bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Rare Case of Cerebral Venous Sinus Thrombosis Presenting as an Acute Focal Neurological Deficit with Autoimmune Hepatitis-related Chronic Liver Disease
Authors: Shahid Rizwana 
Published: February 2025

Abstract
Cerebral venous sinus thrombosis (CVST) accounts for approximately 0.5%–1% of all strokes. The onset of CVST is usually subacute to chronic, and common clinical presentations are headaches and focal neurological deficits. Patients with chronic liver disease (CLD) are at risk of bleeding as well as venous thromboembolic events. Deep venous thrombosis, thrombosis involving the portal, splanchnic, and hepatic veins, and pulmonary embolism are commonly reported with CLD; however, CVST is not a recognized complication. There are occasional case reports of CVST with hepatitis A or C-related CVST; however, we were unable to find any report of autoimmune hepatitis (AIH)-related CVST in the literature; therefore, we report the case of a 56-year-old female, diagnosed with AIH-related CLD, who presented with sudden-onset confusion and decreased verbal output. She did not have any provoking or underlying hypercoagulable disorder. Her computed tomography (CT) head, followed by magnetic resonance imaging brain, revealed evidence of cerebral venous infarction, and a CT venogram revealed extensive venous sinus thrombosis. Her coagulation profile was deranged, and workup for hypercoagulable state was negative. It was a diagnostic and therapeutic challenge to anticoagulate in the presence of significant derangement of her coagulation profile. The likely etiology for CVST in this scenario was autoimmune liver damage.
Prevalence and Risk Factors of Restless Legs Syndrome among Medical Students in Saudi Arabia: An Observational Study
Authors: Alabdulqader Razan , Alqahtani Raghad , Alsunaikh Khadija , Almousa Sara , Alsalem Ammar , Alokley Alia 
Published: February 2025

Abstract

Background:
Restless legs syndrome (RLS) is a sensorimotor condition that affects the quality of sleep for those who have it. The diagnosis is made according to the consensus criteria by the National Institute of Health panel as follows: “(i) a strong desire to move one’s legs, usually in response to an unpleasant sensation; (ii) a stronger urge in the evening and at night; (iii) movement usually satisfies the urge; and (iv) rest increases the urge.” This study aims to investigate the prevalence and associated risk factors of RLS among medical students in Saudi Arabia; furthermore, the severity and impact of RLS on sleep status.

Methodology:
A cross-sectional study conducted between 2022 and 2024 in medical students in Saudi Arabia. Three hundred and thirty-one students (233 female and 98 male) participated and completed an online consented questionnaire to detect the prevalence of RLS and associated risk factors including medical comorbidities, smoking, and caffeine intake based on criteria proposed by the International Restless Legs Syndrome Study Group. Furthermore, the severity and impact of RLS on sleep status were studied using the Epworth Sleepiness Scale and the RLS rating scale, respectively.

Results:
The frequency of RLS among medical students is 20.2%. The severity of RLS reported in 23.9% of the students with mild-to-severe rates. About 40.3% of students with RLS had daytime fatigue and 33.4% had sleep disturbances. About 64.1% of medical students who suffer from RLS have associated medical comorbidities including iron-deficiency anemia, diabetes mellitus, and peripheral neuropathy. Thirty-seven percent are smokers and 42.9% of students who had 3–4 cups of coffee daily had RLS compared to 18.6% of others who did not.

Conclusion:
RLS has a significant prevalence among medical students, in Saudi Arabia. RLS is highly associated with sleeping disturbance and daytime fatigue. Caffeine and smoking are considered risk factors for RLS.
Correlation of IGF2 levels with sperm quality, inflammation, and DNA damage in infertile patients
Authors: Wu Jing-Gen , Zhou Cai-Ping , Gui Wei-Wei , Liang Zhong-Yan , Zhang Feng-Bin , Fu Ying-Ge , Li Rui , Wu Fang , Lin Xi-Hua 
Published: February 2025

Abstract
Insulin-like growth factor 2 (IGF2) is a critical endocrine mediator implicated in male reproductive physiology. To investigate the correlation between IGF2 protein levels and various aspects of male infertility, specifically focusing on sperm quality, inflammation, and DNA damage, a cohort of 320 male participants was recruited from the Women’s Hospital, Zhejiang University School of Medicine (Hangzhou, China) between 1st January 2024 and 1st March 2024. The relationship between IGF2 protein concentrations and sperm parameters was assessed, and Spearman correlation and linear regression analysis were employed to evaluate the independent associations between IGF2 protein levels and risk factors for infertility. Enzyme-linked immunosorbent assay (ELISA) was used to measure IGF2 protein levels in seminal plasma, alongside markers of inflammation (tumor necrosis factor-alpha [TNF-α] and interleukin-1β [IL-1β]). The relationship between seminal plasma IGF2 protein levels and DNA damage marker phosphorylated histone H2AX (γ-H2AX) was also explored. Our findings reveal that IGF2 protein expression decreased notably in patients with asthenospermia and teratospermia. Correlation analysis revealed nuanced associations between IGF2 protein levels and specific sperm parameters, and low IGF2 protein concentrations correlated with increased inflammation and DNA damage in sperm. The observed correlations between IGF2 protein levels and specific sperm parameters, along with its connection to inflammation and DNA damage, underscore the importance of IGF2 in the broader context of male reproductive health. These findings lay the groundwork for future research and potential therapeutic interventions targeting IGF2-related pathways to enhance male fertility.
SEM evaluation of smear layer removal by two different single file system along with various irrigating solutions - An in vitro study
Authors: Ramachandran Kavitha , Rajasekaran Meenakshi Sundaram , Ramachandran Anil Kumar , Narayan Gopal Shankar , Venkatesan Sokkalingam Mothilal 
Published: February 2025

Aim:
The objective of this study was to compare the efficacy of smear layer removal from root canal using two different instrumentation systems, HyFlex electrical discharge machining (EDM) and WaveOne Gold, and to evaluate the smear layer removal ability of three different irrigants, Qmix, sodium hypochlorite (NaOCl), and ethylene diamine tetraacetic acid (EDTA).

Methods:
Sixty single-rooted human mandibular premolars without caries or developmental defects were divided into two groups: Group A (HyFlex EDM) along with NaOCl (A1), EDTA (A2), and Qmix (A3), Group B (WaveOne Gold) along with NaOCl (B1), EDTA (B2), and Qmix (B3) were used. The root canals were prepared according to the assigned instrumentation system and irrigants. The prepared teeth were then split longitudinally, and scanning electron microscopy was employed to assess and photograph the samples.

Results:
The results indicated that the WaveOne Gold-Qmix subgroup (B3) showed significantly better smear layer removal scores when compared to other subgroups. Furthermore, there was a significant difference in smear layer removal between the coronal and middle thirds of the root canal, while there was no significant difference observed in the apical third.

Conclusion:
WaveOne Gold instrumentation system exhibited superior smear layer removal ability compared to the HyFlex EDM. Moreover, the Qmix irrigant showed better smear layer removal efficacy than NaOCl and EDTA. The findings also emphasized the importance of considering the location within the root canal, as increased smear layer removal was observed in the coronal and middle thirds compared to the apical third.
Macro-Thyrotropin Syndrome: Prevalence and Clinical Profile of an Under-Recognised Rare Entity in Thyroidology
Authors: Patel Maitri M. , Patel Dhara K. , Patel Lalitkumar B. , Dharaiya Chetan B. , Patel Dhruvkumar M. , Vasani Ravi M. , Patel Mukundkumar V. 
Published: February 2025

Abstract

Introduction:
Macro-thyrotropin syndrome (macro-TSH) is a rare condition characterised by the formation of a complex between thyroid-stimulating hormone (TSH) and an unknown component, resulting in elevated TSH levels that do not accurately reflect thyroid status. This study aimed to investigate the prevalence and clinical profile of macro-TSH among patients with subclinical hypothyroidism (SCH).

Methods:
A total of 1500 patients were evaluated, with 135 exhibiting elevated TSH levels (>10 IU/mL) and normal free-thyroxine levels. Macro-TSH was diagnosed based on persistent elevated TSH levels despite serial dilutions and confirmed by less than 60% TSH recovery following polyethylene glycol (PEG) precipitation.

Results:
Finally, 115 were diagnosed with SCH, 15 with macro-TSH, and 1245 were categorised into non-thyroid groups. The prevalence of macro-TSH, SCH, and heterophilic antibodies interfering with immunoassay was 1.09%, 8.36%, and 0.36%, respectively. Among macro-TSH patients, 13.33% exhibited classical hypothyroid features, contrasting with the 52.0% observed in SCH patients. Female gender and a family history of hypothyroidism were associated with higher odds of having macro-TSH. Diabetes mellitus, clinical symptoms of hypothyroidism (except lethargy), higher TSH level, and post-PEG TSH recovery were significantly associated with SCH compared to macro-TSH. The mean TSH level was five times higher in macro-TSH compared to SCH.

Conclusion:
Macro-TSH syndrome represents a distinct clinical entity within the spectrum of SCH, characterised by disproportionately high TSH levels. Recognising macro-TSH is crucial for accurate diagnosis and appropriate management of SCH.
Hip Structural Analysis and Bone Strain Index in Clinical Practice: Their Utility Beyond BMD
Authors: Cherian Kripa E. , Paul Thomas V. 
Published: February 2025

Abstract
Previous studies have demonstrated that in certain medical conditions, fragility fractures tend to occur even at bone mineral density (BMD) levels that are in the nonosteoporotic range. This warrants the assessment of other factors beyond BMD that might confer an increased propensity to fracture. Hip structural analysis (HSA) is also performed by the DXA scanner and evaluates different variables pertaining to proximal hip geometry. Bone Strain Index (BSI) is another novel DXA-based tool that was recently developed to further assess bone health. This has been based on a finite element analysis of grey scale images of density distribution of the femoral and lumbar spine scans obtained from a DXA scanner. Preliminary studies assessing the utility of BSI in predicting fragility fractures have been promising. This review will focus on the technical details and utility of the HSA and BSI beyond conventional BMD assessment.
Evaluation of Utilization of Laser in Practicing Dental Surgeons: A Knowledge, Attitude, and Practice (KAP) Study
Authors: Tripathi Kaushal P. , Mutthineni R. Babu , Shah Ninad U. , Tiwari Rahul , Sahi Nita , Mathur Shilpi , Dixit Heena 
Published: February 2025

ABSTRACT

Background:
Laser technology has significantly impacted the field of dentistry, offering advantages such as precision, reduced pain, faster healing, and minimized bleeding. Despite these benefits, the extent of laser utilization among dental surgeons varies. This study evaluates the knowledge, attitude, and practice (KAP) of dental surgeons regarding laser use in their clinical settings.

Objective:
To assess the level of knowledge, attitude, and practice related to the utilization of lasers among practicing dental surgeons.

Methods:
A cross-sectional study was conducted using a structured questionnaire distributed electronically to 200 practicing dental surgeons. The questionnaire included sections on demographic information, knowledge, attitude, and practice related to laser use in dentistry. Data were analyzed to determine the prevalence and factors associated with laser utilization.

Results:
Out of 200 questionnaires, 150 were returned (75% response rate), with 46.7% aged 30–40 and 60% male, predominantly general practitioners (66.7%). While 80% knew about laser types and 85% saw them as beneficial, only 50% used them, citing cost and training as major barriers.

Conclusion:
The study revealed a high level of awareness and a positive attitude toward laser utilization among dental surgeons. However, practical application remains limited due to cost and insufficient training. Addressing these barriers through affordable laser technology and comprehensive training programs could enhance the adoption of lasers in dental practice.
Evaluate the Antimicrobial Properties of Double Antibiotic Paste (DAP) and Morinda Citrifolia and Propolis Paste (MCP) Used in Regenerative Endodontics: An In vitro Study
Authors: Bhavsar Bhavika A. , Jain Vaishali , Kumari Annu , Shukla Prabhooti , Pandya Riddhi , Kumar Modi R. , Singh Shanaya 
Published: February 2025

ABSTRACT

Objective:
To Evaluate The Antimicrobial Properties of Double Antibiotic Paste and Morinda citrifolia And Propolis Paste Used In Regenerative Endodontics.

Materials and Method:
Using intact human teeth, radicular dentin samples were prepared (dimensions 4×4×2 mm) by following a standard method. The samples were cut using a diamond saw at minimal speed using water as coolant and smoothed with abrasive papers. To expose the dentin tubules and eliminate the smear layer, they were treated with NaOCl (1.5%), distilled water, and EDTA (17%). A total of 30 dentin samples went through a three-week anaerobic infection with bacterial biofilms sourced from the root canal of an underdeveloped tooth showing pulp necrosis. Group 1 acted as the control, while Group 2 received treatment with DAP, and Group 3 was treated with a paste of Morinda citrifolia and Propolis. After a week, pastes were cleaned, and specimens were dipped in phosphate-buffered saline for a day. The biofilm was released from each specimen by sonicating and vortexing it for 30 seconds. It was then diluted, spiral-plated on blood agar, and cultured anaerobically for a day. An automated colony counter was utilized to measure colony-forming units (CFU/mL), and statistical analysis was conducted using the Wilcoxon rank-sum test.

Result:
The wash from dentin samples treated with DAP and MCP showed minimal CFU counts, indicating both pastes’ high efficiency against biofilm-forming microbes from the canals of an immature tooth exhibiting pulp necrosis.

Conclusion:
Dentin samples infused with DAP and MCP showed minimal CFU counts, indicating their high effectiveness against biofilm-forming microbes from the root canal of an underdeveloped tooth with pulp necrosis. Additional research is required to validate these findings.
Patient Satisfaction and Oral Health-Related Quality of Life with Complete Dentures
Authors: Sailasri Kunchala , Kar Aswini K. , Shujaulla Syed , Bagewadi Nagaratna , Kumar P. Arun , Rajakumari Kandra , Khan Azaram M. 
Published: February 2025

ABSTRACT

Introduction:
The purpose of complete dentures is to restore oral function and aesthetics for individuals with missing teeth. Understanding the relationship relating patient satisfaction and “Oral Health-Related Quality of Life (OHRQoL)” with complete dentures is essential for optimizing treatment outcomes and enhancing patient-centered care.

Methods:
A cross-sectional research was conducted among 500 individuals aged 50 and above who received complete dentures. Data were collected through structured interviews and validated questionnaires including the “Oral Health Impact Profile (OHIP-14)” and the “Dental Satisfaction Questionnaire (DSQ).” Statistical analysis was performed to assess correlations relating patient satisfaction, OHRQoL, and demographic variables.

Results:
The evaluation revealed a significant positive correlation among patient satisfaction and OHRQoL (P < 0.001). Factors such as denture stability, aesthetics, and chewing ability significantly influenced patient satisfaction. Tables presenting demographic characteristics and OHIP-14 scores among research subjects are provided.

Conclusion:
This research demonstrates a significant association relating patient satisfaction and OHRQoL with complete dentures. Denture stability, aesthetics, and chewing ability emerged as critical determinants of patient satisfaction. Clinicians should prioritize patient-centered care and consider patient-reported outcomes when planning and delivering prosthodontic treatment.
Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients
Authors: Moeinzadeh Firouzeh , Shahidi Shahrzad , Heidari Raheleh , Mortazavi Mojgan , Mansourian Marjan , Yadegar Bahareh Botlani 
Published: February 2025

Background:
There are conflicting results regarding survival in preemptive versus non-preemptive kidney transplant recipients. The present study aimed to estimate the risk of death in preemptive versus non-preemptive kidney transplant recipients.

Materials and Methods:
In the present retrospective cohort study, all end-stage renal disease (ESRD) patients who underwent kidney transplantation between 1996 and 2021 in referral kidney transplantation centers in Isfahan province were investigated. In total, 499 patients who received dialysis before kidney transplantation (non-preemptive) and 168 patients who received no dialysis before kidney transplantation (preemptive) were included in the final analysis. Data regarding demographic and clinical variables including sex, age, body mass index (BMI), follow-up duration, immunosuppressive regimen change, kidney donor type, underlying causes of ESRD, and comorbidities before and after kidney transplantation were collected.

Results:
The mean age was 55.47 ± 15.53 years in preemptive and 54.87 ± 14.69 years in non-preemptive patients (P = 0.65). Mortality rates were 24.44/1000 person-years of follow-up for preemptive and 18.25/1000 person-years of follow-up for non-preemptive patients (P = 0.013). In the crude model of Cox regression analysis, preemptive kidney transplant recipients had a significantly higher risk of mortality compared to non-preemptive kidney transplant recipients (hazard ratio [HR] = 1.59; 95% confidence interval [CI]: 1.09–2.33; P = 0.015). However, the association attenuated and became insignificant after adjustment for confounders, including age, BMI, immunosuppressive regimen change, kidney donor type, and comorbidities (HR = 1.35; 95% CI: 0.92–1.99; P = 0.12).

Conclusion:
The results of the present study indicated that there is no independent association between preemptive kidney transplantation and increased risk of mortality.
Prevalence of a Cerebral Midline Cavity - Cavum Septum Pellucidum in Schizophrenia: A Cross-sectional Study
Authors: Dias Medora Celine D’Souza , Fernandes Andre , Kantak Mandar Pandurang , Thirumaran Balaaji 
Published: February 2025

Abstract

Background:
Cavum septi pellucidi (CSP) is a potential midline cavity between the two layers of the septi pellucidi, which is one of the three midline cavities in the cerebrum. It is a neurodevelopmental anomaly, observed inconsistently among schizophrenics. This study estimated the presence of CSP among the schizophrenia patients and compared same with nonschizophrenics.

Methodology:
A cross-sectional study was carried out among adults who underwent computerized tomography scans of the brain at a tertiary care hospital in an urban area. The sample size was calculated as 562 excluding participants with known neurological anomalies, lesions, signs, injuries, and drug abuse. The prevalence of CSP, measurements of antero-posterior length, and transverse width of CSP were taken. The diagnosis of schizophrenia was made based on the Structured Clinical Interview for DSM-V. SPSS version-16 was used for statistical analyses, where descriptive results were expressed as tables. Analytic tests namely, Chi-square test, Mann–Whitney U-test, and independent sample t-test were performed.

Results:
The mean age of 578 study participants was 44.36 ± 18.45 years with 61.5% males and 15.4% having schizophrenia. CSP was observed in 5.2% among the study population with the proportion higher among the schizophrenics than the normal subject (15.7% vs. 3.2%). CSP was observed in higher proportion among males and male schizophrenics had higher proportion of CSP than female counterparts. The size of CSP was comparable among the groups.

Conclusion:
Higher prevalence of CSP among the schizophrenics makes CSP a potential neuroimaging marker for schizophrenia and its associated spectrum of disease.
Crafting an effective questionnaire: An essential prerequisite of engaging surveys
Authors: Sharma Hunny , Ruikar Manisha 
Published: February 2025

Abstract
Questionnaires play a crucial role in biomedical research, enabling valuable data collection from individuals. However, the effectiveness of a questionnaire depends on its ability to engage respondents and gather accurate information. This manuscript delves into the intricacies of crafting an effective questionnaire, exploring the essential elements that contribute to their success and impact, and highlights the need for well-crafted questionnaires in biomedical research emphasizing the importance of maximizing respondent engagement, obtaining reliable data, enhancing data completeness, minimizing nonresponse rates and bias, and facilitating data analysis. The article further sheds light on the factors influencing questionnaire effectiveness, including clear and concise language, logical flow and structure, relevance and significance, avoidance of double-barreled and leading questions, and using balanced response options and skip questions. This narrative review examines how each factor contributes to questionnaire quality and offers examples to illustrate their importance. Moreover, it emphasizes the significance of investing time and effort in designing effective questionnaires to ensure the validity and success of biomedical research. By understanding the art of engaging surveys, researchers can optimize their data collection processes and enhance the reliability and validity of their findings.
Bufalin Suppresses Esophageal Squamous Cell Carcinoma Progression through Protein Arginine Methyltransferase-6/AKT/Mammalian Target of Rapamycin Pathway Inhibition
Authors: Jia Yao-Ke , Ju Qian-Qian , Shi Hui , Si Xin-Xin 
Published: February 2025

Objective:
Esophageal squamous cell carcinoma (ESCC), a commonly encountered malignant tumor in the gastrointestinal tract, poses a significant health burden. Bufalin, a pharmacologically active molecule, has been shown to exhibit antitumor activity against various types of cancers. This study investigates the molecular mechanism underpinning the effects of bufalin on ESCCs.

Materials and Methods:
The impact of bufalin on the proliferation and migration of ESCC cells was evaluated through the utilization of the Cell Counting Kit-8 (CCK-8), scratch assay, and transwell assay. In addition, ribonucleic acid (RNA) sequencing was performed to identify genes that were abnormally expressed in response to bufalin treatment. Western blotting was utilized to ascertain the expression levels of protein arginine methyltransferase-6 (PRMT6), phosphorylated AKT (p-AKT), and phosphorylated mammalian target of rapamycin (p-mTOR). Cell transfection was then performed to observe the rescue effect of PRMT6 on bufalin.

Results:
Bufalin displayed a significant time-dependent inhibition of the proliferation, migration, and invasion of ECA109 cells. An RNA sequencing (RNA-seq) analysis revealed that PRMT6 expression was downregulated in the cells treated with bufalin. PRMT6 promoted the proliferation, migration, and invasive potential of ECA109 cells. The overexpression of PRMT6 boosted p-AKT and p-mTOR levels in ECA109 cells and reversed bufalin inhibition.

Conclusions:
These findings indicate that bufalin exerts its inhibitory effects on ESCCs through the PRMT6/AKT/mTOR signaling pathway. These findings lay the groundwork for bufalin as a promising therapeutic candidate for the treatment of ESCC.