bluuebunny/crossref_metadata_2025_split huggingface dataset:
Narcotic Drugs and Psychotropic Substances Control System in Ethiopia: A National Survey
Authors: Beyene Kidanemariam G/Michael , Borta Heran Gerba , Alemu Asnakech , Shute Teshita , Zewdie Baharu , Fantaw Debalke , Shimelis Bitsat , Dagnachew Betelhem , Alemu Wondie , Mekie Yonas , Endale Sisay , Tamiru Melaku Tileku 
Published: October 2024

Abstract

Introduction
Narcotic drugs and Psychotropic substances (NPS) play an indispensable role in health care despite their misuse could jeopardize the health of the people and the health system. The study presents a comprehensive assessment of NPS control system in Ethiopia, aiming to elucidate its regulatory landscape, challenges, and opportunities. By integrating both quantitative and qualitative data, the study offers a nuanced understanding of the multifaceted factors influencing NPS control system in the country.
Methods
An institution-based cross-sectional mixed study design was employed among 1199 study participants and 26 key informants in Ethiopia from April 14 to May 30, 2022. Multi-stage sampling technique was used to select study participants, and purposive sampling technique was used to select the key informants. The quantitative data were collected using a structured interview questionnaire whereas semi-structured questionnaire was used for in-depth interviews. Descriptive analysis was used for quantitative data analysis, and thematic analysis method was used for qualitative data.
Results
Findings from the qualitative analysis reveal significant gaps in the implementation of NPS laws and regulations, particularly in terms of enforcement and coordination. Structural deficiencies, stakeholder collaboration challenges, and communication gaps were identified as key barriers to effective NPS control. The quantitative survey provided detailed insights into the operational aspects of NPS management, highlighting areas for improvement such as reporting practices, storage methods, and dispensing protocols.
Conclusions
There are considerable gaps in the NPS control system in Ethiopia. The study underscores the importance of addressing the identified challenges to optimize NPS control efforts and safeguard public health in Ethiopia. Hence, necessary measures at all levels must be taken to strengthen the NPS control system in Ethiopia.
The microsurgical anatomy of the paracentral lobule artery: a cadaveric series
Authors: Georgountzos Georgios , Triantafyllou George , Mavrovounis Georgios , Piagkou Maria , Stranjalis George , Kalamatianos Theodosis 
Published: October 2024

Abstract

Purpose
The paracentral lobule artery (PLA) is a typically present branch of the distal anterior cerebral artery (ACA), irrigating the homonymous lobule. The PLA origin is either a pericallosal portion of the ACA or a prominent branch of the ACA termed callosomarginal (CMA). In addition to the paracentral lobule, the PLA irrigates the cingulate gyrus in the medial hemispheric surface, and the superior portion of the precentral and postcentral gyri in the lateral hemispheric surface. The present cadaveric case series aimed at establishing previously unreported morphometric estimates of the PLA, including its length according to its site of origin, its supplying branches according to its distribution area, as well as its anastomoses.
Methods
Seventeen colored latex-injected cadaveric heads were studied with a surgical microscope and microsurgical instruments.
Results
The PLA was invariably present and most commonly originated from the A4 (n = 15 hemispheres, 50%) segment of the ACA. Other PLA origins were the CMA (n = 10, 30%), the A3 (n = 5, 16.7%) and the A5 (n = 1, 3.3%) segments. When the PLA originated from the A4, its mean (SD) overall length was 7.6 (17.9) mm and its mean (SD) diameter was 0.88 (0.26) mm. The PLA supplied the paracentral lobule, cingulate gyrus and post central gyrus with a mean (SD) of 28.07 (13.4), 8.53 (4.27), 5.92 (4.4) branches respectively and the precentral gyrus with a median [IQR] of 2 [0–6] branches. The most common anastomoses of the PLA in the medial and the lateral hemispheric surface involved the ipsilateral posterior internal frontal artery and the branches of the middle cerebral artery, respectively. There were no significant differences between genders or hemispheric sides for the anatomical features of the artery analyzed.
Conclusion
The present study established previously unreported morphometric estimates for the PLA by considering all possible PLA variant origins and morphological variants. Given that variable pathologies have been previously detected in the areas supplied by the PLA, a better understanding of its anatomy can aid surgical planning and approaches.
Machine Learning Algorithms to Detect Patient-Ventilator Asynchrony. A Feasibility Study.
Authors: Williams Jeffrey , Ahari Jalil , Wong Kendrew , Jose Arun , Gutierrez Guillermo 
Published: October 2024

Abstract

Background: Adequate ventilatory support requires frequent assessment of patient-ventilator interactions. It is desirable, therefore, to develop a reliable, automated method for this task. This study evaluates the feasibility of developing machine-learning algorithms to emulate how experienced clinicians evaluate normal and abnormal breathing patterns, including patient-ventilator asynchrony.
Methods: We enrolled 44 adult patients within 24 hours of initiating invasive mechanical ventilation. Airway flow and pressure signals were acquired directly from the ventilator and stored as sequential 2.2-minute epochs for waveform classification. Experienced clinicians visually classified 50,712 epochs, encompassing approximately 2.6 million breathing cycles. Nineteen clinical variables were used to train four Random Forest algorithms to: 1) detect asynchronous breathing, 2) identify asynchrony type, 3) grade signal disruption, and 4) identify dynamic hyperinflation. Algorithm accuracy was assessed by the percentage of correctly identified epochs, while clinical reliability was evaluated by comparing the algorithms’ predictions to those of clinicians with varying experience in asynchrony classification.
Results: The algorithm detected asynchronous breathing with 91% accuracy. Accuracies for asynchrony classification, severity grading, and dynamic hyperinflation were 82%, 87%, and 93%, respectively. Algorithm classifications aligned more closely with expert clinicians (kappa = 0.46, and 0.59) than non-experts (kappa = 0.25, and 0.38; p < 0.05). Greater time asynchronous was associated with increased 28-day mortality (p = 0.015).
Conclusions: Machine-learning algorithms may be trained to emulate experienced clinicians in evaluating breathing during mechanical ventilation. Larger databases and advancements in artificial intelligence may lead to powerful algorithms capable of establishing associations between airway signals and successful ventilatory support.
Gadoxetic acid-enhanced magnetic resonance imaging to predict pathologic complete response of colorectal liver metastases in preoperative chemotherapy
Authors: Noguchi Yuka , Einama Takahiro , Ohara Mayuko , Ichio Kouki , Kobayashi Kazuki , Yonamine Naoto , Tsunenari Takazumi , Takihata Yasuhiro , Takao Mikiya , Edo Hiromi , Okamoto Koichi , Kajiwara Yoshiki , Shinto Eiji , Ogata Sho , Ueno Hideki , Shinmoto Hiroshi , Kishi Yoji 
Published: October 2024

Abstract

Background
Recent advances in chemotherapy have expanded the opportunity for curative resection of colorectal liver metastases (CRLMs). Disappearing liver metastases (DLMs) are often encountered following chemotherapy. This study aimed to determine whether the DLMs observed by contrast-enhanced computed tomography (CECT) and gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) following preoperative chemotherapy were associated with a pathologic complete response(pCR).
Methods
Patients who underwent hepatectomy between April 2020 and December 2022, following preoperative chemotherapy at our institution, were selected. Before chemotherapy, all patients underwent CECT, some patients also underwent EOB-MRI, and both imaging studies were performed on all patients after chemotherapy. Pathologic responses of all resected tumors were evaluated. For the unresected DLMs, they were defined as DLMs if they did not reappear in the imaging studies conducted over the following year.
Results
A total of 29 patients were selected. After chemotherapy, 138 DLMs were found by CECT and 106 were found by EOB-MRI. Of the resected DLMs confirmed only by CECT, tumor cells remained in 90% of them. All of resected DLMs confirmed by EOB-MRI showed a pCR. Of the remaining 39 unresected DLMs, one reappeared within a year.
Conclusions
EOB-MRI is superior to CECT for the diagnosis of DLMs.
Incremental prognostic value of combined information of arterial stiffness and the result of treadmill exercise test in patients with suspected coronary artery disease
Authors: Chung Jaehoon , Kim Hack-Lyoung , Joh Hyun Sung , Lim Woo-Hyun , Seo Jae-Bin , Kim Sang-Hyun , Zo Joo-Hee , Kim Myung-A 
Published: October 2024

Abstract

The effectiveness of diagnostic tools can be enhanced by their combination. This study aimed to investigate whether arterial stiffness data, obtained by brachial-ankle pulse wave velocity (baPWV) measurement, could improve prognostic value to exercise treadmill test (ETT) to predict future cardiovascular events. A total of 1,788 consecutive subjects (mean age 55.8 ± 10.7 years, 59.1% men) with suspected of having coronary artery disease (CAD), who underwent ETT and baPWV on the same day were prospectively recruited. The study outcome was major adverse cardiovascular event (MACE), a composite of cardiac death, non-fatal myocardial infarction, and coronary revascularization. During a mean follow-up period of 875 days (interquartile range, 116–2,212 days), there were 88 cases of MACE (4.9%). The elevated baPWV (≥ 1,440 cm/s) (hazard ratio [HR] 5.18, 95% confidence interval [CI] 2.68–10.0, P < 0.001) and positive ETT result (HR 2.81, 95% CI 1.77–4.47, P < 0.001) were associated with MACE even after adjustment for potential confounders. The combination of baPWV to traditional risk factors and ETT result further stratified the subjects’ risk (low baPWV and negative ETT result vs high baPVW and positive ETT result; HR 16.44, 95% CI 6.17–43.78, P < 0.001). Arterial stiffness, assessed by baPWV, had incremental prognostic value to ETT result in patients with suspected of CAD. Combined information of baPWV and ETT result can serve as a useful clinical tool for risk stratification in this high-risk patient population.
Correlation between METS-IR index and obstructive sleep apnea in non- diabetic adults: evidence from NHANES 2001–2018
Authors: Yin Huangyi , Huang Wei , Yang Bijun 
Published: October 2024

Abstract

Background: Insulin resistance (IR) is strongly associated with obstructive sleep apnea (OSA). Whereas, few studies have focused on the potential correlation between the Metabolic Score for Insulin Resistance (METS-IR), a novel non-insulin-dependent IR index, and OSA.
Methods: Subjects from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2008 and 2015-2018 were recruited. The potential relationship between METS-IR and other IR indices with OSA was explored through three logistic regression analysis models and restricted cubic spline (RCS) curves. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of these indicators for OSA. On the basis of age, sex, race, body mass index (BMI), hypertension, and cardiovascular disease (CVD), subgroup analyses were conducted to test the robustness of the METS-IR and OSA relationship.
Results: In all of 6,633 non-diabetic participants were enrolled, with an OSA prevalence of 28.40%. After adjusting for potential confounders, METS-IR, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, triglyceride glucose Index (TyG), and homeostatic model assessment of insulin resistance (HOMA-IR) indices showed positive associations with OSA prevalence. In the highest tertile of METS-IR, TG/HDL-C, TyG index, and HOMA-IR indices, OSA prevalence was 3.22-fold, 1.42-fold, 1.45-fold, and 1.51-fold higher, respectively, compared to the lowest tertile (METS-IR: OR = 3.22, 95% CI: 2.67, 3.89, P < 0.0001; TG/HDL-C: OR = 1.42, 95% CI: 1.15, 1.76, P =0.002; TyG index: OR = 1.45, 95% CI: 1.18, 1.78, P<0.001; HOMA-IR: OR = 1.51, 95% CI: 1.24, 1.85, P <0.001). ROC analysis revealed that METS-IR had the highest diagnostic accuracy for OSA (AUC = 0.65). The relationship between METS-IR and OSA did not show significant interaction across all subgroups (P for interaction > 0.05).
Conclusion: Compared with HOMA-IR, TG/HDL-C and TyG, METS-IR index was positively correlated with OSA prevalence and had superior diagnostic accuracy.
Compare the molecular differences of pleural effusion and metastatic lymph node biopsy of lung adenocarcinoma based on NGS and evaluate the Clinical efficacy
Authors: Liang Shuo , Wang Yuan , Wei Jiacong , Sun Zihan , Xiao Xiaoyue , Li Weihua , Wang Cong , Sun Yue , Chang Xinxiang , Zhao Linlin , Zhao Huan , Guo Huiqin , Zhang Zhihui 
Published: October 2024

Abstract

Objective
The present study is to investigate the next-generation sequencing (NGS) molecular typing results of liquid-based cytology specimens (LBCSs) of pleural effusion in lung adenocarcinoma evaluate the clinical efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) treatment and compare the consistency of the molecular typing results with those of metastatic lymph node biopsy specimens (MLNBSs).
Methods
A total of 222 cases of lung adenocarcinoma pleural effusion LBCSs and 201 cases of MLNBSs were collected to compare the consistency of NGS molecular typing results. The impacts of different tumor cell contents in LBCSs on mutation detection limitation was evaluated. The clinical efficacy evaluation was performed on 91 patients treated with EGFR-TKI was evaluated and the survival curve analysis was conducted using Kaplan-Meier method.
Results
The mutation rates of cancer-related genes detected by NGS were comparable LBCSs and MLNBSs of lung adenocarcinoma(82.0% vs 79.1%, P = 0.455). However, the mutation rate of EGFR T790M was significantly higher in pleural effusion LBCSs than in MLNBSs(12.2%>3.5%, P = 0.001). After EGFR-TKI treatment, the mean progression-free survival time (PFS) was 11.4 months in 91 patients with molecular typing based on LBCSs.
Conclusions
The results of NGS molecular typing of pleural effusion LBCSs from lung adenocarcinoma patients can yield comparable PFS to that of histological specimens following the clinical application of EGFR-TKI treatment.
Structural modifications of certain pyrrolizidine alkaloids during sample extraction and its impact on analytical results
Authors: Kaltner Florian , Klein Lisa Monika 
Published: October 2024

Abstract

Pyrrolizidine alkaloids (PAs), a group of plant toxins often contaminating food or feed, are typically extracted from samples using liquid extraction. The crude extracts are then often purified using solid-phase extraction (SPE) cartridges before being analysed by LC-MS/MS. During the development of analytical methods based on strong cation exchange SPE, certain structurally related PAs showed unexpectedly low or significantly increased recoveries, suggesting transformation reactions may be at play. To investigate this hypothesis, sample preparations were conducted using PA-free milk as food matrix, water or organic solvents, into which PA reference standards were spiked before or after critical steps of the protocol. The results revealed a significant decrease in acetylated PA N-oxides to their corresponding deacetylated compounds, as well as the formation of epoxydic PAs from PA compounds containing chlorine and hydroxyl groups in the α position. Evaporation of the alkaline SPE eluates, combined with the use of the protic solvent methanol in cases of deacetylation, was responsible for these phenomena. An alkaline ester hydrolysis mechanism was hypothesised for the deacetylation, while an internal SN2 reaction, similar to the chlorohydrin reaction, was suggested for the formation of epoxy PA compounds. Consequently, using different sample preparation methods may inadvertently bias the determined PA patterns.
A prospective split-mouth clinical study: Comparison of the effect of lornoxicam and etodolac on postoperative sequels following lower third molar surgery
Authors: Karabıyık Zulfikar , BASIRY Mohammad NABI 
Published: October 2024

Abstract

Purpose
This study aims to compare the efficacy of two non-steroidal anti-inflammatory agents (NSAIDs), namely lornoxicam and etodolac for controlling pain, edema and trismus after removal of lower impacted third molars.
Materials and Methods
A total of 20 patients comprised of both genders with bilateral impacted lower impacted third molars (in similar positions) was included in the present study. Patients were randomly assigned either to the lornoxicam group (8 mg of lornoxicam) or to the etodolac group (400 mg of etodolac). The drugs prescribed were handed out immediately after tooth extraction. Postoperative pain was assessed using visual analog scale (VAS). Swelling was evaluated using reference lines on the face. Trismus was assessed using a caliper at maximum mouth opening (mm).
Results
There was no significant difference in postoperative pain, trismus, and swelling between lornoxicam and etodolac group (p > 0.05).
Conclusions
Based on the results obtained in the present study, ıt has been verified that both lornoxicam and etodolac were adequately effective in the management of pain following third molar surgery. Lornoxicam and etodolac had similar impacts on pain, swelling and trismus after lower third molar surgical extractions.
NanoString nCounter-based assay for detection of fusion-associated salivary gland tumors
Authors: Goytain Angela , Ng Tony L. 
Published: October 2024

Abstract

Purpose
Salivary gland tumors include numerous subtypes that vary from benign to highly aggressive, with many showing overlapping histopathological features that can make diagnosis challenging. Most subtypes express driver fusion genes that are tumor specific, and detection of such fusions is useful for differentiating amongst specific diagnoses, determining appropriate tumor grading, and guiding effective treatment. Currently, fusions can be detected by FISH, RT-PCR or through next-generation sequencing approaches, all of which are highly effective methodologies but can be costly or time consuming, limiting their use on a routine basis.
Methods
We developed a rapid NanoString nCounter platform-based assay to detect salivary gland tumor fusions using a combination of fusion junction-specific probes and an approach through differential exon expression analysis. The assay includes 68 junction-specific probes and analysis of exon expression across 9 fusion-associated genes in a single multiplex assay.
Results
Out of 55 retrospective and 171 prospective cases assayed, we accurately detected the majority of cases of pleomorphic adenoma, adenoid cystic carcinoma, cribriform adenocarcinoma, clear cell carcinoma, mammary analogue secretory carcinoma and NUT-rearranged carcinoms, including cases of these tumor types arising in non-salivary gland sites, with the major drawback being an inability to detect MAML2-containing mucoepidermoid samples. With mucoepidermoid carcinoma excluded, the assay shows an overall sensitivity of 96.1% and specificity of 100%.
Conclusion
We show that the majority of salivary gland tumor fusions can be effectively detected with a single rapid NanoString based assay, which can serve as a useful adjunctive tool for routine diagnostic head and neck pathology. The assay is low cost with a rapid turnaround time (30 hour total assay time per sample batch, with minimal technician input required) compared to alternate detection methods.
Study of hemodialysis catheter infections in Menofia University Hospital
Authors: Gomaa Azza A.E. , Zeid Amany M.A. , Nagy Ibrahim M. 
Published: October 2024

Abstract

Introduction
Central line-associated bloodstream infection (CLABSI) is a bloodstream infection proven by a laboratory within 48 hours after central line installation and unrelated to another location infection. We aimed to decrease the incidence of catheter-related blood stream infection (CRBSI) at the Menofia University Hospital hemodialysis unit by improving the safety of patients with central venous catheters (CVC).
Methods
We conducted a prospective interventional study conducted at Hemodialysis Unit Menofia University Hospital on 100 patients with CVC and followed up for CRBSI during the period from the beginning of January 2024 till the end of March 2024, followed by an educational program during April 2024 about general infection control procedures, and then reassessment was done during the period from the start of May 2024 till the end of July 2024. 100 patients, 53 males and 47 females, were enrolled before and after the intervention educational program.
Results
The infection prevalence in the pre-intervention was 42%, which was significantly reduced after intervention to 14%. This illustrates the role of intervention to decrease the incidence of the participants fever, chills, discharge, and tenderness (P < 0.05). Comparison of pre-intervention versus post-intervention infection control procedures showed that the intervention is a significantly improving factor against catheter-related infection (CRI).
Conclusions
The predictive factors of CRI included prolonged duration of CVC usage, difficult insertion, patient role (keeping the catheter dressing clean and dry), and catheter type. These factors can be considered as risk factors for the presence of infection.
Quality of Life and Appraisal Factors of Patients with Advanced Cancer and Their Family Caregivers
Authors: Liu Jia , Zhang Yuexia , Guan Ting , Wang Xiaomeng , Ma Chunxuan , Northouse Laurel , Song Lixin 
Published: October 2024

Abstract

Purpose
Few existing interventions have effectively improved the quality of life (QOL) for patients with advanced cancer and their caregivers, partly due to limited research on the factors associated with QOL. Guided by an adapted stress-coping model, this study aimed to examine the associations between the QOL of cancer patients and their caregivers and their primary and secondary appraisals. Primary appraisals involve perceptions and evaluations of advanced cancer and related caregiving, while secondary appraisals relate to their available resources and coping capabilities.
Methods
Using multi-level modeling, we conducted a secondary analysis of the baseline data collected from a randomized clinical trial that examined the effects of a family-based, psychoeducational support program for patients with advanced cancer and their caregivers (N = 362 dyads).
Results
The appraisal variables hypothesized in the adapted stress-coping model explained 74.14% of the variance in the QOL of patients with advanced cancer and their caregivers when controlling for demographics and other disease-related variables. Better QOL in patients and caregivers was associated with less negative appraisals of illness/caregiving, less uncertainty and hopelessness, less avoidant coping strategies, more family support, more health behaviors, higher self-efficacy, and more active coping strategies.
Conclusion
Our study highlights the significant impact that advanced cancer has on patients and their caregivers’ perceptions, responses to the illness, and QOL. It also highlights that effective interventions may need to target illness/caregiving appraisals, uncertainty, hopelessness, family support, health behaviors, self-efficacy, and coping strategies tailored to patient and caregiver needs.