bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving measures of context in process evaluations: development and use of the Context Tracker tool
Authors: Busza Joanna , Machingura Fortunate , Vuckovic Cedomir
Published: November 2024

Background

Process evaluations are increasingly integrated into randomised controlled trials (RCTs) of complex interventions to document their delivery and interactions with local systems and dynamics, helping understand observed health outcomes. Yet process evaluations often struggle to assess relevant contextual determinants, leaving much of the important role of “context” in shaping an intervention’s mechanisms opaque in many studies. A lack of easily adapted data collection methods to help define and operationalise indicators of context likely contributes to this.

Methods

We present a method to help structure measures of context in process evaluations and describe its use in two very different settings. The “Context Tracker” is an innovative tool for use within trials and quasi-experiments to more systematically capture and understand key dimensions of context. It was developed in Zimbabwe as part of a cluster randomised controlled trial and then adapted for a quasi-experimental evaluation in the UK. Both studies provided harm reduction and health services for marginalised and hard-to-reach populations.

Results

We developed the Context Tracker to be both standardised (i.e. formatted and applied in the same way across study sites) and flexible enough to allow unique features to be explored in greater detail. Drawing on the Context and Implementation of Complex Interventions (CICI) and Risk Environments frameworks, we mapped 5 domains across micro, meso and macro levels in a simple table and used existing evidence and experience to predict factors likely to affect delivery of and participation in intervention components. We tracked these over time across study sites using routine programme statistics, observation and qualitative methods. The Context Tracker enables identification and comparison of facilitators and barriers to implementation, variations in engagement with interventions, and how mechanisms of action are (or are not) triggered in different settings.

Conclusions

The Context Tracker is one example of how evidence-based contextual determinants can be used to guide data collection and analysis within process evaluations. It is relevant in low- and high-income settings and applicable to both qualitative and quantitative analyses. While perhaps most useful to process evaluations of complex interventions targeting marginalised communities, the broader approach would benefit a more general research audience.
Percutaneous cryoablation in soft tissue tumor management: an educational review
Authors: Bodard Sylvain , Geevarghese Ruben , Razakamanantsoa Leo , Frandon Julien , Petre Elena N. , Marcelin Clement , Cornelis François H.
Published: November 2024

Background

Percutaneous cryoablation (PCA), having shown effectiveness in treating liver, lung, prostate, breast, and kidney tumors, is now gaining attention for the treatment of soft tissue tumors. PCA functions by freezing tissue, which induces ice crystal formation and cell death without damaging collagen structures. Technical considerations include the selection and handling of cryoprobes and cryogenic agents, procedural duration, and choice of image guidance for precision. This review aims to synthesize the mechanisms, applications, and technical aspects of PCA in the treatment of soft tissue tumors.

Methods

Adhering to PRISMA 2020 guidelines, a review was conducted of studies published prior to March 2024 that investigated PCA of soft tissue tumors. The review focused on technical and procedural aspects of cryoablation, cryobiological principles, cellular and tissue responses to extreme cold, intra- and post-procedure physiological mechanisms during and post-procedure, and main clinical applications.

Results

PCA is efficient in treating soft tissue tumors, including desmoid tumors, vascular malformations, and abdominal wall endometriosis. Several cryobiological mechanisms are involved, notably ice crystal formation, cellular dehydration, osmotic effects, and the inflammatory response, all of which contribute to its efficacy. Key technical aspects include the choice of cryoprobes, cryogenic agents (argon gas or liquid nitrogen), and the duration and control of freezing/thawing cycles. PCA also frequently outperformed traditional treatments like surgery and radiotherapy in terms of pain reduction, tumor size reduction, and patient outcomes. Moreover, its nerve sideration properties make it effective under local anesthesia.

Conclusion

Demonstrating substantial pain reduction, tumor size decrease, and high technical success rates, PCA offers a promising and minimally invasive alternative for soft tissue tumor treatment.

Critical relevance statement

Percutaneous cryoablation provides a minimally invasive, precise alternative for soft tissue tumor management, advancing clinical radiology by offering effective treatment with reduced patient risk and enhanced outcomes through image-guided procedures.

Key Points

Percutaneous cryoablation (PCA) offers a promising, minimally invasive alternative for managing soft tissue tumors.

PCA employs image-guided techniques to accurately target and treat tumors, ensuring high precision and control.

PCA preserves structures like collagen, reduces pain, decreases tumor size, and generally enhances patient outcomes.

Graphical Abstract
Contribution to the Prediction of the Recycling Potential of Recycled Concrete as a Cement Admixture Based on the Compressive Strength of the Parent Concrete
Authors: Sičáková Alena , Kim Jeonghyun , Bálintová Magdaléna , Eštoková Adriana , Junáková Natália , Orolin Peter , Ubysz Andrzej
Published: November 2024

When processing construction and demolition waste, determining the most effective waste management, potential use and recycling method for the identified materials is a key element. To do this, it is necessary not only to determine the type of materials, but also knowledge which aspects of the quality of the original materials are relevant for recycling and the ability to determine the values of these parameters as easily and quickly as possible, directly during demolition activities, is highlighted as an effective tool. This paper, intended as a case study, focuses on the evaluation of the effect of finely ground parent concrete as a cement component, the main objective being to find out whether the differentiation of the quality of the parent concrete, by compressive strength, plays a significant role. The parent concrete, the powder prepared from it, and the new standard mortar mixes, were analysed to obtain a comprehensive picture of the possibility of predicting the properties of the mixes based on the strength of the parent concrete. In general, no clear effect of the parent concrete strength on the flexural strength, compressive strength, water absorption, and ultrasonic pulse velocity values of the new generation mortar was observed. However, finely ground recycled concrete have shown a nice potential to be incorporated in Portland fine-grain cements, reaching strength classes 32.5 and 42.5. Care and precise verification require a 25% replacement, especially in the case of low strength parent concrete.
Seeing through “brain fog”: neuroimaging assessment and imaging biomarkers for cancer-related cognitive impairments
Authors: Gu Quanquan , Wang Liya , King Tricia Z. , Chen Hongbo , Zhang Longjiang , Ni Jianming , Mao Hui
Published: November 2024

Advances in cancer diagnosis and treatment have substantially improved patient outcomes and survival in recent years. However, up to 75% of cancer patients and survivors, including those with non-central nervous system (non-CNS) cancers, suffer from “brain fog” or impairments in cognitive functions such as attention, memory, learning, and decision-making. While we recognize the impact of cancer-related cognitive impairment (CRCI), we have not fully investigated and understood the causes, mechanisms and interplays of various involving factors. Consequently, there are unmet needs in clinical oncology in assessing the risk of CRCI and managing patients and survivors with this condition in order to make informed treatment decisions and ensure the quality of life for cancer survivors. The state-of-the-art neuroimaging technologies, particularly clinical imaging modalities like magnetic resonance imaging (MRI) and positron emission tomography (PET), have been widely used to study neuroscience questions, including CRCI. However, in-depth applications of these functional and molecular imaging methods in CRCI and their clinical implementation for CRCI management are largely limited. This scoping review provides the current understanding of contributing neurological factors to CRCI and applications of the state-of-the-art multi-modal neuroimaging methods in investigating the functional and structural alterations related to CRCI. Findings from these studies and potential imaging-biomarkers of CRCI that can be used to improve the assessment and characterization of CRCI as well as to predict the risk of CRCI are also highlighted. Emerging issues and perspectives on future development and applications of neuroimaging tools to better understand CRCI and incorporate neuroimaging-based approaches to treatment decisions and patient management are discussed.
Characteristics and initiation mechanism of the large mudstone Dongping landslide induced by heavy rainfall in Gansu Province, NW China
Authors: Li Ran , Sun Ping , Sang Kangyun , Ke Chaoying , Zhang Shuai
Published: November 2024

Background

At approximately 4:00 PM on 18 July 2023, a heavy rainstorm lasting one hour triggered a significant mudstone landslide in Dongping, Weiyuan County, Gansu Province, Northwest China. The landslide resulted in the burial of houses, the fracturing and destruction of roads, and posed a serious threat to 16 households. The estimated economical loss from this disaster reached 3.2 million yuan. This study presents a detailed field investigation of the Dongping landslide, focusing on the deformation and failure characteristics through a multi-layered analysis of sliding strata, rock mass structure, slope configuration, and failure mechanism. Moreover, the study explores the key triggering factors of the Dongping landslide, with particular attention to the roles of seismic activity, rainfall, and preferential flow in the development of large-scale mudstone landslides.

Results

The stratigraphic profile of the Dongping landslide reveals a two-layer structure, consisting of overlying loess and underlying mudstone, with the sliding surface primarily located within the underlying Neogene red mudstone. The initiation location of the Dongping landslide is situated at the rear of the slope, while the main slip-resistant section is located in the middle section of the landslide, exhibiting a predominantly thrust-sliding. After encountering resistance in the middle section, the front part of the sliding mass continued to move, leading to the formation of secondary landslides. The overall movement of the Dongping landslide is characterized by rotational sliding, with the sliding mass remaining relatively intact.

Conclusions

The initiation of the large-scale mudstone landslide in Dongping was driven by multiple factors. The heavy rainfall served as the direct triggering factor for the landslide occurrence. However, some historical factors, including seismic activity and previous sliding surface, had already weakened the slope structure by degrading the mechanical properties of the landslide mass and creating preferential flow channels, thereby setting the stage for the Dongping landslide. Structural fractures in the landslide area, along with sinkholes formed by a combination of tectonic joints, soil properties, and human activities, constituted preferential seepage pathways for water within the slope. These pathways provided the hydraulic conditions necessary for rainfall-induced landslides, making them the primary controlling factors in the occurrence of the Dongping landslide.
Application and evaluation knitted electrodes for body signal measurement using adhesive intermediate electrode
Authors: Song Ji Eun , Lee Sohee
Published: November 2024

Textile electrode is capable of measuring the myoelectric potentials of skeletal muscles such as electromyography (EMG), owing to their outstanding low weight, flexibility, breathability, and comfort properties. Nonetheless, textile surfaces often exhibit intermittent adhesion between the electrode surface and the skin, which can result in fluctuations in electrical resistivity due to the inherent characteristics of textiles. This study aimed to suggest the solutions to improve adhesive of textile electrode for the improvement of electrode performance with high quality signal by minimizing these intermittent contacts. For this, an adhesive intermediate, two different conductive materials, between the skin and the textile electrode was introduced to improve the instability skin contact, respectively. To assess the impact of various adhesive intermediates on knitted electrodes, two different types of adhesive intermediates were utilized: a conductive hydrogel-based adhesive intermediate and a conductive paste-based adhesive intermediate. Moreover, the durability of knitted electrodes with adhesive intermediate was evaluated by assessing the changes of signal quality during drying time for 180 min. As a results of sEMG measurement, it was confirmed that the sEMG signal was stably detecting by applying the adhesive intermediate. Both types of adhesive intermediate significantly increased the signal acquisition performance of knitted electrodes by more than threefold. After five washing cycle, the knitted electrodes with two types of adhesive intermediate maintained approximately 80% of their initial SNR values. Therefore, the use of the adhesive intermediate presented in this study not only improves the performance of the electrode but also ensures reusability.
Quantification of fungal biomass in mycelium composites made from diverse biogenic side streams
Authors: Nussbaumer Marcello , Karl Tanja , Benz J. Philipp
Published: November 2024

Mycelium composite materials are comprised of renewable organic substrates interconnected by fungal mycelium, allowing full biodegradability after use. Due to their promising material properties, adaptability, and sustainable nature, these biomaterials are investigated intensively. However, one crucial aspect that has hardly been covered so far is the proportion of fungal biomass in the composites, which would be necessary to assess its contribution to the material characteristics. Since a complete physical separation of mycelium and substrate is not feasible, we approached this issue by isolating the fungal DNA and relating it to the mass of mycelium with the help of quantitative PCR. Overall, 20 different combinations of fungi and biogenic side streams were evaluated for their handling stability, and growth observations were related to the quantification results. Ganoderma sessile was able to form stable composites with almost all substrates, and a positive correlation between mycelial biomass and composite stability could be found. However, the amount of mycelium required for fabricating firm materials strongly depends on the combination of substrate and fungal species used. Less than five mass percent of fungal biomass can suffice to achieve this, as for example when combining Trametes versicolor with sugar beet pulp, whereas a mass fraction of twenty percent leads to crumbly materials when using Pleurotus pulmonarius on green waste. These results indicate that the mycelial biomass is an important factor for the composite’s stability but that the properties of the fungal hyphae, as well as those of the substrate, are also relevant. The presented quantification method not only allows to estimate fungal growth during composite production but can also improve our understanding of how the mycelium influences the material.
Choroidal vascularity index in health and systemic diseases: a systematic review
Authors: Motamed Shariati Mehrdad , Khazaei Sahel , Yaghoobi Mariye
Published: November 2024

Background

The choroid, a highly vascular structure within the eye, is significantly influenced by various systemic conditions. The advent of enhanced depth optical coherence tomography has improved our ability to evaluate choroidal pathophysiology. The choroidal vascularity index (CVI), a noninvasive and reliable tool, serves as an effective means of assessing the choroidal vascular structure. Recent studies have increasingly focused on exploring CVI alterations under different systemic conditions. This study aims to provide a comprehensive summary of the latest research findings in this area.

Methods

A systematic literature review was conducted on October 1, 2023, using two databases, MEDLINE (via PubMed) and Scopus. Search terms were tailored specifically for each database to ensure a thorough exploration of relevant literature. The studies identified were qualitatively assessed, with particular emphasis on outcomes related to CVI and choroidal thickness.

Results

A total of 48 studies were included in the review, encompassing a diverse range of systemic conditions such as diabetes, central nervous system disorders, cardiovascular diseases, autoimmune disorders, and infectious diseases. Notable reductions in CVI were observed in diabetic retinopathy, autoimmune diseases, and neurodegenerative disorders. Additionally, the review highlighted variations in CVI values related to the severity of systemic diseases, indicating its potential use as a biomarker for disease progression.

Conclusion

This review highlights the significant correlation between variations in the choroidal vascularity index and diverse systemic conditions affecting hemodynamics. An enhanced understanding of CVI provides deeper insights into the pathophysiological mechanisms underlying these disorders and positions CVI as a promising biomarker for early detection and monitoring. Nevertheless, its clinical utility warrants careful assessment. Future research should address the potential limitations of CVI to fully capitalize on its diagnostic and prognostic potential.
Addressing the challenges and strategies for Western classical music in North America as a living heritage art form
Authors: Shiu Henry C.H.
Published: November 2024

This article proposes viewing classical music in North America as a “living heritage art form” that acknowledges the deep foundational roots of classical music, similar to how all forms of world heritage are constructed while recognizing that classical music can remain relevant within a modern cultural context. In doing so, it examines the challenges threatening the genre’s survival and proposes strategies for overcoming these obstacles. Additionally, it highlights the opportunities presented by modern technologies to support ongoing composition, performance, and public engagement, ensuring the continued appreciation and evolution of classical music in the modern era.
Technical feasibility of automated blur detection in digital mammography using convolutional neural network
Authors: Nowakowska S. , Vescoli V. , Schnitzler T. , Ruppert C. , Borkowski K. , Boss A. , Rossi C. , Wein B. , Ciritsis A.
Published: November 2024

Background

The presence of a blurred area, depending on its localization, in a mammogram can limit diagnostic accuracy. The goal of this study was to develop a model for automatic detection of blur in diagnostically relevant locations in digital mammography.

Methods

A retrospective dataset consisting of 152 examinations acquired with mammography machines from three different vendors was utilized. The blurred areas were contoured by expert breast radiologists. Normalized Wiener spectra (nWS) were extracted in a sliding window manner from each mammogram. These spectra served as input for a convolutional neural network (CNN) generating the probability of the spectra originating from a blurred region. The resulting blur probability mask, upon thresholding, facilitated the classification of a mammogram as either blurred or sharp. Ground truth for the test set was defined by the consensus of two radiologists.

Results

A significant correlation between the view (p < 0.001), as well as between the laterality and the presence of blur (p = 0.004) was identified. The developed model AUROC of 0.808 (95% confidence interval 0.794–0.821) aligned with the consensus in 78% (67–83%) of mammograms classified as blurred. For mammograms classified by consensus as sharp, the model achieved agreement in 75% (67–83%) of them.

Conclusion

A model for blur detection was developed and assessed. The results indicate that a robust approach to blur detection, based on feature extraction in frequency space, tailored to radiologist expertise regarding clinical relevance, could eliminate the subjectivity associated with the visual assessment.

Relevance statement

This blur detection model, if implemented in clinical practice, could provide instantaneous feedback to technicians, allowing for prompt mammogram retakes and ensuring that only high-quality mammograms are sent for screening and diagnostic tasks.

Key Points

Blurring in mammography limits radiologist interpretation and diagnostic accuracy.

This objective blur detection tool ensures image quality, and reduces retakes and unnecessary exposures.

Wiener spectrum analysis and CNN enabled automated blur detection in mammography.

Graphical Abstract
Paracetamol overdose associated with cortical blindness-complicated acute leukoencephalopathy: a case report
Authors: Khasawneh Ruba , Keewan Nour , Aburahma Samah K. , Khurfan Basel Waleed
Published: November 2024

Background

Paracetamol is one of the most used antipyretics and analgesics among pediatrics, and its overdose is highly encountered among pediatrics especially in the pre-school age. While it is well-known that paracetamol overdose may lead to toxicities including severe hepatic toxicity, some recent reports have highlighted its “in situ” toxicity on brain tissue at high doses, even in the absence of hepatotoxicity. This can result in acute leukoencephalopathy (AL), coma, or even death. This report describes a case of a child who developed cortical blindness-complicated AL, following a paracetamol overdose.

Case presentation

An 18-month-old previously healthy girl accidentally ingested 300 mg/kg of paracetamol suspension. After ingestion, the child was in an initial bad condition that has gradually improved. Several days after ingestion, the patient lost her vision, and she remained blind since then despite a newer appreciation to light. The initial brain magnetic resonance imaging (MRI) suggested AL demonstrated as a faint high T2/fluid-attenuated inversion recovery (FLAIR) signal intensity in the cortical and subcortical regions of both parieto-occipital lobes with sulcal effacement and restricted diffusion. After around 3 months, the subsequent brain MRI showed involutional changes that were manifested as a brain volume loss in the same areas with evidence of gyri-form laminar necrosis in both parieto-occipital regions without restricted diffusion. Other brain MRI findings include right cerebral convexity hyperacute subdural hematoma with prominent subarachnoid spaces.

Conclusions

The child developed cortical blindness-complicated AL following a paracetamol overdose. It is well- known that AL may result from several toxins by their direct and/or indirect effect on the cerebral white matter. However, there is still no enough data in the literature clearly explaining the relation of paracetamol overdose to AL. The generally proposed effect of paracetamol on the brain is mainly justified by the excessive oxidative stress. Further studies at the cellular and genetic levels are still needed to investigate the exact association between paracetamol overdose and AL, as well as the underlying mechanisms involved.
Concurrent spinal schwannoma and meningioma without neurofibromatosis: case presentation and review of literature
Authors: Elnoamany Hossam , Salim Mohammud
Published: November 2024

Background

Concurrent multiple tumors developing in the spinal cord are rare, except for in genetic disorders, such as neurofibromatosis and von Hippel–Lindau disease. The presence of multiple histologically different spinal tumors in the absence of NF-2 is extremely rare. Schwannoma and meningioma can be explained partly by their common origin from the same mesenchymal cell, there is currently no explanation for the simultaneous existence of different spinal tumors other than simple coincidence.

Case presentation

After review of literature, there are thirteen such cases reported in the literature in addition to the present case. The current patient presents with lower limb weakness, and the patient radiology revealed intradural mass opposite the fourth lumbar vertebra with contrast enhancement and intradural extramedullary mass opposite the tenth dorsal vertebra with contrast enhancement in MRI spine. The coexistence of these tumors may be coincidental or might be due to a common histological origin of the Schwann cells and the meningocytes.

Conclusion

Schwannoma and meningioma have different radiological characteristics and require different managing procedures such as dural base coagulation in meningiomas and rootlet sacrifice in schwannomas.
Exploring “Mandai”: gastronomy of Banjar ethnic in Kalimantan, Indonesia
Authors: Gozali Gozali , Setyawati Ria , Duari I Putu Hardani Hesti , Zulkarnain Zulkarnain , Nooryastuti Nandyan Ayu , Yudistira Sukma , Purwaningrum Hesti
Published: November 2024

Mandai is a traditional food product made from the inner skin of the cempedak fruit (Artocarpus champeden), processed using a fermentation method, and discovered by the Banjar ethnic group in Kalimantan. This article aims to review the history, development, fermentation process, derivative products, and Mandai in Banjar ethnic gastronomy, and to discuss the potential of Mandai as a tourism product. A narrative literature review was used to describe the Mandai phenomenon from various relevant sources. These results depict that Mandai is a traditional fermented food that continues to grow and has the potential to support the tourism industry in the respective region. This article is the first international review that examines Mandai from a scientific perspective. The findings of this study enrich knowledge about traditional fermented foods and serve as a guide for gastronomy and tourism professionals in Kalimantan in the future Mandai development.
Significance of three-dimensional turbo spin-echo magnetic resonance imaging with semiquantitative assessment of knee osteoarthritis: correlation to two-dimensional routine magnetic resonance imaging
Authors: Hashem Aya Mohamed Bassam , El-Liethy Nevien Ezzat Mohamed , El-Din Osama Mohamed Helmy Noor , Mahmoud Mostafa Ezzat , Hashem Lamiaa Mohamed Bassam
Published: November 2024

Background

As one of the most prevalent chronic degenerative diseases, knee osteoarthritis (KOA) is associated with the progressive degradation of articular cartilage, meniscus, synovium, ligaments, bone, muscles, and tendons. Knee osteoarthritis affects the quality of life and can cause chronic disability worldwide. Magnetic resonance imaging (MRI) is a crucial imaging modality for the morphological assessment of cartilage and all other joint tissues involved in osteoarthritis. The objective of this study was to evaluate the effectiveness of the three-dimensional (3D) turbo spin-echo (TSE) MRI and to compare its relevance to two-dimensional (2D) routine MRI in adding additional information and in the early detection of KOA.

Results

Total agreement between the two techniques ranged between 82.7% (cartilage degeneration), 91.4% (osteophytes), 98.3% for bone marrow edema and periarticular cyst up to 100% of other several features regarding meniscal injury and ligamentous tear.

Conclusions

When compared to standard 2D TSE MRI, 3D TSE MRI demonstrates substantial to almost complete agreement and high accuracy for semiquantitative assessment of knee osteoarthritis (OA). 3D TSE MRI also takes less time, which is important for large OA studies and can be used for the detection of early knee joint changes.
Thymoma-associated paraneoplastic encephalitis resolved by robotic-assisted radical thymectomy: a case report
Authors: Becherano Gaston , Podgaetz Eitan , Ahmed Shair , Ringenberg Sigrid , Schwartz Gary
Published: November 2024

Background

We present a rare case of autoimmune encephalitis associated with an incidentally discovered thymoma. Limited case reports exist of thymoma-associated paraneoplastic encephalitis. The unique clinical presentation and subsequent surgical intervention offer valuable insights into the management of similar cases.

Case presentation

A 41-year-old female presented with irritability, personality changes, fatigue, and seizures. Physical examination and bloodwork on first encounter were unremarkable. Neurological evaluation was done, and a brain magnetic resonance imaging (MRI) with and without contrast demonstrated numerous hyperintensity foci within bilateral cerebral cortices on T2-/FLAIR-weighted images affecting only the supratentorial brain, findings highly suggestive of encephalitis. A chest computed tomography (CT) revealed an anterior mediastinal mass compatible with a thymoma. Cerebrospinal fluid from a lumbar puncture was unremarkable. Paraneoplastic autoantibody evaluation was positive, and the patient was diagnosed with autoimmune encephalitis believed to be associated with an incidentally discovered thymoma. Given her rapid neurological deterioration, the thoracic surgery team was urgently consulted.

Patient underwent robotic-assisted radical thymectomy with prompt resolution of symptoms. During her 2-week postoperative visit, she was neurologically intact with no residual deficits. Follow-up MRI at 6 months demonstrated resolution of abnormal signal intensities, with continued improvement noted 1-year post-operation. Chest CT scans at 6 and 12 months revealed no residual or recurrent thymic tissue.

Conclusions

This case illustrates the connection between thymoma and autoimmune neurological disorders like encephalitis. It emphasizes the significance of comprehensive neurological and oncological assessments for patients with unexplained neurological symptoms. Prompt diagnosis and treatment led to positive outcomes in this case, underscoring the potential for full recovery in similar cases.
Clustering of hepatitis C infection among family members in Aden, Yemen
Authors: Gubran Ali N.M. , Al-Barq Ali Mohsen Mohammed , Hashem Mohammed Abdulbaset Mohammed , Saleh Noura Ramzy Mohammed , Saleh Abdulsalam Abdullah Mohammed , Mohammed Shaima Rashad Saleh Ali , Bn Zead Wala Salem Saleh Salem , Muswat Fatima Luai Ali Saeed , Bahumaish Arwa Khaled Ali Mohammed , Al-Saadi Yousif Fahmi Qasim
Published: November 2024

Background

Hepatitis C infection is a common cause of liver diseases such as cirrhosis and liver carcinoma. This study aims to determine the clustering of HCV infection among family members of HCV-positive patients (index cases) and the association between internal and external risk factors and HCV infection among these family members.

Methods

This cross-sectional study was conducted during a period from January to June 2024. One hundred and seventeen family members belonging to 26 index cases were enrolled in this study. Blood samples were collected from all family members, and then sera were separated and tested for anti-HCV antibodies by using a commercially available Cobas technique based on ECLIA.

Results

Among 117 family members, the majority 55.6% were females. The clustering of HCV infection among family members was 7.7%. The highest rates were 9.6% among males and 11.8% among members who were in close contact with female-positive cases, 12.8% in the age group 20–29 years, and 27.3% among brothers, but there were no HCV-positive cases detected among fathers, daughters, and husbands. There was a significant association between HCV infection and some behaviors of family members such as sharing the same sleeping places, nail clippers, and towels with index cases and exposure to cupping (p = 0.0001, 0.002, 0.017, and 0.050), respectively.

Conclusion

The HCV infection among family members in Aden, Yemen, was low in comparison with most studies globally. The highest rates were found among males, those in contact with female index cases, in the age group 20–29 years, and brothers as relatives, but there were no positive cases among fathers, husbands, daughters, and other relatives.
Associations Between Sensitivity to Thyroid Hormones and Visceral Adiposity in Euthyroid Adults
Authors: Wei Ying , Yang Mengge , Liu Jia , Wang Ying , Wang Guang
Published: November 2024

Objectives

The study aimed to explore the association between thyroid hormone (TH) sensitivity and obesity assessed by body mass index (BMI) and visceral adiposity index (VAI) in euthyroid adults.

Methods

This cross-sectional study used the Thyroid Feedback Quantile-based Index (TFQI), TSH index (TSHI), and thyrotrophic T4 resistance index (TT4RI) to indicate central TH sensitivity, and VAI to assess visceral obesity. Participants were categorized according to tertiles. We used logistic and linear regressions to explore the associations stratified by sex.

Results

The study enrolled 5411 men and 5749 women with normal thyroid function. Men with the highest tertile of TT4RI had 1 kg/m2 higher BMI compared with men with the lowest tertile of TT4RI (P = .001) after adjustment for age, hypertension, hyperlipidemia, diabetes, hyperuricemia, and renal function. There was no significant difference in BMI across tertiles of TFQI and TSHI in men, and TFQI, TSHI, and TT4RI in women after adjustment for other risk factors. TH sensitivity indices were positively related to VAI after adjustment for confounders in women but not in men. There were 1.21 (95% CI, 1.02-1.44; P = .03), 1.43 (95% CI, 1.20-1.70; P < .001), and 1.47 (95% CI, 1.23-1.75; P < .001) times higher odds of having high VAI among women in the highest TFQI, TSHI, and TT4RI tertiles, respectively, compared to women in the lowest tertile.

Conclusion

Reduced central TH sensitivity was associated with increased visceral adiposity in women but not men. Our findings supplemented the evidence of the importance of TH sensitivity to metabolic disorders, especially among women.
Use of Whole-Exome Sequencing and Pedigree Analysis to Identify X-linked Hypophosphatemia in Saudi Arabian Families
Authors: Al-Hamed Mohamed H , Bakhamis Sarah , Abdelfattah Sara I , Alsagheir Afaf
Published: November 2024

Context

X-linked hypophosphatemia (XLH) is the most common form of inherited hypophosphatemic rickets (HR), caused by pathogenic variants in the PHEX gene. Genetic diagnosis of XLH facilitates early treatment optimization, especially for patients suitable for burosumab, a recombinant anti-fibroblast growth factor-23 monoclonal antibody.

Objective

This study aimed to use whole-exome sequencing (WES) and pedigree analysis to identify patients with XLH.

Methods

Medical records at a single center in Saudi Arabia were screened between 2014 and 2024 to identify patients with suggested HR. Of the 800 patients identified, 27 had had suspected XLH. The genetic study comprised 100 patients drawn from these 27 families.

Results

Clinical manifestations were widespread and variable within families. Severe disease was reported in 55% of children and 25% of adults. At presentation, all children were receiving either conventional therapy (60%) or burosumab (40%); however, 53% of adults were not treated. WES provided a genetic diagnosis in 23 families: alterations in the PHEX gene (20 families), with homozygous ENPP1 and DMP1 variants detected in 2 and 1 families, respectively. Pathogenic/likely pathogenic variants were detected in 23 families (diagnostic yield 85%). Ten novel likely pathogenic variants were detected. Pedigree analysis provided information to support disease-specific patient management.

Conclusion

WES detected a diagnostic molecular abnormality in 85% of families with HR phenotypes; PHEX variants were the most common. Combined use of WES and pedigree analysis highlighted the underdiagnosis of adult XLH in this population, with most family members being diagnosed after the pedigree analysis.
The Impact of Hypothyroidism on Cardiovascular-Related Healthcare Utilization in the US Population With Diabetes
Authors: Ramirez Marcelo , Bianco Antonio C , Ettleson Matthew D
Published: November 2024

Context

Suboptimal treatment of hypothyroidism (HT) is associated with adverse cardiovascular disease (CVD) outcomes, for which patients with diabetes mellitus (DM) are at increased risk.

Objective

This study aimed to compare CVD-related healthcare utilization in DM patients with and without HT in the US population.

Methods

Participant data were collected from the Medical Expenditure Panel Survey (MEPS) over 10 years (2011-2020). Medical conditions were identified by ICD-9/ICD-10 codes associated with expenditures. Healthcare utilization outcomes included number of emergency, hospital, and outpatient visits associated with coronary artery disease (CAD), stroke/transient ischemic attack (TIA), or heart failure; prescriptions related to CVD; and number of visits to specialty providers. A propensity score-based fine stratification matching approach was used to balance sociodemographic covariates to determine the relative risk (RR) contributed by HT on CVD-related care utilization.

Results

A total of 15 580 adult participants with DM were identified, of whom 11.9% had treated HT. In the weighted analysis, a significantly greater proportion of participants with HT had CAD and stroke/TIA-associated visits compared to those without HT (respectively, 22.4% vs 17.8%, P = .002; and 7.3% vs 5.4%, P = .020). In the matched analysis, participants with HT were more likely to see a specialist (cardiology, endocrinology, and nephrology). Participants with HT were more likely to be treated with cholesterol-lowering medications, beta-blockers, and diuretics.

Conclusion

HT as a comorbidity with DM was associated with increased healthcare utilization related to CVD, specifically visits associated with stroke/TIA, increased use of specialty care, and greater utilization of CVD-related medications.
Racial and Ethnic Disparities in Epidural Blood Patch Utilization Among Obstetric Patients in the United States: A Nationwide Analysis, 2016–2020
Authors: Potnuru Paul P. , Jonna Srikar , Orlando Barbara , Nwokolo Omonele O.
Published: November 2024

BACKGROUND:

Racial and ethnic disparities in health care delivery can lead to inadequate peripartum pain management and associated adverse maternal outcomes. An epidural blood patch (EBP) is the definitive treatment for moderate to severe postdural puncture headache (PDPH), a potentially debilitating neuraxial anesthesia complication associated with significant maternal morbidity if undertreated. In this nationwide study, we examine the racial and ethnic disparities in the inpatient utilization of EBP after obstetric PDPH in the United States.

METHODS:

In this retrospective observational study, we used the National Inpatient Sample, a nationally representative database of discharge records for inpatient admissions in the United States, from 2016 to 2020. We analyzed delivery hospitalizations of women of childbearing age (15–49 years) diagnosed with PDPH. Adjusting for maternal and hospitalization characteristics as confounders, we used a multilevel mixed-effects logistic regression model to compare the rates of EBP utilization by race and ethnicity. Secondarily, among hospitalizations with an EBP, we examined the association between race and ethnicity and the timing of the EBP procedure.

RESULTS:

We analyzed 49,300 delivery hospitalizations with a diagnosis of PDPH. An EBP was performed in 24,075 (48.8%; 95% confidence interval [CI], 47.8%–49.9%) of these hospitalizations. EBP was performed in 52.7% (95% CI, 51.3%–54.1%) of White non-Hispanic patients with PDPH. Compared to White non-Hispanic patients, Black non-Hispanic (adjusted odds ratio [aOR] = 0.69; 99% CI, 0.56–0.84), Hispanic (aOR = 0.80, 99% CI, 0.68–0.95), and Asian or Pacific Islander patients (aOR = 0.74, 99% CI, 0.58–0.96) were less likely to receive an EBP. The median (interquartile range [IQR]) time to perform an EBP was 2 (1–3) days after admission, with 90% of EBP procedures completed within 4 days of admission. There was no significant association between race and ethnicity and the timing of EBP placement.

CONCLUSIONS:

In this nationwide analysis of delivery hospitalizations from 2016 to 2020 in the United States with a diagnosis of PDPH, we identified racial and ethnic disparities in the utilization of EBP. Minoritized patients identified as Black non-Hispanic, Hispanic, or Asian or Pacific Islander were less likely to receive an EBP for the treatment of PDPH compared to White non-Hispanic patients. Suboptimal treatment of PDPH may be associated with adverse long-term outcomes such as postpartum depression, posttraumatic stress disorder, and chronic headaches. Racial and ethnic disparities in EBP utilization should be further investigated to ensure equitable health care delivery.
Supratotal Resection Versus Gross Total Resection for Isocitrate Dehydrogenase-Wildtype Glioblastoma and Grade 4 Isocitrate Dehydrogenase-Mutant Astrocytoma: Meta-Analysis of Individual Patient Data
Authors: Verly Gabriel , Delfino Thiffany , Bresciani Lucas , Oliveira Matheus , Oyon Daniel , Chandler James , Galvão Gustavo da Fontoura
Published: November 2024

BACKGROUND AND OBJECTIVES:

IDH-wildtype glioblastoma multiforme (GBM) and grade 4 IDH-mutant astrocytoma are challenging to manage in oncology. This study explores the contrast between gross total resection (GTR) and supratotal resection (SupTR) for IDH-wildtype GBM and grade 4 IDH-mutant astrocytoma, aiming to summarize their influence on crucial clinical outcomes.

METHODS:

This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Web of Science, Embase, Scopus, and Cochrane were searched for articles until December 2023.

RESULTS:

Ten studies were included, involving 1043 patients with IDH-wildtype GBM and grade 4 IDH-mutant astrocytoma who underwent GTR or SupTR. SupTR demonstrated a favorable impact on long-term overall survival (OS) and progression-free survival (PFS) compared with GTR. The hazard ratio for OS was 0.655 (95% CI: 0.5703-0.7522, P < .0001), and for PFS, it was 0.732 (95% CI: 0.6279-0.8540, P = .0001) in the long-term analysis. Short-term analysis (18 months) reinforced the superiority of SupTR, with a hazard ratio for OS of 0.544 (95% CI: 0.450-0.659, P < .0001), and for PFS, it was 0.697 (95% CI: 0.586-0.830, P < .0001) in this timespan.

CONCLUSION:

SupTR appears to be a promising alternative to GTR for treating IDH-wildtype GBM and grade 4 IDH-mutant astrocytoma, showing improved OS and PFS outcomes. More robust studies that are less susceptible to bias are needed to strengthen this conclusion.
Prenatal Exercise Decreases Urinary Incontinence in Late Pregnancy and 3 Months Postpartum: A Randomized Controlled Trial
Authors: ZHANG DINGFENG , SÁNCHEZ-POLÁN MIGUEL , SILVA-JOSE CRISTINA , DÍAZ-BLANCO ÁNGELES , BRIK MAIA , ARIAS ARANZAZU MARTÍN , HERNANDO PALOMA , BARAKAT RUBÉN
Published: November 2024

Purpose

This study aimed to evaluate the impact of a supervised exercise program, including pelvic floor muscle training, throughout pregnancy on Urinary Incontinence (UI).

Methods

A randomized clinical trial (NCT04563065) was conducted. Initially, 600 pregnant women were screened for eligibility, with data from 356 participants eventually analyzed. Of these, 172 were allocated to the exercise group (EG) and 184 to the control group (CG). Participants in the EG engaged in a supervised moderate exercise program 3 d·wk−1, each session lasting 60 min, from 8–10 to 38–40 wk of gestation, achieving an adherence rate of 73.5%.

Results

A lower prevalence of UI in the EG compared with the CG was observed during late pregnancy (χ
2 = 20.04; P = 0.001) and at 3 months postpartum (χ
2 = 12.52; P = 0.03), as well as in birth weight (F = 4.16; P = 0.04). No significant differences were found between the groups in other maternal and newborn outcomes.

Conclusions

Supervised exercise during pregnancy, which included pelvic floor muscle training, effectively reduced the incidence of UI in late pregnancy and at 3 months postpartum.
Professional development for Indonesian elementary school teachers: Increased competency and sustainable teacher development programs
Authors: . Rasmitadila , Rachmadtullah Reza , Prasetyo Teguh , Humaira Megan Asri , Sari Diah Andika , Samsudin Achmad , Nurtanto Muhammad , . Fitriyani , ZamZam Rohimi
Published: November 2024

Background Various problems, such as a shortage of teachers, especially in certain outlying and underdeveloped provinces, unequal distribution of teachers, low teacher competency, and mismatch between educational qualifications and scientific fields, as well as the demands of increasingly dynamic developments in science and technology, resulting in the need for professional development for elementary school teachers to improve teacher professionalism in Indonesia. These background as a basis for the government to create teacher professional education program for elementary school teachers continuously. It is hoped that it will be able to answer the educational problems facing the Indonesian nation. This research explores the opinions of elementary school teachers who have participated in teacher professional development activities through the in-service teacher professional education program. Methods We collected data through a written survey of 24 elementary school teachers, as well as article documents relevant to the research topic. Data were analyzed using thematic analysis. Result The research produced two main themes: increasing teacher competencies and sustainable teacher development programs. Increasing teacher competency related to social competence, pedagogical competence and professional competence. The sustainable teacher development program is related to the guaranteeing the instructional quality of post-program and multi-sectoral collaboration Conclusion Developing teacher professionalism through teacher professional education program in elementary schools in Indonesia positively impacts teachers’ becoming professional teachers. Teacher professional education program is an indication of improving teacher professionalism, especially in developing teaching skills, improving the quality of instruction, teacher motivation and individual development in dealing with various problems in instruction in the classroom, especially in elementary schools, so that the instructional objectives that have been set can be achieved. The professionalism of elementary school teachers will improve if there are sustainable programs such as mentoring programs from the government, universities and parties that focus on improving the quality of education in Indonesia