and individuals with migration background (and with personal migration experience) in terms of using preventive healthcare services. It may be helpful to specifically address individuals with migration background (and with migration experience) in terms of using preventive healthcare services.
Is YouTube a sufficient source of information on Sarcoidosis?
Authors: Buschulte Katharina , El-Hadi Sarah , Höger Philipp , Ganter Claudia , Wijsenbeek Marlies , Kahn Nicolas , Kriegsmann Katharina , Goobie Gillian C. , Ryerson Christopher J. , Polke Markus , Trudzinski Franziska , Kreuter Michael
Published: September 2024

Background

The internet is a common source of health information for patients and caregivers. To date, content and information quality of YouTube videos on sarcoidosis has not been studied. The aim of our study was to investigate the content and quality of information on sarcoidosis provided by YouTube videos.

Methods

Of the first 200 results under the search term “sarcoidosis,” all English-language videos with content directed at patients were included. Two independent investigators assessed the content of the videos based on 25 predefined key features (content score with 0–25 points), as well as reliability and quality (HONCode score with 0–8 points, DISCERN score with 1–5 points). Misinformation contained in the videos was described qualitatively.

Results

The majority of the 85 included videos were from an academic or governmental source (n = 63, 74%), and median time since upload was 33 months (IQR 10–55). Median video duration was 8 min (IQR 3–13) and had a median of 2,044 views (IQR 504 − 13,203). Quality assessment suggested partially sufficient information: mean HONCode score was 4.4 (SD 0.9) with 91% of videos having a medium quality HONCode evaluation. Mean DISCERN score was 2.3 (SD 0.5). Video content was generally poor with a mean of 10.5 points (SD 0.6). Frequently absent key features included information on the course of disease (6%), presence of substantial geographical variation (7%), and importance of screening for extrapulmonary manifestations (11%). HONCode scores were higher in videos from academic or governmental sources (p = 0.003), particularly regarding “transparency of sponsorship” (p < 0.001). DISCERN and content scores did not differ by video category.

Conclusions

Most YouTube videos present incomplete information reflected in a poor content score, especially regarding screening for extrapulmonary manifestations. Quality was partially sufficient with higher scores in videos from academic or governmental sources, but often missing references and citing specific evidence. Improving patient access to trustworthy and up to date information is needed.
Protocol of a randomized controlled trial on the effectiveness and cost-effectiveness of the PLACES intervention: a supported employment intervention aimed at enhancing work participation of unemployed and/or work-disabled cancer survivors
Authors: van Ommen F. , Duijts S. F. A. , Coenen P. , Dalton S. O. , Kliffen A. , van Hummel R. , de Boer A. G. E. M. , Greidanus M. A.
Published: September 2024

Background

Approximately onethird of cancer survivors encounter challenges reintegrating into the workforce, often experiencing involuntary unemployment and/or partial or full work disability following diagnosis and treatment. Returning to paid employment presents evident challenges due to uncertainties regarding work ability, perceived employer discrimination, and a lack of support, thereby risking social exclusion. However, interventions addressing return to paid employment among unemployed and/or work-disabled cancer survivors are scarce. Here, we describe the protocol of a randomized controlled trial (RCT), including a process and economic evaluation, evaluating the effectiveness and cost-effectiveness of the PLACES (unemPLoyed cAnCEr survivors Support) intervention aimed at supporting unemployed and/or work-disabled cancer survivors returning to paid employment.

Methods

A two-armed RCT with a 12-month follow-up period will be conducted. Eligible participants: (1) are of working age (18–65 years), (2) are diagnosed with cancer between 6 months and 10 years ago, (3) are unemployed and/or partially or fully work-disabled, (4) have completed cancer treatment, and (5) are seeking paid employment and are motivated to initiate work immediately. Participants will primarily be identified through the Dutch Social Security Agency and the Netherlands Cancer Registry and recruited via healthcare professionals. Participants randomly allocated to the intervention group (n = 82) will receive the PLACES intervention: a tailored supported employment intervention based on the principles of Individual Placement and Support (IPS). This includes support in seeking, returning to, and maintaining paid employment. Participants allocated to the control group (n = 82) will receive care as usual. All participants will be asked to complete questionnaires, at baseline (T0), and after 3 (T1), 6 (T2), and 12 (T3) months of follow-up. The primary outcome is paid employment [yes/no]. Secondary outcomes are time until paid employment, change in working hours, work ability, quality of (working) life, and self-efficacy regarding return to work. Additionally, process and economic evaluations will be conducted.

Discussion

We hypothesize that the PLACES intervention will be effective in obtaining paid employment, enhancing work ability, and improving quality of life. In addition, we expect the intervention to be cost-effective. If proven effective and cost-effective, actions should be taken to implement the intervention in usual care.

Trial registration

NCT06028048.
Task-based functional neural correlates of social cognition across autism and schizophrenia spectrum disorders
Authors: Oliver Lindsay D. , Moxon-Emre Iska , Hawco Colin , Dickie Erin W. , Dakli Arla , Lyon Rachael E. , Szatmari Peter , Haltigan John D. , Goldenberg Anna , Rashidi Ayesha G. , Tan Vinh , Secara Maria T. , Desarkar Pushpal , Foussias George , Buchanan Robert W. , Malhotra Anil K. , Lai Meng-Chuan , Voineskos Aristotle N. , Ameis Stephanie H.
Published: September 2024

Background

Autism and schizophrenia spectrum disorders (SSDs) both feature atypical social cognition. Despite evidence for comparable group-level performance in lower-level emotion processing and higher-level mentalizing, limited research has examined the neural basis of social cognition across these conditions. Our goal was to compare the neural correlates of social cognition in autism, SSDs, and typically developing controls (TDCs).

Methods

Data came from two harmonized studies in individuals diagnosed with autism or SSDs and TDCs (aged 16–35 years), including behavioral social cognitive metrics and two functional magnetic resonance imaging (fMRI) tasks: a social mirroring Imitate/Observe (ImObs) task and the Empathic Accuracy (EA) task. Group-level comparisons, and transdiagnostic analyses incorporating social cognitive performance, were run using FSL’s PALM for each task, covarying for age and sex (1000 permutations, thresholded at p < 0.05 FWE-corrected). Exploratory region of interest (ROI)-based analyses were also conducted.

Results

ImObs and EA analyses included 164 and 174 participants, respectively (autism N = 56/59, SSD N = 50/56, TDC N = 58/59). EA and both lower- and higher-level social cognition scores differed across groups. While canonical social cognitive networks were activated, no significant whole-brain or ROI-based group-level differences in neural correlates for either task were detected. Transdiagnostically, neural activity during the EA task, but not the ImObs task, was associated with lower- and higher-level social cognitive performance.

Limitations

Despite attempting to match our groups on age, sex, and race, significant group differences remained. Power to detect regional brain differences is also influenced by sample size and multiple comparisons in whole-brain analyses. Our findings may not generalize to autism and SSD individuals with co-occurring intellectual disabilities.

Conclusions

The lack of whole-brain and ROI-based group-level differences identified and the dimensional EA brain-behavior relationship observed across our sample suggest that the EA task may be well-suited to target engagement in novel intervention testing. Our results also emphasize the potential utility of cross-condition approaches to better understand social cognition across autism and SSDs.
Unsupervised weathering identification of grottoes sandstone via statistical features of acoustic emission signals and graph neural network
Authors: Zhang Ruoyu , Cheng Yuan , Huang Jizhong , Zhang Yue , Yan Hongbin
Published: September 2024

Weathering features of sandstone heritage can be recognized by using artificial intelligence (AI) based surrogate models, and most models perform classification tasks for types based on precise labels. But there are lack of prior validated knowledge of the weathering or untagged historical data for complex weathering conditions in many cases. To this aim, a unsupervised graph neural network (GNN) based on the statistical features of the acoustic emission (AE) signals is constructed. Firstly, taking unweathered sandstone as a reference, we define 4 weathering levels of sandstone ranging from I to IV based on pore indicators. We selected 11 statistical features that are high correlated with pore of sandstone. Then, this GNN is constructed and trained by 2880 sets of statistical measured AE signals. Compared with AEs, LOF and IF models, GNN achieves the best identification performance among the four evaluation criteria. Each iteration of the GNN network is fitting the feature information of the signals and their neighbors. By data dimensionality reduction techniques, when the GNN stops iterating, it will be easy to distinguish unweathered AE signals from weathered one by comparing the reconstruction error of each signal. Furthermore, when the nearest neighbor’s k gradually increases, the AUC of GNN also gradually increases and then tend to stable when k equals to 50–100. While the hidden layers of the network aggregates less information about the neighborhood features of the signals and cannot distinguish significantly between unweathered and weathered signals when the value of k is small. As the depth of the network deepens, the feature values between signals become more and more similar, their reconstruction errors in the output layer of the network to become more similar, making it difficult to distinguish unweathered AE signals from weathered AE signals via GNN. Meanwhile, GNN adopts more AE features and considers the similarity between each features. This can greatly eliminate various errors caused by wave velocity measurement, greatly improving the robustness of AE detection. Hence, the GNN model presented addresses the limitations of relying solely on P-wave velocity measurements to assess the degree of sandstone weathering at stone cultural heritage.
Individual methanogenic granules are whole-ecosystem replicates with reproducible responses to environmental cues
Authors: Trego Anna , O’Sullivan Sarah , O’Flaherty Vincent , Collins Gavin , Ijaz Umer Zeeshan
Published: September 2024

Background

In this study, individual methanogenic (anaerobic), granular biofilms were used as true community replicates to assess whole-microbial-community responses to environmental cues. The aggregates were sourced from a lab-scale, engineered, biological wastewater treatment system, were size-separated, and the largest granules were individually subjected to controlled environmental cues in micro-batch reactors (μBRs).

Results

Individual granules were identical with respect to the structure of the active community based on cDNA analysis. Additionally, it was observed that the active microbial community of individual granules, at the depth of 16S rRNA gene sequencing, produced reproducible responses to environmental changes in pH, temperature, substrate, and trace-metal supplementation. We identified resilient and susceptible taxa associated with each environmental condition tested, as well as selected specialists, whose niche preferences span the entire trophic chain required for the complete anaerobic degradation of organic matter.

Conclusions

We found that single anaerobic granules can be considered highly-replicated whole-ecosystems with potential usefulness for the field of microbial ecology. Additionally, they act as the smallest whole-community unit within the meta-community of an engineered bioreactor. When subjected to various environmental cues, anaerobic granules responded reproducibly allowing for rare or unique opportunities for high-throughput studies testing whole-community responses to a wide range of environmental conditions.
Effect of fatigue on quality of life in patients with rheumatoid arthritis: the chain mediating role of resilience and self-efficacy
Authors: Zhou Jian , Fan Xinxin , Gan Yuqin , Luo Zongting , Qi Hong , Cao Yuqiong
Published: September 2024

Objectives

Exploring the effect of resilience and self-efficacy in mediating the chain between fatigue and quality of life(QOL) in patients with rheumatoid arthritis (RA).

Methods

From June 2022 to November 2022, 423 RA patients were chosen by a convenience sample method from two tertiary care facilities in Chengdu, Sichuan Province. General Information Questionnaire, Bristol Multidimensional Scale of Fatigue in Patients with Rheumatoid Arthritis, SF−12 Health Survey Short Form, Chinese version of the ten-item psychological Resilience Scale, and Chinese-language Arthritis Self-Efficacy Scale, an 8-element version, were among the questionnaires used.

Results

In the physical component summary( PCS), self-efficacy, psychological resilience, and self-efficacy were all significantly mediated by fatigue (total effect mediated 8.88%). In the mental component summary (MCS), fatigue (total effect mediated 10.79%), self-efficacy (total effect mediated 8.99%), psychological resilience, and self-efficacy (total effect mediated 2.01%) were all significantly mediated by fatigue.

Conclusion

Fatigue in RA patients can affect the quality of life both directly and indirectly through the mediating effects of psychological resilience, self-efficacy, and the chain mediating effect of psychological resilience-self-efficacy.
Role of right ventricular–pulmonary arterial coupling assessed by echocardiography to predict adverse outcomes in patients with acute pulmonary embolism
Authors: Mostafa Amir , Medhat Mahmoud , Alhosary Hossam , Amin Wassim
Published: September 2024

Background

Pulmonary embolism (PE) is a lethal type of venous thromboembolic disease. Right ventricular (RV) failure is not an uncommon complication of PE leading to higher adverse outcomes. The tricuspid annular peak systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio as a surrogate for RV–pulmonary artery coupling has proven to be among the predictor of clinical outcomes in multiple patient groups. We evaluated in this study the role of TAPSE/PASP ratio in predicting adverse clinical outcomes in patients with acute PE.

Results

Among patients with established diagnosis of acute PE admitted to the coronary care unit, echocardiography was done within 12 h of admission and TAPSE/PASP ratio was calculated. The patients were followed during hospitalization and after discharge for 3 months for development of adverse outcomes including rehospitalization due to heart failure, recurrent PE and mortality. A total of fifty-five consecutive patients were recruited with mean age 58.3 ± 6.9 years and nearly equal male-to-female ratio. The mean ratio of TAPSE/PASP was 0.479 ± 0.206. In-hospital and 3-month follow-up showed that 10.9% needed rehospitalization with heart failure, 14.5% developed recurrent pulmonary embolism, and mortality was 9.1%. TAPSE/PASP ratio was significantly lower among the patients who developed adverse outcomes. TAPSE/PASP ratio was among the independent predictors of rehospitalization with heart failure, recurrent pulmonary embolism but not mortality at 3-month follow-up. TAPSE/PASP ratio predicted rehospitalization with heart failure at a cutoff point ≤ 0.325, with 100% sensitivity and 79.6% specificity, and predicted recurrent pulmonary embolism at a cutoff point ≤ 0.325, with 75% sensitivity and 78.7% specificity.

Conclusion

TAPSE/PASP ratio is a noninvasive tool that can predict the development of early adverse outcomes in patients with acute PE including rehospitalization with heart failure and recurrent pulmonary embolism.
A study of the predictive role of multiple variables for the incidence of acute kidney injury and its outcomes in Indian patients with ST-elevation myocardial infarction and cardiogenic shock
Authors: Kanabar Kewal , Sharma Yash Paul , Krishnappa Darshan , Santosh Krishna , Dhudasia Miren
Published: September 2024

Background

Acute kidney injury (AKI) occurs frequently in ST-elevation myocardial infarction with cardiogenic shock (CS-STEMI) and is a strong independent prognostic marker for short and intermediate-term outcomes. Owing to the delayed presentation and limited facilities for primary percutaneous coronary intervention in low- and middle-income countries, the incidence, predictors, and outcome of AKI are likely to be different compared to the developed countries. We performed a post hoc analysis of patients presenting with CS-STEMI over 7 years (2016–2022) at a tertiary referral center in North India. The primary outcome assessed was AKI and the secondary outcome was in-hospital mortality.

Results

Of the 426 patients, 194 (45.5%) patients developed AKI, as defined by the Kidney Disease Improving Global Outcomes criteria. Left ventricular (LV) pump failure with pulmonary edema [Odds ratio (OR) 1.67; 95% confidence interval (CI) 1.04–2.67], LV ejection fraction (OR 1.35 per 10% decrease in ejection fraction; CI 1.04–1.73), complete heart block (OR 2.06; CI 1.2–3.53), right ventricular infarction (OR 2.76; CI 1.39–5.49), mechanical complications (OR 3.89; CI 1.85–8.21), ventricular tachycardia (OR 2.80; CI 1.57–4.99), and non-revascularization (OR 2.2; CI 1.33–3.67) were independent predictors of AKI in multivariate logistic regression analysis. Additionally, AKI was a strong predictor of in-hospital mortality (univariate OR 30.61, CI 17.37–53.95).

Conclusions

There is a higher incidence of AKI in CS-STEMI in resource-limited settings and is associated with adverse short-term outcomes. Additional studies are needed to address the optimal strategies for the prevention and management of AKI in such settings.
Correlation between thoracoscopic presentations and pathological patterns in undiagnosed pleural effusion
Authors: Elfeqy Mohamed Elsaid Ali Hassan , Hamed Hanaa Sami , Ibrahim Dalia Anas
Published: September 2024

Background

Pleural effusion is the most prevalent pleural disorder. One third of pleural effusions are caused by lung cancer. Thoracoscopy is regarded as the most reliable diagnostic method for the evaluation of suspected pleural malignancy.

Aim and objectives

To assess visible pleural characteristics of abnormalities and their locations for malignant and benign pathologies as well as to determine the incidence of malignancy in the apparent normal pleura.

Patients and methods

This was a descriptive, observational, and cross-sectional research that was performed on 36 cases with undiagnosed exudative pleural effusions prepared for medical thoracoscopy and on whom the cytological analysis was inconclusive, at the thoracoscopic Unit Department of Chest Diseases, Faculty of Medicine Zagazig University, from December 2023 to May 2024.

Results

The apparent normal pleura and adhesions were significantly greater in benign effusions than in malignant effusions (p = 0.019 and p = 0.04, respectively), while nodular effusion was significantly greater in malignant effusions than in benign effusions (p = 0.003). Bleeding was significantly greater in malignant effusions than in benign effusions (p = 0.019). As regards the thoracoscopic findings, 24 (66.7%) patients showed nodular patterns, 14 (38.9%) patients showed adhesions, and two (5.6%) patients had pus, while six (16.7%) patients had apparent normal pleura. The costal pleura was the most frequently affected site (88.9%) followed by the visceral pleura (55.6%) then the diaphragmatic pleura (38.9%).

Conclusion

Medical thoracoscopy (MT), a minimally invasive and a generally safe treatment, enables the interventional pulmonologist to access the pleural cavity directly and obtain pleural samples under direct view helping in predicting the pathology.
Large Language Models to Help Appeal Denied Radiotherapy Services
Authors: Kiser Kendall J. , Waters Michael , Reckford Jocelyn , Lundeberg Christopher , Abraham Christopher D.
Published: September 2024

PURPOSE

Large language model (LLM) artificial intelligences may help physicians appeal insurer denials of prescribed medical services, a task that delays patient care and contributes to burnout. We evaluated LLM performance at this task for denials of radiotherapy services.

METHODS

We evaluated generative pretrained transformer 3.5 (GPT-3.5; OpenAI, San Francisco, CA), GPT-4, GPT-4 with internet search functionality (GPT-4web), and GPT-3.5ft. The latter was developed by fine-tuning GPT-3.5 via an OpenAI application programming interface with 53 examples of appeal letters written by radiation oncologists. Twenty test prompts with simulated patient histories were programmatically presented to the LLMs, and output appeal letters were scored by three blinded radiation oncologists for language representation, clinical detail inclusion, clinical reasoning validity, literature citations, and overall readiness for insurer submission.

RESULTS

Interobserver agreement between radiation oncologists' scores was moderate or better for all domains (Cohen's kappa coefficients: 0.41-0.91). GPT-3.5, GPT-4, and GPT-4web wrote letters that were on average linguistically clear, summarized provided clinical histories without confabulation, reasoned appropriately, and were scored useful to expedite the insurance appeal process. GPT-4 and GPT-4web letters demonstrated superior clinical reasoning and were readier for submission than GPT-3.5 letters ( P < .001). Fine-tuning increased GPT-3.5ft confabulation and compromised performance compared with other LLMs across all domains ( P < .001). All LLMs, including GPT-4web, were poor at supporting clinical assertions with existing, relevant, and appropriately cited primary literature.

CONCLUSION

When prompted appropriately, three commercially available LLMs drafted letters that physicians deemed would expedite appealing insurer denials of radiotherapy services. LLMs may decrease this task's clerical workload on providers. However, LLM performance worsened when fine-tuned with a task-specific, small training data set.
Association of Hormonal Exposures With Grip Strength in Women >45 Years: Data From the CONSTANCES Cohort Study
Authors: Le Noan-Lainé Maryline , Artaud Fanny , Ozguler Anna , Cœuret-Pellicer Mireille , Ringa Virginie , Elbaz Alexis , Canonico Marianne
Published: September 2024

Context

Although biological findings show that estrogens are beneficial for muscular mass maintenance and bone resorption inhibition, the association of hormonal exposure with physical performance are controversial.

Objective

We investigated the association of reproductive history and exogenous hormone use with hand-grip strength (GS) in women.

Methods

Using the data from the CONSTANCES French prospective population-based cohort study, we ran linear mixed models to investigate the association of reproductive history and exogenous hormones use with maximal GS in 37 976 women aged 45 to 69 years recruited between 2012 and 2020. We used multiple imputation by chained equations to control missing values and corrections for multiple testing.

Results

The mean age of women was 57.2 years. Mean GS was 26.6 kg. After adjustment for age and confounders, GS increased with age at menarche (β+1 year = 0.14; 95% CI, 0.10-0.17) and duration of breastfeeding (β for ≥10 months vs <5 months = 0.39; 95% CI, 0.20-0.59; P for linear trend <.01). Compared to nonmenopausal women, postmenopausal women had significantly lower GS (β = −0.78; 95% CI, −0.98 to −0.58). GS was negatively associated with hormone therapy (HT) past use (β = −0.25; 95% CI, −0.42 to −0.07).

Conclusion

Our results suggested that menopausal transition was strongly associated with lower GS. However, despite our hypothesis, increased age at menarche and duration of breastfeeding were associated with higher GS and HT past users presented lower GS than HT never users. These findings could help identify women at high risk of poor physical performance.
Joaquín Les Gusta: On Gut-Level Love for a Lamb of the House
Authors: Ibáñez Martín Rebeca , Mol Annemarie
Published: September 2024

A Spanish phrase animates this chapter by Rebeca Ibáñez Martín and Annemarie Mol: Joaquín les gusta. This forms an entrance into human-animal relations in a small village in Galicia, in the north of Spain. Here, we explore a particular kind of love for animals, condensed in the Spanish word gustar. There are guts in this word. Gustar is a gut-level love that stretches all the way from the attentive care for a beloved animal, to its slaughtering, its dedicated cooking, and the savoring of its meat during a festive meal. The term gustar was not borrowed from scholarly literatures to take to our fieldsite, but worked the other way around: it was distilled it from the field. Instead of critiquing the people to whom Joaquin gustar-s, is the chapter suggests that their story might help other scholars to ask if, in the sites and situations in which they find themselves, or with which they are confronted, some form of gustar might also flow between animals and humans.
Differences and Appreciations
Authors: Mol Annemarie
Published: September 2024

This concluding chapter by Annemarie Mol makes explicit why the earlier chapters forewent the use of well-vested academic terms like class, race and gender. They are yet more English words. All too easily, these terms are made to travel as residual universals, while their meaning and salience in different sites is riven with specificities. These terms therefore deserve to either be unpacked, or left out, but not black boxed in quick asides and unstudied presumptions. Subsequently, the author circles back to a theme that the preceding chapters all share: valuing. Academic researchers readily equate valuing with judging. The investigations presented in the book, by contrast, dwell on such things as encouraging others to enjoy their food, the pleasures of eating with fingers, the gratification following on from accepting the generous invitation of juicy fruits to bite into them, rewarding lunches shared with others, love for both an animal and its meat, and, finally, the careful avoidance of discomfort. They widening valuing out to appreciating. The gratitude that follows from appreciative eating, the authors contend, is not an emotion hidden inside a person, but a relational engagement. Finally, the conclusion comes back to the knowledge politics of this book. Attending to material and semiotic untranslatables does not enclose people and their words in separate cages. Instead, only by caring for equivocations may we stop distantiating ourselves from them and hope to engage in conversations.
Impact of Religion-Based Mindful Walking Meditation on Cardiometabolic and Mental Health
Authors: Tanaka Hirofumi , Suksom Daroonwan
Published: September 2024

Walking meditation or mindful walking is a widely performed form of Buddhist practice that focuses on mind-body interactions. We have found that this particular form of exercise was highly effective in eliciting improvements in cardiometabolic and functional fitness measures in a number of clinical populations. In some key measures, the magnitudes of benefits were greater than the traditional walking program.
Growing demand for Bilateral Total Knee Arthroplasty: How to balance patient outcome with healthcare system challenges
Authors: Jawaid Shaukat Ali
Published: September 2024

doi: https://doi.org/10.12669/pjms.40.9.10790
How to cite this: Jawaid SA. Growing demand for Bilateral Total Knee Arthroplasty (BTKA): How to balance patient outcome with healthcare system challenges. Pak J Med Sci. 2024;40(9):1895-1897. doi: https://doi.org/10.12669/pjms.40.9.10790
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effect of positive psychological intervention on the treatment and prognosis of patients with acute cerebral infarction
Authors: Xu Yunhe , Li Xiaojun , Tao Ting , Guo Xiaoli , Gao Wenbin
Published: September 2024

Objective: To analyze the psychological status of patients with acute cerebral infarction (ACI), and to evaluate the effect of positive psychological intervention on the treatment and prognosis of ACI.
Methods: This was retrospective study. Eighty patients with ACI admitted to Institute of Psychology, Chinese Academy of Sciences from January 2021 to September 2022 were included and randomly divided into observation group (n=40) and control group(n=40). Patients in the control group received conventional treatment and routine care, while those in the observation group received positive psychological intervention based on the control group. Adverse psychological scores, treatment and prognosis, and quality of life as well as nursing satisfaction etc. were analyzed and compared between the two groups.
Results: Both groups showed a significant decrease in SDS and SAS scores at three months after the intervention compared with the pre-intervention period, with a statistically significant difference(P<0.05). After the intervention, the NIHSS score of both groups decreased, with a statistically significant difference(P<0.05). The FMAS and MBI scores increased in both groups compared with those before the intervention, with a statistically significant difference(P<0.05). The SS-QOL scores of both groups were significantly improved compared with before the intervention, with a statistically significant difference(P<0.05). The hospital satisfaction rate in the observation group was significantly higher than that in the control group, with a statistically significant difference (t=12.325, P=0.000).
Conclusion: Positive psychological intervention offers a variety of benefits in the treatment of patients with ACI, such as may alleviate anxiety and depression, reduce neurological deficits, improving quality of life and motor function, and ameliorate the prognosis of patients.
doi: https://doi.org/10.12669/pjms.40.9.7731
How to cite this: Xu Y, Li X, Guo X, Gao W. Effect of positive psychological intervention on the treatment and prognosis of patients with acute cerebral infarction. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.7731
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Risk factors for cardiovascular disease in women with preeclampsia and intrauterine growth restriction
Authors: Memon Fehmida , Aijaz Samia , Bhatti Mahreen , Sheikh Naheed
Published: September 2024

Objective: To identify the risk factors for cardiovascular disease in women with pre-eclampsia and intrauterine growth retardation.
Methods: This cross sectional study was conducted in Department of Gynecology and Obstetrics, Liaquat University Hospital, Hyderabad, from April 2022 to October 2022. Patients with history of intrauterine growth retardation or preeclampsia after 20 weeks of gestation, age more than 18 years were included in this study. Patients were assessed for cardiovascular risk factors during pregnancy.
Results: The average age and gestational age were almost equal in preeclampsia and IUGR patients, (p≤0.050). The primparous were higher in preeclampsia than IUGR, n=286 (73.5%) and n=80 (52.3%), respectively, (p=0.000). The average birth weight of IUGR was lower than preeclampsia patients, 925.19±6.35 gram and 1324.76±10.19 gram, respectively, (p=0.000). The average systolic and diastolic blood pressure of IUGR patients was less than preeclampsia patients, (p=0.000). But, the chronic hypertension was higher in preeclampsia patients n=99 (25.4%) as compare to IUGR n=13 (8.5%) patients, (p=0.000). The average cholesterol level in IUGR was 5.52±0.58(mmol/L) versus preeclampsia 5.34±1.01(mmol/L), (p=0.043). The average triglycerides was almost equal in both the groups, (p=0.924). The mean Lp(a) in preeclampsia patients was 177.15±20.15(mg/L) versus 202.94±24.83 (mg/L), (p=0.000).
Conclusion: Findings of this study help conclude that women with known history of IUGR or preeclampsia must be screened for possible cardiovascular risk factors and treated for these risk factors in order to avoid future mortality and morbidity associated with cardiovascular diseases.
doi: https://doi.org/10.12669/pjms.40.9.8184
How to cite this: Memon F, Aijaz S, Bhatti M, Sheikh N. Risk factors for cardiovascular disease in women with preeclampsia and intrauterine growth restriction. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.8184
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical effects of IPCH after the surgery for ovarian cancer at the middle or advanced stage and its impacts on tumor markers and immune functions
Authors: Li Heyue , Zhang Yan , Tang Hong , Li Linxia
Published: September 2024

Objective: To evaluate the clinical effects of intraperitoneal chemohyperthermia (IPCH) in the treatment of postoperative patients with advanced stage ovarian cancer, and its impacts on tumor markers and immune functions.
Methods: This is a retrospective study. One hundred and twenty patients with advanced stage ovarian cancer received in Shanghai 7th People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from May 10, 2022 to June 10, 2023 were selected and randomly divided into control and study groups (n=60 each group). Patients in the control group were administered routine intravenous chemotherapy, the study group underwent IPCH besides routine intravenous chemotherapy based on the control group. Comparatively analyzed the clinical effects, adverse reaction occurrence rates, and variations in relevant observation targets, the tumor marker after and before the treatment.
Results: Total efficacy in the study and control groups are proved to be with statistically significant differences. The occurrence of adverse reactions proved that no significant differences is seen between both groups. After the treatment, CEA, CA19-9, and CA125 levels in patients of the study group are apparently lower than those in the control group, showing statistically significant differences; expression levels of CD3+, CD4+ and CD4+/CD8+, in the study group were enormously above those in the control group after the treatment, with statistically significant differences.
Conclusions: IPCH has the potential to effectively enhance comprehensively clinical therapeutic effects among postoperative patients with ovarian cancer, significantly improve patients’ immune states, and evidently reduce expression levels of various tumor markers.
doi: https://doi.org/10.12669/pjms.40.9.8720
How to cite this: Li H, Zhang Y, Tang H, Li L. Clinical effects of IPCH after the surgery for ovarian cancer at the middle or advanced stage and its impacts on tumor markers and immune functions. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.8720
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Diagnostic accuracy of low dose CT-Scan abdomen in patients with clinical features of acute appendicitis
Authors: Asim Syed Jehanzeb , Masood Zubia , Soomro Erum , Qureshi Abdul Sami
Published: September 2024

Background & Objective: Acute appendicitis is one of the commonest causes of acute abdominal pain presenting to emergency department (ED) and Computerized Tomography scan (CT) is considered gold standard for its diagnosis. Internationally Low Dose Computerized Tomography scan (LDCT) in emergency department is recommended as a beneficial tool to diagnose acute appendicitis with less exposure to radiation and reduction in the rate of negative laparotomy. Local trials are needed to determine the diagnostic accuracy of LDCT as the first line imaging test for acute appendicitis. Our objective was to determine the diagnostic accuracy of LDCT as the first line imaging test for acute appendicitis.
Methods: An observational study was conducted over a sample of 147 patients presented with suspected acute appendicitis to the emergency department of Ziauddin University Hospital, Karachi from November 2018 till May 2019. Non–probability consecutive technique used. Aged ≥ 16 years presented in emergency department with the history (symptoms) and physical examination (Signs) suspecting acute appendicitis were included. Patients with contraindications to CT scan e.g. pregnant women. Patients with signs of Acute Peritonitis requiring immediate surgery. CT scan refused by the patient or patient’s attendant were excluded. Histopathology was the gold standard in diagnosing acute appendicitis. The data was analyzed using open epi sample size calculator.
Results: One hundred forty six patients had positive findings on LDCT for acute appendicitis (99.3%) whereas only one patient had negative findings (0.7%). The sensitivity and specificity of LDCT for the detection of acute appendicitis were estimated as 96.45% and 16.67% by taking histopathology as gold standard. Negative predictive value (NPV) and positive predictive value (PPV) were estimated as 16.67% and 96.45% respectively. The overall accuracy of LDCT was 93.88%.
Conclusion: Our study showed that for diagnosing acute appendicitis, LDCT is harmless, fast and economical imaging modality and has diagnostic accuracy with decrease in radiation dose.
doi: https://doi.org/10.12669/pjms.40.9.9862
How to cite this: Asim SJ, Masood Z, Soomro E, Qureshi AS. Diagnostic accuracy of low dose CT-Scan abdomen in patients with clinical features of acute appendicitis. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.9862
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.