bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of social and behavioral change interventions on minimum dietary diversity among pregnant women and associated socio-economic inequality in Rajasthan, India
Authors: Sharma Anshita , Chanda Srei , Porwal Akash , Wadhwa Namita , Santhanam Divya , Ranjan Raghwesh , Shah Hemang , Adyanthaya Shachi , Meena Ramavatar 
Published: June 2024

Abstract
Background
Maternal dietary diversity is a key to improving the birth and child health outcomes. Besides socio-economic factors, the nutrition specific program- Social and Behavioural Change Communication (SBCC) interventions aimed to improve maternal dietary diversity has varied levels of impact on the socio-economic groups in poor resource setups.

Objective
To measure the factors associated with the minimum dietary diversity (MDD) among pregnant women in selected districts of Rajasthan with special emphasis on the SBCC components. Additionally, it measures the socio-economic gaps in the behaviour of consumption of diversified diet during pregnancy.

Methods
Data from a cross sectional survey of 6848 pregnant women, who have received a continuous SBCC counselling and registered under a state introduced conditional cash transfer program, during May to June, 2023, in five intervention districts -Banswara, Baran, Dunagrpur, Pratapgarh and Udaipur in Rajasthan was used. A 24 h recall based food consumption behaviour has been gathered to measure the MDD of pregnant women. Study has used descriptive statistics, multivariate regressions, and multivariate decomposition analysis to address the research objectives.

Results
Study finds that only 55.2% of pregnant women are consuming diverse diet in the study duration with mean dietary diversity score is 4.8 (+/- 1.5). Logistic regression finds that SBCC components such as frontline workers (aOR = 1.3, CI: 1.1–1.4), community motivators (aOR = 1.9, CI: 1.7–2.1), and participation in MCHND (aOR = 1.0, CI: 0.9-1.2) have significant and higher likelihood on consumption of MDD food on previous day. A higher education and belonging from richer wealth quintile also show higher association for consumption of MDD. Multivariate decomposition shows, among richest and poorest wealth categories there is 19% point difference (58% difference due to coefficient vs. 42% difference due to composition) in MDD consumption. This is positively contributed by the caste and educational categories of women.

Conclusion
Despite a predominant vegetarian diet consuming population, better maternal dietary diversity was observed among those exposed to higher dose of SBCC intervention package. Educational status and caste of the respondent were significantly associated with minimum dietary diversity and contributed to the socio-economic inequality highlighting the importance of tailored and sustained SBCC interventions.
The relationship between body composition and left ventricular performance in women with breast, lymphoma, or sarcoma cancer
Authors: Mabudian Leila , Reding Kerry , D’Agostino Ralph B. , Heiston Emily M. , Bellissimo Moriah P. , Olson Kristine , Ntim William O. , Klepin Heidi D. , Dressler Emily V. , Moore Tonya , Jordan Jennifer H. , O’Connell Nathaniel S. , Ladd Amy , Weaver Kathryn E. , Ky Bonnie , Wagner Lynne I. , Hackney Mary Helen , Lesser Glenn J. , Hundley W Gregory ,   The UPBEAT Study Team
Published: June 2024

Abstract
Background
To understand how body composition in those with elevated body mass index impacts left ventricular function decline during cancer treatment, we determined the association between baseline body mass index (BMI), intra-abdominal adipose tissue (IAT) and subcutaneous adipose tissue (SAT) with baseline to 3-month left ventricular ejection fraction (LVEF) change among women receiving potentially cardiotoxic chemotherapy for breast cancer, lymphoma, or sarcoma.

Methods
Women underwent potentially cardiotoxic chemotherapy, such as doxorubicin, cyclophosphamide, paclitaxel, and trastuzumab, for treatment of breast cancer, lymphoma, or sarcoma. We obtained magnetic resonance images (MRIs) of body composition and cardiac function prior to treatment, and then a repeat MRI for cardiac function assessment at three months into treatment. Analyses and assessment of abdominal adipose tissue volumes and LVEF outcomes were conducted by independent reviewers blinded to all patient identifiers. A general linear model was created to examine associations between adipose tissue depots, BMI, and 3-month LVEF change.

Results
Women (n = 210) aged 56 ± 11 years with breast cancer, lymphoma, and sarcoma were enrolled (n = 195, 14, 1 respectively). Baseline BMI, IAT, and SAT fat were independently associated with 3-month LVEF declines (p = 0.001 to 0.025 for all). After adjusting for baseline cardiovascular disease risk factors, BMI, IAT, and SAT, BMI remained the only variable associated with 3-month LVEF decline (p = 0.047).

Conclusions
These results suggest that factors other than abdominal adipose tissue or traditional cardiovascular risk factors may contribute to 3-month declines in LVEF among women with elevated BMI receiving potentially cardiotoxic chemotherapy. Further investigation should be conducted on psychosocial stress, physical activity, sleep, or diet.

Trial registration
DETECTIV_NCT01719562, WF99112, & WF97415—NCT02791581.
The achievement of pre-operative expectations in patients undergoing knee arthroplasty: a cohort study evaluating unique patient goals
Authors: Karunaratne Sascha , Harris Ian Andrew , Horsley Mark , Trevena Lyndal , Solomon Michael 
Published: June 2024

Abstract
Background
Total knee arthroplasty (TKA) is a common procedure employed to treat end-stage osteoarthritis. While TKA is generally believed to have acceptable outcomes, many patients report pain or functional deficits not in line with their expectation following the procedure. It has been postulated that patient’s pre-operative expectations regarding post-operative treatment outcomes play a significant role in satisfaction. It is therefore important to assess if the outcomes of surgery truly align with patient’s individual expectations. Thus, the purpose of this study was to determine the degree to which patient expectations of TKA are achieved and the contribution of TKA to achieving patient goals one year after surgery.

Methods
A consecutive sample of 110 patients booked for total knee arthroplasty were asked to identify their most important goals to inform the Direct Questioning of Objectives Index (DQO Index, range 0 to 1) and identify their surgical goals and grade their expectation that a knee arthroplasty would achieve each goal on an 11-point scale. One year after surgery, the DQO Index was repeated to assess their current ability to achieve each pre-operative goal, and asked to estimate the contribution of their knee arthroplasty in achieving each goal. Mean differences between baseline and one year follow-up were calculated regarding the DQO Index and expected achievement of pre-operative goals.

Results
According to the DQO Index at one year, patients improved from a poor quality of life pre-operatively (mean ± standard deviation: 0.20 ± 0.18) to moderately high quality of life (mean ± standard deviation: 0.71 ± 0.21) reflecting a large improvement in ability to achieve each goal. Although achievement improved, for each goal, the patient estimates of the extent to which the knee arthroplasty had contributed to achieving the goal was lower than their initial expectation provided pre-operatively (mean difference range: 0.6 to 1.9 on an 11-point scale).

Conclusion
Patients undergoing TKA have high expectations that their surgery will address their primary goals. Despite surgery largely achieving these goals (improved pain and function), the extent to which the goals were achieved was lower than patients had expected pre-operatively.
Diagnosis and treatment of Parkinson´s disease (guideline of the German Society for Neurology)
Authors: Höglinger Günter ,   German Parkinson’s Guidelines Committee, Bähr Mathias , Becktepe Jos , Berg Daniela , Brockmann Kathrin , Buhmann Carsten , Ceballos-Baumann Andrés , Claßen Joseph , Deuschl Cornelius , Deuschl Günther , Dodel Richard , Ebersbach Georg , Eggers Carsten , van Eimeren Thilo , Fanciulli Alessandra , Fimm Bruno , Folkerts Ann-Kristin , Gausepohl Madeleine , Hasan Alkomiet , Hermann Wiebke , Hilker-Roggendorf Rüdiger , Höglinger Günter , Höllerhage Matthias , Hopfner Franziska , Jost Wolfgang , Kalbe Elke , Kassubek Jan , Klebe Stephan , Klein Christine , Klietz Martin , Koeglsperger Thomas , Kühn Andrea , Krack Paul , Krismer Florian , Kuhlenbäumer Gregor , Levin Johannes , Liepelt-Scarfone Inga , Lingor Paul , Loewenbrück Kai , Löhle Matthias , Lorenzl Stefan , Maaß Sylvia , Maetzler Walter , Menzel Regina , Meyer Philipp T , Mollenhauer Brit , Neumann Manuela , Odin Per , Outeiro Tiago , Pötter-Nerger Monika , Reese René , Reetz Kathrin , Rieß Olaf , Ruf Viktoria , Schneider Anja , Schrader Christoph , Schnitzler Alfons , Seppi Klaus , Sixel-Döring Friederike , Storch Alexander , Tönges Lars , Trenkwalder Claudia , Walter Uwe , Wächter Tobias , Warnecke Tobias , Wegner Florian , Winkler Christian , Witt Karsten , Woitalla Dirk , Zeuner Kirsten , Trenkwalder Claudia 
Published: June 2024

Abstract
Introduction
The aim of this German national guideline is to optimize the clinical care of patients with Parkinson's disease (PD) in terms of diagnostics, drug and surgical treatment and care.

Summary or definition of the topic
This guidance was prepared for the German Society of Neurology (DGN) in collaboration with the Austrian Society of Neurology (ÖGN) and the Swiss Neurological Society (SNG) for German-speaking countries. The guidelines for the diagnosis and treatment of PD have been revised by a national expert group and the guideline commission of the DGN at S2k level. The main objective of these guidelines is to optimize the clinical care of PD patients regarding diagnosis, including early detection, technical diagnostic examinations, and pharmacological as well as invasive treatment options.

Recommendations
The updated PD diagnosis and treatment guidelines are emphasizing optimized clinical care. Key revisions include preferring the name "Parkinson's disease" over previous terms and adopting International Parkinson and Movement Disorder Society (MDS) diagnostic criteria. Recommendations cover genetic and imaging diagnostics, initial pharmacotherapy considering efficacy and patient factors, and tailored pharmacological combinations for complications. Guidelines extend to managing cognitive, affective, psychotic, and autonomic symptoms, along with non-oral therapies like pump therapy and deep brain stimulation. Special situations like akinetic crisis, driving ability, and care concepts are addressed, ensuring comprehensive management for PD patients at various stages and conditions.

Conclusions
This guidance reflects the state of the art at the beginning of 2024.
Prevalence and predictors of depression, anxiety, and stress among refugees in Egypt
Authors: El-Ghitany Engy M. , Ashour Ayat , Elrewany Ehab , Farghaly Azza G. , Shata Zeinab 
Published: June 2024

Abstract
Background
Many Refugees show multiple distressing psychological and mental health problems associated with stressful and adverse conditions in host countries. Even though Egypt is one of the top five destination countries hosting refugees and asylum-seekers in the MENA region, there is a lack of studies investigating mental health problems among refugees in Egypt. This study aimed to assess the prevalence and predictors of depression, anxiety, and stress symptoms among refugees living in Egypt.

Methods
A total of 398 refugees aged 18 and above were interviewed from migrants’/refugees' community centers in Giza, Alexandria, Dakahlia, and Damietta governorates. A predesigned structured interview questionnaire was used to collect socio-demographic and migration-related variables. The Arabic Version of Depression Anxiety Stress Scales (DASS-21) was used to assess the presence and severity of the three negative emotional states.

Results
Nearly two-thirds of the participants were Syrian (66.4%). The majority resided in Alexandria and Giza governorates (75.9%), were females (73.4%), and were married (71.1%). The most reported migration difficulty was housing (41.5%). Anxiety symptoms were reported among 63.3% (95% CI: 58.59%- 68.05%) of sampled refugees, followed by depression (61.3%, 95% CI: 56.52%-66.10%), and stress symptoms (51.5%, 95% CI: 46.56%-56.36%). Results of regression analysis showed that; female gender predicted anxiety (aOR 2.419, 95% CI: 1.485–3.941, p < 0.001) and stress (aOR 2.053, 95% CI: 1.197–3.519, p = 0.009), while younger age groups (18–25 yr. and 26–50 yr.) compared to the older age group (51 yr. and older) predicted depression (aOR 4.529, 95% CI: 1.696–12.097, p = 0.003 and aOR 2.177, 95% CI: 1.270- 3.733, p = 0.005, respectively) and stress (aOR 4.334, 95% CI: 1.556–12.074, p = 0.005 and aOR 1.808, 95% CI: 1.023–3.193, p = 0.041, respectively). Residence in Alexandria, housing, and employment difficulties predicted anxiety (aOR 2.354, 95% CI: 1.420–3.902, p < 0.001, aOR 1.726, 95% CI: 1.073–2.778, p = 0.025, and aOR 3.044, 95% CI: 1.248–7.425, p = 0.014, respectively), depression (aOR 1.949, 95% CI: 1.163–3.266, p = 0.011, aOR 1.666, 95% CI: 1.036–2.681, p = 0.035, and aOR 3.216, 95% CI: 1.321–7.828, p = 0.010, respectively), and stress (aOR 2.450, 95% CI: 1.431–4.195, p < 0.001, aOR 1.911, 95% CI: 1.187–3.078, p = 0.008, and aOR 4.482, 95% CI: 1.867–10.760, p < 0.001, respectively).

Conclusion
Mental health problems are prevalent among the refugee population in Egypt that are compounded by the difficult post-migration socio-economic situation. Multisectoral attention towards refugees’ mental health is urgently needed.
Ultrasound-guided foam sclerotherapy versus four-layer compression only for treatment of chronic venous ulcers
Authors: Issa Ahmed Sayed Ibrahim , Ibrahim Riham , Ayad Michael Samuel , Nagy Momen , Zaher Azza M. Abdel , Yassin Ahmed M. 
Published: June 2024

Abstract
Background
Chronic venous ulcers are prevalent, its incidence (1%) in the general population. Venous ulcers are quite a challenge for physicians to treat. Among the numerous pathological causes, venous hypertension remains the leading cause. This study aims to compare the safety, efficacy, short-term complications, factors affecting wound healing as well as pathological outcomes of ultrasound-guided foam sclerotherapy (UGFS) in conjunction with the four-layer compression bandage in the management of chronic venous ulcers.

Methods
Retrospective analysis of a hundred patients with chronic venous ulcers treated between December 2018 and December 2021. Two groups were studied: the control group, which received conventional compression, and the study group, which underwent injection sclerotherapy and conventional compression. Punch skin biopsies were taken from both groups before and after treatment to compare the histological effects of the two methods.

Results
Complete healing was achieved in 100% of the patients, with a shorter healing time in the study group (34.82 ± 4.7). Additionally, the degree of inflammation was significantly decreased but there was a higher local complication rate in the study group.

Conclusions
UGFS in conjunction with the compression bandage showed superior clinical and pathological results but, risk of complication was increased.
Role of diaphragmatic ultrasound in predicting weaning success from mechanical ventilation in pediatric intensive care unit
Authors: Eskander Amir Maurice , Abd-Elhameed Abeer Maghawry , Osman Noha Mohamed , Magdy Sondos Mohamed , ElKess George Ezzat 
Published: June 2024

Abstract
Background
Weaning off mechanical ventilation (MV) is a critical step in pediatric ICU; however, it lacks standardized criteria. Diaphragmatic ultrasound parameters like diaphragm thickening fraction (DTF), diaphragmatic excursion (DE) and time to peak inspiratory amplitude (TPIA) can be used to assess diaphragmatic muscle strength and to predict weaning success.

Aim of study
Is to assess the validity of diaphragmatic ultrasonography as a predictor of weaning outcome from mechanical ventilation in pediatric age group.

Methods
Prospective cohort study including 30 pediatric patients aged 0–18 years on mechanical ventilation. Ultrasound measurements of diaphragmatic thickening fraction, diaphragmatic excursion and time to peak inspiratory amplitude were taken during the spontaneous breathing trial (SBT) and compared between successful and failed weaning groups.

Results
Out of the included 30 patients (50% male), 19 patients (63.3%) were successfully weaned. Mechanical ventilation duration was significantly longer in the failed weaning group (P = 0.017). There was significant difference between both groups regarding right DE (P = 0.032) and left DE (P = 0.022) with cutoff values of > 4.1 mm and > 5.5 mm with AUC (Area under curve) of 0.737 and 0.831, respectively. There was no statistically significant difference between both groups regarding DTF or TPIA.

Conclusion
We have found that DE is a predictor of weaning success, while DTF and diaphragmatic TPIA had no correlation with weaning outcome.
From parental responsibility towards mutual understanding: reimagining the employment of epigenetic knowledge
Authors: Moormann Emma 
Published: June 2024

AbstractThis paper is interested in normative translations of findings in intergenerational epigenetics. Particularly, what role can and should epigenetic knowledge play in our normative thinking about parenthood and relationships such as those between individual parents and broader society or between parents and their children? How should epigeneticists engage in science communication to ensure that knowledge of intergenerational epigenetic effects is useful rather than harmful to parents and children? Much of the existing literature on the ethical aspects of epigenetics points out worrisome tendencies of epigenetic knowledge inspiring policies and discourses that lead to blaming and stigmatization of individual parents and women in particular. While such warnings are important, they are not the only shape ethical discussion of intergenerational epigenetics can take. Firstly, this paper claims that it is also worthwhile and necessary to imagine potential positive effects of epigenetic knowledge on parents and their children. It will be argued that an approach that focuses on empowerment of individual parents and children rather than general responsibility distributions fits will with a nonideal approach to normative theory that takes into account the unequal distributions of social, economic and material resources among parents. The second part of this paper explores whether narrative identity is a useful concept to imagine such a positive framework for the employment of epigenetic knowledge. It argues that integration of epigenetic knowledge in a shared narrative identity may benefit mutual understanding and self-knowledge, and perhaps also have an empowering effect on parents, children and families. After discussing the risks of (1) attaching too much weight to etiology and (2) any epigenetics discourse playing into ‘bionormativity’, the paper concludes that epigenetic knowledge can and should be used in a framework that goes beyond deterministic etiologies but embraces the complexities and interrelatedness of all factors influencing the health of future generations.
Consensus-Based Guidelines for Acute Myeloid Leukemia Management in Gulf Cooperation Council Countries: Addressing Unmet Regional Needs and the Changing AML Landscape
Authors: Al-Khabori Murtadha K. , Alhuraiji Ahmad , Alam Arif R. , Khan Faraz A. , El Omri Halima , Osman Hani Y. , AaL Yaseen Hasan M. , Al Bulushi Mahdiya Pir , Pandita Ramesh K. , Marashi Mahmoud M. 
Published: June 2024

PURPOSE AML is a heterogeneous hematologic malignancy. Region-specific recommendations for AML management can enhance patient outcomes. This article aimed to develop recommendations for the Gulf Cooperation Council (GCC) countries. METHODS Ten AML panel members from Kuwait, Oman, Qatar, and the United Arab Emirates (KOQU) participated in a modified two-round Delphi process. The panel first identified the unmet regional needs and finalized a list of core variables. Next, they voted on iterative statements drawn from international recommendations and provided feedback via a questionnaire. Consensus voting ≤70% was discussed, and additional clinical decision making statements were suggested. At round closure, a consensus vote took place on revised statements. RESULTS The panel reached ≥97.8% consensus on AML management. The panel agreed to use international risk stratification categories for personalized treatment of AML. The presence of ≥10% blasts for recurrent genetic abnormalities was required for a diagnosis of AML. Key consensus was reached for different treatment stages. The panel noted that older patients pose a challenge because of poor cytogenetics and genetic anomalies and require different treatment approaches. The panel recommended venetoclax-hypomethylating agents; fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor; and targeted therapy for AML relapsed/refractory disease. Supportive care is considered on the basis of prevailing organisms and drug resistance. CONCLUSION The GCC KOQU's consensus-based recommendations for managing AML include an evidence-based and region-specific framework.
Impact of exposure on outcomes with enfortumab vedotin in patients with locally advanced or metastatic urothelial cancer.
Authors: Petrylak Daniel P. , Chia Yen Lin , Yu Evan Y. , Powles Thomas , Flaig Thomas W. , Loriot Yohann , O'Donnell Peter H. , Heath Elisabeth I. , Kojima Takahiro , Park Se Hoon , Sonpavde Guru P. , Picus Joel , Matsubara Nobuaki , Obara Wataru , Chudasama Vaishali , Poondru Srinivasu , Harrison Michael , Kim Eric , Brancato Sam Joseph , Rosenberg Jonathan E. 
Published: June 2024

4503 Background: Enfortumab vedotin (EV) is approved in combination with pembrolizumab and as a monotherapy for locally advanced or metastatic urothelial cancer (la/mUC). EV, alone and in combination with pembrolizumab, has demonstrated an OS benefit and a generally manageable safety profile in patients (pts) with previously treated or untreated la/mUC. Dose modifications, including reductions and interruptions, are recommended to manage EV-related AEs. This analysis evaluates the association between EV plasma exposure, which is impacted by dose modifications, and safety and efficacy outcomes. Methods: Characterization of dose- and exposure-response for efficacy and exposure-response for safety outcomes included pts in EV-101 (EV monotherapy 0.75, 1.0, and 1.25 mg/kg on days 1, 8, and 15 of a 28-day cycle [3Q4W]), EV-201, and EV-301 (EV monotherapy 1.25 mg/kg 3Q4W). Time-averaged exposure up to an event of interest, Cavg, was computed using a population PK model. PK assessment included multiple samples in first 2 cycles, and pre-dose samples in subsequent cycles. Results: Dose modifications were common, including dose reductions to 1.0 mg/kg (EV-201 42.1%; EV-301 35.1%) and 0.75 mg/kg (EV-201 13.6%; EV-301 11.1%). EV showed consistent improvement in median PFS and OS vs chemotherapy across all exposure quartiles in EV-301 inclusive of dose modifications (Table). Greater initial EV exposure in the first 2 cycles was associated with a higher ORR and was consistent with dose-response (0.75 mg/kg 21.4% [sample size {n} = 14]; 1.0 mg/kg 18.5% [n = 27]; 1.25 mg/kg 40-51.1% across studies [n = 613]). Lower EV exposure was associated with lower risk of EV-related Grade ≥3 rash or skin reactions, Grade ≥2 peripheral neuropathy, and Grade ≥3 hyperglycemia (P<0.0001 for all). Conclusions: EV improved PFS and OS outcomes vs chemotherapy in pts with la/mUC across all exposure quartiles. The starting dose of 1.25 mg/kg 3Q4W resulted in EV exposure that maximized likelihood of response. Recommended dose modifications are effective for managing EV-related AEs and should be used as clinically indicated. Clinical trial information: NCT02091999 , NCT03219333 , and NCT03474107 . [Table: see text]