bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive screening of per- and polyfluoroalkyl substances in consumer products using pyrolysis GC-MS
Authors: YANAGISAWA Hiroyuki , OBAYASHI Kenichi , FURUTA Masataka , FUJIMAKI Shigehiko 
Published: August 2024

Abstract

This paper presents a screening method for diverse classes of per- and polyfluoroalkyl substances (PFAS) in consumer products using a Pyrolysis Gas Chromatography Mass Spectrometer (Py-GC-MS). During the pyrolysis process, polar functional groups (carboxylic or sulfonic) are thermally dissociated, allowing the non-polar perfluoroalkyl moieties to elute through the GC column. We successfully detected various classes of PFAS, from non-polymeric forms of different chain lengths to polymeric forms, within 30 minutes, achieving detection limits below 1/100 of the typical intentional use concentrations of PFAS in consumer products. Therefore, the screening method can detect even low levels of intentionally added PFAS within a comfortable margin.
Prevalence of Physical and Oral Frailty Among the Community Dwelling Geriatric Population -a Cross Sectional Study From South India
Authors: N Sandhya K , Varma Beena Varma , Janakiram Chandasekar , Vijayakumar Priya , Kartha Niveditha 
Published: August 2024

Abstract

Objective: Data on the prevalence of frailty in Kerala is sparse. The objective of this study was to estimate the prevalence of frailty among community-dwelling elderly people in Kerala and explore the sociodemographic factors associated with physical and oral frailty among this population. We further explored the associations between physical and oral frailty.
Design: Community based cross-sectional study.
Setting: Cluster sampled area of Thrissur District, Kerala.
Participants: Random sample0 of adults aged 60 years and above, from the cluster sampled
area of Thrissur district.
Methods: We sampled 1079 community-dwelling adults aged ≥60 years from the Thrissur district of Kerala, using stratified random cluster sampling. Physical frailty was defined and recorded based on Fried’s Frailty Phenotype, Reported Edmonton Frail Scale (REFS), and SARC-F sarcopenia scales. Oral frailty was recorded based on Tanaka measures and Oral and Maxillofacial Frailty Index (OMFI). Logistic regressions with robust standard errors were utilized to examine the associations between socio-demographic determinants and frailty, and between physical frailty and oral frailty.
Results: Overall, 35.2% were classified as physically frail and 62.2% as prefrail, while 22% of population had oral frailty. In the unadjusted model, individuals with oral frailty showed greater odds of being physically frail than those without oral frailty. (Crude OR= 1.584, 95% CI=1.157-2.169, p-value= 0.004). This association persisted after controlling for socio demographic variables and number of teeth. (Adjusted OR=1.423,95% CI=1.020-1.987, p value;0.038).
Conclusion: Integrating the multidisciplinary approaches like oral frailty assessment along with general frailty assessment can promote healthy aging.
Retrospective Analysis of Earthquake Related Crush Injurie Patients in ICU: 6-February Earthquake in Türkiye
Authors: Temel Sahin , Yuksel Recep Civan , Kaynar Ahmet Safa , Caliskan Mustafa , Demir Berna , Alkan Mustafa , Ülger Birkan , Deveci Kamil , Sipahioglu Hilal , Metin Hatice , Kayaaltı Selda , Kaya Elif , Unal Canan Baran , Esmaoğlu Aliye , Sungur Murat , Goksuluk Dincer , Gundogan Kursat 
Published: August 2024

Abstract

Background
On February 6, 2023 a devastating earthquake hit the south-eastern region of the Turkey. It is caused thousands of people injury and dead. The aim was to determine the characteristics, treatment and clinical outcomes of critically ill patients with crush injuries in ICU.
Subjects/methods:
This study was performed with a retrospective design in ICU. Patients were included as follows; effected 6 February earthquake, need ICU treatment and being crush syndrome.
Results
A total of 62 patients were included. The mean age was 41 ± 19 years and 47% were male. The median APACHE II score was 14. The most common ICU admission was multitrauma and crush injury. A total of %77 patients were needed surgical procedure (most of them extremities surgery (36%)and fasciotomy 36% due to compartment syndrome) and %24 patients had extremity amputation. AKI was developed in %65 of patients. A total of 25 (%40) patients were received RRT. The mNUTRIC score (p = 0.022), the BUN (p = 0.043) and the blood lactate level (p = 0.012) were identified as independent risk factors for 28-day mortality. An independent risk factor for limb amputation was identified in patients with high APACHE II and SOFA scores (p = 0.026, p = 0.034, respectively). The 28-day mortality was 13%.
Conclusions
As a result of the study, most of the patients need surgical operations and a quarter of patients required extremity amputation. AKI developed at a high rate and 40% of those patients needed RRT. The mNUTRIC score was found to be the most powerful predictor of mortality at 28 days.
Substitution of the Empirical Antibiotic Regimen Eliminated an Outbreak of Tobramycin Resistant Staphylococcus aureus of spa type t084 in a Swedish Neonatal Intensive Care Unit – We recommend an Early Warning System for Antibiotic Resistance
Authors: Jogenfors Anna , Mernelius Sara , Löfgren Sture , Bengnér Malin , Bengnér Johannes , Ingemansson Fredrik , Wetterbrandt Sofia , Matussek Andreas 
Published: August 2024

Abstract

During spring 2010, four cases of bacteraemia caused by a tobramycin resistant Staphylococcus aureus (TRSA) of spa type t084 were identified in the neonatal intensive care unit at Ryhov County Hospital, Jönköping, Sweden. Retrospective investigation and screening revealed an outbreak of TRSA t084 that may have started in late 2009. This study describes the outbreak and the measures taken to eradicate it. Screening of infants, staff members, environmental samplings, antibiotic susceptibility testing and spa typing was done. Moreover, pasteurization and bacteriology screening of donated human milk, multimodal hygiene interventions, antibiotic substitution (tobramycin for amikacin) were done. TRSA septicaemia was statistically significantly more common before compared to after the antibiotic substitution in infants with TRSA in clinical samples. This may indicate an insufficient empirical antibiotic regimen. The S. aureus prevalence among the infants was reduced (p = 0.002) after the multimodal hygiene interventions, but had no effect on the proportion of TRSA. No TRSA was found after July 2019 to the end of follow-up in December 2021. Only S. aureus spa type t084 resulted in secondary spread, indicating that this strain may have virulence traits that improve colonization and spread. Hygiene interventions reduced the prevalence of S. aureus. After the antibiotic substitution, no more cases of TRSA septicaemia were observed. The outbreak strain was eliminated after five years. Antibiotic resistance surveillance systems may reveal the presence of resistant strains and facilitate early identification of an outbreak. Furthermore, it provides guidance for an effective empiric antibiotic regimen.
Mind the Gap: Oncologist perceptions and knowledge of meditation as a complementary therapy
Authors: Godinho Alexandra , Seo Christina , Joshi Krutika , Phadke Siona , Rana Punam , Wegier Pete 
Published: August 2024

Abstract

Purpose
To understand the recommendation practices of mind-body complementary therapies by Canadian oncologists. In particular, to examine oncologist perceptions and knowledge of meditation, awareness for 2018 ASCO guidelines that recommend meditation to breast cancer patients for reducing anxiety/stress, and associated changes in oncologists’ recommendation of mind-body therapies to their patients.
Methods
Medical oncologists were invited to complete an online survey about prescribing meditation for improving quality of life. The survey assessed demographic and professional practice characteristics. Current complementary therapy recommendations, knowledge of meditation, and general awareness for the ASCO guidelines were assessed. Data was analyzed using a series of descriptive statistics.
Results
A large portion of oncologists (83%) reported recommending at least one form of complementary therapy; with 40% recommending meditation. Most oncologists were knowledgeable about the benefits of meditation, and had a general awareness of resources (i.e., digital meditation tools, 80%). Less than one third of oncologists were aware of the ASCO guidelines, however 56% of those unaware of the guidelines indicated that they plan on recommending these therapies in the future.
Conclusion
The results from this study are promising, as becoming aware of the guidelines had a positive impact on the willingness of oncologists to recommend complementary therapies to their patients. Future research should replicate the study in a larger sample of oncologists, and further explore potential reasons why some oncologists may be hesitant to recommend complementary therapies, such as meditation.
A Large-Scale Empirical Analysis of Electric Vehicle Us-age and Charging: Operational Demands and Infrastructure Implications
Authors: Yeh Sonia , Zhan Weipeng , Liao Yuan , Deng Junjun , Wang Zhenpo 
Published: August 2024

Abstract

As global electric vehicle (EV) adoption accelerates, granular analysis of empirical usage andcharging patterns remains scarce. This study presents a unique large-scale empirical exam-ination of 1.6 million EVs, including a broad array of vehicle types—private, taxi, rental,official, bus, and special purpose vehicle—across seven major Chinese cities with over 854million observations of driving and charging events. Our findings illuminate significant het-erogeneity in EV usage, battery energy, and charging behaviour across vehicle types withnotable city differences. Day-time high-power charging presents high loads on the electric-ity grid across all vehicle types, particularly from service-oriented vehicles, including taxis,rental cars, and buses. The maximum loads also are the highest in the center of the cities. Ourstudy of large-scale EV usage offers critical insights for developing charging infrastructure,managing energy grids, and providing flexibility services, which are pivotal to the evolutionof future transport ecosystems.
Development and Validation of a Nomogram Based on CT Imaging Features for Differentiating Pancreatic Head Cancer in Periampullary Carcinomas
Authors: Zhang Xiaohuan , Wang Junqing , Wu Wenjuan , Zhang Zhuiyang , Chen Fangming , Zhu Dongyang , Zhang Lei 
Published: August 2024

Abstract

Purpose To construct a predictive nomogram for differentiate pancreatic head cancer from other periampullary cancers based on CT imaging features.
Methods
This is a retrospective analysis, Patients diagnosed with periampullary carcinoma by pathological findings from April 2013 to April 2024 were consecutively collected. The variables evaluated included imaging characteristics (direct and indirect signs) and clinical data. Univariate and multivariate regression analyses were used to find statistically significant variables. A nomogram prediction models based on regression analysis and was internally validated.
Results
Multivariable analysis revealed that the distance from the end of the dilated pancreatic duct to the medial wall of the papilla (P＜0.05), the distance from the end of the dilated bile duct to the medial wall of the papilla (P＜0.01), papilla enlargement（P＜0.01）, and the presence of pancreatic and/or bile ducts between the tumor and the papilla (P＜0.05)were identified as independent risk factors for differentiating pancreatic head cancer from non-pancreatic head cancers, and were used to construct a nomogram. The nomogram demonstrated high accuracy, with an AUC of 0.826 in the development cohort and 0.801 in the validation cohort.
Conclusions
This study is based on CT imaging features to differentiate pancreatic head cancer from non-pancreatic head cancer in periampullary cancer. Multiple imaging signs with differential diagnostic significance were obtained, Development and validation of a nomogram that integrates these imaging features, providing a basis for treatment and comprehensive assessment in the clinic. Keywords Periampullary cancer·Pancreatic head cancer·Differential diagnosis·Computed tomography (CT)·Nomogram
Influence of hypothyroidism on radiomorphometric parameters of mandibular radiograph: A cross-sectional case control study
Authors: Nair Ananya , Bhardwaj Isha , Patil Vathsala , Singhal Deepak Kumar , Smriti Komal , Chhaparwal Yogesh , Chhaparwal Shubha 
Published: August 2024

Abstract

Thyroid hormones have a catabolic effect on bone mineral homeostasis. Hypothyroid patients have shown changes in bone mineral density with increased risk for osteoporosis and bone fractures. Radiomorphometric parameters on panoramic images are good indicators of bone mineral density. The aim of the study was to compare the radiomorphometric changes in dental panoramic images of patients diagnosed with hypothyroidism with age- and gender-matched control populations.
Materials and Methods
Panoramic radiographs of 47 patients diagnosed with hypothyroidism was measured for Radio morphometric indices like Mental index (MI), The inferior panoramic mandibular index (PMI), The antegonial index (AGI), Gonial Index (GI) and Mandibular cortical Index (MCI). The measurements were compared with age and gender matched healthy controls.
Results
The mean values of mental index, inferior panoramic mandibular index, and gonial index were observed in hypothyroidism than in healthy controls. However, only AGI showed statistically significant differences between cases and controls (p = 0.03).
Conclusion
Further studies with larger samples, comparing the dosage of hormone replacement therapy and hormone levels with bone changes, can provide substantial validated data
Health Policy Spotlight Effects on Critical Time-Sensitive Diseases: Evidence from Taiwan Categorization of Hospital Emergency Capability Policy
Authors: Lin Chih-Yuan , Liu Chih-Chin , Huang Yu-Tung , Lee Yue-Chune 
Published: August 2024

Abstract

Objective To investigate the effects of the Categorization of hospital emergency capability (CHEC) policy on critical time-sensitive diseases (CTSDs).
Setting CHEC is a policy implemented worldwide to regionalize and guide the dispatch of critical patients to the nearest appropriate hospital. In 2009, Taiwan's CHEC policy was designed to improve the quality of emergent care for CTSDs.
Research Design and Participants A nationwide observational quasi-experimental study was conducted to examine the quality of care for CTSD before (2006-2008) and after (2009-2012) the implementation of the CHEC policy. CHEC policy focused on acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), septic shock, and major trauma. A difference-in-differences estimation was used to assess the impact of the CHEC policy exposure (AIS and STEMI) on clinical practice and outcomes, compared with the unexposed counterfactual of septic shock. We selected diagnosis and treatment guideline adherence process quality measures as primary outcome and medical utilization, upward transfer rate, short-term and long-term mortality as secondary outcomes. Taiwan National Health Insurance 2005 Longitudinal Health Insurance Database contains one million random cases, including time-sensitive disease samples.
Results In our cohort of 9,923 cases, refined through 1:1 propensity score matching, 56% were male, mostly older adults. The CHEC policy significantly reduced medical orders and major diagnostic indicators, yet diagnostic fees notably increased. This led to a decrease in mortality rates, ultimately lowering overall medical expenses. Septic shock cases showed marked reductions in both primary diagnosis indicators and medical orders. In contrast, primary treatment indicators for AIS and STEMI rose, supporting the hypothesis of a health policy spotlight effect.
Conclusions This study highlights the CHEC policy's dual effects on reducing costs and enhancing patient outcomes. We observed a health policy spotlight effect, which led to a disproportionate improvement in guideline adherence and process quality for CTSDs that have time-based surveillance indicators.
Automated Analysis of Heart Sound Signals in Screening for Structural Heart Disease in Children
Authors: Papunen Ida , Ylänen Kaisa , Lundqvist Oliver , Porkholm Martin , Rahkonen Otto , Mecklin Minna , Eerola Anneli , Kallio Merja , Arola Anita , Niemelä Jussi , Jaakkola Ilkka , Poutanen Tuija 
Published: August 2024

Abstract

Purpose
Our aim was to investigate the ability of an artificial intelligence (AI)-based algorithm to differentiate innocent murmurs from pathologic ones.
Methods
An AI-based algorithm was developed using heart sound recordings collected from 1413 patients at the five university hospitals in Finland. The corresponding heart condition was verified using echocardiography. In the second phase of the study, patients referred to Helsinki New Children’s Hospital due to a heart murmur were prospectively assessed with the algorithm, and then the results were compared with echocardiography findings.
Results
Ninety-eight children were included in this prospective study. The algorithm classified 72 (73%) of the heart sounds as normal and 26 (27%) as abnormal. Echocardiography was normal in 63 (64%) children and abnormal in 35 (36%). The algorithm recognised abnormal heart sounds in 24 of 35 children with abnormal echocardiography and normal heart sounds with normal echocardiography in 61 of 63 children. When the murmur was audible, the sensitivity and specificity of the algorithm were 83% (24/29) (confidence interval (CI) 64–94%) and 97% (59/61) (CI 89–100%), respectively.
Conclusions
The algorithm was able to distinguish murmurs associated with structural cardiac anomalies from innocent murmurs with good sensitivity and specificity. The algorithm was unable to identify heart defects that did not cause a murmur. Further research is needed on the use of the algorithm in screening for heart murmurs in primary health care.
Malaria Endgame: Can engagement of the for-profit private sector help the country reach the last mile of malaria elimination in Bangladesh?
Authors: Alam Mohammad Shafiul , Alam Md Jahangir , Hossain Mohammad Sharif , Matin Mohammad Abdul , Phru Ching Swe , Hasan Anamul , Rahman Md Mushfiqur , Rahaman Md Mosiqure , Islam Md Nazrul , Das Shyamol Kumer , Aktaruzzaman M. M. , Adnan Sheikh Daud , Islam Md Nazmul , Hazarika Anupama 
Published: August 2024

Abstract

Background
Among 13 endemic districts, the Chittagong Hill Tracts bear more than 90% of Bangladesh's malaria burden. Despite the private sector's prominence in rural healthcare, its role in malaria management remains underutilized. This study aimed to strategize leveraging the for-profit private sector, such as diagnostic and treatment centers, to bolster national malaria surveillance and control, advancing Bangladesh toward malaria elimination by 2030.
Methods
This mixed-method study commenced with a questionnaire-based cross-sectional survey followed by selected focused group discussions (FGDs) among the participants. Based on the endemicity and strategic priorities, a comprehensive mapping of private for-profit facilities from the regions comprising 15 sub-districts across 8 chosen districts (7 malaria endemic districts and the rest non-endemic districts) was created. For the non-endemic zone, the sub-districts were selected based on their proximity to an area with high malaria transmission.
Results
Among the 104 representative participants, majority were male (n=92, 88.5%), had a diploma in their respective fields (n=53, 51%) and were involved either in laboratory work (n=49, 47.1%) or as owners/managers of health centers (n=41, 39.4%). The selected health facilities were close to the corresponding UHC (mean distance 2.8 km), but were distantly located from the designated district hospitals (mean distance 48.9 km). The main sources of RDT kits (62.3%) and anti-malarial drugs (63.2%) were local wholesale markets. A large share of the corresponding facilities neither provided malaria treatment services (81.7%) nor worked with the NMEP (93.3%). Three FGDs were held with the for-profit service providers so that further insights and qualitative viewpoints of them can be utilized in situation analysis.
Conclusions
This study highlights challenges and recommendations for engaging private for-profit health facilities in Bangladesh's malaria elimination efforts. The identified challenges include low-quality RDTs, staff shortages, and inadequate capacity building. Recommendations emphasize effective training, stakeholder interaction, and enhanced oversight for successful malaria control efforts.
Enhancing parathyroid preservation in papillary thyroid carcinoma surgery using nano-carbon suspension
Authors: Lin De-Xin , Zhuo Xin-bin , Lin Yin , Lei Wen-Di , Chang Gui-Jian , Zhang Yong , Zhang Shi-Yan 
Published: August 2024

Abstract

This study evaluates the clinical significance of using nano-carbon suspension in total thyroidectomy with cervical lymph node dissection for papillary thyroid carcinoma (PTC). The objective is to assess the efficacy of nano-carbon in enhancing parathyroid gland preservation, reducing postoperative complications, and improving surgical precision. A retrospective analysis of 219 PTC patients who underwent total thyroidectomy and cervical lymph node dissection from March 2014 to March 2018 was conducted. Patients were divided into two groups: control (n = 112) without nano-carbon suspension and experimental (n = 107) with nano-carbon suspension. Comparative analyses included demographics, surgical parameters, postoperative calcium and parathyroid hormone (PTH) levels, number of lymph nodes dissected, and incidence of complications. Baseline characteristics, including age, sex, and BMI, were comparable between the experimental and control groups, with no statistically significant differences observed. Postoperative calcium levels were significantly more stable in the experimental group, with median levels of 2.22 mmol/L on day 1 compared to 2.06 mmol/L in the control group (p < 0.001), and 2.29 mmol/L at week 1 compared to 2.22 mmol/L in the control group (p < 0.001). PTH levels were also higher in the experimental group (35 pg/mL on day 1 vs. 28 pg/mL, p < 0.001; 37 pg/mL at week 1 vs. 30 pg/mL, p < 0.001). The experimental group had more lymph nodes dissected (median 135.83 vs. 84.12, p < 0.001) and a lower pathological parathyroid gland count (6.5% vs. 23.2%, p < 0.001). Postoperative numbness and twitching were reduced (4.7% vs. 16.1%, p = 0.006), and the recurrence rate at 12 months was lower (4.7% vs. 12.5%, p = 0.040). Nano-carbon suspension in thyroidectomy with cervical lymph node dissection for PTC enhances parathyroid gland preservation, improves surgical precision, and reduces specific postoperative complications, advocating its standard use in thyroid cancer surgeries to optimize patient outcomes.