bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical assessment of anterior plate system, bilateral pedicle screw and transdiscal screw system for high-grade spondylolisthesis: a finite element study
Authors: Dhar Utpal K. , Sultan Hadi , Aghayev Kamran , Tsai Chi-Tay , Vrionis Frank D. 
Published: November 2024

IntroductionLimited information regarding the biomechanical evaluation of various internal fixation techniques for high-grade L5-S1 spondylolisthesis is available. The stiffness of the operated segment and stress on the hardware can profoundly influence clinical outcomes and patient satisfaction. The objective of this study was to quantitatively investigate biomechanical profiles of various fusion methods used for high-grade spondylolisthesis by using finite element (FE) analysis.MethodsAn FE lumbar spine model of healthy spine was developed based on a patient’s CT scan. High-grade (III-IV) spondylolisthesis (SP model) was created by sliding L5 anteriorly and modifying L5-S1 facet joints. Three treatment scenarios were created by adding various implants to the model. These scenarios included L5-S1 interbody cage in combination with three different fixation methods–the anterior plate system (APS), bilateral pedicle screw system (BPSS), and transdiscal screw system (TSS). Range of motion (ROM), von Mises stress on cage, internal fixation as well as on the adjacent annuli were obtained and compared. The resistance to slippage was investigated by applying shear force on L5 vertebra and measuring its displacement regarding to S1.ResultsUnder different loading conditions all treatment scenarios showed substantial reduction of ROM in comparison with SP model. No notable differences in ROM were observed between treatment models. There was no notable difference in cage stress among models. The von Mises stress on the internal fixation in the TSS model was less than in APS and BPSS. The TSS model demonstrated superior resistance to shear load compared to APS and BPSS. No discernible difference was observed between the SP, APS, BPSS, and TSS models when compared the ROM for adjacent level L4-L5. TSS’s von Mises stress of the adjacent annulus was higher than in APS and BPSS.ConclusionsThe TSS model exhibited biomechanical superiority over the APS and BPSS models.
Application of microscopic smartphone attachment for remote preoperative lab testing
Authors: Song Kefan , Adams Alexander T. 
Published: November 2024

IntroductionCurrent preoperative exam guidelines utilize extensive lab tests, including blood tests and urine analysis, which are crucial for assessing surgical readiness. However, logistical challenges, especially for patients traveling long distances for high-quality medical care, create significant delays and burdens. This study aims to address these challenges by applying a previously developed point-of-care (POC) device system to perform accurate and rapid lab tests. This device is designed to assist both healthcare providers in resource-limited settings and patients by offering a low-cost, portable diagnostic tool that enables both in-clinic and at-home testing.MethodsThe system was tested for adaptability and compatibility by transitioning from its original Android platform to an iOS platform. A custom application was developed to maintain the system’s capabilities of capturing optimal cell images across different mobile platforms. The system’s cell counting algorithm was tailored to process the captured images, featuring a streamlined workflow that includes image processing and automated cell detection using a Hough circle algorithm.ResultsThe new system provided good-quality raw images with 26.3 px/μm pixel resolution and 2.19 μm spatial resolution, facilitating effective cell recognition and counting. The cell counting algorithm demonstrated high precision (0.8663) and high recall (0.9312), with a correlation (R2=0.89535) between algorithm-generated counts and actual counts.DiscussionThis study highlights the potential of the POC device to streamline preoperative testing, making it more accessible and efficient, particularly for patients in rural areas or those needing to travel for medical care. Future enhancements, including wider field-of-view, adjustable magnification, more advanced and integrated algorithms as well as integration with a microfluidic channel for direct sample analysis, are proposed to expand the device’s functionality. The device’s portability, ease of use, and rapid processing time position it as a promising alternative to traditional lab tests, ultimately aiming to improve patient care and surgical outcomes.
Automated machine learning for image-based detection of dental plaque on permanent teeth
Authors: Nantakeeratipat Teerachate , Apisaksirikul Natchapon , Boonrojsaree Boonyaon , Boonkijkullatat Sirapob , Simaphichet Arida 
Published: November 2024

IntroductionTo detect dental plaque, manual assessment and plaque-disclosing dyes are commonly used. However, they are time-consuming and prone to human error. This study aims to investigate the feasibility of using Google Cloud's Vertex artificial intelligence (AI) automated machine learning (AutoML) to develop a model for detecting dental plaque levels on permanent teeth using undyed photographic images.MethodsPhotographic images of both undyed and corresponding erythrosine solution-dyed upper anterior permanent teeth from 100 dental students were captured using a smartphone camera. All photos were cropped to individual tooth images. Dyed images were analyzed to classify plaque levels based on the percentage of dyed surface area: mild (&lt;30%), moderate (30%–60%), and heavy (&gt;60%) categories. These true labels were used as the ground truth for undyed images. Two AutoML models, a three-class model (mild, moderate, heavy plaque) and a two-class model (acceptable vs. unacceptable plaque), were developed using undyed images in Vertex AI environment. Both models were evaluated based on precision, recall, and F1-score.ResultsThe three-class model achieved an average precision of 0.907, with the highest precision (0.983) in the heavy plaque category. Misclassifications were more common in the mild and moderate categories. The two-class acceptable-unacceptable model demonstrated improved performance with an average precision of 0.964 and an F1-score of 0.931.ConclusionThis study demonstrated the potential of Vertex AI AutoML for non-invasive detection of dental plaque. While the two-class model showed promise for clinical use, further studies with larger datasets are recommended to enhance model generalization and real-world applicability.
Elucidating the causal links between plasma and cerebrospinal fluid metabolites and pituitary tumors: a Mendelian randomization analysis
Authors: Wang Wencai , Liu Menghao , Wang Zun , Ye Wei , Li Xianfeng 
Published: November 2024

BackgroundPituitary tumors (PTs) are common benign intracranial tumors. Investigating the metabolites in serum and cerebrospinal fluid in PTs is essential to understanding the underlying biological mechanisms and identifying new biomarkers and therapeutic strategies.MethodsWe used the GWAS dataset of PTs from the FinnGen database, a dataset of 486 plasma metabolites from the GWAS catalog database, and a dataset of 338 cerebrospinal fluid (CSF) metabolites from the WADRC and WRAP study collections. An inverse variance weighting (IVW) approach was utilized as the mainly method to investigate causality between metabolites and PTs, supplemented by four complementary methods to strengthen our findings. Additionally, we utilized several sensitivity methods to guarantee the robustness of our findings.ResultsThe study identified 17 plasma metabolites and 10 CSF metabolites related to PTs. Among these, 11 metabolites indicated a significant positive causality with PTs, while 16 displayed a remarkable negative causality. Particularly, plasma levels of 3-dehydrocarnitine (OR = 2.73, 95% CI = 1.55–4.83, P = 0.001) and acetylcarnitine (OR = 0.35, 95% CI = 0.19–0.63, P = 0.001) were found to be significant exposure factors for PTs. Multiple sensitivity analyses confirm the robustness of the results. The study found no evidence of a reverse causality between PTs and the plasma levels of 3-dehydrocarnitine and acetylcarnitine.ConclusionsThe present study identified 27 metabolites associated with the incidence of PTs, among which 3-dehydrocarnitine and acetylcarnitine are the most noteworthy.
Comparison between thyroid stimulating immunoglobulin and TSH-receptor antibodies in the diagnosis and management of Graves’ disease
Authors: Yao Peiwei , Xie Yunliang , Wang Yunlin , Liang Chunyan , Huang Bingwen 
Published: November 2024

IntroductionTSH-receptor antibodies (TRAb) directed against the TSH receptor (TSH-R) induce hyperthyroidism in patients with Graves′ disease (GD). TRAb detected by previous radioimmunoassay only reflects the presence of autoantibodies, but not the function of such antibodies. Thyroid stimulating immunoglobulins (TSI) is a relatively new method for assessing TSH-receptor antibodies function. The aim of this study was to investigate the role of TSI in the diagnosis and management of GD.MethodsPatients with newly diagnosed GD (n=140, age 38.00 ± 11.99 years, 106 women) received pharmacological therapy (methimazole) up to 18 months in the outpatient or inpatient department of the Second People’s Hospital of Foshan City from January 2013 to December 2018. GD was identified by clinical signs and symptoms and relevant laboratory tests. Blood samples for TSI and TRAb and other thyroidal biomarkers were obtained at baseline and at three times during the follow-up. All patients with GD were followed up for at least 5 years to see if the patient was cured or had relapsed.ResultsTSI and TRAb in GD patients were significantly higher than those in the normal control group (P&lt;0.001), and there was a strong correlation between TSI and TRAb in GD patients (P&lt;0.001). After treatment, TSI and TRAb significantly decreased (P&lt;0.05), TSI and TRAb in patients with disease course more than 2 years were significantly higher than those in patients with disease course less than 2 years (P&lt;0.05), There was no statistically significant difference in TSI and TRAb at initial diagnosis between patients with a disease duration of more than 2 years and less than 5 years and those with a disease duration of more than 5 years (P&gt;0.05); if the patients were still positive for TSI or TRAb antibodies at 5 years of follow-up after treatment with anti-hyperthyroidism medication, the patients were at a higher risk of relapse (P&lt;0.001).ConclusionThe higher TSI at the initial diagnosis of GD, the longer duration of treatment with anti-hyperthyroid drugs and the higher risk of relapse. Compared with TRAb, serum TSI level is also important in the clinical diagnosis and prognosis of GD, but which one is superior to the other needs further study.
Healthcare providers’ experiences of maternity care service delivery during the COVID-19 pandemic in the United Kingdom: a follow-up systematic review and qualitative evidence synthesis
Authors: Dasgupta Tisha , Bousfield Emily , Pathak Yosha , Horgan Gillian , Peterson Lili , Mistry Hiten D. , Wilson Milly , Hill Meg , Smith Valerie , Boulding Harriet , Sheen Kayleigh S. , Van Citters Aricca D. , Nelson Eugene C. , Duncan Emma L. , von Dadelszen Peter ,   The RESILIENT Study Group, Silverio Sergio A. , Magee Laura A. 
Published: November 2024

Problem and backgroundDuring the COVID-19 pandemic, there was substantial reconfiguration of maternity care services, affecting both users and healthcare providers (HCPs), in the United Kingdom (UK) and globally.AimTo further our understanding of the impact of maternity service reconfigurations in the UK, from the perspective of maternity HCPs.MethodsScopus, MEDLINE, EMBASE, CINAHL, PsycINFO and the Cochrane COVID Study Register were searched for relevant studies reporting qualitative data from the UK, published in English between 01 June 2021 and 30 September 2023. Qualitative data on HCPs’ experiences of maternity care reconfiguration during the pandemic were extracted from 15 studies. Data were subjected to thematic synthesis according to key service reconfigurations.ResultsNine themes were identified: Care-seeking and Care Experience: Changes to existing care, Limitations placed on the partner, Mental health and lack of support networks, and Barriers to successful implementation of reconfiguration strategies; Virtual Care: Impact on quality of care, Increased convenience and flexibility, and Digital exclusion; and Ethical Future of Maternity Care Services: Optimising patient care, and Service users and staff as the driving force for change. No studies reported on the concepts of Self-monitoring or COVID-19 vaccination.Discussion and conclusionThe review findings highlight HCPs’ views of the need for greater inclusion of partners, choice of virtual or in-person care for women and birthing people; and a need for co-designed services for future policy-making.
Prevalence and antibiotic resistance profile of UTI-causing uropathogenic bacteria in diabetics and non-diabetics at the Maternity and Children Hospital in Jeddah, Saudi Arabia
Authors: Farag Peter F. , Albulushi Hamzah O. , Eskembaji Mohammed H. , Habash Mohammad F. , Malki Mohammed S. , Albadrani Muayad S. , Hanafy Ahmed M. 
Published: November 2024

IntroductionOne of the most prevalent and recurrent infectious diseases that can range from moderate to fatal is urinary tract infection (UTI). Broad-spectrum antibiotics are the only management strategy for UTIs in ambulators and hospital stays. Due to the ongoing emergence of antibiotic resistance among uropathogens, there is a need for proper selection of antibiotics for empirical therapy against UTIs. This study aimed to compare the etiological profiles and antibiotic susceptibility patterns between diabetic and non-diabetic UTI female patients from the Maternity and Children Hospital in Jeddah, Saudi Arabia.MethodsUrine samples from different age categories of female UTI patients were collected from January 2021 to June 2023. The positive urine cultures with a single pathogen were selected and all bacterial isolates were identified by MALDI-TOF/MS system. Antibiotic susceptibility testing was done using VITEK-2. Our study included 2,245 female patients, of which 1825 (81%) were non-diabetic and 420 (19%) were diabetic.ResultsThe results showed a significant relationship (p = 0.00063) between the average age and the number of diabetic UTI patients. Gram-negative bacilli were more dominant (84.7%, n = 1903) than gram-positive cocci (15.3%, n = 342). Escherichia coli (40.8%) was the most prevalent pathogen identified with a significant (p &lt; 0.0001) increase in non-diabetic (45.26%) than diabetic UTI patients (21.43%). Proteus mirabilis (10.2%) and Pseudomonas aeruginosa (8.7%) followed E. coli in pathogen distribution. Among gram-positive species, Enterococcus faecalis, Staphylococcus aureus, and Staphylococcus saprophyticus were found in all age groups of diabetic and non-diabetic UTI patients. The findings showed that the most resistant bacteria from patients with non-diabetic UTIs were found to be resistant to amoxicillin (37.7%) and ampicillin (40%), while the most resistant bacteria from patients with diabetes were found to be resistant to tetracycline (43.3%) and cephalothin (43.5%). In patients with UTIs, ciprofloxacin was found to be the most effective antibiotic against all bacterial species.DiscussionAccording to the results, we concluded that the UTI etiological profiles varied among different ages. Ciprofloxacin is a safe medication with optimal sensitivity that can be used to treat both gram-positive and gram-negative bacteria.
The efficacy of ultrasound-guided pulsed radiofrequency in the treatment of primary glossopharyngeal neuralgia
Authors: Li Fubo , Lu Hongcheng , Gong Gege , Ou Cehua , Zhang Yue 
Published: November 2024

ObjectiveThis study evaluates the clinical efficacy and safety of ultrasound-guided long duration, high voltage pulse radiofrequency (PRF) in managing primary glossopharyngeal neuralgia (GPN).MethodsClinical data were retrospectively analyzed for 13 patients with primary GPN who underwent this treatment between August 2019 and October 2022. Visual Analog Scale (VAS) scores were assessed pre-treatment and at 1 week, 1 month, 3 months, and 6 months post-treatment. Additionally, the rates of discontinuation of oral oxcarbazepine and pregabalin, efficacy, and complication rates at 6 months post-procedure were monitored.ResultsSignificant post-treatment pain relief, was observed across all patients, with statistically significant improvements in VAS scores (p &lt; 0.05). Discontinuation rates for oxcarbazepine and pregabalin were also high (p &lt; 0.05). At the 6-month follow-up, 69.23% of patients achieved excellent and good efficacy, 84.61% demonstrated overall effectiveness, while 15.38% showed poor efficacy. No critical complications were reported in any case.ConclusionUltrasound-guided, long-term, high-voltage PRF effectively relieves primary glossopharyngeal neuralgia and improves quality of life. Featuring ease of operation, high safety and minimal complications making it a promising approach for clinical application.
Differences in the effect of repetitive transcranial magnetic stimulation and median nerve electrical stimulation in patients with prolonged disorders of consciousness after intracerebral hemorrhage: a randomized controlled trial protocol
Authors: Zhao Guoshun , Fang Mingzhu , Han Shiyu , Peng Xiaoke , Dong Anqin 
Published: November 2024

BackgroundRepetitive transcranial magnetic stimulation (rTMS) and median nerve electrical stimulation (MNES) are two non-invasive neuromodulation techniques that have demonstrated potential in facilitating the recovery of consciousness in patients with impaired consciousness. However, existing studies on awakening interventions for patients with prolonged disorders of consciousness (pDoC) following intracerebral hemorrhage remains limited. In particular, systematic comparisons of the efficacy of rTMS versus MNES in this specific patient population are lacking.MethodsThis is a single-center randomized controlled trial in which 45 patients will be randomly assigned to the control group, rTMS group and MNES group. The intervention period will lasts 4 weeks. All patients underwent multimodal assessments before and at the end of treatment, which were used to comprehensively evaluate their recovery of consciousness and changes in brain function. The assessments includes the Coma Recovery Scale, electroencephalogram, event-related potentials (P300 and mismatched negative) and functional near-infrared spectroscopy.DiscussionThis study represents the first systematic comparison of the efficacy between rTMS and MNES in patients with pDoC following intracerebral hemorrhage. The objective is to employ multimodal assessment techniques to provide clinical references into the individualized application of these neuromodulation therapies.Clinical trial registrationhttps://www.chictr.org.cn/, identifier ChiCTR2400082022.
The preoperative hemoglobin, albumin, lymphocyte, and platelet score (HALP) as a prognostic indicator in patients with non-small cell lung cancer
Authors: Liu Qiteng , Xie Hailun , Cheng Wenjuan , Liu Tong , Liu Chenan , Zhang Heyang , Lin Shiqi , Liu Xiaoyue , Tian Haiying , Li Xiangrui , Zheng Xin , Chen Yue , Shi Jinyu , Zhao Hong , Shi Hanping 
Published: November 2024

BackgroundThe Hemoglobin, Albumin, Lymphocyte, and Platelet score (HALP) is an inflammatory nutrition-related biomarker based on hemoglobin and albumin levels, as well as the lymphocyte and platelet load index, which has been reported to be associated with the prognosis of various types of tumors. This study aims to investigate the prognostic value of HALP in patients with non-small cell lung cancer (NSCLC).MethodsA total of 2,428 patients with NSCLC were enrolled in the INSCOC study. Time-patient survival trends were validated using Kaplan–Meier curves and log-rank tests. The Restricted Cubic Spline function was used to analyze the relationship between the HALP index and overall survival (OS). The Cox regression model was used for univariate and multivariate analyses.ResultsThe study included 2,053 patients with detailed biological information and follow-up data, consisting of 1,346 men (65.6%) and 707 women (34.4%). Within this cohort, 138 patients (6.7%) had stage I disease, 282 (13.7%) had stage II, 477 (23.2%) had stage III, and 1,156 (56.3%) had stage IV. A total of 536 patients (26.1%) underwent surgery, 1,494 (72.8%) received chemotherapy, and 271 (13.2%) received radiotherapy. The 1-, 2-, 3-, and 5-year survival rates for patients with NSCLC were 68.6, 48.6, 37.4, and 30.9%, respectively. The optimal cut-off for HALP was determined to be 29.71, with a sensitivity of 53.1% and specificity of 62.9%, leading to the categorization of patients into low (&lt;29.71) (n = 963) and high (≥29.71) (n = 1,090) HALP groups. Patients with a high HALP demonstrated a significantly higher 5-year overall survival (OS) rate compared to those with a low HALP (38% vs. 23%, p &lt; 0.001). Multivariable Cox proportional hazards regression analysis identified that low HALP was an independent risk factor for the survival of patients with non-small cell lung cancer.ConclusionThe HALP index can be used as an independent prognostic factor for patients with NSCLC, offering clinicians a reference to identify high-risk patient with poor long-term prognoses and improve individualized treatment.
Serum trimethylamine N-oxide and its precursors are associated with the occurrence of mild cognition impairment as well as changes in neurocognitive status
Authors: Bai He , Zhang Yao , Tian Peiying , Wu Yani , Peng Ruiheng , Liang Bin , Ruan Wenli , Cai Enmao , Lu Ying , Ma Mingfeng , Zheng Liqiang 
Published: November 2024

BackgroundThis study aims to examine the association between gut microbe-dependent trimethylamine N-oxide (TMAO) and its precursors (choline, betaine, and carnitine) levels and mild cognition impairment (MCI), alongside changes in the Chinese version of the Montreal Cognitive Assessment-Basic (ΔMoCA-BC) score in rural adults.MethodsDrawing data from a large-scale epidemiological study conducted in rural areas of Fuxin County, Liaoning Province, China. 1,535 participants free from brain-related ailments were initially surveyed. MCI was assessed through the MoCA-BC score. Logistic regression models and restricted cubic spline were used to investigate the association between TMAO and its precursors levels and MCI. Additionally, the association between TMAO and its precursors levels and ΔMoCA-BC was analyzed using a generalized linear model in the longitudinal study.ResultsThe average age of the study participants was 58.6 ± 9.4 years and the prevalence rate of MCI was 34.5%. With the second quartile as the reference in the logistic regression model, the OR for risk of MCI in the highest quartile for TMAO, betaine, and carnitine was 1.685 (95% CI: 1.232–2.303, p = 0.001), 2.367 (95% CI: 1.722–3.255, p &lt; 0.001), and 2.239 (95% CI: 1.742–3.295, p &lt; 0.001), respectively. The OR of choline for the highest versus lowest quartile was 2.711 (95% CI: 2.012–3.817, p &lt; 0.001) for the risk of MCI. We find a J-shaped association between betaine (Pnon-linear = 0.001) and carnitine (Pnon-linear = 0.003) levels and MCI. Furthermore, TMAO and its precursors levels were associated with ΔMoCA-BC in the third and fourth quartiles group (All p &lt; 0.05).ConclusionThe findings suggest the existence of an optimal concentration range for serum levels of TMAO, betaine, and carnitine that mitigates MCI risk, paving the way for enhanced dietary interventions aimed at preventing and treating MCI.