bluuebunny/crossref_metadata_2025 huggingface dataset:
Second peak of myocardial markers predicts in-hospital adverse outcomes after primary PCI for ST-segment elevation myocardial infarction
Authors: Niu Xiaodou , Ma Yuanji , Cui Xiaotong , Gao Wei , Xia Yan , Wu Shujing , Zhang Meng , Chen Yaolin , Guan Lihua , Wu Hongyi
Published: August 2024

Background
A second peak of high-sensitivity cardiac troponin T (hs-cTnT) after reperfusion therapy in acute myocardial infarction (AMI) patients was reported, while the causes and clinical meanings remain controversial.
Methods
In this retrospective study, we enrolled patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI). The association between second peak of myocardial markers, including creatine kinase-MB (CK-MB) and hs-cTnT and clinical outcomes, D-dimer (D-D), cardiac structure and function were analyzed. The main study outcome was in-hospital major adverse cardiovascular events (MACE), including cardiac death, non-fatal AMI, revascularization and stroke.
Results
A total of 264 patients were included in the study, with an average age of 63 ± 12 years. Of these, 220 were male. Second peak of cardiac markers including hs-cTnT and CK-MB of STEMI patients after PPCI was universal: The proportion of STEMI patients with secondary elevation of cardiac troponin T (cTnT) was 62.8%, while CK-MB 28.8%. Maximum D-D during hospitalization independently predicted second myocardial markers elevation. STEMI patients with second cardiac markers elevation after PPCI had a worse in-hospital composite endpoint.
Conclusions
D-D was an independent predictor of secondary cardiac markers elevation in STEMI patients after PPCI. Patients with second peak of cardiac markers had a worse outcome.
The Effects of Perturbation Intensities on Backward Slip-Falls Induced by a Split-belt Treadmill
Authors: Lee Chihyeong , Ahn Jooeun , Lee Beom-Chan
Published: August 2024

Fall-inducing systems have two critical applications. One is to obtain the biomechanical features of falling, and the other is to systematically train individuals and reduce the risk of falling. While the former application necessitates the actual occurrence of falls, the latter does not require fall-inducing perturbations to be excessively intense. This study investigated the effects of perturbation intensities (a combination of speeds and durations) on the number of falls, fall rates, and maximum loading forces resulting from backward slips induced by a split-belt treadmill. Twenty-four healthy young adults (12 males and 12 females), naïve to the purpose of the study, completed 16 randomized trials, including 12 perturbation trials and 4 false trials. The forces between a safety harness and a rail were used to identify falls and non-falls and to assess the maximum loading force during falls. Although the number of falls, fall rates, and maximum loading force significantly increase as the slipping speed increases for both durations, the relative risk analysis shows that fall risk significantly increases as the slipping speed increases regardless of the duration. These findings can contribute to establishing design criteria for controlled perturbations in studies on the biomechanics of falls and fall prevention training.
Prediction and classification the risk of stroke patients using data mining techniques
Authors: alizadeh-dizaj ghasem , khoshsirat shiva
Published: August 2024

Background
Stroke is one of the most common causes of death and neurological disabilities in all societies. The use of data mining techniques to create predictive models is very helpful in identifying people at risk to reduce the complications of the disease. The purpose of this study was to investigate the performance of data mining algorithms and predict the risk of stroke in suspected stroke patients using decision tree based on the risk factors that affect it.
Methods
The study analyzed medical records of 1184 stroke-suspected patients presenting at an Emergency Department using data mining algorithms. Attributes such as age, primary diagnoses, gender, blood pressure, smoking, diabetes, and other relevant factors were considered. The dataset was preprocessed to handle missing and incompatible data. Algorithms like Naïve Bayes, Neural Network, kNN, SVM, and Classification Tree were applied, with a training-test data split of 70 − 30 using K-fold Cross Validation.
Results
Among the data mining algorithms used, kNN demonstrated the highest accuracy (97.30%), sensitivity (98.75%), specificity (98.72%), and F1 criteria (98.66%) in predicting stroke severity. Physical inactivity, high cholesterol, cardiovascular disease, history of transient ischemic attack, and high blood pressure emerged as the most influential risk factors for stroke severity. Decision Tree analysis provided valuable insights into the relationship between risk factors and stroke severity.
Conclusion
Data mining techniques proved effective in identifying risk factors and predicting stroke severity, showing promise in enhancing stroke management strategies. The study highlighted the importance of physical inactivity and other key risk factors in stroke prediction. Consistency in risk factor importance across studies suggests common underlying factors, while acknowledging variations based on geographic and lifestyle factors.
Echocardiographic Hemodynamics Correlate with Differences in DOAC-specific Bleeding and Stroke Rates in Non-Valvular Atrial Fibrillation
Authors: O’Shea Michael P , Yusuf Ali , Habib Eiad , Ravi Srekar , Karikalan Suganya Arunachalam , Chao Chieh Ju , Ashraf Hasan , Agasthi Pradyumna , Newton Sam , Scott Robert L , Barry Timothy , Ayoub Chadi , Arsanjani Reza , Masry Hicham El
Published: August 2024

Aims: Direct oral anticoagulants (DOACs) are widely used for stroke prevention in people with non-valvular atrial fibrillation/flutter (NVAF). Anticoagulants have different bleeding profiles. Apixaban is associated with the lowest bleeding risk. This study evaluates the interaction between DOAC used and right ventricular systolic pressure (RVSP) on echocardiogram and bleeding rates. It was hypothesized that pulmonary hypertension may be associated with excess bleeding based on anticoagulant-specific pharmacologic profiles.
Methods & Results: A retrospective analysis of a database was conducted. Multivariable regression models for bleeding rates were developed using a causative analysis approach among participants who had undergone an echocardiogram, and interaction terms for DOAC choice were incorporated. Stratum specific estimates were calculated using linear computation.
Patients taking Apixaban had lower bleeding rates than those taking Rivaroxaban and Dabigatran. Among those without pulmonary hypertension, there was no difference in bleeding rates. Where RVSP was ≥45mmHg, there was a 90% increase in bleeding rates with use of Dabigatran (HR 1.99, p=0.024) and Rivaroxaban (HR 1.86, p=0.042) compared to Apixaban (Figure 1).
Conclusions: Elevated RVSP is associated with excess bleeding in patients taking Rivaroxaban and Dabigatran, but not Apixaban, after controlling for confounding variables.
Exploring the Interplay Between Phytoplankton Taxonomy, Pigments, and Optical Properties in Ratnagiri Coastal Waters using a Multi-Parameter Approach
Authors: Krishna Aswathy Vijaya , Tirkey Anima , Raman Mini , Ali Syed Moosa , Gupta Anurag , Deb Sanjib Kumar , B Srijith
Published: August 2024

This study presents a comprehensive analysis of phytoplankton diversity and optical properties in the coastal waters of Ratnagiri, India. Ratnagiri, located on the southern coast of Maharashtra, is one of the major centre for fishing activities in India as well as a developing hub for industrial activities. Given its ecological significance and the pressures it faces, the coastal waters of Ratnagiri present a valuable case for studying phytoplankton dynamics and their optical properties. We integrated multiple parameters, including phytoplankton taxonomy, pigment composition, coloured dissolved organic matter (CDOM), and absorption characteristics to provide a holistic view of the phytoplankton community and its optical environment. Phytoplankton samples were collected across various sites in Ratnagiri and analyzed using advanced microscopy and high-performance liquid chromatography for taxonomic identification and pigment profiling. CDOM and absorption properties were measured using spectrophotometric methods. Our findings reveal more or less spatial uniformity in phytoplankton composition, with significant diversity within the phytoplankton community. Pigment analysis identified key marker pigments corresponding to various phytoplankton classes majorly bacillariophytes (diatoms), chlorophytes, cyanophytes, haptophytes and cryptophytes. facilitating a deeper understanding of community structure. CDOM analysis indicated varying levels of dissolved organic matter, influencing light absorption and availability in the water column. The absorption data highlighted the specific wavelengths most affected by phytoplankton presence, notably those contributed by diatoms and cyanophytes, providing insights into the optical properties of Ratnagiri's coastal waters. This integrative approach underscores the importance of considering multiple parameters to accurately assess phytoplankton dynamics and their impact on the aquatic environment. The results contribute to a better understanding of the ecological processes governing coastal waters in Ratnagiri and offer valuable information for future monitoring and management efforts.
Differential analysis of clinical outcomes in cerebral infarction associated with REM-OSA and NREM-OSA
Authors: Xu Liwen , Yu Wenyi , Sun Shutong , Zheng Yixi , Xu Gang , Liu Ruonan , Chu Cheng
Published: August 2024

OBJECTIVE
To investigate the relationships among obstructive sleep apnea (OSA), which is primarily characterized by the rapid eye movement (REM) phase, laboratory tests, cerebral infarction location, respiratory events and cerebral infarction clinical prognosis.
METHODS: At the Department of Neurology at the Affiliated Hospital of Yangzhou University, a retrospective cohort study was performed to gather general data, routine blood, magnetic resonance, objective sleep data from the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and polysomnography (PSG), as well as prognostic indicators from the follow-up of patients with cerebral infarction from February 2022 to September 2023. Additionally, the association between the rapid eye movement apnea hypopnea index (REM-AHI) and clinical data was examined using linear regression, and the relationship between the prognosis of cerebral infarction and REM-OSA was examined using binary logistic regression.
RESULTS: After screening 274 OSA patients with cerebral infarction (N = 229) with an AHI ≥ 5, the patients were divided into two groups: REM-OSA (N = 37, 16.2%) and NREM-OSA (N = 192, 83.8%). Multiple linear regression analysis revealed that leukocyte count, BMI and REM-AHI were linearly related. Binary logistic regression analysis revealed a relationship between the mRS score and REM-OSA, and the results of the t test indicated that the mRS score was lower in the cerebral infarction with REM-OSA group.
CONCLUSION: The prognosis for cerebral infarction patients with REM-OSA is worse than that for patients with NREM-OSA, and the differences between NREM and REM potentially suggest a mechanistic difference.
Tumor-associated chromosomal instability drives progression of colorectal adenoma to adenocarcinoma: evidence from 17-year follow-up after adenoma diagnosis
Authors: LI HUI , YANG FANG , BAI BINGJUN , JIANG ZHINONG , Li Bing , FU GUOXIANG , HU XIAOTONG
Published: August 2024

Background
Colorectal cancer (CRC) is a leading cause of cancer-related deaths globally. Adenomas, precursors to CRC, can be diagnosed early, but the genetic events leading to adenoma–adenocarcinoma conversion remain unclear. This study explored the role of chromosomal instabilities (CINs) in this conversion.
Method
Over a 17-year follow-up period, 119 adenomas were analyzed using low-coverage whole-genome sequencing (LC-WGS) and Ultrasensitive Chromosomal Aneuploidy Detector. Risk factors for adenocarcinoma development were identified through logistic regression analysis, and survival was assessed using Kaplan–Meier curves.
Results
CIN was found in 32% of adenomas, with a higher incidence in high-grade adenomas (P = 0.0359). Common chromosomal changes included loss of 18q, 1p, and 17p and gain of 8q (MYC), 20q, and 7p (EGFR). During the 17-year follow-up, 88 patients experienced tumor recurrence, including 40 cases of adenomas and 48 cases of progression to adenocarcinoma. CIN was identified in 40% of progression cases, 33.6% of adenoma recurrence cases, and 26% of nonrecurrent cases. A strong genetic linkage was observed before and after tumor transformation, with a high match between the tumors and matched prior adenomas. CIN was significantly associated with disease progression (HR: 2.5, 95% CI: 1.4–4.5, P = 0.00162) and was an independent risk factor. Additionally, MFN2 gene copy number deletion was linked to recurrence and/or progression after resection, with reduced expression in tumor tissues.
Conclusions
CIN is a key risk factor for adenoma recurrence and progression, and MFN2 gene copy number deletion is associated with adverse outcomes, providing insights for more accurate clinical prognostication of adenoma-to-adenocarcinoma transformation.
Design and Development of a Training Framework for Specialized Nurses in Central Sterile Supply Department: A Modified Delphi Study
Authors: liu jiawei , qin nian , gui fengliu , chen hui
Published: August 2024

Background Improving the essential competencies of nurses in disinfection supply centers is vital, as these nurses act as a principal defense against infections in hospitals. Therefore, it is necessary to develop a unified training system for the training of nurses at the National Disinfection Supply Center . The aim of this study was to develop a scientific training framework for specialized nurses in disinfection supplies to serve as a benchmark for ongoing training at disinfection supply centers.
Methods: The initialdevelopment of the CSSD nurse training system involved an extensive literature review and discussions among expert groups. From April to June 2024, two rounds of Delphi surveys were conducted, and 25 experts in related fields from 9 provinces in China were consulted to reach a consensus on the index system. Descriptive statistics were used to analyze the data. The consensus threshold is set according to the mean (≥3.5), coefficient of variation (<0.25) and full score ratio (≥70%).
Results: The recovery rates of valid questionnaires in the two rounds of expert consultation were 92.59% and 100%, respectively, and the average authority coefficient of the two rounds was 0.912. In the first round, 13 itemswere modified, 4 items were deleted, 2 items were relocated, and 20 itemswere added. The indicators were not modified in the second round. Finally, the training process index system of specialized nurses in the disinfection supply center (5 first-level indicators, 12 second-level indicators and 50 third-level indicators) and the training content index system (4 first-level indicators, 24 second-level indicators and 107 third-level indicators) were developed. The Kendall's W coefficients for the training process and training content were 0.199 and 0.187 in the first round and 0.227 and 0.218, respectively, in the second round of consultations (p <0.001).
Conclusion: The training index system for specialized nurses in disinfection supply centers is scientific and reliable and can provide a reference for access, curriculum setting and quality management in the training process of specialized nurses in disinfection supply centers.
New definition of borderline resectable colorectal liver metastasis based on prognostic outcomes
Authors: Chiba Naokazu , Iida Shoma , Nakagawa Masashi , Gunji Takahiro , Yokozuka Kei , Kobayashi Toshimichi , Sano Toru , Shigoka Masatoshi , Tabuchi Satoshi , Hidaka Eiji , Kawachi Shigeyuki
Published: August 2024

Background
Although surgical resection is the curative treatment for colorectal liver metastases (CRLM), the efficacy of neoadjuvant chemotherapy (NAC) has been discussed due to recent remarkable advances in chemotherapy. The definition of borderline resectable (BR) is most important, where neoadjuvant chemotherapy should be administered. This study aimed to examine a new definition of BR CRLM based on the results of the treatment outcomes.
Methods
This study included 127 patients who underwent liver resection for CRLM after exclusion of conversion cases between April 2010 and December 2023. Upfront resection was performed for synchronous and single liver metastasis or metachronous liver metastases. NAC was administered for multiple synchronous liver metastases. In order to find a new definition of BR, we examined the prognostic factors obtained from the treatment outcomes.
Results
CA19-9 level >37.0 was the only prognostic factor in the upfront group [hazard ratio (HR) 2.386, 95% CI, 1.583–4.769; p=0.049]. in the NAC group, a maximum tumor diameter ˃3 cm (HR 2.248, 95% CI 1.038–4,867, p=0.040), CA19-9 level >37.0 (HR 2.239, 95% CI 1.044–4.800, p=0.038), and a right-sided primary tumor in the colon (HR 2.770, 95% CI 1.284-5.988, p=0.009) were identified as significant prognostic factors.
Conclusions
In cases of CRLM, patients with CA19-9 levels >37.0, or CA19-9 level with <37.0 but with a primary tumor in the right colon or a maximum tumor diameter of >3 cm can be defined as BR CRLM and should be treated with NAC.
Post-Pandemic Study on Self-Reported Long Covid and its Determinants in a Rural North Indian Adult Population
Authors: Senjam Suraj Singh , Goel Garima , Manna Souvik , Balhara Yatan Pal Singh , Gupta Yashdeep , Ray Animesh , Lomi Neiwete
Published: August 2024

Background
Most studies on long COVID-19 symptoms (LCSs) have been conducted in urban areas or in hospital-based settings. To date, relevant evidence on LCSs from community-based rural studies is lacking. Therefore, the present study aimed to investigate LCSs and their determinants in a rural adult population of northern India.
Methods
A population-based cross-sectional study was conducted in a rural predominant district, Jhajjar, Haryana, in 2023. A total of forty clusters were covered from one randomly selected subdistrict. The semistructured questionnaire on the SurveyMonkey platform consisted of questions related to sociodemographic profile, health problems, preexisting morbidity, LCSs, and functional difficulties. The data regarding infection with COVID-19 were collected based on self-reported positive RT‒PCR results for SARS-CoV-2.
Results
Out of the 3700 eligible individuals identified, 2954 (79.8%) were surveyed. Based on a self-reported positive test, the rate of past COVID-19 infection was 6.2% (183/2954, 95% CI: 5.3–7.1). Furthermore, approximately 23% (42/183, 95% CI: 17.01–29.7) of the infected patients had LCS, whereas 1.4% (42/2954) of the study population had LCS. The prevalence of LCSs was greater in females than in males (28.7% vs 17.7%). Weakness (14, 33.4%), weight loss (6, 14.3%), memory problems (6, 14.3%) and headache (4, 9.5%) were common reported LCSs. Univariable analysis revealed a significant association between LCSs and age groups of 26–35 years (OR 0.32, 95% CI: 0.10–0.83, p value = 0.019), lower education (OR 4.46, 95% CI: 1.47–13.78, p value = 0.003), preexisting morbidities such as seeing difficulty (OR 2.91, 95% CI: 1.09–7.58, p value = 0.021), difficulty in self-care (OR 3.72, 95% CI: 1.07–12.88, p value = 0.021), and communication difficulties (OR 5.28, 95% CI: (0.76–45.74, p value = 0.046). The multivariable analysis also revealed a similar pattern.
Conclusion
One-fifth of those who were previously infected with COVID-19 had developed LCSs. A greater probability of LCSs was found among older females, participants with less education, and participants with preexisting comorbidities.
A machine learning-based model for assessing the risk of new-onset liver injury following cardiac surgery under cardiopulmonary bypass
Authors: Zheng Zhuo , Luo Jiawei , Yang Liren , Wang Yishun , Yang Xiaoyan , Zhou Xiaobo , Guo Yingqiang , Du Lei
Published: August 2024

Objective:
This study aimed to develop and validate a predictive model for assessing the risk of new-onset liver injury following cardiac surgery under cardiopulmonary bypass (CPB), using non-redundant and informative features extracted from electronic health records.
Materials and Methods:
We employed machine learning algorithms including Generalized Additive Model (GAM), Random Forest, XGBoost, LightGBM, and Fully Convolutional Network (FCN) to construct the models using data from 5,364 patients at a large medical center in China, and validated these models with an independent dataset of 1,207 patients from another center. A three-stage feature selection process was used to refine the input variables.
Results:
The GAM model displayed the best performance with good predictive accuracy in both internal and external validations, despite a noticeable performance decline in the external dataset potentially due to differences in feature distributions. The most impactful factors included CPB time, cryo time, and preoperative bilirubin levels.
Conclusion:
The predictive model developed provides a valuable tool for early identification of patients at risk of postoperative liver injury, potentially aiding in preventive treatment planning. However, the model requires further prospective validation and optimization for broader application across different medical centers. The model's robustness against clinical practice variations highlights its potential utility in improving patient safety and reducing healthcare costs.
Surgical risk assessment tool for unplanned readmissions (STUR)
Authors: Snyders Pieter , Swart Oostewalt , Lubbe Jeanne
Published: August 2024

Introduction:
There are multiple readmission prediction models available in high-income countries (HIC) aimed at predicting the risk of readmission within 30 days of discharge after surgical intervention. The accurate prediction of a patient’s individual readmission risk allows for targeted outpatient follow-up and early recognition and management to decrease morbidity, mortality, and cost. There are limited risk prediction models available for low-middle income countries (LMIC).
Methods:
This is a weighted prediction model development study, using prospective electronically captured data including all patients undergoing surgical intervention at a large regional hospital in South Africa, from January 2014 to December 2017. The discriminative performance of the predictive model was assessed using receiver operating characteristic (ROC) analysis based on multivariate logistic analysis of previously identified risk factors for readmission, with temporal validation performed on the 2018 surgical patient cohort.
Results:
In total 5588 patients were included with 200 (3.6%) readmitted within 30 days. Univariate analysis identified the following risk factors for readmission: major operative magnitude, emergency operation, higher operative wound classification, and unplanned reoperation. Multivariate analysis revealed that operative wound classification III and IV (OR = 2.5, p < 0.001), unplanned reoperation (OR = 17.4, p < 0.001) and malignancy (OR = 1.9, p = 0.04) were significant predictors of readmission within 30 days. Comparing weighted multivariate analysis findings, a cut-off score of 25 demonstrated optimal sensitivity (>0.75) and 1-specificity (<0.25) for predicting readmission within 30 days. Findings using ROC analysis revealed that the derivation group had an area under the curve (AUC) of 0.82 compared to 0.78 in the temporal validation group.
Conclusion:
The predictive model named theSurgical Risk Assessment Tool for Unplanned Readmissions (STUR) has been developed and internally validated in a LMIC and can be easily applied at discharge.It enables accurate risk stratification and potential targeted follow up.
Sialadenitis Associated with Sialolith in the Parotid Duct - minimal intervention with 3D printed drain - Case Report
Authors: Neto Sebastião Orestes Pereira , Rozendo Daiana Moreira Mendes , Pernambuco Caroline Miranda , Oliveira Carine Ervolino , Hanemann João Adolfo Costa , Reis Leonardo Amaral
Published: August 2024

A woman, 67-year-old, leucoderma was referred by a dentist to the Stomatology Clinic of the School of Dentistry at UNIFAL, presenting complaints of pain and facial swelling persisting for approximately 60 days. Extraoral physical examination, swelling and redness were observed on the right side of the face. Intraoral palpation revealed purulent exudate discharge from Stensen's duct. A panoramic radiograph depicted a radiopaque entity. Clinical and imaging findings suggested intraductal parotid sialolithiasis. Surgical removal, accompanied by duct milking, and placement of a 3D-printed drain in the glandular duct, was performed. Histological examination revealed a calcified material not only basophilic but also eosinophilic, consistent with the clinical diagnosis of sialolith. The patient returned after 7 days for drain removal, demonstrating complete healing, and remains under clinical and radiographic surveillance without signs or symptoms of inflammation.
Optimum design of a biodegradable implant for femoral shaft fracture fixation using finite element method.
Authors: Taghipour Sina , Tahami Farid Vakili , Allahverdizadeh Akbar
Published: August 2024

Recent developments in biodegradable implant technology have expanded its use in several medical fields, such as orthopedics, cardiology, dentistry, and tissue engineering. Degradable bone-fixing implants have shown favorable results among others. Degradable implants, consisting of a plate and screws, provide the advantage of completely degrading after efficaciously supporting the broken bone for the required duration. They may even provide nutrients that accelerate the healing process while ensuring sufficient mechanical stability. Magnesium alloys are being considered by researchers as promising options for bone implants due to their natural degradability, good biocompatibility, and ability to lower the chances of long-term complications. The rapid corrosion rate and inferior mechanical properties of magnesium relative to non-biodegradable materials are significant challenges in their clinical usage as implant material. This leads to a loss of structural strength before the broken bone completely heals. Hence This article mainly concentrates on the design of a biodegradable implant plate for a femoral shaft fracture in the walking cycle, considering the plate's dimension, number of screws, biodegradation rate, and sufficient mechanical stability. Using the results of the numerical analyses, the safe zone of the implant plate design is determined based on the implant plate stress and the total displacement of the femur bone. Then, the optimum topology of the plate and appropriate number of screws are determined.
NBS for SCID: only early diagnosis will change the overall survival of the disease?
Authors: Goebel Gabriela Assunção , Cunha Luciana Araújo Oliveira , Minafra Fernanda Gontijo , Pinto Jorge Andrade
Published: August 2024

Severe combined immunodeficiency (SCID) is a heterogeneous genetic disease characterized by severe T-cell lymphopenia with a profound impairment of T- and B-cells’ function and, in some types, also NK cells. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment currently available in Brazil. Late diagnosis and treatment are the main factors affecting the survival of these children. This study aims to describe the demographic, phenotypic, genotypic, and clinical characteristics of twenty SCID patients (including typical SCID, leaky-SCID, and Omenn Syndrome) followed at a Brazilian reference center and correlate this data with their clinical outcome. The children were analyzed into two groups: patients diagnosed early at birth, by newborn screening (NBS) or family history, n=7, and patients with late diagnosis, by clinical presentation, n=13. The 2-year overall survival (OS) of the late group was 29.2%, in contrast to the 2-year OS of the early diagnosis group of 71.4% (p=0.053). Despite the early diagnosis in the first group, the time between diagnosis and HSCT in both groups was similar, with a median of 11 months. The OS after HSCT was not different between the groups (p=0.774). This research shows that early diagnosis alone does not change the prognosis of SCID newborns after HSCT. The reality in developing countries still needs public policies to change the harsh reality of these patients.
Diagnosing Skin Cancer Using Shearlet Transform Multiresolution Computation
Authors: Sikkander Abdul Razak Mohamed , Kolekar Maheshkumar H. , v Vidya Lakshmi , G Theivanathan , K Radhakrishnan
Published: August 2024

Skin cancer diagnosis relies on the accurate analysis of medical images to identify malignant and benign lesions. The Shearlet transform, a powerful mathematical tool for multiresolution analysis, has shown promise in enhancing the detection and classification of skin cancer. This study investigates the application of Shearlet transform-based multiresolution analysis in skin cancer diagnosis. The Shearlet transform, known for its ability to capture anisotropic features and directional information, provides a comprehensive representation of skin lesion images at multiple scales and orientations. We integrate the Shearlet transform with advanced image processing techniques to extract discriminative features from dermoscopic images. These features are then utilized to train a machine learning classifier, specifically a support vector machine (SVM), to distinguish between malignant and benign skin lesions. The proposed methodology is evaluated on a publicly available dataset, and the results demonstrate significant improvements in diagnostic accuracy compared to traditional methods. Our approach enhances feature extraction capabilities, leading to more reliable and precise skin cancer diagnosis, ultimately contributing to better patient outcomes.
Is systematic biopsy mandatory in all MRI guided fusion prostate biopsies? A machine learning prediction model
Authors: Longo Omer , Neheman Amos , Raviv Gil , Miki Haifler
Published: August 2024

Purpose During MRI/US fusion biopsy targeted and systematic sampling is performed. Systematic sampling adds up to 14% to the cancer detection rate but increases the complication rates. Since, only the highest risk prostate cancer determines the treatment course, systematic sampling with lower risk cancer compared to the targeted sampling is redundant. Our aim is to develop a prediction model to predict which patient will harbor higher risk prostate cancer in the systematic compared to the targeted biopsy in prostate fusion biopsy.Methods We included all patients who underwent fusion biopsy. Clinical and radiographic variables were collected from patients records. The outcome of the model was higher risk prostate cancer in the systematic compared with targeted biopsies. Extreme Gradient boosting model was trained and tested. We evaluated variable importance and clinical benefit.Results Five hundred and twenty-nine patients were included. 82 (15.5%) patients had higher risk prostate cancer in the systematic biopsies. The area under the ROC curve and negative predictive value were 0.82 and 0.92, respectively. The 4 most important features for outcome prediction were prostate volume, PSAD, patient's age and PSA. The decision curve showed increased clinical benefit of our model at threshold probabilities of 0-0.5. Limitations include the retrospective design of the study and lack of external validation of the model.Conclusions We developed a prediction model able to accurately predict which patient must undergo systematic and targeted biopsy. This prediction model has the potential to help in the decision whether to perform SB and thus may lower adverse event rate while keeping high detection rate.
Awareness of Radiation Dose and Related Hazards Among Palestinian Physicians Requesting Radiologic Examinations for Pediatric and Potentially Pregnant Patients
Authors: Daraghmeh Dala N , Ghanim Rania , Awwad Dalia , Jamous Safia , ALMasri Hussein
Published: August 2024

Background
Diagnostic imaging techniques are vital for diagnosing diseases. While the demand for these images is rising globally, it is essential that physicians in Palestine exercise caution, especially when requesting radiological exams for pediatric and possibly pregnant patients. This study aims at assessing physicians' understanding of radiation levels, doses, and risks to determine any changes amid advancements.
Methods
A cross-sectional descriptive study questionnaire was distributed to general physicians, residents, specialists, and internships, who are working in Palestinian hospitals and clinics. The questionnaire consisted of 6 sections: socio-demographic section, level of training and source of education, general radiation knowledge, pediatric radiation knowledge, pregnant radiation knowledge, and radiation risk. The data were presented through descriptive analysis and multivariate regression analysis. The assessment of general knowledge and pediatric radiation knowledge utilized a scoring system in which correct answers were assigned a score of one, while incorrect answers or omissions received a score of zero. Those scoring ≤ 50% were deemed to have poor knowledge, 51–69% were considered fair, and those achieving ≥ 70% were classified as knowledgeable.
Results
A total of 211 physicians participated in the study. 63.5% of them were males, 43.1% of the study sample were specialists. 51.2% confirmed receiving a specific education in the field of diagnostic radiation. The questionnaire results showed an average score of 3.5 out of 10 for general radiation knowledge, 2.1 out of 12 for pediatric knowledge, and 2.3 out of 5 for radiation risk, which was deemed poor.
Conclusion
The study findings align with prior studies indicating a widespread poor level of general knowledge in radiation, pediatric radiation, pregnant radiation, and radiation risk among physicians. This emphasizes the necessity for Palestinian physicians to be updated in the field of radiation dosimetry in medical imaging and to actively engage in official training courses about radiation risks and protection measures.
Women’s Empowerment and the Use of Insecticide-treated Nets for Malaria Prevention in Six sub-Saharan African Countries
Authors: Kwansa Benjamin Kobina , Atobrah Deborah , Adumbire David , Badasu Delali Margaret , Kretchy Irene Akwo
Published: August 2024

Background
Past studies have revealed significant relationships between gender and health outcomes, including malaria prevention. Women tend to exhibit more positive health-seeking behaviours than men. Thus, gender dynamics can influence the adoption of measures to prevent infections, including malaria. This study investigated the role of women’s empowerment indicators in adopting insecticide-treated nets (ITNs) to control malaria in six sub-Saharan African (SSA) countries.
Methods
The data for the study were based on the demographic and health survey (DHS) datasets for the respective countries: Ghana, Uganda, Nigeria, Cameroon, Togo and Burkina Faso. The six countries' datasets were merged, cleaned, harmonized and recoded where necessary. The Pearson chi-square independence test was used to examine the association between ITN use and six women’s empowerment indicators: (1) employment or earning (economic), (2) household decision-making, (3) absence of domestic violence, (4) ownership of property, (5) educational attainment and (6) financial inclusion. Binary logistic regression was employed to examine factors associated with ITN use. SPSSsoftware was used for managing and analysing the data.
Results
Among the 116,088 women surveyed, 60,605 (52.2%) had slept under ITNs the night before the survey. Controlling for individual characteristics and the adoption of ITNs in malaria prevention, the odds of using ITNs improved among women who had high decision-making autonomy (AOR = 1.21; CI = 1.07–1.35; P < 0.05), financial inclusion (AOR = 1.16; CI = 1.08–1.23; P < 0.05), who earned the same as their husbands or partners (AOR = 1.07; CI = 0.98–1.17; P < 0.05), and who had a primary education (AOR = 1.31; CI = 1.17–1.47). The results show that women’s empowerment indicators significantly influenced ITN use. Women’s decision-making autonomy, education, financial inclusion and freedom from domestic violence were positively associated with the uptake of ITNs.
Conclusion
Women’s empowerment is an important element in adopting measures to control malaria infection. Improved women’s empowerment was associated with increased use of ITNs. Efforts to address the challenges associated with malaria elimination and prevention in SSA countries should consider an intentional focus on women’s empowerment indicators for more successful outcomes.
Breaking down healthcare hurdles: understanding the barriers to readiness to seek medical care in the event of illness among residents in Ghana: a community-based cross-sectional study
Authors: Asare Micheal Nii , Salu Samuel , Nyame Charlene Makafui , Charles-Unadike Veronica Okwuchi
Published: August 2024

Background
Optimal health plays a significant role in enhancing one's quality of life, empowering individuals to actively engage in productive endeavors for wealth generation. Recently, the unhealthy lifestyles of individuals resulting from their healthcare-seeking behavior have gained significant attention in research circles, both at the national and international levels, as his issue has become a central concern for healthcare stakeholders worldwide. This study evaluated the barriers to readiness to seek medical care in the event of illness among residents in Ghana.
Methodology:
We employed a community-based cross-sectional study design in this study. A multi-stage sampling technique was used to sample 400 study participants. Data were collected with a paper-based questionnaire, coded and entered into Epi-Data version 4.6.0.2. Data analysis was carried out in STATA V.16.0.
Result
Overall, only 193 (48.2%) out of the 400 participants expressed readiness to seek medical care in the event of illness. Further analysis revealed that participants who were educated to the tertiary level were 4.2 times more likely to seek medical care than those with secondary and primary/JHS levels of education [AOR = 4.2 (95% CI: 1.73–10.25), p = 0.002]. Participants who reported having no form of family support in the event of illness were 0.2 times less likely to seek medical care [AOR = 0.2 (95% CI: 0.11–0.34), p = 0.001]. More specifically, participants who lacked financial support from their family/relatives were 0.4 times less likely to seek medical care in the event of illness [AOR = 0.4 (95% CI: 0.23–0.80), p = 0.008]. Furthermore, participants who were not escorted by their family/relatives to the health facility were also 0.4 times less likely to seek medical care in the event of illness [AOR = 0.4 (95% CI: 0.24–0.74), p = 0.003].
Conclusion
In conclusion, our findings emphasize the complex interrelationship between individual, cultural, and structural factors in shaping healthcare-seeking behavior. Resolving these factors through targeted interventions and policies can enhance healthcare utilization, reduce health disparities, and ultimately contribute to the overall well-being and socio-economic development of the community and the country at large.
A novel prognostic model for colorectal cancer based on epithelial cell marker genes identified and validated by combining Single-Cell and Bulk RNA- Sequencing
Authors: Cai Liyang , Guo Xin , Zhang Yucheng , Xie Huajie , Liu Yongfeng , Zhou Jianlong , Feng Huolun , Zheng Jiabin , Li Yong
Published: August 2024

Background
Colorectal cancer (CRC) is a prevalent malignant tumor characterized by high global incidence and mortality rates. Furthermore, it is imperative to comprehend the molecular mechanisms underlying its development and to identify effective prognostic markers. These efforts are crucial for pinpointing potential therapeutic targets and enhancing patient survival rates. Therefore, We develop a novel prognostic model aimed at providing new theoretical support for clinical prognosis evaluation and treatment.
Methods
We downloaded data from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Subsequently, we performed single-cell analysis and developed a prognostic model associated with colorectal cancer.
Results
We divided the scRNA-seq dataset (GSE221575) into 19 cell clusters and classified these clusters into 11 distinct cell types using marker genes. Using univariate Cox regression and LASSO (Least Absolute Shrinkage and Selection Operator) analyses, we developed a prognostic model consisting of 9 genes. Based on our 9-gene model, we divided patients into high-risk and low-risk groups using the median risk score. The high-risk group demonstrated significant positive correlations with M0 macrophages, CD8 + T cells, and M2 macrophages. The enrichment analyses indicate significant enrichment of immune-related pathways in the high-risk group, including HEDGEHOG_SIGNALING, Wnt signaling pathway, and cell adhesion molecules. Drug sensitivity analysis revealed that the low-risk group was sensitive to 5 chemotherapeutic drugs, while the high-risk group was sensitive to only 1. Additionally, we developed a highly reliable nomogram for clinical application. This suggests that the risk score derived from our modeling analysis is highly effective for stratifying colorectal cancer samples.
Conclusions
This study comprehensively applied bioinformatics methods to construct a risk score model. The model showed good predictive performance, offering potential guidance for individualized treatment of colorectal cancer patients. Furthermore, it may provide valuable insights into the disease's pathogenesis and identify potential therapeutic targets for further research.
Social Development of Kindergarten Children: Teachers Roles in Play Activities in the Nanton District, Ghana
Authors: Mohammed Issah , Sunu Seth
Published: August 2024

Play-oriented activities develop young children physically, emotionally, socially and cognitively. The study explored the contribution of play activities to the social development of kindergarten children in the Nanton District. A qualitative approach using a case study design was used for the study. Purposive sampling techniques was used to select thirty (30) pupils and (20) twenty teachers for the study. A semi-structured interview was used to gather information from respondents. Also, observational checklist was used to gather information to triangulate with the interview data. The data was manually analysed thematically. The results were interpreted using inductive reasoning to draw meanings from the data collected. The findings were that; it was emerged that teachers’ role in kindergarten children’s play promote their social development. Also, the study found that the combination of play types promotes the social skills development of kindergarten children. The study concludes that, the teachers’ role during play was very important as it promoted the children social skills development by providing guidance on difficult plays as well as providing security and engaging them in meaningful play. Also, children who engaged in different types of play significantly improved their social skills development. The researcher recommended that the study recommended that kindergarten teachers should always supervise pupils play activities to ensure their safety, guide them, motivate them and also engage them in meaningful play. Also, the study recommended that kindergarten teachers should engage pupils in varieties of play types to accelerate their social development.
Blood ethylene oxide levels in relation to the progression of hepatic steatosis and liver fibrosis: a cross-sectional study
Authors: Zhao Can , Bian Xuqiang , Li Longsong , Chai Ningli
Published: August 2024

Background: Ethylene oxide (EO) may cause liver damage or transient liver function impairment in humans. The purpose of this study was to investigate the relationship between ethylene oxide exposure and hepatic fibrosis and hepatic steatosis in adults.
Methods: Cross-sectional data were selected from 4531 participants in the 2013-2020 National Health and Nutrition Examination Survey (NHANES). The FIB-4 index and the HSI hepatic steatosis index were used to evaluate liver fibrosis and liver fat content. Men with serum ALT > 30 IU/L and women with serum ALT > 19 IU/L were defined as non-alcoholic fatty liver patients, and FIB-4 > 1.3 was defined as liver fibrosis of different degrees. The relationship between ethylene oxide hemoglobin adjunct (HbEO), inflammatory biomarkers, and liver fibrosis and fatty liver was evaluated using restricted cubic spline plots and multivariate linear regression models. Mediation analysis was used to further evaluate their relevance.
Results: HbEO levels in adults were negatively correlated with the FIB-4 index and HSI index [Q1 VS. Q4, FIB-4: β=0.12 (-0.17, -0.07), HSI: β=-1.30(-1.77, -0.83); p < 0.05], and were negatively associated with liver fibrosis and the risk of non-alcoholic fatty liver disease after correction for confounders [liver fibrosis: OR=0.70(0.49, 1.01), non-alcoholic fatty liver disease: OR=0.89(0.73, 1.08); p < 0.05]. The levels of alkaline phosphatase, leukocytes, lymphocytes, and neutrophils were negatively correlated with the FIB-4 index but positively correlated with the HSI index (all p < 0.05). Mediated analysis showed that exposure to ethylene oxide had different effects on the FIB-4 index and the HSI index through inflammatory mediators.
Conclusions: The present study results show that ethylene oxide exposure is negatively correlated with liver fibrosis and the prevalence of non-alcoholic fatty liver disease and suggest that inflammatory mediators may mediate the relationship between them, but they are not the only mediators, and the mechanism is complex. Further studies are needed to explore how ethylene oxide affects liver function.
Assessment of polygenic risk score performance in East Asian populations for ten common diseases: A Korean cohort study
Authors: Oh Bermseok , Jung Hae-Un , Jung Hyein , Baek Eun Ju , Kang Ji-One , Kwon Shin Young , You Jaeyoon , Lim Ji Eun
Published: August 2024

Polygenic risk score (PRS) uses genetic variants to assess disease susceptibility. While PRS performance is well-studied in Europeans, its accuracy in East Asians is less explored. This study compared East Asian PRS-continuous shrinkage (PRS-CS) from single-population genome-wide association studies (GWAS) with transferability PRS (PRS-CSx) integrating European and East Asian GWAS for ten common diseases in the Health Examinees (HEXA) cohort (n = 55,870) in Korea. PRS-CSx showed significant transferability, improving predictive metrics: likelihood ratio test (LRT) [1.31-fold], odds ratio per 1 standard deviation (perSD OR) [1.04-fold], and net reclassification improvement (NRI) [1.24-fold]. The difference in R2 values between PRS-CS and PRS-CSx, analyzed using the r2redux method, was statistically significant across eight diseases, demonstrating an average increase of 0.35% in R2 for PRS-CSx. Additionally, we compared the relative performance of these East Asian PRSs with their respective European PRSs for seven diseases, resulting in an average performance of 85.69%. Our findings indicate that while transferability enhances the performance of East Asian PRSs, large-scale East Asian GWAS data are essential to bridge the performance gap with European PRSs for effective disease prediction in East Asian populations.