bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Outcomes of Preputial Buttonhole Flap Versus Byars Flap Techniques in Hypospadias Treatment
Authors: Valizade Farzin , rad Hamed Mohseni , Amirkhani Navid 
Published: November 2024

Abstract

Background:
Hypospadias, a prevalent congenital anomaly, is characterized by the incomplete development of the urethral spongiosum and the ventral prepuce. The current standard of care for hypospadias not only targets the attainment of a functional penis, facilitating sexual intercourse and upright urination, but also emphasizes an aesthetically pleasing outcome. The surgical techniques for treating hypospadias are continually advancing.
Methods:
In this study, two distinct skin coverage techniques used in hypospadias repair were compared. The Snodgrass technique was used to repair all 40 cases included in our study. In half of the cases (n = 20), an inner preputial buttonhole flap was used for skin coverage. For the remaining cases, a Byars flap was employed as a waterproof layer. The minimum period of follow-up was six months. Finally, data related to the surgical outcomes and the patients’ demographic characteristics were collected and analyzed using SPSS software.
Results:
The average age of the patients in this study was 26.1 months (SD, 8.5). The results indicated that there was no significant difference between the preputial buttonhole flap and Byars flap techniques in the treatment of hypospadias, considering factors, such as urethral fistula, meatal stenosis, and the need for a repeat surgery postoperatively (P > 0.05).
Conclusions:
Our findings suggest that the preputial buttonhole flap technique may be more effective than the Byars flap surgery in neourethra coverage for preventing fistulas in distal hypospadias. However, to substantiate these findings, further studies with larger sample sizes are required.
Epidemiological Trends and Clinical Characteristics of Measles in Iraq (2023-2024): A Retrospective Cross-Sectional Study
Authors: Jalal Mohammed A. , Halboot Kamil M. , Lami Sundus A. , Gumar Entidhar A. , al-Delphi Mortada H. Kreeb , Lami Faris , Taher Taqi Mohammed Jwad 
Published: November 2024

Abstract

Background: Measles remains a major public health challenge globally, especially in regions with low vaccination coverage. Iraq has experienced recurrent outbreaks in recent years, primarily due to inconsistent vaccination rates and a weakened healthcare system. Analyzing the epidemiological patterns and clinical features of measles in Iraq is essential for developing effective public health interventions.
Methods: This retrospective cross-sectional study examined measles cases reported from January 2023 to August 2024, using data from the national surveillance system. The analysis emphasized demographic and clinical information, specifically vaccination status, age distribution, and clinical symptoms. Statistical analyses were performed using SPSS version 25, incorporating descriptive statistics, logistic regression, and Chi-square tests.
Results: The measles incidence in Iraq increased significantly from 22.1 to 69.3 cases per-100,000 population. Notable rises in cases were observed among infants under 9 months (12% to 16.7%) and individuals over 15 years (6.4% to 12.1%). The percentage of cases with unknown vaccination status rose to 50.2%. Symptoms such as fever and rash were prevalent, exhibiting significant variations by age and vaccination status.
Conclusion: The resurgence of measles in Iraq from January 2023 to August 2024 highlights significant public health challenges, driven by socio-economic instability. The increase in cases, especially among under-immunized populations and infants, necessitates urgent action. Strengthening vaccination programs, enhancing public awareness, and improving healthcare access are essential. Additionally, better surveillance and record-keeping are crucial for effective outbreak management. Tailored public health strategies are needed to address geographic disparities in incidence, and further research on vaccine hesitancy is critical for developing robust catch-up vaccination campaigns.
Joint Association of Education and Neighborhood Socioeconomic Status with Smoking Behavior: The Multiethnic Cohort Study
Authors: Walsh Catherine P. , Shariff-Marco Salma , Lee Younghan , Wilkens Lynne R. , Marchand Loic Le , Haiman Christopher A. , Cheng Iona , Park S. Lani 
Published: November 2024

Abstract

Background Cigarette smoking is the leading cause of preventable mortality. Both neighborhood- and individual-level socioeconomic status (SES) are inversely associated with smoking. However, their joint effect on smoking behavior has not been evaluated.Methods This cross-sectional study examined the association of education and neighborhood SES (nSES) with smoking among 166,475 Multiethnic Cohort (MEC) participants (African American, Japanese American, Latino, Native Hawaiian, White individuals) recruited between 1993–1996 from Hawaii and LA County. nSES was based on a composite score of 1990 US Census data and assigned to geocoded addresses; nSES quintiles were based on region-specific distributions. The joint education/nSES variable had four categories: high nSES (Quintiles 4–5)/high education (> high school), high nSES/low education (≤ high school), low nSES (Quintiles 1–3)/high education, and low nSES/low education. Poisson regression estimated state-specific prevalence ratios (PR) for current smoking versus non-smoking across joint SES categories, with subgroup analyses by sex and race/ethnicity.Results In California, compared to MEC participants with high nSES/high education, the PR for smoking was highest for low nSES/low education (PR = 1.50), followed by low nSES/high education (PR = 1.33) and high nSES/low education (PR = 1.29). All pairwise comparisons between PR were statistically different (p < 0.0001), except high nSES/low education vs. low nSES/high education. In Hawaii, compared to high nSES/high education, the PR for smoking was also highest for low nSES/low education (PR = 1.41), but followed by high nSES/low education (PR = 1.36), then low nSES/high education (PR = 1.20). All pairwise comparisons were statistically different (p < 0.0001), except high nSES/low education vs. low nSES/low education. These patterns were consistent across sex and race/ethnicity within each state.Conclusion In California and Hawaii, individuals with low education living in low SES neighborhoods had the highest smoking prevalence. However, regional differences were noted: in California, both low education and low nSES increased smoking prevalence; whereas in Hawaii, low education had a greater impact.
An extra-glossal ectomesenchymal chondromyxoid tumor with RREB1::MRTFB fusion-positive: A case report of a rare tumor at a rare site
Authors: Deng Yu , Liu Wei , Sun Ke 
Published: November 2024

Abstract

Background: Ectomesenchymal chondromyxoid tumor (ECT) is a rare benign intraoral tumor which almost exclusively presents as a small mass of the anterior dorsal tongue. Recently, the RREB1–MRTFB (previously known as MKL2) fusion gene has been identified in 90% of ECTs, all located in the tongue, emphasizing its genetic distinctiveness. Herein we report one mesenchymal tumor involving the bottom of the left foot of young women with RREB1–MRTFB fusions.
Case presentation: The tumor presented as well-circumscribed masse. After complete excision recurrence was not observed at 6 months. Although tumor were originally unclassifiable, targeted RNA sequencing revealed RREB1 (exon 8)–MRTFB (exon 11) fusion transcripts. The tumor cells showed mild nuclear atypical with very low mitotic activity. Immunohistochemistry staining show S100, glial fibrillary acidic protein, CD56 diffuse positive, variable expression of SMA, and negative for SOX10、P63. Overall, these findings suggest that they may represent previously undescribed extra-glossal ECT involving the plantar fascia. However, it has brought many obstacles to our diagnosis because of its unclassical morphology and uncommon site.
Conclusions: We report for the first time a mesenchymal chondromyxoid tumor with RREB1-MTRFB gene fusion occurring in the foot. This case furthers awareness of the extra-glossal distribution of ECT. By carefully observing morphology and combining immunohistochemistry and molecular techniques, we can effectively avoid misdiagnosis and missed diagnosis of the diseases.
The mid-term results of screws plus cement repair during primary total knee arthroplasty for Rand type II bone defects
Authors: Wang Tihui , wu jinqing , zhang zhiwei , zheng tianqin , lu zhenbao , wang xu , lin feiyue 
Published: November 2024

Abstract

【 Objective 】 To investigate the midterm results of the screws plus cement repair technique for medial tibial plateau bone defects during total knee arthroplasty.
【 Methods 】 From September 2014 to September 2019, 38 patients with Rand type II bone defects who underwent the screws plus cement technique during primary TKA were included in the study. The clinical results were evaluated via the knee society knee score (KSKS) and the knee society function score (KSFS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and range of motion (ROM). The hip–knee–ankle angle (HKAA), femorotibial angle (FTA), and radiolucent lines were assessed radiologically.
【 Results 】Onepatient had incomplete data, 1 patient died due to a traffic accident, and 1 patient was lost to follow-up. Thirty-five patients were followed up for an average of 92.6 months (60–120 months). At the last follow-up visit, the KSKS, KSFS, WOMAC score, and ROM significantly improved. The HKAA and FTA were corrected postoperatively. In 3 patients, a nonprogressive radiolucent line measuring approximately 1 mm was observed at the interface between the host bone and the cement at 3, 6 and 12 months after surgery, with an incidence of 8.3%, and no radiolucent lines were found around the screws in any of the patients at the last follow-up visit. No infection, fracture or prosthesis loosening occurred in any of the patients.
【 Conclusion 】The screws plus cement technique in primary total knee arthroplasty for the repair of Rand type II bone defects achieved satisfactory clinical and radiological results and solid fixation after a minimum 5-year follow-up period. The screws plus cement technique could be considered an economical and practical method to repair mild and moderate bone defects in primary TKA patients.
Active screening and Molecular Epidemiology Characteristics of fecal colonization of Carbapenem resistance Enterobacterales from Intensive Care Units wards in a Tertiary Hospital in Shanghai, China
Authors: Zhang Hui , Zhou Cong , Xu Maosuo , Shen Chunmei , Shen Fang , Lin Yong 
Published: November 2024

Abstract

Background: Active screening fecal colonization of carbapenem resistance Enterobacterales(CRE) and intervention in Intensive Care Units(ICU) wards have become important measures to prevent CRE infection. However, limited data is available on molecular epidemiological characteristics and homology analysis of fecal colonization of CRE(CRE-fc) in ICU wards. This prospective observational study was aimed to investigate the molecular epidemiological characteristics and homology analysis of fecal colonization of CRE in ICU wards from a university hospital in China.
Methods: Fecal swabs were collected from 435 patients in ICU wards of a tertiary hospital in Shanghai, China from March 1, 2022 to February 28, 2023, and the above specimens were inoculated in Resistant Bacteria Chromogenic Plate (Antu Bio, China). We removed duplicate strains from the same patient and only retain the first isolated CRE-fc. Infection prevention and control (IPC) interventions were carried out for patients with positive CRE screening results. The bacterial identification, antimicrobial susceptibility, MLST and serotypes were profiled. We also applied whole-genome sequencing and core-genome MLST to analysis the molecular epidemiological characteristics and homology of these strains.
Results: The prevalence of CRE-fc in ICU wards was 12.6%(55/435). The predominate CRE-fc was Klebsiella pneumoniae (83.6%, 46/55), followed by Escherichia coli (9.1%, 5/55), Enterobacter aerogenes (3.7%, 2/55), Enterobacter cloacae (1.8%, 1/55), Citrobacter freundii (1.8%, 1/55). Through active screening of CRE-fc and IPC interventions in 2022, we found that the CRE infection rate in 2022 (22.8%) was significantly lower than that in 2021 (33.7%). MLST analysis revealed that the 46 fecal colonization of carbapenem resistance Klebsiella pneumoniae (CRKP-fc) belonged to 3 different ST, ST11 was the most predominant ST (71.7%, 33/46), followed by ST15 (26.1%, 12/46) and ST290 (2.2%, 1/46). All ST11 and ST15 strains harbored blaKPC-2, and ten ST15 strains carried two carbapenemase genes (blaKPC-2, blaOXA-1) at the same time. The phylogenetic tree identified two major clades, cluster 1 corresponding to ST11, cluster 2 to ST15.
Conclusion: Phylogenetic analysis showed clonal spread of CRKP among patients in ICU wards. ST11-KL64 CRKP has emerged as the most prevalent fecal colonized carbapenem-resistant Enterobacterales and may contribute to hospital outbreaks of infection. Active screening of CRE-fc and IPC interventions can reduce the CRE infection rate in ICU wards.
Analysis of the Correlations between Changes in Posterior Segment and Anterior Chamber Segment after Implantable Collamer Lens Implantation in Highly Myopic Patients
Authors: Peng Yifei , Xiong Lu , Qu Haokun , Liu Yang , Wang Zheng 
Published: November 2024

Abstract

Purpose
To investigate the effects of implantable collamer lens (ICL) implantation on the posterior segment of the eye and its correlation with the structural changes of the anterior chamber angle in patients with high myopia.
Methods
Patients with high myopia undergoing ICL surgery from September 2022 to June 2023 were selected as the surgical group, while those with high myopia not undergoing surgery during the same period served as the non-surgery group. The patients in the surgical group underwent assessments for uncorrected distance visual acuity (UDVA), intraocular pressure (IOP), refraction, anterior segment optical coherence tomography (AS-OCT), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) preoperatively, and on 1 day, 1 week, 1month, and 3 months postoperatively. In contrast, the patients in the non-surgery group were evaluated at the baseline and three months later.
Results
Conclusion
Anterior chamber depth narrowed after ICL implantation, which remained stable at 3 months postoperatively. The superficial vessel density fluctuated postoperatively, returning to preoperative levels by 3 months. The deep vessel density (DVD) also fluctuated, with the nasal quadrant around the fovea showing an increase in DVD at 3 months postoperatively compared to preoperatively, while DVD in other areas returned to preoperative levels by 3 months. The fluctuations in vascular density postoperatively correlated with changes in the anterior chamber angle structure. ICL implantation demonstrates good safety and efficacy for patients with high myopia.
The Effect of Music on Resistance to Mental Fatigue：Evidence of EEG Power Spectrum
Authors: Liu Jin , He Tingting , Hu Zhigang 
Published: November 2024

Abstract

Objective: To evaluate the efficacy of music listening in alleviating mental fatigue among healthy participants and to explore the neural evidence by electroencephalography (EEG).
Methods: A total of 30 participants were recruited and randomly assigned to either the Music or Control groups. Mental fatigue was induced in both groups using a 30-minute Stroop task. Following this task, the Music group listened to music for 20 minutes, while the Control group sat quietly for the same duration. Measurements were taken at three time points: before the Stroop task, immediately after the Stroop task, and after the 20-minute intervention period. Visual Analog Scale (VAS) scores and 3-minute resting-state EEG signals were collected at each time point.
Results: The data indicated that music listening significantly reduced mental fatigue. VAS scores decreased more in the Music group than the Control group (P=0.031). The EEG iAPF showed a significant recovery in the Music group (P<0.0001). Delta power in the frontal region decreased significantly post-intervention in the Music group (P=0.011). Theta and alpha power also decreased significantly in the Music group across multiple brain regions (all Ps<0.0076), with no significant changes observed in beta power.
Conclusion: These findings highlight the potential of music as a non-invasive and enjoyable intervention for mitigating the effects of mental fatigue. Moreover, iAPF, theta, and alpha power can serve as reliable biomarkers for assessing mental fatigue and the restorative effects of interventions like music.
Flooding Spread of Manipulated Knowledge in LLM-Based Multi-Agent Communities
Authors: Ju Tianjie , Wang Yiting , Hua Yi , Ma Xinbei , Cheng Pengzhou , Zhao Haodong , Wang Yulong , Liu Lifeng , Xie Jian , Zhang Zhuosheng , Liu Gongshen 
Published: November 2024

Abstract

The rapid adoption of large language models (LLMs) in multi-agent systems has highlighted their impressive capabilities in various applications. However, the security implications of these LLM-based multi-agent systems have not been thoroughly investigated, particularly concerning the spread of manipulated knowledge. In this paper, we aim to understand the security vulnerabilities associated with LLM-based multi-agent systems. We design a novel two-stage attack methodology, consisting of Persuasiveness Injection and Manipulated Knowledge Injection, to investigate the potential for manipulated knowledge to permeate trusted third-party platforms without explicit adversarial prompt attack. Through extensive experiments, we demonstrate that our attack method can successfully induce LLM-based agents to spread both counterfactual and toxic knowledge without degrading their foundational capabilities during agent communication. Furthermore, we show that these manipulations can persist through popular retrieval-augmented generation (RAG) frameworks, where several benign agents store and retrieve manipulated chat histories for future interactions. To mitigate the potential risk, we propose two defense strategies by designing system prompts to encourage agents to critically verify the knowledge they share and incorporating supervisory agents to oversee interactions. Results demonstrate that those strategies can effectively reduce the spread success rate. This work highlights the critical vulnerabilities inherent in LLM-based multi-agent communities and calls for the urgent need for platforms to swiftly adopt targeted defenses against manipulated knowledge spread. Results demonstrate that even these straightforward strategies can significantly reduce the spread success rate, which calls for platforms to swiftly adopt targeted, cost-effective measures to prevent the spread of manipulated knowledge.
N6-methyladenosine modification of DYNLT1 Facilitates Tamoxifen Resistance in Luminal B Breast Cancer
Authors: Li Qiji , Li Chenxin , Zhang Di , Lei Kefeng , Wang Yun , Zhu Qingqing , Zhang Yuhao , Sun Xiaoting , Zheng Zihan , Yang Xiaoying , Tian Qin , Zhu Chengming , Ye Liping 
Published: November 2024

Abstract

Purpose
Resistance to tamoxifen poses a significant clinical challenge in the management of Luminal B breast cancer, necessitating the identification of novel biomarkers for predicting treatment response and prognosis. The specific role of DYNLT1 in endocrine response within Luminal B breast cancer remains uncertain.
Methods
The expression levels of DYNLT1 were assessed in breast cancer samples using immunohistochemistry, real-time PCR, and western blot analysis. The potential role of DYNLT1 in promoting resistance to tamoxifen was investigated through cell viability and colony formation assays. Furthermore, an in vivo mammary fat pad model was employed to examine the impact of DYNLT1 on tamoxifen resistance in breast tumors. Additionally, luciferase activity assays were conducted to explore the activation of the ER signaling pathway. The enrichment of ELAVL1 on mRNA of DYNLT1 was detected utilizing RNA immunoprecipitation assay.
Results
This study demonstrated that the DYNLT1 expression was particularly upregulated in the Luminal B subtype of breast cancer tissues. Notably, elevated DYNLT1 expression was associated with poorer relapse-free survival among Luminal B breast cancer patients treated with tamoxifen. Functionally, increased DYNLT1 expression induced resistance to tamoxifen both in vivo and in vitro. Additionally, upregulation of DYNLT1 significantly promoted ligand-independent activation of the ER signaling pathway. ELAVL1-mediated m6A modification led to overexpression of DYNLT1 and facilitated the acquisition of tamoxifen resistance phenotype.
Conclusion
Overall, these findings highlight that DYNLT1 could potentially act as a novel biological marker for predicting the effectiveness of tamoxifen treatment and patient prognosis in Luminal B breast cancer.
Multilayered substructures of a non-enzymatic chemical reaction network synthesizing sugars
Authors: Hase Yoko , Chikatani Gena , Nishijima Hiroaki , Ito Yuji , Nagita Kaito , Tabata Hiro , Harada Takashi , Miyake Rika , Nakanishi Shuji 
Published: November 2024

Abstract

In biological chemical reactions, such as those found in metabolism, substructures formed through multi-step enzymatic reactions organize into large chemical reaction networks (CRNs) that produce complex and sophisticated functions. Recently, significant attention has been paid to artificial, non-enzymatic control of multi-step chemical reactions aimed at synthesizing compounds with structural complexity. Sequential reactions, where multiple catalysts each drive specific steps, have emerged as a promising strategy to enhance overall efficiency; however, the synergistic effects arising from the activation of different substructures within a CRN by multiple catalysts, and the emergent functions resulting from the combination of these substructures, remain largely unexplored. In this study, we focus on the formose reaction as a non-enzymatic CRN to demonstrate that the complementary activation of multiple substructures by distinct catalysts leads to the emergence of novel functions. We conducted a statistical analysis of temporal changes in compound concentrations during reactions catalyzed by γ-Al2O3 and a phosphate buffer solution. The results suggested the presence of a third catalytic species and revealed synergistic effects among the substructures activated by γ-Al2O3, phosphates, and this third species. Our findings demonstrate that the synergistic effects of multiple catalysts can be harnessed to design and control the functions of CRNs.
Serum-based studies show novel biomarkers for circulating HPV-DNA in high-risk HPV women as a biomarker for early detection of cervical cancer.
Authors: Venkatesh  , gowda Jadeppa , BS Anjali Devi 
Published: November 2024

Abstract

Background:
Cervical cancer caused by HPV is the fourth most common cancer in women worldwide. Detecting circulating cell-free HPV-DNA can provide valuable information about treatment response as well as serve as a diagnostic and prognostic tool for residual disease and relapse. However, only a few biomarkers are available for early diagnosis, and the current ones require tissue excision or invasive procedures, limiting their use in routine diagnosis. Analysis of nucleic acids has become popular for cancer diagnosis, and circulating HPV-DNA is a newly reported biomarker for identifying individuals with cancer. In a recent study, HPV-DNA was successfully detected in 85% of treatment-naive patients, and changes in HPV-DNA levels corresponding to treatment response and relapse were observed. HPV-DNA shows promise as a biomarker for therapy monitoring in both primary and recurrent cervical cancer, and it could become a sensitive, non-invasive, and easily accessible tool for diagnosis and follow-up.