bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined active and passive isothermic heating leads to similar core temperature compared to exercise alone
Authors: Wardenaar Floris C. , Navarro Sonia , Caballero Rachel , Vento Kaila A. , Kavouras Stavros A. , Vanos Jenni 
Published: October 2024

ABSTRACT

Context
The training stress of heat acclimatization optimizing exercise performance in a hot environment can be demanding.

Objective
This study evaluated the efficiency of different single heating protocols to elevate core temperature.

Design
Not randomized controlled trial.

Setting
Passive heating (PAS), 30-min active heating using a high-intensity bike protocol (HIBP) in a hot environment with 30-min passive heating (EH-PAS), 60-min HIBP in a hot environment (EH), or 60-min HIBP at room temperature (EM).

Participants
Ten male participants (25±3 years) performed four different 60-min heating strategies at least one week apart.

Intervention(s)
Protocols were performed three times per week for six weeks. The single-task group underwent one-leg static balance training with and without vision and hopping balance training. The dual-task group underwent balance and cognitive training (backward counting task).

Main Outcome Measures
Body core temperature and heart rate.

Results
The highest peak gastrointestinal temperature occurred in EH-PAS (39.1±0.4°C), followed by EH (38.9±0.3°C), EM (38.4±0.3°C), and PAS (38.1±0.5°C). The average HR, measured as a control for intensity, was not different between exercise strategies (EH-PAS: 142±12.3, EH: 146±9.7, and EM: 142±13.3, p&gt;0.05), while different from PAS: 98±15.2 bpm, p&lt;0.05.

Conclusions
Adding passive heating to a shorter exercise protocol can be just as effective in keeping core temperature elevated as exercise in the heat alone during a 60-minute session. Therefore, a single-bout combination of exercise and passive heating may result in a similar body temperature induction compared to exercise heat stress alone.
National estimates of nonurgent emergency department utilization for sportsrelated injuries in high school-age population
Authors: Peterson Collin , Li Tao , Norcross Marc , Johnson Sam 
Published: October 2024

Abstract

Context:
Athletic trainers (ATs) can manage nonurgent, musculoskeletal emergency department (ED) visits. Little is known about what populations are most likely to use the ED for nonurgent, sports-related musculoskeletal injuries.

Objectives
Our object is to provide national-level evidence on whether high-school age population with public insurance or lower socioeconomic status were more likely to have ED visits for nonurgent injuries.

Design
Cross-sectional study.

Setting
Secondary data analysis of the 2017-2019 Nationwide Emergency Department Sample (NEDS).

Patients or Other Participants
ED visits for high school-age patients with a sports-related musculoskeletal injury.

Main Outcome Measure
We used a multi-step process and AT scope of care threshold to classify ED visits for musculoskeletal injuries as urgent and nonurgent. National estimates of the proportions of visit, patient, and hospital characteristics by urgent, nonurgent, and total injury ED visits were reported. Survey weighted logistic regression was used to calculate odds ratios of an ED visit being for a nonurgent injury based on a patient's insurance type and socioeconomic status.

Results
For ED visits for musculoskeletal injuries in a high school-age, sports exposed population, 52.93% (95% CI: 51.11, 54.73) were for nonurgent injuries. Patients with public insurance were more likely (OR = 1.39; 95% CI: 1.35, 1.44) to have an ED visit for a nonurgent injury compared to ED visits for patients with private insurance. Patients from the lowest estimated neighborhood income quartiles were more likely (OR = 1.10; 95% CI: 1.02, 1.20) to have an ED visit for a nonurgent injury compared to ED visits for patients in the highest estimated income quartile.

Conclusions
Our results suggest opportunities to reduce nonurgent ED use using AT services exist, especially in high school-age athletes from vulnerable populations.
Electoral participation of people with and without disabilities in urban communities in Cameroon and Senegal
Authors: Pente Vladimir Y. , Jeyam Anita , Bechange Stevens , Jolley Emma , Roca Anne , Dossou Sandra R. , Ba Khady , Oye Joseph , Bocoum Salimata , Leclercq Laurene , Schmidt Elena 
Published: October 2024

Background: The right to participate in political processes is fundamental to democratic governance, economic development and human rights.Objectives: We assessed participation in political processes and also explored factors associated with voting at the most recent election for people with and without disabilities.Method: We conducted cross-sectional survey in four cities in Senegal and three in Cameroon in 2021. Disability was assessed using the Washington Group Short Set of questions. Univariate and multiple regression analyses were conducted to identify the factors associated with voting at the most recent elections.Results: Among 4180 participants in Cameroon and 4171 in Senegal, disability prevalence was 9.77% and 10.89%, respectively. More than half of the participants had voted at the most recent elections in both Cameroon (52.31%) and Senegal (58.27%). Participants with an interest in politics, having all the key documents or registered with a political party were more likely to have voted in both countries. Adjusting for socio-demographic characteristics, people with disabilities were less likely to have voted compared to those without disabilities in Cameroon (odds ratio [OR] = 0.58 [0.40, 0.84]) and in Senegal (OR = 0.36 [0.26, 0.44]).Conclusion: There is an urgent need to address the socio-political and environmental factors that have been identified so as to close the disability gaps in voting and ensure equitable opportunities and levels of political participation between people with and without disabilities.Contribution: This article contributes to the existing knowledge base on the political participation of people with and without disabilities in Cameroon and Senegal.
Resilience and preparedness of hospitals for pandemics: Lessons learned from COVID-19
Authors: Raphela Tlou D. 
Published: October 2024

Amidst the COVID-19 pandemic, health systems around the world took a lot of pressure, and the resilience of these systems has been addressed in thedisaster management and COVID-19 literature. However, little focus has been given to the resilience of hospitals in general. Therefore, the study assessed one hospital in the Free State province of South Africa as a preliminary study for a project that will look at all hospitals in the Free State province. The study assessed the following: (1) the preparedness and actionable strategies that were implemented across the waves of the COVID-19 pandemic; (2) the resilience plans of the hospitals and also determined (3) the resilience of the hospital amid the COVID-19 pandemic; (4) the vulnerabilities exposed by the COVID-19 pandemic in the hospital. Using the R statistical program and modelling, I found that the study hospital was not prepared holistically for the COVID-19 pandemic. The five generalised linear mixed models and the general linear models applied did not show significant differences for the most important variables used to measure resilience. The models showed the hospital to be less resilient to pandemics. Several vulnerabilities were recorded across the hospital.Contribution: This study’s findings suggest that the studied hospital is not resilient to pandemics and will be able to make recommendations to relevant government departments to work together to strengthen the resilience of the country’s healthcare system once the project is completed.
Slow Flow And No-Reflow Phenomenon In The Intervention Of Coronary Arteries At The Viet Nam National Heart Institute - Bach Mai Hospital
Authors: Lam Truong Hoai , Yen Nguyen Thi Bach , Dat Phan Tuan , Hung Nguyen Duc , Minh Tran Duc , Long Nguyen Tuan , Vu Nguyen Hoai , Linh Duong Cong , Thanh Nguyen Cong , Thanh Nguyen Van 
Published: October 2024

Abstract

Background:
Slow or no-reflow can occur in both acute coronary syndrome (ACS) and chronic coronary syndrome (CCS), with an incidence rate of up to 32% in patients with ACS. No-reflow is associated with increased rates of rehospitalization, ventricular remodeling, malignant arrhythmias, and heart failure, and is an independent predictor of myocardial infarction and mortality. Although various treatments and medications, such as Adenosine, Nitroglycerin, Nicardipine, and Adrenaline, have shown effectiveness in improving flow when this phenomenon occurs, not all cases respond to these flow-improving drugs. Additionally, the use of these drugs may be unsuitable due to adverse developments that contraindicate their use

Objective:
A descriptive of the clinical and paraclinical characteristics and slow or no-reflow phenomenon during coronary artery interventions at the Viet Nam National Heart Institute, Bach Mai Hospital.

Method:
This is an observational study describing the clinical and paraclinical characteristics and management methods for slow or no-reflow in 40 patients undergoing coronary artery interventions at the Viet Nam National Heart Institute, Bach Mai Hospital.

Results:
Among the 40 observed patients, 80% were admitted with a diagnosis of STEMI. Males accounted for 57.5%, averaging 71.43 ± 10.97 years. All patients had mildly reduced left ventricular systolic function with an LVEF of 45.75 ± 10.43%. Slow flow primarily occurred in the culprit branch, with the LAD accounting for 50% and the right coronary artery for 32%. There were 14 anemic patients, accounting for 35%, with the lowest hemoglobin level being 80g/L. Blood potassium levels <3.5 mmol/L accounted for 22.5%, with the lowest being 2.9 mmol/L.
Adenosine was used to manage slow flow in 33 patients, with 32 patients (97%) showing improved flow after administration. Six patients were treated with Nitroglycerin, which improved TIMI flow in four patients. Two patients did not respond to Nitroglycerin but responded to Adenosine. Two patients with TIMI flow 0-1 did not respond to Adenosine and were subsequently treated with Adrenaline; however, TIMI flow did not improve, leading to short-term complications during hospitalization

Conclusion:
Slow or no-reflow is commonly observed in patients with acute coronary syndrome, predominantly in older males. These cases are often seen in patients with heart failure and mildly to moderately reduced left ventricular systolic function. The LAD is the most frequently affected coronary artery branch compared to the other two branches. Adenosine is the first-line drug and is more effective in managing slow or no-reflow.
Hysterectomy across Different Occupational Groups of Women in India: A Cross-sectional Study
Authors: Gunnal Gaurav Suresh , Roy Sudeshna 
Published: October 2024

Abstract

Aims and Objective:
The paper aims to examine the prevalence of hysterectomy amongst 451,853 women aged 25–49 years by different occupation groups in India and seek to identify associated factors. It is a cross-sectional study using bivariate and multivariate analyses.

Materials and Methods:
Data available in the public domain from the fourth round of the National Family Health Survey, conducted pan-India including both rural and urban areas during 2015–2016 by the Ministry of Health and Family Welfare, Government of India, are used. Descriptive statistical analyses were performed to investigate hysterectomy prevalence across various states and union territories and other independent variables in India. Further, two binary logistic regression models were run to examine the determinants of hysterectomy where the dependent variable had undergone hysterectomy and not undergone hysterectomy.

Results:
The result revealed that about five in every 100 Indian women had undergone hysterectomy. Excessive menstrual bleeding was the most common underlying condition for undergoing hysterectomy amongst all occupation groups. The prevalence was found to be the highest amongst agricultural women workers who are 32% (odds ratio = 1.320; confidence interval: 1.209–1.440) significantly more likely to undergo hysterectomy compared to other occupation groups.

Conclusion:
These results raise questions about poor access to quality healthcare services particularly for sexual and reproductive health amongst women working in the agricultural sector.
Evaluating the Efficacy of a Polymerase Chain Reaction Assay for Pneumocystis carinii Detection in Respiratory Samples
Authors: Agarwal Sonu Kumari , Thakur Harendra Kumar , Tarai Bansidhar 
Published: October 2024

Introduction:
Accurately identifying patients with pneumocystis pneumonia (PCP) presents considerable challenges, primarily relying on clinical suspicion. The manifestations of PCP lack specificity, encompassing symptoms such as cough, dyspnoea, fever, hypoxaemia, malaise and weight loss. Therefore, this study assesses the efficacy of a polymerase chain reaction (PCR) assay intended for use in clinical microbiology laboratories for the identification of Pneumocystis carinii from respiratory specimens.

Materials and Methods:
In this retrospective study, the medical records of patients aged 18 years and above were examined, focusing on those assessed using pneumocystis PCR-based tests. The study spanned from 2019 to 2022 in our tertiary care centre at Max Hospital, Saket. In this study, sputum and bronchoalveolar lavage (BAL) samples were proceeded for both staining and PCR for multi-copy mtLSU gene and single-copy dihydropteroate synthase polymorphisms (DHPS) fas gene of P. jirovecii.

Results:
In the analysis of 112 BAL specimens, 17 were identified as positive for P. carinii through both Grocott-Gomori’s Methenamine Silver Staining (GMS) staining and PCR. In addition, two BAL specimens were negative through GMS staining but showed positive results with PCR. On reviewing the clinical details of the patients associated with these two specimens, it was discovered that both individuals were under systemic steroid treatment, yet neither exhibited clinical signs of pneumocystis pneumonia (PCP). Consequently, these instances were classified as false positives by PCR. In comparison to GMS, the PCR assay demonstrated a sensitivity of 100% and specificity of 98% for detecting P. carinii in BAL specimens.

Conclusions:
The study underscores the necessity for individualised approaches, with each laboratory assessing the positive and negative predictive values based on their specific prevalence rates. In the ongoing pursuit of improving PCP diagnosis, PCR emerges as a promising screening tool that when used judiciously in conjunction with confirmatory measures, can enhance diagnostic precision in immunosuppressed populations.
Altering Trends in Pathological Spectrum of Cholecystectomy Specimen: Time to be More Vigilant
Authors: Gowda Vinay N. , Kumar Arvind , Singh Ashok , Durgapal Prashant , Gupta Amit , Kishore Sanjeev , Phulware Ravi Hari 
Published: October 2024

Abstract

Background:
Gall bladder cancer is a rare, most common and aggressive malignancy of the biliary tree, accounting for 80%–90% of biliary tract cancers. Gallstones are one of the major causes of the development of cholecystitis and long-term malignancy in developing countries. Cholecystectomy specimens have a great value in documenting various entities with clinical significance. Early detection is the most important step in improving the prognosis of gall bladder carcinoma (GBC) screening.

Aim:
Clinico- pathological spectrum of cholecystectomy specimen and Incidence of malignancy and its precursor lesion with gallstones.

Patient and Methods:
We conducted a retrospective analysis of all gall bladder specimens (cholecystectomy, laparoscopic, open or radical) from the period of January 2019–January 2022, including demographic data of the patients such as age and sex. Additional findings, such as the presence of gallstones, cholesterolosis, gastric or intestinal metaplasia, dysplasia and histopathological type of GBC, were documented.

Results:
A total of 1221 gall bladder specimens were received, with a higher female preponderance and a female-to-male ratio of 2.6:1. The mean age of presentation was 45 years. The most common histopathological diagnosis made was chronic cholecystitis (97%), and malignant cases accounted for 3% of the total cases.

Conclusions:
The high propensity of GBC with non-cholelithiasis cases, more than half of cases with metaplasia and increased incidence of adenosquamous carcinoma indicate a high burden of tumours, alerting the clinician as well as the pathologist.
Impact of Multiple-choice and Essay-based Assessments on Academic Performance and Stress Levels among Medical Students: A Cross-sectional Study
Authors: Chauhan Tanya , Hasan Shazia , Vardhan Gyan , Jhanwar Shubham , Negi Gita , Bisht Manisha , Handu Shailendra 
Published: October 2024

Background:
Balancing classroom instruction and examinations poses challenges in education, particularly in diverse student populations, necessitating educational reform and assessment strategies to mitigate stress. Medical education, like other fields, requires both knowledge acquisition and practical application, yet reliance on internet resources may exacerbate stress and hinder academic performance. Assessment tools in medical education vary based on the skills being evaluated, with written formats such as multiple-choice questions (MCQs) and essay-based questions (EBQs) used for cognitive assessments. This study compares MBBS students’ performance and stress levels in pharmacology examinations using MCQs and EBQs.

Aim:
To compare the performance and level of stress in the MBBS students after going through multiple choice questions and essay-based examination pattern.

Methods:
A cross-sectional study surveyed 100 third-semester MBBS students at AIIMS Rishikesh using a validated electronic questionnaire to assess various aspects of their experience with MCQs and EBQs in pharmacology assessments. The study collected data on demographics, stress levels, psychological effects, coping skills and student feedback, while excluding students who were not in the third semester, unwilling to participate or absent during the examination.

Results:
The study outcome showed no significant difference in scores between MCQs and EBQs. Stress factors during MCQ preparation included academic performance concerns and sleep issues, while course issues and sleep disturbances were primary stressors during EBQ preparation. Suggestions for examination pattern changes were common, indicating students’ desire for support.

Conclusion:
The study highlights the importance of addressing multifaceted stressors to support student well-being and academic success. Further research is needed to explore effective interventions.
Predicting the Response of Patients Treated with 177Lu-DOTATATE Using Single-photon Emission Computed Tomography–Computed Tomography Image-based Radiomics and Clinical Features
Authors: Behmanesh Baharak , Abdi-Saray Akbar , Deevband Mohammad Reza , Amoui Mahasti , Haghighatkhah Hamid R. , Shalbaf Ahmad 
Published: October 2024

Abstract

Background:
In this study, we want to evaluate the response to Lutetium-177 (177Lu)-DOTATATE treatment in patients with neuroendocrine tumors (NETs) using single-photon emission computed tomography (SPECT) and computed tomography (CT), based on image-based radiomics and clinical features.

Methods:
The total volume of tumor areas was segmented into 61 SPECT and 41 SPECT-CT images from 22 patients with NETs. A total of 871 radiomics and clinical features were extracted from the SPECT and SPECT-CT images. Subsequently, a feature reduction method called maximum relevance minimum redundancy (mRMR) was used to select the best combination of features. These selected features were modeled using a decision tree (DT), random forest (RF), K-nearest neighbor (KNN), and support vector machine (SVM) classifiers to predict the treatment response in patients. For the SPECT and SPECT-CT images, ten and eight features, respectively, were selected using the mRMR algorithm.

Results:
The results revealed that the RF classifier with feature selection algorithms through mRMR had the highest classification accuracies of 64% and 83% for the SPECT and SPECT-CT images, respectively. The accuracy of the classifications of DT, KNN, and SVM for SPECT-CT images is 79%, 74%, and 67%, respectively. The poor accuracy obtained from different classifications in SPECT images (≈64%) showed that these images are not suitable for predicting treatment response.

Conclusions:
Modeling the selected features of SPECT-CT images based on their anatomy and the presence of extensive gray levels makes it possible to predict responses to the treatment of 177Lu-DOTATATE for patients with NETs.
Corneal Epithelial Thickness in Normal Corneas with Low and High Toricity
Authors: Beheshtnejad Amir Houshang , Hani Mohammad , Abdolalizadeh Parya , Alipour Fateme 
Published: October 2024

Abstract

Purpose:
To compare the corneal epithelial thickness along the flat and steep meridians of corneas with low and high toricity.

Methods:
This was a prospective observational comparative study on healthy subjects with normal corneas seeking preoperative evaluation for refractive surgery at a university-based hospital. Subjects with up to 2 diopters (D) of corneal with-the-rule astigmatism were defined as low corneal toricity (CT), whereas cylinder > two-dimensional was considered as high CT. The anterior segment optical coherence tomography was conducted to measure the epithelial thickness along the principle meridians of CT over a diameter of 9 mm. At the eye level, outcome variables (corneal and epithelial thicknesses in low- and high-astigmatism groups) were assessed using generalized estimating equation models.

Results:
Included were 98 eyes (49 subjects): 46 eyes (23 subjects) with low CT and 52 eyes (26 subjects) with high CT. Two groups were similar with respect to the age (P = 0.82), sex (P = 0.49), and spherical equivalent (P = 0.11). Although the corneal thickness at steep and flat meridians was not different between two groups, high-CT group had significantly thinner epithelium at inferior 2.5–3.5 and 3.5–4.5 mm zones (P = 0.01 and 0.04) as well as superior 2.5–3.5 mm zone (P = 0.03) along the steep meridian. Two groups were similar with respect to epithelial thickness of flat meridian (all P > 0.05).

Conclusion:
The epithelium of steep meridian was thinner in the high-CT group compared to the low-CT group.