bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing optical quality and simulated defocus curves: head-to-head analysis of hydrophilic and hydrophobic trifocal intraocular lenses
Authors: Łabuz Grzegorz , Yan Weijia , Khoramnia Ramin , Auffarth Gerd U. 
Published: November 2024

Purpose:
To examine the optical function of the new AT ELANA trifocal intraocular lens (IOL) made of hydrophobic material against an equivalent version made of hydrophilic material.

Setting:
David J Apple Center for Vision Research, Heidelberg, Germany.

Design:
Laboratory investigation.

Methods:
This optical investigation was conducted on +20 diopter (D) samples of the AT ELANA and AT LISA tri. The area under the modulation transfer function (MTFa) served as a quality criterion. Simulated visual acuity (VA) and defocus curves across +1 to −3.5 D range were derived from an empirical formula according to ANSI Z80.35. Susceptibility to photic phenomena was evaluated by assessing the light distribution around a point light source.

Results:
The 2 models demonstrated comparable optical quality. While at distance, a 4% improvement was noted with the AT LISA tri, the AT ELANA's near MTFa was 5% higher. Only a marginal difference (1%) was noted at intermediate. Both IOLs reached simulated VA of 0.0 logMAR far vision, 0.10 logMAR at 80 cm, and 0.05 logMAR at 40 cm. Still, the near range was slightly expanded with the hydrophobic model. The light-spread profile was comparable between the 2 trifocals.

Conclusions:
The AT ELANA and AT LISA tri demonstrated comparable optical quality and similarities in the potential for inducing photic phenomena. This study suggests that the hydrophobic trifocal IOL may provide visual range comparable with its hydrophilic counterpart. However, the asphericity change may facilitate the selection of a model that more effectively addresses specific corneal aberrations.
Application of dexmedetomidine combined with propofol–etomidate mixture in radical gastrectomy under general anesthesia
Authors: Liu Ji , Yang Jinqiu , Yang Xiyang , Yin Guangfen , Li Tao , Li Ruoyu , Wang Ai 
Published: November 2024

Background:
Gastric cancer is the third most common malignant tumor with the second highest mortality rate in the world, and radical gastrectomy is the main treatment method, but the operation needs a long period of time to carry out and has strong surgical trauma stimulation, which is likely to cause sympathetic nerve excitement and stress reaction in the body. Therefore, the selection of appropriate anesthetic medication regimen and anesthesia method has an important impact on the intraoperative management and postoperative recovery of patients. This study aims to compare the clinical effects of dexmedetomidine alone in combination with propofol, etomidate and propofol-etomidate mixture in the treatment of radical gastrectomy for gastric cancer.

Methods:
A total of 90 patients undergoing elective radical gastrectomy were randomly divided into the propofol group (group P), the etomidate group (group E), and the etomidate–propofol mixture group (group PE). Anesthesia induction was performed under the monitoring of bispectral index anesthesia depth. The same pumping drugs were used in 3 groups: 0.1 to 0.3 μg/kg·min remifentanil, 0.5 μg/kg·h dexmedetomidine, and 5 to 10 μg/kg·min rocuronium. The primary outcome indicator was the hemodynamic conditions. The secondary outcome indicators included awakening time and time to accurately answer questions after operation, the prevalence of postoperative respiratory depression and adverse events, the incidence of postoperative cognitive dysfunction, and preoperative and postoperative Montreal Cognitive Assessment and Mini-Mental State Examination scores.

Results:
Among the 3 groups of patients, the use rate of vasoactive drugs in group P was higher (P < .05); the systolic blood pressure, diastolic blood pressure, and heart rate of group P at T1 to T4 were significantly lower than those of groups E and PE (P < .05); the systolic blood pressure, diastolic blood pressure, and heart rate of group E in T
2, T
4, and T
6 were significantly higher than those of groups P and PE (P < .05). The wake-up time after operation and the time to accurately answer the questions were longer in group E than in groups P and PE (P < .05). The incidence of postoperative respiratory depression in group P was higher than that in groups E and PE (P < .05). The Montreal Cognitive Assessment score of group P was lower than that of groups E and PE 7 days after operation (P < .05).

Conclusion:
Dexmedetomidine combined with propofol–etomidate mixture is a better anesthesia drug combination.
Vitamin D levels in children and adolescents are associated with coronavirus disease-2019 outcomes: A systematic review and meta-analysis
Authors: Wang Ji-Gan , Dou Hui-Hong , Liang Qiong-You 
Published: November 2024

Background:
To explore the relationship between vitamin D levels and risk of SARS-CoV-2 infection and its severity in children and adolescents, and provide a theoretical basis for clinical practice.

Methods:
The PubMed, Web of Science, Embase, MEDLINE, and Cochrane Library databases were searched for comprehensive cohort and case–control studies on the association between childhood vitamin D deficiency and the risk and prognosis of coronavirus disease-2019 (COVID-19). The search period was set from December 1, 2019, to December 31, 2023.

Results:
The vitamin D insufficiency rate in children with COVID-19 was 80.78% (95% CI, 62.6% to 93.89%), with a deficiency rate of 32% (95% CI: 19.01% to 46.61%). Vitamin D insufficiency was more common in children with COVID-19 than in healthy children (OR, 4.86; 95% CI: 2.56–9.26). The incidence of severe illness was higher (OR, 4.73; 95% CI: 1.39–16.11) whereas that of asymptomatic illness was lower (OR, 0.38; 95% CI: 0.38–0.81) in children with COVID-19 who had vitamin D insufficiency than in those who did not.

Conclusions:
Vitamin D insufficiency in children may increase the risk of COVID-19 infection and is associated with poor prognostic outcomes. Further research is required to confirm the optimal Vitamin D dose to prevent insufficiency in various sections of the population.
The effect of a subclinical dose of esketamine on depression and pain after cesarean section: A prospective, randomized, double-blinded controlled trial
Authors: Wan Xiangqian , Li Ming , Li Xiantao , Dai Huan , Peng Mingqing 
Published: November 2024

Background:
The aim of this randomized, double-blind placebo-controlled clinical trial was to study the effects of subclinical doses of esketamine on postpartum depression and pain following elective cesarean sections.

Methods:
This randomized, double-blind placebo-controlled trial included 150 pregnant women undergoing elective cesarean sections. After umbilical cord clamping, participants received either subclinical doses of esketamine (0.25 mg/kg, diluted in 10 mL of 0.9% saline) or a placebo (10 mL of 0.9% saline). The primary outcome measures were the incidence of postpartum depression (PPD) and postoperative pain. The Edinburgh Postnatal Depression Scale was used to evaluate PPD on days 3, 7, and 14 postpartum, with an Edinburgh Postnatal Depression Scale score ≥ 10 indicating PPD. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 4, 24, and 48 hours post-surgery. Secondary outcomes included adverse reactions and Ramsay sedation scores at 5 and 15 minutes post-administration.

Results:
There were no significant differences in the incidence of PPD between the 2 groups on days 3, 7, and 14 postpartum (P > .05). The VAS scores showed significant differences between the 2 groups at 4 and 24 hours postoperatively (P < .05), but not at 48 hours (P > .05). The experimental group had significantly higher adverse reactions and Ramsay sedation scores 5 minutes post-administration compared to the control group (P < .05), but no significant differences were observed upon leaving the operating room (P > .05).

Conclusion:
Subclinical doses of esketamine did not reduce the incidence of PPD at 14 days postpartum but did significantly lower VAS scores at 24 hours post-surgery. The experimental group experienced temporary increases in adverse reactions and Ramsay sedation scores shortly after administration.
Leiomyoma of the prostate: A case report and literature review
Authors: Liu Zejun , Lu Ji , Yu Kai , Jian Tengteng , Hu Rui , Liu Min 
Published: November 2024

Rationale:
Prostate leiomyoma is a rare condition globally, often challenging to diagnose preoperatively, with most cases being definitively identified through postoperative pathology. This benign tumor generally has a good prognosis and is primarily treated with transurethral resection of the prostate in clinical settings. However, there are no established guidelines or therapeutic protocols for managing this disease.

Patient concerns:
The patient was admitted to our hospital’s Department of Urology with complaints of hematuria, urinary frequency, and urgency for 1 month. Pelvic computed tomography revealed an irregular, mass-like high-density shadow posterior to the bladder, indistinctly separated from the prostate. The patient had been diagnosed with renal insufficiency during a physical examination 4 years prior but had not received standardized treatment. Six years ago, the patient underwent electrocision of the prostate at our hospital, and postoperative pathology indicated prostate leiomyoma.

Diagnoses:
Postoperative pathology confirmed a diagnosis of prostate leiomyoma.

Interventions:
The patient presented with an enlarged prostate and preoperative hematuria. Holmium laser enucleation of the prostate (HoLEP) was performed. The Foley catheter was removed on the second postoperative day, and the patient was discharged 3 days after surgery.

Outcomes:
Following discharge, the patient was instructed to undergo reexaminations every 6 months. Current follow-up indicates the patient is in good health, with no recurrence of the mass observed.

Lessons:
Prostate leiomyoma is an extremely rare condition, and the current primary approach for managing prostate smooth muscle tumors involves active patient monitoring, regular evaluations, and timely surgical intervention if clinical symptoms emerge. In this study, we present a new case report of prostatic smooth muscle tumor and review the existing literature to explore treatment options for prostate leiomyoma within this field.
Effective treatment with intravenous immunoglobulin for Henoch–Schönlein purpura with refractory gastrointestinal symptoms in an adolescent: A CARE-compliant case report
Authors: Chen Liji , Zhong Cailing , Fan Longxiu , Luo Ming , Cai Linkun , Zhang Beiping , Zhang Haiyan 
Published: November 2024

Rationale:
This article presents a complex case of refractory Henoch–Schönlein purpura (HSP), initially manifesting with complex gastrointestinal (GI) symptoms, and discusses diagnostic and therapeutic challenges encountered. It aims to enhance understanding of the disease and provide evidence for the potential efficacy of intravenous immunoglobulin (IVIG) treatment in this condition.

Patient concerns:
A 16-year-old male patient presented with persistent abdominal pain, nausea, vomiting, and constipation for 8 days, leading to hospital admission.

Diagnoses:
Establishing a definitive diagnosis was challenging initially due to the absence of typical petechiae. However, the appearance of characteristic petechiae subsequently confirmed the diagnosis of HSP.

Interventions:
Initial treatment with methylprednisolone sodium succinate for 3 days failed to elicit improvement. Subsequently, IVIG was introduced as a combination therapy.

Outcomes:
Following the combined administration of IVIG, the patient experienced complete resolution of abdominal pain, petechiae, and arthralgia within 4 days.

Lessons:
This case highlights the importance of considering HSP in the differential diagnosis of patients with complex GI symptoms. Furthermore, it suggests that IVIG may be a valuable therapeutic option for HSP patients with refractory GI symptoms. High-quality comparative trials are needed to establish more definitive evidence for the effectiveness of IVIG and to develop specific treatment guidelines.
The effect of Baduanjin on body mass and body composition of college students: A randomized controlled trial
Authors: Wen Nana , Zhao Fang , Sun Shanshan , Xiong Jian , Zheng Guohua 
Published: November 2024

Background:
Previous studies have also found that Baduanjin training can improve health-related physical fitness in young adults. However, it is unclear whether Baduanjin training can improve body mass and body composition in young adults. The aim of this study was to investigate the effects of the Baduanjin training on body mass and body composition in college students.

Methods:
This was a single-center, randomized controlled trial comparing 12 weeks of Baduanjin exercise training group (BEG) at a frequency of 60 minutes per day, 4 days per week with no special exercise control group (CG) on the health-related physical fitness in college students. Body mass and body composition were assessed using the body mass index, waist-to-hip ratio, and Inbody 720 devices. A total of 93 college students (56 in the BEG and 37 in the CG) completed 2 body composition assessments and were included in the analysis. A mixed linear model was used to analyze the effect of the Baduanjin exercise intervention.

Results:
After 12 weeks of intervention, the body mass index and waist-to-hip ratio in the BEG were significantly lower than that in the CG (P =.007 and P =.028) with a moderate effect size (Cohen d = 0.584 and 0.474) and a significant interaction effect of group by time (P =.007 and.028). The fat mass indicators of body composition including percent body fat, body fat mass, and body fat mass of both arms, both legs and trunk in the BEG were significantly lower than those in the CG (all P <.05), with a moderate effect size (Cohen d from 0.452 to 0.624) and a significant interaction effect of group by time (all P <.05); no significant differences were found in the total body composition indicators and the fat-free mass indicators of body composition between the 2 groups.

Conclusion:
Regular Baduanjin exercise training may be beneficial for improving body composition in young adults.
Extremely rare mucinous adenocarcinoma of the small bowel causing bilateral metastatic Kukenberg tumors of the ovaries: A case report
Authors: Zhu Lichao , Liu Ye , Chen Shuai , Yang Guanghua , Wang Changyou 
Published: November 2024

Rationale:
Small bowel adenocarcinoma (SBA) is an extremely rare tumor that is not fully understood, SBA accounts for less than 5% of gastrointestinal cancers, Krukenberg tumors account for a lower proportion of all ovarian tumors, close to 2%. Stomach is the most common primary site of Krukenberg tumor. The phenomenon of bilateral ovarian Kukenberg tumor caused by implantation and metastasis of small bowel cancer is extremely rare, with few literature reports and limited clinical diagnosis and treatment data. We present a case of a 55-year-old woman with bilateral Kukenberg’s tumor caused by small bowel cancer implantation and share our views on the diagnosis and treatment of this case.

Patient concerns:
A 55-year-old woman presented with vaginal bleeding and persistent lower abdominal pain after fatigue 10 days ago. Pelvic ultrasound at a local hospital revealed 2 solid masses in her pelvis, and she came to our hospital for further diagnosis and treatment. The results of colonofiberscope examination and histopathological examination confirmed intramucosal adenocarcinoma in the small intestine.

Diagnoses:
The results of colonofiberscope examination and histopathological examination confirmed intramucosal adenocarcinoma in the small intestine. Contrast-enhanced computed tomography showed multiple cystic space-occupying lesions in the pelvic cavity, and the possibility of ovarian tumor was considered.

Interventions:
Radical treatment of right half colon cancer and pelvic mass resection were performed under general anesthesia. Combined with intraoperative and postoperative pathological examination, the diagnosis was mucinous adenocarcinoma of the small intestine stage IV (pT4N1M1). Bilateral ovarian metastasis, metastatic cancer (3/19): lymph nodes around the small intestine (3/12), lymph nodes around the colon (0/7).

Outcomes:
He is currently receiving chemotherapy, the chemotherapy regimen is XELOX regimen. The specific drugs were oxaliplatin and capecitabine.

Lessons:
SBA is often difficult to diagnose due to few specific symptoms and is usually detected at stage IV. Bilateral ovarian Kukenberg tumor caused by small bowel cancer implantation metastases is extremely rare, and clinicians must be vigilant for women with fewer specific symptoms of gastrointestinal discomfort and conduct further diagnostic studies to avoid delayed diagnosis and treatment.
Identifying Typologies of Symptoms and Functional Impairments in Chinese Children With Leukemia and Their Population Characteristics
Authors: Wang Jingting , Wu Xiaochen , Zhang Wen , Bi Xuanyi , Wang Yingwen , Yu Ling , Wu Huifang , Yang Qi , Huang Haiying , Wang Yanqing , Yuan Changrong 
Published: November 2024

Background
Symptom distress and functional impairments in children with leukemia directly affect their quality of life.

Objectives
To identify subgroups of symptom distress and functional impairments in Chinese children with leukemia and to examine the associations of the latent classes with individual characteristics.

Methods
This multicenter cross-sectional survey study recruited children with leukemia who received chemotherapy in 4 hospitals in Shanghai, Jiangsu, Zhejiang, and Guangdong Province. The participants were surveyed via PROMIS-25 (Patient-Reported Outcomes Measurement Information System Pediatric-25 Profile). Latent profile analysis and multinomial logistic regression model were performed to identify subgroups of symptom distress and function impairments among children with leukemia.

Results
Latent profile analysis results suggested the classification of 3 subgroups: profile 1: “moderate symptom distress, moderate mobility impairment with fair peer relationship function” group (69, 28.3%), profile 2: “mild symptom distress, no mobility impairment with good peer relationship function” group (97, 39.8%), and profile 3: “no symptom distress, no mobility impairment with good peer relationship function” group (78, 32.0%). Sociodemographic characteristics, including gender of the children, gender and marital status of the parents, average monthly income of the family, and reimbursement ratio of treatment expenses, had significant associations with the latent profile membership (P < .05).

Conclusion
This study identified 3 distinct profiles of symptom distress and functional impairments in children with leukemia and found significant associations between these profiles and sociodemographic characteristics.

Implications for Practice
The classification of the 3 latent profiles in children with leukemia helps to provide targeted supportive intervention to those children and their families.
Pictorial Essay
Authors: Palaniswamy Shanmuga Sundaram , Subramanyam Padma , Puthenveettil Vinayan K. 
Published: November 2024

Abstract
Brain development is a very complex process that starts within first 20 days of gestation. By the third week, prosencephalon (forebrain), mesencephalon (midbrain), and rhombencephalon (hindbrain) appear. Failure of brain development can occur at any level. Defects in neural tube closure, folding, induction of neuroepithelial migration, and differentiation can result in congenital brain malformation. Similarly, disruption at neuronal cell proliferation, differentiation, migration, and organization also result in structural anomalies. This pictorial collection highlights the 18F-FDG brain PET-MR findings in children who presented with recurrent seizures. Further to imaging, many required additional investigations such as genetic testing, ophthalmic, cardiorespiratory, and screening laboratory metabolic studies.
Utility of Generative Artificial Intelligence for Patient Care Counseling for Mandibular Fractures
Authors: Shaari Ariana L. , Patil Disha P. , Mohammed Saad , Salehi Parsa P. 
Published: November 2024

Objective:
To determine the readability and accuracy of information regarding mandible fractures generated by Chat Generative Pre-trained Transformer (ChatGPT) versions 3.5 and 4o.

Background:
Patients are increasingly turning to generative artificial intelligence to answer medical queries. To date, the accuracy and readability of responses regarding mandible fractures have not been assessed.

Methods:
Twenty patient questions regarding mandible fractures were developed by querying AlsoAsked (https://alsoasked.com), SearchResponse (https://searchresponse.io), and Answer the Public (https://answerthepublic.com/). Questions were posed to ChatGPT 3.5 and 4o. Readability was assessed by calculating the Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, number of sentences, and percentage of complex words. Accuracy was assessed by a board-certified facial plastic and reconstructive otolaryngologist using a 5-point Likert Scale.

Results:
No significant differences were observed between the two versions for readability or accuracy. Readability was above recommended levels for patient education materials. Accuracy was low, and a majority of responses were deemed inappropriate for patient use with multiple inaccuracies and/or missing information.

Conclusion:
ChatGPT produced responses written at a high level inappropriate for the average patient, in addition to containing several inaccurate statements. Patients and clinicians should be aware of the limitations of generative artificial intelligence when seeking medical information regarding mandible fractures.