bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Primary Patency for Femoropopliteal Graft Entrapment within the Sartorius Muscle
Authors: Rodgers Jeffrey , Brothers Thomas 
Published: August 2024

Abstract

Purpose: Blind tunneling of subfascial femoropopliteal bypass grafts may result in inadvertent graft passage through the sartorius. The purpose of this study was to determine whether intramuscular passage of femoropopliteal bypass grafts affects primary patency.
Methods: Patients undergoing femoropopliteal bypass at a Veterans Administration hospital and associated university medical center over a recent 13-year period who also had postoperative cross-sectional imaging adequate to determine graft location were examined. Five-year primary patency of grafts circumferentially enveloped by the muscle was compared with that of both extramuscular subfascial grafts and subcutaneous grafts.
Results: 370 femoropopliteal grafts were identified, among which 258 (70%) were subfascial. Vein grafts comprised 51% of the subfascial grafts, and 53% were inserted above the knee. Available postoperative imaging in 110 subfascial grafts demonstrated 74 (67%) to lie completely within the muscle at some point. Among imaged subfascial grafts, primary patency at five years for intramuscular grafts was not significantly worse than extramuscular grafts (P=.31). This remained true whether grafts were vein (P=.39) or prosthetic (P=.31) and whether grafts inserted to the above-knee (P=.43) or below-knee (P=.21) popliteal artery. Multivariable Cox regression revealed a significant relationship between use of vein grafts (P=.013), active smoking (P=.01), and hypertension (P=.041) and primary patency, but not intramuscular graft location (P=.31).
Conclusion: This study limited to 110 patients failed to demonstrate significantly inferior primary patency among subfascial grafts tunneled intramuscularly. Larger studies may be required to adequately detect any differences in patency by muscular entrapment, especially among subgroups.
Unrelated umbilical cord blood transplantation using a noval conditioning regimen for small month-old infants with rare non-malignant disorders
Authors: Wang Feiyan , Qu Yuhua , Jiang Hua 
Published: August 2024

Abstract

Background
Patients afflicted with rare non-malignant disorders endure the pain of the disease from birth. Receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT), especially umbilical cord blood transplantation (UCBT), as soon as possible has becomes the only cure opportunity for such patients. For infants under six months old, the toxicity caused by chemotherapy-based conditioning regimens is a key issue that needs to be focused on. Nevertheless, consensus regarding specific dosage adjustments for conditioning regimens in such infants remains elusive.
Objective
Our pilot study aimed to determine a noval dose-adjusted conditioning regimen suitable for infants under 6 months of age with rare non malignant diseases who underwent unrelated umbilical cord blood transplantation.
Methods
We reported the transplant outcomes of five infants under 6 months old with rare non-malignant disease who underwent UCBT at our center from 2021 to 2024. Patients received a conditioning regimen containing adjusted dose of cyclophosphamide, fludarabine, anti-thymocyte immunoglobulin, busulfan and thiotepa, using ≥ 8/10 UCB as the cell source.
Results
The median age of the patients was 4.2 months (range, 4.0 to 5.1) and the median weight of the patients was 5.5 kg (range, 3.5 to 7.5) at transplantation. These infants were diagnosed with Krabbe disease, very early onset inflammatory bowel disease (VEO-IBD), Shwachman-Diamond syndrome (SDS) and Methoxyvaleric aciduria. The median time for neutrophil engraftment and platelet engraftment in all patients was 24 days (range, 12–30 days) and 32 days (range, 26 to 46 days), respectively. The whole blood donor chimerism in all patients was > 95% at 100 days post-UCBT, and all patients achieved a durable complete donor chimerism. The primary diseases of all patients have been effectively corrected, determined by regularly monitoring the enzyme concentration or gene mutation recovery. All patients survived until the follow-up date, and the event free survival rate after UCBT was 100%. Two out of five patients developed acute GVHD, but none had progressed to grade IV aGVHD or chronic GVHD. All patients achieved good lymphocyte reconstruction, especially with CD4 + cells reaching over 200/uL in all patients at 100 days after UCBT. Moreover, natural killer cells and B cells also recover rapidly, with a immunoglobulin class switching.
Conclusions:
In summary, our preliminary research suggest that UCBT with this novel conditioning regimen offers a safe and effective option for infants under 6 months with rare non-malignant diseases, achieving early and rapid donor engraftment, good immune reconstitution with mild GVHD, and superior overall survival.
The Impact of Coronary CT Angiography Image Quality on Artificial Intelligence Technology's Ability To Automatically Identify Coronary Artery Lesions And Stenosis
Authors: Guo Danling , Huang Yanan , Lv Sangying , Guan Le , Wu Guanzuan , Zhai Xiaoya , Li Huaifeng 
Published: August 2024

Abstract

Background
To explore the impact of image quality on the ability of artificial intelligence (AI) to identify coronary artery lesions and detect the degree of coronary artery stenosis in coronary artery CT angiography (CCTA), using invasive coronary angiography (ICA) as the reference standard.
Methods
156 patients suspected of coronary heart disease were enrolled from June 2020 to June 2021, including 92 males and 64 females, with an average age of 66.1 ± 9.4 years. Left anterior descending (LAD), right coronary artery (RCA), and left circumflex (LCX) were divided into non-stenosis, mild stenosis, moderate stenosis, severe stenosis, and occlusion according to ICA as the gold standard. With image quality as the categorical variable, each vessel was evaluated to investigate the effect of image quality on the performance of AI technology in automatically detecting coronary artery lesions and the degree of CCTA.
Results
Compared with traditional manual postprocessing (13.9 ± 3.6min per case), the average postprocessing and interpretation times of AI were 5.4 ± 1.5min per case were significantly reduced; there was no significant difference in the detection of plaques between the coronary AI technology and ICA (P = 0.213). The consistency of AI in assessing the stenosis degree of 156 subjects were medium consistent with that of ICA, with P value < 0.001. With image quality as the categorical variable, the accuracy of human + AI in evaluating the degree of LAD, RCA stenosis was significantly higher than that of AI (P < 0.001), with OR values of 5.258 (2.451,11.376) and 6.552 (2.989,14.362) for the image quality of medium, with OR values of 8.200 (2.747,24.478) and 14.333 (3.886,52.874) for image quality of high, respectively; and the accuracy of human + AI in evaluating the degree of LCX stenosis was significantly higher than that of AI (P < 0.05), with OR values of 2.179 (1.063,4.468) and 3.266 (1.198,8.903) for image quality of high and medium, respectively.
Conclusion
Compared with traditional CCTA manual processing, coronary artery AI-assisted diagnosis technology has a shorter processing time, consistent plaque detection with ICA, and the ability to evaluate the degree of stenosis of each coronary artery under the supervision of a physician, thereby improving work efficiency.
Evaluation of the Outcomes and Influencing Factors of Non-Custodial Educational Programmes for Drug Abusers
Authors: Nam Kyung-ae , Oh In-Sun , Park Sun-Kyeong 
Published: August 2024

Abstract

This study evaluated the effectiveness of deferred prosecution (DP) and probation, defined as non-custodial education programmes (NCEPs), for drug abusers in South Korea. We analysed participants’ questionnaire responses in the DP (N = 203) and probation (N = 254) groups over a two-year period (January 2022–December 2023). The Wilcoxon signed-rank test was used to compare pre-and post-programme questionnaires on knowledge of drug addiction and the Hanil Drug Insight Scale (HDIS) for participants in DP and probation. Using multivariate logistic analysis, we examined the factors influencing effectiveness, including previous treatment experience, Meaning of Life Questionnaire (MLQ) scores, and mental health status. NCEP effectiveness was assessed based on the participants’ reported intentions for future treatment at the end of the NCEP. DP participants and probationers showed significant increases in their knowledge of drug addiction and HDIS scores (p < 0.001). Results showed that treatment experience (odds ratio [OR] 3.73, 95% confidence interval [CI] 1.30–10.71), poor mental health (OR 2.45, 95% CI 1.01–5.95), and good MLQ (OR 2.90, 95% CI 1.50–5.63) were significantly associated with improved NCEP effectiveness. This study provides the first evidence of the beneficial outcomes of the NCEP and identifies the factors influencing its effectiveness.
Telescopic Alluvial Fans and Pleistocene-Holocene temporary lakes in the quebradas del Río Toro and Tastil (Salta, NW Argentina): main sedimentary features
Authors: Colombo Ferran , Salfity J.A. , Sánchez Maria Cristina 
Published: August 2024

Abstract

The Toro and Tastil Quebradas (river valleys) present different terrace-like geoforms made up of deposits of coarse-grained clastic materials. These terraces display convex-upward surfaces, a highly variable distribution, have a small lateral extension and depend on the lithology of the geological basement, which differs significantly along the quebradas. The number of terraces between one area and another indicates that these terraced geoforms should not be ascribed to one single cause, but rather to a variety of factors, i.e. local variations at base-level. The coarse-grained materials of the terraces are usually arranged in roughly horizontal layers that characterize the outcrops. These are interfingered with fine-grained mud-rich materials. The freshwater gastropod remains in the mud-rich materials indicate that they accumulated in lacustrine-like sedimentary environments. These developed from alluvial fans that spread out from the lateral quebradas to occupy the entire main valley (quebrada), giving rise to natural dams and temporary lakes upstream. Absolute dates obtained by radiocarbon (14C) methods strongly suggest that the alluvial fans were coeval with the temporary lakes in the Upper Pleistocene - Middle Holocene. The ENSO effects could have brought about the local variations in base-level that generated the younger temporary lakes, whereas the older ones were probably controlled by precession cycles (at about 21,000 y). The large number of temporary lakes scattered across the region suggests the overlapping of forcing factors at local and regional scales.
Pulsed Azithromycin for the Treatment of Dacomitinib Induced Skin Toxicity in Patient with Tetracycline Intolerance – A Case Report
Authors: Ho Wei , Chen Yi-Ming , Lin Mong-Wei , Liao Yu-Qing , Lin Shu-Wen 
Published: August 2024

Abstract

Background Skin toxicities such as paronychia and acneiform rash are common side-effects of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKI) and significantly altered the quality of life of patients. Consensus guidelines recommended tetracycline antibiotics as the first line choices for both prophylaxis and treatment for grade II-III acneiform rash and paronychia. While generally well-tolerated, a subset of patients experiences adverse effects such as nausea, vomiting, diarrhea, headache, and photosensitivity, leading to antibiotics intolerance and leaving EGFR TKI-induced skin toxicities unmanaged. Therefore, an alternative treatment is needed.Methods We present a case of stage IV EGFR-mutated non-small cell lung cancer (NSCLC) treated with the second-generation EGFR TKI, dacomitinib. The patient developed grade 3 skin toxicities and was subsequently treated with azithromycin after demonstrating intolerance to tetracycline antibiotics.Results Azithromycin was administered using various dosing strategies, and our findings indicated that 500 mg every other day might be the most effective regimen for treating EGFR-TKI-induced acneiform rash. However, this approach appeared to be less effective in managing paronychia.Conclusion This case highlights the potential efficacy of azithromycin 500mg once another day as an alternative to tetracycline antibiotics for managing EGFR TKI-related skin toxicities in NSCLC patients.
Modified Abdominal Wall Reservoir Placement during Penile Prosthesis Implantation in Chinese Patients with Traumatic Pelvic Erectile Dysfunction: 8-year experience
Authors: Zhi ER lei , Bai Haowei , jiang ting , LI Peng , Yao Chencheng , Chen Huirong , Tian Ruhui , Huang yuhua , Li Zheng 
Published: August 2024

Abstract

This study aims to investigate a modified abdominal wall reservoir placement during penile prosthesis implantation (PPI) in Chinese patients with traumatic pelvic erectile dysfunction. A total of 27 patients, with a mean age of 32years (IQR: 24-50), and the mean duration was 84 months (IQR: 18-168),were included in this study. Fracture patterns were categorized as lateral compression (LC) (44.4%), anteroposterior compression (APC) (30%), and vertical shear (VS) (25.6%), and 70% of the patients experienced urogenital injuries. All patients were provided with a follow-up questionnaire consisting of four portions: IIEF-5, SF-36 scores , Bhojwani’s sexual satisfaction score and complications. Following the surgery, the mean IIEF-5 scores improved significantly, rising from 5.72±0.13 to 22.15±1.26. The SF-36 quality of life scale demonstrated substantial improvement except for vitality. Overall satisfaction rates for patients and their partners were 91.0% and 87.5%, respectively. Notably, only two patients (7.41%) experienced postoperative pain or foreign body sensation, which resolved during follow-up. 1 prothesis was removed due to infection (3.70%), 2 prothesis was revised due to pump malfunction (7.41%). Modified abdominal wall musculature placement will be suited to those patients with altered pelvic anatomy as a result of trauma and prior surgery.
Assessment of the use of electronic medical records system and barriers in Rwanda
Authors: Uwambajimana Emmanuel , Rugirangoga Philbert , Musabyimana Emmanuel , Ingabire Nadine , Ikibasumba Jolie , Turikumwenimana Regis , Munezero Aicha , Mukashyaka Joyeuse , Theobald Gasigwa , Musabyeyezu Alice , Mutuyimana Honorine , Nyinawabeza Solange , Havugimana Shaban , Kamayirese Eric. N , Uwamahoro Bibiane , Nshimiyimana Emmanuel , Niyoyita Jean Claude , Mutabazi Vincent , Niragire Esperance , Benemariya Noella , Hagabimana Aphrodis , Ruseesa Edward , Rwagasore Edson , Umutoni Angela , Stamatakis Caroline , Emmanuel UWAMBAJIMANA 
Published: August 2024

Abstract

Background
Since 2004, the global implementation of electronic medical records (EMR) systems has significantly improved healthcare delivery. However, challenges persist in achieving full EMR adoption, particularly in developing countries. In Rwanda, OpenMRS system was introduced in 2013 as a strategy to align digital health to the country's information and communication technologies (ICT)-for-development agenda. Reports from healthcare providers indicate varying EMR adoption levels in health facilities in Rwanda. This study aims to assess the current usage of EMR and identify implementation barriers in Rwandan health facilities.
Methods
A cross-sectional study was conducted in 257 Rwandan health facilities using an electronically designed questionnaire in Epi Info 7. Face-to-face interviews were held with 1074 participants, including facility representatives and staff from departments utilizing EMRs. The study covered all district hospitals and 44% of associated health facilities. Descriptive analysis was performed to assess EMR use, user knowledge, attitudes, and practices.
Results
A total of 257 health facilities were assessed (42 district hospitals and 215 health centers). All 42 district hospitals used EMRs, of which 35(83.3%) used OpenMRS while only 71 (33.0%) out of 215 health centers used EMRs of which about 55% used OpenMRS. Among 234 responses for non-use of EMRs, 98 (41.8%) had never used EMRs, 46 (19.6%) reported system damage, and 42 (17.9%) reported lack of internet. Reported barriers met by users included electricity and internet issues, limited computer access, and software glitches.
Conclusion
District hospitals in Rwanda showed to have widely utilized EMRs, while health centers exhibited lower utilization rates due to system unavailability or damage. OpenMRS was prevalent in hospitals, whereas health centers used diverse health systems. Respondents preferred EMRs over paper-based methods, but challenges such as internet issues, lack of user guides, power disruptions, staff shortages, and missing features hindered EMR adoption and use. Recommendations include providing comprehensive staff training, improving infrastructure (updating EMR modules, ensuring electricity and internet availability), and providing user guides to healthcare providers to enhance ICT implementation in health facilities.
Trial registration:
Not applicable
Theory-Based Flood Disaster Education Enhances Disaster Preparedness Among Adolescents in Selangor, Malaysia: A Cluster Randomized Controlled Study
Authors: Makmon Khairunnisa , Azman Fattah , Manaf Rosliza Abdul , Baharudin Mohd Rafee 
Published: August 2024

Abstract

Flood disasters are prevalent and severely impact humans and the environment, with adolescents being particularly vulnerable. This study evaluated the "Get-Ready DEM," a tailored disaster educational module based on the Extended Parallel Pathway Model (EPPM), to enhance flood disaster preparedness among adolescents in Selangor, Malaysia. A two-arm, single-blinded, cluster-randomised controlled trial involved 287 adolescents from eight secondary schools, divided into intervention (140 participants) and control (147 participants) groups. The intervention group received the "Get-Ready DEM" once after the baseline assessment, while the control group was on the waitlist. Preparedness was measured using the Flood Disaster Preparedness Index (FDPI) scores at baseline, immediate post-intervention, and three months post-intervention. Data were analysed using a generalised estimation equation. Results showed a significant increase in FDPI scores for the intervention group immediately post-intervention (β = 2.15; 95% CI = 1.64, 2.65; p < 0.001) and at the three-month follow-up (β = 1.53; 95% CI = 0.96, 2.10; p < 0.001) compared to the control group. These findings underscore the EPPM framework's efficacy in designing effective flood disaster education. Implementing modules like "Get-Ready DEM" can significantly enhance adolescents' resilience and preparedness, suggesting a promising approach for disaster preparedness programs. This study was registered under Thai Clinical Trial Registry TCTR20240426001 on 26th April 2024 and obtained ethical approval by the Ethics Committee of Human Research University Putra Malaysia (JKEUPM-2022-858) and the Ministry of Education, Malaysia (KPM.600-3/2/3-eras (15189).
Trend and Gender Inequality in Non-Communicable Disease Burden in Ethiopia: evidence from GBD and EDHS 2000-2019
Authors: Habtemichael Mizan , Belay Winini Winini , Mengesha Tariku , Habtamu Robera , Belay Amanuel 
Published: August 2024

Abstract

Background: The global noncommunicable disease burden is significantly increasing and has become a major reason for morbidity, productivity loss, higher healthcare costs, and sources of inequality. To mitigate the impact of these diseases among the vulnerable population, understanding the trends and gender disparities in the NCD burden is essential. We aimed to investigate the trends of NCD burden in Ethiopia, with a particular focus on examining gender-specific disparities.
Methods: We analyzed data from the global burden of disease and five-round survey data from the Ethiopian demographic and health survey. The trend of NCD burden was measured in terms of death rate, DALY, YLL, and YLD from 1980 – 2021 using data from the global disease burden. Gender disparities concerning NCD death rate, DALY, and YLL were assessed using data from EDHS 2000,2005, 2011, 2016, and 2019 mini-EDHS. To measure inequality, difference, population attributable fraction, population attributable risk, and ratio were considered.
Results: In Ethiopia, the NCD disease burden showed a decreasing trend between 1990 to 2021 with a greater reduction between the years 2000 and 2010. During this period greater change in death and DALY was seen among females. R and D measures revealed noticeable gender inequality favoring females, while PAR and PAF did not indicate inequality in NCD death rates. On the contrary, during the years 2000 and 2010, DALY concentrations were higher among females (D = -127.2 in 2000 and -106.7 in 2010), but in 2005, 2015, and 2019, the concentrations shifted to males. Across all years, YLL due to mortality was higher among females according to D and R measures, while PAF and PAR measures showed higher YLL due to disability among males.
Conclusions: The study revealed the existence of significant gender inequalities in NCD burden
Multi optimization of laser drilling of GFRP composites via TOPSIS approach
Authors: Elsad R. A. , Mahrous Ahmed Bahei El-Deen 
Published: August 2024

Abstract

Composite materials are very promising for use in a variety of applications. However, due to their anisotropy, they are challenging to cut using traditional machining. A desirable option for cutting composites is laser beam machining (LBM). In the present study, laser beam drilling (LBD) experiments with a CO2 laser on glass fibre reinforced polyester (GFRP) composites were conducted based on Taguchi’s L9 orthogonal array to decide on a parametric optimization of multiple responses, such as hole taper angle (θ), heat affected zone (HAZ), and material removal rate (MRR), using Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) approach. The input process parameters are cutting speed (S), laser power (P), and diameter of laser drilled hole (D). Based on closeness coefficient (Si*) of TOPSIS, the optimum levels of parameters were identified and analysis of variance (ANOVA) was used to quantitatively assess the influence of the input parameters on the output responses. The results demonstrated that all the selected cutting parameters have a significant effect on all the measured responses. From the confirmation experiment carried out at the optimum LBD conditions, there has been an improvement of Si* by 12%.