bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteonecrosis of the Femoral Head: treatment before the collapse. Experience with decompression and biological therapy
Authors: Lara-Taranchenko Yuri , Mimendia Iñaki , Ojeda Víctor Barro , Guzmám María , Hernández Margalida , Martínez Andrés Aliaga , Soza Diego , Collado Diego , Farfán Ernesto Guerra , Hernández Alejandro 
Published: December 2024

Abstract

INTRODUCTION
Osteonecrosis is a disabling condition and one of the most frequent causes of hip arthroplasty in the young population. Early detection and treatment in stages prior to femoral head collapse are essential to prevent progression and conversion to total hip arthroplasty (THA). The present study aims to demonstrate the results obtained in the treatment of patients with initial stages of ONFH, treated with a decompression system that associates biologic therapy (platelet-rich plasma and mesenchymal stem cells) (PERFUSE).
METHODOLOGY:
Retrospective unicentric study in which all patients with ONFH treated with decompression of the necrotic area and biological therapy between May 2018 and May 2023, were collected. Demographic data of the patients (age and gender), risk factors for AVN, area of necrosis (Kerboul), ARCO classification, collapse rate and conversion to THA were obtained.
RESULTS
24 patients with ONFH were treated using the PERFUSE system. The mean age was 47.67 years old, and the mean follow-up was 26.1 months. The mean improvement in the modified Harris Hip Score (mHHS) was 10.11 (from 70.79 to 80.56; p = 0.018). Patients who developed femoral head collapse had worse mHHS scores. 6 patients (25%) progressed to femoral head collapse, of which 2 (8.33%) were converted to total hip arthroplasty (THA). The probability of collapse-free survival at 12 months was 90.9% (SD 6.2; 95%CI, 79.5–100%), and at 18 months it was 85.2% (SD 8.0; 95%CI, 70.9–100%), and at 24 months it was 65.7% (SD 11.7; 95%CI, 46.3–93.2%).
CONCLUSION
Core decompression with bone aspirate marrow and platelet-rich plasma can enhances bone regeneration and delays femoral head collapse, especially when implemented in early-stage ONFH. In this sense, combining both, core decompression with biological support can offer a promising approach for managing early-stage ONFH. Despite encouraging outcomes, further research is needed to optimize treatment protocols and evaluate long-term efficacy.
Knowledge and Practice of Solid Healthcare Waste Management Among Waste Handlers in Hospitals in Southern Ghana: A Qualitative Study.
Authors: Affordofe Michael , Udofia Emilia A. , Koranteng Francis Ofosu , Tettey Prudence , Botwe Paul K. , Akyeampong Enoch , Andoh Theresah , Peprah Elijah Kwasi , Attah Hope Yaw , Tabong Philip , Boateng Godfred , Quansah Reginald 
Published: December 2024

Abstract

Background
Despite Ghana's healthcare waste management guidelines, improper solid waste management remains a public health concern. Although there is extant evidence of the knowledge and practices of healthcare waste management among medical waste handlers elsewhere, evidence in Ghana is sparse. This study sought to assess the knowledge, and practices of waste handlers involved in solid healthcare waste management in selected health facilities in Accra, Ghana.
Methods
This study employed a descriptive phenomenology study design. We conducted three levels of sampling: facility-level sampling, departmental sampling, and a sample of study participants. We recruited medical waste handlers from Korle Bu Teaching Hospital, Tema General Hospital, and Shai-Osu-Doku Hospital for the study. To facilitate the discussion, we used a focus group discussion guide. We transcribed the audio-recorded interviews and uploaded the data into NVivo 14 software for coding. We synthesized the output into themes, sub-themes, and verbatim quotes to bolster the narrative.
Results
While the Waste handlers could describe the different types of healthcare waste, they could not label the colour codes according to the national colours used to identify the waste to be placed in a particular liner and container. In many cases, there was no attempt at managing infectious and sharp wastes, which resulted in needle pricks, falls, or even injuries due to poor transport systems. Although they were not familiar with the treatment processes for healthcare waste, they were aware of the frequency of bin cleaning. Most of the Waste handlers lacked infection-fighting vaccinations. Personal protective equipment, colour-coded bags, and a supply of disinfectants/soap needed to be improved.
Conclusions
Waste handlers are central to effective healthcare waste management and must be more adequately informed and protected against infections. Targeted training programs should be organized for health workers, emphasizing the importance of proper waste disposal and safety protocols to improve healthcare waste management practices.
Prognostic significance of NUAK1 and its association with immune infiltration in stomach adenocarcinoma
Authors: Ni Xin , Pan Fan , Lang Yakun , Zhang Wei 
Published: December 2024

Abstract

BACKGROUND: Stomach adenocarcinoma (STAD) represents a significant global health burden, accounting for a considerable proportion of cancer-related mortalities, and NUAK1, a protein kinase, plays a crucial role in cellular metabolism, cell cycle regulation, migration, and tumor progression. However, its relationship with prognosis and immune infiltration in STAD has not been thoroughly investigated.
METHODS: RNA sequencing data from the Cancer Genome Atlas (TCGA) and Genotypic Tissue Expression Project (GTEx) databases were employed to assess disparities in NUAK1 expression between STAD tumour and normal tissues. Additionally, we investigated the correlation between NUAK1 expression and patient prognosis, in addition to the level of immune cell infiltration. The potential functions were elucidated through an examination of the Gene Ontology (GO) Encyclopedia, the Kyoto Encyclopedia of Genes and Genomes (KEGG), and an enrichment analysis (GSEA).
RESULTS: Our analysis demonstrated that NUAK1 expression in tumour tissues exhibited a notable disparity from that observed in normal tissues, with elevated levels detected in STAD tissues. An elevated NUAK1 expression level was found to correlate with a poorer overall survival (OS), disease-specific survival (DSS), and progression-free intervals (PFI). Additionally, immune infiltration analysis indicated a significant positive correlation between NUAK1 expression and various tumor-infiltrating immune cells, while a negative correlation was observed with T helper cell 17(Th17) cells. Furthermore, enrichment analysis was conducted to identify relevant biological features and pathways.
CONCLUSION: The expression levels of NUAK1 are significantly increased in STAD, and this heightened expression correlates with diminished OS, DSS, and PFI among affected patients. These observations indicate that NUAK1 has the potential to function as a prognostic biomarker for STAD and may represent a viable therapeutic target for intervention in its management.
Identification of dengue risk-prone areas using multicriteria decision-making model and machine learning algorithm in Kolkata and Howrah Municipal Corporation areas
Authors: Naskar Suvankar , Biswas Brototi , Das Jayanta , Osman Shuayb Abdinour 
Published: December 2024

Abstract

Dengue fever poses a critical global health challenge, particularly in tropical and subtropical regions. Accurate identification of dengue-prone areas is essential for effective prevention and control. West Bengal, India, has witnessed significant dengue outbreaks, with the Kolkata-Howrah Municipal Corporation (KMC) area being the most affected. This study presents a novel approach, comparing Machine Learning (ML) and Multi-Criteria Decision Making (MCDM) techniques, to create a dengue susceptibility zonation model. We leverage diverse datasets, including environmental variables, demographic variables, and historical dengue incidence records collected through primary surveys. The models are built using the Fuzzy Analytic Hierarchy Process (F-AHP) and Random Forest (RF) algorithms, and their performance is assessed through Receiver Operating Characteristic (ROC) curve analysis, yielding Area Under the ROC Curve (AUC) values. While both models achieve similar AUC values, they produce different zonation patterns. Random Forest generates a dispersed susceptibility map, while F-AHP yields a more concentrated pattern. Remarkably, Random Forest identifies high-risk zones effectively, with approximately 21.69% of dengue cases occurring in these areas, compared to 4.35% in the F-AHP model. These zonation maps are invaluable for decision-makers, health authorities, and disaster management teams, aiding in proactive measures to curtail dengue spread and reduce mortality. This study underscores the power of ML techniques in predicting dengue susceptibility zones, reinforcing existing knowledge of dengue risk factors. By bridging advanced data analysis with practical applications, we advance dengue prevention and control efforts in West Bengal, offering insights that could benefit regions grappling with similar challenges worldwide.
Status of partial and complete edentulism and restoration and associated factors in Guangdong adults: a cross-sectional survey in 2021
Authors: Li Bingchun , Yin Luopin , Ye Shu , Li Jianbo , Lu Caihong 
Published: December 2024

Abstract

Background: The completeness of dentition serves as a key indicator for evaluating oral health and functionality within the middle-aged and elderly population. The study uses data from the epidemiological survey on oral health in Guangdong province among middle-aged and elderly individuals to investigate the status of tooth loss and denture restoration, explore the associated influencing factors, and provide fundamental data for oral health studies.
Methods: This study was a cross-sectional survey targeting adults aged 35-44 and 65-74 in 13 cities in Guangdong Province, conducted between 2021 and 2022. The status of tooth loss and denture restoration was investigated. T-tests, Chi-square tests, and ANOVA were used to analyze the differences in the number of individuals with partial or complete edentulism, the number of missing teeth, and the restoration rate between the two age groups. Chi-square tests and binary logistic regression were employed to analyze the risk factors. SPSS 20.0 software was used for statistical analysis of the survey data, p-value of≤0.05 was considered statistically significant.
Results: A total of 824 individuals participated in this survey, including 392 males and 432 females, 445 residents (54.0%) had partial tooth loss, including 206 males and 239 females, 9 individuals (1.1%) had complete tooth loss, comprising 6 males and 3 females. The prevalence of tooth loss was higher in the 65-74 age group compared to the 35-44 age group (p=0.012). The molar region is the most common area for missing teeth in both age groups. The 65-74 age group exhibits a higher number of missing teeth in the incisor, premolar, and molar regions compared to the 35-44 age group, with statistically significant differences in the number of missing teeth observed in each of these regions between the two age groups (p≤0.001). Different age groups, levels of education, regions, periodontal pockets, and the use of cleaning aids affected the prevalence of partial and complete edentulism. The restoration rate is higher in the 65-74 age group compared to the 35-44 age group (p≤0.001), and rural residents exhibit a lower restoration rate than urban residents (p≤0.001). Different age groups, county areas, and diabetes have an impact on whether teeth are restored.
Conclusions: The prevalence of tooth loss among adults in Guangdong Province remains at a relatively high level. This may be associated with factors such as age, education level, geographical location, periodontal health, and the use of wrong interdental cleaning aids. Therefore, there is a continued need to enhance oral health education among the population in Guangdong, emphasizing the importance of using proper interdental cleaning aids to maintain dental health.
Guiding the Scroll: How to Effectively Regulate Reproductive Health Information on social media?
Authors: Pandey Deeksha , Inukollu Pranadeep , Alla Mounika , velaga Sirisha , Pothyil Dan Issac , Nair Rema V 
Published: December 2024

Abstract

Introduction: In women, health literacy has the potential to profoundly affect numerous aspects of reproductive healthcare.This qualitative study seeks to explore healthcare providers' perspectives on the impact of social media on women’s reproductive health literacy and to identify strategies for improving and regulating this rapidly evolving domain.
Material & Methods: This study was conducted in a span of ten months (from October 2023 to July 2024), with a qualitative descriptive design. In the final analysis, 43 participants (11 postgraduates, 21 undergraduates and 11 consultants) were included, as by then saturation was reached.
Results: Four key themes emerged from the analysis of the data with seventeen subthemes. The key themes included A. Content alert: Accuracy and censorship information, B. Credibility and verification, C. Enforcement and penalties, D. Education, accreditation and ensuring quality.
Conclusion: As misinformation continues to proliferate in digital spaces, it becomes increasingly vital to establish effective regulatory frameworks. Implementing well-considered measures across all three levels of control—content creators, consumers, and platforms—can significantly enhance the quality and reliability of health information shared online. By fostering collaboration among these stakeholders, we can create a more informed public and mitigate the risks associated with misleading reproductive health information in social media environments.
The Predictive Value of Combined Nutritional Risk Screening (NRS 2002) and Inflammatory Markers for the Efficacy of Non-Small Cell Lung Cancer (NSCLC) Patients Treated with Immune Checkpoint Inhibitors (ICIs)
Authors: Liu Jianying , Liu Jiaxin , Chen Haiyan , Zhang Qingwei , Zhang Peihong , Chen Zhisheng , Lu Xuefeng , Xu Yijiao 
Published: December 2024

Abstract

Background
In the treatment of non-small cell lung cancer (NSCLC), immune checkpoint inhibitors (ICIs) have markedly improved patient survival, yet some patients do not benefit. The existing prognostic factors are limited, highlighting the development of reliable and convenient predictive indicators.
Methods
A retrospective analysis was performed on 219 NSCLC patients treated with ICIs from June 2019 to January 2024. The nutritional risk screening (NRS 2002) and the neutrophil-to-lymphocyte ratio (NLR) were employed to evaluate the patients' nutritional status and inflammatory response, aiming to investigate the correlation between these markers and treatment outcomes.
Results
The median follow-up duration was 29 (IQR: 25.96–32.04) months. The median progression-free survival (mPFS) and median overall survival (mOS) in the high nutritional risk (NRS2002 ≥ 3, 23.74%) group were significantly lower than those in the low nutritional risk group (mPFS: 2.5 vs 16 months; mOS: 8 vs 16 months, both P < 0.001). Similarly, patients with high NLR values (> 4.92) had significantly shorter OS and PFS than those with low NLR (≤ 4.92) values (mOS: 7 vs 18 months; mPFS: 3 vs 17 months, both P < 0.001). Multivariate Cox analysis revealed that a high NRS 2002 score (HR = 2.73, 95% CI: 1.66 ~ 4.48, P < 0.001) and high NLR (HR = 2.79, 95% CI: 1.65 ~ 4.70, P < 0.001) were independent predictors of poor prognosis. Risk stratification was performed using a combined scoring system of NRS 2002 and NLR (0 points - low risk, 1 point - moderate risk, 2 points - high risk), and it was found that as the risk score increased, OS and PFS significantly decreased. The utility of the combined NLR and NRS2002 scoring model was assessed using a time-dependent receiver operating characteristic (ROC) curve, with results indicating that at 12 months, the AUC value of the combined scoring model was 0.81 (CI: 0.72–0.90). At 24 and 36 months, the AUC values were 0.73 (CI: 0.66–0.80) and 0.70 (CI: 0.64–0.76), respectively. Moreover, the nomogram model exhibited high predictive accuracy in predicting survival prognosis, with AUC values of 0.84 (CI: 0.77–0.91), 0.85 (CI: 0.79–0.91), and 0.78 (CI: 0.69–0.88) at 12, 24, and 36 months, respectively.
Conclusion
The combined NRS 2002 and NLR scoring can serve as an effective prognostic tool for NSCLC patients receiving ICIs treatment. This scoring system helps clinicians more accurately identify patients who will benefit from immunotherapy, thereby facilitating more personalized treatment plans.
Impact of upper tract urothelial carcinoma on patients with non-muscle-invasive bladder cancer undergoing intravesical chemotherapy
Authors: Ji Jiaxiang , Wang Fei , Lai Chin-Hui , Wang Mingrui , Hu Haopu , Xu Kexin , Xu Tao , Hu Hao 
Published: December 2024

Abstract

Background: This study was designed to evaluate the impact of upper tract urothelial carcinoma (UTUC) history on prognosis in patients with non-muscle-invasive bladder cancer (NMIBC) receiving intravesical chemotherapy.
Methods: We conducted a single center, retrospective, cohort study of 444 NMIBC patients who received intravesical chemotherapy after transurethral resection of the bladder cancer (TURBT) at Peking University People's Hospital from 2000 to 2015. Patients were divided into UTUC-NMIBC group (with UTUC history) and primary NMIBC group (without UTUC history) by presence of previous UTUC. Demographic, clinical and pathologic factors were analyzed. Kaplan–Meier curves and the log-rank test were used to depict and compare recurrence-free survival (RFS) and progression-free survival (PFS) between the two groups. Multivariable Cox regression models were constructed to determine the variables associated with RFS and PFS.
Results: Compared to the primary NMIBC group (n = 410), the UTUC-NMIBC group (n = 34) had an older median age [72.0 (65.0–81.0) vs 66.0 (58–75) years; P = 0.007], a higher incidence of multiple tumors (52.9% vs 33.9%; P = 0.026) and a higher recurrence rate (52.9% vs 30.7%; P = 0.008) and worse RFS (P < 0.001). In multivariate analysis, UTUC history was an independent risk factor for recurrence (hazard ratio = 2.242; P = 0.001), but not for progression. Interestingly, subgroup analysis indicated patients with recent UTUC history (≤ 24 months between UTUC and NMIBC diagnoses) were associated with increased recurrence rates (73.7% vs 26.7%; P = 0.014) .
Conclusion: Presence of UTUC history was an independent risk factor for recurrence in patients with NMIBC who received intravesical chemotherapy, especially in those with a shorter interval between UTUC and NMIBC diagnoses.
Association of urinary dipeptidyl peptidase 4 activity with clinical outcomes in people with chronic kidney disease
Authors: Benetti Acaris , Ribeiro-Silva Joao Carlos , Gómez Luz M. , Tavares Caio A. M. , Bensenor Isabela J. , Lotufo Paulo A. , Titan Silvia M. O. , Girardi Adriana C. C. 
Published: December 2024

Abstract

Background
Experimental studies have shown that urinary dipeptidyl peptidase 4 (uDPP4), unlike serum DPP4 (sDPP4) activity, correlates with proteinuria, serum creatinine, and left ventricular (LV) hypertrophy in 5/6 nephrectomized rats, suggesting a potential role for uDPP4 in chronic kidney disease (CKD) progression. This study investigated the relationship of uDPP4 and sDPP4 activities with renal, cardiovascular, and metabolic function markers, along with mortality and initiation of kidney replacement therapy (KRT) events in individuals with CKD.
Methods
We analyzed DPP4 activity in the urine and serum of 426 participants from the Brazilian CKD cohort, PROGREDIR. Participants were divided into tertiles based on uDPP4 and sDPP4 activities. Multivariable linear regression models, structural equation modeling, Kaplan-Meier survival analysis, and Cox proportional hazard regression models were utilized.
Results
uDPP4 activity was associated with albuminuria, urinary retinol-binding protein 4, LV mass, and type 2 diabetes, but inversely with body mass index and use of renin-angiotensin system blockers. In contrast, sDPP4 activity correlated only with age and biological sex. Higher uDPP4 activity was associated with a higher incidence rate of all-cause mortality (p < 0.0001). Participants in the intermediate and highest uDPP4 activity tertiles had increased mortality risk (HR 2.03, 95% CI 1.46–3.04 and 2.48, 95% CI 1.67–3.67 for T2 and T3, respectively), compared to those in the lowest tertile, even after controlling for potential confounders. Conversely, sDPP4 activity did not correlate with an increased risk of death or KRT in CKD.
Conclusion
These findings support uDPP4's involvement in CKD progression and its association with increased mortality risk in CKD.
Long-Standing Thrombocytosis and Thrombotic Events Preceding Recognition of Polycythemia Vera: A Single-Center Retrospective Study
Authors: LASPA Evgenia , GRANDONI Francesco , ALBERIO Lorenzo , STALDER Grégoire 
Published: December 2024

Abstract

Background: Patients with polycythemia vera (PV) are at a higher risk for thrombotic events (TE), which may occur at any time before diagnosis, at diagnosis, or later during the disease. Besides an increased hematocrit, thrombocytosis may be an early marker of PV. Our study aimed to analyze the frequency of TE and the presence of thrombocytosis/erythrocytosis preceding the diagnosis of PV.
Methods: In this monocentric, retrospective study patients diagnosed with PV, aged 18 years or older, seen at our institution between January 2008 and December 2018, were included. Baseline demographic, PV diagnosis information, comorbidities, presence and type of TE, and blood counts before TE and PV diagnosis were analyzed.
Results: A total of 79 eligible patients were included. There was a slight male predominance (57%) with a median age at PV diagnosis of 69 years. Fifty-two patients (66%) had a TE (24 before or concomitant with PV diagnosis, 11 after PV diagnosis, and 17 both before and after PV diagnosis). Overall, 40 patients suffered arterial and 31 venous thrombotic events. For the 41 patients with TE before or concomitant to PV diagnosis: Median platelet count at time of TE was 365 G/l before and 479 G/l at PV diagnosis; median leucocyte was 11.2 G/l and 11.5 G/L, respectively; hemoglobin (hematocrit) level was 168 g/l (50%) and 179 g/l (53%), respectively. We had access to 90 blood counts performed before PV diagnosis in 17 patients with TE prior or concomitant with PV diagnosis. For these patients, the median time from the first blood count showing platelets >350 G/L or >450 G/l to the diagnosis of PV was 36 months and 24 months, respectively. Four patients had a TE prior to PV diagnosis with a normal platelet count. In these four patients, the median delay between the TE and PV diagnosis was 32 months. For the remaining 13 patients, the median time from the first blood count with platelets >350 G/L or >450 G/l and the TE was 46 months and 10 months, respectively. The median time from the earliest available blood count showing Hb >16.5 g/dL (Hct >49%) for men or Hb >16.0 g/dL (Hct >48%) for women to the diagnosis of PV was 25 months and 24 months respectively and to the TE was 12 months and 13 months, respectively.
Conclusion: Our study shows that both thrombocytosis and/or erythrocytosis are frequently present months and even years before the diagnosis of PV. In addition, the occurrence of a thrombotic event may be the earliest indicator of PV, particularly with thrombocytosis >350 G/L. The presence of thrombocytosis and/or erythrocytosis, even moderate, in the absence of a secondary cause, should evoke the diagnosis of a myeloproliferative neoplasia, including PV.