bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visual assessment of cerebrospinal fluid flow dynamics using 3D T2-weighted SPACE sequence-based classification system
Authors: Naldemir İbrahim Feyyaz , Karaman Ahmet Kursat , Ogul Hayri , Onbas Omer 
Published: November 2024

Background Flow-related signal void artifacts can be visualized on the T2-weighted (T2W) three-dimensional sampling perfection with application-optimized contrast (3D-SPACE) sequence. Flow void artifacts in the cerebral aqueduct and the fourth ventricle can provide information about cerebrospinal fluid (CSF) flow dynamics. Purpose In this study, we aimed to test the performance of the T2W 3D-SPACE sequence in assessing the CSF flow in the aqueduct and/or fourth ventricle. Material and Methods A total of 137 patients (age range = 3–89 years) who underwent CSF flow study were included. The amount of signal loss on T2W 3D-SPACE due to flow in the aqueduct and fourth ventricle was assessed and graded using a 4-point scale of 0 (absence of flow void) to 3 (signal void filling the aqueduct and entire fourth ventricle). A correlation was then sought between the quantitative values obtained by phase-contrast magnetic resonance imaging (PC-MRI) and the amount of signal void in the 3D-SPACE sequence. Results At the aqueduct level, there was a statistically significant difference in the forward flow velocity and the flow volume among different grades (all P < 0.001). In the grade 3 group, CSF peak systolic flow velocity and mean flow volume were found to be significantly higher than in the other grades ( P < 0.001). The mean aqueduct area in the grade 0 group was found to be significantly different from that in the other classes ( P < 0.001). Conclusion The amount of signal loss in the fourth ventricle observed on T2W 3D-SPACE is correlated with the peak systolic velocity and flow volume measured quantitatively in PC-MRI.
Understanding occupational therapy perinatal mental health practice in mothers from ethnic minorities: A qualitative study of practitioner perceived barriers and enablers
Authors: Halsall Kathryn , Ward Kath , Jarvis Kathryn 
Published: November 2024

Introduction: In the United Kingdom, ethnic minority mothers experience increased risk of mental illness compared to white women of British heritage. However, there is insufficient research to guide perinatal mental health occupational therapists to develop services that are accessible and meet the diverse needs of service users. This study explored perinatal mental health occupational therapists’ perceptions of the barriers and enablers to an inclusive service provision for ethnic minority mothers. Methods: A qualitative study was undertaken. Recruitment via social media used non-probability sampling. Semi-structured interviews collected data which were then analysed thematically. Results: Eight occupational therapist participated in the study. Three main themes were identified: observation of caseloads; experience of providing occupational therapy; influence of the therapist’s culture. Participants perceived stigma, fear, language and cultural perceptions created barriers for ethnic minority mothers. Discussion: Limited workforce diversity, ineffective mandatory training and insufficient referral to occupational therapy by other healthcare professionals were believed to negatively impact service delivery. Cultural experience and reflective practice were felt to enable inclusive practice. Recommendations to inform perinatal mental health occupational therapy practice in the United Kingdom and internationally include collaborations to gain a more diverse workforce, improved mandatory training and strategies to increase cultural sensitivity and competence.
Understanding the Effectiveness of Cognitive Behavioural Therapy: A Study on Offenders
Authors: Saxena Khyati , Sahai Anjali 
Published: November 2024

Background Cognitive behavioural therapy (CBT) is well known for its effectiveness in addressing psychiatric disorders such as depression, anxiety, PTSD, and borderline personality disorder, often used alongside medication. Summary CBT is used more often in the criminal justice system to help rehabilitate offenders by targeting cognitive distortions affecting their social and decision-making abilities. These maladaptive behaviours and sense of entitlement can result from distortions, which CBT works to address by restructuring thought patterns and encouraging adaptive behaviours. In general, CBT is a crucial method for decreasing repeat offences and dealing with mental health problems within the legal system. Key message CBT has demonstrated encouraging outcomes in decreasing reoffending rates in both youths and adults, aiding criminals in acquiring abilities to successfully re-enter society. Although it has replaced traditional rehabilitative services such as education and occupational therapy, its success highlights its importance in offender rehabilitation programmes. Nevertheless, inmates are frequently required to participate, causing doubts about their willingness to engage voluntarily.
Concomitant Factors Associated With Tillaux-Chaput Fractures in Adults: A Case-Control Study
Authors: Massri-Pugin Jafet , Matamoros Gabriel , Morales Sergio , Urrutia Tomás , Lira María Jesús , Filippi Jorge 
Published: November 2024

Background: Tillaux-Chaput fractures (TCFs) consist of fractures of the anterolateral distal tibia. They rarely occur in isolation in adults. When TCFs are missed, there is a risk of chronic pain, instability, and ankle osteoarthritis. This study aimed to identify which factors are related to the presence of TCFs in ankle injuries. Methods: A retrospective review of 1134 ankle fractures evaluated between 2013 and 2023 at a level 1 trauma center was performed. Inclusion criteria were patients aged ≥18 years, ankle radiographs and computed tomographic (CT) scan evaluation, and the presence of a TCF confirmed by CT scan. Exclusion criteria were prior ankle surgery, pilon, or distal tibial fractures. A musculoskeletal radiologist and a foot and ankle–trained orthopaedic surgeon classified the TCFs into type 1, an extraarticular avulsion; type 2, a fracture involving the incisura fibularis; and type 3, a fracture with impaction of the anterolateral tibial plafond. A matching control group of ankle fractures without TCF was created with a 1:2 ratio. The following variables were collected: sex, age (<50 vs >50 years), ankle dislocation or subluxation, Weber classification, Maisonneuve fracture, type of medial and posterior malleolar fracture, Lauge-Hansen classification, malleoli involved, and osteochondral lesion of the talus. Multivariate logistic regression was performed to detect which variables had an association with the TCF and their subtypes. P value <.05 was considered significant. Results: A total of 481 ankle fractures had radiographs and CT scans available for evaluation, of which 83 (17.3%) had a TCF. Of these, 44.6% were type 1, 44.6% type 2, and 9.6% type 3. The mean age was 52.2 years; 66.3% were women. Six patients (7.2%) had an isolated TCF. Fifty-eight (69.9%), 50 (60.2%), and 62 (74.7%) ankles had involvement of the lateral, medial, and posterior malleolus, respectively. Age ≥50 years (OR 2.73, 95% CI 1.45-5.14) and pronation external rotation injuries (OR 2.94, 95% CI 1.43-6.06) had a significant association with TCF. Moreover, ankle dislocation or subluxation (OR 3.16, 95% CI 1.11-8.96) and the absence of posterior malleolar fracture (OR 5.97, 95% CI 1.65-21.6) were significantly associated with TCF type 2 and 3. Conclusion: In this study, age ≥50 years and pronation external rotation injuries were the unique independent risk factors for TCF. Furthermore, ankle dislocation or subluxation and the absence of posterior malleolar fractures increased the odds of having a more severe TCF. This study provides insights into the factors associated with TCF and its subtypes during adulthood.
Optic disc pit maculopathy: Covering or filling technique with human amniotic membrane patch to treat the optic disc pit maculopathy?
Authors: Fiore Tito , Tucci Davide , Santi Nicola De , Lupidi Marco , Cagini Carlo , Mariotti Cesare 
Published: November 2024

Purpose To describe two patients affected by optic disk pit-maculopathy ODP-M surgically treated with pars-plana vitrectomy (PPV) and the apposition of a human Amniotic Membrane (hAM) patch. Methods Patients underwent a PPV with the apposition of a hAM patch to cover the ODP. In case 1, a 2nd surgery was necessary to push the hAM patch inside the pit, whereas in case 2 the patch was pulled inside the pit following the pressure gradient when infusion was turned on. Results After surgery the hAM patch filled the ODP and in both cases, during follow-up, there was a progressive reduction of macular OCT changes and a concomitant BCVA improvement. Conclusion Our experience seems to support the idea that the dynamic fluctuation of pressure between intra-ocular and intra-cranial spaces can direct the movement of fluid through the anomalous communication created by the ODP. In this perspective, our cases seem to support the idea that the primary goal of any surgery should be to create a permanent barrier to fluid migration through the ODP to the intra-ocular space, and that hAM can be successfully used to fill the OPD and to create that permanent barrier to achieve the resolution of ODP-M.
Unveiling the prognostic significance of malignant ascites in advanced gastrointestinal cancers: a marker of peritoneal carcinomatosis burden
Authors: Provenzano Leonardo , Gwee Yong Xiang , Conca Veronica , Lonardi Sara , Bozzarelli Silvia , Tamburini Emiliano , Passardi Alessandro , Zaniboni Alberto , Tosi Federica , Aprile Giuseppe , Nasca Vincenzo , Boccaccino Alessandra , Ambrosini Margherita , Vetere Guglielmo , Carullo Martina , Guaglio Marcello , Battaglia Luigi , Zhao Joseph Jonathan , Chia Daryl Kai Ann , Yong Wei Peng , Tan Patrick , So Jimmy , Kim Guowei , Shabbir Asim , Ong Chin-Ann Johnny , Casella Francesco , Cremolini Chiara , Bencivenga Maria , Sundar Raghav , Pietrantonio Filippo 
Published: November 2024

Background: Ascites is common in advanced gastrointestinal cancers with peritoneal metastases (PM) and negatively impacts patient survival. No study to date has specifically evaluated the relationship between ascites, PM and survival outcomes in metastatic colorectal cancer (mCRC) and metastatic gastric cancer (mGC). Objectives: This study aims to investigate and elucidate the relationship between malignant ascites, PM and survival outcomes in both mCRC and mGC patients. Design: This is a retrospective analysis of prospectively collected clinical trial data of mCRC and mGC patients with PM. Methods: We performed two pooled analyses, firstly of two Italian randomized trials enrolling patients with mCRC eligible for systemic therapy (TRIBE2; VALENTINO), and secondly of gastric cancer and peritoneal metastasis (GCPM) patients who underwent bi-directional therapeutic treatment comprising systemic and peritoneal-directed therapies. Results: Of 900 mCRC patients, 39 (4.3%) had PM with malignant ascites. Compared to the group without PM, median progression-free and overall survival were significantly inferior in the ascites group (hazard ratio (HR) for progression-free survival (PFS) 1.68, 95% confidence interval (CI): 1.21–2.35, p = 0.007; HR for overall survival (OS) 2.14, 95% CI: 1.57–3.01, p < 0.001), but not in the group of PM without ascites (HR for PFS 1.10, 95% CI: 0.91 – 1.34; HR for OS 1.04, 95% CI: 0.84 – 1.30). Of 170 patients with GCPM, those with ascites had higher median Peritoneal Cancer Index scores (23 vs 9, p < 0.001). Median OS was significantly inferior among those with ascites compared to those without (13.0 vs 21.0 months, HR 1.71, 95% CI: 1.16–2.52, p = 0.007). Conclusion: Ascites identifies a subgroup of patients with PM and poor outcomes, for whom tailored research are needed.
Early stereotactic body radiation therapy improves progression-free survival of first-generation EGFR tyrosine kinase inhibitors in EGFR-mutated lung cancer: an observational cohort study
Authors: Xu Hailing , Qi Rongbin , Zhou Chao , Yu Yingying , Lin Ling , Wu Xiaomai , Lv Dongqing 
Published: November 2024

Background: Stereotactic body radiation therapy (SBRT) in treating non-small-cell lung cancer (NSCLC) exhibits a remarkable therapeutic efficacy. However, its effectiveness in overcoming resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with advanced EGFR mutations (EGFRm) NSCLC remains uncertain. Objective: We aimed to analyze the effect of SBRT on patients with first-line EGFR-TKIs. Design and methods: Eligible patients with advanced NSCLC initially diagnosed with EGFRm were enrolled. Patients in the EGFR-TKIs group received only the first-generation EGFR-TKIs until disease progression or death, while the others in the EGFR-TKIs + SBRT group received EGFR-TKIs and early SBRT (dose of 40–60 Gy/5–8 F) targeting the primary lung tumor at 1 month after EGFR-TKIs. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were treatment-related adverse effects, overall survival (OS), and sites of initial failure. Results: A total of 184 advanced NSCLC patients with EGFRm were enrolled, including 39 patients in the EGFR-TKIs + SBRT group and 145 patients in the EGFR-TKIs group. The median PFS was 15.50 months in the EGFR-TKIs + SBRT group compared to 9.33 months in the EGFR-TKIs group ( p = 0.0020). However, the median OS was 29.10 months in the EGFR-TKIs + SBRT group and 26.33 months in the EGFR-TKIs group, with no significant difference observed ( p = 0.22). SBRT is an independent positive prognostic factor for PFS in advanced EGFRm NSCLC. EGFR exon 19 deletion mutation (16.33 vs 11.55 months, p = 0.0087) and fewer metastases (0–5) (31.94 vs 9.59 months, p = 0.0059) were associated with improved PFS in EGFR-TKIs + SBRT versus EGFR-TKIs. Combination therapy increased radiation pneumonitis mainly in Grades 1–2 (89.74% vs 0.0%). The EGFR-TKIs + SBRT group mainly had new site failure (57.10% vs 32.10%) rather than the original site failure. Conclusion: Early SBRT for primary lung tumors may overcome targeted resistance in advanced EGFRm NSCLC patients combined with EGFR-TKIs without serious toxicities, especially for EGFR exon 19-del. Trial registration: ChiCTR-OIN-17013920.
The role of baseline 18F-FDG PET/CT for survival prognosis in NSCLC patients undergoing immunotherapy: a systematic review and meta-analysis
Authors: Huang Mingxing , Zou Yuheng , Wang Weichen , Li Qianrui , Tian Rong 
Published: November 2024

Background: The value of pretreatment baseline 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET)/computed tomography (CT) as a prognostic factor for survival of patients with non-small-cell lung cancer (NSCLC) receiving immunotherapy remained uncertain. Objectives: To investigate the prognostic ability of baseline 18F-FDG PET/CT in patients with NSCLC receiving immunotherapy. Design: A systematic review and meta-analysis. Data sources and methods: We searched the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases until May 7, 2024, and extracted data related to patient characteristics, semiquantitative parameters of 18F-FDG PET/CT, and survival. We pooled hazard ratios (HRs) to evaluate the prognostic value of the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for overall survival (OS) and progression-free survival (PFS). Results: A total of 22 studies (1363 patients, average age range 30–88 years) were included. Baseline 18F-FDG PET/CT-derived MTV was significantly associated with both OS (HR: 1.124, 95% confidence interval (CI) 1.058–1.195, I2 = 81.70%) and PFS (HR: 1.069, 95% CI: 1.016–1.124, I2 = 71.80%). Other baseline 18F-FDG PET/CT-derived parameters, including SUVmax (OS: HR: 0.930, 95% CI: 0.718–1.230; PFS: HR: 0.979, 95% CI: 0.759–1.262), SUVmean (OS: HR: 0.801, 95% CI: 0.549–1.170; PFS: HR: 0.688, 95% CI: 0.464–1.020), and TLG (OS: HR: 0.999, 95% CI: 0.980–1.018; PFS: HR: 0.995, 95% CI: 0.980–1.010), were not associated with survival. Sensitivity analyses by removing one study at a time did not significantly alter the association between MTV and PFS or between MTV and OS. There was no evidence of publication bias. Conclusion: Pretreatment baseline 18F-FDG PET/CT-derived MTV might be a prognostic biomarker in NSCLC patients receiving immunotherapy. Further studies are needed to support routine use.
Exploratory analysis of immunomodulatory factors identifies L1CAM as a prognostic marker in alveolar soft-part sarcoma
Authors: Mondaza-Hernandez José L. , Hindi Nadia , Fernandez-Serra Antonio , Ramos Rafael , Gonzalez-Cámpora Ricardo , Gómez-Mateo María Carmen , Martinez-Trufero Javier , Lavernia Javier , Lopez-Pousa Antonio , Laínez Nuria , Martinez-Garcia Jeronimo , Valverde Claudia , Vaz-Salgado María Ángeles , Garcia-Plaza Gabriel , Marin-Borrero Isabel , Carrillo-Garcia Jaime , Martin-Ruiz Marta , Romero Pablo , Gutierrez Antonio , López-Guerrero Jose A. , Moura David S. , Martin-Broto Javier 
Published: November 2024

Background: Alveolar soft-part sarcoma (ASPS) is a rare tumor driven by the ASPSCR1-TFE3 fusion protein, with a propensity for metastasis. Prognostic factors remain poorly understood, and traditional chemotherapies are largely ineffective. Recent interest lies in immune checkpoint inhibitors (ICIs), yet predictive biomarkers for treatment response are lacking. Previous studies have shown promising results with ICIs in ASPS, indicating a need for further investigation into biomarkers associated with immune response. Objectives: To identify prognostic biomarkers in ASPS and to explore the role of immune-related markers, particularly L1CAM, in predicting patient outcomes. Design: A retrospective cohort study of 19 ASPS patients registered in the GEIS database. The study involved the collection of clinical and histopathological data, followed by an analysis of immune markers and gene expression profiles to identify potential prognostic indicators. Methods: Clinical and histopathological data were retrospectively collected from the GEIS-26 study cohort of 19 ASPS patients. Immunohistochemistry was performed to evaluate immune markers programmed death-1 ligand (PD-L1), programmed death-1, FAS, FASL, CD8, CD3, and CD4. An HTG ImmunOncology panel was conducted on formalin-fixed paraffin-embedded samples to explore gene expression. Effects of differentially expressed genes on survival were explored by Kaplan–Meier. Results: PD-L1 positivity was widely observed (63%) in tumors, and CD8+ lymphocytic infiltration was common. High CD8 density correlated with greater overall survival (OS) while not statistically significant. No associations were found for other immune markers. L1CAM was identified as differentially expressed in patients with low CD8 infiltration and correlated negatively with OS. Conclusion: High L1CAM expression correlated with poorer OS, highlighting its potential as a prognostic marker and therapeutic target in ASPS. Immunomodulatory interventions may hold promise, as evidenced by PD-L1 expression and CD8+ infiltration. Further research, including larger cohorts and international collaborations, is needed to validate these findings and explore therapeutic strategies targeting L1CAM in ASPS.
Costs of physician and diagnostic imaging services for shoulder, knee, and low back pain conditions: A population-based study in Alberta, Canada
Authors: Thanh Nguyen Xuan , Eubank Breda , Waye Arianna , Werle Jason , Walker Richard , Hart David A , Sheps David M , Schneider Geoff , Takahashi Tim , Wasylak Tracy , Slomp Mel 
Published: November 2024

Objectives To 1) estimate the utilization and costs of physician and diagnostic imaging (DI) services for shoulder, knee, and low-back pain (LBP) conditions; and 2) examine determinants of the utilization and costs of these services. Methods All patients visiting a physician for shoulder, knee, or LBP conditions (identified by the ICD-9 codes) in Alberta, Canada, in fiscal year (FY) 2022/2023 were included. Interested outcomes included numbers and costs of physician visits and DI exams stratified by condition, physician specialty, DI modality, and patients’ sex and age. Multivariate regressions were used to examine determinants of the outcomes. Results In FY 2022/2023, 10.4%, 7.0%, and 6.7% of the population saw physicians for shoulder, knee, and LBP conditions, respectively. This costs Alberta $307.04 million ($67.93 per capita), of which shoulder accounted for 41%, knee 28%, and LBP 31%. In the same FY, 17,734 computed tomography (CT), 43,939 magnetic resonance imaging (MRI), 686 ultrasound (US), and 170,936 X-ray exams related to shoulder/knee/LBP conditions were ordered for these patients, costing another $29.07 million, of which CT accounted for 14%, MRI 48%, US 0%, and X-ray 37%. Female, older age, comorbidity scores, and capital zone used physician services more frequently. Patients with a higher comorbidity index scores or more physician visits were more likely being referred for CT or MRI. Conclusion Musculoskeletal conditions are common and result in patients seeking healthcare services. Visits to family physicians, specialists, and the ordering of DI contribute to extensive utilization of health services, contributing to considerable health system costs.
Patients and healthcare practitioners’ perspective on the development of a digital interprofessional intervention for COPD
Authors: Biset Natacha , Rosière Amélie , Lartigue Victoria , Pochet Stéphanie , De Vriese Carine 
Published: November 2024

Background Chronic obstructive pulmonary disease (COPD) patients often have poor health literacy, leading to non-adherence to treatment and poor inhalation technique. Technological solutions can help manage COPD, but adherence tends to be low due to various factors. Objectives and Methods We conducted a qualitative study to determine the needs of COPD patients and healthcare practitioners (HCPs) towards a mobile application and a web platform. We also aimed to identify potential barriers or facilitators to the use of such digital tools and their potential impact, and to assess the current state of collaboration between healthcare practitioners. Results Our study found that COPD patients face difficulties in managing the disease and treatments, lack information and need easier contact with caregivers. Patients’ needs include access to reliable information about COPD, its medical treatments and smoking cessation, help in maintaining good physical condition through adapted exercises, incentives and reminders, and crisis management protocols or a logbook. As patient needs can differ, it would be ideal if the mobile application could be customized. HCPs cite patient adherence, correct intake of the treatment, communication and lack of patient motivation as challenges. In particular, they would like to have access to information on patient follow-up and logbooks, as well as scientific documentation. They believe that interprofessional collaboration is essential for good patient care. However, lack of time is a major hurdle in optimizing this collaboration. Conclusion Our study showed that most patients and HCPs view a technological platform positively to support the care of COPD patients and promote interprofessional collaboration.