bluuebunny/crossref_metadata_2025_split huggingface dataset:
TDF and its analogs have not survival advantage over entecavir for patients with Hepatitis B Virus-Associated Acute-on-Chronic Liver Failure
Authors: Xu Xinyi , Tu Huilan , Xu Xianbin , Yu Xia , Weng Haoda , Yu Yue , Zhang Xiuding , Zhou Ruoqi , Zhu Wenfeng , Yu Shi , Sheng Jifang 
Published: December 2024

Abstract

Background: Both entecavir and tenofovir are frequently prescribed for HBV-ACLF, however, their comparative efficacy were not fully clarified. The study aimed to compare the survival, virological and liver function response between patients with entecavir and tenofovir and its analogs.
Methods: We retrospectively analyzed 534 patients with HBV-ACLF who were given either entecavir (n= 115) or tenofovir and its analogs (n= 102) in a single medical center in China. The primary endpoints were 28-day and 90-day liver-transplantation-free mortality. Secondary outcomes were changes of serum HBV-DNA and MELD scores.
Results: Over 90-day follow-up, 20.9% died in patients with entecavir, and 11.8% in those with tenofovir and its analogs. The cumulative liver-transplantation-free survival rates were similar between the two groups ( 18.2% and 22.2% for 28-day and 90-day mortality in entecavir group; 5.1% and 12.2% for 28-day and 90-day mortality in tenofovir group, respectively, P= 0.003, and 0.060, respectively). In the multivariate Cox proportional hazard analysis adjusting age, cirrhosis, hepatic encephalopathy, ascites, MELD scores, serum HBV-DNA levels and sex, the types of antivirals was not associated to the 90-day mortality (HR: 0.691, 95% CI: 0.337 to 1.42, P=0.314)(entecavir as the reference). The main findings were consistent with that after PSM or by competing risk model. Beside, the decline of serum HBV-DNA levels and improvement of MELD scores were also comparable between the two groups.
Conclusion: There was no significant difference in the efficacy of entecavir and tenofovir and analogs in treating patients with HBV-ACLF. There findings suggest both entecavir and tenofovir and its analogs can serve as first-line antivirals for HBV-ACLF.
Human Immunodeficiency Virus - Assocciated Hyperthropic Cardiomyopathy Presenting with Chest Pain Suspected with Acute Myocarditis: An Unusual Case Report
Authors: Pramana Ketut Angga Aditya Putra , Suyasa I Putu Gede Eka Ariawan 
Published: December 2024

Abstract

Background: Human Immunodeficiency Virus-associated cardiomyopathy (HIVAC) is a stage 4 disease that is linked to HIV and is still a major cause of illness and death in people who have HIV. The cause of HIVAC and how it shows up in the body depend on how weak the host's immune system is. Myocarditis caused by direct HIV toxicity, opportunistic diseases, and food deficiencies may be a cause of HIVAC. We describe a woman with a low CD4 count who had severe dilated cardiomyopathy caused by HIV.
Case Presentation: A 40-year-old female with HIV receiving antiretroviral therapy presented with severe chest pain that began two hours before hospital admission. Complaints were linked to perspiration and shortness of breath. The vital signs revealed a blood pressure of 80/50 mmHg, a heart rate of 85 bpm, and a respiratory rate of 25 brpm. The electrocardiogram revealed normal sinus rhythm with anteroseptal old myocardial infarction, while echocardiography showed left ventricular hypertrophy, a 77% ejection fraction, septal thickening with asynergic ventricular regions in the inferolateral area, and a suspicion of myocarditis. The CD4 count at admission was reduced to 144 cells/mm3, and the high sensitivity troponin level was increased. She initiated inotropic and vasopressor therapy, a maintenance protocol of dual antiplatelet medicines, anticoagulants, heart failure care, and steroid treatment. After five days of therapy, the patient's symptoms improved, and a referral for magnetic resonance imaging (MRI) was arranged to validate the diagnosis of acute myocarditis.
Conclusion: This instance underscores the significance of antiretroviral therapy (ART) in sustaining adequate CD4 counts and suppressing elevated viral loads to avert opportunistic infections, perhaps serving as a crucial factor in HIVAC.
Menstrual inequity: the ‘stain’ on participation and democracy in South Africa
Authors: Nomsenge Sinazo 
Published: December 2024

Abstract

Healthy experiences of menstruation require access to material and nonmaterial resources including sanitation facilities, privacy and comfort infrastructure, hygiene and pain management products as well as accurate and empowering menstrual education. These resources remain inaccessible for many women and adolescents thereby compromising their participation in various aspects of their socioeconomic advancement including schooling, work, and personal development. For adolescents, inadequate access to essential menstrual resources compromises schooling experiences with research suggesting that in addition to many adolescents missing school during menstruation, the quality of their social and educational participation is significantly impeded by the lack of access to essential resources. Beyond this, limited access to critical resources and infrastructure interferes with women’s work and socioeconomic engagements in ways that compel many to employ menstrual concealment practices that compromise their health, comfort, safety, and ultimately, their equitable participation in social and economic activity. Moreover, stigma and secrecy surrounding menstruation limit open engagements about menstrual needs and challenges thereby making various aspects of society inherently inequitable and incapable of fostering democratic participation. This paper draws on qualitative phenomenological research conducted with 15 women living in uMlazi and Inanda in KwaZulu-Natal, South Africa. In-depth interviews were used to explore participants’ experiences and perceptions on how menstrual inequity influences patterns of socio-economic, educational, and developmental participation among adolescents and women. From data collected, the paper suggests that inadequate access to essential menstrual resources shapes inequitable patterns of participation in schooling, work, social and developmental activity.
Histological Anaplasia and Chromosome 6 Chromothripsis as Predictive Factors of Aggressivity in Low-grade Glioma, MYB/MYBL1-Altered
Authors: Aboubakr Oumaima , Wefers Annika K. , Dangouloff-Ros Volodia , Métais Alice , Sievers Philipp , Roux Alexandre , Hasty Lauren , Saffroy Raphaël , Pierron Gaelle , Guillemot Delphine , Daoud Lina , Adle-Biassette Homa , Samoyeau Thomas , Boddaert Nathalie , Grill Jacques , Pallud Johan , Beccaria Kevin , Blauwblomme Thomas , Varlet Pascale , Tauziède-Espariat Arnault 
Published: December 2024

Abstract

In the Central Nervous System (CNS), MYB/MYBL1 alterations are found in two tumor types: angiocentric glioma (AG), and diffuse astrocytoma (DA). These tumors share clinical features (mainly epileptic pediatric tumors located in the supratentorial area), a histopathological pattern (AG can look like DA) and seem to be associated with comparably favorable prognoses. However, aggressive cases of AG have been reported in the literature, one of them harboring a MYB::QKI fusion. This study aims to compare and contrast aggressive cases of low-grade gliomas (LGGs), MYB/MYBL1-altered to typically indolent cases in order to identify factors (clinical, radiological or histomolecular) associated with aggressive forms of AG and DA. We retrospectively reviewed and fully characterized 28 LGGs (14 AGs and 14 DAs) with MYB/MYBL1 alterations in terms of clinical course, radiology, histopathology and molecular biology (including DNA-methylation profiling). While most AGs and DAs in our cohort had a favorable oncological outcome, we describe three cases of AG and one case of DA with tumor progression and one terminal case of AG. Initial signs of histopathological anaplasia were exclusively found in aggressive AGs (2/3) but their significance in DA is unclear as they were encountered in the aggressive case but also in two indolent cases, and because DA seem to respond well to chemotherapy. Two aggressive AGs also were found to have a chromosome 6 chromothripsis and harbored additional molecular alterations in their initial tumor sample (KRAS, hTERT, and TP53 mutations). No radiological pattern, fusion partner or methylation cluster was associated with progression in LGG, MYB/MYBL1-altered. These cases with an aggressive clinical course raise the question of potential higher grades of LGG, MYB/MYBL1-altered, which need to be confirmed by additional reports.
Developing a Comprehensive Model of Home-Based Long-Term Care for Older People in Iran: A Multi-Method Study
Authors: Mobasseri Khorshid , Ghasemyani Shabnam , Khodayari-Zarnaq Rahim , kousha ahmad 
Published: December 2024

Abstract

Introduction
: With the increasing aging population, the demand for care that fosters independence in older adults is rising. Complications from hospitalization and the preference for aging in place highlight the need for geriatric home care systems. This study aims to develop a comprehensive home-based care model specifically for Iranian seniors and evaluate its feasibility.
Methods
This study employed a multi-phase approach in Iran. It began with a mixed-methods analysis, including a survey on caregiver reliance followed by qualitative interviews to identify challenges in home care services. Phase 2 involved a scoping review of home care frameworks from various countries. In Phase 3, an initial model was created based on previous findings and relevant documents in Iran. In the fourth phase, feedback was gathered from an expert panel selected through purposive sampling, with discussions recorded and concluding at saturation. The feedback was then integrated into the final model. Additionally, in a Delphi study, experts evaluated the model components using a four-point Likert scale, calculating the content validity index (CVI) for each item, where a CVI of 79% or higher indicated validity, and continuous feedback led to iterative refinements.
Results
Following the design of the initial model, an expert panel convened with 15 participants to review the framework. The final model comprises seven key components: leadership & governance, legislative framework, financial framework, human resource management system, information management system, and control & monitoring system. Results from the Delphi study indicated that with a CVI exceeding 80%, this model is deemed a valid framework for delivering home-based care.
Conclusion
This study presents a comprehensive model that serves as a valuable guide for policymakers seeking to implement integrated home care with professional oversight. By doing so, it aims to enhance the quality of care and improve stakeholder satisfaction.
Comparison of the Lethal Triad and the Lethal Diamond in a multicenter cohort from the TraumaBase® registry of severe trauma patients
Authors: Dupuy Charles , Martinez Thibault , Duranteau Olivier , Gauss Tobias , Kapandji Natacha , Pasqueron Jean , Holleville Mathilde , Abdallah Georges Abi , Harrois Anatole , Ramonda Véronique , Huet-Garrigue Delphine , Doublet Téophane , Leone Marc , Legros Vincent , Pottecher Julien , Audibert Gérard , Millot Ingrid , Popoff Benjamin , Cohen Benjamin , Vardon-Bounes Fanny , Willig Mathieu , Gosset Pierre , Angles Emilie , Mellati Nouchan , Higel Nicolas , Boutonnet Mathieu , Pasquier Pierre 
Published: December 2024

Abstract

Background
To reduce the number of deaths caused by exsanguination, the initial management of severe trauma aims to prevent, if not limit, the lethal triad, which consists of acidosis, coagulopathy, and hypothermia. Recently, several studies have suggested adding hypocalcemia to the lethal triad to form the lethal diamond, but the evidence supporting this change is limited. Therefore, the aim of this study was to compare the lethal triad and lethal diamond for their respective associations with 24-hour mortality in transfused severe trauma patients.
Methods
We performed a multicenter retrospective analysis of patients in TraumaBase®, a French database (2011–2023). The patients included in this study were all trauma patients who had received transfusions of at least 1 unit of packed red blood cells (RBCs) within the first 6 hours of hospital admission and for whom ionized calcium measurements were available. Hypocalcemia was defined as an ionized calcium level < 1.1 mmol/L.
Results
A total of 2141 severe trauma patients were included (median age: 39, interquartile range [IQR]: 26–57; median injury severity score [ISS]: 27, IQR: 17–41). Patients primarily presented with blunt trauma (81.7%), and a 24-hour mortality rate of 16.1% was observed. Receiver operating characteristic (ROC) curve analysis revealed no significant difference in the association with 24-hour mortality between the lethal diamond (area under the curve [AUC]: 0.71) and the lethal triad (AUC: 0.72) (p = 0.26). The strength of the association with 24-hour mortality was similar between the lethal triad and the lethal diamond, with Cramer’s V values of 0.29 and 0.28, respectively.
Conclusions
This study revealed no significant difference between the lethal triad and the lethal diamond in terms of their respective associations with 24-hour mortality in severe trauma patients requiring transfusion. These results raise questions about the independent role of hypocalcemia in early mortality.
Challenges in the Diagnosis of Pelvic Fracture-Related Lower Urinary Tract Injury: A 13-Year Retrospective Analysis
Authors: Yang Yu-Kuan , Wang Ta-Ming , Cheng Chi-Tung , Tee Yu-San , Liao Chien-Hung , Hsieh Chi-Hsun , Fu Chih-Yuan 
Published: December 2024

Abstract

Introduction: Pelvic fractures from high-energy trauma are associated with lower urinary tract injuries (LUTI) in 10-15% of cases, leading to significant morbidity if not promptly diagnosed. Bladder and urethral injuries can result in infection, urinary obstruction, and long-term complications. However, diagnosing LUTI in hemodynamically unstable patients remains challenging, often requiring a combination of retrograde cystography, computed tomography (CT) cystography, and retrograde urethrography (RUG). This study reviews 13 years of clinical experience with pelvic fracture-related LUTI, focusing on the diagnostic role of CT imaging.
Materials and Methods: We retrospectively analyzed pelvic fracture cases with hematuria at a tertiary center from 2009 to 2021. All patients received abdominal and pelvic CT scans on admission. We recorded demographic data, injury characteristics, Injury Severity Score (ISS), diagnostic methods, and infection rates. Comparisons were made between patients with bladder and urethral injuries, and between patients with initial positive and negative CT findings of LUTI. Additionally, the clinical characteristics of delayed LUTI diagnosis in patients with severe trauma were summarized
Results: Of 2,865 patients with pelvic fractures, 127 (4.4%) were diagnosed with LUTI. The median age was 36 years, and 76% were male, with a median ISS of 26. Bladder injuries were present in 54% of LUTI cases, urethral injuries in 40%, and combined injuries in 6%. Diagnosis via CT was significantly higher for bladder injuries (58%) than urethral injuries (20%). Among those diagnosed with CT in the emergency department, infection rates and need for further urological imaging were lower. Thirteen patients (10%) had delayed diagnoses, primarily due to initial focus on life-saving interventions. No significant difference in outcomes was noted between early and delayed diagnoses.
Conclusion: CT imaging is valuable for the initial evaluation of pelvic fractures with suspected LUTI, reducing the need for invasive diagnostic studies and aiding early diagnosis. Delays in LUTI diagnosis did not significantly impact outcomes, especially when diagnosis was made within two weeks. Future studies should focus on refining guidelines for early diagnosis in emergency settings where comprehensive urological assessments may be limited.
Robot-assisted Vesicovaginal Fistula Repair with “Rainbow-shaped” Peritoneal Flap : A Single-center Experience
Authors: Yang Yang , Huang Chenchen , Wu Shiliang , Chen Yuke , Shen Cheng 
Published: December 2024

Abstract

Purpose
Vesicovaginal fistula (VVF) refers to an abnormal communication between the bladder and vagina, leading to uncontrolled leakage of urine from the vagina. This study aimed to assess the efficacy and safety of robot-assisted laparoscopic VVF repair with a "rainbow-shaped" peritoneal flap.
Methods
A retrospective analysis was conducted on 15 patients who underwent robot-assisted VVF repair from July 2021 to March 2023 in Peking University First Hospital. The patient cohort included 1 patient who had undergone abdominal hysterectomy, 11 patients who had laparoscopic hysterectomy, 1 patient who had cervical conization, and 2 adolescents with residual intravaginal foreign bodies.
Results
7 had a history of failed VVF repair, while 8 underwent primary repair. The mean operative time was 137 (range: 92–182) minutes, and the mean hospital stay was 4.9 (range: 4.3–5.5) days. Surgical blood loss was minimal, averaging 14 (range: 6–22) ml. The fistula was located supratrigonal in 14 patients and in the triangle area in 1 patient. In the vagina, the fistula was situated at the stump in 12 patients and at the anterior wall or cervix in 3 patients. All procedures were successfully completed without the need for open conversion. All 15 patients achieved successful repair, with no complications reported during the mean follow-up period of 7.8 months.
Conclusion
Robot-assisted laparoscopic repair with a "rainbow-shaped" peritoneal flap for VVF is an effective, safe, and highly successful technique.
Workload in cockpit work on high-speed workboats: How to improve crew performance
Authors: Lehtimäki Mikko , Teperi Anna-Maria 
Published: December 2024

Abstract

This study examined the mental workload (MWL) of cockpit work on high-speed workboats’ (HSWs), as the crews of these boats are exposed to harmfully high and low MWL, which are both detrimental to safety and performance. MWL was measured during observed, real-life voyages using an experimental subjective Likert scale that assessed cognitive reserve capacity that could then be compared to retrospective NASA TLX data. The crews were interviewed about the factors that affected their MWL during voyages and the need to improve MWL management in the sociotechnical system of the HSWs. The MWL measures were sensitive to cognitive load variations and suitable for measuring MWL in the maritime field. The crews' MWL, but on the other hand cognitive reserves were repeatedly reported as low. Crew competencies in particular were seen to improve workload management, which was especially weakened by insufficient skills, the technology used, its usability, and the cockpit layout. The interviewees made proposals for how to enhance MWL management. The results contributed to improving MWL management and the mastery of human factors in HSWs and small-craft operations.
Highly Luminescent Nitrogen Doped Carbon Quantum Dots for Mercury Ion Sensing with Antibacterial Activity
Authors: Dutta Ankita , Dam Somasri , Mandal Ujjwal 
Published: December 2024

Abstract

Nitrogen doped Carbon Quantum Dots (NCQDs) is synthesized in most economical and easiest hydrothermal process. Here N-phenyl orthophenyldiamine and citric acid are applied as a source of nitrogen and carbon for the preparation of NCQDs. The synthesized NCQDs were characterized using experimental techniques like UV−Vis absorption, FT-IR, transmission electron microscopy (TEM), X-ray Diffraction (XRD), dynamic light scattering (DLS), fluorimeter and time resolved fluorescence spectroscopy. These nitrogen doped carbon quantum dots are used to study their bactericidal activity against representative Gram-negative (E. coli and P. aeruginosa) and Gram-positive (B. Subtilis and S. Aureus) bacterial strains by the agar well diffusion method. Results shows that synthesized Nitrogen doped carbon quantum dots have maximum antibacterial activity against S. aureus with good inhibitory effect and inhibition range from 2 mg mL-1 to 3 mg mL-1. These Nitrogen doped carbon quantum dots are also used as fluorescence probe for sensitive and selective detection of mercury. The emission intensity of carbon quantum dots has drastically quenched by Hg2+ ion. Observed limit of detection (LOD) is 4.98 nM, much below than the approved limit prescribed by Environmental Protection Agency. Hence the synthesized NCQDs play an important role in monitoring the antibacterial effect as well as water quality. Measured quantum yield of the NCQDs were ~ 53%. TEM image shows that the NCQDs are quasi-spherical shaped with average size of 3.5 nm.
Prevalence and factors associated with admission to the neonatal intensive care unit at Gulu regional referral hospital
Authors: Oilo Simon Peter , Omara Timothy , Obol Justine , Akera Peter 
Published: December 2024

Abstract

Background
Globally, neonatal intensive care unit (NICU) admissions are a global concern, particularly in regions like sub-Saharan Africa. This study explored the prevalence and factors associated with NICU admission at Gulu regional referral hospital GRRH in northern Uganda.
Method
This was a cross-sectional study that employed quantitative techniques. Data were retrospectively collected from 576 randomly selected hospital records on NICU admissions from 1st July 2022 to 30th June 2023. All data were analysed using SPSS 25.0 statistical software. Descriptive and logistic regression analyses examined factors associated with NICU admission.
Results
Of the 576 records reviewed, there were111 (19.3%) neonates were admitted to the neonatal intensive care. Factors associated with admission of neonates to the neonatal intensive care unit were caesarean delivery, aOR: 3.82, 95% CI (2.17–6.72), preterm labour, aOR: 4.22, 95% CI (1.18–15.13), premature rupture of membranes, aOR: 11.16, 95% CI (5.79–21.49), and malaria in pregnancy, aOR: 4.37, 95% CI (1.53–12.53).
Conclusion
The rate of NICU admission at Gulu regional referral hospital was high. The factors associated with the admission of neonates to the neonatal intensive care unit at Gulu regional referral hospital were malaria in pregnancy, premature rupture of membranes, preterm labour and caesarean section.