bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Sense of Loneliness on Geriatric Depression: The Mediating Role of Sense of Mattering and Psychological Adjustment
Authors: Aman Haya 
Published: August 2024

Abstract

Background
Depression is a highly prevalent mental disorder in older adults, and among its highest risk factors is loneliness. Although this relationship is commonly evident, the mechanisms underlying it, such as sense of mattering and psychological adjustment, lack exploration. The current research aims to examine the relationship between loneliness and geriatric depression and explore the mediating roles of sense of mattering and psychological adjustment.
Methods
A sample of 200 older adults (63.5% females; mean age = 75.6; SD = 8.806) was recruited from 24 geriatric homes in Cairo, Egypt. Participants responded to the Arabic versions of the Mini Mental State Examination for excluding the severely demented, Geriatric Depression Scale-15, University of California, Los Angeles Loneliness Scale-version 3, General Mattering Scale, and Brief Adjustment Scale-6. The mediation analysis was conducted using multiple linear regression with Hayes’ process macro on SPSS26 and structural equation modelling on JASP0.18.1.0
Results
Sense of mattering and psychological adjustment showed a significant total effect (β = .051, 95%CI [.045, .056], z = 18.436, p < .001) separated into a significant direct effect (β = .019, 95%CI [.009, .029], z = 3.784, p < .001) and a significant indirect effect (β = .031, 95%CI [.022, .041], z = 6.478, p < .001), indicating simultaneous partial mediation by the two variables. Additionally, sense of mattering accounts for 76% of the impact of loneliness on geriatric depression, and psychological adjustment accounts for 60.1%.
Conclusion
Loneliness significantly impacts geriatric depression through sense of mattering and psychological adjustment. These findings implicate substantial insight for interventions that can be targeted at the reduction of geriatric depression through reducing loneliness feelings and enhancing sense of mattering and adjustment.
The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy
Authors: He Tian , Xu Bin , Wang Lu-Na , Wang Zi-Yi , Shi Huan-Chen , Zhong Cheng-Jie , Zhu Xiao-Dong , Shen Ying-Hao , Zhou Jian , Fan Jia , Sun Hui-Chuan , Hu Bo , Huang Cheng 
Published: August 2024

Abstract

This study evaluates the Systemic Immune-Inflammation Index (SII) for predicting immune-based therapy response and prognosis in unresectable hepatocellular carcinoma (HCC) patients.A cohort of 268 HCC patients treated with immune-based therapy from January 2019 to March 2023 was studied. The training group of 93 patients received atezolizumab plus bevacizumab (T+A) treatment, while 175 patients in the validation group were treated with tyrosine kinase inhibitors (TKIs) and anti-PD-(L)1 therapy. SII’s cutoff point was determined using X-tile analysis based on overall survival (OS) in the training cohort. Prognostic factors were identified through univariate and multivariate logistic and Cox regression analyses, with survival outcomes compared using Kaplan-Meier methods. The predictive accuracy of SII was assessed using receiver operating characteristic (ROC) curves.
The optimal cutoff for SII was 752*109. Univariate and multivariate logistic regression indicated that SII was a strong predictor for the objective response rate (ORR). The ORR was significantly different between the low SII and high SII subgroups (34.72% vs. 9.52%, P = 0.019), similar results were validated in the validation group (34.09% vs. 16.28%, P = 0.026). SII also demonstrated prognostic significance in Cox regression and Kaplan-Meier analyses. ROC curves showed that the SII’s predictive function was superior among common clinical indicators, with relevance even in AFP-negative patients. Lower SII was associated with a higher T cell ratio, higher CD8+T cell and GranzymeB+CD8+T cell number in peripheral blood.
SII is a viable predictor of the efficacy and prognosis of various kinds of immune-based therapy in HCC patients, potentially serving aiding therapeutic decisions, thus increasing the likelihood of patients benefiting from immune-based therapy.
Accuracy of Contrast-Enhanced Ultrasound for Hepatocellular Carcinoma post Transcatheter Arterial Chemoembolization
Authors: McGillen Kathryn , Pryor III William , Yee Nelson , Zhu Junjia , Krok Karen , Waybill Peter 
Published: August 2024

Abstract

Purpose
This prospective pilot study was performed to evaluate non-inferiority between CEUS and the clinical gold standard of CECT/MRI in patients with HCC following TACE in a United States population using Lumason® contrast agent and Liver Reporting and Data System (LIRADS).
Methods
Following institutional review board protocols, adult patients with a first-time diagnosis of HCC were identified and consented for inclusion. Follow-up CT/MRI was directed by referring clinicians and CEUS was performed on the same day. CEUS evaluated for treated lesion(s), any new lesion(s), and portal vein thrombus before and after Lumason®. Any subsequent follow-up imaging was reviewed.
Results
In the 26 enrolled patients, 33 target lesions were identified, size ranging between 0.9 and 16.8 cm (mean 3 cm); 26 were LIRADS-5 or -M. CEUS identified 19 cases of residual tumor, 12 with no viable disease; while CT/MRI identified 17 cases of residual tumor, 16 with no viable disease (p = 0.617). Both CEUS and CT/MRI identified 5 portal vein thrombi, 2 lesions were missed or miscategorized on CEUS, while 6 were missed or miscategorized on CT/MRI (p = 0.289). Six new lesions were identified on both CEUS and CT/MRI ranging between 0.7 and 3.3 cm (mean 1.6 cm) on CEUS, and 0.7 and 2.8 cm (mean 1.7 cm) on CT/MRI. Of these new lesions, 4 were identified only on CT/MRI and 3 only by CEUS. Post-TACE, there was no significant difference in detecting residual tumor and no viable tumor between CEUS and CT/MRI (p = 0.617).
Conclusion
CEUS is non-inferior to CT/MRI performed at identical follow-up interval, in evaluating for residual versus treated HCC following first-time TACE. CEUS may represent an option for patients with contrast allergies or contraindications to MRI. CEUS can be used to examine small or isoechoic tumors after treatment.
Clinical significance of peri-appendiceal abscess and phlegmon in acute complicated appendicitis patients undergoing emergency appendectomy: A single-center retrospective study
Authors: Min Lingqiang , Lu Jing , He Hongyong 
Published: August 2024

Abstract

Background
This study aimed to analyze the clinical data of patients who underwent emergency appendectomy for acute complicated appendicitis with peri-appendiceal abscess or phlegmon, identify factors influencing the postoperative length of hospital stay (LOS), and improve treatment strategies.
Methods
The clinical data of acute complicated appendicitis patients with peri-appendiceal abscess or phlegmon who underwent emergency appendectomy at the Department of Emergency Surgery, Zhongshan Hospital, Fudan University, from January 2016 to March 2023, were retrospectively analyzed.
Results
A total of 234 patients were included in our study. The duration of symptoms and the presence of an appendicolith were significantly correlated with the occurrence of peri-appendiceal abscess in patients with acute complicated appendicitis (P < 0.001 and P = 0.015, respectively). Patients with symptoms lasting longer than 72 hours had a significantly longer postoperative LOS compared to those with symptoms lasting 72 hours or less (HR, 1.208; 95% CI, 1.107 to 1.319; P < 0.001). Additionally, patients with peri-appendiceal abscesses had a significantly longer postoperative LOS compared to those with phlegmon (HR, 1.217; 95% CI, 1.095 to 1.352; P < 0.001). The patients with peri-appendiceal abscesses were divided into two groups based on the median size of the abscess: those with abscesses smaller than 5.0 cm (n = 69) and those with abscesses 5.0 cm or larger (n = 82). Patients with peri-appendiceal abscesses measuring 5.0 cm or larger had a significantly longer postoperative LOS than those with abscesses smaller than 5.0 cm (P = 0.038).
Conclusion
The duration of symptoms and the presence of an appendicolith are significant risk factors for the formation of peri-appendiceal abscesses in patients with acute complicated appendicitis. Patients with peri-appendiceal abscesses experience a significantly longer postoperative LOS compared to those with peri-appendiceal phlegmon.
Arthroscopic Transosseous Suture Bridge for Repairing Avulsion Fractures of the Tibial Insertion of the Anterior Cruciate Ligament：A Mini Tunnel Technique
Authors: Pu Jinsong , Zheng Lin , Jian Changchun 
Published: August 2024

Abstract

The study presents a novel arthroscopic transosseous suture bridge technique for repairing avulsion fractures of the tibial insertion of the anterior cruciate ligament (ACL), specifically tailored for adolescent patients. This minimally invasive surgical approach combines elements of both the transosseous tunneling and suture bridge techniques, aiming to reduce impact on the bone bed while ensuring stable fixation. Over a seven-year period, 39 patients with Meyers-Mckeever types II, III, and IV tibial avulsion fractures underwent this procedure. The surgery had an average duration of 52.7 minutes and resulted in decreased swelling and pain within two months postoperatively. All patients achieved full knee extension and over 120° of flexion. X-rays confirmed complete fracture healing within six to 12 months, and negative anterior drawer and Lachman tests indicated stable fixation. Significant improvements were seen in Lysholm and IKDC scores, reflecting enhanced knee function. This technique offers several advantages: it is effective, stable, minimally invasive to growth and development, and particularly suitable for adolescents due to the reduced impact on the bone bed and successful avoidance of epiphyseal plate injury.
Effects of Cardiac Surgery on Heart Rate Variability and Its Correlation with the Quality of Life
Authors: Lee Li-Chiu , Chang Huai-Jen , Hsieh Chih-Cheng , Kuo Terry B.J. , Chen Mei-Yin , Lin Hsin-Wei , Lo Po-Chun 
Published: August 2024

Abstract

Objectives
The purpose of this study is to explore the changes in HRV before and after cardiac surgery and the relationship between HRV and quality of life.
Methods
A total of 21 patients who received cardiac surgery were included in this study. All cases were conducted with a five-minute ECG uploaded by a Bluetooth signal three times. The ECGs were measured before the operation (1st), after the operation (2nd), and one month after the operation (3rd). The parameters of HRV included: standard deviation of normal to normal (SDNN), low frequency (LF), high frequency (HF), normalized low frequency (LF %), and LF/HF. In the third ECG measurement, the patients were also required to answer the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) in the concise Taiwanese version. The parameters of HRV were analyzed with Wilcoxon signed ranked test. The Spearman correlation test analyzed the correlations between the parameters of HRV and quality of life. Informed consent was obtained from all subjects and/or their legal guardian(s).
Results
Compared with the 1st ECG measurement, the SDNN, LF, and LF% decreased significantly in the 2nd ECG. There was a significant increase in SDNN in the 3rd ECG, but there was no significant difference compared with the 1st ECG. There was a significant positive correlation between HRV and the psychological category of quality of life.
Conclusions
Heart rate variability decreased after cardiac surgery, and the slight recovery of heart rate variability one month after surgery was mainly due to the recovery of sympathetic nerves. The psychological category of quality of life after surgery received the lowest score, which may be related to the incomplete recovery of parasympathetic nerve activity after surgery. The objective data of heart rate variability analysis can reflect the subjective psychological category of patients after heart surgery.
Determinants of Child Stunting in Ethiopia: A Longitudinal Analysis of Sociodemographic Factors and Regional Disparities
Authors: Haile Yilikal Tesfaye , Legisso Tesfahun Zewde 
Published: August 2024

Abstract

Stunting remains a critical issue affecting child health in Ethiopia, with significant implications for growth and development. Despite efforts to address stunting, understanding the determinants and trends over time is essential for effective interventions. The objective of this study is to examine the trends and determinants of child stunting in Ethiopia, focusing on sociodemographic factors and regional disparities. This longitudinal observational study utilized data from the Young Lives project covering the period from 2002 to 2016. An ordinal logistic regression model with generalized estimating equation (GEE) was used to analyse 7,680 observations from 1,536 children across Ethiopia. Variables included sociodemographic factors, access to resources, and parental education levels. Over the study period, there were notable improvements in child stunting rates, influenced by variables such as household wealth, maternal education, access to safe drinking water, and urban versus rural residence. Children in households with higher wealth and maternal education levels experienced lower rates of stunting. Regional disparities were evident, with a greater prevalence in Amhara and lower rates in Addis Ababa. The findings underscore the importance of targeted interventions to address socioeconomic disparities and improve resource access. Enhancing maternal education, ensuring access to safe water, and addressing regional disparities are critical to reducing child stunting rates in Ethiopia.
A Qualitative Study of Referral Practices of the Public Healthcare System in Bhopal District of Madhya Pradesh
Authors: M SUSHMA YADAV , Kumar Sanjeev , Dabar Deepti , Prasad Pankaj 
Published: August 2024

Abstract

Background- Referral system is backbone of any healthcare delivery system. Referral defined as the handover of patients from doctor to doctor or from one team to another has been identified as a high-risk area as patient valuable information can be lost or not quantified or recorded properly during the transit. Many referrals are regarded as unnecessary, meaning that the problem could be handled by the General Practitioner (GP). Improving the quality of the referral process is important to facilitate timely access to speciality care.
Objectives- To understand the perceptions, attitude, behaviour, challenges and facilitators of referral policy, practices and pattern from all the stake holders involved in the referral process, i.e., the health policy makers, healthcare providers and users from primary care to higher levels of health care facilities in the public health system of Bhopal district in Madhya Pradesh.
Materials and Methods- 24 in-depth interviews of the health policy or decision makers of the state, doctors, and administrators/ in-charges of the public health system in Bhopal by purposive sampling and exit interviews of a quota sampling of 63 patients were conducted. Thematic framework analysis was done manually and a conceptual framework for the referral system was generated.
Results- Five major themes conceptualised for the continuous process of the referral system were referral policy, roles and responsibilities, implementation, barriers and facilitators, monitoring, feedback and evaluation.
Conclusion- The implementation of the referral policy regarding the maintenance of the referral registers, issuing of referral slips, etc were not up to the required standards. There is a need for a uniform state referral policy and the establishment of a GP system to ensure continuity of care.
Molecular imaging of coronary plaque vulnerability using 18F- fluorocholine PET-MRI in patients with coronary artery disease: validation with optical coherence tomography
Authors: Pol Jochem A.J. van der , Rahel Braim , Cauteren Yvonne J.M. van , Moonen Rik P.M. , Meeder Joan G. , Gerretsen Suzanne C. , Aizaz Mueez , Prieto Claudia , Botnar René M. , Bucerius Jan , Langen Herman van , Wildberger Joachim E. , Holtackers Robert J. , Kooi M. Eline 
Published: August 2024

Abstract

Purpose
18F-fluorocholine is a positron emission tomography (PET) tracer earlier found to be a marker of macrophage content in carotid plaques. We aimed to assess the feasibility of 18F-choline PET-MRI to non-invasively localize vulnerable coronary plaques, using optical coherence tomography (OCT) as reference standard.
Methods
Patients with recent myocardial infarction who were scheduled for a secondary angiography of a non-culprit vessel, underwent 18F-fluorocholine coronary PET-MRI. Subsequently, OCT was performed during the secondary angiography. Maximum target-to-background (TBRmax) values of 18F-fluorocholine uptake were determined in two vessel sections that contained either vulnerable or stable plaques as defined by OCT. The OCT-based definition of a vulnerable plaque was a fibrous cap thickness <70µm. To enhance the detectability of coronary plaques using PET, three different motion-correction strategies were used: multigate respiratory gating motion correction (MRG-MOCO), extended MR-based motion correction (eMR-MOCO), and extended MR-based motion correction with ECG gating (eMR-MOCO-ECG).
Results
Fifteen patients were included in this study, of which eleven entered final analyses. Data of the other four subjects could only be partially analysed. TBRmax values were as follows for three different reconstructions in vulnerable versus stable plaques: MRG-MOCO: mean TBRmax 1.45 vs 1.35, p=0.52; eMR-MOCO mean TBRmax 1.47 vs 1.27, p= 0.26, eMR-MOCO-ECG: mean TBRmax 1.49 vs 1.26, p= 0.21.
Conclusion
18F-fluorocholine uptake in vulnerable atherosclerotic plaques in coronary arteries was not significantly different from uptake in stable plaques even though advanced motion-correction methods were applied. That may be caused by multiple factors, such as small coronary plaque size and remaining cardiac motion.
Prolonged Operative Time Significantly Impacts on the Incidence of Complications in Spinal Surgery
Authors: Monetta Annalisa , Griffoni Cristiana , Falzetti Luigi , Evangelisti Gisberto , Noli Luigi Emanuele , Tedesco Giuseppe , Cavallari Carlotta , Bandiera Stefano , Terzi Silvia , Ghermandi Riccardo , Girolami Marco , Pipola Valerio , Gasbarrini Alessandro , Brodano Giovanni Barbanti 
Published: August 2024

Abstract

Background
In spinal surgery adverse events (AE) and surgical complications (SC) significantly affect patient’s outcome and quality of life. The duration of surgery has been investigated in different surgical field as risk factor for complications. The aim of this study is to analyze the correlation between operative time and adverse events in spinal surgery.
Methods
We retrospectively analyzed data collected prospectively in a cohort of 336 patients surgically treated for spinal diseases of oncological and degenerative origin in a single center, between January 2017 to January 2018. Demographics and clinical data were collected. Adverse events were classified using Spinal Adverse Events Severity System version 2 (SAVES-V2) capture system. Focusing on degenerative patients, bivariate analysis and univariate logistic regression were used to determine the association between operative time and complications.
Results
A total of 105/336 patients experienced an AE related to surgery, respectively 38% in the oncological group and 28% in the degenerative group. The average age at surgery was 60.3 years (SD 17.1) and the mean operative time was 164.8 ± 138 minutes. A total of 206 adverse events (30 intraoperative, 135 early postoperative and 41 late postoperative AEs) were recorded. Early post-operative complications accounted for the most recorded AEs (55.5% in the oncological group and 73.2% in the degenerative group). Univariate logistic regression analyses confirmed that operative time correlated with increased risk of intra-operative (p-value = 0.0008), early post-operative (p-value < 0.001) and late post-operative (p-value < 0.001) adverse events.
Conclusions
This study highlights the strong correlation between the occurrence of adverse events in spinal surgery and prolonged operative time and suggests that efforts should be made to minimize the duration of surgical procedures while prioritizing patient’s safety, without compromising the technical achievement of the procedure
Assessment of Peripheral Neuropathy Using Current Perception Threshold Measurement in Patients with Spinocerebellar Ataxia Type 3
Authors: Liu Xia-Hua , Lin Wei , Xu Hao-Ling , Cui Mao-Lin , Huang Zhuo-Ying , Li Ying , Zhang Nan-Nan , Wang Ning , Wang Zhi-Yong , Gan Shi-Rui 
Published: August 2024

Abstract

Background
Peripheral neuropathy (PN) identified as a significant contributor to disability in SCA3 patients.
Objectives
This study seeks to assess the utility of current perception threshold (CPT) measurements in evaluating PN in individuals with SCA3 and aims to identify factors influencing CPT values in SCA3 and ascertain whether these values correlate with the severity of ataxia.
Methods
Ninety-four patients diagnosed with SCA3 and 44 healthy controls were recruited for this investigation. All participants were performed standard CPT assessments. Comparative analysis was conducted on CPT variables between the groups. Multivariable linear regression models were employed to identify potential risk factors influencing CPT values, and to investigate the association between CPT values and the severity of ataxia in SCA3.
Results
The case group exhibited significantly higher values across all CPT variables compared to the control group (P < 0.01). Peripheral neuropathy was prevalent among SCA3 patients, with lower limb nerves demonstrating greater susceptibility than upper limb nerves. Increasing age at onset (AAO) (β = 17.652, P = 0.01) and heightened ataxia severity (β = 33.47, P = 0.011) as predictors of poorer CPT values. Gender also emerged as a predictor of CPT values. Furthermore, CPT values (β = 0, P = 0.011) and disease duration (β = 0.105, P = 0.000) were found to influence the severity of ataxia.
Conclusion
Our findings suggest that the CPT test holds promise for assessing peripheral neuropathy in SCA3 patients and that CPT values may serve as indicators of disease severity in this population.
Amino Acid Stable Carbon Isotopes in Nail Keratin Illuminate Breastfeeding and Weaning Practices of Mother – Infant Dyads
Authors: Salahuddin Hana , Waters-Rist Andrea L. , Longstaffe Fred J. 
Published: August 2024

Abstract

Compound-specific stable carbon isotope analysis of amino acids (CSIA-AA) is widely used in ecological studies to analyze food-webs and is gaining use in archaeology for investigating past diets. However, its use in reconstructing breastfeeding and weaning practices is not fully understood. This study evaluates the efficacy of stable carbon isotope analysis of amino acids in early life diet reconstruction by analyzing keratin from fingernail samples of three mother-infant pairs during late gestation and early postpartum periods. Our results show that stable carbon isotope ratios (δ13C) of glycine, and to a lesser extent glutamate, effectively trace the onset of exclusive breastfeeding and the end of weaning in infants. We propose that glycine’s ‘conditionally essential’ metabolic pathway during infancy allows it to reflect maternal glycine δ13C, indicating breastmilk consumption. Subtle changes in glutamate δ13C likely result from its ‘non-essential’ status. Additionally, δ13C values of glycine and glutamate indicate maternal physiological and pathological stress due to catabolic effects such as gluconeogenesis. These findings have significant implications for ecological and archaeological research using CSIA-AA for dietary reconstructions. They highlight the need to understand how metabolic pathways affecting δ13C of amino acids may change over an individual's lifespan or be altered due to various forms of stress.