bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic value of magnetic resonance diffusion tensor imaging in evaluation of cervical spondylotic myelopathy
Authors: Mostafa Naglaa Said AbdEL-Azim , Hasanin Omar Ahmed Mohamed , Al Yamani Moqbel Esam Abdel Hai , Nagy Hanan Ahmad 
Published: October 2023

Abstract
Background
Radiological diagnosis of cervical spondylotic myelopathy should be made as early as possible to obtain favourable clinical outcomes when compared with later stages. Diffusion tensor imaging can reveal early structural changes of the cord in patients with cervical compressive myelopathy.

Aim
This study aimed to assess the role of magnetic resonance diffusion tensor imaging in the accurate evaluation of cervical spondylotic myelopathy.

Patients and methods
This prospective study included a group of 60 patients with neurological symptoms suggestive for cervical spondylotic myelopathy and a control group of 30 healthy subjects. The clinical severity of compressive myelopathy was assessed based on the European myelopathy score. Magnetic resonance diffusion tensor imaging and tractography were done for all patients and controls.

Results
Fractional anisotropy values at the most compressed segments of spinal cord are lower while apparent diffusion coefficient values of the same segments are higher than healthy segments in controls. Fractional anisotropy and apparent diffusion coefficient parameters had higher sensitivity (97.0% and 88.1%, respectively) than conventional T2 WIs (13.4%) and fibre tractography (10%) for the detection of early compressive myelopathy with cutoff values ≤ 0.56 and > 1.23, respectively, in differentiating between patients and control groups.

Conclusion
Diffusion tensor imaging indices are valuable tools for quantitative assessment of degenerative cervical spondylotic myelopathy in addition to routine cervical spine magnetic resonance.
Full-thickness versus sliced cartilage in type I tympanoplasty, comparative study
Authors: Sabaa Mohamed Abd Elmottaleb , Abdelhameed Abdallah Enayet , Elbatawi Ahmed Mahmoud , ElFouly Mahmoud Sayed , Mohamed Abdelhaleem Ahmed , El-essawy Mahmoud Sherif 
Published: October 2023

Abstract
Introduction
The use of cartilage in type I tympanoplasty is associated with concern about a poor audiological outcome. Slicing the cartilage could be a tool to overcome such a feared problem.

Objective
To compare the healing and hearing outcomes of using sliced cartilage to full-thickness cartilage in type I tympanoplasty.

Methods
Seventy patients with small to medium-sized central dry tympanic membrane perforation were included in this prospective study. The patients were randomly assigned to one of these two groups: group A: full-thickness cartilage tympanoplasty was done, and group B: partial thickness cartilage tympanoplasty was done. The assessment of healing and hearing was done at 3 and 12 months postoperatively.

Results
The healing was achieved in 88.2% and 90.9% in group A and group B, respectively. In group A, the mean ABG was 23.44 dB preoperatively and 14.2 dB, and 12.6 dB in the first and second follow-ups, respectively. In group B, preoperative ABG was 23.58 dB compared to 7.9 dB and 6.93 dB in the two follow-ups, respectively. The results were significantly better in group B rather than group A at both follow-ups.

Conclusion
Hearing results are better when sliced cartilage is used in tympanoplasty type I than full-thickness cartilage.
The effect of combined balance and strength exercise program in patients with different grades of primary knee osteoarthritis
Authors: Abdel-Fattah Yousra Hisham , Abdel Hamid Mowaffak Moustafa , Metawaa Sara Ibraheem Mohamed Seleem , Eltawab Sarah Sayed 
Published: October 2023

Abstract
Background
Knee osteoarthritis (KOA) is a degenerative disease that affects all parts of the joint including the surrounding ligaments, tendons, and muscles. Biomechanical changes that occur in KOA cause aggravation of symptoms with further joint damage. Thus, modifying the biomechanics of the knee joint may help in the prevention and treatment of KOA. For that reason, our aim was to assess the effect of combined balance and strengthening exercise programs in patients with different grades of primary KOA.

Results
All studied groups showed comparable significant improvement in quadricep muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (< 0.001), time-up and go score (< 0.001), 6-m walk time (< 0.001), and dynamic balance (< 0.001) at the end of exercise program. Furthermore, patients with mild-moderate KOA showed a significant improvement in pain, physical function, total WOMAC scores, and dynamic balance compared to those with more severe KOA.

Conclusion
Combined balance and strengthening exercise programs may help improve pain, physical function, and dynamic balance in patients with KOA regardless of its severity. However, following exercise patients with milder forms of KOA may show greater improvement compared to patients with severe KOA.
Role of long-term oxygen therapy in interstitial lung diseases
Authors: Yossif Sahar Farghly , El-Qarn Atef F. , El-Tayeb Asmaa M. M. , Abd El-Ghany Mohamed F. 
Published: October 2023

Abstract
Background
Long-term oxygen therapy in patients with interstitial lung diseases is frequently given in order to enhance gas exchange, lessen dyspnea, and increase physical activity.

Objective
To evaluate how individuals with hypoxemia and interstitial lung disease respond to long-term oxygen therapy.

Results
Between October 2019 and July 2021, this prospective analytical (cross-sectional) study was carried out at the Assiut University Hospital’s Chest Department. Seventy ILD patients were evaluated utilizing a 6-min walk test (SMWT), the St. George respiratory questionnaire (SGRQ), MMRC, and echocardiography and follow-up was done at 1, 3, 6, and 12 months for ABG, SMWT, and MMRC. As regards echocardiography and SGRQ, a follow-up was done on admission and 1 year after starting LTOT. Significant improvement in St. George’s respiratory questionnaire score, MMRC, and EF by echocardiography was observed meanwhile PASP showed insignificant reduction.

Conclusion
Long-term oxygen therapy is beneficial for patients with ILD and hypoxemia.

Trial registration
Long-term oxygen therapy in patients with interstitial lung disease: ClinicalTrials.gov ID: NCT04089826 Registered on September 12, 2019.
Reassuring Data on the Cardiovascular Risk in Adults With X-linked Hypophosphatemia Receiving Conventional Therapy
Authors: Bouzemane Alexandre , Vignot Emmanuelle , Derain Dubourg Laurence , De Mul Aurélie , Molin Arnaud , Chapurlat Roland , Fontanges Elisabeth , Delsart Daphne , Akbari Alireza , Huang Shih Han Susan , McIntyre Christopher W , Bacchetta Justine , Lemoine Sandrine 
Published: October 2023

Abstract

Context
X-linked hypophosphatemia (XLH) is a rare genetic disorder that results in increased plasma levels of fibroblast growth factor 23 (FGF23). Several studies have demonstrated a direct association between FGF23 and cardiovascular mortality in cohorts of patients with chronic renal failure. However, in patients with XLH, studies on the cardiovascular impact of the disease are rare, with contradictory results.

Objective
The aim was to assess whether the disease led to an increased cardiovascular risk.

Methods
We conducted a single-center retrospective observational study on a local cohort of adult patients with XLH. The primary endpoint was a composite endpoint of the frequency of left ventricular hypertrophy (LVH) or presence of high blood pressure. Our secondary objectives were to assess echocardiographic, pulse wave velocity, and central blood pressure data as other markers of CV health. Independently of this cohort, tissue sodium content with magnetic resonance imaging was studied in 2 patients with XLH before and after burosumab.

Results
Twenty-two patients were included. Median serum phosphate was 0.57 (0.47-0.72) mmol/L and FGF23 94 pg/L (58-2226). Median blood pressure was 124 (115-130)/68 (65-80) mm Hg, with only 9% of patients being hypertensive. A majority of patients (69%) had no LVH, only 1 had a left ventricular mass &gt;100 g/m² and 25% of patients had left ventricular remodeling. Pulse wave velocity was normal in all patients. No differences in skin and muscle sodium content were observed before and after burosumab in the 2 patients who underwent sodium magnetic resonance imaging.

Conclusion
We found no elevated risk of developing hypertension or LVH in patients with XLH.
Low Back Pain–Induced Dynamic Trunk Muscle Control Impairments Are Associated with Altered Spatial EMG–Torque Relationships
Authors: ARVANITIDIS MICHAIL , JIMÉNEZ-GRANDE DAVID , HAOUIDJI-JAVAUX NADÈGE , FALLA DEBORAH , MARTINEZ-VALDES EDUARDO 
Published: October 2023

ABSTRACT

Purpose
We quantified the relationship between high-density surface electromyographic (HDsEMG) oscillations (in both time and frequency domains) and torque steadiness during submaximal concentric/eccentric trunk extension/flexion contractions, in individuals with and without chronic low back pain (CLBP).

Methods
Comparisons were made between regional differences in HDsEMG amplitude and HDsEMG–torque cross-correlation and coherence of the thoracolumbar erector spinae (ES), rectus abdominis (RA), and external oblique (EO) muscles between the two groups. HDsEMG signals were recorded from the thoracolumbar ES with two 64-electrode grids and from the RA and EO muscles with a single 64-electrode grid placed over each muscle. Torque signals were recorded with an isokinetic dynamometer. Coherence (δ band (0–5 Hz)) and cross-correlation analyses were used to examine the relationship between HDsEMG and torque signals. For this purpose, we used principal component analysis to reduce data dimensionality and improve HDsEMG-based torque estimation.

Results
We found that people with CLBP had poorer control during both concentric and eccentric trunk flexion and extension. Specifically, during trunk extension, they exhibited a higher HDsEMG–torque coherence in more cranial regions of the thoracolumbar ES and a higher HDsEMG cross-correlation compared with asymptomatic controls. During trunk flexion movements, they demonstrated higher HDsEMG amplitude of the abdominal muscles, with the center of activation being more cranial and a higher contribution of this musculature to the resultant torque (particularly the EO muscle).

Conclusions
Our findings underscore the importance of evaluating torque steadiness in individuals with CLBP. Future research should consider the value of torque steadiness training and HDsEMG-based biofeedback for modifying trunk muscle recruitment strategies and improving torque steadiness performance in individuals with CLBP.
Prevalence and determinants of obesity among individuals with diabetes in Indonesia
Authors: Azam Mahalul , Sakinah Luluk Fadhoh , Kartasurya Martha Irene , Fibriana Arulita Ika , Minuljo Tania Tedjo , Aljunid Syed Mohamed 
Published: October 2023

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911 DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), high HDL (POR=0.60; 95% CI: 0.46-0.78, and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity among DM subjects; while higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions: The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.
Comparative evaluation of the effect of the complete denture on airflow between hypertensive and non-hypertensive patients - in vivo study
Authors: Minase Dhanashree , Sathe Seema 
Published: October 2023

Background: Edentulism is a disabling condition of oral cavity and can impact the stomatognathic system as a whole, which cause a reduction in the size of the airway lumen. Among the vital functions affected by edentulism, respiration is one of the most important as edentulism affects cardio-respiratory symptoms by increasing pharyngeal collapsibility. A prosthodontist's priority should be in-depth knowledge of the patient in order to encourage patients to recognize the type of prosthesis they might require. Spirometry is a technique for determining how well a respiratory system is working and its mechanical qualities by measuring volumes of lungs and their capacities. Previous studies have suggested that hypertensive individual’s pulmonary function measures were significantly lowered than the percentage anticipated values in spirometry. Hypertensive patients had lower pulmonary function metrics, according to certain researchers. We aim to evaluate the effect of complete dentures on the airflow in hypertensive and non-hypertensive complete denture wearers. Methods: The study is an in vivo study and will be carried out in the Prosthodontics department. This study will be comprised of 40 subjects, over 40 years of age, split into two groups. Measurement of the peak expiratory flow rate (PEFR), and the forced vital capacity (FVC) will be done in all participants. Statistical analysis will be performed by using the Chi-square test will be applied for analysis and the students’ unpaired t-test. Evaluation will be done in four groups- wearing both dentures, without both dentures and only upper and only lower dentures. Expected results: This study may show a definite correlation in the airflow between hypertensive complete denture wearers and non-hypertensive complete denture wearers. Changes in treatment plans by shifting to other treatment modalities can be done if the study shows a reduction in airflow in the hypertensive complete denture wearers and non-hypertensive complete denture wearers.
Pulmonary haemorrhage as a frequent cause of death among patients with severe complicated Leptospirosis in Southern Sri Lanka
Authors: Fonseka Chathuranga Lakmal , Dahanayake Niroshana Jathun , Mihiran Denagama J. D. , Wijesinghe Kalani Mithunika , Liyanage Lakshani Nawanjana , Wickramasuriya Hesaru S. , Wijayaratne Gaya Bandara , Sanjaya Kelum , Bodinayake Champica K. 
Published: October 2023

Background
Leptospirosis is a tropical disease associated with life threatening complications. Identifying clinical and investigation-based parameters that predict mortality and morbidity is vital to provide optimal supportive care

Methods
We conducted an observational study in an endemic setting, in the southern Sri Lanka. Consecutive patients having complicated leptospirosis were recruited over 18 months. Clinical, investigational and treatment data were collected and the predictors of mortality were analysed.

Results
Out of 88 patients having complicated leptospirosis, 89% were male. Mean age was 47yrs (±16.0). Among the total major complications 94.3% had acute kidney injury, 38.6% pulmonary haemorrhages, 12.5% fulminant hepatic failure, 60.2% hemodynamic instability and 33% myocarditis. An acute significant reduction of haemoglobin (Hb) was observed in 79.4% of patients with pulmonary haemorrhage. The mean of the highest haemoglobin reduction in patients with pulmonary haemorrhage was 3.1g/dL. The presence of pulmonary haemorrhage (PH) and hemodynamic instability within first 48 hours of admission significantly predicted mortality (p<0.05) in severe leptospirosis. Additionally, within first 48 hours of admission, elevated SGOT (AST), presence of atrial fibrillation, presence of significant haemoglobin reduction, higher number of inotropes used, prolonged shock, invasive ventilation and admission to ICU significantly predicted mortality. Out of major complications during the first week after admission, pulmonary haemorrhage and fulminant hepatic failure (FHF) combination had significant adjusted odds of mortality (OR = 6.5 and 4.8, p<0.05). Six patients with severe respiratory failure due to PH underwent ECMO and four survived. The overall mortality in complicated leptospirosis was 17%. In PH and FHF, the mortality rate was higher reaching 35.4% and 54.5%, respectively.

Conclusions
Within first 48 hours of admission, major complications such as pulmonary haemorrhage and haemodynamic instability and other parameters such as atrial fibrillation, acute haemoglobin reduction, elevated SGOT level could be used as early parameters predictive of mortality in severe leptospirosis. PH and FHF during the first week of admission in leptospirosis are associated with high morbidity and mortality requiring prolonged ICU care and hospitalisation. Above parameters could be used as parameters indicating severity for triaging and intensifying treatment. Using ECMO is a plausible treatment option in patients with severe pulmonary haemorrhage.
Seroprevalence and related risk factors of Brucella spp. in livestock and humans in Garbatula subcounty, Isiolo county, Kenya
Authors: Mwatondo Athman , Muturi Mathew , Akoko James , Nyamota Richard , Nthiwa Daniel , Maina Josphat , Omolo Jack , Gichuhi Stephen , Mureithi Marianne W. , Bett Bernard 
Published: October 2023

Background
Brucellosis is a neglected zoonotic disease that affects both animals and humans, causing debilitating illness in humans and socio-economic losses in livestock-keeping households globally. The disease is endemic in many developing countries, including Kenya, but measures to prevent and control the disease are often inadequate among high-risk populations. This study aimed to investigate the human and livestock seroprevalence of brucellosis and associated risk factors of Brucella spp. in a pastoralist region of northern Kenya.

Methods
A cross-sectional survey was conducted using a two-stage cluster sampling method to select households, livestock, and humans for sampling. Blood samples were collected from 683 humans and 2157 animals, and Brucella immunoglobulin G (IgG) antibodies were detected using enzyme-linked immunosorbent assays. A structured questionnaire was used to collect data on potential risk factors associated with human and animal exposures. Risk factors associated with Brucella spp. exposures in humans and livestock were identified using Multivariate logistic regression.

Results
The results indicated an overall livestock Brucella spp. seroprevalence of 10.4% (95% Confidence Interval (CI): 9.2–11.7). Camels had the highest exposure rates at 19.6% (95% CI: 12.4–27.3), followed by goats at 13.2% (95% CI: 9.3–17.1), cattle at 13.1% (95% CI: 11.1–15.3) and sheep at 5.4% (95% CI: 4.0–6.9). The herd-level seroprevalence was 51.7% (95% CI: 47.9–55.7). Adult animals (Adjusted Odds Ratio (aOR) = 2.3, CI: 1.3–4.0), female animals (aOR = 1.7, CI: 1.1–2.6), and large herd sizes (aOR = 2.3, CI: 1.3–4.0) were significantly associated with anti-brucella antibody detection while sheep had significantly lower odds of Brucella spp. exposure compared to cattle (aOR = 1.3, CI: 0.8–2.1) and camels (aOR = 2.4, CI: 1.2–4.8). Human individual and household seroprevalences were 54.0% (95% CI: 50.2–58.0) and 86.4% (95% CI: 84.0–89.0), respectively. Significant risk factors associated with human seropositivity included being male (aOR = 2.1, CI:1.3–3.2), residing in Sericho ward (aOR = 1.6, CI:1.1–2.5) and having no formal education (aOR = 3.0, CI:1.5–5.9). There was a strong correlation between human seropositivity and herd exposure (aOR = 1.6, CI:1.2–2.3).

Conclusions
The study provides evidence of high human and livestock exposures to Brucella spp. and identifies important risk factors associated with disease spread. These findings emphasize the need for targeted prevention and control measures to curb the spread of brucellosis and implement a One Health surveillance to ensure early detection of the disease in Isiolo County, Northern Kenya.
Identifying key factors contributing to treatment costs for snakebite envenoming in private tertiary healthcare settings in Tamil Nadu, India
Authors: Salim Anika , Williams Jarred , Abdel Wahab Samir , Adeshokan Tade , Almeida José R. , Williams Harry F. , Vaiyapuri Rajendran , Senthilkumaran Subramanian , Thirumalaikolundusubramanian Ponniah , Patel Ketan , Baksh M. Fazil , Lewin Matthew R. , Vaiyapuri Sakthivel 
Published: October 2023

BackgroundIndia suffers ~58,000 annual deaths due to snakebites. The ‘Big Four’ snakes (Russell’s viper, Indian cobra, common krait, and saw-scaled viper) that are responsible for most bites cause diverse clinical effects. Delayed treatment increases the risk of serious complications and treatment costs. Although government hospitals offer free treatment for snakebites in India, most patients opt for private healthcare, which is an out-of-pocket expense as they often lack health insurance coverage. This study aims to analyse snakebite treatment costs in private tertiary care hospitals in Tamil Nadu, India and identifies the key factors contributing to treatment costs.Methodology/Principal findingsThe treatment cost details for 913 snakebite victims were collected from 10 private tertiary care hospitals across Tamil Nadu. The data were classified into hospital, pharmacy, investigation, and laboratory costs, and analysed to determine various factors that contribute to the costs. The results demonstrate that the average treatment costs vary widely for different snakes. The hospital and pharmacy costs are higher than investigation and laboratory costs for all snakebites. Notably, Russell’s viper bites cost significantly more than the bites from other snakes. Overall, the type of snake, nature of complications, specialist treatments required, and arrival time to hospitals were identified as some of the key factors for higher treatment costs.Conclusions/SignificanceThese data demonstrate that ~80% of snakebite patients can be treated with INR 100,000 (~GBP 1000 or USD 1200) or less. This study emphasises the urgent need to improve rural medical care by providing appropriate training for healthcare professionals and essential resources to facilitate early assessment of patients, administer the initial dose of antivenom and refer the patients to tertiary care only when needed. Moreover, the outcome of this study forms a basis for developing appropriate policies to regulate snakebite treatment costs and provide affordable medical insurance for vulnerable communities.