bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of uterine artery Doppler studies as predictors for postmolar gestational trophoblastic neoplasia
Authors: De Ramos Maria Febi Billones , Bustamante Lara Marie David , Jacinto Elizabeth Karunungan 
Published: January 2024

BACKGROUND:
Gestational trophoblastic neoplasia (GTN) is considered one of the most curable malignancies, especially when diagnosis and treatment are commenced early. Identifying predictors for the development of GTN will enable prompt management equating to an excellent prognosis.

OBJECTIVES:
The objectives of this study were to determine the validity of uterine artery Doppler parameters (UADPs) as predictors for postmolar GTN, compare UADP values before and after evacuation, determine cutoff values and relationship with beta-human chorionic gonadotropin (hCG) levels.

MATERIALS AND METHODS:
This was a prospective cohort study, which included histopathologically confirmed hydatidiform mole (HM) patients who underwent suction curettage. UADPs (pulsatility index (PI), resistive index, and systolic/diastolic [S/D] ratio) were measured preevacuation, 4 weeks postevacuation, and 6 weeks postevacuation. Patients were followed up to determine whether they will develop postmolar GTN or not.

RESULTS:
A total of 31 HM patients were admitted during the study period, 84% (26/31) of whom underwent suction curettage. Of these, 92% (24/26) had histopathology of complete HM and were recruited. However, only 17 patients followed up and completed the study. Results showed that there was an increasing trend of the UADP from preevacuation to 6 weeks postevacuation and the trend between those with and without postmolar GTN was statistically significant. There was also an inverse relationship between the UADP and baseline β-hCG values. UADP showed lower values among patients who developed postmolar GTN compared to those who did not. The cutoff values recommended by the area under curve (AUC) that can be a possible predictor were 4th-week right PI of 2.14 (AUC = 0.71) and right S/D ratio of 2.60 (AUC = 0.73) and 6th-week left PI of 2.80 (AUC = 0.70) and right PI of 2.53 (AUC = 0.74).

CONCLUSION:
Neoangiogenesis, a hallmark of malignancy, is correlated with invasive disease and will show increased myometrial vascularization with lower uterine artery indices. Doppler ultrasound may be a useful tool for postmolar follow-up and GTN diagnosis. However, the small sample size in this study is a limitation and a larger multicenter study is recommended.
Qualitative assessment of the concerns on treatment and patient health among patients with gestational trophoblastic neoplasia and their caregivers during the COVID-19 pandemic
Authors: Mercado Jessabeth Bibat , De Ramos Maria Febi Billones , Cagayan Maria Stephanie Fay Samadan 
Published: January 2024

BACKGROUND:
The COVID-19 pandemic has immobilized and impaired the operation of hospitals, clinics, and other health-care facilities leaving a plethora of patients and persons-at-risk in a more precarious position. Cancer patients were vulnerable to infections and complications due to the nature of the malignancy. Their caregivers were likewise predisposed to infection while taking care of them. This paper focused on determining the concerns of both gestational trophoblastic neoplasia (GTN) patients and their caregivers and identified possible factors of improvement in the delivery of essential cancer care.

OBJECTIVE:
The objective of the study was to describe the different concerns of GTN patients and their caregivers during chemotherapy and other adjunctive treatments during the COVID-19 pandemic in a Tertiary Government Hospital.

MATERIALS AND METHODS:
A qualitative type of research was employed in this research, for which an in-depth interview was used. A total of 12 respondents, 6 patients and 6 caregivers, were interviewed using a semi-structured pretested questionnaire.

RESULTS:
Findings showed that infection with COVID-19, financial and logistical constraints exacerbated by the pandemic were the main concerns of both patients and caregivers. Other concerns recorded include change in their attending physician, survivability of the patient, and the availability of caregivers.

CONCLUSIONS:
Despite the recorded apprehensions from the patients and caregivers, there was a general satisfaction in the delivery of health care at the Division of Trophoblastic Diseases due to the clarity in the follow-up and treatment schedules which have been optimized through the revised guidelines and protocols set by the division to adapt to the COVID-19 pandemic.
Association of ultrasound morphological features with serum β subunit human chorionic gonadotrophin and histopathology among sonologically diagnosed cases of gestational trophoblastic neoplasia in a tertiary hospital
Authors: Taub-Hernando Donnabelle R. , Amosco Melissa D. 
Published: January 2024

BACKGROUND:
Gestational trophoblastic neoplasia (GTN) presents as vascular mass of varying morphology on ultrasound and confirmed through quantitative serum β subunit human chorionic gonadotrophin (β-hCG). In regions with limited access to β-hCG, ultrasound plays a crucial role in the initial diagnosis for timely management.

OBJECTIVES:
This study aimed to investigate the associations between ultrasound vascular morphologic features, serum β-hCG levels, and histopathology in GTN cases.

METHODOLOGY:
A cross-sectional review was conducted on 113 cases with ultrasound impression of GTN over an 8-year period. The patient data were extracted from case records, and ultrasound images were categorized based on the distinct features. Associations with β-hCG levels and histopathology were analyzed using the Chi-square test and Mann–Whitney U-test. Statistical significance was set at P < 0.05.

RESULTS:
A significant association was observed between ultrasound category and serum β-hCG (P < 0.0001). The compact and diffuse types were more prevalent with β-hCG levels between 104 to <105 mIU/mL, while the lacunar type was common among patients with ≥105 mIU/mL. However, there was no significant association between ultrasound categories and mean β-hCG levels. Regarding histopathology, the lacunar type was more common in invasive moles, whereas the compact and diffuse types tended to be seen with choriocarcinoma, although these were not statistically significant (P = 0.182).

CONCLUSIONS:
Morphologic types of GTN by gray scale and Doppler ultrasound vary across the different levels of serum β-hCG and may suggest the histopathological diagnosis. This study provides valuable insights into the ultrasonographic characteristics of GTN, which can aid in its diagnosis and management.
Clinical and ultrasound features of pseudomyxoma peritonei and its histopathological subtypes among women seen at a Philippine tertiary hospital: A 10-year review
Authors: Viloria Toni Andrea Marie D. , Amosco Melissa D. 
Published: January 2024

OBJECTIVES:
Pseudomyxoma peritonei (PMP) in women arises from an appendiceal or ovarian pathology and presents either of two histological subtypes of differing prognosis, disseminated peritoneal adenomucinosis (DPAM), or peritoneal mucinous carcinomatosis (PMCA). This study aimed to evaluate the demographic, clinical, and sonographic features among affected women and the differences between the two histological subtypes.

METHODS:
A retrospective study was conducted involving 36 women with histopathological diagnosis of PMP who had preoperative ultrasound and underwent surgery at the department of obstetrics and gynecology in a tertiary hospital. Demographic and clinical data, ultrasound images and reports, and final histopathology were reviewed. To compare the subtypes, one-way analysis of variance for continuous data and Chi-square/Fisher exact test for categorical data were used, with P < 0.05 indicating statistical significance.

RESULTS:
Patients were mostly >50 years of age, multigravid, and presented with abdominal distention. Ultrasound examinations consistently showed amorphous, mixed echo or echogenic ascites, peritoneal thickening, and omental caking. Adnexal/ovarian masses were detected in 66.7% of cases. Omental caking was significantly more prevalent in PMCA (83.3%; P = 0.0002), whereas larger ovarian tumors (>20 cm) and papillarities were more common in DPAM (both 92.9%; P = 0.0005). Most patients underwent gynecologic surgery (n = 31; 86.1%), and 14 (38.9%) required readmission due to recurrence. The final histopathology revealed largest tumor involvement of the appendix (n = 13; 36.1%), the ovaries (n = 11; 30.5%), or undetermined (n = 12; 33.3%).

CONCLUSIONS:
Preoperative diagnosis of PMP is possible based on its clinical and ultrasound features. Although the subtypes are similar in most of these features, certain ultrasound findings may aid in distinguishing them.
Sonologic features of vulvar cancer and lymph node status among patients at a tertiary hospital – A 10-year review
Authors: Siao Ma. Patricia Grace O. , Comia Leovegildo L. 
Published: January 2024

CONTEXT:
Vulvar cancers are rare gynecologic tumors. Ultrasound can characterize primary tumors and guide the biopsy of suspicious nodes. Currently, there are no studies on the sonologic features of different vulvar cancer types.

AIMS:
The aim is to determine the sonologic features of different vulvar malignancies. To compare the accuracy of ultrasound in identifying lymph node status.

SETTINGS AND DESIGN:
This is a retrospective descriptive study.

SUBJECTS AND METHODS:
Patient records, ultrasound images, and reports of vulvar cancer with long- and short-axis (L/S) ratio of inguinal nodes were reviewed from the year 2010 to 2019.

STATISTICAL ANALYSIS USED:
The accuracy of ultrasound to detect lymph nodes and the correlation of L/S ratio to histopathology were done.

RESULTS:
The study included 49 patients. The most common histopathologies were squamous cell carcinoma (SCCA), vulvar melanoma (VM), and adenocarcinoma (ADCA). Most tumors were > 4 cm, unifocal, and lateral in location. SCCA, verrucous carcinoma, VM, ADCA, adenosquamous carcinoma (ASCA), eccrine carcinoma (ECCA), and carcinosarcoma (CS) were irregular heterogeneous masses. Leiomyosarcoma (LMS) and proximal-type epithelioid sarcoma (PES) were regular, heterogeneous masses. Paget’s disease of the vulva (PDV) was hypoechogenic with regular borders. Vascularities were absent in PDV and LMS, minimal in ECCA, moderate in ASCA and PES, moderate to abundant in CS, and variable in VM. The accuracy of ultrasound in detecting lymph nodes was 78%; the accuracy of the L/S ratio was 75%. Tumor border and FIGO stage showed significant association with histopathologic type.

CONCLUSIONS:
Sonologic features and accuracy of ultrasound in predicting lymph node status help prognostication in vulvar cancer. Nodal morphometric studies are recommended for future researches.
A comparative study of subjective and objective techniques using two-dimensional ultrasound in the preoperative assessment of cervical and myometrial invasion in patients with endometrial cancer
Authors: Abria-Ybañez Doreen Baco , David-Bustamante Lara Marie , Reforma Kareen Nora 
Published: January 2024

CONTEXT:
Endometrial cancer is the third most common malignancy of the female genital tract in the Philippines, following cervical and ovarian cancer. Ultrasound as the first line in imaging has a major role in preoperative treatment and planning.

AIMS:
To compare the diagnostic accuracy of subjective versus objective ultrasound measurement techniques in detecting cervical stromal invasion (CSI) and deep myometrial invasion (MI).

MATERIALS AND METHODS:
Fifty-seven patients were enrolled in this cross-sectional study. Deep MI and CSI were evaluated both subjectively and objectively by measuring tumor-free distance (TFD), distance from the outer cervical os to lowest edge of the tumor border (Dist-OCO), and distance from the internal cervical os to caudal tumor border (Dist-ICO). Histopathological result used as the gold standard.

RESULTS:
Subjective assessment for deep (MI) had 79.3% sensitivity, 82.1% specificity, 82.1% positive predictive value (PPV), 82.1% negative predictive value (NPV), and 80.7%. Subjective assessment for CSI had a sensitivity, specificity, PPV, NPV, and overall accuracy of 80%, 90.4%, 44.4%, 97.9%, and 89.5%. Objective measurement (TFD ≤0.8 cm) to detect deep MI had 86.2% sensitivity, 57.1% specificity, 67.4% PPV, 80% NPV, and 71.9% overall accuracy. Adjusting TFD cutoff to 0.65 increased to 71.4% specificity, making it comparable with subjective assessment. Dist-OCO (≤2.1 cm) yielded 100% sensitivity, 86.3% specificity, 30% PPV, 100% NPV, and 87% overall accuracy. Dist-ICO was first used in this study, hence no cutoff yet. By using receiver operating characteristics, cutoff was 0.45 cm, which yielded a 60% sensitivity and 92% specificity (area under the curve 0.731, P = 0.09).

CONCLUSIONS:
Subjective assessment of CSI and deep MI performs better than objective measurement techniques. TFD and Dist-OCO as the objective measurements showed clinically comparable accuracy to subjective assessment by an expert. Dist-ICO needs to be validated to a larger population to determine its clinical value in predicting CSI.
Pelvic arteriovenous malformation involving the uterine and internal iliac vessels with concomitant true aneurysm of uterine artery diagnosed through color Doppler ultrasound
Authors: Salamilao-Sabularce Ma Cresilda Paz B. , Cruz-Javier Gumersinda 
Published: January 2024

BACKGROUND:
Pelvic arteriovenous malformations (AVMs) are rare but carries life-threatening consequences.

CASE REPORT:
A 47-year-old multipara who had previously undergone four cesarean sections came for re-evaluation of a malignant ovarian new growth. She was asymptomatic. Repeat ultrasound revealed normal ovaries, and a cystic structure at the left adnexa with abundant mixing of colors, turbulent flow and pulsative waveforms on spectral Doppler. It arises from serpentine tubular structures from the uterine isthmus. Uterine artery aneurysm was considered. Magnetic resonance angiography confirmed the findings of aneurysm and pelvic arteriovenous malformation. The patient underwent a hysterectomy with ligation and excision of aneurysm. Histopathologic findings showed pelvic AVM and a true aneurysm of the uterine artery.

CONCLUSION:
Ultrasound with color Doppler is a low-cost and readily available tool for gynecologists for the diagnosis and management of pelvic AVM.
Human papillomavirus-DNA test in patients with abnormal cervical smears: A tool to improve the detection of invasive cervical cancer in early stages
Authors: Agarwal Neelima , Jain Ritu , Gupta Manisha , Agrawal Alpana 
Published: January 2024

ABSTRACT

Introduction:
Cervical cancer is the second most frequent cancer among women in developing countries. Human papillomavirus (HPV) can be detected in 99.7% of cervical cancers. Its detection can be used as a tool to detect women, at risk for consequent development of cervical cancer. The objective of the study was to determine the prevalence of high-risk HPV in women with or without cervicitis and to evaluate the associated risk factors.

Materials and Methods:
A total of 66 patients who met with the inclusion criteria were included as case group. Thirty cytologically normal cervical smears were also included as a control and were collected from asymptomatic patients. Two cervical specimens were collected for Pap smear and HPV 16/18 reverse transcription polymerase chain reaction (PCR).

Results:
In the case group, 45.5% of patients had abnormal cervical cytological findings and majority of them had one or more menstrual abnormalities and vaginal infection, as compared to control group (P < 0.5). 13.6% of patients were HPV-PCR positive in the case group compared with none in the control group. In the HPV-positive group, the mean age was of 50.26 ± 13.293 years, while in the HPV-negative group, it was 35.29 ± 8.768 years (P < 0.0001). The rate of positivity of HPV-DNA test increased as the severity of dysplastic changes increased in cervical cytology.

Conclusion:
HPV-DNA testing should be used as an adjunct to Pap smears for the detection of cervical precancerous lesions and cervical cancer at its early stages.
On definable groups andD-groups in certain fields with a generic derivation
Authors: Peterzil Ya’acov , Pillay Anand , Point Françoise 
Published: January 2024

AbstractWe continue our study from Peterzil et al. (2022,Preprint, arXiv:2208.08293) of finite-dimensional definable groups in models of the theory$T_{\partial }$, the model companion of an o-minimal${\mathcal {L}}$-theoryTexpanded by a generic derivation$\partial $as in Fornasiero and Kaplan (2021,Journal of Mathematical Logic21, 2150007).We generalize Buium’s notion of an algebraicD-group to${\mathcal {L}}$-definableD-groups, namely$(G,s)$, whereGis an${\mathcal {L}}$-definable group in a model ofT, and$s:G\to \tau (G)$is an${\mathcal {L}}$-definable group section. Our main theorem says that every definable group of finite dimension in a model of$T_\partial $is definably isomorphic to a group of the form$$ \begin{align*}(G,s)^\partial=\{g\in G:s(g)=\nabla g\},\end{align*} $$for some${\mathcal {L}}$-definableD-group$(G,s)$(where$\nabla (g)=(g,\partial g)$).We obtain analogous results whenTis either the theory ofp-adically closed fields or the theory of pseudo-finite fields of characteristic$0$.
Integral mean estimates for univalent and locally univalent harmonic mappings
Authors: Das Suman , Sairam Kaliraj Anbareeswaran 
Published: January 2024

AbstractWe verify a long-standing conjecture on the membership of univalent harmonic mappings in the Hardy space, whenever the functions have a “nice” analytic part. We also produce a coefficient estimate for these functions, which is in a sense best possible. The problem is then explored in a new direction, without the additional hypothesis. Interestingly, our ideas extend to certain classes of locally univalent harmonic mappings. Finally, we prove a Baernstein-type extremal result for the function
$\log (h'+cg')$
, when
$f=h+\overline {g}$
is a close-to-convex harmonic function, and c is a constant. This leads to a sharp coefficient inequality for these functions.
The 2022 Crimean-Congo Hemorrhagic Fever outbreak in Iraq
Authors: Al Salihi Karima , Hassan Younise Mohammed , Zuhair Mahmoud Zakaria , Hussain Tanveer 
Published: January 2024

Crimean-Congo Hemorrhagic fever (CCHF) is an endemic, zoonotic, viral, and tick-borne disease that causes hemorrhagic symptoms. The disease has been reported in Iraq since 1979 comprising six cases between 1989 and 2009. Subsequently, 11, 3, and 33 cases were reported in 2010, 2018, and 2021, respectively. This study describes the 2022 Crimean-Congo Hemorrhagic fever virus (CCHFV) outbreak in different Iraqi governorates. In the 2022 outbreak, 212 cases of human CCHFV were reported between January 1 and May 22. These included 97 (46%) cases confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) and 115 (54%) suspected cases. Most human cases have been reported for livestock breeders and butchers. Approximately half of the confirmed cases (48%) were reported in the Dhi Qar governorate, whereas the others were reported in Missan, Muthanna, Wasit, Diwaniya, Karkh/Baghdad, Rusafa/Baghdad, Kirkuk, Basra, Najaf, Nineveh, Babylon, and Karbala. Patients with CCHFV showed symptoms of the pre-hemorrhagic phase, including sudden fever, anorexia, vomiting, diarrhea, headache, nose bleeding, and abdominal and joint pain. Later, hemorrhagic symptoms started with unexplained bleeding lesions, ranging from small petechiae to large hematomas. The factors responsible for the re-emergence of CCHFV included a shortage of veterinary services during the COVID-19 pandemic and illegal slaughtering of animals outside the abattoirs. This led to massive tick infestations that acted as viral vectors.
In conclusion, this is the first report documenting the 2022 CCHFV outbreak in Iraq, with a total of 212 patients and 27 overall deaths, including 13 laboratory-confirmed cases. The authors recommend improving veterinary services provided to farmers. Additionally, future studies need to be done including the sero-epidemiology and molecular studies on local livestock and ticks to understand their roles in circulating the virus to humans.
The Identification of the Perceptions of Final-Year Midwifery Students on The Profession of Midwifery
Authors: ERGİN Ayla , KAYA ODABAŞ Resmiye , DEMİR Gözde 
Published: January 2024

Background: Thoughts and perceptions of midwifery students, who are the midwives of the future, about
the profession of midwifery are quite important.

Objective: This study aims to identify the perceptions of final-year midwifery students on the profession of
midwifery.

Methods: This analytical cross-sectional study was conducted from December 2021 to January 2022 The
population was final-year undergraduate midwifery students enrolled in 11 public universities selected by lot in Turkey, whilst the sample comprised final-year midwifery students selected from this population (n=330). The data were collected online using a Personal Information Form and the Midwifery Vocational Perception Scale. In the analysis of the data, descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis H test were used.

Results: The participants had a mean age of 22.06±2.02 years. Of all participants, 93.3% stated that they
viewed the profession of midwifery positively. Moreover, the mean Midwifery Vocational Perception Scale
score of the participants was 75.58±5.14, and the Cronbach’s alpha coefficient of the scale was calculated as .89. There was no statistically significant difference in the mean Midwifery Vocational Perception Scale scores of the participants based on their age, marital status, family type, economic status, employment status, maternal education level and employment status, paternal education level and employment status (p>.05), Midwifery Vocational Perception Scale scores of those who viewed the profession positively (76.03±4.58) were statistically higher than those who thought negatively (69.18±7.85) (p
Yenidoğan Yoğun Bakım Ünitesinde Preterm Bebeği Yatan Annelerin Memnuniyetleri ile Hastaneden Eve Geçişte Yaşadıkları Sorunlar Arasındaki İlişkinin İncelenmesi: Kesitsel Bir Çalışma
Authors: ARIKAN Cansu , MENEKŞE Dilek 
Published: January 2024

Giriş: Yenidoğan Yoğun Bakım Ünitesinde (YYBÜ) preterm bebeği yatan ebeveynler için hastanedeki yatış
ve eve geçiş dönemi kritik bir zamandır.

Amaç: Bu çalışma yenidoğan yoğun bakım ünitesinde preterm bebeği yatan annelerin memnuniyetleri ile
hastaneden eve geçişte yaşadıkları sorunlar arasındaki ilişkiyi belirlemek amacıyla yapılmıştır.

Yöntem: Tanımlayıcı, kesitsel ve ilişki arayıcı olarak planlanan araştırma, İstanbul ilinde bir eğitim ve
araştırma hastanesinin YYBÜ’nde preterm bebeği yatan 200 anne ile yapılmıştır. Veriler Nisan 2021- Nisan
2022 tarihleri arasında “Tanıtıcı Bilgi Formu”, “Preterm Yenidoğan Tanıtıcı Bilgi Formu”, “Yenidoğanda
Ebeveynlerin Güçlendirilmesi (EMpowerment of PArents in THe Intensive Care/ EMPATHIC-30)” anketi
ve “Eve Geçiş: Preterm Ebeveyn Ölçeği (EG: PEÖ)” kullanılarak toplanmıştır. Veriler, SPSS programı
kullanılarak yüzdeler, ortalamalar, bağımsız t-testi, ANOVA, pearson korelasyon analizi ile değerlendirilmiştir.

Bulgular: Annelerin EMPATIC-30 ölçek toplam puan ortalaması 5.41±.34, EG: PEÖ toplam puan ortalaması
73.82±8.31’dir. EMPATHIC-30 ölçeği ile EG: PEÖ arasında anlamlı bir ilişki bulunmamıştır (r=-.06; p=.331).
EMPATHIC-30 ölçeği bakım-tedavi alt boyutu ile EG: PEÖ endişe ve izolasyon boyutu arasında istatistiksel
olarak anlamlı ve negatif yönlü bir ilişki olduğu saptanmıştır (r=-.156; p=.028).

Sonuç: Yenidoğan yoğun bakım ünitesinde preterm bebeği yatan annelerin memnuniyetleri ile hastanedeneve geçişte yaşadıkları sorunlar arasında herhangi ilişki bulunmamıştır.