bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Topical Heparin Spray on Donor Site Wound Healing Time Compared to Conventional Dressing Among Patients Undergoing Split Thickness Skin Grafting
Authors: Adil Faraz , Memon Mahak Ali , Akhlaq Faisal , Piprani Farhan Zahid , Awan Asadullah , Siddiqui Saad Uddin 
Published: August 2024

Abstract

Background
All wounds that cannot be closed primarily needs skin coverage earliest to prevent form infections. Skin graft provides earliest and easiest wound coverage, but produces another wound, i.e. donor site wound. This study is conducted to see healing time efficacy of topical heparin spray versus conventional dressing in healing donor site wounds.
METHODOLOGY
The study was designed as a single center, prospective, randomized control trial study. It was conducted in the Department of Plastic and Reconstructive Surgery at Civil Hospital Karachi. The study was carried out for 10 months of the period from Sep 2020 to July 2021. The sample was calculated by using OpenEpi version 3.01.The minimum sample size was calculated to be 8 at 95% confidence level and 80% power, though the study included 60 patients who underwent split thickness skin grafting for healthy granulating wounds. From the next day of surgery heparin dressing and conventional dressings groups were made and dressing was done daily till seventh postoperative day. Data in form of questionnaire and photographic assessment was recorded filled at every change of dressing. This study was a self-controlled trial, therefore every trial participant served as his/her own control. Data was analyzed by using Statistical Package for Social Sciences (SPSS version 24).
RESULT
The results of the analysis showed the mean age of the participants was (35.30 ± 8.87). Male gender predominated with a frequency of 82% while females were 18%. A decrease in soakage of dressing was recorded in 48 (98.0%) male participants at interventional half; however, all females experienced no difference at both dressing sites. Similarly 48 (98.0%) male participants a reduction in itching at intervention site and all females had experienced no difference in itching at both dressing sites. In regard to wound size, 40% of participants showed a reduction in wound size and only 20% showed no improvement at interventional half. During 7days, 81.67% of participants showed improvement in edema at intervention half and 96.7% of participants reported no change in edema with conventional therapy. None of the participants scored worst pain at the intervention area.
CONCLUSION
The study showed heparin irrigation result in better wound healing and significantly reduces pain, edema, enhances faster healing and reduces soakage of dressings.
Trial registration:
The study was approved by Institutional Review Board of Dow University of Health Sciences and was registered at Clinical Trials.gov (ID: NCT04613336).
Radiological characterization related to lithology and risk assessment of bottled natural mineral water
Authors: Martínez Joana , Peñalver Alejandra , Riu Jordi , Aguilar Carme , Borrull Francesc 
Published: August 2024

Abstract

The enhancement of natural radioactivity in groundwater, specifically in natural mineral water, is related to the lithological formations through which water bodies or courses pass. Although natural mineral waters are exempt from monitoring for radioactive substances according to Council Directive 2013/51/EURATOM, this study focuses on the radiological characterization of natural mineral water under Spanish Royal Decree 3/2023. The water studied was taken from Catalan aquifers with different lithological characteristics (sedimentary, metamorphic, or granitic) and is sold on local markets. Moreover, radiological data on the water was correlated with its lithological origin and the health risk for different age groups was assessed. Our results showed that of the 26 natural mineral waters studied, 10 exceeded gross alpha screening value (100 mBq/L), all from granitic aquifers. Further research on natural individual radionuclides was conducted on these 10 samples. 234U and 238U at around 1100–1600 mBq/L. In addition, 210Pb was found in two samples, which also presented the highest 226Ra activity, associated with granitic bedrock and the presence of 210Po. The annual effective dose was 179.0 and 145.9 µSv/y, exceeding 100 µSv/y mainly due to the contribution of 210Pb >234,238U >210Po>226Ra, in this order. After assessing the lifetime cancer risk, these two samples were determined not to pose a health risk due to ingestion. Although no radiological monitoring is required for natural mineral water, further surveillance is recommendable.
How can services better support women with a body mass index ≥25 kg/m2 to breastfeed: a qualitative study.
Authors: Cooke Susan , Heslehurst Nicola , Scott Rebecca , Rankin Judith 
Published: August 2024

Abstract

Aim: This study explores the experiences and perspectives of women with a Body Mass Index (BMI) ≥25 kg/m2 on infant feeding.
Subject and methods: Women with a BMI ≥25 kg/m2 have lower rates of initiating, maintaining and exclusive breastfeeding than women with a BMI <25 kg/m2. There is limited qualitative research on this topic, particularly for women living with overweight (BMI ≥25 kg/m2-29.9 kg/m2). Eighteen women with a BMI ≥25 kg/m2 living in the North East of England and an infant under eighteen months of age participated in a semi-structured interview concerning infant feeding practices during May and June 2021. Participants were recruited through social media platforms. An inductive thematic analysis was undertaken to analyse the interview data.
Results: Two overarching themes were identified: lower confidence and a perceived negative judgement from others for living with higher weight. These themes reduced women’s confidence in their ability to breastfeed and led to negative experiences or avoidance of public feeding. Difficulties with latching and positioning in relation to body shape also reduced confidence in breastfeeding further. Due to these barriers, women felt that they required additional, tailored support to achieve breastfeeding.
Conclusion: Improving breastfeeding support for women with a BMI≥25 kg/m2 requires a whole systems approach involving education systems, healthcare professionals and the community. The impact of terminology, such as labelling a women’s pregnancy ‘high risk’, on women’s breastfeeding confidence needs to be considered further.
Host genetic diversity contributes to disease outcome in Crimean-Congo hemorrhagic fever virus infection
Authors: Rao Deepashri , Lewis Matthew , Meade-White Kimberly , Shaia Carl , Okumura Atsushi , Ferris Martin T. , Schäfer Alexandra , Baric Ralph , Feldmann Heinz , Hawman David W. 
Published: August 2024

Abstract

The Crimean-Congo hemorrhagic fever virus (CCHFV) causes Crimean-Congo hemorrhagic fever (CCHF), a widely distributed disease with significant morbidity and mortality. The virus has high genetic diversity correlated with geographic distribution, but limited temporal evolution within regions. Despite this, cases of CCHF within a region present as a spectrum of disease from often unrecognized asymptomatic infections to a severe, fatal viral hemorrhagic fever, suggesting host factors may play a role in disease outcome. We investigated the effect of host genetic diversity on the outcome of CCHFV infection in the genetically diverse Collaborative Cross mouse model. Infected mice recapitulated the full spectrum of disease recognized in humans and similar to human disease, virus replication, tissue pathology and inflammatory responses were associated with disease severity. Our study demonstrates that host genetics contribute to disease outcome in CCHF infection and establishes the Collaborative Cross mouse resource as a model to understand how host genetic diversity contributes to CCHF outcome.
Multicenter analysis of the efficacy of early cholecystectomy and preoperative cholecystostomy for severe acute cholecystitis: A retrospective study of data from the multi-institutional database of the Hiroshima Surgical Study Group of Clinical Oncology
Authors: Abe Tomoyuki , Kobayashi Tsuyoshi , Kuroda Shintaro , Hamaoka Michinori , Mashima Hiroaki , Onoe Takashi , Honmyo Naruhiko , Oishi Koichi , Ohdan Hideki 
Published: August 2024

Abstract

Background
Severe acute cholecystitis (AC) is a challenging disease because it comprises coexisting systemic infections that lead to vital organ dysfunction. This study evaluated the optimal surgical timing and efficacy of preoperative percutaneous cholecystostomy (PC) for patients with severe AC.
Methods
Data of 142 patients who underwent cholecystectomy for severe AC between 2011 and 2021 were retrospectively collected from a multi-institutional database of the Hiroshima Surgical Study Group of Clinical Oncology and divided into the early cholecystectomy (EC) group (within 72 hours of symptom onset) and delayed cholecystectomy (DC) group. Patients were also subdivided into the upfront cholecystectomy group and preoperative PC after cholecystectomy group. The diagnosis and severity of AC were graded according to the Tokyo Guidelines 2018. Clinicopathological variables and outcomes were compared.
Results
No significant differences in age, body mass index, American Society Anesthesiologist (ASA) classification, and Carlson comorbidity index were observed between the EC and DC groups. Preoperative drainage was more commonly performed in the DC group than in the EC group. Local severe AC features were more commonly detected in the DC group than in the EC group. The postoperative outcomes of the EC and DC groups were comparable. The upfront cholecystectomy group included more patients with ASA physical status ≥ 3 and patients who used oral warfarin than the preoperative PC after cholecystectomy group. Warfarin usage and cardiovascular dysfunction rates of the PC after cholecystectomy group were higher than those of the upfront cholecystectomy group. PC was associated with significantly less intraoperative bleeding and shorter hospital stays.
Conclusions
Patients who can tolerate general anesthesia are good candidates for EC. Patients who use warfarin and those with cardiovascular dysfunction are considered to be at high risk; therefore, PC after cholecystectomy is a better choice than upfront cholecystectomy for these patients.
Contraceptive use in women of childbearing age with bipolar disorder
Authors: Rodríguez-Toscano Elisa , de Chazeron Ingrid , Belzeaux Raoul , Llorca Pierre Michel , Samalin Ludovic 
Published: August 2024

Abstract

Introduction
Unplanned pregnancies are frequent in women with bipolar disorder (BD) while perinatal period is associated with a higher risk of relapse. Effective contraception during childbearing age in BD could reduce the risk of unplanned pregnancy and its consequences. The present study studied the prevalence of contraceptive use and which sociodemographic and clinical variables affect its use in women with BD.
Methods
796 women (18-50 years old) with BD were recruited and evaluated by the MONTRA survey in France among hospital and consultant psychiatrists. Sociodemographic, clinical and treatment variables were compared between patients with and without contraception use. A logistic regression estimated which variables had a predictive effect on the use of contraception.
Results
A 61.2% reported the use of effective contraception. Women who use contraception were in 26-35 (OR=2.40,p<0.001) and 36-45 (OR=1.92,p<0.001) range age, displayed higher levels of education (OR= 5.07,p=0.003), were more active (OR=1.63,p=0.006), did not live alone (OR=1.41,p=0.033) and had fewer manic or mixed episodes (OR=0.50,p=0.007).No association was found with the nature of pharmacological treatment.
Conclusion
Sociodemographic variables were mainly associated with contraception use among BD women. As preventive measures for risk of relapse in BD, contraceptive counseling, including reduction of unplanned pregnancies, should be systematically ensured.
Elucidating fungi pathogens and multi-drug resistance in oculomycosis, and bioprospecting native plants as antifungal therapy
Authors: Badu Kingsley , Boateng Abigail Oforiwaa , Junior Isaiah Osei Duah , Akuffo Kwadwo Owusu , Gyimah Lord 
Published: August 2024

Abstract

Background
Ocular mycoses have a debilitating impact on ocular health and quality of life. However, the burden and etiology of ocular mycoses and the efficacy of clinical antifungal agents used in the management of ocular fungal infections remain unclear. The study assesses the prevalence of ocular fungal pathogens and multi-drug resistance patterns, and further explored native medicinal plants as a source of antifungal agents in Ghana.
Methods
In this multicenter, cross-sectional study, biographic, medical, and ophthalmic data were collected using a structured questionnaire, and conjunctival swabs and corneal samples were collected for microbiological characterization and antifungal susceptibility testing. Patient demographic and clinical data were stratified by sex and differences were tested using chi-squared analysis. Microbiological data were presented as proportions, means, and standard deviations. Bivariate logistic regression was used to test the association between patient characteristics and the likelihood of isolating fungal pathogens from the eyes of persons with presenting eye infections.
Results
Approximately ten percent (9.36%) of ocular specimens were positive for fungal culture with the predominant fungal etiology being Candida albicans. Multi-drug resistance was observed for clinically used antifungal agents; amphotericin B and fluconazole, itraconazole, terbinafine. Alternatively, ethanolic extracts of Cinnamomum verum (C. verum) and Syzygium aromaticum (S. aromaticum), demonstrated potent fungistatic and fungicidal activity against the common implicated pathogen, Candida albicans (C. albicans).
Conclusion
Overall, the study broadens our understanding of the pathogenesis of ocular mycoses in Ghana and the implications of clinical use of antifungal treatments. Leveraging on the medicinal plant screening, we propose characterization of the bioactive compound(s) in C. verum and S. aromaticum for clinical translation into ocular antifungal therapeutics.
The MRI estimations of cervical length and cervical volume correlate with massive hemorrhage in patients with placenta accreta spectrum disorders
Authors: Yue Yongfei , Yan Jun , Song Ye , Zhou Xinfang , Kang Yan , Yuan Min 
Published: August 2024

Abstract

Objective
The purpose of this study is to evaluate the capacity of two MRI parameters to predict massive hemorrhage in pregnancies with placenta accreta spectrum disorders.
Methods and materials:
This case-control study evaluated 174 patients who underwent MRI for placental assessment. MRI images were reviewed by two experienced radiologists blinded to all clinical data. Multivariate logistic regression was performed to analyze the risk factors for patients with massive hemorrhage. The area under the curve were used to compare the predictive ability between cervical length and cervical volume.
Results
Patients with massive hemorrhage exhibited smaller neonatal birthweight (P < 0.001), longer operation time (P < 0.001), and more blood loss (P < 0.001). The percentage of ICU admission and hysterectomy were both significantly higher than patients without massive hemorrhage. The area under the curve of cervical length and cervical volume in predicting MH were 0.812 and 0.845, respectively. And the area under the curve increased to 0.906 by the two combined parameters.
Conclusion
Shorter cervical length and smaller cervical volume are associated with massive hemorrhage during cesarean section. These methods can be utilized to better predict massive hemorrhage in placenta accreta spectrum disorders.
Using patient-reported outcomes in clinical studies for cardiovascular diseases of Traditional Chinese medicine worldwide: a cross-sectional study
Authors: Liu Hao , Guan Xinmiao , Lin Yuanyuan , Luo Minjing , Liang Changhao , Zhang Xinyue , Rong Hongguo , Fei Yutong 
Published: August 2024

Abstract

Background and purpose:
Patient-reported outcomes (PROs) are health condition assessments directly expressed by patients, providing a precise reflection of the patient's perspective. We aim to understand how PROs were being used to provide suggestions for conducting high-quality clinical studies of Traditional Chinese medicine (TCM) for cardiovascular diseases (CVD).
Methods:
We searched clinical studies of TCM for CVD from the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) registered between January 1, 2010, and December 31, 2023. Trial phases, study types, age, gender, TCM interventions, regions and countries, time trends, PROs as primary/secondary/co-primary outcomes, and PRO instruments explicitly specified or implicitly specified were analyzed. We classified the studies that explicitly specified PROs into 14 categories based on the International Classification of Diseases-11 (ICD-11) ,and compared their PRO instruments with the Core Outcome Measures in Effectiveness Trials (COMET).
Results:
487 TCM CVD studies were identified. 194 studies did not mention the use of PRO instruments. 250 studies explicitly specified the PRO tool, while 43 studies implicitly (studies registration mentioned the use of PROs, but PRO instruments were not specified). Out of the 293 studies that included PROs, 84 (17.2%) listed PROs as their primary outcomes, 144 (29.6%) as secondary outcomes and 65 (13.3%) as co-primary outcomes. Chronic coronary heart disease (26.96%), hypertension (15.70%), and heart failure (14.68%) were the most common diseases in that 250 studies. Furthermore, their PRO instruments partially complied with COMET's recommendations ,while other diseases did not. Frequently used PRO instruments included the SAQ (Seattle Angina Questionnaire), the TCMSS (TCM syndrome score), the SF-8/12/36 (Short-Form 8/12/36-item Health Survey), and the VAS (Vsual Analog Scale).
Conclusion:
Over the past decade, there has been a continued increase in the use of PROs as a measure in clinical investigations focused on TCM for CVD. Research and development of PROs core endpoints for different CVD could be improved. Given the current challenges surrounding the use of PROs in clinical studies of TCM, such as the inconsistent availability and absence of standardized PRO instruments for TCM, it is crucial to prioritize research on establishing standardized and normalized scales specifically designed for TCM.
Equine therapy in the management of teenagers with severe anorexia nervosa : a qualitative study
Authors: Lepy Camille , Letranchant Aurélie , Aniorte Jean-Luc , Bedos Julien , Hotchkin Rebecca , Corcos Maurice , Piot Marie-Aude 
Published: August 2024

Abstract

Background
Severe anorexia nervosa is a complex psychiatric pathology with limited therapeutic tools to reduce morbidity and mortality. Equine-assisted therapy could provide additional therapeutic benefits.
Objectives
We aimed to explore the effects of equine assisted therapy on the experience of adolescents with severe anorexia nervosa.
Méthods
Using a qualitative approach based on Interpretative Phenomenological Analysis, we conducted semi-structured interviews with nine participants who had taken part in equine-assisted therapy sessions.
Results
Three super-ordinate themes were found. An experience of insecurity appeared at the forefront of the discovery of the horse which was perceived as a source of fear, and the displacement of the spatiotemporal framework. Equine therapy offered a sense of support and emotional regulation through role-playing that allowed for investment without fear of perceived social judgment, a reassuring experience through relational adjustment with the horse, and an experience of support from the humans present. Last but not least, equine therapy was a transformative learning experience, enabling participants to embody their body bodies, develop emotional regulation and care for someone other than themselves.
Conclusion
Equine-assisted therapy constitutes a therapeutic mediation with bodily, emotional and relational therapeutic benefits in severe anorexia nervosa. The setting, place and function of the equine therapist, the participants' previous experience with horses and the interaction with other care areas seem to be essential to ensure therapeutic conditions.
Computer-Aided Detection of Biparietal Diameter and Femur Length Measurements from Prenatal Ultrasound Images
Authors: abdi Rabah Al , Al-Goraee Ashraf , Hijazi Heba , Ghazal Mohammed , Al-bashir Areen , Alquran Hiam , Sindiani Amer , Abdulhay Enas , Issa Wejdan Bani 
Published: August 2024

Abstract

Background
Routine ultrasound exams for fetal biometry are hindered by the reliance on obstetricians' expertise, emphasizing the necessity for an automated computer-aided method to ensure accurate gestational age estimation. This paper describes a completely automatic method for identifying and accurately measuring two biometrics: biparietal diameter (BPD) and femur length (FL).
Methods
The method uses first- and second-order total variation denoising (FSTVD) to remove speckle noise and preserve edges in prenatal ultrasound images. Automatic estimation of FL and BPD was implemented by selecting and determining regions of interest based on their shape, size, location, and orientation in the filtered images. The method was tested on 431 ultrasound images, and the results were compared with manual measurements made by expert obstetricians. Pearson’s correlation and the Bland–Altman plot were used to assess the agreement between the automatic and manual measurements.
Results
The results showed a strong correlation (r > 0.99) between the automatic and manual measurements for both FL and BPD. A mean error of less than 2 mm was found for the difference between automatic and manual measurements for both FL and BPD. Additionally, the processing time for filtering a regular-sized image and determining FL or BPD using the presented method was less than 0.5 seconds.
Conclusions
The proposed method demonstrates high accuracy in estimating FL and BPD from ultrasound images. Additionally, its short processing time allows for real-time estimation of FL and BPD within ultrasound imaging systems.