bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and content validation of a financial and functional outcomes tool for diabetes-related foot disease in patients undergoing major lower limb amputation: a prospective observational study from Pakistan
Authors: Siddiqui Nadeem Ahmed , Khaliq Muhammad Anees , Pirzada Muhammad Ammar , Rehman Ziaur , Shaikh Fareed , Riaz Amna , Khan Sadaf 
Published: March 2024

ObjectiveTo develop and content validate a questionnaire to assess the financial and functional impact of major lower limb amputation in patients with diabetes-related foot disease.DesignProspective observational study.SettingThis study was conducted at a tertiary care centre in Pakistan.ParticipantsWe conducted a thorough literature review and a group interview with 10 participants, resulting in domain identification and item generation. The group included seven patients with diabetes-related foot disease who underwent major lower limb amputation and three caregivers. Subsequently, a focused group discussion was held to assess overlap and duplication among the items, and two rounds of content validation were carried out by five content and five lay experts in both English and Urdu. Question items with a Content Validity Index (CVI) score of >0.79 were retained, items with a CVI score between 0.70 and 0.79 were revised and items with a CVI score of <0.70 were excluded.ResultsThe initial literature review and group interview resulted in 61 items in the financial and functional domains. After the focused group discussion, the questionnaire was reduced to 37 items. Following two rounds of content validation, the English questionnaire achieved the Scale-Content Validity Index/Average (S-CVI/Ave) of 0.92 and 0.89 on relevance and clarity, respectively. Similarly, the Urdu questionnaire achieved the S-CVI-Ave of 0.92 and 0.95, respectively.ConclusionA 37-item multidimensional questionnaire was developed and rigorously content-validated to assess the financial and functional impact of major lower limb amputation in patients with diabetes-related foot disease. The questionnaire used in this study has shown robust content validity specifically for our population.
impHFrEF trial: study protocol for an open-label, multicentre study of improvement the outcome of patients with heart failure in China using a mobile hEalth-supported platForm
Authors: Chen Fuzhong , Li Guangjuan , Zhang Xinxin , Shen Qin , Wang Fangfang , Dong Xiaoyu , Zou Yu , Chen Wensen , Xu Bing , Wang Junhong 
Published: March 2024

BackgroundPatients with chronic heart failure (CHF) often have a long duration of illness, difficulty in attending follow-up visits, and poor adherence to treatment. As a result, they frequently cannot receive guideline-directed medical therapy (GDMT) at the desired or maximum tolerable drug dosage. This leads to high hospitalisation and mortality rates for HF patients. Therefore, effective management and monitoring of patients with HF to ensure they receive GDMT is crucial for improving the prognosis.Design and methodsThis is a multicentre, open-label, randomised, parallel-group study involving patients with CHF across five centres. The study aims to assess the impact of an optimised GDMT model for HF patients, established on a mobile health (mHealth) platform, compared with a control group. Patients must have a left ventricular ejection fraction of less than 50% and be receiving medication titration therapy that has not yet reached the target dose, with a modest increase in N-terminal pro-B-type natriuretic peptide level. The primary composite outcome is worsening HF events (hospitalisation or emergency treatment with intravenous fluids) or cardiovascular death.Ethics and disseminationOn 22 December 2021, this study received ethical approval from the Ethics Review Board of the First Affiliated Hospital of Nanjing Medical University, with the ethics number 2021-SR-530. All study participants will be informed of the research purpose and their participation will be voluntary. Informed consent will be obtained by providing and signing an informed consent form. We will ensure compliance with relevant laws and regulations regarding privacy and data protection. The results of this study will be published in a peer-reviewed academic journal. We will ensure that the dissemination of study results is accurate, clear and timely.Trial registration numberChiCTR2200056527.
Time elapsed from definitive diagnosis to surgery for osteonecrosis of the femoral head: a nationwide observational study in Japan
Authors: Nakamura Junichi , Fukushima Wakaba , Ando Wataru , Hagiwara Shigeo , Kawarai Yuya , Shiko Yuki , Kawasaki Yohei , Sakai Takashi , Ito Kazuya , Arishima Yoshiya , Chosa Etsuo , Fujimoto Yusuke , Fujiwara Kazuo , Hasegawa Yukiharu , Hayashi Shinya , Imagama Takashi , Inaba Yutaka , Ishibashi Yasuyuki , Ishidou Yasuhiro , Ito Hideya , Ito Hiroshi , Ito Juji , Jinno Tetsuya , Kabata Tamon , Kaku Nobuhiro , Kaneuji Ayumi , Kishida Shunji , Kobayashi Seneki , Komiya Setsuro , Kubo Toshikazu , Majima Tokifumi , Mashima Naohiko , Mawatari Masaaki , Miki Hidenobu , Miyatake Kazumasa , Motomura Goro , Nagoya Satoshi , Nakamura Hiroaki , Nakamura Yoshihide , Nakanishi Ryosuke , Nakashima Yasuharu , Nakasone Satoshi , Nishii Takashi , Nishiyama Takayuki , Ohta Yoichi , Ohzono Kenji , Osaki Makoto , Sasaki Kan , Seki Taisuke , Shishido Takaaki , Shoji Takeshi , Sudo Akihiro , Takagi Michiaki , Takahashi Daisuke , Takao Masaki , Tanaka Sakae , Tanaka Takeyuki , Tetsunaga Tomonori , Ueshima Keiichiro , Yamamoto Kengo , Yamamoto Takuaki , Yamamoto Yuji , Yamasaki Takuma , Yasunaga Yuji , Sugano Nobuhiko 
Published: March 2024

ObjectivesThis study documents the time elapsed from the diagnosis of osteonecrosis of the femoral head (ONFH) to surgery, exploring the factors that influence ONFH severity.DesignRetrospective observational study of a nationwide database.SettingThe Kaplan-Meier method with log-rank tests was applied to examine the period from definitive diagnosis of ONFH to surgery using any surgery as the end point. For bilateral cases, the date of the first surgery was the endpoint.ParticipantsThis study included 2074 ONFH cases registered in 34 university hospitals and highly specialised hospitals of the multicentre sentinel monitoring system of the Japanese Investigation Committee between 1997 and 2018.Main outcome measureThe primary outcome was the time from diagnosis to surgery. The secondary outcome was the proportion of subjects remaining without surgery at 3, 6 and 9 months, and at 1, 2 and 5 years after diagnosis.ResultsThe median time to surgery was 9 months (IQR 4–22 months) after diagnosis of ONFH. The time to surgery was significantly shorter in the alcohol alone group and the combined corticosteroid and alcohol group than in the corticosteroid alone group (p=0.018 and p<0.001, respectively), in early stage ONFH with no or mild joint destruction (stages II and III, p<0.001), and with joint preserving surgery (p<0.001). The proportion without surgery was 75.8% at 3 months, 59.6% at 6 months, 48.2% at 9 months, 40.5% at 1 year, 22.2% at 2 years and 8.3% at 5 years.ConclusionONFH has been considered to be an intractable disease that often requires surgical treatment, but the fact that surgery was performed in more than half of the patients within 9 months from diagnosis suggests severe disease with a significant clinical impact.Trial registration numberChiba University ID1049.
Novel scoring system provides high separation of diploidy and triploidy to aid partial hydatidiform mole diagnosis: an adaption ofHER2D-DISH for ploidy analysis
Authors: Joyce Caroline M , Dineen Susan , Deane Julie , Conlon Niamh , O'Shea Paula M , Corcoran Paul , Coulter John , O'Donoghue Keelin , Fitzgerald Brendan 
Published: March 2024

AimsDiagnosis of hydatidiform mole or molar pregnancy based on morphology alone can be challenging, particularly in early gestation, necessitating the use of ancillary techniques for accurate diagnosis. We sought to adapt the VENTANAHER2dual-colour dual-hapten in-situ hybridisation (D-DISH) assay by using the internal chromosome 17 enumeration probe to determine ploidy status.MethodsWe selected 25 products of conception, consisting of molar and non-molar cases, to validate theHER2D-DISH assay. These cases had prior morphological assessment by a perinatal pathologist and ploidy analysis using molecular cytogenetics. Three independent observers, blinded to the original histopathological and genetic diagnosis, scored 10 representative areas on each slide. Interobserver variability was assessed by comparing the total scores of each observer using analysis of variance (ANOVA) and the kappa statistic.ResultsOur ploidy scoring system accurately determined the correct number of diploid and triploid conceptuses, demonstrating complete concordance with pre-existing ploidy status and the initial diagnosis. Interobserver agreement between three independent scorers was robust: ANOVA (p=0.36) and kappa statistic (0.812, p<0.001). We achieved clear separation of average nuclear signals for diploid and triploid conceptuses, which was statistically significant (p<0.05). Employing our innovative scoring system, known as the ‘rule of 5’, we established ploidy decision thresholds for all 25 cases.ConclusionsOur modifiedHER2D-DISH ploidy assay simplifies the process of ploidy determination and improves the accuracy of morphological diagnosis of molar pregnancy. TheHER2D-DISH assay was selected for ploidy analysis due to the widespread availability of in-situ hybridisation in pathology laboratories.
Exploring CP violation in $$\varvec{H \rightarrow \tau ^+\,\tau ^-\,\gamma }$$
Authors: Aakvaag Erlend , Fomin Nikolai , Lipniacka Anna , Pokorski Stefan , Rosiek Janusz , Sahoo Dibyakrupa 
Published: March 2024

AbstractWe propose a method of measuring the CP-odd part of the Yukawa interaction of Higgs boson and $$\tau $$
τ
leptons by observing the forward–backward asymmetry in the decay $$H \rightarrow \tau ^+ \, \tau ^- \, \gamma $$

H
→

τ
+

τ
-

γ

. The source of such asymmetry is the interference of the CP-even loop-level contribution coming from $$H \rightarrow Z \, \gamma \rightarrow \tau ^+ \, \tau ^- \, \gamma $$

H
→
Z

γ
→

τ
+

τ
-

γ

decay channel with the contribution from tree-level CP-odd Yukawa interaction. We find that the CP violating effect is maximum when the invariant mass of the $$\tau ^+\,\tau ^-$$

τ
+

τ
-

pair is equal to the mass of the Z boson. We propose and utilise various Dalitz plot asymmetries to quantify the maximal size of the asymmetry and perform Monte Carlo simulations to study the feasibility of measuring it in the high luminosity phase of the Large Hadron Collider (HL-LHC).
Synthesis of PANIHCl/ZnO conductive composite by in-situ polymerization and for humidity sensing application
Authors: Chen Cheng-Ho , Wu Jian-Fu , Lin Hung-Mao 
Published: March 2024

In this study, the conductive polyaniline doped by hydrochloric acid (PANIHCl)/zinc oxide (PANIHCl/ZnO) conductive composite was synthesized by in-situ polymerization. The conductive PANIHCl solution or PANIHCl/ZnO conductive composite solution was coated on an interdigital electrode (IDE) by drop coating to make a humidity sensor. The synthesis process, chemical structure, surface morphology, and humidity sensing characteristics of PANIHCl and PANIHCl/ZnO conductive composite were investigated. Field emission scanning electron microscope (FE-SEM) images suggested that the surface morphology of the PANIHCl/ZnO conductive composite is fibrous or rod-shaped, with a diameter of about 100 nm. The sensing responses of PANIHCl and PANIHCl/ZnO were 40% and 87%, respectively. The humidity sensing response of PANIHCl/ZnO as the sensing material was more than twice that of PANIHCl as the sensing material. The response time (Tres) is 13 s, and the recovery time (Trec) is 171 s. Research results showed that adding ZnO to PANIHCl can effectively improve the response of the sensor to humidity detection. Therefore, using PANIHCl/ZnO conductive composite as a sensing material will have great potential for application in humidity or other gas sensing devices.
Estrategias didácticas para la enseñanza de la anatomía humana en la Universidad Austral de Chile
Authors: Urdaneta José Ramón , Bucarey Sandra , Tiznado Maetzner Gonzalo , Cabezas Oyarzun Ximena 
Published: March 2024

La presente revisión narrativa propone caracterizar las estrategias didácticas actualmente utilizadas en el Instituto de Anatomía, Histología y Patología de la Universidad Austral de Chile (UACh), para la enseñanza de la Anatomía Humana en los estudiantes de las carreras de Enfermería, Kinesiología, Medicina, Obstetricia y Puericultura, Odontología y Terapia Ocupacional de su Facultad de Medicina. Se listan las diversas estrategias didácticas implementadas y se explica la manera en que se han venido aplicando en esta institución a fin de perfeccionar la enseñanza anatómica, considerando los retos y desafíos que demandan las generaciones actuales de estudiantes y la dinámica del mundo contemporáneo.
Palabras clave: anatomía humana, enseñanza, estrategias didácticas.
Rib Fractures and Frailty in Geriatric Trauma Patients
Authors: Brown Joan H. , LaRosa Samantha K. , Moore Katherine G. , Perea Lindsey L. 
Published: March 2024

As rib fractures are a common injury in the geriatric trauma population and can result in increased morbidity and mortality, we sought to understand predicting outcomes in this population. We hypothesized that frail geriatric rib fracture patients would have worse outcomes than their non-frail counterparts. This single-center retrospective study includes patients from July 2019 to June 2022 who were ≥65 years-old, had ≥ 2 rib fractures, and a documented Clinical Frailty Scale score. Univariate analysis was conducted comparing frail vs non-frail, and ≤3 rib fractures vs >3 rib fractures. Multivariate logistic regressions for risk of mortality and of frailty were performed. We found higher mortality in patients with >3 rib fractures on univariate analysis; however, this did not hold true on multivariate analysis. Frail patients were less likely discharged home and had a lower functional status at discharge. Further investigation is needed to effectively improve outcomes for geriatric trauma patients with rib fractures.
A Cognitive Approach to Maladaptive Daydreaming
Authors: Shanbhag Trusha , Pothiyil Dan Isaac 
Published: March 2024

Background of the study: Maladaptive daydreaming (MDD) is a mental activity that develops from unconscious material but differs from normal daydreaming in terms of experience, content, quantity, control, distress, and interference with everyday living. Dreaming often involves fantasizing about an idealized self, which includes motifs of companionship, romance, and compensatory scripts like power, escape, and rescue. The MDD is understood as a form of unusual imagination that is vivid and addictive but impedes academic and occupational responsibilities. Individuals report narratives that feature their idealized selves or characters, which are conflicting but rewarding, thus resulting in repetitive episodes of MDD. Materials and method: The present study explored the phenomenon of MDD and evaluated the clinical effectiveness of a single case intervention study of a 24-year-old male with MDD. The patient was assessed using the MDD Scale (MDS-16). The data were collected at baseline and treatment termination. The intervention for the patient was conducted in four phases: building coping skills, behavior modification, cognitive restructuring, and relapse prevention. Results: The data analysis showed a decrease in scores between baseline (66) and treatment termination (32), below the cut-off of 40, indicating a significant reduction in the symptoms. Conclusion: MDD is associated with emotional and functional distress. A tailor-made cognitive approach to the intervention effectively reduced the symptoms of MDD.
“Externalizing the Internalized:” Exploring Externalizing Conversations in Narrative Therapy with Adolescents and Young Adults in the Indian Context
Authors: Jagatdeb Soumya , Mishra Sanjana , Bajpai Thwisha , Sen Shelja 
Published: March 2024

People who seek therapy often view the problems they are experiencing as reflections of something internal, which could lead to a sense of helplessness over the problem, ideas of blame, and negative self-worth. Narrative therapy is a respectful, non-blaming approach to therapy that centers people as the experts in their own lives and views problems as separate from people. Externalizing conversations are a facet of narrative therapy that seek to separate individuals from these “internalized” understandings or ideas of a problem, place the problem in the social context, and construct preferred stories that align with their values and skills to re-author problem stories. The problem stories people bring into therapy may often focus on perceived failures, weaknesses, or feeling overwhelmed with the problem. Externalizing conversations can play a role in deconstructing these narratives and therefore challenge the negative perceptions of self and identity associated with the problem. The stories presented in this article by three narrative practitioners working in the Indian context revolve around their therapeutic work with three young people, with a focus on the use of externalizing conversations to de-pathologize LGBTQIA+ identities, work with experiences of violence and abuse without retraumatization, and deconstruct the diagnosis of ADHD. Here, externalizing conversations serve as a framework to deconstruct ideas of internalized blame, shame, and guilt for young people with different problems, ages, and socio-cultural contexts. Weaving these distinct stories together and reflecting on the use of externalizing conversations in the therapeutic context, this article seeks to explore and discuss dominant ideas about problem stories and therapeutic intervention and create paths to reauthored stories with a focus on individual agency and social justice.
Maternal and Perinatal Outcomes in Pregnant Women with Takayasu’s Arteritis: 10 Years Retrospective Study at Tertiary Centre in South India
Authors: Devi Kallur Sailaja , Shah Anisha Satish , Tarakeswari Surapaneni , Manokanth Madapu , Usha G. 
Published: March 2024

Background: Takayasu’s arteritis (TA) is a rare medical disorder of probable immune aetiology which complicates pregnancy. It affects younger women predominantly and may have a significant impact on maternal and foetal health. Aim: To study the maternal and perinatal outcomes among pregnant women with TA, attending a dedicated obstetric hospital in South India. Method: It is a retrospective observational study done at Fernandez Hospital, Hyderabad, with 10,000 births per annum. All women with TA-complicating pregnancies who were birthed from 2005 to 2022 were included. American College of Rheumatology criteria were used for the diagnosis of TA. The primary outcome of interest was to analyse the type of TA, maternal and foetal outcomes in pregnant women with TA. The secondary outcome of interest was to compare foetal outcomes between pregnancies managed at Fernandez Hospital (group A) versus previous pregnancies managed elsewhere (group B). Results: During the study period, there were 119,053 births of which 38 women had TA, with a total of 92 pregnancies, of which 59 pregnancies were in group A and 33 pregnancies in group B. Type 4 was the commonest seen in 44% of women. Hypertensive disorders of pregnancy were seen in 67.7% of women. The live birth rate was 84%, miscarriages were 10% and 5% of women had stillbirths. Caesarean section rate was 59.3%. There was one maternal mortality. Conclusions: TA should be considered in young women with secondary hypertension. Maternal and foetal outcomes are good with appropriate diagnosis, treatment and management of complications.
Prevalence and Clinical Associations of Anti-C1q Antibodies in Paediatric Systemic Lupus Erythematosus in Indian Children
Authors: Vettiyil George , Anu Punnen K.  , Prakash John Jude , Jayaseelan Visalakshi , Kumar Sathish 
Published: March 2024

Background: Paediatric systemic lupus erythematosus (pSLE) is a heterogeneous, chronic autoimmune disease characterised by multi-system inflammation and the production of antibodies-directed self-antigens. Anti-C1q has been associated with SLE as well as other connective tissue diseases. They have been considered as a marker for disease activity and the presence of nephritis. Objectives: To determine the prevalence of anti-C1q antibodies in the paediatric SLE and to determine clinical associations of elevated anti-C1q antibody levels, especially with lupus nephritis. Methods: All consecutive children with SLE on treatment with immunosuppressive drugs attending our clinic were recruited. After obtaining informed consent, blood samples were tested for anti-C1q antibodies by a commercially available ELISA kit. The prevalence of anti-C1q and its association with lupus nephritis were determined. Results: Out of a total 150 children with SLE, anti-C1q positivity was present in 95 children (64%), at a cut-off value of 20 U/mL. Children with proteinuria, low C3, low C4 and anti-dsDNA positivity had significantly more anti-C1q antibody positivity. Children with lupus nephritis were significantly more likely to have anti-C1q antibody positivity than children without renal involvement (74% vs. 51%, p = .02). Among the children with lupus nephritis, children with active renal disease were more likely to have anti-C1q positivity than in children with quiescent disease (88% vs. 53%, p = .002). Anti-C1q antibodies had a sensitivity of 74% and specificity of 54% at a cut-off value of 22 U/L for renal disease in pSLE. Conclusion: In our study, children with lupus nephritis were significantly associated with elevated anti-C1q antibodies, and children with active renal disease had higher anti-C1q positivity than those with quiescent disease. Anti-C1q levels showed significant associations with low C3, low C4 and anti-dsDNA positivity. Anti-C1q levels did not show significant associations with clinical features of SLE like malar rash, arthritis and CNS involvement. Anti-C1q antibody titres were found to have a positive correlation with renal disease and hence could be used as an adjunctive biomarker in monitoring the disease activity in children with lupus nephritis.