bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motivational factors for choosing treatment destinations among the patients treated overseas from the United Arab Emirates: results from the knowledge, attitudes and perceptions survey 2012
Authors: Alnakhi Wafa K. , Segal Jodi B. , Frick Kevin D. , Ahmed Saifuddin , Morlock Laura 
Published: September 2019

Abstract

Background
Travelling seeking healthcare is becoming common phenomenon. There is limited research to understand factors associated with destinations of choice. Each year the Dubai Health Authority (DHA) spends millions of dollars to cover Emiratis seeking healthcare overseas. The objective of this study is to examine the association of treatment destinations, patients’ characteristics and motivation factors among the patients treated overseas from the UAE during 2009–2012.

Method
The data from the Knowledge, Attitudes and Perceptions Survey 2012 in Dubai on medical travel. Examining destinations by patients’ characteristics and motivational factors under push and pull factor framework. Modified Poisson regression model was used to identify factors associated with treatment destinations.

Results
Three hundred thirty-six UAE national families with a member who sought overseas treatment during 2009–2012 were analyzed for this study regarding their most recent trip. The aim of the survey is to explore their knowledge, attitudes and perceptions. The majority of respondents were family members not the patients who had experienced the medical treatment overseas (63%). Germany was the top treatment destination (45%). The top 3 medical conditions for which people traveled overseas were cancer (17%), bone and joint diseases (16%), and heart diseases (15%). However, patients diagnosed with stroke (brain hemorrhage or clot) are more likely to travel to Germany for medical treatment while patients diagnosed with eye diseases are more likely to seek medical treatment at other destinations. Cost was a primary motivational factor for choosing a treatment destination.

Conclusion
This study addressed knowledge gap related medical travel in the UAE. The results provided evidence about perceptions when choosing treatment destinations. Medical condition and financial factors were main predictors for choosing treatment destination. The result will influence policies related financial coverage by the government. The results suggest understanding patients’ perceptions in-depth related their medical conditions and financial factors for better regulation of overseas treatment strategy in the UAE.
Effect of Garcinia kola seeds supplemented diet on growth performance and gonadal development of Oreochromis niloticus juveniles breed in ponds
Authors: Nyadjeu Paulin , Angoun Jeannette , Ndasi Ngwasiri Pride , Tabi-Tomedi Minette Eyango 
Published: September 2019

Abstract

Background
Despite the favorable geo-climatic potential of Cameroon, the national production of tilapia remains low due to poor tilapia growth reported by fish farmers. One of the underlying reasons is the early female maturation at a very small size and precocious breeding in earthen ponds, resulting in overpopulation which leads to stunted growth and therefore to the production of unmarketable fish size. Studies have shown that dietary supplementation of G. kola enhanced growth in young Clarias gariepinus and Oreochromis niloticus. It was also reported that G. kola inhibited spawning in Tilapia adult females. Therefore, this study sought to assess the effects of Garcinia kola as growth promoter and inhibitor of gonadal development in young Oreochromis niloticus.

Methods
A total of 108 juveniles weighing 13.32 ± 0.62 g were randomly distributed in 9 hapas of 12 fishes each (9 females and 3 males) and fed for 70 days with three isonitrogenous diets, 40% crude protein with increasing Garcinia kola supplementation levels of 0 (normal diet), 6% and 10% (experimental diets). Physico-chemical parameters of the water (temperature, dissolved oxygen, pH, nitrate, nitrite, ammonia, and transparency) were measured twice a week. Every 14 days, fish were harvested, counted, and weighed. At the end of the experiment, three fish of each sex per replicate were sacrificed and their gonad and liver collected and weighed. Data were statistically analyzed using one-way analysis of variance repeated measure followed by Newman-Keuls multiple tests.

Results
The results showed that all physico-chemical parameters of the water were within the recommended values for Tilapia culture. Tilapia fed 6% Garcinia kola supplemented diet displayed higher final body weight in males (38.60 ± 3.50 g) and females (36.77 ± 3.62 g) compared to those receiving normal diet (36.23 ± 1.36 g and 25.87 ± 3.32 g; respectively to the final body weight in males and females). The gonadosomatic index and hepatosomatic index indicated no significant variation in males while in females, these were significantly low in the experimental fish compared to control fish.

Conclusion
The results of this study demonstrated that supplementation of G. kola seeds in diets of young Tilapia improved growth performance and impaired gonadal development in females.
Indonesian food culture mapping: a starter contribution to promote Indonesian culinary tourism
Authors: Wijaya Serli 
Published: September 2019

AbstractThe food culture of Indonesia is shaped by several factors such as nature, history, and culture. With its enormous geographic and cultural diversity across the archipelagos, it is evident that Indonesian cuisine is rich in variety and taste. As such, food can be utilised as a strategic means to boost the tourism industry of the country. In the past 5 years, the Indonesian government has given a great support for the development of culinary tourism as one special interest tourism sector that is promoted extensively to the international market. Promoting Indonesian culinary tourism should not be merely exposing the ample varieties of the traditional food that Indonesia has, but more importantly, telling the market about the socio-cultural values behind the food itself. This study aimed to portray how Indonesian food culture has been shaped, developed, and held as the value embedded in the society and has been passed from one generation to the next. For the purpose of the study, a range of literature from journal articles, books, archives, magazines, and articles to Internet sources that are relevant to Indonesian culinary discussions was reviewed.
Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty
Authors: Farrag Hazem M. A. , Setouhi Amr M. , El-Mokadem Mustafa O. , El-Swasany Mustafa A. , Mahmoud Khalid S. , Mahmoud Hesham B. , Ibrahim Alaa M. 
Published: September 2019

Abstract

Background
Results of percutaneous balloon mitral valvuloplasty (BMV) are basically dependent on suitable patient selection. Currently used two-dimensional (2D) echocardiography (2DE) scores have many limitations. Three-dimensional (3D) echocardiography (3DE)-based scores were developed for better patient selection and outcome prediction. We aimed to compare between 3D-Anwar and 2D-Wilkins scores in mitral assessment for BMV, and investigate the additive value of 3DE in prediction of immediate post-procedural outcome. Fifty patients with rheumatic mitral stenosis and candidates for BMV were included. Patients were subjected to 2D- and real-time 3D-transthoracic echocardiography (TTE) before and immediately after BMV for assessing MV area (MVA), 2D-Wilkins and 3D-Anwar score, commissural splitting, and mitral regurgitation (MR). Transesophageal echocardiography (TEE) was also undertaken immediately before and intra-procedural. Percutaneous BMV was performed by either multi-track or Inoue balloon technique.

Results
The 2DE underestimated post-procedural MVA than 3DE (p = 0.008). Patients with post-procedural suboptimal MVA or significant MR had higher 3D-Anwar score compared to 2D-Wilkins score (p = 0.008 and p = 0.03 respectively). The 3D-Anwar score showed a negative correlation with post-procedural MVA (r = − 0.48, p = 0.001). Receiver operating characteristic (ROC) curve analysis for both scores revealed superior prediction of suboptimal results by 3D-Anwar score (p < 0.0001). The 3DE showed better post-procedural posterior-commissural splitting than 2DE (p = 0.004). Results of both multi-track and Inoue balloon were comparable except for favorable posterior-commissural splitting by multi-track balloon (p = 0.04).

Conclusion
The 3DE gave valuable additive data before BMV that may predict immediate post-procedural outcome and suboptimal results.
BIRADS 4 breast lesions: comparison of contrast-enhanced spectral mammography and contrast-enhanced MRI
Authors: Yasin Rabab , El Ghany Enas Abd 
Published: September 2019

AbstractBackgroundBreast cancer is the most common cancer in women worldwide. It is responsible for about 23% of cancer in females in both developed and developing countries [1]. We aimed to assess the accuracy of contrast-enhanced spectral mammography (CESM) versus contrast-enhanced breast MRI in the evaluation of BIRADS 4 breast lesions.ResultsFifty patients were included in this study; there were 28 malignant cases and 22 benign cases; all cases were proved by histopathological result either by core biopsy or excision biopsy. CESM was found to have less sensitivity (94.1%) than MRI (100%) but CESM has higher specificity (100%) than MRI (95.5%). The accuracy of CESM was 96.4%, while the accuracy of MRI was 98.2% with no statistical significance (Pvalue 0.827).ConclusionCESM can be used as a sensitive diagnostic tool in the detection and staging of breast cancer with higher specificity and less sensitivity as compared to contrast enhanced breast MRI.
Role of lumbar spine signal intensity measurement by MRI in the diagnosis of osteoporosis in post-menopausal women
Authors: Saad Maha M. , Ahmed Ahmed Tohamy , Mohamed Khaled E. , Habba Mohamed R. 
Published: September 2019

Abstract

Background
Osteoporosis is a worldwide health problem and a common cause of bone fractures; the most common type of osteoporosis is post-menopausal type. MRI has a role in the diagnosis of osteoporosis and can be used as a screening tool, so the purpose of our study was to define a quantitative MRI-based score (M-score) for the detection of lumbar spine osteoporosis and to evaluate the correlation between lumbar spine signal intensity measured by MRI and BMD (bone mineral density) in post-menopausal women. Our case-control study involved 100 cases (50 old post-menopausal females as a case group and 50 healthy females as a control group of matched age). Both groups were subjected to history taking, dual-energy X-ray absorptiometry (DEXA), and conventional lumbar MRI. DEXA was performed for the lumbar spine and all scores (T-score, Z-score, BMD) were calculated. Lumbar MRI was performed (sagittal T1WI and T2WI) from L1–L4 levels. SNRL1–L4 and M-score were calculated from T1W images.

Results
All DEXA scores were significantly lower in post-menopausal females compared to the control group (P < 0.0001). Meanwhile, SNRL1–L4 and M-score were significantly higher among cases than controls (P < 0.0001). The diagnostic threshold of SNRL1–L4 and M-score for distinguishing osteoporotic from non-osteoporotic females was 104.5 for SNRL1–L4 with a sensitivity of 94%, specificity 60%, positive predictive values (PPV) 31%, and negative predictive values (NPV) 98%, and 3.5 for M-score with a sensitivity of 93.3%, specificity 83.5%, PPV 50%, and NPV 98.6%. SNRL1–L4 was negatively correlated with M-score (r = − 0.74, P < 0.0001), T-score (r = − 0.42, P < 0.0001), Z-score (r = − 0.32, P < 0.0001), and BMD (r = − 0.31, P < 0.0001). M-score was negatively correlated with T-score (r = − 0.48, P < 0.0001), Z-score (r = − 0.36, P < 0.0001), and BMD (r = − 0.37, P < 0.0001). M-score moderately agreed with T-score (κ = 0.5, P < 0.0001).

Conclusion
The MRI-based score (M-score) of the lumbar spine is an accurate quantitative method for distinguishing osteoporotic from non-osteoporotic females. M-score and SNRL1–L4 are significantly correlated with osteoporotic indices (T-score and BMD).
Increased Infection Risk in Addison’s Disease and Congenital Adrenal Hyperplasia
Authors: Tresoldi Alberto S , Sumilo Dana , Perrins Mary , Toulis Konstantinos A , Prete Alessandro , Reddy Narendra , Wass John A H , Arlt Wiebke , Nirantharakumar Krishnarajah 
Published: September 2019

Abstract

Context
Mortality and infection-related hospital admissions are increased in patients with primary adrenal insufficiency (PAI). However, the risk of primary care–managed infections in patients with PAI is unknown.

Objective
To estimate infection risk in PAI due to Addison’s disease (AD) and congenital adrenal hyperplasia (CAH) in a primary care setting.

Design
Retrospective cohort study using UK data collected from 1995 to 2018.

Main outcome measures
Incidence of lower respiratory tract infections (LRTIs), urinary tract infections (UTIs), gastrointestinal infections (GIIs), and prescription counts of antimicrobials in adult PAI patients compared to unexposed controls.

Results
A diagnosis of PAI was established in 1580 AD patients (mean age 51.7 years) and 602 CAH patients (mean age 35.4 years). All AD patients and 42% of CAH patients were prescribed glucocorticoids, most frequently hydrocortisone in AD (82%) and prednisolone in CAH (50%). AD and CAH patients exposed to glucocorticoids, but not CAH patients without glucocorticoid treatment, had a significantly increased risk of LRTIs (adjusted incidence rate ratio AD 2.11 [95% confidence interval (CI) 1.64–2.69], CAH 3.23 [95% CI 1.21–8.61]), UTIs (AD 1.51 [95% CI 1.29–1.77], CAH 2.20 [95% CI 1.43–3.34]), and GIIs (AD 3.80 [95% CI 2.99–4.84], CAH 1.93 [95% CI 1.06–3.52]). This was mirrored by increased prescription of antibiotics (AD 1.73 [95% CI 1.69–1.77], CAH 1.77 [95% CI 1.66–1.89]) and antifungals (AD 1.89 [95% CI 1.74–2.05], CAH 1.91 [95% CI 1.50–2.43]).

Conclusions
There is an increased risk of infections and antimicrobial use in PAI in the primary care setting at least partially linked to glucocorticoid treatment. Future studies will need to address whether more physiological glucocorticoid replacement modes could reduce this risk.
IAEA survey of dental cone beam computed tomography practice and related patient exposure in nine Central and Eastern European countries
Authors: Beganović Adnan , Ciraj-Bjelac Olivera , Dyakov Iliya , Gershan Vesna , Kralik Ivana , Milatović Aleksandra , Šalát Dušan , Stepanyan Karapet , Vladimirov Anatoli , Vassileva Jenia 
Published: September 2019

Objectives:Cone beam CT (CBCT) in dentistry and maxillofacial surgery is a widely used imaging method for the assessment of various maxillofacial and dental pathological conditions. The objective of this study was to summarize the results of a multinational retrospective–prospective study that focused on patient exposure in this modality.Methods:The study included 27 CBCT units and 325 adult and paediatric patients, in total. Data on patients, clinical indications, technical parameters of exposure, patient dose indicator, or, alternatively, dose to phantom were collected. The dose indicator used was air kerma–area product, PKA.Results:In most scanners operators are offered with a variety of options regarding technical parameters, especially the field of view size. The median and the third quartile value of PKAfor adult patients in 14 different facilities were 820 mGy cm² and 1000 mGy cm² (interquartile range = 1058 mGy cm²), and 653 mGy cm² and 740 mGy cm² (interquartile range = 1179 mGy cm²) for children, as reported by four different institutions. Phantom dose data were reported from 15 institutions, and median PKAranged from 125 mGy cm² to 1951 mGy cm². Median PKAvalues varied by more than a 10-fold between institutions, mainly due to differences in imaging protocol used, in particular field of view and tube current-exposure time product.Conclusions:The results emphasize the need for a cautious approach to using dental CBCT. Imaging only when the clinical indications are clear, accompanied with the appropriate radiographic techniques and the optimum imaging protocol, will help reduce radiation dose to patients.
Imaging of root canal treatment using ultra high field 9.4T UTE-MRI – a preliminary study
Authors: Timme Maximilian , Masthoff Max , Nagelmann Nina , Masthoff Malte , Faber Cornelius , Bürklein Sebastian 
Published: September 2019

Objectives: To investigate the potential of 9.4T ultrashort echo time (UTE) technology visualizing tooth anatomy and root canal treatment in vitro. In particular, it was evaluated whether the currently achievable resolution is suited presenting all anatomical structures and whether the root canal filling materials are distinguishable in UTE-MRI. Methods: Four extracted human teeth were examined using 9.4T UTE-MRI prior endodontic treatment (native teeth), after preparation and after obturation procedure. Root canal obturation was performed using warm vertical compaction (Schilder technique) with an epoxy-resin-based sealer. A single gutta-percha cone measured by MRI served as intensity-reference. MRI results were validated with corresponding histologic sections of the teeth. In addition, all teeth were examined at the different stages with CBCT and conventional X-ray. Results: 9.4T UTE-MRI enabled a precise visualization of root canal anatomy of all teeth at a resolution of 66 µm. After obturation, dentin, sealer and gutta-percha cones showed distinct MRI signal changes that allowed clear differentiation of the obturation materials from surrounding tooth structure. The filling materials, isthmal root canal connections and even dentin-cracks that were identified in the MR-images could be verified in histological sections. Conclusions: 9.4T UTE-MRI is suitable for visualization of root canal anatomy, the evaluation of root canal preparation and obturation with a high spatial resolution and may provide a versatile tool for dental material research in endodontics.
Vaccine hesitancy among parents in Kuala Lumpur: a single center study
Authors: Musa Ahmad Farouk , Soni Trived , Cheong Xian Pei , Nordin Rusli Bin 
Published: September 2019

Background: Vaccine hesitancy (VH) is defined as the delay in acceptance or refusal of vaccination despite availability of vaccination services. The main objective of this study was to improve the understanding of vaccine hesitancy (VH) among parents in Kuala Lumpur (KL), Malaysia, by determining the prevalence of VH among parents and to identify the predictors associated with a vaccine hesitant attitude. Methods: This cross-sectional study was conducted in KL. A questionnaire was devised to collect information from parents, namely sociodemographic information, WHO determinants of VH and the Parents Attitude towards Childhood Vaccine (PACV) scale. Results: A total of 380 questionnaires were distributed and 337 were returned (88.6% response rate). Those that completed 49 (>90%) out of the 55 given questions in the survey were included for data analysis. Based on inclusion and exclusion criteria, 23 were excluded, giving a sample size of 314. To identify parents, those with at least one child were included, giving a sample size of 221. We noted 60.2% (189) of the participants were females and 80.3% (252) were Malay. Our study found a prevalence of VH of 14.5% among parents based on the 15-item PACV scale. Univariate analysis found no link between sociodemographic factors and VH in parents. Only five of these determinants were included in the final model as statistically significant (p< 0.05) predictors of VH among parents in KL. The five factors were introduction to a new vaccine, negative past experiences of vaccinations, distrust of the pharmaceutical industry, distrust of health systems and providers and being male. Conclusions: Factors contributing towards a prevalence of VH of 14.5% in KL, Malaysia must be studied further to identify any temporal relationship to the under-immunization of children in order to reach the WHO goal of 100% immunization coverage in children and eradication of vaccine preventable diseases.
Spindle epithelial tumour with thymus-like differentiation: report of two cases
Authors: Karaisli S , Haciyanli M , Gücek Haciyanli S , Tavusbay C , Gur EO , Kamer E , Arikan Etit D 
Published: September 2019

Spindle epithelial tumour with thymus-like differentiation (SETTLE) is a very rare neck malignancy arising from thymic tissue or branchial pouch, mostly seen in the early decades of life. SETTLE is thought to be a low-grade neoplasm but distant metastases have been reported. Fewer than 50 cases have been reported in the PubMed database. We report on the four-year follow-up for a 13-year-old boy, with no signs of recurrence or distant metastasis. In addition, a 45-year-old woman was admitted to hospital with neck mass. Fine-needle aspiration biopsy was compatible with medullary thyroid carcinoma but serum levels of calcitonin were normal. Total thyroidectomy and central compartment lymph node dissection was planned with an initial diagnosis of medullary thyroid carcinoma. At surgery, frozen section analysis converted our diagnosis to SETTLE and the intraoperative strategy was changed. SETTLE should be considered in a patient with normal serum calcitonin levels in the presence of suspicious medullary thyroid carcinoma at fine-needle aspiration biopsy. Frozen section analysis may help to manage the intraoperative strategy. This report describes the first case of SETTLE successfully diagnosed by frozen section analysis.
Accelerating raw data analysis with the ACCORDA software and hardware architecture
Authors: Fang Yuanwei , Zou Chen , Chien Andrew A. 
Published: September 2019

The data science revolution and growing popularity of data lakes make efficient processing of raw data increasingly important. To address this, we propose the ACCelerated Operators for Raw Data Analysis (ACCORDA) architecture. By extending the operator interface (subtype with encoding) and employing a uniform runtime worker model, ACCORDA integrates data transformation acceleration seamlessly, enabling a new class of encoding optimizations and robust high-performance raw data processing. Together, these key features preserve the software system architecture, empowering state-of-art heuristic optimizations to drive flexible data encoding for performance. ACCORDA derives performance from its software architecture, but depends critically on the acceleration of the Unstructured Data Processor (UDP) that is integrated into the memory-hierarchy, and accelerates data transformation tasks by 16x-21x (parsing, decompression) to as much as 160x (deserialization) compared to an x86 core.
We evaluate ACCORDA using TPC-H queries on tabular data formats, exercising raw data properties such as parsing and data conversion. The ACCORDA system achieves 2.9x-13.2x speedups when compared to SparkSQL, reducing raw data processing overhead to a geomean of 1.2x (20%). In doing so, ACCORDA robustly matches or outperforms prior systems that depend on caching loaded data, while computing on raw, unloaded data. This performance benefit is robust across format complexity, query predicates, and selectivity (data statistics). ACCORDA's encoding-extended operator interface unlocks aggressive encoding-oriented optimizations that deliver 80% average performance increase over the 7 affected TPC-H queries.