bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between contrast-enhanced adenosine-stress perfusion cardiac magnetic resonance imaging and invasive coronary angiogram for the detection of coronary artery disease: A retrospective analysis
Authors: Khan Sher Bahadar , Ghaffar Rehmat , Muhammad Adil  , Jan Muneeb 
Published: September 2023

Objective: The objective of this study was to determine the diagnostic value of stress perfusion CMR for the detection of coronary artery disease.
Methods: The was a retrospective cross sectional study in which 43 subjects were included from Cardiac MRI unit in the Hayatabad Medical Complex, Peshawar for study from 1st April 2020 to 30th November 2020. All the subjects who had been referred for stress perfusion CMR with suspected CAD were included in the study. Cardiac MRI both at rest and with adenosine stress perfusion was performed which was followed by invasive coronary angiography.
Result: A total of 43 patients were enrolled for the detection or exclusion CAD who underwent stress perfusion CMRI and invasive coronary artery angiography. The study revealed strong and statistically significant association between positive stress perfusion CMR and positive coronary angiogram vs negative stress perfusion CMR and negative coronary angiogram (p= value 0.0001).
Conclusions: Stress perfusion CMRI can be considered as a first line, relatively safe, noninvasive test with significant accuracy to diagnose coronary artery disease in patients with suspected CAD without subjecting these patients to invasive coronary angiogram
Abbreviations:CMR: Cardiac magnetic resonance imaging, CAD: Coronary artery disease, FFR: Free Fractional Reserve, MACE: Major Adverse Cardiovascular Events.
doi: https://doi.org/10.12669/pjms.39.6.8008
How to cite this: Khan SB, Ghaffar R, Adil M, Jan MU. Association between contrast-enhanced adenosine-stress perfusion cardiac magnetic resonance imaging and invasive coronary angiogram for the detection of coronary artery disease: A retrospective analysis. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.8008
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.
Application and impact assessment of an interactive journal club format among endocrinology fellows-in-training in a tertiary hospital academic center: a case study
Authors: Chiu Harold Henrison , Isip-Tan Iris Thiele 
Published: September 2023

Background: The interactive journal club is designed to utilize a new approach in appraising research in order to maximize the benefits of the traditional journal club. In this new approach, the participants are actively involved in a structured process of critical data appraisal rather than just being passive listeners. In this case study, we applied the interactive journal club format and assessed its impact among our endocrinology fellows-in-training. Methods: We conducted four interactive journal club sessions within a four-week span, one per each week via a virtual platform. The 12 participants were the same throughout all sessions. Each session was recorded following informed consent. At the end of all sessions, feedback was obtained, tabulated and compared. Results: Sessions lasted from 59 to 83 minutes (mean, 67.75 minutes). Participants became more active and spontaneous as the sessions progressed. All participants found the format more fun and proactive. This approach allowed more critical thinking and processing of information. Salient features include increased self-esteem and confidence, additional learning from other participants, better retention of information, and utilization in future practice. Conclusions: Traditional approaches are transformed from passive presentations of recent developments in medicine into an interactive discussion while allowing the retention of the spirit and essence of a traditional journal club, as well as exploring new and improved approaches in clinical training and education.
A study on biomedical researchers’ perspectives on public engagement in Southeast Asia
Authors: Tran Dong Thai Han , Van Thuy Qui Huong , Vu Duy Thanh , Fisher Jaom , Chambers Mary 
Published: September 2023

Introduction: Public engagement is increasingly promoted in the scientific community. Although there are studies about researchers’ perspectives on public engagement, these are predominantly from Global North settings and there is little data from the context of Southeast Asia. The Oxford University Clinical Research Unit (OUCRU) is a clinical and public health research programme with sites in Vietnam, Nepal and Indonesia. There is a dedicated public engagement team, and it is recognised as an important part of the research process. Methods: Through this study we explored the views and needs of local researchers with regards to practicing public engagement. We obtained opinions of 70 researchers through an online survey with both open-ended and closed-ended questions. Results: Most researchers perceived public engagement as improving public science literacy, rather than supporting public participation in science and research. While the participants largely see public engagement as a necessary practice, they experienced four main barriers to taking part in public engagement: time, lack of capacity, lack of support and personal perceptions. Most participants indicated they had somewhat to low confidence to communicate about science to the public. Experience, skill and knowledge, and personal preference emerged as factors that influence their perceived confidence for science communication. In our analysis, experience appeared to be the main factor contributing to researchers' high confidence. Recommendations: We recommended to support researchers by not only providing them with training for skills and knowledge, but also with opportunities to conduct public engagement, and a range of methods to suit their personal styles of communicating. It is also evident that more support is needed to build an enabling institutional environment that gives researchers professional recognition for their engagement work. This study, while modest in its scope, has informed our approach to supporting researcher-led engagement, and may guide other institutes wishing to improve this.
Health significance of body position during sleep - literature review
Authors: Sudelska Katarzyna , Sawińska Zuzanna , Tarsa Grzegorz , Kępka Przemysław , Łokczewska-Bojar Aleksandra , Kuziemkowska Daria , Kuźma Jan , Ben Rhaiem Rami , Skotalczyk Magdalena , Łącka-Majcher Anna 
Published: September 2023

Introduction:
Sleep is a fundamental biological need of the body, crucial for maintaining health and body’s regeneration. The body position during sleep not only affects sleep quality and well-being but also influences various health aspects, such as obstructive sleep apnea, back pain or gastroesophageal reflux.
Aim of the study:
The aim of our study is to summarize the impact of body position during sleep on human health. We paid attention to the relationship between sleep position and aspects like: sleep quality, obstructive sleep apnea, back pain and gastroesophageal reflux.
State of knowledge:
The body position during sleep is crucial for maintaining mental and physical health. It affects sleep quality as well as health aspects such as: obstructive sleep apnea, back pain or gastroesophageal reflux disease. In the case of sleep quality, the most beneficial position is on the right side. The supine position is associated with worsened obstructive sleep apnea, while on the side - with reducing the frequency of symptoms. Neck pain is connected with an asymmetrical side and an upright head position, while lower back pain is associated with a supine position. The described position that reduces the reflux of gastric contents into the esophagus, and thus reduces the symptoms of reflux disease, is on the left side and with an elevated head of the bed.
Summary:
Sleep position is significant for many aspects of human health. Besides affecting sleep quality and well-being, it also has an impact on conditions such as obstructive sleep apnea, back pain and gastroesophageal reflux.
The ‘inbetweeners’: living on a watch and wait approach for chronic lymphocytic leukaemia – a qualitative study
Authors: Dunnion Claire , Giltenane Martina , Dowling Maura 
Published: September 2023

Background: Chronic lymphocytic leukaemia (CLL) is an incurable disease; many people with the condition do not require active treatment and are monitored using a watch and wait approach. Aim: The aim of this study was to explore the experiences of people living with a diagnosis of CLL and on watch and wait. Methods: Using a descriptive qualitative approach, seven participants on the watch and wait approach were interviewed. Data analysis was guided by systematic text condensation. Findings: Participants reported anxiety, referring to ‘wait and worry’. Their information needs were not met, and they resorted to seeking information on possible future treatments themselves. They also experienced feeling like an imposter because they were not receiving active treatment like other patients with cancer. Conclusions: A greater understanding of how information provision affects levels of anxiety and worry among people living with CLL on watch and wait is needed. In addition, clinical nurse specialists could deliver education on the watch and wait approach, supplemented by video-based educational materials developed by the haematology team.
Challenges in prospective observational studies evaluating pressure ulcer costs: how to price the items correctly
Authors: Pokorná Andrea , Krupová Lenka , Benešová Klára , Mužík Jan , Jarkovský Jirí , Búrilová Petra , Dolanová Dana , Saibertová Simona , Klugar Miloslav , Krupa Miroslav 
Published: September 2023

Objective: Pressure ulcers (PUs) are a significant healthcare problem with a negative impact on patients' quality of life and incurring substantial healthcare expenses. Our study aimed to analyse the costs of treating PUs in hospitalised patients in the Czech Republic, in the context of current treatment procedures and price levels, and to pilot-test the detailed methodology developed. Method: A prospective, observational, non-interventional study was conducted at the Clinic of Anesthesiology, Resuscitation and Intensive Medicine, the Internal Medicine Department and the Surgical Department of the University Hospital Ostrava. The study included all hospitalised patients with a PU from March–May 2021. Data were collected using the hospital information system. A bottom-up, person-based approach to cost analysis was used, based on a comprehensive cost structure using accurate patient-specific consumption records. Results: The length of hospitalisations ranged from 1–31 (mean: 12.7) days. The average cost of PU treatment per hospitalisation was calculated at €1579. The average daily cost of PU treatment was €179, including antibiotic therapy (ATB) and €112 without ATB. Most of the costs were associated with ATB (38.6%) and caregivers' time (35.9%). Based on the results, a predictive model was developed to estimate the cost of treating a hospitalised patient with a PU, which could be used in future research to assess the costs of treating these patients. Conclusion: We have faced many challenges in the methodology of preparation of cost analysis (e.g., how to count amorphous topical agents and sprays, how to properly identify PUs, how to price the positioning aids and mattresses, and how to relate the ATB treatment to the PU). This analysis provides important input for developing a comprehensive and more accurate methodology for monitoring PU costs in hospitalised patients, applicable in clinical practice for inpatient healthcare providers.
Use of a dynamic tissue system and biological xenograft in complex traumatic wound closure
Authors: Collins Reagan A , Dang Michael , McReynolds Shirley , Puckett Yana , Ronaghan Catherine A 
Published: September 2023

Objective: Asymmetrical dimensions and nonlinear margins of a multilayered traumatic wound often preclude healing via primary intention. We present the case of an otherwise healthy 21-year-old male who sustained trauma following a boating accident. Method: The patient sustained three lacerations to the posterior thighs from the boat propeller. The most extensive wound measured 25×10×6cm of muscle extrusion with a divot fracture involving the posterior femur. Results: Primary closure and restoration of muscle biomechanics was achieved using a combination of a dynamic tissue system (DTS) and porcine urinary bladder matrix (PUBM) xenograft. After 24 days of treatment in hospital, the patient was discharged without the need for home health, outpatient wound care, or ongoing negative pressure wound therapy. The patient recovered full function of the legs and was cleared for participation in all activities. Conclusion: This complex traumatic boat propeller injury presented many challenges, including a transverse orientation on the extremity, degree of muscle injury/extrusion, and significant soft tissue loss. The combined application of a DTS with PUBM biological xenograft achieved a primary myocutaneous closure without the need for skin graft or flap reconstruction by plastic surgery.
Real-time surveillance of international SARS-CoV-2 prevalence using systematic traveller arrival screening: An observational study
Authors: Kucharski Adam J. , Chung Kiyojiken , Aubry Maite , Teiti Iotefa , Teissier Anita , Richard Vaea , Russell Timothy W. , Bos Raphaëlle , Olivier Sophie , Cao-Lormeau Van-Mai 
Published: September 2023

Background
Effective Coronavirus Disease 2019 (COVID-19) response relies on good knowledge of population infection dynamics, but owing to under-ascertainment and delays in symptom-based reporting, obtaining reliable infection data has typically required large dedicated local population studies. Although many countries implemented Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) testing among travellers, it remains unclear how accurately arrival testing data can capture international patterns of infection, because those arrival testing data were rarely reported systematically, and predeparture testing was often in place as well, leading to nonrepresentative infection status among arrivals.

Methods and findings
In French Polynesia, testing data were reported systematically with enforced predeparture testing type and timing, making it possible to adjust for nonrepresentative infection status among arrivals. Combining statistical models of polymerase chain reaction (PCR) positivity with data on international travel protocols, we reconstructed estimates of prevalence at departure using only testing data from arrivals. We then applied this estimation approach to the United States of America and France, using data from over 220,000 tests from travellers arriving into French Polynesia between July 2020 and March 2022. We estimated a peak infection prevalence at departure of 2.1% (95% credible interval: 1.7, 2.6%) in France and 1% (95% CrI: 0.63, 1.4%) in the USA in late 2020/early 2021, with prevalence of 4.6% (95% CrI: 3.9, 5.2%) and 4.3% (95% CrI: 3.6, 5%), respectively, estimated for the Omicron BA.1 waves in early 2022. We found that our infection estimates were a leading indicator of later reported case dynamics, as well as being consistent with subsequent observed changes in seroprevalence over time. We did not have linked data on traveller demography or unbiased domestic infection estimates (e.g., from random community infection surveys) in the USA and France. However, our methodology would allow for the incorporation of prior data from additional sources if available in future.

Conclusions
As well as elucidating previously unmeasured infection dynamics in these countries, our analysis provides a proof-of-concept for scalable and accurate leading indicator of global infections during future pandemics.
Evaluation of models for multi-step forecasting of hand, foot and mouth disease using multi-input multi-output: A case study of Chengdu, China
Authors: Geng Xiaoran , Ma Yue , Cai Wennian , Zha Yuanyi , Zhang Tao , Zhang Huadong , Yang Changhong , Yin Fei , Shui Tiejun 
Published: September 2023

BackgroundHand, foot and mouth disease (HFMD) is a public health concern that threatens the health of children. Accurately forecasting of HFMD cases multiple days ahead and early detection of peaks in the number of cases followed by timely response are essential for HFMD prevention and control. However, many studies mainly predict future one-day incidence, which reduces the flexibility of prevention and control.MethodsWe collected the daily number of HFMD cases among children aged 0–14 years in Chengdu from 2011 to 2017, as well as meteorological and air pollutant data for the same period. The LSTM, Seq2Seq, Seq2Seq-Luong and Seq2Seq-Shih models were used to perform multi-step prediction of HFMD through multi-input multi-output. We evaluated the models in terms of overall prediction performance, the time delay and intensity of detection peaks.ResultsFrom 2011 to 2017, HFMD in Chengdu showed seasonal trends that were consistent with temperature, air pressure, rainfall, relative humidity, and PM10. The Seq2Seq-Shih model achieved the best performance, with RMSE, sMAPE and PCC values of 13.943~22.192, 17.880~27.937, and 0.887~0.705 for the 2-day to 15-day predictions, respectively. Meanwhile, the Seq2Seq-Shih model is able to detect peaks in the next 15 days with a smaller time delay.ConclusionsThe deep learning Seq2Seq-Shih model achieves the best performance in overall and peak prediction, and is applicable to HFMD multi-step prediction based on environmental factors.
Incidence of switching to second-line antiretroviral therapy and its predictors among children on antiretroviral therapy at general hospitals, Northern Ethiopia: A survival analysis
Authors: Sibhat Migbar Mekonnen , Mulugeta Tewodros Nigussie , Aklilu Dawit W/tsadik 
Published: September 2023

Background
With expanding access to pediatric antiretroviral therapy, several patients in the developing world were switched to the second-line regimen, and some require third-line medications. A delay in a second-line switch is associated with an increased risk of mortality and other undesired therapeutic outcomes, drives up program costs, and challenges the pediatric antiretroviral therapy service. Nevertheless, there remain limited and often conflicting estimates on second-line antiretroviral therapy use during childhood, especially in resource-limited settings like Ethiopia. Thus, this study intended to determine the incidence and predictors of switching to second-line antiretroviral therapy among children.

Methods
A retrospective cohort study was conducted by reviewing records of 424 randomly selected children on first-line antiretroviral therapy from January 2014 to December 2018 at public hospitals in the Central and Southern Zones of Tigray, Northern Ethiopia. Data were collected using extraction tool; entered into Epi-data; cleaned, and analyzed by STATA version-14. Kaplan-Meier curve, log-rank test, and life table were used for data description and adjusted hazard ratios and p-value for analysis by Cox proportional hazard regression. Variables at a P-value of ≤0.20 in the bi-variable analysis were taken to multivariable analysis. Finally, statistical significance was declared at a P-value of ≤0.05.

Results and conclusion
Analysis was conducted on 424 charts with a total person-time observation of 11686.1 child-months and an incidence switch rate of 5.6 (95%CI: 4.36–7.09) per 1000 child-month-observations. Being orphan [AHR = 2.36; 95%CI: 1.10–5.07], suboptimal adherence [AHR = 2.10; 95% CI: 1.12–3.92], drug toxicity [AHR = 7.05; 95% CI: 3.61–13.75], advanced latest clinical stage [AHR = 2.75; 95%CI: 1.05–7.15], and tuberculosis co-infection at baseline [AHR = 3.08; 95%CI: 1.26–7.51] were significantly associated with switch to second-line antiretroviral therapy regimen. Moreover, a long duration of follow-up [AHR = 0.75; 95% CI: 0.71–0.81] was associated with decreased risk of switching. Hence, it is better to prioritize strengthening the focused evaluation of tuberculosis co-infection and treatment failure with continuous adherence monitoring. Further research is also needed to evaluate the effect of drug resistance.
Factors associated with higher hemoglobin A1c and type 2 diabetes-related costs: Secondary data analysis of adults 18 to 64 in Texas with commercial insurance
Authors: Ory Marcia G. , Han Gang , Jani Sagar N. , Zhong Lixian , Andreyeva Elena , Carpenter Keri , Towne Samuel D. , Preston Veronica Averhart , Smith Matthew Lee 
Published: September 2023

ObjectiveThis study will identify factors associated with higher hemoglobin A1c (A1c) values and diabetes-related costs among commercially insured adults in Texas diagnosed with type 2 diabetes.Research design and methodsThis secondary data analysis was based on claims data from commercially insured individuals 18–64 years of age residing in Texas with diagnosed type 2 diabetes during the 2018–2019 study period. The final analysis sample after all the exclusions consisted of 34,992 individuals. Measures included hemoglobin A1c, diabetes-related costs, Charlson Comorbidity Index, diabetes-related complications, rurality and other socioeconomic characteristics. Longitudinal A1c measurements were modeled using age, sex, rurality, comorbidity, and diabetes-related complications in generalized linear longitudinal regression models adjusting the observation time, which was one of the 8 quarters in 2018 and 2019. The diabetes-related costs were similarly modeled in both univariable and multivariable generalized linear longitudinal regression models adjusting the observation time by calendar quarters and covariates.ResultsThe median A1c value was 7, and the median quarterly diabetes-related cost was $120. A positive statistically significant relationship (p = < .0001) was found between A1c levels and diabetes-related costs, although this trend slowed down as A1c levels exceeded 8.0%. Higher A1c values were associated with being male, having diabetes-related complications, and living in rural areas. Higher costs were associated with higher A1c values, older age, and higher Charlson Comorbidity Index scores.ConclusionThe study adds updated analyses of the interrelationships among demographic and geographic factors, clinical indicators, and health-related costs, reinforcing the role of higher A1c values and complications as diabetes-related cost drivers.