bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preference of Near-optical Low-vision Devices among Patients with Low Vision Attending Low-vision Clinic of a Tertiary Eye Hospital in Nepal
Authors: Bhusal Bigyan , Thapa Hari Bahadur , Khadka Dikshya 
Published: December 2024

Background:
This study assessed the preference for near-optical low-vision devices by patients visiting the low-vision clinic of a tertiary eye hospital.

Methods:
A hospital-based descriptive cross-sectional study was conducted among 66 participants at the Low Vision Department of Lumbini Eye Institute and Research Center, Rupandehi, Nepal, from April 2023 to September 2023. A nonprobability, purposive sampling technique was used for sampling. Patients with the best-corrected visual acuity worse than 6/18 to Perception of light (PL) were included in the study. A detailed ophthalmological evaluation, visual acuity assessment, distance and near refractive correction, and low-vision evaluation were done. The patient’s preference for a low-vision device was assessed during low-vision evaluation based on visual acuity improvement and the patient’s subjective response. Statistical analysis was carried out using SPSS software, version 17.0.

Results:
Among 66 patients, 40 were male and 26 were female. The mean age of patients was 28.50 ± 18.350 years. Overall 47 patients preferred near-optical low-vision devices. Among them, handheld (HH), stand, and spectacle magnifiers were preferred by 44.6%, 40.4%, and 14.9% of patients, respectively. The major causes of low vision were retinitis pigmentosa (16.7%) followed by nystagmus (15.2%).

Conclusion:
HH magnifiers were the most commonly preferred devices in a short period with proper counseling and demonstration. Identifying the preferred low-vision devices can help develop and implement the low-vision rehabilitation service effectively and reduce patient chair time for selecting low-vision devices.
Prevalence of Bacterial Pathogens and their Antimicrobial Susceptibility Patterns at a Tertiary Care Hospital in Riyadh
Authors: Khalid Fizza , Elsheikh Azza , Mahmood Abid , Poulose Christy , Khojah Osamah T. 
Published: December 2024

Abstract

Objectives:
The current study aimed to set up the prevalence of commonly isolated pathogens and their susceptibility patterns in a tertiary care reference center in Riyadh through a 3-year retrospective study.

Materials and Methodology:
Patient samples from two tertiary care hospitals with approximately 450 beds were submitted for culture and sensitivity to MDLab, Riyadh. Microsoft Office Excel was used to analyze all the data.

Results:
Among a total of 8389 positive cultures, urine was the most common sample submitted for bacterial culture over these 3 years, followed by pus and wounds. Gram-negative bacteria were prevalent compared to gram-positive bacteria. However, Staphylococcus aureus was the most commonly isolated pathogen from pus and wounds. From outpatients, Escherichia coli was the leading pathogen (50.5%), followed by Klebsiella and S. aureus (15.8% and 13.5%, respectively). In contrast, Pseudomonas was the most frequently isolated pathogen (20.8%) from hospitalized patients, followed by Klebsiella (18.7%) and E. coli (16%). Percent resistance was found to be higher in admitted patients as compared to walk-in patients. High resistance was noted in Acinetobacter baumannii complex to almost all classes of antibiotics among the gram-negative bacterial isolates. Oxacillin resistance ranged from 35% to 40% in Staphylococci.

Conclusion:
Overall, in our study, a high resistance of more than 30% up to 84% was noted in gram-negative bacterial isolates against the commonly used beta-lactam drugs and co-trimoxazole. A report from this type of local investigation is highly beneficial in guiding physicians on empirical therapy by providing insights into the level of antibiotic resistance within their specific settings.
Effect of Ergonomic Intervention on Cognitive Function of Office Workers
Authors: Mottaghi Zahra , Halvani Gholamhossein , Jambarsang Sara , Mehrparvar Amir H. 
Published: December 2024

Background:
Different domains of cognitive function are important in some jobs, such as office work. Ergonomic risk factors may affect cognitive function.

Aim:
This study was designed to assess the effect of an ergonomic training intervention on the cognitive function of office workers.

Materials and Methods:
This was a before-after study performed in 2020 in Yazd, Iran on female office workers. Cognitive function (working memory, attention, and response time) was assessed by Wechsler working memory and Stroop tests before and after the intervention. Ergonomic intervention consisted of an ergonomic modification of the workstation and a training program about ergonomic principles of office work. Data were analyzed by SPSS (ver. 24) using paired t-test and the multiple regression linear model.

Results:
Mean age and work experience of the participants were 35.38 ± 1.60 and 8.54 ± 1.24 yr., respectively. Forward visual memory, response time, and interference time were significantly changed after the intervention, but the change in other aspects of cognitive function (i.e., memory span, backward visual memory, and interference score) was not statistically significant. Marital status, age, and working hours significantly affected working memory, test duration and response time, and number of errors, respectively.

Conclusion:
This study showed that ergonomic intervention (modification of workstation and training) may significantly affect some aspects of cognitive function in office workers.
The Effect of Kidney Transplantation on Pulmonary Hypertension in End-stage Kidney Disease Patients on Hemodialysis
Authors: Jane Christine Mary , Kumar K. Vinod , Kumar R. Anil , Unni V. Narayanan , Prasannan Bipi K. , Pullockara Jojo K. , Dev U. R. S. Vishnu 
Published: December 2024

Introduction:
Pulmonary hypertension (PH) is highly prevalent in chronic kidney disease (CKD) patients, especially those undergoing hemodialysis. PH is a strong independent predictor of mortality in dialysis patients. Kidney transplantation (KT) is the best treatment modality for reversing adverse cardiac effects of CKD.

Methods:
A prospective cohort study was done in end-stage kidney disease (ESKD) patients on hemodialysis with PH (defined as pulmonary artery systolic pressure [PASP] of 35 mmHg or above) who subsequently underwent KT. Follow-up echocardiogram was done at an average of 15 months post KT.

Results:
A total of 277 patients underwent KT, out of which 95 had PH (prevalence 34.3%). Our study included 65 patients with PH who consented for the study. There was a significant improvement in PH as evidenced by a reduction in PASP (PASP pre KT 44.8 [±9.91] post KT 32.77 [±6.33], P = 0.001). 72.3% of patients achieved normal pulmonary pressures. There was also a significant improvement in ejection fraction (63.01 [±7.4] vs. 65.06 [±5.61], P = 0.04) and left atrial diameter (3.9 [±0.45] vs. 3.52 [±0.51], P = 0.001) post KT. There was an improvement in mean hemoglobin level (10.4 [±2.17] vs. 13.5 [±2.13], P = 0.001), serum calcium levels (serum Ca 8.76 [±0.72] vs. 9.19 [±0.82], P = 0.001) and improvement in the New York Heart Association (NYHA) class.

Conclusions:
KT significantly improves PH in ESKD patients on hemodialysis and can potentially normalize it. There is also improvement in overall cardiac functions, serum hemoglobin, and calcium levels. This translates to better physical endurance as evidenced by improvement in NYHA class post KT.
Extramedullary hematopoiesis in a case of rhabdomyosarcoma with bone marrow metastasis
Authors: Pulappadi Vishnu Prasad , Chandrashekhara Sheragaru Hanumanthappa , Pal Chandan Kumar , Ratre Brajesh Kumar 
Published: December 2024

ABSTRACT
Extramedullary hematopoiesis (EMH) occurs in bone marrow failure due to a variety of causes. Although common in hematological disorders like myelofibrosis and hemoglobinopathies, EMH occurring as a result of bone marrow metastasis from solid tumors is very rare. We report a case of EMH subsequent to bone marrow metastasis from parameningeal rhabdomyosarcoma in a 17-year-old girl. The patient presented with anemia and thrombocytopenia. Bone marrow biopsy revealed metastasis from rhabdomyosarcoma. Contrast-enhanced computed tomography (CECT) was performed and revealed an enhancing mass in the left nasal cavity, with adjacent bone erosion suggestive of parameningeal rhabdomyosarcoma. Additionally, multiple homogenously enhancing masses were seen in the paravertebral location, adjoining multiple bilateral ribs, along the anterior surface of the sternum and in the presacral space, suggestive of EMH. Chemotherapy was subsequently started, but the patient developed febrile neutropenia and expired as a result of septic shock.
Palliative radiotherapy in a patient with Erdheim–Chester disease
Authors: Katano Atsuto , Yamashita Hideomi 
Published: December 2024

ABSTRACT
Erdheim–Chester disease (ECD) is a rare type of non-Langerhans cell histiocytosis, which is reported in less than a thousand cases. Although palliative radiotherapy is the principal treatment of patients with painful bone metastasis, there is very limited evidence for the efficacy of palliative radiotherapy for ECD. A 50-year-old female patient with ECD was referred to our department with a complaint of back pain and numbness in the lower limbs owing to spinal cord compression. She underwent several courses of palliative radiation therapy, some of which resulted in a marked response. She was treated with palliative radiotherapy of 30 Gy in 10 fractions for the knee. Almost complete disappearance of the pain was achieved after radiation therapy. Radiotherapy comprising 20 Gy in five fractions was performed for spinal cord compression in the upper thoracic spine. Post-treatment magnetic resonance imaging showed marked improvement in spinal compression. The present case report represented the effect of radiotherapy on bone lesions associated with ECD. Further research on radiotherapy for ECD should be conducted in the future.
Pretreatment C-reactive protein level predicts the response to neoadjuvant chemotherapy of muscle-invasive bladder cancer
Authors: Tochigi Kosuke , Nagayama Jun , Yuguchi Yuri , Hattori Kyosuke , Morishita Koya , Nakane Wataru , Sai Hiroki , Matsui Hirotaka , Kanada Yoshie , Akamatsu Susuke 
Published: December 2024

ABSTRACT

Introduction:
There is no established predictor of the neoadjuvant chemotherapy (NAC) response in patients with muscle-invasive bladder cancer (MIBC) treated via radical cystectomy (RC). We assessed the predictive utility of the pretreatment C-reactive protein (CRP) level in terms of the response to NAC in patients with MIBC treated with RC.

Patients and Methods:
This retrospective study enrolled patients with MIBC treated via RC following NAC at Nagoya University Hospital and affiliated hospitals from January 2004 to December 2020. An elevated CRP was defined as a CRP level ≥1 mg/dL. The association between the response to NAC and the pretreatment CRP level was investigated.

Results:
We retrospectively identified 192 patients of whom 101 (52.6%) were NAC nonresponders (pathological ≥T2 or node-positive). Nonresponders exhibited poorer 5-year disease-free survival (DFS) (82.5% vs. 42.7%, P < 0.01) and overall survival (OS) (95.3% vs. 48.8%, P < 0.01) than responders. Thirty patients (15.6%) showed elevated CRP levels that correlated with poorer 5 year DFS (66.7% vs. 33.0%, P < 0.01) and OS (74.6% vs. 48.3%, P < 0.01) than others. In multivariate analyses, an elevated CRP level was significantly associated with poorer 5-year DFS [hazard ratio (HR) 3.35, 95% confidence interval (CI) 1.88–5.97, P < 0.01)], OS (HR 2.13, 95% CI 1.13–4.03, P = 0.02), and nonresponder status (odds ratio 3.83, 95% CI 1.4–10.3, P < 0.01).

Conclusion:
An elevated CRP level may predict NAC nonresponder status and poorer oncological outcome. Upfront RC should be considered for patients with an elevated CRP level.
A prospective randomized control study of neo-adjuvant chemo radiation followed by surgery versus upfront surgery in resectable and borderline resectable pancreatic head cancer: Pilot study
Authors: Kumar Vipan , Singh Abhinav , Khosla Divya , Rana Surinder , Kang Mandeep , Singh Harjeet , Kapoor Rakesh , Gupta Rajesh 
Published: December 2024

ABSTRACT

Introduction:
Neo-adjuvant chemoradiotherapy may improve survival in resectable or borderline resectable pancreatic cancer, but its feasibility, benefits, and challenges remain unproven in the resource constraint setup of developing countries.

Patients and Methods:
In this single-center randomized trial, patients with resectable or borderline resectable pancreatic cancer were randomly assigned to receive preoperative chemoradiotherapy or upfront surgery. Neo-adjuvant therapy consisted of two cycles of chemotherapy of gemcitabine and Nab-paclitaxel, followed by concurrent chemoradiotherapy with oral capecitabine combined with radiation therapy to a dose of 25 fractions × 1.8 Gray, followed by surgery and four cycles of adjuvant therapy or upfront surgery and six cycles of adjuvant chemotherapy. The primary end point was overall survival.

Results:
From March 2019 to March 2021, 80 patients were randomly assigned into two groups: 41 in neo-adjuvant therapy and 39 in upfront surgery. Per protocol analysis, 25/31 (80.65%) patients completed the intended neo-adjuvant treatment, with a dropout rate of 19.35%. Recurrent cholangitis due to stent block was the foremost reason for dropout. The median overall survival was 18.90 months with neo-adjuvant and 14.7 months in the upfront surgery group (hazard ratio, 0.78; 95% confidence interval, 0.58 to 1.05; P = .096). The resection rate was 36/41 (87.80%) in the upfront surgery group versus 14/31 (45.61%) in the NACRT group (P = <.001). The secondary end points favoured neo-adjuvant therapy, R0 resection rate, 92.86% vs. 75%; P = .18, pathologic lymph nodes, 00% vs. 30.56%; P = .006, perineural invasion, 14.29% vs. 36.11%; P = .14.

Conclusion:
The median overall survival and disease-free survival showed an advantage with neo-adjuvant therapy but did not reach statistical significance. The secondary end points favoured neo-adjuvant treatment, but logistics, multiple visits, prolonged treatment, and financial constraints are some of the main hurdles for developing countries to deliver multimodality treatment.
Evaluation of the dose rate and energy dependence of GafchromicTM EBT3 film for the application of total body irradiation and total skin electron therapy dosimetry
Authors: Sundaramoorthy Dhivya , Chandrasekaran Anuradha 
Published: December 2024

ABSTRACT

Aim:
Total body irradiation (TBI) and total skin electron therapy (TSET) are special radiotherapy techniques that differ from routine radiotherapy therapy. They are intended to deliver a uniform dose to the entire body or skin and involve complex treatment procedures. It is therefore mandatory to perform an in-vivo dosimetry check to ensure dose accuracy and dose homogeneity during treatment. This study aims to investigate the dosimetric characteristics of GafchromicTM EBT3 film aimed at the application of TBI and TSET dosimetry.

Materials and Methods:
GafchromicTM EBT3 film by Ashland is a more widely used and convenient in-vivo detector than other detectors. Though many studies have reported the dosimetric characteristics of EBT3 film, those based on the electron beam are very limited. In our hospital, we perform in-vivo dosimetry in TBI and TSET with EBT3 films. Since TSET is performed with a high dose rate, the calibration curves of the low, nominal and high dose rates of the 6 MeV electron beam were evaluated in this study. Additionally, the change in response of a 6 MV photon beam to a 6 MeV electron beam was compared. Furthermore the orientation and stabilization time of EBT3 film were analysed in this study.

Results:
This study confirms that EBT3 films are dose-rate independent, and the change in response of a 6 MV photon beam to a 6 MeV electron beam was negligible. Further, this study shows that the photon calibration curve can be used in the dosimetric evaluation of both TBI and TSET.

Conclusions:
Consequently, Gafchromic EBT3 films are shown to be reliable for TBI and TSET in-vivo dosimetry..
Investigation on the TMR10 and convolution algorithms of the gamma plan treatment planning system utilizing the lightning software for the treatment of vestibular schwannoma in the gamma knife icon unit
Authors: Natesan Ponnusamy , Palaniappan Senthil Manikandan , Bahadur Sulthan Asath , Muthuvinayagam Muthiah , Sadashiva Nishanth 
Published: December 2024

ABSTRACT

Introduction:
Leksell Gamma Plan (LGP) treatment planning is a software system that offers two-dose calculation algorithms for stereotactic radiosurgery/stereotactic radiotherapy treatments. The latest version of LGP is based on lightning software and includes TMR10 and convolution algorithms. TMR10 considers all brain structures as water and calculates the dose based on attenuation in water, while convolution accounts for the heterogeneous tissue inside the brain based on electron densities of all structures in the planning CT images. This study compares the dosimetric outcomes of these two algorithms for vestibular schwannoma cases and evaluates the impact of lightning software in heterogeneity corrections.

Materials and Methods:
Our Institute has conducted a comprehensive analysis of data from 16 patients who were diagnosed with vestibular schwannoma and underwent treatment with LGK SRS plans utilizing LGP Version 11.3 lighting software. These plans were developed using both TMR10 and convolution algorithms, with a prescribed dose of 12 Gy to the planning target volume (PTV) and a 50% isodose curve utilized to effectively cover the PTV while minimizing potential harm to healthy tissue. Our analysis focused on assessing the dosimetry data for the treatment plans, specifically in relation to the brainstem and cochlea as organs at risk. In our study, we conducted a comparison of the treatment plan indices for TMR and convolution using paired t-test analysis.

Results:
The maximum dose of PTV was 22.1 (1.7) Gy in the TMR10 algorithm and 21.4 (2.0) Gy in the convolution algorithm. The mean dose was 16 Gy and 15.2 Gy for TMR10 and convolution, respectively, with a difference of –5.00%. The Paddick conformity index was 0.82 and 0.84 for TMR10 and convolution, respectively, with a difference of 2.43%. The maximum and mean doses of the brainstem were 10.1 Gy and 9.8 Gy, and 2.6 Gy and 2.5 Gy in TMR10 and convolution algorithms, respectively.

Conclusion:
The TMR10 algorithm assumes all structures are unit densities and is traditionally used in LGK units for dose calculation. However, the convolution algorithm accurately predicts the delivered dose by accounting for in-homogeneities in the head structure. The use of a convolution algorithm may be necessary when the target is surrounded by highly tissue in-homogeneities such as air tissue interface and bone structures. Additionally, it may be necessary for patients with anterior venous malformation who require embolization to arrest bleeding. The use of a convolution algorithm in clinical practice needs to be validated before implementation.
Deficient mismatch repair and BRAF-V600E-mutated metastatic colorectal cancer responds to nivolumab therapy after progression under bevacizumab plus FOLFIRI
Authors: Chen Po-Jung , Yeh Yung-Sung , Tsai Hsiang-Lin , Huang Ching-Wen , Yang Sheau-Fang , Wang Jaw-Yuan 
Published: December 2024

ABSTRACT
Nivolumab, a PD-1 immune checkpoint inhibitor, has been demonstrated to be clinically effective in patients with deficient mismatch repair (dMMR) and BRAF-V600E-mutated metastatic colorectal cancer (mCRC). We present the case of an 81-year-old Taiwanese woman with mCRC who responded favorably to nivolumab for 20 months after the failure of bevacizumab plus FOLFIRI (5-fluorouracil, folinic acid, and irinotecan) treatment. The woman visited our institute and received a diagnosis of ascending colon cancer in December 2019. She underwent right hemicolectomy; the pathologic stage was T3N1bM0, stage IIIb. After 7 months, multiple liver metastases had developed and bevacizumab plus FOLFIRI were administered. However, the disease progressed even after targeted therapy plus chemotherapy. Since February 2021, she has received 3 mg/kg nivolumab biweekly and the best objective response has been found to be partial response as per the response evaluation criteria in solid tumors criteria. No severe adverse events have occurred. The patient has received 33 cycles of nivolumab over 20 months without exhibiting eventual tumor progression. Nivolumab could be considered for dMMR and BRAF-V600E-mutated mCRC that has progressed despite treatment with bevacizumab plus FOLFIRI.
Patterns and stages of breast cancer in Northern Kerala, India; Results based on 2016 Hospital-Based Cancer Registry of a Tertiary Cancer Center
Authors: Ambali Parambil Neethu , Kannan Srinivasan 
Published: December 2024

ABSTRACT

Background:
Breast cancer is leading globally in 2020, with mortality being a concern in developing countries. Cancer registration can help in studying systematically collected data about breast cancer. The aim of this study is (1) to describe demographic aspects, stage at diagnosis, histological types, and treatment availed by evaluating the 2016 Hospital-Based Cancer Registry (HBCR) of a Tertiary Cancer Centre (TCC), (2) to study the relationship between sociodemographic factors, the stage of the disease, the time between diagnosis and registration at TCC and the treatment status.

Methodology:
The data of all breast cancer patients who registered at the institution in 2016 was included in the study. The variables in the HBCR core form were used as a baseline for collecting data from hospital records.

Results:
The number of patients registered in 2016 was 534. The mean age was 53.8 (SD 53.8 ± 12.11). Majority (59.2%) presented in the early stages. Seventy-two percent were from rural areas, and 59.5% had a middle school education and above. Our study found a significant association between education status, the stage of disease, and treatment status.

Conclusion:
Education level plays an important role in early presentation and treatment completion. Registry data analysis can be used as a guideline for understanding patterns and for formulating cancer control activities in the state.
Prosthodontic rehabilitation of mandibular discontinuity post-luminal type ameloblastoma using direct metal laser-sintering printed preci-vertix attachment and cast partial denture—A case report
Authors: Rathee Manu , Singh Sandeep , Jain Prachi , Divakar S , Chahal Sujata , Tomar Sarthak Singh 
Published: December 2024

ABSTRACT
The Indian subcontinent has the highest prevalence of orofacial cancer, according to WHO statistics. Surgery, radiation, chemotherapy, or combination therapies are commonly administered treatment modalities for the treatment of oral cancer. The degree of disability and complexity of prosthetic rehabilitation is usually influenced by the size and location of the defect. Ameloblastomas are anatomically benign but locally invasive odontogenic tumors most frequently located in the mandible. The surgical resection of the tumor with safety margins is the gold standard of care. Postsurgical defects generate significant morbidity that needs reconstruction and prosthodontic rehabilitation to restore oral functions. This case report describes the prosthetic rehabilitation of a 45-year-old male after the resection of a mandibular ameloblastoma. The lesion was excised by segmental mandibulectomy followed by reconstruction plate placement. Rehabilitation was achieved by direct metal laser-sintering (DMLS) printed preci-vertix attachment and cast partial denture (CPD).