bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of implementing a surgical patient safety checklist: prospective cross-sectional evaluation
Authors: Harris Kristin , Søfteland Eirik , Moi Asgjerd Litleré , Harthug Stig , Ravnøy Mette , Storesund Anette , Jurmy Elaheh , Skeie Eli , Wæhle Hilde Valen , Sevdalis Nick , Haugen Arvid Steinar 
Published: March 2023

Abstract
Background
The World Health Organization’s Global Patient Safety Action Plan 2021–2030 call for attention to patient and family involvement to reduce preventable patient harm. Existing evidence indicates that patients’ involvement in their own safety has positive effects on reducing hospitalisation time and readmissions. One intervention reported in the literature is the use of checklists designed for patients’ completion. Studies on such checklists are small scale, but they are linked to reduction in length of hospital stay and readmissions. We have previously developed and validated a two-part surgical patient safety checklist (PASC). This study aims to investigate the feasibility of the PASC usage and implementation prior to its use in a large-scale clinical trial.

Methods
This is a prospective cross-sectional feasibility study, set up as part of the design of a larger stepped-wedge cluster randomised controlled trial (SW-CRCT). Descriptive statistics were used to investigate patient demographics, reasons for not completing the PASC and percentage of PASC item usage. Qualitative patient interviews were used to identify barriers and drivers for implementation. Interview was analysed through content analysis.

Results
Out of 428 recruited patients, 50.2% (215/428) used both parts of PASC. A total of 24.1% (103/428) of the patients did not use it at all due to surgical or COVID-19-related cancellations. A total of 19.9% (85/428) did not consent to participate, 5.1% (22/428) lost the checklist and 0.7% (3/428) of the patients died during the study. A total of 86.5% (186/215) patients used ≥ 80% of the checklist items. Barriers and drivers for PASC implementation were grouped into the following categories: Time frame for completing the checklist, patient safety checklist design, impetus to communicate with healthcare professionals and support throughout the surgical pathway.

Conclusions
Elective surgical patients were willing and able to use PASC. The study further revealed a set of barriers and drivers to the implementation. A large-scale definitive clinical-implementation hybrid trial is being launched to ascertain the clinical effectiveness and scalability of PASC in improving surgical patient safety.

Trial registration
Clinicaltrials.gov: NCT03105713. Registered 10.04.2017
Translation, cross-cultural adaptation and measurement properties of three implementation measures into Brazilian-Portuguese
Authors: Fioratti Iuri , Santos Verônica S. , Fernandes Lívia G. , Rodrigues Karina A. , Soares Renato J. , Saragiotto Bruno T. 
Published: March 2023

Abstract
Background
To translate and cross-culturally adapt into Brazilian-Portuguese, and to test the measurement properties of the following items of implementation outcome measures: Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and Feasibility of Intervention Measure (FIM).

Methods
This was a measurement properties study in accordance with the Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN). We conducted a translation and cross-cultural adaptation of three implementation measures according to guidelines for translation and cross-cultural adaptation, then we collected information from patients who had participated in remotely delivered physical therapy treatment for musculoskeletal condition. The patients answered the translated versions of the implementation outcome measures. The measurement properties of the three implementation outcome measures were collected in a test–retest assessment, with an interval of 7 to 14 days.. The measurement properties evaluated in this study were interpretability, measured using Ceiling and Floor Effects, reliability in test–retest evaluation, measured using Cronbach’s Alpha Coefficient, internal consistency, measured using Intraclass Correlation Coefficient and construct validity, measured using Pearson Correlation.

Results
We included 104 participants (76 female). The average age of the sample was 56.8 (SD 14.8) years old. The items of implementation outcome measures (AIM, IAM, and FIM) showed 66.39%, 63.11%, and 63.93% of ceiling effects. The items of implementation outcome measures showed adequate internal consistency measured using Cronbach’s Alpha Coefficient (AIM: 0.89, IAM: 0.91, FIM: 0.93) and values of Standard Error of Measurement between 5 and 10%, showing good measurement error. The results of AIM and IAM was classified as moderate reliability and the FIM as substantial reliability. In a total 96 correlations, > 75% of correlations met our prior hypothesis.

Conclusion
The three Brazilian-Portuguese versions of items of implementation outcome measures had adequate internal consistency, measurement error and construct validity. The three implementation outcome measures showed moderate to substantial reliability values. The Ceiling Effect was observed in the three measures, showing maximum values ​​in more than 15% of the evaluations.
Anthracycline cardiotoxicity: current methods of diagnosis and possible role of 18F-FDG PET/CT as a new biomarker
Authors: Becker Mônica M. C. , Arruda Gustavo F. A. , Berenguer Diego R. F. , Buril Roberto O. , Cardinale Daniela , Brandão Simone C. S. 
Published: March 2023

AbstractDespite advances in chemotherapy, the drugs used in cancer treatment remain rather harmful to the cardiovascular system, causing structural and functional cardiotoxic changes. Positron-emission tomography associated with computed tomography (PET/CT) has emerged like a promising technique in the early diagnosis of these adverse drug effects as the myocardial tissue uptake of fluorodeoxyglucose labeled with fluorine-18 (18F-FDG), a glucose analog, is increased after their use. Among these drugs, anthracyclines are the most frequently associated with cardiotoxicity because they promote heart damage through DNA breaks, and induction of an oxidative, proinflammatory, and toxic environment. This review aimed to present the scientific evidence available so far regarding the use of 18F-FDG PET/CT as an early biomarker of anthracycline-related cardiotoxicity. Thus, it discusses the physiological basis for its uptake, hypotheses to justify its increase in the myocardium affected by anthracyclines, importance of 18F-FDG PET/CT findings for cardio-oncology, and primary challenges of incorporating this technique in standard clinical oncology practice.
A novel cardio-oncology service line model in optimizing care access, quality and equity for large, multi-hospital health systems
Authors: Liu Yan 
Published: March 2023

Abstract
Background
Despite the rapid growth of cardio-oncology as a subspecialty, cancer patients are still underserved from a cardiovascular perspective. A new care model is needed to integrate comprehensive cardio-oncology care with community-based facilities to improve care access, quality, and equity. Here, we present a cardio-oncology service line model for large, multi-hospital health systems to address this need.

Methods
An academic cardio-oncology program was first established using a multidisciplinary approach. Five infrastructure elements for a service line model were created, including strategic accountability, standardized care, dedicated resources, patient experience/education, and branding/identity. We then utilized these elements across our healthcare system to establish a quality-controlled and centrally governed cardio-oncology service line structure. Protocols were created to standardize care and ensure consistency and quality, including referral workflow, imaging, cardiotoxicity surveillance, and clinical management. An IRB-approved cardio-oncology registry was established for outcome tracking.

Results
The standardized cardio-oncology services were expanded to eight hospitals and ten outpatient care centers, including rural outreach offices, resulting in increased patient access and improved clinical quality measures. The service area expanded 17-fold, and an estimated rural population of 204,133 gained access to care. Cardio-oncology office visits increased by approximately 600% three years after implementation of the service line model.

Conclusions
A cardio-oncology service line with standardized care is a feasible and effective care model to improve cardio-oncology care quality, patient access, and health equity in large, multi-hospital health systems. It can be used in conjunction with academic cardio-oncology programs to improve the overall cardio-oncology healthcare efficacy in the US.
Indigenous institutions as adaptive measures to environmental dynamics: an ethnographic study of Loba Community of Upper Mustang, Nepal
Authors: Khattri Man Bahadur , Pandey Rishikesh 
Published: March 2023

AbstractThis paper investigates how different institutions of Loba communities of the Upper Mustang work together and facilitate the community to cope with the environmental dynamics in the region. The indigenous institutions are place-based, and their evolution is concerned with reducing vulnerability and enhancing the resilience capacity of place-based communities to cope with and adapt to local natural and socio-cultural environmental dynamics. The paper is based on anthropological fieldwork. Qualitative data were collected by applying observation and interviews. The paper presents the role of the galbo, (Lo King), ghenba (Village Chief), Lama (Monk), and dhongba (Household) as local institutions that act in close relation and make community-level decisions. The findings reveal that the King is seen as the leader whose governance best suited to the local natural environment, cultural practices, and economy. The Lama plays a major role in reinforcing local rules, while the Ghenba is an agent who mediates the Lo King and people in materializing rules and operationalizing institutional mechanisms. The Dhongbas are units of production of the local social-ecosystem that are entitled to use local resources within the context of the institution’s agreed rules, norms, and values. These local institutions are cooperating well, successfully regulating, managing, and protecting agricultural, forest, and pasture lands, and maintaining the monuments in Lo-manthang for centuries. However, recent social-environmental dynamics such as climate change, migration, and modernization are reducing the relevancies of traditional norms and practices. Nevertheless, the institutions are working hard to continue their existence by frequently modifying their rules and norms.
Clinical risk factors related to post-stroke epilepsy patients in Indonesia: a hospital-based study
Authors: Waafi Afiyf Kaysa , Husna Machlusil , Damayanti Ria , Setijowati Nanik 
Published: March 2023

Abstract
Background
Stroke had been accounted to cause almost 50% of epilepsy in the elderly and may lead to poor functional outcomes. Many studies examining the risk factors have been conducted despite showing inconsistent results and currently still difficult to predict the occurrence of post-stroke epilepsy. The study aimed to determine risk factors related to post-stroke epilepsy that influence clinical seizure, electroencephalography (EEG), and functional outcome of patients. Analytic retrospective case–control study was conducted with a total sampling of 62 samples of post-stroke epilepsy and 62 samples of control from all stroke patients in the Neurology Clinic from January 2019 to December 2021. Epilepsy was classified according to the criteria of the International League Against Epilepsy (ILAE) in 2017. The relevant demographic and clinical data were collected.

Result
The study involved 62 patients in the case group (average age of onset = 57.69; 42 men, 20 women; 51 ischemic stroke, 11 hemorrhagic stroke) and 62 patients in the control group (average age of onset = 56.90; 24 men, 38 women; 52 ischemic stroke, 10 hemorrhagic stroke). We found that 31 patients had focal-to-bilateral seizures, 26 patients had generalized seizures and 5 patients had focal seizures. Men (p = 0.001; OR 3.325) and NIHSS Score (p = 0.027; OR 5.094) had significant correlations with post-stroke epilepsy. Ischemic stroke had a significant correlation (p = 0.008) with seizure onset. Women also had a significant correlation (p = 0.012) with EEG abnormalities. The study found that 59 of 62 post-stroke epilepsy patients had poor functional outcomes (mRS > 2).

Conclusion
Our study confirmed that most patients had focal-to-bilateral seizure patterns that occurred in 1–2 years after stroke, and had poor functional outcomes. Men had 3.325 times more likely to develop post-stroke epilepsy than women. Also, NIHSS score ≥ 15 correlated and 5.094 times more likely to develop post-stroke epilepsy. Ischemic stroke had a peak of epilepsy onset at 1–2 years after stroke and women had significant showing abnormalities on EEG recording than men.
Serial perioperative optic nerve sheath measurements for early diagnosis of the transurethral resection of prostate syndrome: an open label pilot study
Authors: Chauhan Bharti , Raina Pamposh , Dogra Ravi Kant , Pathania Jyoti 
Published: March 2023

AbstractBackgroundUltrasound imaging of optic sheath nerve diameter [ONSD] is reported to reflect changes consistent with intracranial pressure changes seen in traumatic brain injury and also in documented serum hyponatremia. We hypothesized that hyponatremia and hypervolemia seen during trans urethral resection of prostate [TURP] surgery may also have some association with different ONSD readings from the baseline perioperatively, resulting in early detection of TURP syndrome. In this prospective observational study, 50 adult male patients scheduled for TURP surgery meeting inclusion criteria were included and the ONSD measurements were serially recorded perioperatively. Patients with measurements ≥ 5.2 mm with either clinical symptoms or electrolyte changes suggested TURP syndrome were taken as true positive.ResultsThe sensitivity, specificity, area under the curve, positive predictive, and negative predictive value at 95%CI of ONSD for early detection of TURP syndrome was {100% [15.81 to 100.00%], 91.67% [80.02 to 97.68%], 0.96 [0.86 to 0.99%], 33.33% [4.33 to 77.72%], 100% [91.96 to 100.00%]} with a diagnostic accuracy of 95.83%. In univariate logistic regressions, the duration of surgery had a positive association with TURP syndrome [odd ratio 1.066, β coefficient 0.064,p = 0.015]. In multivariate logistic regression, we could not validate the association between these factors and TURP syndrome [p > 0.050].ConclusionsThe ONSD measurements have good diagnostic accuracy for detecting TURP syndrome, but we advocate more multi-centric studies with large sample sizes to validate this association in the multivariate regression model.
Impact of cooking methods on the chemical and antioxidant composition of some indigenous vegetables used in different food dishes in Southeast Nigeria
Authors: Ukom Anthony , Albert Miracle , Ojimelukwe Philippa , Offia-Olua Blessing , Nwanagba Lilian 
Published: March 2023

AbstractBackgroundSome wild and domesticated vegetables of Ibo ethnic tribe of Southeast, Nigeria, namelyPiper guineense,Ocimum gratissimum,Solanum melongenaL.,Gongronema latifolium,Gnetum africanumandVernonia amygdalina, have gained interest in food culinary uses due to its nutritional, antioxidant potentials and health benefits. These vegetables are rich in fiber, minerals and phyto-nutrients and have significant health benefits against degenerative disorders. Due to these facts, cooking methods aimed at better retention of nutrients and antioxidant compounds were exploited.MethodsCarefully selected fresh and shredded indigenous vegetables that are commonly used in different food dishes in Southeast Nigeria were cooked (blanched at 98 °C, 2 min and sautéed at 150 °C, 5 min). They were analyzed on a dry weight basis for minerals, vitamins, phytochemicals and antioxidant activity assayed by DPPH, ABTS and FRAP.ResultsResults exhibited wild variations showing thatOcimum gratissimumandSolanum melongenaL had higher concentrations of functional minerals Zn, Fe, K and Ca. Vitamins B1and β-carotene had higher concentrations inSolanum melongenaL,Gnetum africanumandVernonia amygdalina.Ocimum gratissimumrevealed higher concentrations of TPC and TFC and maintains strong scavenging activity in ABTS and FRAP, while %DPPH manifested stronger activity inSolanum melongenaL.Vernonia amygdalinaexhibited higher phytochemicals concentrations, especially the alkaloid content.ConclusionSautéed cooking retained more nutrients and had stronger antioxidant activity than the blanched method. Overall, these vegetables possess high concentrations of functional constituents that can make them be used to boost human nutrition and benefit the health of consumers.
Artificial-intelligence-enhanced synthetic thick slabs versus standard slices in digital breast tomosynthesis
Authors: Sauer Stephanie Tina , Christner Sara Aniki , Kuhl Philipp Josef , Kunz Andreas Steven , Huflage Henner , Luetkens Karsten Sebastian , Schlaiß Tanja , Bley Thorsten Alexander , Grunz Jan-Peter 
Published: March 2023

Objectives:
Digital breast tomosynthesis (DBT) can provide additional information over mammography, albeit at the cost of prolonged reading time. This study retrospectively investigated the impact of reading enhanced synthetic 6 mm slabs instead of standard 1 mm slices on interpretation time and readers performance in a diagnostic assessment centre.

Methods:
Three radiologists (R1-3; 6/4/2 years of breast imaging experience) reviewed 111 diagnostic DBT examinations. Two datasets were interpreted independently for each patient, with one set containing artificial-intelligence-enhanced synthetic 6 mm slabs with 3 mm overlap, while the other set comprised standard 1 mm slices. Blinded to histology and follow-up, readers noted individual BIRADS categories and diagnostic confidence while reading time was recorded. Among the 111 examinations, 70 findings were histopathologically correlated including 56 malignancies.

Results:
No significant difference was found between BIRADS categories assigned based on 6 mm vs 1 mm datasets (p ≥ 0.317). Diagnostic accuracy was comparable for 6 mm and 1 mm readings (R1: 87.0% vs 87.0%; R2: 86.1% vs 87.0%; R3: 80.0% vs 84.4%; p ≥ 0.125) with high interrater agreement (intraclass correlation coefficient 0.848 vs 0.865). One reader reported higher confidence with 1 mm slices (R1: p = 0.033). Reading time was substantially shorter when interpreting 6 mm slabs compared to 1 mm slices (R1: 33.5 vs 46.2; R2: 49.1 vs 64.8; R3: 39.5 vs 67.2 sec; all p &lt; 0.001).

Conclusions:
Artificial-intelligence-enhanced synthetic 6 mm slabs allow for substantial interpretation time reduction in diagnostic DBT without a decrease in reader accuracy.

Advances in knowledge:
A simplified slab-only protocol instead of 1 mm slices may offset the higher reading time without a loss of diagnosis-relevant image information in first and second readings. Further evaluations are required regarding workflow implications, particularly in screening settings.
An automatic fresh rib fracture detection and positioning system using deep learning
Authors: Li Ning , Wu Zhe , Jiang Chao , Sun Lulu , Li Bingyao , Guo Jun , Liu Feng , Zhou Zhen , Qin Haibo , Tan Weixiong , Tian Lufeng 
Published: March 2023

Objective: To evaluate the performance and robustness of a deep learning-based automatic fresh rib fracture detection and positioning system (FRF-DPS). Methods: CT scans of 18,172 participants admitted to eight hospitals from June 2009 to March 2019 were retrospectively collected. Patients were divided into development set (14,241), multicenter internal test set (1612), and external test set (2319). In internal test set, sensitivity, false positives (FPs) and specificity were used to assess fresh rib fracture detection performance at the lesion- and examination-levels. In external test set, the performance of detecting fresh rib fractures by radiologist and FRF-DPS were evaluated at lesion, rib, and examination levels. Additionally, the accuracy of FRF-DPS in rib positioning was investigated by the ground-truth labeling. Results: In multicenter internal test set, FRF-DPS showed excellent performance at the lesion- (sensitivity: 0.933 [95%CI, 0.916–0.949], FPs: 0.50 [95%CI, 0.397–0.583]) and examination-level. In external test set, the sensitivity and FPs at the lesion-level of FRF-DPS (0.909 [95%CI, 0.883–0.926], p < 0.001; 0.379 [95%CI, 0.303–0.422], p = 0.001) were better than the radiologist (0.789 [95%CI, 0.766–0.807]; 0.496 [95%CI, 0.383–0.571]), so were the rib- and patient-levels. In subgroup analysis of CT parameters, FRF-DPS were robust (0.894–0.927). Finally, FRF-DPS(0.997 [95%CI, 0.992–1.000], p < 0.001) is more accurate than radiologist (0.981 [95%CI, 0.969–0.996]) in rib positioning and takes 20 times less time. Conclusion: FRF-DPS achieved high detection rate of fresh rib fractures with low FP values, and precise positioning of ribs, thus can be used in clinical practice to improve the detection rate and work efficiency. Advances in knowledge: We developed the FRF-DPS system which can detect fresh rib fractures and rib position, and evaluated by a large amount of multicenter data.
Relationship between Monoclonal Gammopathy of undetermined significance and multiple myeloma via online database analysis
Authors: Lu Weiguo , Liu Jiaming , Luo Man , Xiao Mingfeng 
Published: March 2023

Objective: To explore the relationship between Monoclonal Gammopathy of undetermined significance (MGUS) and Multiple Myeloma (MM) based on bioinformatics methods.
Methods: In this study, we conducted bioinformatics to identify genes associated with MGUS and MM using the PubMed pubmed2ensemble (http://pubmed2ensembl.ls.manchester. ac.uk/) until 2021. Gene ontology function was used to label overlapping genes, and Kyoto Encyclopedia of Genes and Genomes analysis was used to identify enriched pathways. The cluster-1 genes obtained from Cytoscape were analyzed by Comparative Toxicogenomics Database (CTD, http://ctdbase.org/) and then used to screen candidate drugs using the DSigDB database (https://amp.pharm.mssm.edu/Enrichr/).
Results: In total, 227 genes were common to both MGUS and MM. These genes were significantly associated with cytokine-cytokine receptor interaction and the PI3K-Akt signaling pathway. The protein-protein interaction network revealed that TNF, IL-1B, IL-6, CSF2, CXCL8, and IL-10 were among the core genes of MM. Finally, eight candidate drugs showed maximum interaction with core genes, which could potentially prevent MGUS from progressing to MM.
Conclusion: The progression of MGUS to MM is driven by aberrant cytokine secretion, which leads to inflammation immune dysfunction, and dysregulation of the PI3K/AKT/mTOR signaling pathway.
doi: https://doi.org/10.12669/pjms.39.3.7206
How to cite this: Lu W, Liu J, Luo M, Xiao M. Relationship between Monoclonal Gammopathy of undetermined significance and multiple myeloma via online database analysis. Pak J Med Sci. 2023;39(3):715-720. doi: https://doi.org/10.12669/pjms.39.3.7206
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.