bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of precision radiotherapy for the management of cancer-related pain in the abdomen
Authors: Glynn Aisling M. , Lawrence Yaacov R. , Dawson Laura A. , Barry Aisling S. 
Published: December 2024

Purpose of review
Abdominal pain due to cancer is a significant and debilitating symptom for cancer patients, which is commonly undertreated. Radiotherapy (RT) for the management of abdominal cancer pain is underused, with limited awareness of its benefit. This review presents a discussion on current precision RT options for the management of cancer pain in the abdomen.

Recent findings
Precision RT focuses on delivering targeted and effective radiation doses while minimizing damage to surrounding healthy tissues. In patients with primary or secondary liver cancer, RT has been shown to significantly improve liver related cancer pain in the majority of patients. Also, symptom sequelae of tumour thrombus may be relieved with the use of palliative RT. Similarly, single dose, high precision stereotactic RT to the celiac plexus has been shown to significantly improve pain in patients with pancreatic cancer. Pain response for adrenal metastases has been less commonly investigated, but small series suggest that stereotactic body RT may reduce or alleviate pain.

Summary
RT is an effective option for the treatment of abdominal cancer pain. RT should be considered within the multidisciplinary treatment armamentarium, and may be successfully integrated, alone or in conjunction with other treatment modalities, in abdominal cancer-related pain.
Palliative radiation therapy for locally advanced breast cancer
Authors: Ciocon Stephen L.B. , Sousa Cecília F.P.M. , Marta Gustavo N. , Kwan Jennifer Y.Y. 
Published: December 2024

Purpose of review
Globally, breast cancer is the most commonly diagnosed cancer in women. Locally advanced breast cancers (LABCs) may necessitate palliative radiation therapy (RT) due to the severity of the patients’ symptoms, inoperability, or other reasons precluding curative-intent treatment such as poor performance status and patient comorbidities. This review aims to discuss current evidence on palliative RT in LABC.

Recent findings
Advanced targeted RT techniques have led to improvements in local control with reduced treatment-related toxicities. Emerging short-course palliative RT prescriptions offer feasible options that avoid delay in systemic therapy. Additionally, recent studies also highlight approaches for integrating palliative RT with systemic therapies.

Summary
Palliative RT plays a vital role in managing symptoms and enhancing quality of life for LABC patients. However, there is currently no consensus on the optimal prescriptions for palliative RT in these patients. Standardized reporting of palliative RT studies is needed for robust comparison of efficacy and toxicity between various treatment regimens. Furthermore, future research on the optimal integration of RT with novel systemic agents is needed.
Penetrating cardiac injuries: What you need to know
Authors: Parreira José Gustavo , Coimbra Raul 
Published: December 2024

ABSTRACT
Despite significant advances in trauma surgery in recent years, patients sustaining penetrating cardiac injuries still have an overall survival rate of 19%. A substantial number of deaths occur at the scene, while approximately 40% of those reaching trauma centers survive. To increase survival, the key factor is timely intervention for bleeding control, pericardial tamponade release, and definitive repair. Asymptomatic patients sustaining precordial wounds or mediastinal gunshot wounds should be assessed with chest ultrasound to rule out cardiac injuries. Shock on admission is an immediate indication of surgery repair. Patients admitted in posttraumatic cardiac arrest may benefit from resuscitative thoracotomy. The surgical team must be assured that appropriate personnel, equipment, instruments, and blood are immediately available in the operating room. A left anterolateral thoracotomy, which can be extended to a clamshell incision, and sternotomy are the most common surgical incisions. Identification of cardiac anatomical landmarks during surgery is vital to avoid complications. There are several technical options for bleeding control, and the surgeon must be trained to use them to obtain optimal results. Ultimately, prioritizing surgical intervention and using effective resuscitation strategies are essential for improving survival rates and outcomes.
Balanced Electrolyte Solutions Versus 0.9% Saline for Kidney Transplantation: An Updated Systematic Review and Meta-analysis
Authors: Wan Susan S. , Wyburn Kate , Chadban Steven J. , Collins Michael G. 
Published: December 2024

Background.
Perioperative intravenous fluids are administered to kidney transplant recipients to maintain hemodynamic stability and graft perfusion; however, the ideal fluid remains uncertain. Although 0.9% saline (saline) is commonly used, its high chloride content causes hyperchloremic metabolic acidosis and may increase the risks of delayed graft function (DGF) and hyperkalemia. Balanced electrolyte solutions (BES) have a more physiological chloride concentration and may reduce these risks. Previous meta-analyses found insufficient evidence to compare BES with saline for these outcomes; however, new studies have recently been published. In this updated review, we compared the effects of BES with saline on the risk of DGF and hyperkalemia in kidney transplantation.

Methods.
MEDLINE, Embase, and CENTRAL were searched for randomized controlled trials comparing BES with saline in kidney transplantation. The primary outcomes were DGF and hyperkalemia. Eligible studies were assessed for risk of bias and data were pooled for analysis. The Grading of Recommendations Assessment, Development, and Evaluation framework was used to assess the quality of evidence.

Results.
Ten studies involving 1532 participants were included. The quality of evidence was high for deceased donor transplantation and very low for living donor transplantation. The relative risk (RR) of DGF associated with BES compared with saline was 0.83 (95% confidence interval [CI], 0.71-0.96; P = 0.01) in deceased donor transplantation. There was no difference in DGF in living donor transplantation (RR 0.79; 95% CI, 0.26-2.41; P = 0.68). There was no difference in hyperkalemia between groups (RR 0.87; 95% CI, 0.59-1.27; P = 0.46).

Conclusions.
Compared with saline, BES reduces the risk of DGF in deceased donor kidney transplantation without increasing hyperkalemia.
Utilizing Connectome Fingerprinting functional MRI models for motor activity prediction in presurgical planning: a feasibility study
Authors: Tripathi Vaibhav , Rigolo Laura , Bracken Bethany , Galvin Colin P. , Golby Alexandra J. , Tie Yanmei , Somers David C 
Published: December 2024

AbstractPresurgical planning prior to brain tumor resection is critical for the preservation of neurologic function post-operatively. Neurosurgeons increasingly use advanced brain mapping techniques pre- and intra-operatively to delineate brain regions which are “eloquent” and should be spared during resection. Functional MRI (fMRI) has emerged as a commonly used non-invasive modality for individual patient mapping of critical cortical regions such as motor, language, and visual cortices. To map motor function, patients are scanned using fMRI while they perform various motor tasks to identify brain networks critical for motor performance, but it may be difficult for some patients to perform tasks in the scanner due to pre-existing deficits. Connectome Fingerprinting (CF) is a machine-learning approach that learns associations between resting-state functional networks of a brain region and the activations in the region for specific tasks; once a CF model is constructed, individualized predictions of task activation can be generated from resting-state data. Here we utilized CF to train models on high-quality data from 208 subjects in the Human Connectome Project (HCP) and used this to predict task activations in our cohort of healthy control subjects (n=15) and presurgical patients (n=16) using resting-state fMRI (rs-fMRI) data. The prediction quality was validated with task fMRI data in the healthy controls and patients. We found that the task predictions for motor areas are on par with actual task activations in most healthy subjects (model accuracy around 90-100% of task reliability) and some patients suggesting the CF models can be reliably substituted where task data is either not possible to collect or hard for subjects to perform. We were also able to make robust predictions in cases in which there were no task-related activations elicited. The findings demonstrate the utility of the CF approach for predicting activations in out-of-sample subjects, across sites and scanners, and in patient populations. This work supports the feasibility of the application of CF models to presurgical planning, while also revealing challenges to be addressed in future developments.
Practices of midwives in the management of postpartum haemorrhage: A case of Maseru, Lesotho
Authors: Chabeli Mpho , Nyangu Isabel , Mpemi Regina 
Published: December 2024

AbstractPostpartum haemorrhage (PPH) remains the common cause of maternal mortality. More than half of maternal deaths from PPH occur within 24 hours of delivery and could be prevented through midwives’ compliance with guidelines and standards for clinical practice. This study aimed to assess the midwives’ practices regarding the management of PPH in Maseru Lesotho. A quantitative cross-sectional study was undertaken. Convenience sampling was used to select 220 midwives who voluntarily completed a structured self-administered questionnaire. Ethical clearance was granted by the Ministry of Health Research and Ethics Committee. Data was analysed using Statistical Package for Social Science and presented using descriptive and analytic statistics. Midwives were competent with estimation and recording blood loss, placenta assessment and vital signs of patients. There was a significant association between the highest education qualification and midwives who estimate and record blood loss, palpate and measure the uterine fundus and assess the completeness of the placenta. The results revealed a significant association between work experience, uterine fundus measurement and estimated blood loss. Midwives reported to practice management of PPH based mostly on guidelines. However, many midwives still disregard recommendations, putting patients at risk hence the need to intensify supervision to ensure safe practices.
A Novel Truncating Variant in MYBPC3 Causes Hypertrophic Cardiomyopathy
Authors: Zhang Yuanyuan , Gong Wenyan , Cong Yusheng , Zhang Xingwei , Zheng Zhelan 
Published: December 2024

AbstractBackgroundFamilial hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease. Related mutations contributing to hypercontractility and poor relaxation in HCM have been incompletely understood. The purpose of this study was to explore and verify a novel variant in cardiac myosin-binding protein C3 (MYBPC3) in a HCM family.MethodsClinical information was collected and cardiac evaluation was performed in the pedigree. Second-generation sequencing technology was used to investigate the proband and his family. Computational prediction of mutation effects at genomic level and 3D visualization of the mutated protein were achieved by in silico analysis.ResultsTypical interventricular septal thickening was detected in all the four HCM patients. A c.1042_1043insCGGCA mutation of MYBPC3 was verified in the proband and family members. Mild phenotype associated with delayed onset and relative favorable prognosis were observed in the pedigree. In silico analysis of the mutation revealed that c.1042_1043insCGGCA led to an early termination of MYBPC protein synthesis at C2 domain, losing the domains that are essential for myosin-and titin-binding.ConclusionThe novel c.1042_1043insCGGCA mutation of MYBPC3 was a genetic basis for HCM.Our gene sequence based computational analysis predicted the pathogenicity of the mutation by correlating MYBPC3 genotypes with clinical phenotypes.
Implementation and enforcement of mandatory calorie labelling regulations for the out-of-home sector in England: qualitative study of the experiences of business implementers and regulatory enforcers
Authors: Essman Michael , Bishop Tom , Burgoine Thomas , Jones Andrew , Polden Megan , Robinson Eric , Sharp Stephen J. , Smith Richard , Adams Jean , White Martin 
Published: December 2024

AbstractBackgroundMandatory calorie labelling on menus of large out-of-home food outlets was implemented in England on 6 April 2022. Barriers and facilitators that were unforeseen before implementation may modify policy impacts. As part of a process evaluation of the policy, we studied the implementation process, examining business experiences and enforcement by local authorities (LAs) to identify barriers and facilitators in achieving the policy goals.MethodsUsing purposive sampling, we recruited 11 employees of large food businesses (implementers) and 9 employees of LA environmental health or trading standards departments (enforcers). Post-implementation semi-structured interviews were conducted by video conference. Interviews were audio recorded, transcribed verbatim and analysed using the Framework Method.ResultsBoth groups of participants described a decentralised approach to delivery and enforcement, and resource constraints meant LAs were unable to assist with all business inquiries. Enforcement activity was limited because complaints about labelling from the public were rare, and enforcers prioritized acute food safety issues. Pre-implementation discussions created the presumption among enforcers that most businesses were compliant. Businesses complied to safeguard their reputation and maintain customer trust. While participants supported calorie labelling, potential barriers to policy impact included a presumed lack of customer interest. Financial pressure during implementation strained business resources, and businesses suggested that customers may prioritise financial over health concerns in their decision-making.ConclusionsThese findings underscore the need for central guidance, verification of adherence, and sufficient enforcement resources. To optimize policy success, future developments should consider economic contexts, customer expectations, and policy refinement, while recognizing common industry arguments against policy implementation.
Diabetics in the United Arab Emirates at higher risk of foot ulceration-Clinical Implications from Kinetics at Ankle Joint
Authors: Hazari Animesh , Kumar Praveen , Kumar Shashi 
Published: December 2024

AbstractIntroductionThe prevalence of diabetes mellitus in the United Arab Emirates stands significantly high. Considering the etiopathogenesis for diabetic foot ulcers, studies suggest that increased plantar pressure, also referred to as the peak plantar pressure beyond a threshold value leads to the breakdown of skin and thus causes an ulcer. The accurate analysis of ground reaction force and peak plantar pressure could be suggestive and predictive for the occurrence of foot ulceration among diabetes mellitus and the study aims to analyze the kinetics at the ankle joint among diabetics in the UAE.MethodologyThe cross-sectional study was conducted at the Thumbay Physical Therapy and Rehabilitation Hospital, Gulf Medical University, Ajman, United Arab Emirates. 38 out of a total of 120 participants screened and diagnosed with Type 2 diabetes mellitus were taken for data collection and analysis. BTS motion analysis and Wintrack foot scan mat were used for kinetics at the ankle joint.ResultsHigher mean peaks of plantar pressure, 810, 654, and 911 kPa respectively were found at all three phases of the gait cycle. A positive and high correlation was found between peak plantar pressure risk of foot ulcer (r= 0.84). A negative and moderate correlation was observed for ankle joint moment and power.ConclusionThe diabetic population in the United Arab Emirates could be at higher risk of foot ulceration with significantly increased peak plantar pressure. The altered kinetics such as reduced ankle joint moment and power could further add to the risk.
Mapping Referred Sensation In Traumatic Brachial Plexus Injury Patients
Authors: Schmaedeke Ana Carolina , Erthal Fátima S. , Vargas Claudia D. , Ramalho Bia L. 
Published: December 2024

AbstractBackgroundReferred sensation (RS) is described as the sensation evoked in the skin areas other than the stimulated region. The aim of the study was to identify and map RS in traumatic brachial plexus injury (TBPI) patients through a standardised assessment.MethodsIn Experiment 1, 12 patients underwent an RS screening by stimulating 22 skin areas distributed in both upper limbs, neck, and face with a cotton swab. In Experiment 2, a detailed RS mapping employing Semmes-Weinstein monofilament was performed at the reinnervated forearm of three subjects who showed RS in experiment 1 screening. In one of these patients, RS mapping was performed over a time span of 6.3 years.ResultsScreening of TBPI patients submitted to different reconstructive surgeries revealed RS only in the patients who underwent intercostal to musculocutaneous nerve (ICN-MCN) transfer. RS systematic mapping of these patients revealed a unique distribution in the forearm and the chest, without any clear topographic organisation. Longitudinal assessment in one of the tested participants showed a scattered expansion of the RS throughout time.ConclusionsThis is the first study to map systematically the RS in patients with TBPI. RS was identified only after ICN-MCN transfer. A possible explanation for this phenomenon is that the greater distance between the representations of the donor and receptor nerves at the primary somatosensory cortex (S1) could constrain plastic reorganisation and thus limit the disentangling of the forearm and chest sensations.
Automated visual acuity estimation by optokinetic nystagmus using a stepped sweep stimulus
Authors: Turuwhenua Jason , LinTun Zaw , Norouzifard Mohammad , Edmonds Misty , Findlay Rebecca , Black Joanna , Thompson Benjamin 
Published: December 2024

ABSTRACTPurposeMeasuring visual acuity (VA) can be challenging in adults with cognitive impairment and young children. We developed an automatic system for measuring VA using Optokinetic Nystagmus (OKN).MethodsVA-OKN and VA by ETDRS (VA-ETDRS) were measured monocularly in healthy participants (n=23, age 30±12). VA was classified as reduced (n=22, >0.2 logMAR) or not (n=24, ≤0.2 logMAR) in each eye. VA-OKN stimulus was an array of drifting (5 deg/sec) vanishing disks presented in descending/ascending size order (0.0 to 1.0 logMAR in 0.1 logMAR steps). The stimulus was stepped every 2 seconds, and 10 sweeps were shown per eye. Eye tracking data determined when OKN activity ceased (descending sweep) or began (ascending sweep) to give an automated sweep VA. Sweep traces were randomized and assessed by a reviewer blinded to VA-ETDRS. A final per sweep VA and VA-OKN was thereby determined.ResultsA single randomly selected eye was used for analysis.VA deficit group:There was no significant difference between overall mean VA-OKN and VA-ETDRS (p>0.05, paired t-test) and the r2statistic was 0.84. The 95% limits of agreement were 0.19 logMAR.No VA deficit group:There was a 0.24 logMAR bias between VA-OKN and VA-ETDRS and no correlation was found (r2= 0.06). However, the overall sensitivity/specificity for classification was 100%.ConclusionsA robust correlation between VA-ETDRS and VA-OKN was found. The method correctly detected a VA deficit.Translational relevanceOKN is a promising method for measuring VA in cognitively impaired adults and pre-verbal children.
Machine Learning Models for the Prediction of Early-Onset Bipolar Using Electronic Health Records
Authors: Wang Bo , Sheu Yi-Han , Lee Hyunjoon , Mealer Robert G. , Castro Victor M. , Smoller Jordan W. 
Published: December 2024

AbstractObjectiveEarly identification of bipolar disorder (BD) provides an important opportunity for timely intervention. In this study, we aimed to develop machine learning models using large-scale electronic health record (EHR) data including clinical notes for predicting early-onset BD.MethodStructured and unstructured data were extracted from the longitudinal EHR of the Mass General Brigham health system. We defined three cohorts aged 10 – 25 years: (1) the full youth cohort (N=300,398); (2) a sub-cohort defined by having a mental health visit (N=105,461); (3) a sub-cohort defined by having a diagnosis of mood disorder or ADHD (N=35,213). By adopting a prospective landmark modeling approach that aligns with clinical practice, we developed and validated a range of machine learning models including neural network-based models, across different cohorts and prediction windows.ResultsWe found the two tree-based models, Random forests (RF) and light gradient-boosting machine (LGBM), achieving good discriminative performance across different clinical settings (area under the receiver operating characteristic curve 0.76-0.88 for RF and 0.74-0.89 for LGBM). In addition, we showed comparable performance can be achieved with a greatly reduced set of features, demonstrating computational efficiency can be attained without significant compromise of model accuracy.ConclusionGood discriminative performance for early-onset BD is achieved utilizing large-scale EHR data. Our study offers a scalable and accurate method for identifying youth at risk for BD that could help inform clinical decision making and facilitate early intervention. Future work includes evaluating the portability of our approach to other healthcare systems and exploring considerations regarding possible implementation.