bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability, reproducibility, and potential pitfalls of the O-RADS scoring with non-dynamic MRI
Authors: Kılıçkap Gulsum , Dölek Betül Akdal , Kaya Serhat , Çevik Numan Ilteriş 
Published: September 2024

Background The O-RADS scoring has been proposed to standardize the reporting of adnexal lesions using magnetic resonance imaging (MRI). Purpose To assess intra- and inter-observer agreement of the O-RADS scoring using non-dynamic MRI and its agreement with pathologic diagnosis, and to provide the pitfalls in the scoring based on discordant ratings. Material and Methods Adnexal lesions that were diagnosed using non-dynamic MRI at two centers were scored using O-RADS. Intra- and inter-observer agreements were assessed using kappa statistics. Cross-tabulations were made for intra- and inter-observer ratings and for O-RADS scores and pathological findings. Results Intra- and inter-observer agreements were assessed for 404 lesions in 339 patients who were admitted to center 1. Intra-observer agreement was almost perfect (97.8%, kappa = 0.963) and inter-observer agreement was substantial (83.2%, kappa = 0.730). The combined data from center 1 and center 2 included 496 patients; of them, 295 (59.5%) were operated. There was no borderline or malignant pathology for the lesions with O-RADS 1 or 2. Of those with an O-RADS score of 3, 3 (4.1%) lesions were borderline and none were malignant. The O-RADS scoring in discriminating borderline/malignant lesions from benign lesions was outstanding (area under the ROC curve 0.950, 95% CI = 0.923–0.971). Sensitivity, specificity, positive, and negative predictive values of O-RADS 4/5 lesions for borderline/malignant lesions were 96.2%, 87.1%, 72.8%, and 98.4%, respectively. Conclusion The O-RADS scoring using non-dynamic MRI is a reproducible method and has good discrimination for borderline/malignant lesions. Potential factors that may lead to discordant ratings are provided here.
Removing environmental barriers to independent living: A feasibility randomised controlled trial targeting people ageing with long-term physical disabilities
Authors: Chen Szu-Wei , Krauss Melissa J , Somerville Emily , Holden Brianna , Devine Megen , Stark Susan 
Published: September 2024

Introduction: People ageing with long-term physical disabilities face unique challenges to maintaining independence. We developed a novel, evidence-based intervention – Removing Environmental Barriers to Independent Living – to support participation and reduce falls. Methods: To examine Removing environmental barriers to independent living’s feasibility and estimate its magnitude of efficacy, we conducted a single-blinded randomised controlled trial. Fifty participants who were aged 45–65 years with a physical disability for at least 5 years were randomised to intervention ( n = 24) or control ( n = 26). Activity performance, environmental barriers to performance, community participation, environmental fall hazards and fall prevention behaviours were assessed at baseline and at 6-month follow-up. Dose, adherence, fidelity and cost were examined. Linear mixed-effects models for repeated measures were used to assess the effects of time, group and group by time interaction on the continuous outcomes. Results: Removing environmental barriers to independent living had high fidelity and adherence and a low implementation cost. There were trends for greater improvements in activity limitations and activity performance among intervention versus control participants. Conclusion: Removing environmental barriers to independent living is a feasible intervention with high fidelity and adherence. Findings trended towards greater improvements in activity performance for intervention participants. Results could inform future planning for a larger pragmatic trial.
Prospective study investigating the influence of nutritional intervention on biochemical profiles in patients with recurrent urolithiasis.
Authors: Ben Othman Rym , bouzid Kahena , Ben Sassi Amira , Naija Ouns , Ferjani Wafa , Mizouri Ramla , Bartkiz Ahlem , Ammari Khouloud , Gamoudi Amel , Berriche Olfa , Jamoussi Henda 
Published: September 2024

Background and objectives: Urolithiasis, commonly known as kidney stones, is a condition significantly impacted by dietary habits. The objective of this study is to evaluate the impact of a tailored dietary plan on the crystalluria and biological parameters of patients with different types of kidney stones over a 3-month period. Methods and study design: We conducted a prospective study of 3 months. The study involved patients with recurrent nephrolithiasis. Alongside the medical consultation, a comprehensive dietary survey was performed to assess the patients’ nutritional habits. Urinary parameters, including volume, calcium, oxalate, uric acid, and power of hydrogen (pH), were evaluated both before and after the dietary intervention. Results: 69 patients were involved. There were 17 patients diagnosed with cystine lithiasis, 33 with oxalocalcic lithiasis and 19 with uric lithiasis. After 3 months, only 32 patients revisited for follow-up. There were significant changes ( p = 0.002 and 0.04) in urine crystalluria for cystinic and uric lithiasis. For the urinary oxalate variation, there was a significant decrease from T1 (before dietary intervention) to T2 (after dietary intervention), with levels dropping from 0.289 ± 0.10 umol/l to 0.215 ± 0.079 umol/l ( p = 0.02).Regarding urinary calcium (calciuria), there was a trend toward a decrease from T1 to T2, although the change was not statistically significant, with levels decreasing from 2.42 ± 1.68 umol/l to 2.14 ± 1.62 umol/l ( p = 0.1). Conclusions: Our research underscores the favorable effects of a tailored and well-balanced diet on both the crystalluria and biological parameters of individuals with recurrent lithiasis.
Anogenital distance and the risk of Late-onset hypogonadism
Authors: Marín-Martínez Florencio Manuel , Arense-Gonzalo Julian J , Artes Miriam Artes , Bobadilla Romero Emny Rochell , Garcia Porcel Victor , Suárez-Pineda Mabel Coromoto , Guzmán Martínez-Valls Pablo Luis , Mendiola Jaime 
Published: September 2024

Objective: to investigate the association between anogenital distance (AGD) and the risk of Late-onset Hypogonadism (LOH). Methods: We prospectively recruited 145 consecutive patients referred for transrectal prostate biopsy due to prostate-specific antigen (PSA) elevation or abnormal digital rectal examination, between September 2019 and December 2021. Two variants of AGD, anus to scrotum base (AGDas) and anus to dorsal insertion of penis (AGDap) were measured. Serum total testosterone levels in fasting conditions between 07.00 and 11.00 h were determined. Patients filled out the Aging Males’ Symptoms (AMS) scale questionnaire. Results: LOH was diagnosed in 29% of the participants and presented both AGDs shorter than men without LOH, with an AGDap of 116.09 mm (9.02 mm) versus 128.71 (10.76), and an AGDas 29.70 (8.01) versus 39.93 (11.64); both p < 0.05. ANCOVA test showed a significant association between the presence of LOH and both AGD measurements. Besides, AGD measurements presented adequate accuracy for the diagnosis of LOH. Conclusions: This work adds to the scientific evidence that AGD—a biomarker of fetal exposure—could provide a non-invasive measure to address LOH, providing a potential useful clinical tool.
Effects of bisphenol A, bisphenol S, and tetramethyl bisphenol F on male fertility in Caenorhabditis elegans
Authors: Higley Cole M , Waligora Katelyn D , Clore Jessica R , Timmons Shannon C , Kuzmanov Aleksandra 
Published: September 2024

Research has shown that exposure to bisphenol A (BPA), a widely used plasticizer, can lead to meiotic errors, resulting in poor reproductive cell quality and infertility. Health-related concerns have prompted the search for BPA alternatives; however, evidence suggests that currently used BPA analogs, such as bisphenol S (BPS), may pose similar risks to human health. While the effects of BPA on female fertility are well documented, the impact of BPA exposure on sperm quality is poorly understood. To better understand the effects of bisphenol analogs on spermatogenesis, we synthesized a less investigated BPA analog, tetramethyl bisphenol F (TMBPF), and compared its reprotoxic potential to that of widely used BPA and BPS using C. elegans-based assays. We evaluated germ cell count, spermatid size, morphology, and activation in males treated with 0.5 mM ethanol-dissolved bisphenol analogs for 48 h as well as their cross-progeny number and viability. Our results indicated that all of the evaluated bisphenol analogs—BPA, BPS, and TMBPF—adversely affect male fertility to varying degrees. Whereas all three bisphenols reduced spermatid size, only BPA exposure resulted in impaired spermatid activation and significantly reduced brood size. In addition, a decrease in embryonic viability, suggestive of an increased incidence of sperm chromosomal aberrations, was observed following exposure to all of the tested bisphenols. Further investigation is necessary to fully elucidate the underlying mechanisms and implications of BPA, BPS, and TMBPF on spermatogenesis.
We Don’t Talk About X(Twitter): A Cross-Sectional Analysis of Social Media Utilization Among Neurologists
Authors: Rosati Justin , Martindale Jaclyn M. , Xixis Kathryn , Gottlieb-Smith Rachel , Russell Gregory , Bass Nancy , Goldstein Jessica 
Published: September 2024

Background and Objectives Medical professionals use social media for career development, education, clinical outreach, or advocacy. Prior studies estimate that 25% to 65% of health care providers use social media professionally; however, the number of users and platforms are rapidly changing. Therefore, as part of a broader study, we set out to assess platform preferences and social media usage among neurologists. Methods This was a multisite cross-sectional analysis consisting of a REDCap survey of clinicians, residents, and medical students. Faculty, trainees, or clinical year medical students interested in child neurology or adult neurology residency or fellowship programs within the United States were eligible to participate. Recruitment methods were broad to encompass as diverse and extensive participation as possible. Results were analyzed using descriptive statistics. Data are presented according to the STROBE guidelines. Results Of the 226 neurology respondents, 55% (n = 124) were child neurology and 45% (n = 102) were adult neurology across all career stages, including students. Of the 70% who reported using social media in a professional capacity, the most commonly reported reasons were for networking and collaboration (n = 95, 60%), self-directed medical learning (n = 90, 57%), and brand building and reputation (n = 62, 39%). Twitter and Facebook were the most common and versatile platforms used by neurologists. Medical students had the highest documentation of social media scholarships on their curriculum vitae (37%, P = .016) and the most interest (33%, P = .016) in learning how to document social media scholarships if they were not already. Early faculty shared this interest more than residents, fellows, or mid–late career faculty. In all groups except for mid–late career faculty, a majority of respondents (>75%) showed interest in learning how to leverage social media for career development. Discussion Social media is used professionally by a majority of neurologists, most commonly for networking, self-directed learning, and building individual brands. Opportunities exist to better understand platform preferences and ways to optimize their use for various professional activities as well as to provide education on effective professional use of social media including documentation for promotion.
A Comparison of Vancomycin Area Under the Curve and Trough Concentration in Specific Populations
Authors: Johnson-Louis Kadaajah L T , Nguyen My-Linh , K Zvonar Rosemary 
Published: September 2024

Background: Vancomycin is an antibiotic known to cause nephrotoxicity, particularly when a vancomycin trough of 15 to 20 mg/L, a surrogate for an area under the curve (AUC) of at least 400 mgh/L, is targeted. Although monitoring vancomycin AUC is more resource intensive, it may especially benefit populations expected to be at higher risk of nephrotoxicity. Objective: To describe the proportion of discordance between vancomycin AUC and trough concentration in targeted high-risk populations. Methods: A prospective observational review was conducted on adults receiving intravenous vancomycin for more than 48 hours from May 9 to June 3, 2022. Patients included were elderly, obese, had renal dysfunction, and/or received 4 grams or more of vancomycin daily with a pending vancomycin trough concentration. A peak concentration was ordered by a project team member to calculate AUC to assess discordance. Results: A total of 47 patients were included with 87 vancomycin minimum concentration (Cmin)/AUC pairs analyzed. Discordance was observed in 52.9% of Cmin/AUC pairs in the entire cohort. The majority (79%) of the 43 Cmin levels <15 mg/L had an associated AUC >400 mgh/L and 57% of 21 Cmin levels within the 15 to 20 mg/L range had an AUC >600 mgh/L. Conclusion: A high degree of discordance between vancomycin Cmin and AUC was present in patients considered to be at high risk of nephrotoxicity. Monitoring vancomycin AUC in these patients may reduce the risk of nephrotoxicity.
Implementation of a multidisciplinary approach to care for people with HIV aged 80 years and over
Authors: Varadarajan Maithili , Blackburn Sophie , Girometti Nicolo , Hicks Alexandra , Senkoro Elizabeth , Candela Caterina , Ridsdill Smith Elizabeth , Naous Nadia , Tong Timothy , Boffito Marta 
Published: September 2024

Background Frailty adversely affects health and quality of life of people with HIV (PWH). A multidisciplinary-team (MDT) was established to perform a Comprehensive Geriatric Assessment (CGA) and to address modifiable risk factors in elderly PWH. Methods PWH aged over 80 years were reviewed by a dedicated HIV/geriatric clinic at Chelsea and Westminster Hospital. Descriptive statistics were used to report the variables of interest. Results Sixty-three PWH were reviewed, with a median age of 82 (IQR 80–86). Fifty-seven (88%) were men. The median number of co-morbidities was five (IQR 4–7) and polypharmacy was seen in 55 (85%), with a median of six (IQR 5–8) co-medications reported. The median Rockwood Clinical Frailty Score was two (IQR 2–5). Antiretrovirals were modernised in 18 (29%) individuals; co-medication changes and de-prescribing was recommended in 39 (62%). Conclusion A MDT approach helped reducing polypharmacy and frailty, suggesting that specialised tools and MDT input are key to identify medical and social concerns in elderly PWH.
Autonomic Dysfunction in Fibromyalgia Patients: Electrophysiological Evidence from a Cross-sectional Study in Kochi, India
Authors: Bhagya Lakxmi C  , Henry Renoy A , Surendran Sandeep , Pradeep Manu 
Published: September 2024

Background: Over the decades, studies from various populations have found fibromyalgia and dysautonomia to be linked. However, recent evidence from Indian populations contradicts these findings. Methods: This cross-sectional study, conducted in a quaternary care centre in South India, recruited 30 women with fibromyalgia (2016 ACR criteria) and 30 age and sex-matched controls. We assessed all participants using Composite Autonomic Symptom Score (COMPASS-31) questionnaires, Sympathetic Skin Response (SSR) for sympathetic dysfunction and Heart Rate Variability battery of tests for parasympathetic dysfunction. Results: Median age of the women was 40 years. Fibromyalgia group reported severe levels of pain and disease impact on life. Fourteen participants (46.7%) with fibromyalgia tested positive for either sympathetic or parasympathetic dysfunction or both, while none of the control participants tested positive for either (odds ratio [OR] = 53.6, 95% confidence interval [CI] = 3–957, p = 0.0068). Conclusion: Dysautonomia is strongly associated with fibromyalgia syndrome. Further research is needed to determine causality.
Atrial Fibrillation and Associated Factors Among Hyperthyroidism Patients Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia
Authors: Tefera Elias Manaye , Tefera Yibekal Manaye , Yimer Mekonnen , Mulat Worku Biruk , Ayele Eleni , Zewdu Asmare Bedilu , Abebe Gebrehana Deresse , Nega Godana Tilahun 
Published: September 2024

Background: The most prevalent heart symptom of hyperthyroidism is atrial fibrillation. Other than sinus tachycardia, which occurs with hyperthyroidism, atrial fibrillation is the most prevalent cardiac arrhythmia. Hyperthyroidism results in excess mortality from increased incidence of circulatory diseases and dysrhythmias. The aims of the study was prevalence and associated factors of atrial fibrillation among hyperthyroidism adult patients attending the University of Gondar Referral Hospital, Northwest Ethiopia Objective: This study aimed to determine the prevalence and associated factors of atrial fibrillation among adult hyperthyroid patients attending the University Of Gondar Referral Hospital, Ethiopia. Methods: Using a consecutive sampling technique, 228 patients with hyperthyroidism participated in an institution-based cross-sectional study. A standardized questionnaire that had been pretested was used to gather the data that was designed to include socio-demographic data, clinical presentation, biochemical profile, and electrocardiography findings through chart review and interviews. The data were manually curated Result: Atrial fibrillation was present in 32 (14%) patients, with a 95% CI of 9.6 to 19.2. The identified predictor variables were age >61 years (Adjusted Odd Ratio = 4.2, 95% CI = 1.5-11.7), female sex (Adjusted Odd Ratio = 4.0, 95% CI = 1.4-12.0), and high serum FT4 >23.9 pmol/l (Adjusted Odd Ratio = 8.0, 95% CI = 2.1-30.0). Conclusion: The prevalence of atrial fibrillation among hyperthyroidism patients was 14%. Being female, being older, and having high serum FT4 levels were significantly associated with AF in hyperthyroid patients.
Glymphatic dysfunction in multiple sclerosis and its association with disease pathology and disability
Authors: Bayoumi Ahmed , Hasan Khader M , Thomas Joseph A , Yazdani Akram , Lincoln John A 
Published: September 2024

Background: The role of the glymphatic system in multiple sclerosis (MS)-related disability remains underexplored. Diffusion-tensor image analysis along the perivascular space (DTI-ALPS) offers a non-invasive method to assess glymphatic function. Objective: To evaluate glymphatic function in MS patients with lower and higher disability. Methods: This study included 118 MS patients who underwent structural, diffusion-weighted imaging, and clinical assessment. The participants were divided into lower (MS-L, n = 57) and higher disability (MS-H, n = 61) subgroups. Brain parenchymal fraction (BPF), lesion load (LL), and DTI-ALPS index were measured. Subgroup differences and correlations between DTI-ALPS index and other measures were explored. Logistic regression was performed to evaluate BPF, LL, and DTI-ALPS index in classifying lower and higher disability patients. Results: Significant differences in DTI-ALPS index between MS-H and MS-L ( d = −0.71, false discovery rate-corrected p-value ( p-FDR) = 0.001) were found. The DTI-ALPS index correlated significantly with disease duration ( rp = −0.29, p-FDR = 0.002) and EDSS ( rsp = −0.35, p-FDR = 0.0002). It also showed significant correlations with BPF and LL. DTI-ALPS index and LL were significant predictors of disability subgroup (DTI-ALPS: odds ratio (OR) = 1.77, p = 0.04, LL: OR = 0.94, p = 0.02). Conclusion: Our findings highlight DTI-ALPS index as an imaging biomarker in MS, suggesting the involvement of glymphatic impairment in MS pathology, although further research is needed to elucidate its role in contributing to MS-related disability.
High levels of Patient Self Advocacy may confound clinical research in understudied patient populations
Authors: Rabinowitz Emily P , Ripley Grant H , Lemek Chase , Allen Philip A , Delahanty Douglas L 
Published: September 2024

Objective: To examine the levels of patient self-advocacy in a sample of participants with Chiari Malformation (CM) and to explore how they relate to clinical outcomes. Methods: As part of a larger clinical trial addressing chronic pain in patients with CM, 111 participants completed the Patient Self Advocacy Scale (PSAS), the Depression, Anxiety, and Stress Scale (DASS-21), and the Brief Pain Inventory (BPI). Results: PSAS scores indicated a moderately high level of patient self-advocacy (Mean = 3.86 SD = 0.50). The PSAS was not related to depression, anxiety, stress, pain intensity, or pain interference. There were no differences in PSAS according to surgical status ( t(61.25) = 0.44, p = 0.66) or use of pain medication ( t(109) = 1.05, p = .29). Discussion: Participants in a clinical trial for CM have high levels of pre-existing patient self-advocacy. Research is needed to understand how patient self-advocacy contributes to the management of CM and how it could impact research of individuals with understudied conditions. Clinical Trials Registration: NCT05581472
Rural Caregiver Perceptions on the Content and Receipt of a Diabetes Management Telehealth Occupation-Based Coaching Intervention
Authors: Jewell Vanessa D. , Funk Katie J. , Currie Alexis , Shin Julia , Knezevich Emily L. , Valdez Andrea , Bunsness Maggie 
Published: September 2024

Background: Type 1 diabetes management for young children requires caregiver involvement to prevent serious health complications. Objectives: Explore the lived experience of rural caregivers’ health management routines and perceptions of an occupation-based coaching (OBC) intervention. Methodology: Following a 12-week, OBC telehealth intervention designed to promote diabetes management and caregiver psychosocial well-being, researchers interviewed eight rural caregivers to explore their perceived quality of life utilizing a phenomenological approach. Findings: Three themes emerged related to caregivers’ OBC intervention needs: occupational deprivation and decreased well-being; longing for connection with social supports; and desire for knowledgeable, relatable, and accessible providers. Two themes emerged related to their experiences postintervention: satisfaction with diabetes management and psychosocial support and renewed hope for childhood normalcy. Conclusion: Despite drastic shift in family routines after a child’s T1D diagnosis, caregivers reported acceptability of OBC for improving health management routines in a rural community following OBC intervention.