bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational exposure to chrysotile in an asbestos cement factory in Kyrgyzstan
Authors: Kurzhunbaeva Zhyldyz , Spinazzè Andrea , Campagnolo Davide , Rovelli Sabrina , Fanti Giacomo , Kasymov Omor , Cattaneo Andrea , Colosio Claudio , Cavallo Domenico M 
Published: July 2024

Abstract

Objectives
An increasing number of countries are banning the production and use of asbestos, in compliance with the ratification of the C162 Asbestos Convention and the Basel Convention, and in response to the call for its elimination in the ILO resolution and WHO reports on the health risks associated with asbestos. Nevertheless, several countries, including Kyrgyzstan, are still miners and/or manufacturers of asbestos. The main objective of the study is to assess the occupational exposure to chrysotile of workers engaged in a production facility of asbestos-cement products in Kyrgyzstan.

Methods
Monitored workers (n = 16, for a total of n = 18 samples) were divided into 3 “Similar Exposure Groups” (SEGs; SEG-1: asbestos loading; SEG-2; asbestos-cement mixing; SEG-3: cutting of asbestos-cement sheets) according to EN 689 standard. Samples were collected through personal sampling and subsequently examined by means of scanning electron microscope equipped with an energy-dispersive spectrometer for the compositional analysis of each fibre. The numerical concentration of airborne asbestos fibres was henceforward determined by dividing the number of fibres and the volume of sampled air (expressed in the number of fibres per millilitre of air: ff/ml).

Results
Investigated workers resulted to be exposed to chrysotile fibres. Results (GM ± GSD) outlined extremely high exposure levels for SEG-1 (2.2 ± 2.1 ff/ml) and SEG-3 (4.7 ± 1.6 ff/ml) workers and lower—but still relevant—exposure values for SEG-2 (0.91 ± 2.6 ff/ml) workers.

Conclusions
The results obtained in this case study can help to document potentially critical situations of occupational exposure to asbestos that can still occur nowadays in low and middle-income countries where asbestos is still mined and processed.
Closing the Loop on Revision: The Impact of Emotional Well-being on Elective Revision After Breast Reconstruction
Authors: Zhang Casey , Wang Vivian L , Sarrami Shayan , Reddy Pooja D , De La Cruz Carolyn 
Published: July 2024

Abstract

Background
A diagnosis of breast cancer has a significant impact on a patient's physical and emotional health. Breast reconstruction improves quality of life and self-esteem following mastectomy. However, many patients undergo additional elective revision procedures after reconstruction.

Objectives
The aim of this study was to assess the relationship between perioperative emotional well-being and elective revisions in breast reconstruction.

Methods
A retrospective review was performed of patients who underwent breast reconstruction with a single surgeon between January 2007 and December 2017. Revision procedures were defined as additional operations that fall outside the index reconstructive plan. Medical records were reviewed for a history of generalized anxiety disorder (GAD) and/or major depressive disorder. Multivariate analysis was performed to identify factors associated with revision.

Results
A total of 775 patients undergoing breast reconstruction were included, of whom 121 (15.6%) underwent elective revision. Overall, a history of any psychiatric history (P &lt; .001), depression alone (P = .001%), and GAD and depression together (P = .003) were significantly associated with revision surgery. On multivariate logistic regression controlling for comorbidities and reconstruction modality, depression alone, and GAD and depression together were significantly associated with an increased likelihood of revision surgery (odds ratio, 3.20, P &lt; .001; odds ratio, 2.63, P &lt; .001).

Conclusions
Perioperative emotional well-being and reconstruction modality impact the rate of secondary revision surgery. An understanding of the surgical and patient-related risk factors for revision can provide more informed patient-decision making and improve surgical planning.

Level of Evidence: 3
Haxe as a Swiss knife for bioinformatic applications: the SeqPHASE case story
Authors: Spöri Yann , Flot Jean-François 
Published: July 2024

AbstractHaxe is a general purpose, object-oriented programming language supporting syntactic macros. The Haxe compiler is well known for its ability to translate the source code of Haxe programs into the source code of a variety of other programming languages including Java, C++, JavaScript, and Python. Although Haxe is more and more used for a variety of purposes, including games, it has not yet attracted much attention from bioinformaticians. This is surprising, as Haxe allows generating different versions of the same program (e.g. a graphical user interface version in JavaScript running in a web browser for beginners and a command-line version in C++ or Python for increased performance) while maintaining a single code, a feature that should be of interest for many bioinformatic applications. To demonstrate the usefulness of Haxe in bioinformatics, we present here the case story of the program SeqPHASE, written originally in Perl (with a CGI version running on a server) and published in 2010. As Perl+CGI is not desirable anymore for security purposes, we decided to rewrite the SeqPHASE program in Haxe and to host it at Github Pages (https://eeg-ebe.github.io/SeqPHASE), thereby alleviating the need to configure and maintain a dedicated server. Using SeqPHASE as an example, we discuss the advantages and disadvantages of Haxe’s source code conversion functionality when it comes to implementing bioinformatic software.
A robust covariate-balancing method for learning optimal individualized treatment regimes
Authors: Li Canhui , Zeng Donglin , Zhu Wensheng 
Published: July 2024

Abstract
One of the most important problems in precision medicine is to find the optimal individualized treatment rule, which is designed to recommend treatment decisions and maximize overall clinical benefit to patients based on their individual characteristics. Typically, the expected clinical outcome is required to be estimated first, for which an outcome regression model or a propensity score model usually needs to be assumed with most existing statistical methods. However, if either model assumption is invalid, the estimated treatment regime will not be reliable. In this article, we first define a contrast value function, which forms the basis for the study of individualized treatment regimes. Then we construct a hybrid estimator of the contrast value function by combining two types of estimation methods. We further propose a robust covariate-balancing estimator of the contrast value function by combining the inverse probability weighted method and matching method, which is based on the covariate balancing propensity score proposed by Imai & Ratkovic (2014). Theoretical results show that the proposed estimator is doubly robust, ie, it is consistent if either the propensity score model or the matching is correct. Based on a large number of simulation studies, we demonstrate that the proposed estimator outperforms existing methods. Application of the proposed method is illustrated through analysis of the SUPPORT study.
A rare instance of latent systematic error in volumetric-modulated arc therapy with field-extended multi-isocentre irradiation leading to a serious dose-delivery accident
Authors: Hanada Takashi , Fukada Junichi , Shiraishi Yutaka , Yoshida Kayo , Sakanoue Naoya , Oguma Kohei , Ohashi Toshio , Shigematsu Naoyuki 
Published: July 2024

Abstract
Volumetric-modulated arc therapy (VMAT) with field-extended multi-isocentre irradiation (VMAT-FEMII) is an effective irradiation technique, particularly for large planning target volumes in the craniocaudal direction. A variety of treatment planning techniques have been reported to reduce the dosimetric impact. However, there is no guarantee that unexpected latent systematic errors would not occur. Herein, we report the experience with a rare case that could have led to a serious VMAT-FEMII-related accident. A patient with uterine cervical carcinoma was scheduled for VMAT-FEMII to the whole pelvis and the para-aortic lymph node region. A combination of the two sets of field groups with different isocentres was planned: one to cover the para-aortic lymph nodes and the other to cover the whole pelvis. Measurements based on the pretreatment dose delivery quality assurance (QA) revealed an unexpected overdose of &gt;20% in the field overlap region. This overdose phenomenon is not reflected in the calculated dose distribution in the radiotherapy treatment planning system. Therefore, the plan was altered; a homogeneous dose distribution inside the dose junction was achieved. Several analyses were performed to elucidate the overdosing phenomenon. However, no conclusive answer was found to why non-reflection at the calculated dose distribution was found. The limitations to VMAT-FEMII are primarily related to systematic errors in the positional setup from patient-derived and/or mechanical sources. However, this report highlights a rare case of overdosing caused by inverse optimization and dose calculation. We recommend checking the aperture status of the jaw and multi-leaf collimator at each control point of the treatment plan and using a high-resolution image measurement system on a VMAT-FEMII QA to confirm the dose junction status.
Risk factors and development of machine learning diagnostic models for lateral lymph node metastasis in rectal cancer: multicentre study
Authors: Kasai Shunsuke , Shiomi Akio , Shimizu Hideyuki , Aoba Monami , Kinugasa Yusuke , Miura Takuya , Uehara Kay , Watanabe Jun , Kawai Kazushige , Ajioka Yoichi 
Published: July 2024

Abstract

Background
The diagnostic criteria for lateral lymph node metastasis in rectal cancer have not been established. This research aimed to investigate the risk factors for lateral lymph node metastasis and develop machine learning models combining these risk factors to improve the diagnostic performance of standard imaging.

Method
This multicentre prospective study included patients who underwent lateral lymph node dissection without preoperative treatment for rectal cancer between 2017 and 2019 in 15 Japanese institutions. First, preoperative clinicopathological factors and magnetic resonance imaging findings were evaluated using multivariable analyses for their correlation with lateral lymph node metastasis. Next, machine learning diagnostic models for lateral lymph node metastasis were developed combining these risk factors. The models were tested in a training set and in an internal validation cohort and their diagnostic performance was tested using receiver operating characteristic curve analyses.

Results
Of 212 rectal cancers, 122 patients were selected, including 232 lateral pelvic sides, 30 sides of which had pathological lateral lymph node metastasis. Multivariable analysis revealed that poorly differentiated/mucinous adenocarcinoma, extramural vascular invasion, tumour deposit and a short-axis diameter of lateral lymph node ≥ 6.0 mm were independent risk factors for lateral lymph node metastasis. Patients were randomly divided into a training cohort (139 sides) and a test cohort (93 sides) and machine learning models were computed on the basis of a combination of significant features (including: histological type, extramural vascular invasion, tumour deposit, short- and long-axis diameter of lateral lymph node, body mass index, serum carcinoembryonic antigen level, cT, cN, cM, irregular border and mixed signal intensity). The top three models with the highest sensitivity in the training cohort were as follows: support vector machine (sensitivity, 1.000; specificity, 0.773), light gradient boosting machine (sensitivity, 0.950; specificity, 0.918) and ensemble learning (sensitivity, 0.950; specificity, 0.917). The diagnostic performances of these models in the test cohort were as follows: support vector machine (sensitivity, 0.750; specificity, 0.667), light gradient boosting machine (sensitivity, 0.500; specificity, 0.852) and ensemble learning (sensitivity, 0.667; specificity, 0.864).

Conclusion
Machine learning models combining multiple risk factors can contribute to improving diagnostic performance of lateral lymph node metastasis.
New scenarios for training in oral radiology: clinical performance and predoctoral students' perception of 3D-printed mannequins
Authors: de Mello Wislem Miranda , Dutra Vinícius , Maracci Lucas Machado , Savegnago Gleica Dal’ Ongaro , Serpa Geraldo Fagundes , Liedke Gabriela Salatino 
Published: July 2024

Abstract

Objectives
This study aimed to evaluate the impact of 3D-printed mannequins on the training of predoctoral students.

Methods
Two 3D-printed training models were developed: a traditional model that simulates a sound adult patient and a customized model with pathological and physiological changes (impacted third molar and edentulous region). Students accomplished their pre-clinical training divided into a control group (CG, n = 23), which had access to the traditional model, and a test group (TG, n = 20), which had access to both models. Afterward, they performed a full mouth series on patients and filled out a perception questionnaire. Radiographs were evaluated for technical parameters. Descriptive statistics and the Mann-Whitney test were used to compare the groups.

Results
Students provided positive feedback regarding the use of 3D printing. The TG reported a more realistic training experience than the CG (P = .037). Both groups demonstrated good clinical performance (CG = 7.41; TG = 7.52), and no significant differences were observed between them.

Conclusions
3D printing is an option for producing simulators for pre-clinical training in Oral Radiology, reducing student stress and increasing confidence during clinical care.
Very late Magmaris scaffold restenosis: a 6-year serial optical coherence tomography case report
Authors: Trøan Jens , Hansen Kirstine Nørregaard , Noori Manijeh , Lassen Jens Flensted , Jensen Lisette Okkels 
Published: July 2024

Abstract

Background
Bioresorbable scaffolds (BRS) have been proposed as an alternative to drug-eluting stents (DES), offering radial support during the early phases of healing, while potentially reducing the risk of long-term complications. A magnesium-based BRS (MgBRS) has shown promising results after implantation. However, there is a lack of knowledge regarding the long-term outcomes.

Case summary
A 62-year-old man with hypertension, dyslipidaemia, family history of ischaemic heart disease, and previous myocardial infarction, presented with non-ST-elevation myocardial infarction (NSTEMI). Six years prior, he also had a NSTEMI and a mid-left anterior descending artery (LAD) lesion was treated with a 3.0/25 mm MgBRS. Post-implantation optical coherence tomography (OCT) revealed proximal edge dissection, and a second MgBRS 3.0/15 mm was implanted. Optical coherence tomography of the scaffold-treated segment was performed after 6 and 12 months with no sign of restenosis. The current angiogram showed a restenosis in the previously MgBRS-treated segment in LAD. Optical coherence tomography showed a plaque rupture in a thin cap fibro-atheroma and scaffold remnants. The lesion was pre-dilated and stented with a 3.0/20 mm DES and post-dilated with a 3.5 mm non-compliant balloon.

Discussion
Most cases of late scaffold failure showed acquired mal-apposition, which also can be related to the degrading process, or uncovered struts, none of which were seen in our case at 6 or 12 months. This case represents an insight into the vascular healing and potential mechanisms for failure of the MgBRS, with serial OCT recording at implantation, and after 6 months, 12 months, and 6 years.
A comparison of symptoms of anxiety and depression in patients with a primary and secondary prophylactic indication for an implantable cardioverter defibrillator. [Data from the ACQUIRE-ICD RCT]
Authors: Frydensberg V S , Skov O , Moller S M , Skovbakke S J , Vinther M , Melchior T M , Nielsen J C , Riahi S , Johansen J B , Pedersen S S P 
Published: July 2024

Abstract

Introduction
Indication for the implantable cardioverter defibrillator (ICD) is either primary or secondary prophylactic. Symptoms of anxiety and depression are known to be evident in patients with an ICD. However, research has not shown agreement in whether there is a difference in the degree of symptoms in these two indication groups.

Purpose
We investigated the association between anxiety and depression and indication for ICD from implantation and up to 24 months of follow-up.

Methods
Data was derived from a national randomized controlled trial the "Web-based healthcare innovation to advance the quality of life and care of patients with an implantable cardioverter defibrillator [ACQUIRE-ICD]" to perform a secondary analysis. A total of 478 patients with a first-time ICD were included and completed the Generalized Anxiety Disorder Assessment (GAD-7) and the Patient Health Questionnaire (PHQ-9) after ICD implantation and at 6, 12 and 24 months. Mixed effects regression models and estimated marginal means were used to analyze longitudinal data.

Results
Anxiety mean scores did not differ statistically between patients with a primary prophylactic ICD as compared to patients with a secondary prophylactic ICD. Most patients showed limited symptoms of anxiety. However, 9% reported values above the cut-off for clinical relevant anxiety.
Depression mean scores were significantly higher at 24 months in patients with primary prophylactic ICD as compared to patients with a secondary prophylactic ICD (mean 4.15 vs. 3.05; p=0.014) but not statistically significant at other time points. Most patients showed limited levels of depression. However, 13.2% reported values above the cut-off for clinical relevant depression. Both anxiety and depression scores decreased over time from baseline in both groups.

Conclusion
Patients with a primary prophylactic ICD did not differ in symptoms of anxiety and had mostly the same level of depression as compared to patients with a secondary prophylactic ICD. However, at 24 months patients with a primary prophylactic ICD reported more symptoms of depression as compared to patients with a secondary prophylactic ICD.Table 1
Treatment paths and resources used for patients with a left ventricular assist device: an Italian survey
Authors: Trenta A M , Gemelli J , Luciani M , Ausili D 
Published: July 2024

Abstract

Background
The number of people with end-stage Heart Failure implanted with a Left Ventricular Assist Device (LVAD) is constantly increasing, demanding hospitals to develop new and specific treatment paths. No previous studies described services and treatments available for these patients at national level. Knowing how hospitals organize their resources in order to meet patients’ need would be useful to standardize and improve care offered to this population.

Purpose
To investigate how Italian hospitals that are reference centers for people with LVAD organize treatment paths and resources for these patients.

Methods
A cross-sectional observational study was conducted. A survey including questions about all the relevant aspects of treatment paths for people with LVAD was created and validated by 4 LVAD experts (2 nurses and 2 physicians) from 2 different hospitals. The survey was then administered to the 22 (&gt; 95%) of the Italian hospitals that are reference centers for people with LVAD.

Results
Results show a picture of how treatment paths and resources for people with LVAD are organized in Italy nowadays. Nurses play a pivotal role in the multi-professional team that takes care of these patients, being often acknowledged as LVAD Coordinator (case-manager) and being involved in crucial activities such as health education, monitoring of health conditions before and after dismission, and improving patients’ empowerment. Health education is recognized as an essential activity, but many hospitals still struggle to organize it according to patients’ needs and not organizational ones. Palliative care, even if recognized by the most recent guidelines as a crucial element of treatment options in people with LVAD, is a need that remains often unmet.

Conclusion
The growing number of people with LVAD requires an effort for re-organizing resources and treatment paths for them. There is a great need for integrating palliative care in the several treatment options for these patients. Nurses play a pivotal role in all stages of the treatment paths, and should be provided with specific education, as the whole multi-professional team.
The experience of the body image for patients with left ventricular assist device
Authors: Milaniak I M , Witkowska E W , Cebula M C , Tomsia P T , Wisniowska Smialek S W S , Gorkiewicz Kot I G K , Kaleta M K , Wasilewski G W , Wierzbicki K W 
Published: July 2024

Abstract

Background
Improvements in LVAD technology and the survival of LVAD-supported patients led to more extensive use of LVADs also among patients with relative contraindications to HTx as a bridge-to-decision option or as a permanent treatment: destination therapy LVADs have been demonstrated to prolong HF patients' survival and to improve their quality of life. LVAD implantation has been demonstrated to have a considerable effect on patients' body image. Patients feel it hard to accept the device as an extension of their body, especially the driveline.

Purpose
The study aimed to examine the relationships between anxiety and depressive symptoms, acceptance of illness, beliefs about pain control, and quality of life with body image among LVAD-implanted patients.

Material and methods
The cross-sectional study included 54 conveniently recruited LVAD-implanted patients who completed the Body Image Scale, SF-12, Acceptance of Illness Scale, The beliefs about Pain Control Questionnaire, NRS, and HADS. The associations between the research variables were examined with multiple regression analyses.

Results
The mean age of the participants was 59.64 (SD=9,63), and 96.3% were men. The mean scores were: Body Image Scale – 28,33 (SD=5,91); Acceptance of Illness Scale- 25,51 (SD=5,92); The beliefs about Pain Control: Internal factors -15,85(SD=4,96), Influence of physicians-17,57 (SD=3,15), Random events-14,37(SD=3,32), NRS=2,80(SD=1,86), HADS anxiety -5,33 (SD=4,12), HADS depression-4,66 (SD=3,10), SF12MCS-45,49(SD=6,48), SF-12PCS-41,33 (SD=6,48). Patients' age (p=0,04), presence of depressive symptoms (p&lt;0,05) and acceptance of illness (p=0,02) significantly predicted body image concerns.

Conclusions
Healthcare professionals should be aware of challenges regarding body image faced by LVAD-implanted patients and address related factors.