bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Impact on Quality of Life of Heavy Menstrual Bleeding in Women on Oral Anticoagulant Therapy
Authors: Hassan Naseerah , Schapkaitz Elise , Rhemtula Haroun , Ncete Nolukholo 
Published: August 2024

Introduction Heavy menstrual bleeding affects up to two thirds of women on oral anticoagulation. The rates of heavy menstrual bleeding, its impact on quality of life and associated risk factors in women attending anticoagulation clinics in South Africa are largely unknown. Materials and Methods A prospective cohort study was performed over an eight-month period in women on Warfarin (n = 30) and Rivaroxaban (n = 27) for a median [interquartile range] duration of 15.5 [78.0] months attending an anticoagulation clinic in Johannesburg, South Africa. Heavy menstrual bleeding was assessed over one menstrual cycle using the validated pictorial blood loss assessment charts (PBAC) and the menstrual bleeding questionnaire (MBQ). Results In this population of predominantly African ethnicity, with a median age of 39 [8] years, 39 (68.4%) women experienced heavy menstrual bleeding, defined as a PBAC score of >100. Median cycle length on anticoagulation and MBQ scores were significantly higher among women with a PBAC score of >100 (p > 0.05). Univariate analysis identified Rivaroxaban as a risk factor for heavy menstrual bleeding (OR 5.03, 95% CI 1.40–18.12). Heavy menstrual bleeding required treatment in 29 (74.4%) women which included management of iron deficiency, anti-fibrinolytics, modification of anticoagulation and hormonal contraception. Conclusion Heavy menstrual bleeding was associated with a considerable negative impact on quality of life. This was most significant for women on Rivaroxaban as compared to Warfarin. It is essential to monitor and appropriately treat heavy menstrual bleeding in at risk women on anticoagulant treatment.
Ultrasonic Doppler as a guide for feline peripheral arterial catheterization
Authors: Haginoya Satoshi , Thomovsky Elizabeth J , Weng Hsin-Yi , Johnson Paula A , Brooks Aimee C 
Published: August 2024

Objectives The study aimed to determine if an ultrasonic Doppler-guided technique (UDGT) leads to improved placement efficacy (time, success) of feline dorsal pedal arterial catheters vs the traditional palpation-guided technique (TPT). Methods A total of 26 adult, client-owned cats requiring sedation or general anesthesia for any reason, aged >12 months and weighing >3.0 kg, and with Doppler blood pressure measurements of at least 80 mmHg were enrolled. Each hindlimb was randomly assigned for dorsal pedal arterial catheterization using either the UDGT or TPT. With the UDGT, the location of the artery was identified by an audible sound using the Doppler. Successful catheter placement was confirmed by visualization of an arterial pressure waveform using a transducer and monitor system attached to the catheter. The Kaplan–Meier method and log-rank test were used to compare the two techniques. Results The overall proportion of successful arterial catheterization was 17% (9/52): 19% (5/26) via UDGT and 15% (4/26) via TPT. Among successful arterial catheterizations (n = 9), the mean time to catheterization was 339 ± 198 s: 328 ± 237 s (n = 5) with UDGT and 353 ± 171 s (n = 4) with TPT. The log-rank test showed the two techniques were not significantly different in likelihood of successful arterial catheter placement or time to successful catheterization ( P = 0.698). An arterial flash occurred in 62% (32/52) of the limbs, 58% (15/26) with the UDGT and 65% (17/26) with the TPT. Complications (self-limiting bruising, hematoma formation) were observed equally between UDGT (3/26 limbs) and TPT (3/26 limbs) in six cats. Conclusions and relevance The UDGT did not improve the efficacy of catheter placement compared with the TPT. Few complications were associated with arterial catheterization.
Prevalence of Hyperuricemia and Associated Factors Among Patients With Type 2 Diabetes Mellitus in Northwestern Tanzania: A Cross-Sectional Study
Authors: Abdel Kulthum A. , Kalluvya Samuel E. , Sadiq Abid M. , Ashir Abdel , Masikini Peter I. 
Published: August 2024

Background: There has been increasing evidence of the association between hyperuricemia and diabetes mellitus (DM). In the general population, hyperuricemia has been associated with pre-diabetes. In DM patients, hyperuricemia has been associated with poor outcomes. Objectives: The objective was to determine the proportion of hyperuricemia and associated factors among patients with type 2 DM in Mwanza, Tanzania. Design: This was a cross-sectional study. Methods: This study was conducted from January to March 2023 among patients with type 2 DM attending clinic at Bugando Medical Centre, Mwanza. Data was obtained from a structured questionnaire. Serum uric acid, HbA1c, lipid profile, and renal functions were analyzed. Analysis was done via STATA version 17. The primary outcome was the proportion of hyperuricemia among patients with type 2 DM, and logistic regression models were used to analyze associated factors. Results: Out of 360 patients, 59.7% were female. The median age was 61 years [IQR 57-68], and the median duration of DM was 5 years [IQR 3-9]. The mean HbA1c was 8.2 ± 2.5%, with 60% of patients having poor control. Most patients had hypertension (78.9%) and were overweight or obese (81.9%). The proportion of patients with DM and hyperuricemia was 44.4%, with mean serum uric acid levels among males and females of 410 ± 137 and 385 ± 119 µmol/L, respectively. We found that being female (P = .001), overweight (P = .021), or obese (P = .007), and having chronic kidney disease (P < .001) was associated with hyperuricemia among patients with type 2 DM. Conclusion: The burden of hyperuricemia among type 2 DM patients is quite high, and it is associated with female gender, high body mass index, lipids, and chronic kidney disease. This calls for regular screening of hyperuricemia in the population, and more studies are needed to establish the outcomes associated with hyperuricemia and create a treatment guideline.
The refined Pathways to Cures Research Roadmap for multiple sclerosis cures
Authors: Bebo Bruce F , Banwell Brenda L , Whitacre Caroline C , Coetzee Timothy , Dalgas Ulrik , De Jager Phillip L , Proebstel Anne-Katrin , Yong V Wee , Benveniste Etty N , Thompson Alan J 
Published: August 2024

Background: Multiple sclerosis is a chronic immune-mediated disease of the central nervous system affecting nearly 3 million people worldwide. Although much progress has been made in the understanding and treatment of MS, cures remain elusive. Objectives: To accelerate the development of cures for MS by updating the Pathways to Cures Research Roadmap based on a contemporary understanding of disease. The refined Roadmap will help to promote research in scientific areas with great potential to reveal insights leading to cures and inspire greater coordination of global resources. Methods: Refinements to the Roadmap were achieved during a Global Summit that included close to 200 academic and industry scientists, health care providers, policy makers, funders, and people with MS from 15 countries. Results: The refined Roadmap describes three pathways that target opportunities for generating scientific insights leading to cures. Recommendations for accelerating research progress include, lowering barriers for global data sharing, enhancing collaboration and coordination among research supporters, committing to sustained funding, considering implications for implementation, engaging PwMS and committing to diversity, equity, and inclusion in the global MS movement. Conclusion: The refined roadmap provides a strategic framework for tackling the complexities of MS and advancing prevention strategies, effective treatments, and cures.
Risk Factors for Early Recurrence After Radical Resection of Hepatocellular Carcinoma Based on Preoperative Contrast-Enhanced Ultrasound and Clinical Features
Authors: Cao Kunpeng , Wu Liuxi , Wang Xinyue , Deng Hongyan , Yuan Ya , Li Lu , Xu Chaoli , Ye Xinhua 
Published: August 2024

ObjectivesTo investigate risk factors for the early recurrence (ER) of hepatocellular carcinoma (HCC) after radical resection based on preoperative contrast-enhanced ultrasound (CEUS) and clinical features to provide guidance for clinical treatment.MethodsThe retrospective analysis selected 130 HCC patients who underwent radical tumor resection from October 2019 to November 2021. All patients underwent preoperative routine ultrasound examination and CEUS, and the pathology was confirmed as HCC after surgery. The patients were divided into two groups based on whether there is an ER, namely the ER group and the non-ER group. The general clinical, routine and CEUS data of patients were collected, and the factors were selected by using the least absolute shrinkage and selection operator (LASSO) regression. Multivariate logistic regression was used to screen the independent influencing factors of ER. Then a nomogram model was established to predict the risk of ER, and the application value of nomogram through internal validation was evaluated.ResultsMultivariate logistic regression identified several independent factors influencing ER after radical HCC resection. Significant factors included early wash-out phase (95%CI = 0.003-0.206, P = 0.001), liver cirrhosis (95%CI = 2.835-221.224, P = 0.004), incomplete envelope (95%CI = 5.247-1056.130,P = 0.001), multiple lesions (95%CI = 1.110-135.424,P = 0.041), Albumin <40 g/L (95%CI = 2.496-127.223,P = 0.004), and Golgi Protein 73 (GP73) ≥ 85 ng/mL (95%CI = 1.594-30.002, P = 0.010), with all P-values <0.05. The nomogram prediction model constructed based on the results of multivariate logistic regression, demonstrated a ROC curve AUC of 0.879, a sensitivity of 93.5%, a specificity of 66.7%, and a C-index of 0.602, indicating superior diagnostic efficiency compared to independent influencing factors. The ER nomogram prediction model confirmed good discrimination and calibration in internal validation.ConclusionThe CEUS-Clinical combined model effectively monitors the risk of ER in high-risk populations following radical resection of HCC, timely interventions to improve patient prognosis.
7T-high resolution MRI-derived radiomic analysis for the identification of symptomatic intracranial atherosclerotic plaques
Authors: Sanchez Sebastian , Veeturi Sricharan , Patel Tatsat , Ojeda Diego J , Sagues Elena , Miller Jacob M , Tutino Vincent M , Samaniego Edgar A 
Published: August 2024

Introduction High-resolution magnetic resonance imaging (HR-MRI) allows for detailed visualization of intracranial atherosclerotic plaques. Radiomics can be used as a tool for objective quantification of the plaque's characteristics. We analyzed the radiomics features (RFs) obtained from 7 T HR-MRI of patients with intracranial atherosclerotic disease (ICAD) to determine distinct characteristics of culprit and non-culprit plaques. Methods Patients with stroke due to ICAD underwent HR-MRI. Culprit plaques in the vascular territory of the stroke were identified. Degree of stenosis, area degree of stenosis and plaque burden were calculated. A three-dimensional segmentation of the plaque was performed, and RFs were obtained. A machine learning model for prediction and identification of culprit plaques using significantly different RFs was evaluated. Results The study included 33 patients with ICAD as stroke etiology. Univariate analysis revealed 24 RFs in pre-contrast MRI, 21 in post-contrast MRI, 13 RFs that were different between pre and post contrast MRIs. Additionally, six shape-based RFs significantly differed from culprit and non-culprit plaques. The random forest model achieved an accuracy rate of 81% (88% sensitivity and 75% specificity) in identifying culprit plaques in the independent testing dataset. This model successfully identified the culprit plaques in all patients during the testing phase. Discussion Symptomatic plaques had a distinct signature RFs compared to other plaques within the same subject. A machine learning model built with RFs successfully identified the symptomatic atherosclerotic plaques in most cases. Radiomics is a promising tool for stratification of plaques in patients with ICAD.
The jailed coiling technique: An endovascular solution for saccular aneurysms with suboptimal fixation sites
Authors: Silverberg Daniel , Bar-Dayan Avner , Raskin Daniel , Canani Sami , Halak Moshe 
Published: August 2024

Objective To evaluate the midterm results of patients with saccular aneurysms treated with the jailed coiling technique. Methods A retrospective review of 17 patients treated with the jailed coiling technique over a 7 year period, between 2018 and 2024 at our institution. Treatment entails placing an endograft across the neck of the saccular aneurysm followed by coiling of the aneurysm through an extraluminal catheter. Debranching procedures of the aortic arch were performed when necessary in order to create a sealing zone of >5 mm. Data collected included demographics, anatomical features of the lesions and sealing zones, indication for intervention, method of treatment and technical success, sac expansion, and reinterventions. Results 17 patients (median age 69, 14 males) were treated for saccular aneurysms with short, suboptimal sealing zones (aortic arch 13, distal thoracic aorta 2, celiac trunk 1, brachiocephalic artery 1). Among the aortic arch aneurysms, six required preoperative debranching procedures of the aortic arch in order to create a short landing zone of 5 mm, making them eligible for the procedure. Technical success was obtained in all patients. One perioperative mortality occurred. Mean follow-up among those treated for arch aneurysms was 32 months (range 1–71 months). One patient who was treated for an aortic arch aneurysm had a persistent endoleak. No sac enlargement was observed. None of the patients required interventions and none experienced aneurysm related mortality. Conclusion The jailed coiling technique is a safe and effective method to treat saccular arterial aneurysms with suboptimal, short sealing zones. It can be utilized for saccular aneurysms located within the aortic arch and for aneurysms located in other locations where coiling or stent grafting is not an option. The procedure can be performed with minimal morbidity with a high percentage of success. Long term durability of the repair needs to be determined.
Staff burnout in intellectual disability services and resistance to change. Implications for leadership support
Authors: Ntinas Konstantinos M 
Published: August 2024

Purpose This article aims to analyse the relationship between staff burnout and resistance to change as well as the implications for leadership. Design/methodology/approach The Job Demands Resource Model, the Social Exchange Theory, and the Model of Socially Induced Burnout were used to analyse the relationship of burnout with resistance to change. Findings Leadership support is essential in reducing the influence of job demands on staff and on overcoming burnout so that resistance to change is prevented. Originality/value This lies on the development of a leadership approach based on the factors that influence burnouted staff against change.
Does the use of a tensioning device improve stability for suture fixation of glenoid bone constructs? A biomechanical analysis
Authors: Paul Kyle D , Yazdi Allen A , Sylvester David M , Williams Marshall D , Hargreaves Mathew D , Momaya Amit M , Brabston Eugene W , Ponce Brent A 
Published: August 2024

Purpose The purpose of this study is to quantify the difference in biomechanical stability of suture button (SB) and suture tape cerclage (STC) constructs with hand tensioning versus device tensioning of anterior glenoid augmentation bone grafts in an anterior glenoid bone loss model. Methods Artificial bone blocks with a density of 15 lb/ft3 (240.3 kg/m3) were used as models for glenoid fixation with bone graft. The biomechanical stability of SB and STC tensioned by hand was compared to those tensioned by a device. Average displacement (mm) following application of various forces (50, 100, 150, and 200 N) during a 7-phase, 100-cycle, stairstep cyclic loading protocol was recorded. Results Both SB and STC fixation displayed significantly lower construct displacement at all tested forces when tensioned with a device versus hand ( p < 0.001). Device-tensioned SB and STC were comparable in construct stability at forces below 100N. However, at forces above 100 N, device-tensioned SB exhibited significantly less displacement than device-tensioned STC. Discussion Using a tensioning device for SB or STC fixation of a coracoid graft model results in less displacement and improved stability compared to hand tensioning. Biomechanically, a tensioning device enhances the stability of suture fixation in glenoid bone graft constructs.
Assessment of the quality of online information on dietary recommendations for inflammatory bowel disease
Authors: Liu Yan , He Le , Guo Hong , Xiang Lingya , Song Xiaomei , Tan Wei 
Published: August 2024

Objective The internet has become a preferred source for people seeking health information, including diet recommendations which are pivotal in the management of inflammatory bowel disease (IBD). Hence, we aimed to assess the quality of online information in China regarding IBD dietary recommendations. Methods The search engines Baidu and Bing were used to screen for their top 25 webpages using the keywords “inflammatory bowel disease diet,” “ulcerative colitis diet,” “Crohn's disease diet,” “inflammatory bowel disease nutrition,” “ulcerative colitis nutrition,” and “Crohn's disease nutrition.” The quality of information was assessed by two physicians according to the Journal of the American Medical Association (JAMA) benchmark, the Global Quality Score (GQS), and the DISCERN instrument. Results One hundred and eight webpages were selected for evaluation. The mean scores for JAMA, GQS, and DISCERN were 1.48, 3.11, and 36.20, respectively. Articles from professionals and non-profit organizations demonstrated superior quality compared to those from commercial and health portal websites. Many webpages failed to provide an explicit source of information or support for shared decision-making. The information on several pages lacked comprehensive descriptions of food types for IBD, with some pages even containing inaccuracies. No statistically significant differences in scores were observed between Baidu and Bing. Conclusions The quality of online information on IBD dietary recommendations in China is moderate to low and exhibits significant variation across different sources. This warrants joint efforts from online authors, internet platforms, and regulators, to improve the quality of popular medical information.
Digital marketing innovation: New business models for pharmaceutical and medical device product marketing
Authors: Hashimoto Satoru , Motozawa Yoshihiro , Mano Toshiki 
Published: August 2024

Background Within the rapidly evolving healthcare landscape in Japan, digital marketing innovations are transforming pharmaceutical and medical device marketing. This study explores the emergence of new business models in the digital marketing, highlighting a transition from traditional methods to more dynamic, data-driven strategies. Methods InsighTCROSS® is a business model that qualitatively and quantitatively examines three steps based on stratified persona images: (1) verifying the effectiveness of product marketing promotions, (2) identifying competitors from the users’ perspective, and (3) developing marketing strategies to counter competition. To demonstrate the effectiveness of this model, a case study was conducted focusing on the current anticoagulant drugs, including apixaban, dabigatran, edoxaban, rivaroxaban, and warfarin. Results Rivaroxaban, the only drug prescribed for the prevention of thrombus and embolism formation in patients with peripheral artery disease after lower limb revascularization, garnered the most interest from interventional cardiologists performing peripheral vascular interventions, as determined by InsighTCROSS® factor analysis, confirming that the manufacturer's marketing activities have effectively penetrated the market. A survey conducted between 20 September 2023 and 3 October 2023, among members of a cardiology website, identified edoxaban as the market leader with a 39.1% share, followed by apixaban (32.7%) and rivaroxaban (16.8%). The main competitor of edoxaban was warfarin, whereas that of rivaroxaban was apixaban. Decision tree analysis was conducted using InsighTCROSS®, highlighting the strengths and weaknesses of each anticoagulant, providing strategic approaches to exploit competitive weaknesses. For edoxaban, increased use was driven by elderly and poorly adherent patients; for apixaban, high-volume percutaneous coronary intervention centers; and for rivaroxaban, the influence of medical representative detailing. It is recommended to avoid markets where these drugs have a strong presence and to focus marketing activities on leveraging their specific strengths. Conclusion The findings suggest that digital marketing enhances product visibility and patient engagement, providing valuable insights into market behavior and consumer preferences.
Magnitude and Severity of Anxiety and Risk Factors among Hypertensive Patients Attending Public Hospitals in Arba Minch Town, Ethiopia
Authors: Akililu Andinet , Ezo Elias , Gezimu Wubishet , Nigusu Elias , Mezgebu Taye , Zekiwos Asnakech , Birhanu Bethelhem , Ossabo Getachew , Admasu Sentayehu 
Published: August 2024

Background Comorbid anxiety in hypertensive patients yields poor remedy adherence which may additionally restrict treatment choices. Objective To assess the magnitude and severity of anxiety and risk factors among hypertensive patients attending public hospitals in Arba Minch town, Ethiopia, 2022. Methods A hospital-based cross-sectional study design was performed from June 1 to July 30/2022. The overall sample size was 336 and a systematic random sampling technique was used to pick out sufferers. Used Epi data version 3.1 for data entry and SPSS version 25 for analysis. Logistic regression analysis was done and variables with p-values less than .25 were taken into multivariable. Statistical significance was declared at a p-value of less than .05 with a 95% confidence interval in the adjusted odds ratio. Result The magnitude of anxiety among hypertensive patients was 32.1% with 95% CI (26.2%–37.1%). Sex [AOR: 2.25, 95%CI: 1.22–4.13], status of blood pressure [AOR: 0.30, 95%CI: 0.15–0.63], family history of hypertension [AOR: 2.48, 95%CI: 1.20–5.12], family history of mental illness [AOR: 0.19, 95%CI: 0.09–0.39], history of admission [AOR: 5.14, 95%CI: 2.73–9.68], social support status [AOR: 2.96, 95%CI: 1.09–7.97], and current alcohol use [AOR: 0.39, 95%CI: 0.18–0.86] had been notably related. Conclusion About three in 10 hypertensive patients attending public hospitals in Arba Minch town public hospitals were anxious. Approximately two in 10 hypertensive sufferers had moderate to severe anxiety. Sex, status of blood pressure, family history of hypertension, family history of mental illness, history of admission, social support status, and current alcohol use have been substantially associated with anxiety among hypertensive patients. Therefore, enhancing gender identity, controlling blood pressure, screening and treating a family history of high blood pressure and family history of mental illness, coping with previous admission, improving social help, and cessation of alcohol use might lessen the burden of anxiety among hypertensive sufferers.