bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Bone Microarchitecture Impairments in Older Men With Type 2 Diabetes—The MrOS Study
Authors: Faraj Malak , Schwartz Ann V , Burghardt Andrew J , Black Dennis , Orwoll Eric , Strotmeyer Elsa S , Vittinghoff Eric , Fogolari Marta , Angeletti Silvia , Banfi Giuseppe , Lombardi Giovanni , Woods Gina , Lui Li-Yung , Bouxsein Mary , Napoli Nicola 
Published: July 2024

Abstract

Context
Impaired bone microarchitecture, assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), may contribute to bone fragility in type 2 diabetes (T2DM) but data on men are lacking.

Objective
To investigate the association between T2DM and HR-pQCT parameters in older men.

Methods
HR-pQCT scans were acquired on 1794 participants in the Osteoporotic Fractures in Men study. T2DM was ascertained by self-report or medication use. Linear regression models, adjusted for age, race, body mass index, limb length, clinic site, and oral corticosteroid use, were used to compare HR-pQCT parameters by diabetes status.

Results
Among 1777 men, 290 had T2DM (mean age, 84.4 years). T2DM men had smaller total cross-sectional area at the distal tibia (P = .028) and diaphyseal tibia (P = .025), and smaller cortical area at the distal (P = .009) and diaphyseal tibia (P = .023). Trabecular indices and cortical porosity were similar between T2DM and non-T2DM. Among men with T2DM, in a model including HbA1c, diabetes duration, and insulin use, diabetes duration ≥ 10 years, compared with &lt;10 years, was significantly associated with higher cortical porosity but with higher trabecular thickness at the distal radius. Insulin use was significantly associated with lower cortical area and thickness at the distal radius and diaphyseal tibia and lower failure load at all 3 scan sites. Lower cortical area, cortical thickness, total bone mineral density, cortical bone mineral density, and failure load of the distal sites were associated with increased risk of incident nonvertebral fracture in T2DM.

Conclusion
Older men with T2DM have smaller bone size compared to those without T2DM, which may contribute to diabetic skeletal fragility. Longer diabetes duration was associated with higher cortical porosity and insulin use with cortical bone deficits and lower failure load.
Systemic Lupus Erythematosus in pregnancy – a multidisciplinary approach to family planning and adverse outcomes prevention
Authors: Nowak Aleksandra , Janus Anita , Łoś Dawid , Kaptur Agata , Dziedziński Dawid 
Published: July 2024

Introduction and purpose
Systemic Lupus Erythematosus is a chronic multisystemic autoimmune disease with periods of remissions and flares [1,5,25]. Because of its possible consequences and unpredictability, it is undoubtedly an issue for such patients to decide about pregnancy [3].
The main aim of this review is to present the possible risks of SLE in pregnancy, its general management and current recommendations regarding pregnancy planning and pre-/postnatal care.
Review Methods

For the review we conducted research of scientific literature from PubMed and books, applying the keywords (below). Consequently, we included in our references above 20 selected articles published between 2017-2024 and 3 chapters of different medical books. All of these were analyzed in terms of their currency and relevance.

A brief description of the State of Knowledge

SLE mostly affects women at the reproductive age [2, 3,5]. It often requires long-term therapy that aims to achieve and maintain an inactive stage by means of numerous aggressive drugs. Its proper management in gestation is even more challenging than usually, owing to the increased risk of adverse pregnancy outcomes (APO) and higher maternal mortality [1,2,4,5,7]. Therefore, to achieve successful pregnancy, risk stratification, therapy modification and individually adjusted plan of follow-up visits are the most crucial conditions to be met [1,6,7,13].

Summary

Considering all the potential complications that may occur in general, the issue of family planning should be raised with every female patient [5,6]. The key to the best outcomes is proper implementation of current strategies and empowering the patient to be an active and aware participant in the decision-making process [1,3,4,6,11].
Computed tomography-based radiomics predicts the fibroblast-related gene EZH2 expression level and survival of hepatocellular carcinoma
Authors: Yu Ting-Yu , Zhan Ze-Juan , Lin Qi , Huang Zhen-Huan 
Published: July 2024

BACKGROUND
Hepatocellular carcinoma (HCC) is the most common subtype of liver cancer. The primary treatment strategies for HCC currently include liver transplantation and surgical resection. However, these methods often yield unsatisfactory outcomes, leading to a poor prognosis for many patients. This underscores the urgent need to identify and evaluate novel therapeutic targets that can improve the prognosis and survival rate of HCC patients.
AIM
To construct a radiomics model that can accurately predict the EZH2 expression in HCC.
METHODS
Gene expression, clinical parameters, HCC-related radiomics, and fibroblast-related genes were acquired from public databases. A gene model was developed, and its clinical efficacy was assessed statistically. Drug sensitivity analysis was conducted with identified hub genes. Radiomics features were extracted and machine learning algorithms were employed to generate a radiomics model related to the hub genes. A nomogram was used to illustrate the prognostic significance of the computed Radscore and the hub genes in the context of HCC patient outcomes.
RESULTS
EZH2 and NRAS were independent predictors for prognosis of HCC and were utilized to construct a predictive gene model. This model demonstrated robust performance in diagnosing HCC and predicted an unfavorable prognosis. A negative correlation was observed between EZH2 expression and drug sensitivity. Elevated EZH2 expression was linked to poorer prognosis, and its diagnostic value in HCC surpassed that of the risk model. A radiomics model, developed using a logistic algorithm, also showed superior efficiency in predicting EZH2 expression. The Radscore was higher in the group with high EZH2 expression. A nomogram was constructed to visually demonstrate the significant roles of the radiomics model and EZH2 expression in predicting the overall survival of HCC patients.
CONCLUSION
EZH2 plays significant roles in diagnosing HCC and therapeutic efficacy. A radiomics model, developed using a logistic algorithm, efficiently predicted EZH2 expression and exhibited strong correlation with HCC prognosis.
“Keyboard sign” and “coffee bean sign” in the prenatal diagnosis of ileal atresia: A case report
Authors: Fei Zhi-Hui , Zhou Qi-Yi , Fan Ling , Yin Chan 
Published: July 2024

BACKGROUND
Ileal atresia is a congenital abnormality where there is significant stenosis or complete absence of a portion of the ileum. The overall diagnostic accuracy of prenatal ultrasound in detecting jejunal and ileal atresia is low. We report a case of ileal atresia diagnosed prenatally by ultrasound examination with the “keyboard sign” and “coffee bean sign”.
CASE SUMMARY
We report a case of ileal atresia diagnosed in utero at 31 weeks' of gestation. Prenatal ultrasound examination revealed two rows of intestines arranged in an ‘S’ shape in the middle abdomen. The inner diameters were 1.7 cm and 1.6 cm, respectively. A typical “keyboard sign” was observed. The intestine canal behind the “keyboard sign” showed an irregular strong echo. There was no normal intestinal wall structure, showing a typical “coffee bean sign”. Termination of the pregnancy and autopsy findings confirmed the diagnosis.
CONCLUSION
The prenatal diagnosis of ileal atresia is difficult. The sonographic features of the “keyboard sign” and “coffee bean sign” are helpful in diagnosing the location of congenital jejunal and ileal atresia.
Broadband vortex beam generation by a reflective meta-surface based on a metal double-slit resonant ring
Authors: Yuan Xufeng , Zhao Chaoying 
Published: July 2024

Recently, the meta-surface (MS) has emerged as a promising alternative method for generating vortex waves. At the same time, MS also faces the problem of a narrow bandwidth; in order to obtain a broad bandwidth, the MS unit cell structure becomes more and more complex, which will bring many inconveniences to the preparation process of MS devices. Therefore, we want to design a simple MS unit cell with a multi-frequency selection. In this paper, based on the principle of geometric phase, we design a simple reflective MS unit cell based on a metal double-slit resonant ring. We elaborate on the resonance mechanism of the MS unit cell. Under the normal incidence of circularly polarized (CP) waves, the reflection coefficient of the same polarization was greater than 85%. By rotating the orientation angle of the resonator on the MS unit cell, the continuous 2π phase coverage was satisfied in the frequency range of 0.52–1.1 THz, and the relative bandwidth becomes 71.6%. Based on this, we construct a vortex generator by using a 15×15 MS unit array. The right-handed circularly polarized (RCP) waves and left-handed circularly polarized (LCP) wave are separately incident on MS with topological charges of l=+1,+2,+3 under multiple resonant frequencies. The generated RCP vortex wave has topological charges of l=−1,−2,−3 and the generated LCP vortex wave has topological charges of l=+1,+2,+3. The numerical simulation results demonstrate that our designed MS, capable of achieving multiple resonance outcomes, can effectively operate in a multi-broadband mode and produce a wide-band vortex beam. In addition, we also calculate the pattern purity. Through theoretical analysis and numerical simulation, we prove that our designed MS can generate a broadband vortex wave.
Knowledge, attitudes and practices toward female genital schistosomiasis among community women and healthcare professionals in Kimpese region, Democratic Republic of Congo
Authors: Wambui Cecilia Wangari , Madinga Joule , Ashepet Mercy Gloria , Anyolitho Maxson Kenneth , Mitashi Patrick , Huyse Tine 
Published: July 2024

Background
Chronic infection with Schistosoma haematobium causes female genital schistosomiasis (FGS), which leads to diverse lesions in the female genital tract and several complications, including infertility and a higher risk for HIV transmission. This study aims to understand the knowledge, attitudes, and practices (KAP) toward FGS and associated factors among women and health professionals in the schistosomiasis endemic focus of Kimpese, western Democratic Republic of Congo (DRC).

Methods
In January 2022, two semi-quantitative questionnaires were administered to 201 randomly selected community women in Kifua II village, and to purposely selected health professionals (20 nurses and 41 doctors) from Kimpese Health Zone. KAP statements were coded using Likert scale, summarized as frequencies and percentages, and assessed for internal reliability using Cronbach’s alpha. Associations between the socio-demographic characteristics of respondents and the KAP variables were assessed using Pearson chi-square (χ2) test, Cramer’s V (φ) and gamma (γ) coefficients.

Results
Overall, respondents had high knowledge of schistosomiasis in general but low FGS-specific knowledge (91% versus 45%). Misconceptions concerned the disease transmission, with 30.3% of women and 25% of the nurses believing that FGS is transmitted by drinking untreated water, while 26.8% of the doctors mentioned sexual contact as a mode of FGS transmission. Negative attitudes included considering FGS not a very serious disease (34.8%), feeling uncomfortable during gynaecological examination (35.3%), difficulties avoiding risky water contact (72.1%) and open defecation/urination (41.3%), not intending to share FGS status with their husbands (38.3%) and loved ones (63.6%), and believing that husbands would leave them if they were infertile (31.8%). Regarding practices, 77.6% of women engaged daily in activities involving contact with water. Practices of health professionals were hampered by the lack of equipment and specialized knowledge for FGS diagnosis with only 57% of healthcare workers having a microscope in their facilities. Women’s KAPs varied by age, education, marital status, occupation and monthly income.

Conclusion
This study highlights insufficient knowledge, existing negative attitudes, at risk practices towards FGS by women, and limitations of FGS management by health professionals. These findings can help for tailored health education and WASH strategies, and call for health professional’s capacities reinforcement.
The relationship between NLR, LDL-C/HDL-C, NHR and coronary artery disease
Authors: Yuan Shuaishuai , Li Lingling , Pu Tian , Fan Xizhen , Wang Zheng , Xie Pailing , Li Peijun 
Published: July 2024

Objective
Chronic inflammation and dyslipidemia are key risk factors for atherosclerotic cardiovascular diseases. We retrospectively explored the association between the neutrophil to lymphocyte ratio (NLR), the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C), and the neutrophil to HDL-C ratio (NHR), and the severity of coronary lesions in patients with acute coronary syndrome (ACS).

Method
In June 2023, we selected 1210 patients who were diagnosed with ACS based on chest pain from January 2017 to December 2022. Of these, 1100 patients with abnormal coronary angiography were categorized into the experimental group, and 110 patients with normal coronary angiography were classified as the control group. We collected routine blood tests, lipid profiles, and coronary angiography results at admission (before coronary angiography). Patients were then stratified into a control group (Gensini score = 0) and an experimental group (Gensini score = 0) based on the Gensini score. The experimental group was further divided into a low score group (Gensini score < 69) and a high score group (Gensini score ≥ 69).

Result
1. Statistically significant differences were observed between the control and experimental groups in terms of gender, age, body mass index (BMI), hypertension, diabetes, smoking history, and counts of neutrophils (NEU), lymphocytes (LYM), monocytes (MON), eosinophils (EOS), red cell distribution width (RDW), total cholesterol (TC), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR (P&lt;0.05). Furthermore, differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, TC, triglyceride (TG), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR were significant between the low and high score groups (P&lt;0.05). 2. NEU, LYM, MON, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR showed significant correlations with the Gensini score (r>0.2, P<0.05), with NLR and LDL-C/HDL-C showing the strongest correlations (r = 0.822, P = 0.000). 3. The Receiver Operating Characteristic (ROC) curve indicated that the combination of NLR and LDL-C/HDL-C had superior sensitivity and specificity in predicting the severity of coronary lesions, with a significant difference (P&lt;0.05). The sensitivity was 87.1%, the specificity was 90.9%, and the cut-off point was 2.04. 4. A predictive model was developed based on the ratio of NLR and LDL-C/HDL-C to the Gensini score. The final model score was calculated as 6.803 + 7.029NLR + 13.079LDL-C/HDL-C (R2 = 0.708).

Conclusion
Compared to NLR, LDL-C/HDL-C, and NHR, the combined NLR and LDL-C/HDL-C ratio is a more accurate marker for assessing the severity of coronary artery disease in ACS patients. Its convenience and effectiveness make it a promising tool for early assessment, timely risk stratification, and appropriate clinical intervention, ultimately improving clinical outcomes for ACS patients.
Integrated group antenatal and pediatric care in Haiti: A comprehensive care accompaniment model
Authors: Casella Jean-Baptiste Meredith , Julmisse Marc , Adeyemo Oluwatosin O. , Vital Julmiste Thamar Monide , Illuzzi Jessica L. 
Published: July 2024

Introduction
The J9 Plus (J9) maternal-child accompaniment program is based on four pillars: group antenatal care (GANC), group pediatric care, psychosocial support, and community-based care. We aimed to evaluate the impact of the J9 model of care on perinatal outcomes.

Methodology
We conducted a convergent mixed methods study of maternal-newborn dyads born in 2019 at Hôpital Universitaire de Mirebalais. Quantitative data was collected retrospectively to compare dyads receiving J9 care to usual care. A secondary analysis of qualitative data described patient perspectives of J9 care.

Results
Antenatal care attendance was significantly higher among women in J9 (n = 524) compared to usual care (n = 523), with 490(93%) and 189(36%) having >4 visits, respectively; p <0.001, as was post-partum visit attendance [271(52%) compared to 84(16%), p<0.001] and use of post-partum family planning methods [98(19%) compared to 47(9%), p = 0.003]. Incidence of pre-eclampsia with severe features was significantly lower in the J9 group [44(9%)] compared to the usual care group [73(14%)], p <0.001. Maternal and neonatal mortality and low birth weight did not differ across groups. Cesarean delivery [103(20%) and 82(16%), p<0.001] and preterm birth [118 (24%)] and 80 (17%), p <0.001] were higher in the J9 group compared to usual care, respectively. In the qualitative analysis, ease of access to high-quality care, meaningful social support, and maternal empowerment through education were identified as key contributors to these outcomes.

Conclusion
Compared to usual care, the J9 Plus maternal-child accompaniment model of care is associated with increased engagement in antenatal and postpartum care, increased utilization of post-partum family planning, and lower incidence of pre-eclampsia with severe features, which remains a leading cause of maternal mortality in Haiti. The J9 accompaniment approach to care is an empowering model that has the potential to be replicated in similar settings to improve quality of care and outcomes globally.
One or many labels? a longitudinal qualitative study of patients’ journey to diagnosis at a specialist NHS Postural Tachycardia Syndrome (PoTS) clinic
Authors: Knoop Iris , Jones Annie S. K. , Ibrahimi Ereza , Bogosian Angeliki , Gall Nicholas , Moss-Morris Rona 
Published: July 2024

Objectives
Postural Tachycardia Syndrome (PoTS) is a poorly understood syndrome of multiple disabling symptoms. This study explored the process of seeking a diagnosis of PoTS. Analysis focused on changes before and after participants’ first appointment with a national PoTS clinic, and explored whether a diagnosis is beneficial in the context of multiple co-occurring conditions and an absence of licenced treatments.

Design
A longitudinal, qualitative study.

Methods
Participants (n = 15) in this nested qualitative study were recruited from a larger study of people who had been newly referred to a National specialist NHS Cardiology PoTS service. Semi-structured interviews were conducted remotely before, and 6 months after their first appointment with the clinic. Data was analysed longitudinally and inductively using Reflexive Thematic Analysis.

Results
Three overarching themes were identified: “Slowly moving forward and finding positive gains”, “Needing more pieces of the puzzle to see the bigger picture”, and “The value and impact of investigations”. Findings suggested that not much had changed in the 6 months between interviews. Participants were moving forward in terms of diagnoses, treatment and adjustment following their appointment, but many were still seeking further clarity and possible diagnoses. Investigations, appointments, and new-found problems, continued to have a substantial impact over time.

Conclusions
The journey to diagnosis for patients with suspected PoTS appeared to promote acceptance of self, and of limitations posed by symptoms. However, many participants continued their search for an explanation for every symptom experience, and this may become increasingly complex, the more labels that have been acquired. Lack of clarity contributed to ongoing difficulties for this patient group alongside fraught relations with health care professionals (HCPs). A more coherent, integrated approach which is communicated clearly to patients is recommended.
Patients’ experiences of living with low anterior resection syndrome three to six months after colorectal cancer surgery: A phenomenological study
Authors: Løvall Camilla , Mjelde Lotte Miriam Eri , Eide Leslie S. P. , Reime Marit Hegg 
Published: July 2024

Background
Increased use of sphincter-preserving surgery following colorectal cancer has led to more people living with low anterior resection syndrome (LARS), a disordered bowel function that significantly impacts quality of life. Little is known about how patients experience the first months following sphincter-preserving surgery and having LARS.

Objective
To shed light on what it means to live with LARS in the first three to six months after colorectal cancer sphincter-preserving surgery.

Method
A qualitative study with a phenomenological approach constitutes the study design. Semi-structured interviews were conducted with five participants from September 2022 to January 2023. The transcribed interviews were analysed using Giorgi’s phenomenological method.

Results
Five themes emerged from the analysis: bowel emptying becomes all-consuming and affects both daily life and working life, you hear what they’re saying, but don’t understand what it means until your body goes through it, low anterior resection syndrome may impact sexual life, leaving feelings of guilt, it doesn’t matter what the circumstances are, but rather how one deals with them, and support and follow-up from healthcare professionals, employers, family and friends are crucial for living a good life with LARS.

Conclusion
Participants described struggles living with major LARS in the early period following hospital discharge. However, few months later, they had developed strategies enabling them to control their everyday life. Support and follow-up from healthcare professionals, employers, family, and friends were crucial when learning to live with major LARS. Participants expressed desire for a systematic and proactive follow-up from healthcare professionals and contact with peer-support groups.