bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing the Treatment Outcomes of Patients Undergoing Urethroplasty for Urethral Stricture at Muhimbili National Hospital
Authors: Mtafu Naomi Herbert , Mtaturu Gabriel Francis , Muhsin Aboud , Alexandre Amini Mitamo , Mhaya Joachim Kulwa , Mwanga Ally Hamis , Nyongole Obadia Venance , Mkony Charles A. 
Published: December 2024

Abstract

Background: Urethral stricture disease poses a substantial challenge in Sub-Saharan Africa, where the prevalence is notably high. This condition predominantly impacts men, and the underlying causes in the region are diverse and varied. There is a significant research gap in understanding the patient-related factors that contribute to the outcomes of urethroplasty for urethral strictures at Muhimbili National Hospital.
Objectives: To determine the factors influencing treatment outcomes among patients undergoing urethroplasty for urethral stricture at Muhimbili National Hospital.
Methodology: This cross-sectional analytical study was carried out at Muhimbili National Hospital. Through convenient sampling, data from the hospital’s patient database, specifically from patients aged 10 years and above, were extracted using a structured abstraction form. Patient information, clinical findings, treatment offered and treatment outcomes were collected. The collected data were analyzed using SPSS 23.
Results: This study examined 126 patients with urethral stricture who underwent urethroplasty at MNH between January 2020 and December 2022. The mean age was 51 years, with the bulbar urethra being the most common stricture site (54%) and trauma the leading cause (44.4%). The success rate of urethroplasty was 85.7%, with a 15.9% complication rate. Early complications included surgical site infections (54.5%), painful scrotum (36.4%), and wound dehiscence (9.1%). Late complications predominantly consisted of irritative lower urinary tract symptoms (83.3%), stress incontinence (5.6%), and erectile dysfunction (11.1%). Younger patients (<60 years) and those with infectious etiologies had significantly higher success rates. The type of stricture, length of stricture, surgical approach, and catheter type did not significantly impact outcomes.
Conclusion: Urethroplasty had a high success rate of 85.7%, particularly in younger patients and those with infectious etiologies. Trauma was identified as the most common cause of urethral strictures, primarily affecting the bulbar urethra. Postoperative complications, both early and late, were observed, indicating the need for careful postoperative monitoring. Factors such as stricture level, length, surgical approach, and catheter type did not significantly impact the success of urethroplasty.
The Impact of Perioperative Aspirin Utilization on Postoperative Hemorrhagic Complications in Idiopathic Normal Pressure Hydrocephalus: A Single-Center Retrospective Analysis
Authors: İsikay Ahmet İlkay , Cekic Efecan , Charehsaz Amin , Uyaniker Zeynep Arzum , Cakmaklı Gul Yalcın , Gocmen Rahsen , Hanalioglu Sahin , Elibol Bulent 
Published: December 2024

Abstract

Background and Objectives Idiopathic normal pressure hydrocephalus (iNPH) is a neurodegenerative condition predominantly affecting the elderly population, for which ventriculoperitoneal (VP) shunt surgery is the standard treatment. Many iNPH patients need aspirin (ASA) treatment to prevent thromboembolic events since they have significant cardiovascular risks. Stopping ASA raises the chance of these side effects. The effect of perioperative ASA administration on hemorrhagic complications in iNPH patients having VP shunt surgery is investigated in this work. Methods Patients who underwent VP shunt surgery for iNPH between January 2020 and September 2024 comprised this retrospective cohort research. Two groups, no ASA (n = 50) and ASA continuous (n = 51), were formed from patients depending on their usage of perioperative ASA. Among the data gathered were demographics, surgical specifics, ASA dosage, and ASA use indications. The main results were occurrences of early and late postoperative bleeding. MRI or CT scans were part of postoperative follow-up at regular intervals—mean ≈ one year. SPSS version 23.0 was used for statistical analyses, including Chi-square tests and independent samples t-tests, and Mann-Whitney U tests were used to examine group variances. Results The study cohort had 101 patients with a mean age of 69.5 ± 7.6 years, 41.6% female and 58.4% male. Early postoperative hemorrhage occurred in 5% of patients, including epidural (1), intraparenchymal(3), and intraventricular hematoma(1). Late postoperative hemorrhages occurred in 4% of patients ( 4 patients in the no-ASA group), with two cases each of unilateral and bilateral subdural hematoma. No significant differences in hemorrhagic outcomes were observed between the ASA continuation and non-use groups (p = 0.092). The mean follow-up period was 300 days. One patient died in the non-ASA group due to neurodegenerative disease. Conclusion These findings, specific to our patient cohort, suggest that continuing ASA in iNPH patients undergoing VP shunt surgery does not significantly increase the risk of perioperative hemorrhagic complications, which may have implications for perioperative antiplatelet management in similar patient populations. This is a particularly important issue for patients with high cardiovascular risk.
The Fate of The Jailed Branch: Challenging the Dogma of PDA Stenting in Cases with Pulmonary Artery Branch Originating from PDA
Authors: Ng'eno Mercy , Gordon Brent M. , Rao Rohit , Ryan Justin R. , Haley Jessica , Ganta Srujan , Nigro John , El-Said Howaida 
Published: December 2024

Abstract

Background
Patent ductus arteriosus (PDA) stenting is evolving as the preferred method for establishing stable pulmonary blood flow in cyanotic infants, offering lower mortality, faster recovery, and shorter hospital stays. However, stenting may lead to branch pulmonary artery (BPA) jailing, potentially restricting blood flow to the jailed branch. This study analyzes patient characteristics, cardiovascular anatomy, stenting techniques, and outcomes involving BPA jailing where the BPA originates from the PDA, with a focus on the growth of the jailed BPA.
Methods
A retrospective review was conducted of infants with duct-dependent pulmonary blood flow who underwent PDA stenting at Rady Children’s Hospital San Diego from 2013 to 2024.
Results
Of 70 infants, 22 (31%) experienced BPA jailing due to the BPA originating from the PDA. The median age and weight at stenting were 9.5 days and 3275g, with PDA as the sole source of pulmonary blood flow in 72% of cases. PDA type III was the most prevalent (77%). The jailed BPA showed significant distal growth (mean Nakata index increase of 117.35 mm²/m², p = 0.0001), with symmetry maintained. Re-intervention for hypoxia was required in 55% of cases and involved procedures such as ballooning, re-stenting, and strut dilation. There were no 30-day mortalities (2 late deaths occurred). Progression to Glenn palliation occurred in 12 patients, 5 had a definitive repair, 1 underwent left pulmonary artery plasty and a BT shunt and 2 await repair.
Conclusion
PDA stenting in infants with a BPA originating from the PDA is feasible with notable distal BPA growth despite frequent re-interventions. Patients maintained pulmonary artery symmetry with excellent survival.
A healthy live birth after preimplantation genetic testing for structural rearrangements and Bionano revealed exceptionally complex chromosome rearrangements.
Authors: Han Chanlin , Meng Xia , Xu Huiling , Zhang Han , Li Shifen , Li Xuemei 
Published: December 2024

Abstract

Background
Complex chromosome rearrangements (CCRs) are extremely rare in the general population, and it is hard to get a healthy delivery in these cases. A recent paper in Scientific Reports reported that 3.6% (45/1,264) of BCR carriers had cryptic complex chromosome rearrangements (CCCRs), and the transferable embryo rate was 7.5% when the CCCR involved three chromosomes [1].
Case presentation
A couple of patients were diagnosed with recurrent spontaneous abortion (RSA) and were admitted to our department because of chromosomal abnormalities. We identified the man’s complex chromosome rearrangement (CCR) via preimplantation genetic testing for structural rearrangements (PGT-SRs) and Bionano. In addition to reciprocal translocation, we recognized the insertion in the man’s chromosome after two cycles of PGT-SR. The results Bionano revealed that the CCR of the man involved (i) an insertion between chromosomes 2 and 3, (ii) an intrachromosomal insertion of the q25.31q26.32 band on chromosome 3 into the p12.3 band on the same chromosome, and (ii) reciprocal translocation between chromosomes 3 and 6. In the second PGT-SR cycle, two embryos were detected as euploid. One of the euploid embryos was transferred, and amniocentesis was performed. The results revealed that the karyotype of the fetus was 46, XN, t(3;6)(q26.2;q21)pat. A phenotypically normal baby was born.
Conclusion
CCRs are rare, and some CCRs cannot be identified via traditional cytogenetic methods. Bionano is the latest and most advanced technology that can detect unrevealed chromosomal abnormalities. Combined with the PGT-SR, it is beneficial for infertile patients with CCR. This case stresses the point of relevance and feasibility of the PGT-SR procedure in cases of complicated CCRs.
A Novel Method to Define Personalized Post-orthodontic Treatment Dental Arch Form
Authors: Su Yingying , Zhang Jiachao , Ma Hanyan , Zheng Xu 
Published: December 2024

Abstract

Background
The dental arch is a fundamental aspect of orthodontic treatment and has considerable implications in planning and therapy. Since arch forms differ (e.g. tapered, ovoid, square), determination of posttreatment arch form should take each patient’s dental arch features into account. This study aims to develop a method to predict optimal post-orthodontic treatment dental arch form.
Methods
Mandibular dental casts of 55 patients who underwent non-extraction treatment and presented with functional occlusion according to functional occlusion criteria were selected. The casts were scanned and digitalized, 18 landmarks were collected and the spatial coordinates were utilized to compute tooth size and intermolar width. Several mathematical functions were then used to ensure a best-fitting mandibular arch form, including beta function, polynomial equations and polynomial combined with circle equations.
Results
After applying several mathematical functions, we developed a mixed model made of two simple geometrical curves. The anterior segment of the dental arch was fitted with a circle and the posterior segment with a quartic curve; both could be calculated simply using tooth size.
Conclusions
The present study presents a new approach to determine an individualized post-orthodontic treatment dental arch form, using the combined width of the lower teeth. The proposed method offers a simple and practical solution that can be easily implemented in clinical practice. These findings hold great promise for digital personalized treatment and the development of customized orthodontic appliances.
Structured pre-briefing: the impact on medical students’ anxiety and learning experience in simulation
Authors: Mostafa Enase M. , Jaradat Ahmed A. , Khonji Sara A. , Alharbi Ghada M. , Khalil Nama A. , Eweida Rasha S. , Garadaha Prof. Taysir S. 
Published: December 2024

Abstract

Introduction: The expansion of simulation-based learning in undergraduate education is mounting, an approach that can reduce the anxiety of learners is emphasized. Methods: This study is conducted in the Medical Skills and Simulation Center (MSSC) to identify the effects of using structured pre-briefing (concept mapping) on final-year medical students’ anxiety levels and the relationship with perception after simulation. Design: Eighty-four fifth-year medical students in Arabian Gulf University on Jan 2021, over three months intervals. Students were divided into two groups: the interventional group of 44 students who received structured pre-briefing, including a concept map, and the control group, which included 40 students that received traditional pre-briefing. At the end of the session, each student completed a sheet of six items: State-Trait Anxiety Inventory (STAI-6) as a tool for measuring anxiety and a questionnaire to evaluate students’ perception (understanding) of simulation. Linear correlation coefficient was measured between anxiety level and students’ understanding or perception of experience. Results: Anxiety level measured by the STAI-6 score was higher in the control group than the interventional group of 48.9 ± 15.5 versus 34.9 ± 11.3, P < 0.001. The perception of experience was shown to be greater for the interventional group than for the control group of 46.5 ± 6.2 versus 41.7 ± 9.7, P,0.001. There was a significant negative correlation between the anxiety level and the students’ understanding (perception) of the pre-briefing (P = - r: 0.004). The implication of anxiety reduction was clear among medical students using the concept mapping as the awareness and perception of the elements of environments improved significantly. Conclusion: Structured pre-briefing using concept mapping decreases their anxiety level, which leads to improve the understanding and perception during simulated clinical experience.
Identification Of Pathogenic Mutations And Application Of Polygenic Risk Scores In Early-Onset Diabetes Patients
Authors: Atava Ivanna , Reščenko Raimonds , Brīvība Monta , Birzniece Līga , Elbere Ilze , Megnis Kaspars , Pečulis Raitis , Lauga-Tuņina Una , Kirillova Ināra , Konrāde Ilze , Dzīvīte-Krišāne Iveta , Kalniņa Ineta , Kloviņš Jānis 
Published: December 2024

Abstract

Background: Maturity-onset Diabetes of the Young (MODY) presents a diagnostic challenge, with a large proportion of cases lacking identifiable genetic mutations, which could lead to sub-optimal medical treatment and, subsequently, a decline in patients’ life quality. This study investigates the utility of polygenic risk score (PRS) in distinguishing monogenic diabetes from early-onset type 1 diabetes (T1D) and type 2 diabetes (T2D) cases to enhance diagnostic accuracy.
Methods: We investigated the genetic basis of early-onset diabetes in a Latvian cohort comprising 66 patients, contrasted with 174 non-diabetic controls, using whole-genome sequencing (WGS).
Results: We identified 22 causative mutations in three MODY genes (GCK, HNF1A, and HNF4A), eight of them being novel. We selected and tested the best-performing population specific T1D and T2D PRS models on the established diabetic cohort and controls. Patients without genetically confirmed MODY had a significantly higher risk for T1D compared to controls. A 75% centile of T1D-PRS included only 8.7% of the genetically confirmed MODY patients, compared to 34% of patients without mutations, providing good specificity for the identification of indicative T1D at this PRS range. While T2D-PRS was increased in the diabetic cohort, it did not demonstrate an ability to discriminate between MODY-positive and negative subgroups.
Conclusions: Our study demonstrates that the application of WGS improves diagnostic accuracy and highlights the potential of T1D-PRS as a critical tool for the stratification of MODY-suspected patients.
Preoperative role of MRI and CEM in breast cancer: Which one is more accurate?
Authors: Barrio-Piqueras Miguel , Urtasun-Iriarte Cesar , Mbongo-Habimana Carmen , Malmierca Patricia , Cordoba Jose Maria Nuñez , Perez Arlette Elizalde , Insausti Jose Luis Pina 
Published: December 2024

Abstract

Background
Breast-MRI is the main technique in preoperative assessment of breast cancer but has not been free of controversy. Contrast-enhanced-mammography (CEM) is an alternative.
Purpose
To evaluate CEM and MRI accuracy in preoperative staging of breast cancer and to determine which technique is more accurate measuring lesion size.
Material and Methods
Between September 2017 and November 2023, 139 histopathologically characterized lesions from 94 patients who underwent MRI and CEM were retrospectively studied. For both, BI-RADS categories and lesion diameters were reevaluated. Sensitivity, false-positive (FP), false-negative (FN) ratios, and area-under-curve (AUC) were calculated. Discrepancies between the lesion size measurements on MRI or CEM and histopathology were also assessed.
Results
94 women with breast cancer with 139 assessable lesions (23 benign and 116 malignant) were included. The global sensitivity was 96.6% for breast MRI vs 81.03% for CEM (p = 0.001). MRI provided 112 true-positives (TP) and 4 FN among 116 malignant biopsies; on the other hand, CEM reported 94 TP and 22 FN out of 116 confirmed malignant biopsies. Among the 23 negatives for malignancy biopsies, MRI showed 18 FP and 5 TN and CEM, 1 FP and 22 TN. AUC of 0.85 for MRI and 0.89 for CEM (p > 0.05). No significant differences in the tumor size assessment accuracy (p = 0.389) were found with a tendency to lesion size overestimation (MRI and CEM measured + 3.35 and + 4.04 mm respectively).
Conclusion
MRI was more sensitive than CEM in the detection of malignant lesions although the accuracy of both techniques was similar. CEM and MRI tend to overestimate the tumor size.
Optimized design and performance analysis of a centipede-like wheel-legged mobile robot
Authors: Zhang Tan , Ding Chen-jun , Wang Dong , Ma Teng-fei , Li Xin-bao , Zhang Jia-ning , Zhu Xue-hong 
Published: December 2024

Abstract

In order to improve the passability and motion flexibility of a mobile robot under unstructured terrain, a multi-drive module articulated mobile robot that can passively adapt to complex and variable obstacle terrains is developed by combining passive deformation wheels and flexible articulation devices, and the passive deformation wheels are optimised. Based on the study of the mechanism of passive deformation of wheels, a mechanical model of robot obstacle crossing is established, and the passability of the robot under different terrains is analysed. The experimental results under different terrains show that the robot has reasonable structural design, good obstacle-crossing performance and motion flexibility, and can passively adapt to complex and variable obstacle terrains.
Association of serum fatty acids with adverse long-term survival among cancer patients
Authors: Liu Fengyi , Cai Hengxuan , Lyu Kun , Li Lei , Zhang Yiying , Xu Wei 
Published: December 2024

Abstract

Background:
Evidence regarding the health effects of saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and total polyunsaturated fatty acids (PUFAs) is controversial. Our objective was to explore the associations between serum-free fatty acids and mortality among cancer survivors.
Methods:
The study included 6,575 participants with or without cancer diagnosis aged 20 years and older with or without a cancer diagnosis who were recruited before December 2014 and followed up through December 31, 2019. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by investigating weighted Cox proportional hazards regression models to assess the associations stratified by cancer status.
Results:
The weighted mean age was 49.6 years, 48.5% were male, and approximately 9.2% of the participants had a diagnosis of cancer. In total, there were 901 deaths over a median follow-up period of 8.74 years. After full adjustment for covariates, the positive associations between several subtypes of long-chain SFAs (C12:0-C16:0) and mortality risk were especially significant among cancer survivors (HRs per an increase of standard deviation 1.29–1.35, each p ≤ 0.022), while very-long chain SFAs (C22:0 and C23:0) were associated with reduced all-cause mortality only among adults without cancer (both p ≤ 0.029). There was substantial heterogeneity in the associations of individuals with different MUFAs with all-cause mortality stratified across cancer status. Omega-3 PUFAs were not related to mortality risk among adults with or without cancer (each p ≥ 0.086), while the individuals of omega-6 PUFAs (C18:2 n-6, C20:3 n-6, C22:4 n-6, and C22:5 n-6) were significantly associated with all-cause mortality risk among cancer survivors but not among those in the health population.
Conclusions:
We found that some subtypes of long-chain SFAs, MUFAs, and omega-6 PUFAs might be associated with increased all-cause mortality risk, while omega-3 PUFAs are not associated with reduced or increased mortality risk among cancer survivors.
The Maxillofacial Surgery Compendium: Insights from 1077 Microvascular Free Flap Reconstructions in the Head and Neck Area
Authors: Lampert Philipp , Fenske Jakob , Kreiker Henri , Steffen Claudius , Koerdt Steffen , Kreutzer Kilian , Rendenbach Carsten , Heiland Max 
Published: December 2024

Abstract

Purpose: This study aims to provide a comprehensive overview of patient demographics, treatment characteristics, and associated complications following microvascular free flap reconstructions in maxillofacial surgery, while also addressing the potential impact of fluctuating surgeon experience in a high-volume training center.
Methods: Adult patients who received a microvascular free flap between April 2017 and July 2023 were analyzed in this retrospective single-center study. Follow-up was recorded until July 2024. Fibula (FFF), scapula (SFF), deep circumflex artery (DCIA), radial forearm (RFF), anterolateral thigh (ALT) and latissimus dorsi (LDF) free flaps were included. Variables were stratified by flap type and the N-1 Chi2-test used to test for statistical significance of complication rates across years.
Results: 1077 patients met the inclusion criteria. DCIA flaps suffered the highest rates of early flap loss (11.1%; mean 3.0%) and wound infection (44.4%; mean 14.4%). SFFs had the highest rate of anastomotic revision (20.7%; mean 5.6%) and longest mean surgery duration (715 ± 183 min). Donor site complications were most common among RFFs (35.4%) and FFFs (33.6%). Overall, wound infection rates were higher among bony compared to soft-tissue flaps (32.3% vs. 10.9%). While complication rates varied significantly from year to year, the overall trends remained stable.
Conclusion: FFFs were associated with fewer recipient-site complications than SFFs and DCIA flaps, but donor site complications were higher. Among soft-tissue flaps, complication rates did not differ considerably. A well-structured resident training program mitigates the impact of experienced surgeons departing the team, though yearly fluctuations in complication rates should still be expected.