bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erectile Dysfunction And Associated Factors Among Adult Hypertensive Patients Attending Outpatient Care At Public Hospitals in Harari Regional State,Eastern Ethiopia
Authors: Abdi Dawit , Misgana Tadesse , Asefa Abdulselam , Bete Tilahun , Temesgen Abdi , Zewudie Abinet , Asefa Hirko , Tilahun Shimelis , Dereje Jermen 
Published: October 2024

Abstract

Introduction. Sexual dysfunction is lack of sexual ideas or thoughts, diminished sexual interest or desire, and unresponsive sexual desire. Sexual dysfunctions is a prevalent issue that can impact both the patients' and their spouses' quality of life. Even though Erectile dysfunction is very common and linked to many medical and health related conditions. There was no study at public hospitals in Eastern Ethiopia.
Objective. This study was aimed to assess the prevalence of erectile dysfunction and associated factors among hypertensive patients attending Public Hospitals in Harari Region, Eastern Ethiopia.
Materias and Methods. An institutional-based cross-sectional study was conducted from January 31 to February 29,2024 among 413 participants selected by systematic random sampling technique. Erectile dysfunction was assessed with the International Index of Erectile Function. Data were entered into EPI Data version 3.1 and analyzed using STATA version 14. Bivariable and multivariable logistic regressions were done to identify factors associated with Erectile dysfunction. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed when the p-value was less than 0.05, which was considered statistically significant.
Results. A total of 413 male adult hypertensive patients were recruited in this study with a 98.3% response rate. The prevalence of erectile dysfunction among hypertensive patients was 54%(95% CI 49.2-58.4). Age between 61 and 80 years (AOR=3.3,95% CI: 1.06-10.32),having a depression (AOR=3.1,95%CI: 1.63- 6.16),having an anxiety (AOR=2.3,95% CI:1.21- 4.41),being in a stage 2 hypertension (AOR=3.2,95% CI:1.09- 9.77),duration of hypertension more than 10 years (AOR=5.6,95%CI:1.98-16.06),having comorbid medical illnesses (AOR=4.0,95%, CI:2.13- 7.53),being on antihypertensive polytherapy (AOR=3.6,95%CI:1.99-6.51), and being physically inactive (AOR=4.4,95% CI:2.42- 8.07) were significantly associated with erectile dysfunction.
Conclusion. More than half of the study participants had erectile dysfunction. and it appears to be significantly associated with age, presence of depression and anxiety, stage of hypertension, duration of the illness, preexisting chronic illnesses, medication polytherapy, and physical activity. All hypertensive patients presenting to a physician should have routine evaluation for erectile dysfunction so as to recognize it early and reduce its effects.
The placenta area in sector 2 and cervical area correlate with massive hemorrhage in patients with placenta accreta spectrum disorders
Authors: Feng Guannan , Yan Jun , Yuan Min , Yue Yongfei 
Published: October 2024

Abstract

Background
Placenta accreta spectrum (PAS) is an obstetric complication related to severe maternal morbidity and mortality, magnetic resonance imaging (MRI) can predict the bleeding risk and the adverse outcomes of the maternal caesarean section in PAS patients. This study aimed to identify whether the placenta area in sector 2 (S2) and cervical area measured by MRI correlate with massive hemorrhage (MH) in complete placenta previa patients with PAS.
Methods
One hundred and thirty-eight patients were diagnosed as PAS from January 2016 to December 2023. The patients were divided into two groups according to the estimated blood loss volume: MH group (estimated blood loss > 2000mL) and non-MH group (estimated blood loss ≤ 2000mL). The correlation between placenta area in S2, cervical area and MH were evaluated with multivariate analysis. The evaluation capabilities of indicators were assessed using receiver operating characteristic (ROC) analysis.
Results
The placenta area in S2 of the MH group was significantly higher than that of the group without MH (P < 0.001), on the contrary, cervical area was significantly lower in PAS patients with MH than that of the group without MH (P < 0.001). A positive linear was found between placental area and amount of blood loss (r = 0.752), and negative linear were found between cervical area and amount of blood loss (r=-0.671), between cervical area and placenta area (r=-0.559). Combined with placental area in S2 and cervical area, the sensitivity, specificity, and the area under the curve (AUC) for the predictive MH were 89.237%, 91.548%, and 0.910, respectively.
Conclusion
The placenta area in S2 and cervical area may be used to recognize MH in patients with PAS.
Safety and Efficacy of High-Power Short-Duration Radiofrequency Ablation (50W) in Patients with Paroxysmal Atrial Fibrillation
Authors: Li Xinzhong , Xiao Zhiwen , Zhang Jiachen , Huang Xiaobo , Lin Hairuo , Huang Senlin , Liao Yulin , Wu Juefei , Xiu Jiancheng , Li Jianyong , Bin Jianping , Wang Yuegang 
Published: October 2024

Abstract

Background
Pulmonary vein isolation (PVI) using conventional power radiofrequency ablation (RFA) has been an effective treatment strategy for paroxysmal atrial fibrillation (PAF), but its longer duration may cause collateral damage to peripheral tissue. High-power RFA, characterized by better transmural performance and reduced collateral damage due to its shorter duration, has sparked a safety and efficacy controversy that still needs further evaluation.
Methods
In this retrospective cohort study, we included 259 patients with PAF who were had performed for lesion size index (LSI)-guided radiofrequency ablation. A total of 119 PAF patients underwent 50 W ablation. Complications and twelve-month arrhythmia-free outcomes of the procedure were compared with 140 patients who underwent 30–35 W ablation.
Results
PVI was successfully achieved in all patients. The procedural duration (140.3 ± 34.4 vs. 151.3 ± 40.6 min, P = 0.022) and overall radiation (112.0 ± 67.2 vs. 188.2 ± 119.2 mGy, P < 0.001) were significantly lower in the 50 W group. No major complications occurred in the high-power short-duration (HPSD) group. The recurrence of arrhythmia at the twelve-month follow-up was not significantly different between the two groups [11 (9.2%) vs. 19 (13.6%), P = 0.278)].
Conclusion
LSI-guided HPSD-RFA demonstrated comparable safety and efficacy for conventional ablation and resulted in reduced procedure time and radiation exposure.
Totally Endoscopic Mitral Valve Repair with Novel Technique of Left Atrial Exposure: Five Years Experience from a Single Center
Authors: Pham Thanh Dat , Nguyen Cong Huu 
Published: October 2024

Abstract

Background
Endoscopic mitral valve repair has become the standard procedure for the management of isolated mitral regurgitation. Our innovative technique for mitral valve exposure has been previously described. This study evaluates the outcomes of totally endoscopic mitral valve repair using this novel technique over a five-year period at a single center.
Methods
A retrospective review was conducted on 122 patients who underwent totally endoscopic mitral valve repair between May 2018 and December 2023. Clinical and echocardiographic data were meticulously collected and analyzed. The surgical procedure was performed completely endoscopic via a 3–4 cm right mini-thoracotomy, with peripheral cardiopulmonary bypass. A novel technique utilizing retraction sutures for mitral valve exposure was employed. Primary outcomes included the results of the endoscopic techniques, mitral valve repair outcomes, perioperative complications, and short-term mortality. Long-term outcomes, including survival, freedom from reoperation, and recurrent mitral regurgitation, were assessed using Kaplan–Meier analysis.
Results
Mitral valve exposure was successfully achieved in all cases. The mean age of the patients was 54.5 ± 14.2 years, and their mean log EuroSCORE II was 1.53 ± 1.30. The repair rate was 96%, with anterior leaflet repair in 13%, posterior leaflet repair in 69%, and bileaflet repair in 14%. Mean aortic cross-clamp time and cardiopulmonary bypass time were 117 ± 39 minutes and 181 ± 48 minutes, respectively. The early mortality rate was 1,6%. Three patients (2.5%) experienced intraoperative conversion to sternotomy and 6 patients (4.9%) underwent a reoperation. There were 2 cases of stroke (1,6%) and 2 cases of unilateral pulmonary edema (1.6%). The minimum follow-up duration for a patient was 6 months, extending up to 72 months, with a mean follow-up duration of 28.6 ± 15.1 months. Kaplan–Meier analysis demonstrated a 96.7 ± 1.6% survival rate at 5 years, with 98.4 ± 1.2% freedom from reoperation, and 86.1 ± 3.1% freedom from recurrent mitral regurgitation.
Conclusions
Totally endoscopic mitral valve repair utilizing the novel technique of left atrial exposure is feasible and can be safely performed with low mortality and morbidity. This approach achieves a high rate of mitral repair and demonstrates favorable long-term outcomes.
Right Ventricular Dysfunction: An Early Sign of Anthracycline Induced Cardiotoxicity - Case Series
Authors: Blair Cheavar , Bryana Levitan , Tori Brown , Nakeya Dewaswala , Amit Arbune 
Published: October 2024

Abstract

Background: Anthracycline-induced cardiotoxicity is clinically distinguished by a reduction in left ventricular ejection fraction (LVEF) exceeding 10% and an LVEF below 50%. Due to these guidelines, alterations in right ventricular (RV) structure and function are often neglected as indicators of cardiotoxicity. In this report, we present two cases of anthracycline-induced cardiotoxicity that initially manifested as RV dilation and dysfunction.
Case presentations: Patient One, A 41-year-old woman with a history of sub-massive pulmonary embolism and obesity, was diagnosed with right pulmonary artery sarcoma and treated with surgical resection, radiation therapy, and adjuvant doxorubicin. Months after starting chemotherapy, she experienced progressive dyspnea on exertion and lower extremity swelling; a follow-up TTE demonstrated normal LV size and function, RV dilation, and RV pressure and volume overload. Since LVEF did not fall under the definition of cardiotoxicity, she continued doxorubicin treatment. Her clinical condition worsened, leading to severe RV dilation, reduced function, and new ECG abnormalities. Eventually, a cardiac MRI revealed reduced biventricular function and RV volume overload, with a final diagnosis of biventricular failure due to chemotherapy.
Patient Two, a 21-year-old male diagnosed with osteosarcoma at age 12, underwent surgical resection, endoprosthesis reconstruction, and adjuvant chemotherapy with cisplatin and doxorubicin. A 7-year post-chemotherapy follow-up echocardiogram noted increased RV pressure suggestive of pulmonary hypertension. Follow-up TTE showed normal LVEF with borderline normal GLS, visually normal RV size and systolic function, and borderline elevated RVSP of 35 mmHg. Subsequent cardiac MRI revealed reduced right and left ventricular function and non-ischemic cardiomyopathy.
Conclusions: These cases illuminate a critical gap in the current diagnostic criteria and definition of cardiotoxicity, emphasizing the necessity for more comprehensive echocardiographic approaches to assess cardiotoxicity. Specifically, they underscore the importance of including changes in right ventricular (RV) structure and function, which are often overlooked but can serve as early indicators of cardiotoxicity.
Molecular Mosaics: Unveiling Heterogeneity in Synchronous Colorectal Cancers
Authors: Lee Hyun Gu , Kim Yesseul , Kim Mi-Ju , Kim Yeon Wook , Jun Sun-Young , Kim Deokhoon , Park In Ja , Hong Seung-Mo 
Published: October 2024

Abstract

Molecular characteristics of synchronous colorectal cancers (SCRCs) remain incompletely elucidated, despite their importance in targeted therapy selection. This retrospective study (2012–2014) compared the molecular characteristics and somatic mutations between SCRCs in 100 patients with surgically resected SCRCs. Molecular characteristics, including microsatellite instability (MSI) and tumor-infiltrating lymphocytes (TILs), were analyzed for all cancer lesions. The intertumoral heterogeneity of SCRCs was evaluated using whole-exome sequencing (WES) for 18 cancers from 9 patients with at least one MSI-high (MSI-H) tumor. Twelve patients had at least one MSI-H tumor; five showed discordant MSI status. Mucinous adenocarcinoma frequency and TIL density were higher in patients with at least one MSI-H tumor than in those with only microsatellite-stable tumors. WES revealed that, except one patient (6.5%), most synchronous cancers shared few variants in each patient (0.09–0.36%). The concordance rates for BRAF, KRAS, NRAS, and PIK3CA in synchronous cancers from each patient were 66.7%, 66.7%, 66.7%, and 55.6%, respectively. Although synchronous cancers shared a mutated gene, the mutation subtypes differed. SCRCs exhibited 5% MSI status discordance rate and a high discordance rate in somatic mutational variants. As intertumoral heterogeneity may affect the targeted therapy response, molecular analysis of all tumors is recommended for patients with SCRCs.
Nutritional Knowledge and Practices of Low-Income Women During Pregnancy: A Qualitative Study in Two Oaxacan Cities
Authors: Marian Marian , Pérez Ramona L. , McClain Amanda C. , Hurst Samantha , Reed Elizabeth , Barker Kathryn M. , Lundgren Rebecka 
Published: October 2024

Abstract

Background
Adequate dietary intake is critical for healthy pregnancies. Recent changes in social services in Mexico, coupled with high levels of food insecurity, call into question whether expecting women of the lowest socioeconomic status are able to meet their dietary and nutritional needs in this changing context. The aim of this study was to explore the nutritional practices, education and received and employed among women during their pregnancy.
Methods
Guided by Ecological Systems Theory and an Intersectionality Framework, this qualitative study was carried out in Oaxaca City and Puerto Escondido, in Oaxaca, a Mexican state with high levels of food insecurity. Women who had at least one child in the past five years and had lived in Oaxaca for the past five years were eligible to participate. Twenty-five women participated in semi-structured in-depth interviews conducted between June and December of 2023. A grounded theory approach was used for coding. NVivo was used for coding and analyses.
Results
Five key themes emerged linked to individual-level characteristics and the multiple social identities related to the social support for nutritional knowledge and practices among low-income Oaxacan women during pregnancy: 1) Life experiences, sociodemographic, and health characteristics that influence nutritional practices and knowledge during pregnancy; 2) Female family members as a primary source of nutritional knowledge and food support; 3) Support from other members of women’s social networks; 4) Medical guidance for nutrition during pregnancy; and 5) Quality and gaps in the broader health care system and social services. These themes highlight how women’s own experiences and social identities and the different interpersonal and community-level environments, particularly those of mothers and grandmothers and health care providers, interact and shape women’s nutritional knowledge and practices, such as foods and nutritional supplements consumed, during pregnancy.
Conclusion
Nutritional knowledge and practices during pregnancy are impacted by multiple social identities women have and different factors at the individual, group, and structural level. Future research and programming that use multi-level approaches (considering the individual and the family and other social influences) are needed to address the gaps in nutrition that women in Oaxaca go through during the prenatal period.
Effect of severed right gastric artery on postoperative anastomosis after Mckeown surgery for esophageal carcinoma: A Randomized controlled trial
Authors: Zhang Guibin , Gao Shuhui , Yin Qifan , Qie peng , Song Yongbin , Wang Huien 
Published: October 2024

Abstract

Objective To evaluate the effect of right gastric artery on anastomotic fistula and anastomotic stenosis after Mckeown surgery for esophageal carcinoma.Methods Prospective analysis of 120 esophageal cancer resection from July 2018 to July 2020 In all cases, esophagogastric and neck anastomosis was performed and randomly divided into 60 cases in the right gastric artery sparing group (Group A) and 60 cases in the right gastric artery disconnection group (Group B), and the occurrence of anastomotic fistula and stenosis in different surgical groups were analyzed.Results Postoperative anastomosis in 120 patients: there was no significant difference in the incidence of postoperative anastomotic fistula (10% / 16.7%) (P > 0.05). There were differences between the two groups in groups A and B 2 months after surgery(P < 0.05); no significant difference between the two groups 4 months after surgery (P > 0.05).Conclusion Separation of right gastric artery has no effect on anastomotic fistula after esophageal cancer and may cause postoperative anastomotic stenosis in patients.
Assessing community vulnerability to initial COVID-19 spread in Florida ZIP Codes using Shapley additive explanations with random forest modeling
Authors: Otano Yilian Alonso , Zaatour Wajdi , Ginjala Raveena , Michael Edwin 
Published: October 2024

Abstract

Background
The identification of the population attributes that play important roles in the early-phase community spread of an epidemic is critical to improving our ability to prepare and develop the resilience of societies to future pandemic-potential pathogens. Our study aimed to assess the vulnerability of communities at the ZIP code-level in the state of Florida to the growth in the case incidence of the COVID-19 epidemic during its initial outbreak phase using local case and CDC/ATDSR SVI data and the application of a novel explainable machine learning model.
Methods
The COVID-19 growth rates were estimated from a log-linear regression fitted to the daily number of cases reported for the initial wave of the pandemic in each ZIP code (n = 935). A random forest model was trained to predict COVID-19 growth rates using 22 social vulnerability indicators. The trained model was interpreted with Shapley additive explanations (SHAP) to investigate the contribution of social vulnerability features to early COVID-19 spread across all ZIP codes in Florida. SHAP feature ranking and results were used to calculate a Social Vulnerability Index (SVI) for each ZIP code.
Results
Estimated COVID-19 growth rates ranged from 1 to 1.247 (mean = 1.054). The percent of single-parent households was the most important feature in predicting growth rates, followed by (in order) population density and the percentages of the population facing language barriers, living in group quarters, burdened by housing costs, and diagnosed with coronary heart disease in a ZIP code. High values of the five highest ranking features were shown to contribute positively to predicted growth rates, whereas high values of the sixth feature contributed negatively. The constructed SVI had a significant positive association (p-value < 0.0001) with the ZIP code-level epidemic growth rates.
Conclusions
The constructed ML-SHAP modeling approach and SVI can help assess the social vulnerability of communities to the early COVID-19 spread that was observed in Florida ZIP codes. They can also serve to identify high risk sub-populations and localities, which will be important for advancing development of mitigation strategies to prevent, enhance community resilience, and respond to future novel pathogens of pandemic potential.
Knowledge, attitudes, and practices toward depression among people living with depression in Vietnam: the cultural dynamics in the era of globalization
Authors: Kieu Nhu Tran , Thai Quynh Chi Nguyen , Khac Thu Nguyen , Van Minh Hoang , Kane Sumit , Dang Hoang-Minh 
Published: October 2024

Abstract

Background
Despite the high burden of depression in Vietnam, little is known about the knowledge, attitudes, beliefs, and practices of Vietnamese people with depression in contemporary society.
Methods
This is a qualitative study with 40 adults, 18–64 years old, with symptoms of depression. In-depth interviews were conducted to explore knowledge (symptoms, causes, treatment), attitudes, and practices to seek support or care for depression.
Results
Knowledge about depression is good amongst the study participants. They could identify several symptoms of depression and are aware of stress and adverse events as causes of depression. However, biological factors as causes are infrequently mentioned. Most people with depression know about psychotherapy and pharmacological treatment. Stigma related to depression seems lesser compared to that in the past. People with depression receive support from family and friends. Despite high awareness about symptoms, causes, and treatment options, misconceptions remain, concealment of illness is common, as is the avoidance of seeking care. Access to care is hindered by cost barriers and a lack of information about reliable providers. Medicines are frequently discontinued due to side effects and insufficient consultation during examination. Praying and offering to altars as cultural practices to treat mental illness still exist. Based on analysis guided by the ‘glocalization theory’ we offer an explanatory account of the current state off knowledge, attitudes, and practices toward depression amongst people living with depression in Vietnam. This analysis recognizes the co-existence of global and local influences. People are creating and adapting their “glocal” views, attitudes, and norms around depression as well as mental illness.
Conclusions
Societal changes have influenced the knowledge, attitudes, and behaviors towards depression in Vietnam in positive ways; however, historical, cultural challenges continue, while new challenges are emerging. Our findings point to the need for renewed, continued efforts to improve mental health related awareness, while simultaneously improving the availability, accessibility, and responsiveness of mental health services. These efforts should take into account both global and local influences on how people in Vietnam think and act regarding mental health issues.
Trial registration:
Clinicaltrials.gov, NCT06456775. Registered June 12, 2024 – Retrospectively registered, https://clinicaltrials.gov/study/NCT06456775?cond=depression&intr=Tele-SSM&rank=1