bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonadherence to Drug Therapy among Pregnant Women in Baghdad/Al-Karkh Directorate (2022)
Authors: Wasif Mais Waleed , Abdul-Sahib Hanadi Muhammad 
Published: July 2024

Abstract

Objectives:
This aim of the study was to estimate the prevalence of noncompliance to medication in pregnant women in Al-Karkh directorate and to address its most common causes.

Methods:
A cross-sectional study was conducted at a number of primary health-care centers located in Baghdad/Al-Karkh directorate including pregnant women in their second and third trimesters through a self-filled questionnaire; data were later analyzed.

Results:
The results obtained from the present study revealed that 185 out of 306 participants (60%) of pregnant women were noncompliant or inadequately compliant with their medication, whereas the remaining 121 (40%) were properly compliant. The most common reasons for noncompliance included wrong use of drugs (38.4%), not understanding or knowing the benefits of drugs (30.3%), forgetting to take drugs (29.7%), or thinking that they were unsafe for the fetus (25.9%).

Conclusions:
Appropriate health education and enhancing doctor–patient relationship and communication during antenatal care visits are crucial to achieve better compliance.
Knowledge and Attitude of Attention-deficit Hyperactivity Disorder among Parents Attending Primary Health-care Centers in Al-Karkh/Baghdad City, 2023
Authors: Jabar Ayat Haider , Saleh Amal Abdulkadir , Akmoosh Sura Ibrahim 
Published: July 2024

Abstract

Background:
Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. Knowledge and attitude of parents about the disorder influence the diagnosis, treatment, and future of the child as an individual and as a part of the community.

Objectives:
The objective of this study was to assess the knowledge and attitude of parents about ADHD in Alkarkh, Baghdad, Iraq, 2023.

Methods:
A cross-sectional study was conducted between February and July 2023, at 12 primary health centers in Al-Karkh Health Directorate in Baghdad City, and a convenient sample of 300 parents was involved. Data were collected using a direct interviewing questionnaire.

Results:
According to age, 196 (65.3%) of the sample fell in the age group of 31–40 years, the mothers-to-fathers ratio was 5:1, 76.3% of participants had higher education, 206 (68.7%) were employed, 134 (44.7%) participants had fair knowledge, and only 8 (2.7%) had good knowledge. More than two-thirds of parents, 214 (71.5%), had good knowledge about the treatment of ADHD, and 164 (54.8%) had symptoms of the disorder, while they had less knowledge about the nature of ADHD and its risk factors. There was a statistically significant association (P < 0.05) between knowledge level and parent’s education, occupation, and residency. About 252 (84%) parents had positive attitude toward ADHD. The positive attitude was significantly associated with the age, education, occupation, and residency of the participants.

Conclusions:
Less than half of the study samples had fair knowledge, and the majority had a good attitude regarding ADHD.
Knowledge, Attitude, and Practice toward Epilepsy among Primary School Teachers in Al-Rusafa/Baghdad 2022
Authors: Jasim Muna Saleh , Hussein Wijdan Akram 
Published: July 2024

Abstract

Background:
Epilepsy is one of the most widespread neurological illnesses in the world with a prevalence rate of 2.8–19.5 per 1000 of the general population, and it is more prevalent in childhood. The understanding of the teachers about epilepsy has a significant impact on the academic performance and social skills of schoolchildren with epilepsy.

Aim of Study:
This study aimed to assess teachers’ knowledge, attitude, and practice regarding epilepsy in schoolchildren and the association of certain studied variables with the level of schoolteachers’ knowledge, attitude, and practice.

Subjects and Methods:
This was a cross-sectional study that included 402 participants and was conducted in Al-Rusafa/Baghdad during the period from November 1, 2021, to January 31, 2022. A self-administered questionnaire was used for data collection method.

Results:
Most of the studied sample demonstrated fair knowledge (52%), attitudes (55%), and practices (55%). A significant association was detected between knowledge, attitude, practices, and each of marital status, specialty, and academic qualification (P < 0.05).

Conclusion:
There was a Fair level of knowledge, attitude, and practice of teachers regarding students with epilepsy. Being single unmarried, of university degree and with a scientific specialty were considered as a predictor factors of good knowledge, attitude, and practice. While age, gender, and years of experience were not associated with any of the knowledge, attitude, and practice parameters. Multiple sources considered a major source of information.
The Heart Team during the Pandemic: A Case Report of Bio-Prosthesis Degeneration Treated with Valve in Valve Implantation
Authors: Manes Maria Teresa , Ritacco Anna Rita , Cassano Susanna , Ferrò Maria Teresa , Manduca Bruno , Spaccarotella Carmen , Musacchio Domenico 
Published: July 2024

The pandemic changed the type of patients. The concept of “patient at the center” became concrete. The execution of simple consultancy was overcome to create effective collaboration and fruitful exchanges between specialists. The “Heart Team” model is on increasing affirmation. The TEAM-BASED approach in the cardiology field is successfully used in patients suffering from ischemic heart disease and valvulopathies for the choice of possible treatments. Degenerative type Sao is the most frequent valvulopathy among the valvulopathies in Western countries and its incidence is correlated with age. In high-risk patients, percutaneous valve replacement (transcatheter aortic valve implantation) is the most valid therapeutic option. The implantation of biological prostheses raises the problem of both degeneration and dysfunction of the prosthesis itself over time in subjects of advanced age and with comorbidities. In this scenario, valve-in-valve (VinV) is a valid therapeutic alternative in high-risk patients. A clinical case of aortic prosthetic degeneration, as an outcome of endocarditis, treated with VinV is presented. The therapeutic decision was made by an “Electronic Heart Team” which represents a further evolution of the treatment pathways and reduces the distance between the specialists in “Hub” Centers and the “Spoke” center.

Summary
The advent of the pandemic caused active collaboration and fruitful discussions among medical specialists. As a matter of fact, a shift from a simple consultation to the establishment of a proper “Heart Team” model occurred and the concept of “patient at the center” arose. TEAM-BASED approaches in cardiology are being successfully used as possible treatments in patients suffering from ischemic heart disease and valvulopathies. Degenerative type Sao is the most frequent valvulopathy in Western countries and its incidence is correlated with age. In high-risk patients, percutaneous valve replacement (TAVI) is the most viable treatment option. However, in subjects of advanced age, with comorbidities, the implantation of biological prostheses is associated with the degeneration and dysfunction of the prosthesis itself over time. In this scenario, Valve-in-valve (VinV) is a viable therapeutic alternative in high-risk patients. A clinical case of aortic prosthetic degeneration, as an outcome of endocarditis, that was treated with VinV is presented. The decision on VinV was made by an “Electronic Heart Team” which represents a further evolution of care pathways to reduce the distance between the “Hub” Centers and the specialist at the “Spoke” center.
How Right is the Right Ventricle in Predicting Cardiac Mortality in Cardiac Failure: A 6-year Prospective Cohort Study
Authors: Sljivic Aleksandra , Kleut Milena Pavlovic , Celic Vera , Neskovic Aleksandar N. , Nesic Ivan , Gazibara Tatjana 
Published: July 2024

Aim:
Two-dimensional speckle tracking echocardiography (2D-STE) and three-dimensional echocardiography (3DE) may overcome many limitations of the conventional 2D echocardiography (2DE) in assessing right ventricular (RV) function. We sought to determine whether characteristics of the right atrium and right ventricle as measured by 2D-STE and 3DE are associated with cardiac mortality in patients with ischemic heart failure, over a 6-year follow-up.

Materials and Methods:
The inclusion criteria were ischemic cardiomyopathy with left ventricular ejection fraction of <40% diagnosed using standard 2DE, 2D-STE, and 3DE examination. Patients were followed for 6 years, and cardiac mortality was recorded.

Results:
The study sample comprised a total of 54 participants. During the period of follow-up, 24% (13/54) died. The 2DE models showed that being older, having a higher body mass index (BMI), having higher systolic pulmonary artery pressure (SPAP), and a lower RV global longitudinal strain were associated with cardiac mortality in our cohort after 6-year follow-up. Finally, the 3DE models showed that in addition to being older, having higher BMI, having a higher SPAP baseline, lower baseline 3DE RV stroke volume, and larger 3DE RV end-diastolic volume and 3DE RV end-systolic volume were associated with cardiac mortality over 6-year follow-up.

Conclusion:
This study provides evidence that RV dysfunction as seen on 2D-STE and 3DE could be associated with increased risk of cardiac-related mortality in patients with heart failure over 6 years.
Echocardiographic Assessment of Recovered Patients with Mild COVID-19 Infection: A Case–Control Study
Authors: Alimi Hedieh , Bigdelu Leila , Poorzand Hoorak , Ghaderi Fereshteh , Emadzadeh Maryam , Yadollahi Asal , Izadi-Moud Azadeh , Fazlinezhad Afsoon , Danesh Maedeh Rezaei 
Published: July 2024

Context:
Coronavirus disease 2019 (COVID-19) has been revealed as a severe illness with a wide-ranging cardiac manifestation and has a worldwide burden on the health-care system.

Aims:
Our aim in this study is to assess the impact of mild COVID-19 infection on cardiac function in patients without previous structural heart disease.

Settings and Design:
We evaluated 100 outpatients with a history of mild COVID-19 infection without needing hospitalization within 3 weeks to 3 months after recovery from the acute phase of the illness between August 2020 and July 2021.

Subjects and Methods:
The patients were compared with 105 healthy participants without a history of COVID-19 as the control group. All participants underwent comprehensive transthoracic echocardiography.

Statistical Analysis Used:
Data were analyzed using IBM SPSS statistics 23. For all tests, P < 0.05 was defined as statistically significant.

Results:
COVID-19 patients had higher global longitudinal strain (P = 0.001), systolic pulmonary artery pressure (P = 0.008), RV E’ (P = 0.049), and RV A’ (P = 0.003), while had lower septal tissue velocities (P = 0.01) and left ventricular ejection fraction (EF) (LVEF) (P = 0.03). Abnormal EF (LVEF <55%) was noted in 19% of the COVID-19 patients and 8.6% of the control group (P = 0.03). Moderate or more diastolic dysfunction was noted in 10 COVID-19 patients but only in one participant in the control group (P = 0.005).

Conclusions:
Mild COVID-19 infection can result in cardiac functional and structural changes, even in patients without known previous structural heart disease. Echocardiography can be a useful modality for risk assessment and follow-up in patients with COVID-19.
Estimation of the Proton Resonance Frequency Coefficient in Agar-based Phantoms
Authors: Filippou Antria , Evripidou Nikolas , Georgiou Andreas , Nikolaou Anastasia , Damianou Christakis 
Published: July 2024

Aim:
Agar-based phantoms are popular in high intensity focused ultrasound (HIFU) studies, with magnetic resonance imaging (MRI) preferred for guidance since it provides temperature monitoring by proton resonance frequency (PRF) shift magnetic resonance (MR) thermometry. MR thermometry monitoring depends on several factors, thus, herein, the PRF coefficient of agar phantoms was estimated.

Materials and Methods:
Seven phantoms were developed with varied agar (2, 4, or 6% w/v) or constant agar (6% w/v) and varied silica concentrations (2, 4, 6, or 8% w/v) to assess the effect of the concentration on the PRF coefficient. Each phantom was sonicated using varied acoustical power for a 30 s duration in both a laboratory setting and inside a 3T MRI scanner. PRF coefficients were estimated through linear trends between phase shift acquired using gradient sequences and thermocouple-based temperatures changes.

Results:
Linear regression (R
2 = 0.9707–0.9991) demonstrated a proportional dependency of phase shift with temperature change, resulting in PRF coefficients between −0.00336 ± 0.00029 and −0.00934 ± 0.00050 ppm/°C for the various phantom recipes. Weak negative linear correlations of the PRF coefficient were observed with increased agar. With silica concentrations, the negative linear correlation was strong. For all phantoms, calibrated PRF coefficients resulted in 1.01–3.01-fold higher temperature changes compared to the values calculated using a literature PRF coefficient.

Conclusions:
Phantoms developed with a 6% w/v agar concentration and doped with 0%–8% w/v silica best resemble tissue PRF coefficients and should be preferred in HIFU studies. The estimated PRF coefficients can result in enhanced MR thermometry monitoring and evaluation of HIFU protocols.
Estimation of Proton Stopping Power Ratio and Mean Excitation Energy Using Electron Density and Its Applications via Machine Learning Approach
Authors: Chika Charles Ekene 
Published: July 2024

Purpose:
The purpose of this study was to develop a simple flexible method for accurate estimation of stopping power ratio (SPR) and mean excitation energy (I) using relative electron density (ρ
e).

Materials and Methods:
The model was formulated using empirical relationships between SPR, mean excitation energy I, and relative electron density. Some examples were implemented, and a comparison was carried out using other existing methods. The needed coefficients in the model were estimated using optimization tools. Basis vector method (BVM) and Hunemohr and Saito (H-S) method were applied to estimate the ρ
e used in the application section. 80 kVp and 150 kVpSn were used as low and high energy, respectively, for the implementation of dual-energy methods.

Results:
All the examples of the proposed method considered have modeling error that is ≤0.32% and testing root mean square error (RMSE) ≤0.92% for SPR with a mean error close to 0.00%. The method was able to achieve modeling RMSE of 2.12% for mean excitation energy with room for improvement. Similar or better results were achieved in application to BVM.

Conclusion:
The method showed robustness in application by achieving lower testing error than other presented methods in most cases. It achieved accurate estimation which can be improved using the machine learning algorithm since it is flexible to implement in terms of the function (model) degree and tissue classification.
Assessing Heterogeneity Effects on Points A, B, and Organs at Risk Doses in High-dose-Rate Brachytherapy for Cervical Cancer – A Comparison of 192Ir and 60Co Sources Using Monte Carlo N-Particle 5
Authors: Sadeghi Mohammad Hossein , Sina Sedigheh , Meigooni Ali Soleimani 
Published: July 2024

Purpose:
The present article deals with investigating the effects of tissue heterogeneity consideration on the dose distribution of 192Ir and 60Co sources in high-dose-rate brachytherapy (HDR-BT).

Materials and Methods:
A Monte Carlo N-Particle 5 (MCNP5) code was developed for the simulation of the dose distribution in homogeneous and heterogeneous phantoms for cervical cancer patients. The phantoms represented water-equivalent and human body-equivalent tissues. Treatment data for a patient undergoing HDR-BT with a 192Ir source were used as a reference for validation, and for 60Co, AAPM Task Group 43 methodology was also applied. The dose values were calculated for both source types in the phantoms.

Results:
The results showed a good agreement between the calculated dose in the homogeneous phantom and the real patient’s treatment data, with a relative difference of less than 5% for both sources. However, when comparing the absorbed doses at critical points such as Point A right, Point A left, Point B right, Point B left, bladder International Commission on Radiation Units and Measurement (ICRU) point, and recto-vaginal ICRU point, the study revealed significant percentage differences (approximately 5.85% to 12.02%) between the homogeneous and heterogeneous setups for both 192Ir and 60Co sources. The analysis of dose–volume histograms (DVH) indicated that organs at risk, notably the rectum and bladder, still received doses within recommended limits.

Conclusions:
The study concludes that 60Co and 192Ir sources can be effectively used in HDR-BT, provided that careful consideration is given to tissue heterogeneity effects during treatment planning to ensure optimal therapeutic outcomes.
Performance Evaluation of Deformable Image Registration Systems – SmartAdapt® and Velocity™
Authors: Kumar M. Anil , Hajare Raghavendra , Nath Bhakti Dev , Lakshmi K. K. Sree , Mahantshetty Umesh M. 
Published: July 2024

Aim:
To commission and validate commercial deformable image registration (DIR) systems (SmartAdapt® and Velocity™) using task group 132 (TG-132) digital phantom datasets. Additionally, the study compares and verifies the DIR algorithms of the two systems.

Materials and Methods:
TG-132 digital phantoms were obtained from the American Association of Physicists in Medicine website and imported into SmartAdapt® and Velocity™ systems for commissioning and validation. The registration results were compared with known shifts using rigid registrations and deformable registrations. Virtual head and neck phantoms obtained online (DIR Evaluation Project) and some selected clinical data sets from the department were imported into the two DIR systems. For both of these datasets, DIR was carried out between the source and target images, and the contours were then propagated from the source to the target image data set. The dice similarity coefficient (DSC), mean distance to agreement (MDA), and Jacobian determinant measures were utilised to evaluate the registration results.

Results:
The recommended criteria for commissioning and validation of DIR system from TG-132 was error <0.5*voxel dimension (vd). Translation only registration: Both systems met TG-132 recommendations except computed tomography (CT)-positron emission tomography registration in both systems (Velocity ~1.1*vd, SmartAdapt ~1.6*vd). Translational and rotational registration: Both systems failed the criteria for all modalities (For velocity, error ranged from 0.6*vd [CT-CT registration] to 3.4*vd [CT-cone-beam CT (CBCT) registration]. For SmartAdapt® the range was 0.6*vd [CT-CBCT] to 3.6*vd [CT-CT]). Mean ± standard deviation for DSC, MDA and Jacobian metrics were used to compare the DIR results between SmartAdapt® and Velocity™.

Conclusion:
The DIR algorithms of SmartAdapt® and Velocity™ were commissioned and their deformation results were compared. Both systems can be used for clinical purpose. While there were only minimal differences between the two systems, Velocity™ provided lower values for parotids, bladder, rectum, and prostate (soft tissue) compared to SmartAdapt. However, for mandible, spinal cord, and femoral heads (rigid structures), both systems showed nearly identical results.
Commissioning of the First MRlinac in Latin America
Authors: Alejandro Rojas-López José , Alexis Cabrera-Santiago , Xesús González Souto 
Published: July 2024

Purpose:
To show the workflow for the commissioning of a MRlinac, and some proposed tests; off-axis targets, output factors for small fields, dose in inhomogeneities, and multileaf collimator quality assurance (MLC QA).

Methods:
The tests were performed based on TG-142, TG-119, ICRU 97, TRS-398, and TRS-483 recommendations as well as national regulations for radiation protection and safety.

Results:
The imaging tests are in agreement with the protocols. The radiation isocenter was 0.34 mm, and for off-axis targets location was up to 0.88 mm. The dose profiles measured and calculated in treatment planning system (TPS) passed in all cases the gamma analysis of 2%/2 mm (global dose differences). The output factors of fields larger than 2 cm × 2 cm are in agreement with the model of the MRlinac in the TPS. However, for smaller fields, their differences are higher than 10%. Picket fence test for different gantry angles showed a maximum leaf deviation up to 0.2 mm. Displacements observed in treatment couch adding weight (50 kg) are lower than 1 mm. Cryostat, bridge, and couch attenuation was up to 1.2%, 10%, and 24%, respectively.

Conclusion:
The implemented tests confirm that the studied MRlinac agrees with the standards reported in the literature and that the strict tolerances established as a baseline should allow a smoother implementation of stereotactic treatments in this machine.
Profile of patients referred for lung transplant and their transplant-free survival
Authors: Rathi Vidushi , Tiwari Pawan , Seth Sandeep , Hadda Vijay , Madan Karan , Agarwal Shubham , Vij Arti , Hote Milind , Sahu Manoj , Mittal Saurabh , Guleria Randeep , Pandey Shivam , Pandey Ravindra M. , Mohan Anant 
Published: July 2024

ABSTRACT

Introduction:
Lung transplant (LTx) is a potential treatment option for all patients with chronic, end-stage respiratory disease, who are refractory to optimal medical therapy or where no medical therapy exists. In India, LTx is still in its evolving stages and published literature is sparse. The current study was carried out to study the selection criteria for lung transplant and to evaluate the clinical and socio-economic profile of patients referred for the same at a tertiary health care facility.

Methods:
The study was a descriptive, prospective, observational study. All adults referred for lung transplant were evaluated for clinical and laboratory profiles. All enrolled patients were assessed for presence of referral criteria, listing criteria, contraindications, and willingness for lung transplant. These patients were followed up for 2 years for transplant-free survival, and the Cox proportional hazards model was used to determine independent predictors of all-cause mortality.

Results:
A total of 103 were included in study. The most common diagnosis was interstitial lung disease (57.2%), followed by bronchiectasis (17.5%) and COPD (13.6%). Most patients were referred for LTx at an advanced stage as 90% met listing criteria. Fifty-four (52.4%) patients had an absolute or relative contraindication to transplant; however, the majority of those contraindications were modifiable. Patients with a lower socio-economic status were less likely to be willing for LTx. The median survival was 757 days. A 6-minute walk distance (6MWD) lesser than 250 m was found to be an independent predictor of mortality.

Conclusion:
Making patients aware about lung transplant early in their treatment may give them sufficient time to come to terms with their disease and understand the risk and benefits associated. Efforts should be focused on screening and early treatment of reversible contraindications for the eligible patients. Patients with 6MWD < 250 m are at increased risk of mortality.