bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiolabeling and preclinical animal model evaluation of DTPA coupled 99mTc-labelled flutamide complex ([99mTc]DTPA-FLUT) as a potential radiotracer for cancer imaging
Authors: Naqvi Syed Ali Raza , Hassan Ahmad Junaid , Janjua Muhammad Ramzan Saeed Ashraf , Abbas Naseem , Zahoor Ameer Fawad , Hassan Sadaf Ul , Hussain Amjad 
Published: May 2024

Background Advances in molecular imaging strategies have had an effect on precise diagnosis and treatment. Research has been intensified to develop more effective and versatile radiopharmaceuticals to uplift diagnostic efficiency and, consequently, the treatment. Purpose To label the flutamide (FLUT) coupled with diethylenetriamine pentaacetate (DTPA) with technetium-99 m (99mTc) and to evaluate its binding efficiency with rhabdomyosarcoma (RMS) cancer cells. Material and methods Radiolabeling of FLUT with 185 MBq freshly eluted 99mTcO4−1 was carried out via DTPA bifunctional chelating agent using stannous chloride reducing agent at pH 5. The labeled compound was assessed for its purity using chromatography analysis, stability in saline and blood serum, AND charge using paper electrophoresis. Normal biodistribution was studied using a mouse model, while binding affinity with RMS cancer cells was studied using an internalization assay. The in vivo accumulation of RMS cancer cells in a rabbit model was monitored using a SPECT gamma camera. Results Radiolabeling reaction displayed a pharmaceutical yield of 97% and a stability assay showed >95% intact radiopharmaceutical up to 6 h in saline and blood serum. In vitro internalization studies showed the potential of [99mTc]DTPA-FLUT to enter into cancer cells. This biodistribution study showed rapid blood clearance and minimum uptake by body organs, and scintigraphy displayed the [99mTc]DTPA-FLUT uptake by lesion, induced by RMS cancer cell lines in rabbit. Conclusion Stable, newly developed [99mTc]DTPA-FLUT seeks its way to internalize into RMS cancer cells, indicating it could be a potential candidate for the diagnosis of RMS cancer.
Application of convolutional neural network for differentiating ovarian thecoma-fibroma and solid ovarian cancer based on MRI
Authors: Zheng Yuemei , Wang Hong , Weng Tingting , Li Qiong , Guo Li 
Published: May 2024

Background Ovarian thecoma-fibroma and solid ovarian cancer have similar clinical and imaging features, and it is difficult for radiologists to differentiate them. Since the treatment and prognosis of them are different, accurate characterization is crucial. Purpose To non-invasively differentiate ovarian thecoma-fibroma and solid ovarian cancer by convolutional neural network based on magnetic resonance imaging (MRI), and to provide the interpretability of the model. Material and Methods A total of 156 tumors, including 86 ovarian thecoma-fibroma and 70 solid ovarian cancer, were split into the training set, the validation set, and the test set according to the ratio of 8:1:1 by stratified random sampling. In this study, we used four different networks, two different weight modes, two different optimizers, and four different sizes of regions of interest (ROI) to test the model performance. This process was repeated 10 times to calculate the average performance of the test set. The gradient weighted class activation mapping (Grad-CAM) was used to explain how the model makes classification decisions by visual location map. Results ResNet18, which had pre-trained weight, using Adam and one multiple ROI circumscribed rectangle, achieved best performance. The average accuracy, precision, recall, and AUC were 0.852, 0.828, 0.848, and 0.919 ( P < 0.01), respectively. Grad-CAM showed areas associated with classification appeared on the edge or interior of ovarian thecoma-fibroma and the interior of solid ovarian cancer. Conclusion This study shows that convolution neural network based on MRI can be helpful for radiologists in differentiating ovarian thecoma-fibroma and solid ovarian cancer.
Does enzalutamide related PSMA upregulation affect outcomes of lutetium-177 PSMA radioligand therapy?
Authors: Cengiz Turgut Bora , Kulkarni Raksha , Novello Matteo , Hafez Anthony , Gavane Somali , Ghesani Munir , Ghesani Nasrin 
Published: May 2024

Background: Enzalutamide is an antiandrogen drug used prior to lutetium-177 prostate specific membrane antigen (Lu-PSMA) radioligand therapy and has shown promising results for upregulating the PSMA expression on prostate cancer cells. In this study, we aim to compare prostate specific antigen (PSA) level changes in prostate cancer patients who received enzalutamide to those who did not. Methods: Prostate cancer patients who underwent Lu-PSMA between 2021 and 2023 were retrospectively included. Patients were grouped based on prior enzalutamide therapy: those who received enzalutamide (EZ+) for at least 14 days and those who did not (EZ−). PSA changes and F-18 DCFPyL SUV (Standardized Uptake Values) were compared. Results: Thirty-seven patients were included, 18 EZ+ and 19 EZ−. The median age, Gleason score, and prior chemo/hormonal therapies were similar for EZ+ and EZ−, except for radium-223. Eleven patients (61%) in EZ+ and 13 patients (68%) in EZ− showed a decrease in PSA after the first cycle ( p = 0.64). Four patients (22%) in EZ+ and seven patients (37%) in EZ− had more than 50% decrease in PSA after the first cycle ( p = 0.33). The average percent decline at the end of the treatment was 23.3% in EZ+ and 50.4% in EZ− ( p = 0.4). There was no difference in terms of lesion with highest SUVmax, mean SUV, total tumor volume or activity on pre-therapy PSMA imaging. Conclusion: Enzalutamide treatment prior to Lu-PSMA does not improve patient outcomes when applied remotely. Larger studies evaluating the combination therapies and the timing of enzalutamide are needed to assess its correlation with Lu-PSMA outcomes.
Effect of moral case deliberation on midwives’ knowledge and practice regarding respectful maternity care
Authors: Samsami Khatoon , Chananeh Maryam , Kamali Farahnaz , Bagherzadeh Razieh 
Published: May 2024

Introduction Although there have been reports of misbehavior and disrespectful maternal care by healthcare providers worldwide, there are few intervention studies aimed at promoting respectful care, particularly among midwives. Research objectives The aim of this study was to examine the effect of Moral Case Deliberation (MCD) on the of midwives’ knowledge and practice in the field of respectful maternity care. Research design and methods This semi-experimental study involved 46 midwives working in the maternity departments of two hospitals affiliated with Bushehr University of Medical Sciences in 2023. The two hospitals were randomly divided into control and intervention groups. All midwives from both hospitals were included in the study. The Dilemma Method of MCD was implemented for midwives of intervention hospital. The Midwives’ Knowledge and Practice of Respectful Maternity Care scale was used for data collection. It was administered both before and two weeks after the intervention. Data were analyzed using SPSS (version 20). Ethical considerations The study was approved by ethics committee of Bushehr University of Medical Sciences in Bushehr, Iran (ethics code: IR.BPUMS.REC.1402.017). All participants provided written informed consent. Findings The intervention group showed a significantly greater increase in knowledge scores from pre-test to post-test compared to the control group ( p < .001). The intervention group had a significantly higher mean change score in practice self-assessment and practice peer evaluation, from pre-test to post-test, than in the control group ( p < .001). Discussion MCD based on the dilemma method can improve practice in the field of respect-oriented midwifery care by increasing knowledge and potentially changing attitudes. Conclusion The Dilemma Method of MCD improved midwives’ knowledge and practice regarding respectful maternity care. This method can be included in the midwifery care quality improvement program to promote respectful maternity care. It is necessary to develop methods for wider dissemination of MCD in the cultural context of Iran.
Medical and Psychological Intervention for Indian Adult Patients with Cancer: A Randomised Control Study
Authors: Barre Vijaya Prasad , G. Padmaja , Rana Suvashisa , Saxena Ravi Kumar , Satapathy Sujata 
Published: May 2024

Background Contemporary cancer care primarily focuses on advanced biomedical treatments, often overlooking the psychological and social challenges associated with the illness (psychosocial factors). This oversight can undermine the efficacy of healthcare and subsequently impact the overall well-being of cancer patients. There is a widespread consensus among medical professionals that psychological factors play a crucial role in the care and treatment of cancer patients. Purpose The main aim of this study was to examine the effects of treatment as usual (TAU) and a combined intervention (CI) of TAU and psychological intervention (PI) on stress, coping strategies and quality of life among adult cancer patients. Methods The present study employed a pretest–post-test control group design comprising two groups—Group I (a control group involving TAU only) and Group II (an experimental group involving TAU and PI). In Group I ( n1 = 30), the patients with cancer were randomly selected from a pool of 105 cancer patients from three cancer types, lung cancer (LC), breast cancer (BC) and head/neck cancer (HNC), and were administered only TAU (e.g., surgery, chemotherapy and radiation‑hormonal therapy). In Group II ( n2 = 30), the participants were administered not only the regular TAU but also the PI involving psychoeducation, cognitive-behavioural therapy (CBT) and guided imagery. Three research instruments, namely QSC-R23, Brief Cope Inventory and EORTC QLQ-C30 version 3.0, were used for the present study. Results The study findings revealed that both TAU and CI resulted in positive outcomes across the measured variables. Notably, there was a decrease in stress levels and an improvement in coping strategies, encompassing problem-focused, emotion-focused and adaptive coping. Furthermore, participants showed a decreased reliance on maladaptive coping strategies and reported an enhanced quality of life, as evidenced by improvements in symptom scales. Conclusion The study indicated that combining PI with TAU resulted in better outcomes, highlighting the effectiveness of CI (TAU with PI) for cancer patients compared to TAU alone.
R&D, Product and  Process Innovation,  and Firm Performance:  A Case Study of the Chinese Firms
Authors: Anwar Sajid , Sun Sizhong 
Published: May 2024

Alongside rapid economic growth, the Chinese economy has witnessed a notable increase in research and development (R&D) expenditure, escalating from 0.56 per cent of GDP in 1996 to 2.43 per cent in 2021. Recognising the significance of innovation in economic growth, this article utilises unique firm-level data from China for the year 2012 to investigate the influence of R&D, product innovation and process innovation on firm productivity. The findings suggest that R&D positively affects the performance of Chinese firms, as measured by either firm sales or sales per permanent full-time employee. Moreover, product innovation may have a detrimental impact on firm performance, whereas the impact of process innovation lacks robustness. JEL: D22, N65, O32
A Phase II Study About Efficacy and Safety of the Continuous IntraVenous Infusion of Ketamine as Adjuvant to Opioids in Terminally Ill Cancer Patients With Refractory Cancer Pain (CIVIK Trial)
Authors: Park Kwonoh , Kim Jae-Joon , Oh Sang-Bo , Oh So Yeon , Hong Yun Jeong , Kim Seo-jun , Park Eun-Ju , Choi Nayeon , Shin Seon-Hi , Kim Sungeun , Ko Heejung 
Published: May 2024

Background Ketamine has been used to control refractory cancer pain as an adjuvant to opioids. We conducted a prospective phase II study to investigate the efficacy and safety of 5-day continuous intravenous infusion (CIVI) of Ketamine in terminally ill cancer patients with refractory cancer pain. Methods Hospitalized terminally ill cancer patients with refractory cancer pain were enrolled. Refractory cancer pain was indicated by requirements for 4 or more rescue opioids or pain intensity using numerical rating scale > personalized pain goal (PPG) despite of intravenous morphine equivalent daily dose (IV MEDD) ≥ 120 mg/day. The CIVI of ketamine was increased from .05 mg/kg/hour to .5 mg/kg/hour by .05 every 8 hours if pain intensity exceeded PPG or if number of rescue opioids ≥2 during prior 8 hours was required. The primary end-point was overall pain response rate, which indicates complete response (both rescue opioid ≤3/day and pain intensity ≤ PPG) plus partial response (rescue opioid ≤3/day), without unacceptable toxicities. Results Among 21 eligible patients enrolled between September 2019 and January 2023, 20 were analyzed. Most pain mechanisms were mixed type (n = 15, 75%), with neuropathic component (n = 17, 85%). The baseline background opioids were IV MEDD 186 mg/24hour (range, 124-592), number of rescue opioids was 6 (IQR, 5-9), and median PPG was 4 (IQR, 3-4). The overall pain response rate was 50% (n = 10) including 40% (n = 8) for complete pain response and 10% (n = 2) for partial pain response. Conclusion This study showed efficacy of gradually increasing CIVI of ketamine for terminally ill cancer patients with refractory cancer pain. CIVI of ketamine could be a useful tool in these patients considering the limited treatment options. (NCT03362073, Initial Release: November 15, 2017).
Comparison of Facial Aesthetic Evaluation Given by Patients with Cleft Lip and/or Palate and Professionals: A Systematic Review
Authors: Wang Xin , Kuang Wenying , Yan Jianan , Xu Jingyi , Zhang Xinyu , Jiang Yanping , Yuan Wenjun 
Published: May 2024

Objective To compare the differences of facial aesthetic evaluation between patients with Cleft Lip and/or Palate (CL/P) and professionals for the treatment outcome of CL/P. Design This systematic review was conducted on MedLine, Web of Science, Embase and Cochrane Library databases. The Risk of Bias in Non-randomized Studies of Intervention (ROBINS-I) tool was used to evaluate the included researches. Setting Not applicable. Patients, Participants Patients with CL/P and professionals Interventions Not applicable. Main Outcome Measures The facial aesthetic evaluation of patients with CL/P and professionals. Results Among the 1695 literatures retrieved, 22 articles were included, including 974 patients with CL/P and 251 professionals. The bias risk assessment on 21 articles was rated “Moderate” and only one article was rated “Serious”. Due to the high heterogeneity of the included studies, meta-analysis was not possible, so descriptive analysis was conducted. Among the included studies, two articles indicated similar views from both groups, 19 noted differences between the two groups, of which three articles indicated more positive evaluation by professionals and nine articles indicated more positive evaluation by patients. Conclusions The available data indicate that there is a difference between patients with CL/P and professionals in the aesthetic evaluation, but it is not clear which group is more positive. During the treatment of patients with CL/P, apart from the objective aesthetic evaluation, professionals should fully consider subjective ideas and self-assessment of patients, in order to improve the quality of life for patients.
Disparities in Mammography Screening: Analyzing Barriers to Access Using Individual Patient Perspectives and the Health Belief Model
Authors: van den Broek-Altenburg Eline M. , Leslie Abimbola A. , Benson Jamie S. , DeStigter Kristen K. 
Published: May 2024

Objective The objective of our study is to explore Nepali women’s beliefs about access to mammography screening, and motivations to get screened or not. This work was intended to be hypothesis generating for subsequent quantitative analysis and to inform policy and decision-making to improve access. Methods We conducted structured qualitative interviews among nine Nepali women in the Northeast of the United States receiving care at a local community health center and among nine white women receiving mammography care at a large academic medical center in the Northeast. We analyzed the transcripts using a mixed deductive (content analysis) and inductive (grounded theory) approach. Deductive codes were generated from the Health Belief Model which states that a person’s belief in the real threat of a disease with their belief in the effectiveness of the recommended health service or behavior or action will predict the likelihood the person will adopt the behavior. We compared and contrasted qualitative results from both groups. Results We found that eligible Nepali women who had not received mammography screening had no knowledge of its availability and its importance. Primary care physicians emerged as a critical link in addressing this disparity: trust was found to be high among Nepali women with their established primary care provider. Conclusion The findings of this study suggest that the role of primary care practitioners in conversations around the importance and eligibility for mammography screening is of critical importance, especially for underserved groups with limited health knowledge of screening opportunities and potential health benefits. Follow-up research should focus on primary care practices.
Triamcinolone injection in the treatment of lid retraction for thyroid-associated ophthalmopathy: A systematic review
Authors: Badjrai Rona Ali , Eldinia Lourisa Ruth , Anandi Lazuardiah , Azhari Fierda Ovita , Anggraini Erika , Budihardja Brigitta Marcia , Nusanti Syntia 
Published: May 2024

Introduction and Objectives Lid retraction is one of the most common symptoms of Thyroid-Associated Ophthalmopathy (TAO), which potentially precipitates various complications, such as dry eyes, exposure keratopathy, and cosmetic concerns. Local corticosteroid injections, such as triamcinolone, have been proposed as a choice of treatment for TAO. This approach may be a favorable alternative for patients intolerant to the systemic effects of high-dose methylprednisolone. However, the efficacy of this intervention remains unestablished. Hence, our review aims to evaluate the efficacy of triamcinolone injection in reducing lid retraction. Methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and was conducted in three databases (PubMed, Science Direct, and ProQuest). This review included studies that use local triamcinolone injections for patients with thyroid-associated ophthalmopathy. The outcome of interest in this review is lid retraction parameters. Results From six studies, a total of 392 patients were included. All studies showed significant improvement in lid retraction in the patient who received triamcinolone (all p < 0.05) as shown by ΔMRD (−0.93 mm in 1 month and −1.38 mm in 3 months), ΔMLD (−1.98 mm at 6 months), and Δpalpebral fissure height (−1.68 in 1 month). The majority of studies showed rapid improvement in lid retraction in the first month of therapy. Conclusion Triamcinolone injection is an effective therapy for lid retraction related to thyroid-associated ophthalmopathy.
Sculpting Foucauldian power in Game of Thrones as a transmedia project: a systemic functional multimodal discourse analysis
Authors: El Shazly Reham , Falaky May Samir El , Khalil Randa 
Published: May 2024

This study analyses the textual, visual and interactional modes employed in creating and representing Daenerys Targaryen in both Home Box Office TV show Game of Thrones and mobile game Reigns: Game of Thrones as a transmedia project to guide users’ construal of the notion of embodied power. The authors examine the structural, functional and semiotic elements that the two media orchestrate to represent how power is attained, developed and relinquished. The results indicate that the two texts/media put forward two different kinds of power (relations) and levels of users’ interactivity. The TV show employs a more linear and developmental conception of power characterizing Daenerys as a transferrable object of power while the game underlines a more dispersed and pervasive notion of power to decentre absolute power. The show deploys immersive cinematic representations/visual spectacle, converging/diverging serial narration that goes beyond the opulent mise-en-scène and complex scenes to attract users’ attention. As for the game, it deploys intellectual and emotional interactivity, choice and coherence that allow users to experience the story, mechanics and environment as users identify with Daenerys. While the show introduces a host of socipolitical tools to maintain longer reign as different forms of governmentality, the game characterizes disciplinary power where subjects/users are offered training opportunities under the designer’s gaze to internalize a series of procedures and sociopolitical tactics. The findings reiterate Foucault’s notion of power as a system of relations, a capillary power that circulates and subjectifies, whilst subjects/users are spaces where subtractive and productive power are wielded, enacted and/or resisted. Each medium deploys its semiotic-specific resources to create meaning differently. While the TV show relies heavily on visual resources and narrative techniques to make meaning, the game mobilizes certain verbo-visual and interactive resources to make meaning. With the growing attention given to transmedia projects as a social practice with social meanings, this article claims to offer critical implications for social semioticians, film creators and game designers through a systematic analytical framework with a special focus on visual meanings.
A multicenter study of the efficacy and safety of treatments (endovascular or conservative) in small intracranial aneurysms in Colombia
Authors: Villamizar Ana Beatriz , Estévez María Fernanda , Vargas Oliverio , Ferreira Carlos Andres , Mejia Juan Andres , Cardona José David , Serrano Sergio Eduardo , Reyes Adriana Lucia , Mantilla Daniel Eduardo 
Published: May 2024

Background The registry of cerebral aneurysms <5 mm, known for their low risk of rupture, is significant, given their high incidence globally. Our study aimed to identify, in small aneurysms (<5 mm), the potential morphological characteristics, risk factors that can predict the risk of rupture, and the risk or benefit of treating them with endovascular or conservative treatment in ruptured and unruptured intracranial aneurysms. Methods The medical records of patients with cerebral aneurysms <5 mm were retrospectively reviewed between January 2014 and December 2022 at two neurovascular centers in Colombia. We evaluated clinical and angiographic outcomes using statistical tests. Results Two hundred fifty-six patients (425 intracranial aneurysms) were registered in the database. Two hundred and seventy-five IA were treated with endovascular treatment: 70 ruptured aneurysms and 205 unruptured aneurysms. One hundred fifty intracranial aneurysms underwent conservative treatment (follow-up). Women accounted for 82.1% of cases. Most cases were incidentally diagnosed (83.5%). After a year of follow-up, 87.3% of unruptured and 67.1% of ruptured intracranial aneurysms had an mRS 0–2. In the Raymond-Roy occlusion classification, among 101 unruptured intracranial aneurysms embolized were 53 cases class I, and among 66 ruptured intracranial aneurysms embolized, 67.1% were class I. Conclusion Endovascular therapy for aneurysms <5 mm appears to be a technically feasible treatment, with satisfactory occlusion rates and few re-treatments at the 12-month follow-up. The complication rates were similar to those reported in studies on small aneurysms.