bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiological and Dosimetric Evaluation of Biomaterial Composite Phantoms with High Energy Photons and Electrons
Authors: Samson Damilola Oluwafemi , Aziz Mohd Zahri Abdul , Shukri Ahmad , Mat Jafri Mohd Zubir , Hashim Rokiah , Zuber Siti Hajar , Hashikin Nurul Ab. Aziz , Rabba James Anthony , Samson Peter Ayoola , Yusof Mohd Fahmi Mohd 
Published: February 2023

Abstract
The current study was undertaken to investigate the radiological and dosimetric parameters of natural product-based composite (SPI/NaOH/IA-PAE/Rhizophora spp.) phantoms. The radiological properties of the phantoms were measured at different gamma energies from Compton scatter of photons through angles of 0, 30, 45, 60, 75, and 90 degrees. Ionization chamber (IC) and Gafchromic EBT3 film dosimeters were employed to evaluate the dosimetric characteristics for photons (6–10 MV) and electrons (6–15 MeV). Radiological property results of the composite phantoms were consistent with good quality compared to those of solid water phantoms and theoretical values of water. Photon beam quality index of the SPI15 phantom with p-values of 0.071 and 0.073 exhibited insignificant changes. In addition, good agreement was found between PDD curves measured with IC and Gafchromic EBT3 film for both photons and electrons. The computed therapeutic and half-value depth ranges matched within the limits and are similar to those of water and solid water phantoms. Therefore, the radiological and dosimetric parameters of the studied composite phantom permit its use in the selection of convenient tissue- and water-equivalent phantom material for medical applications.
Impact of a Caffeine Restriction Policy on Inpatients With Schizophrenia
Authors: Lagreula Juliette , Ferraiolo Mattia , De Timary Philippe , Delatte Benoit , Elens Laure , Hermans Emmanuel , Dalleur Olivia 
Published: February 2023

AbstractBackground/PurposeCaffeine is the most commonly used psychostimulant worldwide. Although its large intake is suspected to worsen psychotic symptoms because of increasing dopamine neurotransmission, schizophrenic patients are heavier caffeine consumers than the general population. This study aims to assess the impact of a caffeine restriction policy in a psychiatric hospital on patient psychopathology, hospitalization characteristics, and psychotropic prescribing patterns.MethodsIt is a retrospective cross-sectional study based on electronic health records of a psychiatric hospital in the French-speaking area of Belgium. Two different periods were compared, the first (n = 142), in 2017, when caffeine was available in the institution and the second (n = 119), between November 2018 and November 2019 after the restriction of access to caffeine was implemented. Adult inpatients with schizophrenia or schizoaffective disorder admitted for an acute hospitalization were included. Antipsychotic exposure, benzodiazepine daily dose, Global Assessment of Functioning scores, length of hospital stay, and some other factors were tested for their potential association with the decaffeinated period.ResultsAfter adjusting for potential confounders, reduced caffeine availability inside the hospital was significantly associated with higher Global Assessment of Functioning scores at discharge (adjusted odds ratio [aOR] = 2.86, 95% confidence interval [CI] = 1.77–4.62) and shorter hospital stays (aOR = 0.68, 95% CI = 0.47–0.99) but was not associated with change in antipsychotic exposure at discharge (aOR = 1.04, 95% CI = 0.64–1.7) or benzodiazepine daily dose (aOR = 0.89, 95% CI = 0.61–1.29).ConclusionsLimiting access to caffeine in psychiatric hospitals is a simple and inexpensive intervention that should be promoted, especially for patients with schizophrenia.
Outcomes of sexagenarian living liver donors in Korea: A multicenter study
Authors: Kim Jong Man , Joo Dong Jin , Hong Suk Kyun , You Young Kyoung , Hwang Shin , Ryu Je Ho , Kim Doo Jin , Yu Hee Chul , Nah Yang Won , Kim Myoung Soo 
Published: February 2023

The safety of elderly living liver donors and recipient outcomes are always of concern. In the present study, the effects of age in 2 donor groups, a 60+years old group and a 50–59 years old group (referred to as the 60s and 50s donor groups, respectively), on living donor liver transplantation were compared regarding donor safety and recipient outcomes. We retrospectively identified 209 patients 50 years and above of age at 9 centers from 2005 to 2017 in Korea. The 60s donor group represented 10% (n=21) of donor patients. One case in each group was a left liver graft, respectively, and the others were right liver grafts. Postoperative complications were more common in the 60s donor group, but the proportion of Clavien-Dindo grade III in the 60s donor group did not differ from that in the 50s donor group. In-hospital mortality did not occur among donors, and donor mortality was not reported during the observation period. Postoperative total bilirubin and hospitalization in recipients of the 60s donor group were higher and longer than in recipients of the 50s donor group, respectively. Although the cumulative overall survival of the recipients in the 60s donor group was significantly lower than that of the 50s donor group, a difference was not observed in graft survival. Multivariate analysis showed that increased living liver donors age, the coexistence of HCC, and increased intraoperative blood loss during the recipient operation were important predisposing factors for patient death.
Present study suggests that highly selected elderly living donors (≥60 y) can safely donate with similar recipient graft survival rates though the recipient overall patient survival is inferior compared to the 50s donor group.
Efficacy of laparoscopic inguinal hernia in day surgery mode and inpatient surgery mode in China: A meta-analysis
Authors: Zhong Yang , He Miao , Liu Zhi , Chen Jian Yu , Lv Xiao Jiang , Liu Mao , Wen Ai Ping , Qin Long , Li Jian Shui 
Published: February 2023

Background:
In China, laparoscopic inguinal hernia repair (LIHR) under the day surgery mode (DSM) has developed rapidly as an important surgical method for inguinal hernia repair, and it has unique advantages in many aspects. Compared with inpatient surgery mode (ISM), there are some differences in intraoperative and postoperative related indicators, hospitalization costs, and patient satisfaction. Many studies have shown that LIHR in DSM can significantly shorten hospital stay, effectively reduce hospitalization costs, and improve patient satisfaction. Accordingly, this study aimed to compare the differences in intraoperative and postoperative related indicators, hospitalization costs, and patient satisfaction of LIHR between DSM and ISM in China.

Methods:
The PubMed/Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wan Fang databases were searched for randomized controlled trials, cohort studies from the establishment of the database to July 1, 2022. Odds ratio (OR), mean difference, standardized mean difference (SMD), and 95% confidence interval were selected as the effect scale indices for the evaluation of the difference in hospitalization costs, hospital stay, operation time, recovery time, complications, and patient satisfaction. All of these were compared using RevMan 5.3 Software (The Cochrane Collaboration, Copenhagen, Denmark).

Results:
Nine studies involving 1176 patients, 590 in the DSM group and 586 in the ISM group, were included. The hospital stay (d) (SMD = −7.27, 95% confidence interval, CI: −8.68 to −5.87, P
< .001), hospitalization costs (SMD = −7.89, 95% CI: −10.25 to −5.53, P
< .001) in DSM group were significantly lower than the ISM group. Additionally, the patient dissatisfaction (OR = 0.05, 95% CI: 0.01–0.17, P < .001) in DSM group was significantly lower than the ISM group. Nevertheless, no significant differences were found in the operation time (minute) (mean difference = −0.32, 95% CI: −1.78 to 1.14, P = .67), recovery time (h) (SMD = −3.27, 95% CI: −6.95 to 0.41, P
= .08), and postoperative complications (OR = 0.80, 95% CI: 0.47–1.36, P = .41) between the 2 groups.

Conclusion:
In China, compared with ISM, LIHR under DSM can significantly shorten hospital stay, greatly reduce hospitalization costs, and significantly improve patient satisfaction. There were no significant differences in operation time, recovery time and postoperative complications.
Multiple cholesterol granulomas of the breast: A case report and review of the literature
Authors: Jin Menglei , Wu Qiang , Miao Bingliang , Jin Jing , Gao Chenyi , Xu Xiaoming , Luo Yingbo , Chen Zhigang 
Published: February 2023

Rationale:
Cholesterol granuloma of the breast is a rare disease defined as chronic reactive inflammation of cholesterol crystals and foreign body giant cells. This disease can mimic breast cancer in the clinic as painless palpable hard nodules, and imaging shows irregular hypoechoic nodules with unclear boundaries. Therefore, the uncommon lesions can be easily misdiagnosed as breast cancer. Meanwhile, it can be easily neglected by clinicians because of poor understanding.

Patient concerns:
In this report, we present a rare case of multiple cholesterol granulomas of the breast, which was analyzed retrospectively and combined with all 11 relevant available studies in the last 50 years.

Interventions:
The patient had undergone multiple breast imaging inspections for breast nodules and had the local resection of nodules.

Diagnoses:
The patient was confirmed to have a final diagnosis of benign cholesterol granulomas but was initially considered as breast cancer.

Outcomes:
The patient did not complain of discomfort after surgery, and ultrasound reexamination 5 months after surgery showed no recurrence.

Lessons:
By retrospective analysis, dynamic contrast-enhanced magnetic resonance imaging and core needle biopsy can synergistically help clinicians distinguish it from other breast disease. To raise awareness of such a rare disease and reduce related misdiagnoses, we summarize the characteristics of cholesterol granulomas and recommend appropriate novel diagnosis and treatment regimens for patients with cholesterol granulomas.
Coordinated Patient Care via Mobile Phone–Based Telemedicine in Secondary Stroke Prevention
Authors: Li Dong-Mei , Lu Xiao-Ying , Yang Peng-Fei , Zheng Jing , Hu Huan-Huan , Zhou Yu , Zhang Ling-Juan , Liu Jian-Min 
Published: February 2023

Background:
To prevent recurrent stroke, patients need to follow evidence-based practices following discharge; however, adherence to these practices is suboptimal.

Purpose:
To evaluate whether a smartphone mobile application can improve medication adherence and stroke awareness in secondary stroke prevention.

Methods:
A retrospective study design was used. Patients with ischemic stroke registered in a database between August 2018 and January 2019 were enrolled. Propensity score matching was used to match patients managed with the mobile application compared with regular practice in a 1:2 ratio.

Results:
Sixty-five patients were paired with 123 controls. Three-month medication adherence was 93.8% in the application group versus 82.9% in the control group (P = .036). Patients in the application group were more likely to know stroke warning signs (P = .003) and when to call an ambulance for stroke symptoms (87.7% vs 72.4%, P = .016).

Conclusions:
Using a mobile application may increase medication adherence and stroke awareness in secondary stroke prevention.
Improved Brain Tumor Conspicuity at 3 T Using Dark Blood, Fat-Suppressed, Dixon Unbalanced T1 Relaxation-Enhanced Steady-State MRI
Authors: Edelman Robert R. , Walker Matthew , Ankenbrandt William J. , Leloudas Nondas , Pang Jianing , Bailes Julian , Bobustic George , Koktzoglou Ioannis 
Published: February 2023

ObjectivesContrast-enhanced magnetic resonance imaging (MRI) is the cornerstone for brain tumor diagnosis and treatment planning. We have developed a novel dual-echo volumetric dark blood pulse sequence called Dixon unbalanced T1 relaxation-enhanced steady-state (uT1RESS) that improves the visibility of contrast-enhancing lesions while suppressing the tissue signals from blood vessels and fat. The purpose of this study was to test the hypothesis that Dixon uT1RESS would significantly improve the conspicuity of brain tumors compared with magnetization-prepared rapid gradient echo (MPRAGE), as well as to determine potential limitations of the technique.Materials and MethodsThis retrospective study was approved by the hospital institutional review board. Forty-seven adult patients undergoing an MRI scan for a brain tumor indication were included. Contrast-enhanced MRI of the brain was performed at 3 T using both MPRAGE and Dixon uT1RESS. To control for any impact of contrast agent washout during the scan procedure, Dixon uT1RESS was acquired in approximately half the subjects immediately after MPRAGE, and in the other half immediately before MPRAGE. Image quality, artifacts, and lesion detection were scored by 3 readers, whereas lesion apparent signal-to-noise ratio and lesion-to-background Weber contrast were calculated from region-of-interest measurements.ResultsImage quality was not rated significantly different between MPRAGE and Dixon uT1RESS, whereas motion artifacts were slightly worse with Dixon uT1RESS. Comparing Dixon uT1RESS with MPRAGE, the respective values for mean lesion apparent signal-to-noise ratio were not significantly different (199.31 ± 99.05 vs 203.81 ± 110.23). Compared with MPRAGE, Dixon uT1RESS significantly increased the tumor-to-brain contrast (1.60 ± 1.18 vs 0.61 ± 0.47 when Dixon uT1RESS was acquired before MPRAGE and 1.94 ± 0.97 vs 0.82 ± 0.55 when Dixon uT1RESS was acquired after MPRAGE). In patients with metastatic disease, Dixon uT1RESS detected at least 1 enhancing brain lesion that was missed by MPRAGE on average in 24.7% of patients, whereas Dixon uT1RESS did not miss any lesions that were demonstrated by MPRAGE. Dixon uT1RESS better detected vascular and dural invasion in a small number of patients.ConclusionsIn conclusion, brain tumors were significantly more conspicuous at 3 T using Dixon uT1RESS compared with MPRAGE, with an approximately 2.5-fold improvement in lesion-to-background contrast irrespective of sequence order. It outperformed MPRAGE for the detection of brain metastases, dural or vascular involvement. These results suggest that Dixon uT1RESS could prove to be a useful adjunct or alternative to existing neuroimaging techniques for the postcontrast evaluation of intracranial tumors.
Severe Postictal Confusion After Electroconvulsive Therapy
Authors: Schuur Gijsbert , Verdijk Joey P.A.J. , ten Doesschate Freek , van Wingen Guido A. , van Waarde Jeroen A. 
Published: February 2023

Objectives
Severe postictal confusion (sPIC) is an important but poorly investigated adverse effect of electroconvulsive therapy (ECT). In this retrospective study, prevalence of sPIC and potential risk factors were explored.

Methods
Medical charts of 295 ECT patients (mean ± SD age, 57 ± 15 years; male, 36%) were scrutinized for occurrence of sPIC, as well as demographic, clinical, and treatment characteristics. Patients showing sPIC were compared with patients who did not, using univariate statistics. Multivariate analyses with a split-sample validation procedure were used to assess whether predictive models could be developed using independent data sets.

Results
O 295 patients, 74 (25.1%) showed sPIC. All patients showing sPIC needed extra medication, 9% (n = 7) required physically restraints, and 5% (n = 4) had to be secluded. Univariate analyses showed several trends: patients with sPIC were more often males (P = 0.05), had more often history of cerebrovascular incident (P = 0.02), did not use concomitant selective serotonin reuptake inhibitors (P = 0.01), received higher median dosage of succinylcholine (P = 0.02), and received pretreatment with flumazenil more often (P = 0.07), but these associations did not remain significant after correction for multiple comparisons. Multiple logistic regression analysis did not result in a model that could predict sPIC in the holdout data set.

Conclusions
In this retrospective naturalistic study in 295 ECT patients, the prevalence of sPIC appeared to be 25%. Patients showing sPIC were characterized by male sex, history of cerebrovascular incident, use of higher-dose succinylcholine, and pretreatment with flumazenil. However, multivariate analysis revealed no significant model to predict sPIC in independent data.
Vitamin B12 in pregnancy and its relationship with maternal BMI and gestational DM
Authors: Muzaffar Rameesha , Khursheed Jameeha , Yousaf Anum 
Published: February 2023

AbstractIntroductionGestational diabetes mellitus (GDM) is one of the most prevalent complications of pregnancy. In a joint statement released in 2018, the International Federation of Obstetrics and Gynecology (FIGO) and the International Diabetes Federation (IDF) stated that high blood glucose levels during pregnancy have an impact on maternal, newborn, and child health and may contribute to the global burden of type 2 diabetes mellitus and cardiovascular metabolic disorders in the short and long term.ObjectivesThe basic aim of the study is to analyze vitamin B12 in pregnancy and its relationship with maternal BMI and gestational DM.Material and methodsThis cross-sectional study was conducted in THQ Hospital Deepalpur, Pakistan during March 2021 to August 2021. Record gathered from 118 hospitals with the total number of 364 women stated for the study coordinator. As per database record, 11% (41 women) were excluded due to initial trimester spontaneous abortion as well as type 2 diabetes diagnosed in 16; 4% and follow up loss 2; 1%.ResultsMaternal outcomes in pregnant women with type 1 diabetes and those without the disease were evaluated in this study. No maternal mortality occurred within 30 days of delivery in 630 pregnancies with type 1 diabetes. However, pregnant women with type 1 diabetes were usually at a much higher risk of developing adverse maternal events during their pregnancy than women without type 1 diabetes, even after adjusting for age and infant sex or age, infant sex, place of residence, income level, occupation, calendar year, and Charlson comorbidity index.ConclusionIt is concluded type 1 diabetes remains a significant disease threatening pregnant women and their offspring. Clinicians should be aware of this clinical situation.
The impact of prolonged walking on fasting plasma glucose in type 2 diabetes: A Randomised controlled crossover study
Authors: Niwaha Anxious J. , Rodgers Lauren R. , Hattersley Andrew T. , Andrews Robert C , Shields Beverley M. , Nyirenda Moffat J. , Jones Angus G. 
Published: February 2023

ABSTRACTAimsIn many low-income countries, fasting glucose is the primary measure of glycaemic control used for treatment titration, as HbA1c is often unavailable or unaffordable. Many patients in these countries walk long distances to the clinic, but the impact of walking on fasting glucose in type 2 diabetes is unknown. We aimed to determine whether this prolonged walking affects the reliability of fasting plasma glucose as a measure of glycaemic control.MethodsIn a randomised crossover trial, the change in glucose from baseline in the fasting state was compared between walking on a treadmill at a predetermined speed of 4.5 km/hour for 1 hour and not walking (resting) in people with type 2 diabetes. The pre-specified primary outcome was glucose at 1 and 2 hours.Results45 participants were enrolled and all completed both visits. 21/45 (46.7%) were female, and the median age was 51. Glucose during and after walking was similar to glucose while at rest; glucose difference (walking minus rest) was -0.15 (95% CI: -0.55, 0.26) and -0.10 (95% CI: - 0.50, 0.31) mmol/L at 1 and 2 hours respectively, p>0.4 for both).ConclusionsFasting plasma glucose is not meaningfully affected by prolonged walking in participants with type 2 diabetes; therefore, the reliability of fasting glucose for monitoring glycaemic burden is unlikely to be altered in patients who walk to the clinic.Research in contextWhat is already known about this subject?Fasting glucose is widely used to assess glycaemic control in people living with diabetes in low income countries, as HbA1c and home glucose monitoring are unaffordable. In these settings people living with diabetes will often walk long distances to receive healthcare.Little is known on the impact of walking on fasting glucose in people living with diabetes.What is the key question?Is fasting plasma glucose measure affected by a single bout of exercise such as walking in individuals with type 2 diabetes (T2D)?What are the new findings?There was no significant change in fasting glucose at the end of the walking exercise.There was no meaningful change in fasting glucose observed at any point up to 3 hours after commencing exercise.How might this impact on clinical practice in the foreseeable future?Fasting plasma glucose is not meaningfully affected by prolonged walking in participants with type 2 diabetes; therefore, the reliability of fasting glucose for monitoring glycaemic burden is unlikely to be altered in patients who walk to the clinic.
Machine Learning-based prediction of Early Neurological Deterioration after Thrombolysis in Acute Ischemic Stroke
Authors: Gao Yuan , Zong Ce , Liu Hongbing , Zhang Ke , Yang Hongxun , Wang Anran , Wang Yunchao , Li Yapeng , Liu Kai , Li Yusheng , Yang Jing , Song Bo , Xu Yuming 
Published: February 2023

ABSTRACTBackgroundEarly neurological deterioration (END) after thrombolysis in acute ischemic stroke (AIS) cannot be ignored. Our aim is to establish an interpretable machine learning (ML) prediction model for clinical practice.MethodsPatients in this study were enrolled from a prospective, multi-center, web-based registry database. Demographic information, treatment information and laboratory tests were collected. END was defined as an increase of ⩾2 points in total National Institutes of Health Stroke Scale (NIHSS) score within 24 hours after thrombolysis. Eight ML models were trained in the training set (70%) and the tuned models were evaluated in the test set (30%) by calculating the area under the curve (AUC), sensitivity, specificity, accuracy, and F1 scores. Calibration curves were plotted and brier scores were calculated. The SHapley Additive exPlanations (SHAP) analysis and web application were developed for interpretation and practice.ResultsA total of 1956 patients were included in the analysis. Of these, 305 patients (15.6%) experienced END. We used logistic regression to identify six important variables: hemoglobin, white blood cell count, the ratio of lymphocytes to monocytes (LMR), thrombin time, onset to treatment time, and prothrombin time. In the test set, the results showed that the Extreme gradient boosting (XGB) model (AUC 0.754, accuracy 0.722, sensitivity 0.723, specificity 0.720, F1 score 0.451) exhibited relatively good performance. Calibration curves showed good agreement between the predicted and true probabilities of the XGB (brier score=0.016) model. We further developed a web application based on it by entering the values of the variables (https://ce-bit123-ml-app1-13tuat.streamlit.app/).ConclusionsThrough the identification of critical features and ML algorithms, we developed a web application to help clinicians identify high-risk of END after thrombolysis in AIS patients more quickly, easily and accurately as well as making timely clinical decisions.