bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bridging online and offline dynamics of the face mask infodemic
Authors: Uyheng Joshua , Robertson Dawn C. , Carley Kathleen M. 
Published: July 2023

Abstract
Background
Online infodemics have represented a major obstacle to the offline success of public health interventions during the COVID-19 pandemic. Offline contexts have likewise fueled public susceptibility to online infodemics. We combine a large-scale dataset of Twitter conversations about face masks with high-performance machine learning tools to detect low-credibility information, bot activity, and stance toward face masks in online conversations. We match these digital analytics with offline data regarding mask-wearing and COVID-19 cases to investigate the bidirectional online-offline dynamics of the face mask infodemic in the United States.

Results
Online prevalence of anti-mask over pro-mask stance predicts decreased offline mask-wearing behavior and subsequently increased COVID-19 infections. These effects are partially influenced by low-credibility information and automated bot activity, which consistently feature greater anti-mask stance online. Despite their purported controversy, mask mandates generally decrease anti-mask stance online and increase mask-wearing offline, thus reducing future COVID-19 infections. Notable asymmetries are observed, however, between states run by Democratic and Republican governors: the latter tend to see higher levels of low-credibility information and anti-mask stance online, and thus lower mask-wearing and higher infection rates offline.

Conclusions
These findings contribute new insights around collective vulnerabilities to online infodemics and their links to evolving offline crises. We highlight the need to synergize and sustain targeted online campaigns from legitimate information sources alongside offline interventions in and beyond the pandemic.
Clonal architecture and evolutionary history of Waldenström's macroglobulinemia at the single-cell level
Authors: García-Sanz Ramón , García-Álvarez María , Medina Alejandro , Askari Elham , González-Calle Verónica , Casanova María , de la Torre-Loizaga Igor , Escalante-Barrigón Fernando , Bastos-Boente Miguel , Bárez Abelardo , Vidaña-Bedera Nerea , Alonso José María , Sarasquete María Eugenia , González Marcos , Chillón María Carmen , Alcoceba Miguel , Jiménez Cristina 
Published: July 2023

ABSTRACT
To provide insight into the subclonal architecture and co-dependency patterns of the alterations in Waldenström's macroglobulinemia (WM), we performed single-cell mutational and protein profiling of eight patients. A custom panel was designed to screen for mutations and copy number alterations at the single-cell level in samples taken from patients at diagnosis (n=5) or at disease progression (n=3). Results showed that in asymptomatic WM at diagnosis, MYD88L265P was the predominant clonal alteration; other events, if present, were secondary and subclonal to MYD88L265P. In symptomatic WM, clonal diversity was more evident, uncovering combinations of alterations that synergized to promote clonal expansion and dominance. At disease progression, a dominant clone was observed, sometimes accompanied by other less complex minor clones, which could be consistent with a clonal selection process. Clonal diversity was also reduced, probably due to the effect of treatment. Finally, we combined protein expression with mutational analysis to map somatic genotype with the immunophenotype. Our findings provide a comprehensive view of the clonality of tumor populations in WM and how clonal complexity can evolve and impact disease progression.
Kinetic Analysis of Redox-active Aromatic Compounds Using Confinement Effects
Authors: Nakasone Kaiya , Katsuhara Kureo , Takimoto Daisuke 
Published: July 2023

Abstract
The kinetic analysis of electroactive molecules has contributed to developing electrode materials for energy storage systems. In this work, we studied the applicability of the confinement effect to evaluate the redox reaction kinetics for quinone- and anthraquinone-based molecules. The kinetics of the redox reactions corresponded well with previously reported theoretical calculation results, suggesting that this novel method can be used as a simple method to investigate the redox reaction kinetics of quinone- and anthraquinone-based molecules.
The impact of mismatch repair status and systemic inflammatory markers on radiological staging in colon cancer
Authors: Platt James R , Ansett Jennifer , Seligmann Jenny F , West Nicholas P , Tolan Damian J M 
Published: July 2023

Objective:
Mismatch repair (MMR) deficient (dMMR) colon cancer (CC) is distinct from MMR proficient (pMMR) CC, yet the impact of MMR status on radiological staging is unclear. The purpose of this study was to investigate how MMR status impacts CC CT staging.

Methods:
We retrospectively compared CT staging accuracy between dMMR and pMMR CC patients undergoing curative resection. Accuracy was assessed as individual tumour (T)/nodal (N) stages and as dichotomous “statuses” (T1/2 vs T3/4; N0 vs N1/2). Patient characteristics were analysed for factors to support staging.

Results:
There was no significant difference in overall staging accuracy between the dMMR (44 patients) and pMMR (57 patients) groups. dMMR tumours with incorrect N stage/“status” were more likely to be overstaged than pMMR tumours (90% vs 59%; p = 0.023 for “N status”). Platelet count, CRP and neutrophil count (AUC 0.76 (p = 0.0078), 0.75 (p = 0.034) and 0.70 (p = 0.044), respectively) were associated with “N status” in dMMR tumours.

Conclusion:
Whilst overall staging accuracy was similar between groups, incorrectly N staged dMMR tumours were more likely to be overstaged than pMMR tumours, risking inappropriate surgical or neoadjuvant treatment. We describe novel relationships between several inflammatory markers and pathological “N status” in dMMR CC, which if integrated into routine practice may improve CT staging accuracy.

Advances in knowledge:
Compared to pMMR CC, dMMR CC is at significant risk of N overstaging. Platelet count, CRP and neutrophil count are higher in dMMR CC patients with nodal metastases than those without, and their role in refining clinical staging requires further investigation.
Interpretable artificial intelligence in radiology and radiation oncology
Authors: Cui Sunan , Traverso Alberto , Niraula Dipesh , Zou Jiaren , Luo Yi , Owen Dawn , El Naqa Issam , Wei Lise 
Published: July 2023

Abstract
Artificial intelligence has been introduced to clinical practice, especially radiology and radiation oncology, from image segmentation, diagnosis, treatment planning and prognosis. It is not only crucial to have an accurate artificial intelligence model, but also to understand the internal logic and gain the trust of the experts. This review is intended to provide some insights into core concepts of the interpretability, the state-of-the-art methods for understanding the machine learning models, the evaluation of these methods, identifying some challenges and limits of them, and gives some examples of medical applications.
Insights into acute mesenteric ischaemia: an up-to-date, evidence-based review from a mesenteric stroke centre unit
Authors: Garzelli Lorenzo , Ben Abdallah Iannis , Nuzzo Alexandre , Zappa Magaly , Corcos Olivier , Dioguardi Burgio Marco , Cazals-Hatem Dominique , Rautou Pierre-Emmanuel , Vilgrain Valérie , Calame Paul , Ronot Maxime 
Published: July 2023

Radiologists play a central role in the diagnostic and prognostic evaluation of patients with acute mesenteric ischaemia (AMI). Unfortunately, more than half of AMI patients undergo imaging with no prior suspicion of AMI, making identifying this disease even more difficult. A confirmed diagnosis of AMI is ideally made with dynamic contrast-enhanced CT but the diagnosis may be made on portal-venous phase images in appropriate clinical settings. AMI is diagnosed on CT based on the identification of vascular impairment and bowel ischaemic injury with no other cause. Moreover, radiologists must evaluate the probability of bowel necrosis, which will influence the treatment options. AMI is usually separated into different entities: arterial, venous, non-occlusive and ischaemic colitis. Arterial AMI can be occlusive or stenotic, the dominant causes being atherothrombosis, embolism and isolated superior mesenteric artery (SMA) dissection. The main finding in the bowel is decreased wall enhancement, and necrosis can be suspected when dilatation >25 mm is identified. Venous AMI is related to superior mesenteric vein (SMV) thrombosis as a result of a thrombophilic state (acquired or inherited), local injury (cancer, inflammation or trauma) or underlying SMV insufficiency. The dominant features in the bowel are hypoattenuating wall thickening with submucosal oedema. Decreased enhancement of the involved bowel suggests necrosis. Non-occlusive mesenteric ischaemia (NOMI) is related to impaired SMA flow following global hypoperfusion associated with low-flow states. There are numerous findings in the bowel characterised by diffuse extension. An absence of bowel enhancement and a thin bowel wall suggest necrosis in NOMI. Finally, ischaemic colitis is a sub-entity of arterial AMI and reflects localised colon ischaemia-reperfusion injury. The main CT finding is a thickened colon wall with fat stranding, which seems to be unrelated to SMA or inferior mesenteric artery lesions. A precise identification and description of vascular lesions, bowel involvement and features associated with transmural necrosis is needed to determine patient treatment and outcome.
Diffusion weighted imaging of extremity bone tumors—inter-reader analysis and incremental value over conventional MR imaging
Authors: Guirguis Mina , Gupta Anurag , Thakur Uma , Pezeshk Parham , Weatherall Paul , Sharan Gaurav , Xi Yin , Chhabra Avneesh 
Published: July 2023

Objective: To determine whether the addition of diffusion-weighted imaging (DWI) to conventional MRI improves diagnostic accuracy of bone tumor characterization with the hypothesis that the DWI has incremental value in the diagnosis of osseous tumors. Methods: In this multireader cross-sectional validation study, four musculoskeletal radiologists evaluated osseous tumors blinded to final diagnosis in two rounds—first without DWI or apparent diffusion coefficient (ADC) maps, then months later with these available. Each reader recorded a binary result as to whether the lesion is benign or malignant. Intraclass correlation (ICC) and Conger’s κ were used. Diagnostic performance measures including area under the receiver operating curve (AUC) were reported. Results: 133 osseous tumors of the extremities (76 benign, 57 malignant) were tested. Blinded to DWI, average reader sensitivity, specificity, positive-predictive value, and negative-predictive value were 0.83, 0.92, 0.94, and 0.82, respectively. With DWI, the values were 0.85, 0.92, 0.94, and 0.83, respectively. Interreader agreement was good for both rounds (0.67 and 0.71, respectively, p-value > 0.05). Average reader confidence was 4.1 and 4.4, respectively (p-value < 0.001). ADC values and DWI/ADC ratios showed significant differences between benign and malignant tumors. Conclusion: DWI and ADC show statistically significantly different values of benign from malignant osseous tumors and mildly increased radiologist confidence with similar interreader reliability. However, given similar diagnostic accuracy, conventional MR imaging is adequate for bone tumor characterization and incremental value of DWI is limited. Advances in knowledge: This paper is the first of its kind to report the use of DWI/ADC ratio for the diagnosis of bone tumors.
Does the shape of the field-of-view influence the magnitude of artefacts from high-density materials in cone-beam computed tomography?
Authors: Cascante-Sequeira Deivi , Fontenele Rocharles Cavalcante , Martins Luciano Augusto Cano , Brasil Danieli Moura , Oliveira Matheus L , Freitas Deborah Queiroz , Haiter-Neto Francisco 
Published: July 2023

Objective:
To compare cylindrical and convex triangular field-of-views (FOVs) concerning the magnitude of artefacts from high-density materials in cone-beam CT (CBCT).

Methods and materials:
Cylinders of amalgam, chromium-cobalt, titanium, and zirconia were individually placed in the anterior and posterior regions of a polymethylmethacrylate phantom and scanned using cylindrical and convex triangular FOVs of the Veraview X800 CBCT device. Using the Image J software, 15 square regions of interest (ROIs) were placed in the axial reconstruction around the middle level of the cylinder and at distances of 0.5, 1.0, and 1.5 cm from the centre of the cylinder. Mean grey value and standard deviation of each ROI were averaged for each distance and subtracted from the values of a control ROI to calculate the magnitude of the artefacts by the grey value mean difference (GVMD) and grey value standard deviation (GVSD). Multiway analysis of variance with Tukey post-hoc test with a significance level of 5% evaluated the effect of the shape of the FOV, position inside the FOV, high-density material, and the distance of the artefact from the material.

Results:
The convex triangular FOV increased the GVSD for all materials in the anterior and posterior regions at 0.5 cm compared to the cylindrical FOV (p &lt; 0.0001). The convex triangular FOV showed greater GVMD for chromium-cobalt and zirconium in the anterior region and all materials in the posterior region at all distances (p &lt; 0.0001).

Conclusion:
The FOV shape influences the magnitude of artefacts from high-density materials. The convex triangular FOV showed greater artefact magnitude with variability among the high-density materials, region in the FOV, and distance from the material.
Ambient light exposure of photostimulable phosphor plates: is there a safe limit for acceptable image quality?
Authors: Sampaio-Oliveira Matheus , Marinho-Vieira Luiz Eduardo , Haiter-Neto Francisco , Freitas Deborah Q , Oliveira Matheus L 
Published: July 2023

Objectives:
To subjectively assess radiographs obtained with photostimulable phosphor (PSP) plates exposed to clinical levels of ambient light prior to read-out to potentially set a safe limit for acceptable image quality.

Methods and materials:
Six dental regions of a dry human skull were X-rayed using PSP plates from VistaScan and Express under four exposure times: 0.1, 0.2, 0.32, and 0.4 s. Before read-out, the PSP plates were exposed to ambient light for 0, 5, 10, 30, 60, and 90 s. Six observers were asked to classify the 288 resulting radiographs as acceptable or unacceptable based on the identification of anatomical structures and global image quality. The number of answers classifying radiographs as unacceptable was used to calculate a rejection rate; a pairwise comparison for better image quality was further conducted among radiographs considered acceptable. Reproducibility was tested by having 25% of all experimental groups reassessed.

Results:
Intra- and interobserver agreement ranged from 0.87 to 1.00 and from 0.81 to 0.92, respectively. Exposure of PSP plates to ambient light increased rejection rates mostly as of 10 s. In the pairwise comparison, subtle differences were observed between radiographs obtained with PSP plates not exposed and those exposed to ambient light for 5 s.

Conclusions:
Ambient light exposure of PSP plates impairs the image quality of radiographs. A safe limit of ambient light exposure of 5 s for VistaScan and Express should be considered. Ambient light exposure of PSP plates within safe limits can avoid retakes and reduce unnecessary patient exposure to X-rays.
Co-existence of blaIMP, blaNDM-1, and blaSHV, genes of Pseudomonas aeruginosa isolated from Quetta: Antimicrobial resistance and clinical significance
Authors: Mohammad Din  , Awan Mohammad Arif , Sadeeq ur Rahman  , Mohammad Ali  , But Momina Aslam 
Published: July 2023

Objective: Molecular detection and co-presence of carbapenem-resistant genes in the isolates of Pseudomonas aeruginosa are less commonly reported from Quetta. In the present study, we determined to highlight the antibiotic sensitivity profile and genetic mechanism of carbapenem resistance.
Methods: The cross-sectional study was conducted from May to September 2018 at the Hi-tech laboratory, Centre for Advance Studies in Vaccinology and Biotechnology, University of Baluchistan, Quetta. Biochemical and molecular methods were ascertained for the recognition of the isolates and minimum inhibitory concentration was performed using E-test and broth microdilution methods. The molecular basis of carbapenemase activity was determined by identifying carbapenemase genes in the isolates.
Results: Of the (n=23) P. aeruginosa isolated from pus aspirates obtained from surgical/burn units, we have detected blaIMP (n=7/8) 87.5%, blaNDM-1 (n=5/8) 62.5%, and blaSHV (n=4/8) 50%. The co-existence of multiple antibiotic-resistant genes, blaIMP, blaNDM-1 and blaSHV was found in (n=2/8) 25% isolates. These isolates displayed resistance against a range of antimicrobials from β-lactams, tetracyclines, cephalosporins, quinolones, monobactams, aminoglycosides, sulphonamides, phosphoric acid, macrolides, and polypeptide groups, suggesting extensive-drug resistance.
Conclusion: The emergence of MBL and ESBL producers is an alarming threat in the region. It is of great importance to determine the resistance mechanism of bacterial bugs. The lack of new antimicrobials particularly against gram-negative bacteria is quite alarming worldwide.
doi: https://doi.org/10.12669/pjms.39.5.7188
How to cite this: Din M, Awan MA, Sadeeq ur Rahman, Ali M, Aslam M. Co-existence of blaIMP, blaNDM-1, and blaSHV, genes of Pseudomonas aeruginosa isolated from Quetta: Antimicrobial resistance and clinical significance. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7188
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.
Burnout and Health Related Quality of Life among emergency physicians working at emergency at Tertiary Care Hospital in Lahore Pakistan
Authors: Sarwar Shahid , Mahmood Asma , Farooq Raja Mahnoor , Mahmud Yasir 
Published: July 2023

Objective: To determine frequency of burnout in emergency physicians and to identify its impact on their health-related quality of life (HRQOL).
Methods: In this cross-sectional study, physicians from departments with emergency cover of Jinnah Hospital Lahore were included. Their burnout and HRQOL scores using Maslach Burnout Inventory (MBI) and Short Form (SF)-36 respectively were determined in March 2022. Burnout scores were graded as low, moderate and high and were correlated with domains of HRQOL using chi X2 and analysis of variance (ANOVA).
Results: One hundred fifty physicians were included with mean age 26.2 (±2.59), male to female ratio 0.78:1 (66/84) and House Officer (HO) to Postgraduate Resident (PGR) ratio 1.94:1 (99/51). High burnout was identified in 76 (50.7%) participants while 48 (32%) had moderate and 26 (17.3%) had low burnout. Males scored better than female physicians in vitality (0.008), general mental health (0.004), and mental component summary (0.01) domains of HRQOL. Doctors with high burnout had significantly lower scores in both physical component summary (p-value 0.004) and mental component summary (p-value < 0.0001) domains of HRQOL.
Conclusion: Physicians working in emergency settings have high frequency of burnout and it adversely affects their mental and physical health related quality of life.
doi: https://doi.org/10.12669/pjms.39.5.7560
How to cite this: Sarwar S, Mahmood A, Raja MF, Mahmud Y. Burnout and Health Related Quality of Life among emergency physicians working at emergency at Tertiary Care Hospital in Lahore Pakistan. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7560
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.
Case Report: Case report: An unusual presentation of granulomatosis with polyangiitis
Authors: Bannour Ichrak , Ben Brahim Maroi , Arfa Sondes , Amor Soumaya ben , Ben Mabrouk Asma , Berrich Olfa , Hammemi Sonia 
Published: July 2023

Aim: We are reporting a case of an unusual presentation of granulomatosis with polyangiitis (GPA) with liver involvement. Case presentation: A 45-year-old male patient presented with erythematous plaques on the face and bilateral nasal obstruction. On physical examination, the patient had a ring-shaped squamous plaque on the face. The laboratory findings revealed an accelerated erythrocyte sedimentation rate at 100 mm/h, an elevated C-reactive protein at 66 mg/L, hyper gamma globulinemia 16 g/L and an elevated alkaline phosphatase (twice the upper normal limit). The craniofacial and thoracoabdominal computed tomography (CT) -scans showed ethmoid and maxillary sinusitis, low facial bone density, multiple mediastinal and hilar lymphadenopathy, diffuse small pulmonary nodules, and hepatomegaly. A cutaneous lesion biopsy, the nasal mucosa, and the liver showed a chronic inflammatory granulomatosis process with necrosis. Serum anti-neutrophil cytoplasmic antibody (ANCA) against PR3 was positive. The clinical, biological, radiological, and histological findings substantiated the diagnosis of GPA. The patient received systemic steroids combined with cyclophosphamide pulses on days 1, 14 and 28 and then he was lost to follow-up. Two-years later, he presented with a cardiac failure and skin ulcer in the right lower limb. A nasal endoscopic exam showed nasal septum cartilage perforation with resorption of the middle and inferior nasal concha. Two weeks later, he developed a diffuse alveolar hemorrhage and was therefore transferred to the intensive care unit but died of respiratory failure 3 days later. Conclusion: Clinicians should be aware of GPA atypical clinical manifestations.
Age of first self-harm act in childhood and adolescence: A scoping review protocol
Authors: Wiggin Daisy , McMahon Elaine , McNicholas Fiona , Khan Almas , Griffin Eve 
Published: July 2023

Background: Self-harm in young people is associated with adverse outcomes for many. The age of first self-harm is not often reported in the literature and there is considerable heterogeneity in how it is reported and in the methods used to estimate it. The objective of this study will be to examine the age of first self-harm act in childhood and adolescence and to identify the methods used to assess this. Methods: This scoping review will follow JBI guidance. Five electronic databases, Medline, PsycInfo, CINAHL Plus, Embase, and Web of Science will be searched from inception. Grey literature will be searched via Google Scholar. Studies reporting the age of first act of self-harm in young people aged 17 years and younger are of interest. Any study design and methodology will be eligible for inclusion. Included studies may use any self-harm definition, any measures used to assess self-harm and the age of the first act. The focus can be in any context, including health services presenting or community samples. Title and abstract screening and full text screening will be carried out by two reviewers independently. The data extraction tool will be piloted by two reviewers independently, included studies will undergo data extraction by one reviewer and this will be checked by a second, independent reviewer. Results: The resulting data will be presented using descriptive statistics, in tabular format, and accompanied with a narrative presentation of results. The results of this study will be distributed by publication in an academic journal.