bluuebunny/crossref_metadata_2025_split huggingface dataset:
Keratoconus Detection in High-Astigmatism Pediatric Patients: Optimal Pentacam Indices and Cutoff Points
Authors: Souza Oliveira Renato , Gil João Quadrado , Rosa Andreia , Quadrado Maria João , Campos Mauro 
Published: November 2024

Purpose:
To assess the accuracy of various Pentacam indices in distinguishing keratoconus (KC) in pediatric patients with high astigmatism and to establish appropriate cutoff values.

Methods:
This prospective multicenter cross-sectional study included 312 eyes from 167 patients aged 6 to 18 years (mean age, 13.1 ± 3.2 years) evaluated with Oculus Pentacam HR. Patients were categorized into 4 groups: KC, forme fruste keratoconus, astigmatism greater than 2 diopters (Cyl2D), and control. A subgroup of Cyl2D comprised patients with astigmatism greater than 4 diopters (Cyl4D). Twenty-three Pentacam indices were analyzed, and receiver operating characteristic curves determined optimal cutoff points, sensitivity, and specificity.

Results:
The best indices for distinguishing KC from Cyl2D were high-order aberration root mean square of the anterior corneal surface (area under the receiver operating characteristic curve 0.987), Belin/Ambrosio enhanced ectasia total derivation (0.971), index of vertical asymmetry (0.971), average pachymetric progression index (0.962), maximum Ambrosio relational thickness (0.960), posterior elevation (0.952), and anterior elevation (0.948). The accuracy of these indices was highest in the control group and lowest in the Cyl4D group. Area under the receiver operating characteristic curve was significantly lower for fruste keratoconus than KC. Optimal cutoff values were higher for astigmatic patients than for those with no refractive error.

Conclusions:
Most indices effectively distinguished between KC and normal pediatric patients. For individuals with high astigmatism, we suggest focusing on specific indices such as high-order aberration root mean square, Belin/Ambrosio enhanced ectasia total derivation value, maximum Ambrosio relational thickness, average pachymetric progression index, and index of vertical asymmetry. Optimal cutoff points for these patients were higher than those for nonastigmatic children and differed from adult populations.
Comparative risk of mortality in new users of prescription opioids for noncancer pain: results from the International Pharmacosurveillance Study
Authors: Jani Meghna , Girard Nadyne , Bates David W. , Buckeridge David L. , Dixon William G. , Tamblyn Robyn 
Published: November 2024

Abstract
Although opioids continue to be used internationally for noncancer pain, evidence to date on the comparative safety of different opioids is sparse and conflicting. The aim of this study was to examine the comparative risk of all-cause mortality in patients newly initiated on opioids for noncancer pain, across 3 jurisdictions in the United Kingdom (UK), United States, and Canada. A multicentre retrospective, population-based cohort study was conducted. Data sources included UK national primary care electronic health records (Clinical Practice Research Datalink), The Partners HealthCare Research Patient Data in Boston (US), and The Montreal Population Health Record data (Canada). New users of opioids aged ≥18 years without cancer were included. Patients with a diagnosis of a pain condition and with known back pain were analysed separately. Fully adjusted hazard ratios (HRs) were calculated using Cox-proportional models and adjusted for confounders. In total, 1,066,216 patients were included (UK: n = 993,294; Boston, US: n = 43,243; Montreal, Canada: n = 26,116). Compared with codeine, patients using morphine had a significantly higher adjusted risk in the UK {HR: 12.58 [95% confidence interval (CI), 11.87-13.32]}, US (HR: 8.62 [95% CI, 3.34-22.27]), and Canadian cohorts (HR: 6.69; [95% CI, 1.35-32.22]). In addition, other factors associated with higher mortality were being on combination opioids, fentanyl, buprenorphine, and oxycodone. Compared with those on <50 morphine milligram equivalents/day, patients on higher-doses experience an incremental increase in risk. In new users of opioids, compared with codeine, strong opioids, including morphine, fentanyl, buprenorphine, oxycodone, and combination opioids, and those on ≥50 morphine milligram equivalent/day were associated with a higher subsequent risk of all-cause mortality.
A Process Evaluation Approach to Central Line–Associated Bloodstream Infection Reduction in a Neonatal Population
Authors: Riley Soraya , Osterholm Erin , Vadner Emily , Cramer Julianne 
Published: November 2024

ABSTRACT

Objective:
To reduce the rate of central line–associated bloodstream infections (CLABSI) in the M Health Fairview Neonatal Intensive Care Unit (NICU) from 2.15 infections per 1,000 central line days to less than one per 1,000 line days using process evaluation.

Methods:
An interdisciplinary team used process mapping and Failure Modes and Effects Analysis (FMEA) to identify root causes and improvement opportunities in central line maintenance. The focus was on neonates born at <32 weeks of gestational age and weighing less than 750 g. Interventions included standardized clean space, algorithms to reduce line access, and standardized kits for line maintenance.

Results:
Over 4 years, the project achieved an 86.6% reduction in CLABSI events, decreasing from 15 events in 2019 to two in 2023. The CLABSI rate dropped by 85%, from 2.15 to 0.32 per 1,000 line days. Statistical analysis indicated a significant reduction in FMEA risk scores for the identified failure modes, with an average reduction of 33%.

Conclusion:
The process-focused approach and interdisciplinary collaboration significantly reduced CLABSI rates in the NICU. Future efforts should aim to maintain these improvements and achieve a target of zero CLABSI events.
The Application of Sentiment Treatment and Narrative Medicine in Infertility
Authors: TONG Yuheng , CHEN Wei , Vaishnani Deep K , Khaing Wut Yi Hla , CHEN Chen , CHEN Yanman 
Published: November 2024

Abstract
This study delves into the integration of traditional Chinese medicine (TCM) sentiment therapy with modern medical interventions in treating infertility, aiming to enhance the therapeutic outcomes for patients. It posits that infertility encompasses not only physical factors but also significant psychological and emotional dimensions. The synthesis of TCM sentiment therapy and contemporary reproductive medicine signifies a paradigm shift in comprehending the interactions among health, emotions, psychology, and physiology. By analyzing the diagnostic and treatment methods of TCM, this study elucidates how sentiment can enhance modern treatments, thereby promoting a more holistic, patient-centered approach to infertility care. Furthermore, it underscores the necessity of fostering a comprehensive understanding of health and disease within medical education.
Progressive multiple sclerosis: A bibliometric analysis
Authors: Shawawrah Mays , Alryalat Saif Aldeen 
Published: November 2024

Background:
Progressive multiple sclerosis (MS) is a chronic immune-mediated disease with a poorly understood pathophysiology. This bibliometric analysis of the literature aims to gain an overview of the current state of research on progressive MS.

Methods:
The Scopus database was searched using the terms “progressive” and “multiple sclerosis” in the title. The search was done till the 7th of January 2023. We analyzed annual trends, countries, institutions, authors, journals, articles, and keywords based primarily on the citation count.

Results:
One thousand nine hundred ninety-one studies out of 1993 search results were included. The included studies had 65,788 citations with a mean of 33 citations per study. Most studies were published between the years 2016 and 2020 (n = 607) with a mean number of 20 citations. The United States of America had the highest number of publications (n = 547) and citations (n = 24,921). The top 3 authors were Thompson A.J., Miller D.H., and Filippi M., and Multiple Sclerosis Journal had the most publications (n = 227) and citations (n = 6849).

Conclusion:
To our knowledge, this is the first bibliometric study to address the topic of progressive MS in particular and potentially emphasize the direction of progressive MS research.
Safety and efficacy of S1P receptor modulators for the induction and maintenance phases in inflammatory bowel disease: A systematic review and meta-analysis of randomized controlled trials
Authors: Akram Abdullah , Ahmed Misha , Farhan Kanza , Omer Areeb , Kaleem Shamama , Khan Ali Tahir , Aslam Uzma , Tahir Muhammad Abdullah , Memon Saria , Karam Ayatul , Furqan Humam , Anjum Muhammad Umair , Bhattarai Pratik 
Published: November 2024

Background:
Inflammatory bowel disease (IBD) is a chronic inflammatory condition that significantly affects quality of life. Conventional treatments have had limited success. this study evaluates the safety and efficacy of Sphingosine 1-phosphate receptor modulators (S1PrMs) as a potential treatment for IBD.

Methods:
We conducted a thorough search of published literature on PubMed, EMBASE, and Google Scholar from 2000 to 2023. The inclusion criteria were randomized controlled trials (RCTs) with a target population comprising of IBD patients receiving either S1PrMs or placebo and a comparison of the 2. The statistical analysis was conducted using RevMan (version 5.4). Forest plots presented the results as risk ratios (RR) with a 95% confidence interval.

Results:
A total of 7 RCTs involving 2471 patients were included. The results were reported for both the induction and maintenance phases of treatment. in the induction phase, the intervention group proved to have a significantly higher incidence of histological remission (RR = 2.67; 95% CI [1.97, 3.60]; P < .00001), endoscopic improvement (RR = 2.06; 95% CI [1.66, 2.56]; P < .00001), clinical remission (RR = 2.23; 95% CI [1.43, 3.46]; P < .0004) and clinical response (RR = 1.37; 95% CI [1.01, 1.84]; P = .04) compared to the placebo group. Outcomes assessed in maintenance phase significantly favored the intervention group over placebo as well, histologic remission (RR = 2.39; 95% CI [1.83, 3.11]; P < .00001), endoscopic improvement (RR = 2.20; 95% CI [1.28, 3.77]; P = .004), clinical remission (RR = 3.03; 95% CI [1.84, 4.99]; P < .0001), and clinical response (RR = 1.74; 95% CI [1.25, 2.42]; P = .001).

Conclusion:
S1PrMs show promising potential for establishing histologic remission, endoscopic improvement, clinical remission, and corticosteroid-free clinical remission. With more studies and clinical trials, these modulators may become a reliable therapeutic choice for UC patients everywhere.
The role of prophylactic transfusion on the maternal and fetal outcomes in pregnant women with sickle cell disease: A systematic review and meta-analysis
Authors: AlMoshary May , Arabdin Maria 
Published: November 2024

Background:
In the present review, we aimed to synthesize evidence from studies on the safety and effectiveness of prophylactic blood transfusion in pregnant women with sickle cell disease.

Material and methods:
To gather relevant information, we conducted systematic electronic searches of databases such as SCOPUS, Medline via PubMed, Web of Science, and Cochrane Central Register of Controlled Trials. We included both retrospective and prospective studies that examined the impact of prophylactic blood transfusions during pregnancy. The collected data were analyzed using Review Manager, version 5.3.

Results:
The review included 15 cohort studies. The overall findings indicated a preference for the prophylactic blood transfusion group over the control group across several key parameters. Specifically, the prophylactic group demonstrated lower rates of maternal mortality (odds ratio [OR] = 0.33; 95% confidence interval [CI] = 0.10–1.13; P = .08), reduced incidence of vaso-occlusive painful events (OR = 0.31; 95% CI = 0.14–0.73; P = .007), fewer pulmonary complications (OR = 0.21; 95% CI = 0.08–0.53; P = .001), decreased perinatal mortality (OR = 0.35; 95% CI = 0.17–0.75; P = .03), and lower likelihood of preterm birth (OR = 0.67; 95% CI = 0.47–0.96; P = .02). Notably, statistically significant heterogeneities were observed in the pooled effect estimates.

Conclusion:
The present meta-analysis indicated that prophylactic blood transfusion in pregnant women with sickle cell disease may improve maternal and fetal outcomes. However, substantial variations in the methodology and transfusion protocols among the included studies limited the credibility of the current evidence supporting the routine clinical use of prophylactic transfusion for SCD during pregnancy.
Insights into the mechanism of Danggui Liuhuang Tang in treating night sweats: A network pharmacology and molecular docking approach
Authors: Qiu Jinling , Huang Xingran , Li Hongyang , Jin Shuying , Yang Ruo , Gu Wei 
Published: November 2024

Background:
Night sweats can occur independently or in association with a number of medical conditions and can significantly disrupt daily life. This study focuses on the treatment of primary night sweats. Despite the considerable interest in Danggui Liuhuang Tang (DGLHT), an effective traditional Chinese medicine formula, its mechanism of action remains unknown. There is also no existing literature on the subject.

Methods:
Network pharmacology and molecular docking techniques.

Results:
Network pharmacology techniques were employed to identify 109 active ingredients and 808 potential targets of DGLHT, as well as 2385 targets associated with night sweating diseases. The screening process yielded 375 common targets shared between DGLHT and night sweating. These included the active ingredients baicalein, quercetin, huarangiin, and tetrahydroafrican antipyrine, and the core targets interleukin 6, serine/threonine protein kinase 1, tumor necrosis factor, GAPDH enzyme, and Src protein kinase were identified. The Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that DGLHT exerts its therapeutic effects primarily by modulating the PI3K–Akt signaling pathway, neuroactive ligand–receptor interactions, lipid metabolism, and atherosclerosis pathways. Molecular docking revealed strong binding activity between the main active ingredients and their potential targets.

Conclusion:
The research identifies promising active ingredients and targets related to the effectiveness of DGLHT in controlling night sweats, thus contributing to the further exploration of potential therapeutics for this condition. In addition, the results of this experiment provide a basis for future research into night sweats.
Paraganglioma With Intracranial Invasion Demonstrated on 68Ga-DOTATATE PET/CT
Authors: Kesim Selin , Filizoglu Nuh 
Published: November 2024

Abstract

68Ga-DOTATATE PET/CT demonstrates superior sensitivity compared with other cross-sectional and functional imaging techniques in detecting head and neck paragangliomas. It is the primary recommended imaging modality for the evaluation of head and neck paragangliomas, especially in patients suspected of having locally aggressive, multifocal, or metastatic disease, as well as those being considered for targeted peptide-receptor therapy. Herein, we demonstrate the 68Ga-DOTATATE PET/CT findings of a skull base paraganglioma with extensive local invasion and intracranial extension.
Analysis of the Surgical Efficacy and Risk Factors of a One-stage Unilateral Approach for Clipping Bilateral MCA Mirror Aneurysms
Authors: Wang Chao , Yu Bing , Xu Yifan , Zhang Chonghui , Feng Yugong 
Published: November 2024

Background:
Numerous microsurgical approaches are available for treating middle cerebral artery (MCA) mirror aneurysms. However, a definitive conclusion regarding which approach yields the best outcome has yet to be reached.

Methods:
Thirty-three patients with MCA aneurysms were categorized into 2 groups: one-stage unilateral approach and other surgical approaches. Prognostic differences were compared using the Modified Rankin Scale (mRS). In addition, the length of hospital stay and costs were also compared. Among the patients with a proposed preoperative one-stage unilateral approach, they were divided into success and failure groups, and these factors were collected, including Hunt-Hess grade, contralateral aneurysm orientation and maximum diameter, contralateral A1+M1 length, and contralateral ICA bifurcation angle. These parameters were analyzed using multivariate logistic regressions to identify the risk factors.

Results:
The prognosis of patients in the one-stage unilateral approach group did not differ significantly from that of other surgical approaches. However, patients in the one-stage unilateral approach group experienced shorter hospital stays and incurred lower hospital expenses. In the multivariate regressions, the length of the contralateral A1+M1 was identified as an independent risk factor.

Conclusions:
The one-stage unilateral pterional approach for clipping bilateral aneurysms is an effective method of treating MCA mirror aneurysms. However, in cases where patients have an excessive length of A1+M1 on the contralateral side, this approach may result in surgical failure.
Trans-Tragal Approach for Mandibular Neck and Head Condylar Fractures
Authors: Girotto Riccardo , Cirignaco Giulio , De Tomaso Silvia , Racano Carmine , Balercia Andrea , De Feudis Francesco , Balercia Paolo 
Published: November 2024

This retrospective observational study evaluates the trans-tragal approach for the treatment of mandibular head and neck condylar fractures. From January 2009 to May 2024, 34 patients (20 males, 14 females, mean age 34 years) with 36 condylar fractures were treated using this approach. Surgical outcomes were assessed based on occlusal relationship, maximum mouth opening, and facial nerve function (House-Brackmann scale). Postoperative imaging included computed tomography scans, with follow-ups at 1, 3, 6 months, and 1 year. Complications such as wound infection, hematoma, and salivary fistula were also evaluated.
Results showed satisfactory postoperative outcomes, with 32 patients maintaining normal occlusion and a mean interincisal opening distance of 40 mm. Three patients experienced complications, including temporary facial nerve numbness in one case, with complete recovery in 2 weeks, and 2 cases requiring reoperation due to condylar segment displacement. No cases of permanent facial nerve damage, salivary fistula, or tragal cartilage necrosis were observed. Aesthetic outcomes were satisfactory, with scars hidden in natural folds.
The trans-tragal approach provides adequate surgical exposure to the posterior condylar region while minimizing the risk of facial nerve injury. Although the results of this study indicate favorable outcomes, further randomized controlled studies are required to validate these findings due to the non-randomized design and small sample size.
Positive impact of Type-A and -C response regulator genes on growth and panicle architecture in rice
Authors: Rong Chenyu , Zhang Renren , Xie Jing , Li Jieru , Yan Tiantian , Liu Ziyu , Liu Yuexin , Xu Ruihan , Shi Xi’an , Zhao Xuebin , Song Jiali , Meng Yayi , Chang Zhongyuan , Ding Yanfeng , Ding Chengqiang 
Published: November 2024

AbstractCytokinin signal transduction occurs through a "two-component system." Type-A and -C response regulators (RRs) are groups of proteins of similar structures constituting significant components of cytokinin signal transduction. In rice, 13 (Type-A) and two (Type–C)RRshave been identified to date; however, their functions remain partially known. In this study, we examined the expression patterns of Type-A and Type-C RRs in rice using RNA-Seq and confirmed their functions by constructing mutants of the 15 genes with CRISPR/Cas9. Almost all Type-ARRsplayed positive roles in the development of secondary branches and secondary spikelets, particularlyRR2andRR4. Notably,rr1 rr2andrr8 rr12 rr13higher-order mutants displayed small panicle sizes and decreased plant height. Additionally, both Type-CRRsplayed positive roles in regulating heading date. RNA-seq revealed several genes with significantly altered expression in therr2andrr4mutants, with almost half of the differentially expressed genes (DEGs) overlapping between the two mutants. Many of the DEGs were associated with the cytokinin and abscisic acid pathways. Our findings provide new insights into the functions of Type-A and -CRRsin rice growth and may serve as a foundation for future studies focusing on cytokinin signaling.
Effectiveness of mRNA COVID-19 vaccines and hybrid immunity in preventing SARS-CoV-2 infection and symptomatic COVID-19 among adults in the United States
Authors: Feldstein Leora R. , Ruffin Jasmine , Wiegand Ryan E. , James-Gist Jade , Babu Tara M. , Borkowf Craig B. , Briggs-Hagen Melissa , Chappell James , Chu Helen Y. , Englund Janet A. , Kuntz Jennifer L. , Lauring Adam S. , Lo Natalie , Carone Marco , Lockwood Christina , Martin Emily T. , Midgley Claire M. , Monto Arnold S. , Naleway Allison L. , Ogilvie Tara , Saydah Sharon , Schmidt Mark A. , Schmitz Jonathan E. , Smith Ning , Sohn Ine , Starita Lea , Talbot H. Keipp , Weil Ana A. , Grijalva Carlos G. 
Published: November 2024

AbstractBackgroundUnderstanding protection against SARS-CoV-2 infection by vaccine and hybrid immunity is important for informing public health strategies as new variants emerge.MethodsWe analyzed data from three cohort studies spanning September 1, 2022–July 31, 2023, to estimate COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 infection and symptomatic COVID-19 among adults with and without prior infection in the United States. Participants collected weekly nasal swabs, irrespective of symptoms, annual blood draws, and completed periodic surveys, which included vaccination status and prior infection history. Swabs were tested molecularly for SARS-CoV-2. VE was estimated using Cox proportional hazards models for the hazard ratios of infections, adjusting for covariates. VE was calculated considering prior infection and recency of vaccination.ResultsAmong 3,343 adults, adjusted VE of bivalent vaccine against infection was 37.2% (95% CI: 11.4-58.5%) within 7-60 days of vaccination and 17.0% (95% CI: -3.7-33.2%) within 60-179 days of vaccination compared to participants who were unvaccinated/received an original monovalent vaccine dose ≥180 days prior. Overall, adjusted VE of bivalent vaccine, in conjunction with prior infection, was 62.2% (95% CI: 44.2-74.6%) within 7-179 days of vaccination and 39.4% (95% CI: 11.7-61.3%) ≥180 days compared to naïve participants who were unvaccinated/received a monovalent vaccine dose ≥180 days prior.ConclusionsAdults with both prior infection and recent vaccination had high protection against infection and symptomatic illness. Recent vaccination alone provided moderate protection.