bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of a new immobilization method using a reusable 3‐point fixation cylinder system and bite‐block type immobilization methods in veterinary radiotherapy
Authors: Yoda Shinichiro , Maruo Takuya , Arai Haruka , Takahashi Rihoko , Kusaka Takuya , Nishiyama Yuta , Kayanuma Hideki 
Published: March 2024

AbstractIn veterinary radiotherapy, highly reproducible immobilization is important for accurate irradiation. Consequently, we developed a new reusable head‐immobilization method for dogs using cylinders. This study aimed to compare the accuracy of our novel immobilization method using cylinders with that of bite‐block type immobilization methods. Three immobilization methods were compared: bite‐block only, bite‐block combined with torso immobilization, and immobilization using cylinders. Five beagles with canine teeth underwent CT five times for each of the three immobilization methods. One beagle without canine teeth underwent CT 15 times using each method. Three maxillary landmarks (maxillary incisor, frontal sinus, and occipital bone) and one mandibular landmark (mandibular incisor) were established, and the errors in each immobilization method were measured. For all head landmarks, the error in the immobilization method using cylinders was the most reproducible, with the smallest errors. No significant differences were observed in the time required for immobilization. Although there were limitations (such as the use of dogs from a single breed, a single episode of anesthesia, no disassembly of the immobilization system between scans, and the same person performing the positioning on the same day), we found our new reusable immobilization method using cylinders was the most accurate among the three compared methods. This was a proof‐of‐principle study to evaluate head immobilization using cylinders, and further investigations are needed to confirm its clinical utility.
Local terrestrial snails as natural intermediate hosts of the zoonotic parasite Angiostrongylus cantonensis in the new European endemic area of Valencia, Spain
Authors: Fuentes Màrius V. , Gomez‐Samblas Mercedes , Richter Orly , Sáez‐Durán Sandra , Bueno‐Marí Rubén , Osuna Antonio , Galán‐Puchades María Teresa 
Published: March 2024

AbstractAimThe rat lungworm, Angiostrongylus cantonensis, has recently been found in the city of Valencia, parasitizing rats, Rattus norvegicus and Rattus rattus, its natural definitive hosts. This is the first finding of this zoonotic nematode in continental Europe. After informing local and national health authorities, the collection of local terrestrial snails took place with the aim of elucidating their potential role as intermediate hosts of A. cantonensis.Methods and ResultsA total of 145 terrestrial snails, belonging to the species Cernuella virgata, Cornu aspersum, Eobania vermiculata, Otala punctata, Pseudotachea splendida, Rumina decollata and Theba pisana, were randomly collected between May and December 2022 in public gardens, parks and orchards in six districts of Valencia, in five of which A. cantonensis had been reported previously in rats. Once collected and identified, the snails were frozen at −20°C. Subsequently, the DNA was isolated and screened by PCR using specific primers targeting the A. cantonensis COI gene. Seven individual snails, belonging to the species C. virgata, C. aspersum and T. pisana, were positive, for an overall prevalence of 4.8%. The PCR product from one of them was sequenced by Sanger sequencing.ConclusionsThe three positive terrestrial snail species are among the edible species that are frequently included in various dishes in Spain. C. virgata is reported as a previously unrecorded intermediate host and should be added to the list of more than 200 species of terrestrial snails that have been reported worldwide as intermediate hosts of the rat lungworm. Considering that these terrestrial snails may release infective larvae of A. cantonensis on leafy green vegetables on which they feed and during their handling and preparation for consumption, prophylactic measures to prevent human neuroangiostrongyliasis in Valencia and other regions to which this zoonotic parasite may spread are recommended.
Gravitational instantons with quadratic volume growth
Authors: Chen Gao , Viaclovsky Jeff 
Published: March 2024

AbstractThere are two known classes of gravitational instantons with quadratic volume growth at infinity, known as type and . Gravitational instantons of type were previously classified by Chen–Chen. In this paper, we prove a classification theorem for gravitational instantons. We determine the topology and prove existence of “uniform” coordinates at infinity for both ALG and gravitational instantons. We also prove a result regarding the relationship between ALG gravitational instantons of order and those of order 2.
Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain (DAS-EP project) – study protocol
Authors: Bereziartua Ainhoa , Cabrera-León Andrés , Subiza-Pérez Mikel , García-Baquero Gonzalo , Delís Gomez Salvador , Ballester Ferran , Estarlich Marisa , Merelles Antonio , Esplugues Ana , Irles Maria Angeles , Barona Carmen , Mas Rosa , Font-Ribera Laia , Bartoll X , Pérez Katherine , Oliveras Laura , Binter Anne-Claire , Daponte Antonio , García Mochon Leticia , García Cortés Helena , Sánchez-Cantalejo Garrido María del Carmen , Lacasaña Marina , Cáceres Rocío , Rueda María , Saez Marc , Lertxundi Aitana 
Published: March 2024

IntroductionThe European Environment Agency estimates that 75% of the European population lives in cities. Despite the many advantages of city life, the risks and challenges to health arising from urbanisation need to be addressed in order to tackle the growing burden of disease and health inequalities in cities. This study,Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain(DAS-EP project), aims to investigate the complex association between the urban environmental exposures (UrbEEs) and health.Methods and analysisDAS-EP is a Spanish multiregional cross-sectional project that combines population health surveys (PHS) and geographical information systems (GIS) allowing to collect rich individual-level data from 17 000 adult citizens participating in the PHS conducted in the autonomous regions of the Basque Country, Andalusia, and the Valencian Community, and the city of Barcelona in the years 2021–2023. This study focuses on the population living in cities or metropolitan areas with more than 100 000 inhabitants. UrbEEs are described by objective estimates at participants’ home addresses by GIS, and subjective indicators present in PHS. The health outcomes included in the PHS and selected for this study are self-perceived health (general and mental), prevalence of chronic mental disorders, health-related quality of life, consumption of medication for common mental disorders and sleep quality. We aim to further understand the direct and indirect effects between UrbEEs and health, as well as to estimate the impact at the population level, taking respondents’ sociodemographic and socioeconomic characteristics, and lifestyle into consideration.Ethics and disseminationThe study was approved by the regional Research Ethics Committee of the Basque Country (Ethics Committee for Research Involving Medicinal Products in the Basque Country; PI2022138), Andalusia (Biomedical Research Ethics Committee of the Province of Granada; 2078-N-22), Barcelona (CEIC-PSMar; 2022/10667) and the Valencian Community (Ethics Committee for Clinical Research of the Directorate General of Public Health and Center for Advanced Research in Public Health; 20221125/04). The results will be communicated to the general population, health professionals, and institutions through conferences, reports and scientific articles.
Developing an AI-assisted digital auscultation tool for automatic assessment of the severity of mitral regurgitation: protocol for a cross-sectional, non-interventional study
Authors: Zhang Li , Cheng Zhenfeng , Xu Dongyang , Wang Zhi , Cai Shengsheng , Hu Nan , Ma Jianming , Mei Xueqin 
Published: March 2024

IntroductionMitral regurgitation (MR) is the most common valvular heart disorder, with a morbidity rate of 2.5%. While echocardiography is commonly used in assessing MR, it has many limitations, especially for large-scale MR screening. Cardiac auscultation with electronic stethoscope and artificial intelligence (AI) can be a fast and economical modality for assessing MR severity. Our objectives are (1) to establish a deep neural network (DNN)-based cardiac auscultation method for assessing the severity of MR; and (2) to quantitatively measure the performance of the developed AI-based MR assessment method by virtual clinical trial.Methods and analysisIn a cross-sectional design, phonocardiogram will be recorded at the mitral valve auscultation area of outpatients. The enrolled patients will be checked by echocardiography to confirm the diagnosis of MR or no MR. Echocardiographic parameters will be used as gold standard to assess the severity of MR, classified into four levels: none, mild, moderate and severe. The study consists of two stages. First, an MR-related cardiac sound database will be created on which a DNN-based MR severity classifier will be trained. The automatic MR severity classifier will be integrated with the Smartho-D2 electronic stethoscope. Second, the performance of the developed smart device will be assessed in an independent clinical validation data set. Sensitivity, specificity, precision, accuracy and F1 score of the developed smart MR assessment device will be evaluated. Agreement on the performance of the smart device between cardiologist users and patient users will be inspected. The interpretability of the developed model will also be studied with statistical comparisons of occlusion map-guided variables among the four severity groups.Ethics and disseminationThe study protocol was approved by the Medical Ethics Committee of Huzhou Central Hospital, China (registration number: 202302009-01). Informed consent is required from all participants. Dissemination will be through conference presentations and peer-reviewed journals.Trial registration numberChiCTR2300069496.
Reasons, experiences and expectations of women with delayed medical care for ectopic pregnancies in Chinese urban edges: a qualitative study
Authors: Liu Jing , Liang Yulian , Su Yinzhi , Lilenga Hamza Saidi , Zhai Jinguo 
Published: March 2024

ObjectiveTo explore the experiences of patients with ectopic pregnancies with delayed medical care, with the goals to promote timely access to care, reduce subsequent physical and psychological impacts, and provide recommendations for improved management of ectopic pregnancies.DesignA qualitative study.SettingA 1000-bed urban edge hospital located in the suburban area of Guangzhou, China, between December 2022 and February 2023.Participants21 patients with delays in seeking medical care for ectopic pregnancy.Primary and secondary outcome measuresSemistructured, in-depth, face-to-face interviews were conducted to understand the experience and expectations of these women.ResultsThree main themes emerged, including delaying medical care, physical and psychological experiences, and expectations of their healthcare providers. Each of these main themes had several subthemes. The central theme of reasons for delaying medical care had five subthemes, including lack of knowledge on early symptoms of ectopic pregnancy, family dynamics and circumstances, traditional fertility ideology and intentions, avoidance of medical treatment behaviour, and medical delays. The main theme of physical and psychological experiences had two subthemes, including learnings from the experiences and negative impacts of the experiences. The main theme of expectations of their healthcare providers included three subthemes that were reducing the length of outpatient examinations and waiting times, increasing public understanding of early symptoms of ectopic pregnancy and increasing male awareness of safe contraceptive methods.ConclusionsA lack of knowledge about the early symptoms of ectopic pregnancy was the main reason for delays in seeking medical care and had a dual impact on patients’ physical and mental health, affecting their recovery and future healthcare. A collective effort from patients, families, healthcare providers and medical institutions is required for better medical education, family support, specialised professional training and local fertility policy to decrease the incidence of delayed medical care and achieve satisfactory pregnancy outcomes.
Tripartite prehabilitation of patients with acute myeloid leukaemia and high-risk myelodysplastic syndromes during intensive chemotherapy before allogeneic haematopoietic stem cell transplantation (COHABILIT): protocol for an innovating prospective multicentre study
Authors: Saillard Colombe , Cuvelier Sarah , Villaron-Goetgheluck Charlène , Boher Jean-Marie , Almeida-Lopez Leonor , Le Corroller Anne-Gaelle , Denis Pauline , Rivieccio Céline , Calvin Sarah , Vey Norbert , Bannier-Braticevic Cécile 
Published: March 2024

ObjectivesAcute myeloid leukaemia (AML) and high-risk myelodysplastic syndromes (MDS) are often treated with intensive chemotherapy followed by allogeneic haematopoietic stem cell transplantation (allo-HSCT). The pretransplant treatment results in a general deterioration of the patient’s health and quality of life. Furthermore, allo-HSCT can be responsible for significant toxicity with risks of graft-versus-host disease (GvHD). Developing strategies to prevent physical deconditioning, undernutrition and psychological distress could help maintain a satisfactory general state of health before transplantation and thus limit these deleterious effects. This protocol evaluates the feasibility and adherence to a personalised prehabilitation programme, which can be modulated and assisted by connected objects, provided from the diagnosis to the allo-HSCT.Methods and analysisThis multicentre interventional study will include 50 patients treated for AML or high-risk MDS with intensive chemotherapy and eligible for allo-HSCT. The intervention consists of a coached, supervised or self-directed physical activity programme, organised during the hospitalisation phases and periods at home. At the same time, patients will receive a weekly dietary follow-up. The whole intervention is controlled and modulated through the use of a dedicated application and connected objects allowing adaptation and individualisation. The rate of participation in the prescribed physical activity sessions will assess the feasibility of this study. In addition, the evolution of physical capacities (Short Physical Performance Battery, grip and quadriceps strengths), psychosocial parameters (Functional Assessment of Cancer Therapy - Leukaemia, Functional Assessment of Cancer Therapy - Fatigue, subjective well-being, Hospital Anxiety and Depression Scale, self-efficacy, Coach-Athlete Relationship Questionnaire, interviews) and clinical status (weight, lean body mass, survival rate, number of infections, days of hospitalisation, GvHD) will be evaluated.Ethics and disseminationThe study procedures have been approved by the National Ethics Committee (21.00223.000003). Consent is given in person by each participant. The information collected on the participants contains only a non-identifiable study identifier. The results of this protocol will be published in a scientific paper and communicated to the medical staff of the medical centre.Trial registration numberNCT03595787.
Iranian nurses’ attitudes towards the disclosure of patient safety incidents: a qualitative study
Authors: Irani Parichehr Sabbaghzadeh , Dehghan Mahlagha , Mehdipour Roghayeh 
Published: March 2024

ObjectiveStatistics suggests that patients and officials are unaware of a large number of patient safety incidents in healthcare centres. This study aimed to explore the concept of disclosure of patient safety incidents from the perspectives of Iranian nurses.DesignQualitative content analysis.SettingThe study population was nurses working in hospitals affiliated with The Hormozgan University of Medical Sciences, military hospitals and private hospitals in Bandar Abbas, Iran. Sampling was done from January 2021 to September 2021.Participants11 female and 6 male nurses aged 27–59 years with a work experience of 3–34 years were included.Primary and secondary outcome measuresThis qualitative content analysis was to explore the experiences of Iranian nurses (n=17) using purposive sampling and semistructured, in-depth interviews. Maximum variation sampling (age, sex, work experience, education level, type of hospital and type of ward) was considered to obtain rich information. Guba and Lincoln criteria were used to increase the study’s trustworthiness and rigour, and the Graneheim and Lundman method and MAXQDA 2020 were used to analyse data.ResultsWe extracted one theme, four categories and nine subcategories. The main theme was the mental schemas of disclosure of patient safety incidents with four categories: (1) misconceptions of harm to the organisation or self, (2) attributes of the disclosure process and its outcomes, (3) reactions to the disclosing incidents and (4) interpersonal conflicts.ConclusionOur study identified factors influencing the disclosure of patient safety incidents among nurses, including concerns about reputation, fear of consequences and perceptions of the disclosure process. Positive attitudes towards incident disclosure were associated with supportive organisational environments and transparent communication. Barriers to disclosure included patient and companion reactions, misinterpretation and anxiety. Healthcare organisations should foster a non-punitive reporting culture to enhance patient safety and accountability.
Comparative efficacy and safety of different surgical approaches for the treatment of anterior cruciate ligament injury: a Bayesian network meta-analysis protocol
Authors: He Yuchen , Fan Yishu , Zhai Longxiang , Zhu Weihong 
Published: March 2024

IntroductionAnterior cruciate ligament (ACL) rupture can be treated surgically or non-surgically, with several surgical interventions available at present. However, the comparatively effective surgical intervention with relatively fewer side effects remains unknown. This study aims to fill in this gap by conducting a Bayesian network meta-analysis (NMA) and provide a theoretical basis for the clinical application.Method and analysisWe will perform a Bayesian NMA and will include randomised controlled trials (RCTs) published in English or Chinese that compare surgical intervention (ie, standard ACL reconstruction, ACL remnant-preserving reconstruction and ACL repair with suture augmentation to conservative therapy or studies that compare one surgical intervention to another for the symptom relief and function recovery of patients with ACL rupture. Primary outcome will be the proportion of patients with symptomatic and functional improvement measured by the Knee Injury and Osteoarthritis Outcome Score before and 6 months after treatment, with scores ranging from 0 (worst) to 100 (best). Secondary outcomes will be knee-specific quality of life (ACL QoL), return to activity and level of sport participation (Tegner or modified Tegner score), health-related QoL (EuroQol Group 5-Dimension 5-Level, EQ-5D-5L), resource use, intervention-related complications and patient satisfaction. We have developed search strategies for PubMed, Embase, the Cochrane Library and Web of Science, retrieving RCTs that meet the inclusion criteria from database inception to 1 December 2023. The methodological quality of the included RCTs will be assessed based on the Cochrane risk of bias table. The relative ranking probability of the best intervention will be estimated using the surface under the cumulative ranking curve. The Bayesian NMA will be conducted by using WinBUGS V.1.4.3. The Grading of Recommendations Assessment, Development and Evaluation approach will be applied to determine our confidence in an overall treatment ranking from the NMA.Ethics and disseminationEthical approval for this study is not required because no private or confidential patient data will be used in this study. Findings of this study would be disseminated through the publication in a peer-reviewed medical journal.PROSPERO registration numberCRD42023437115.
Impairment of health-related quality of life and its determinants among patients with podoconiosis in East Wollega Zone, Oromia Regional State, Ethiopia: institutional-based cross-sectional study
Authors: Geta Edosa Tesfaye , Guteta Temesgen Oluma , Tiruneh Gemechu 
Published: March 2024

ObjectiveThis study aimed to assess the impairment of health-related quality of life (HRQoL) and its determinants among patients diagnosed with podoconiosis in East Wollega Zone, Oromia Regional State, Ethiopia.MethodsAn institutional-based cross-sectional study design was used in the setting of primary healthcare facilities to assess impaired HRQoL among patients with podoconiosis in the East Wollega Zone from 1 March 2023 to 30 April 2023, using the Dermatologic Life Quality Index (DLQI). Data was collected from 494 patients with podoconiosis, and a multistage sampling technique was employed. The data was entered into EpiData V.4.6 and exported to SPSS V.27 for analysis. A linear regression model with a 95% cofidence interval (CI) was used to estimate level of HRQoL and to identify its determinants estimating beta (β) coefficient declaring the significance level at p<0.05.ResultsThe quality of life among patients was impaired on average by 9.6±6.1 with the lowest DLQI Score in the domain of treatment (0.8±0.97) and the highest in the domain of daily activity (2.3±1.72). The identified significant determinants of impairment of HRQoL associated with DLQI scores were duration of disease (95% CI, β=0.11 (0.08 to 0.15)), acute dermato-lymphangio-adenitis (ADLA) (95% CI, β=0.08 (0.01 to 0.16)), comorbidity (95% CI, β=1.26 (0.37 to 2.16)), consistently wearing shoes (95% CI, β=−0.06 (–0.09 to –0.03)), feeling of stigmatised (95% CI, β=0.21 (0.16 to 0.25)) and psychological distress (95% CI, β=0.17 (0.14 to 0.21)) and being female (95% CI, β=1.16 (0.19 to 2.12)).ConclusionOverall, HRQoL among patients with podoconiosis was moderately impaired. The duration of disease, ADLA, comorbidity, stigma, psychological distress and being female in sex significantly impaired HRQoL, whereas consistently wearing shoes significantly improved HRQoL among the patients with podoconiosis. Therefore, healthcare providers and public health experts should work on educating communities and counselling patients to avoid stigma and psychological distress, wearing shoes consistently and treating podoconiosis and other comorbidities among these patients.