bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation Study between Chronic Suppurative Otitis Media Severity and the Air Conduction Threshold of Its Contralateral Ear
Authors: Wahyudiono Ahmad Dian , Tanudjaja Beatrice , Indrasworo Dyah 
Published: November 2024

Abstract

Background:
The more severe the middle ear inflammation with chronic suppurative otitis media (CSOM), the more likely its contralateral middle ear suffers from chronic otitis media. Paparella’s continuum theory describes otitis media as a continuous and dynamic inflammation that starts from eustachian tube blockage. This ongoing and prolonged inflammation may affect the contralateral ear (CLE), manifesting in bilateral chronic otitis media.

Methods:
A cross-sectional study on 42 medical records of CSOM patients hospitalized for middle ear surgery. In this research, we used the middle ear risk index (MERI) scoring to measure CSOM severity, which is estimated to affect air conduction (AC) threshold of the CLE by interfering with its middle ear impedance. The correlation between the MERI score of the CSOM ear and AC of the CLE was analyzed using the Pearson correlation test.

Results:
There was a strong positive correlation between the MERI score of CSOM with cholesteatoma and its CLE AC threshold (r = 0.610, P < 0.01), while the MERI score of CSOM without cholesteatoma had a weak positive correlation with its CLE AC (r = 0.384, P < 0.05).

Conclusions:
The higher MERI scores in either CSOM with cholesteatoma or without cholesteatoma were correlated to higher CLE AC threshold.
Evaluation of abdominal expiratory muscle thickness pattern, diaphragmatic excursion, diaphragmatic thickness fraction and lung ultrasound score in critically ill patients and their association with weaning patterns: A prospective study
Authors: Bansal Priyanka , Jakhar Bhawna , Arya Rajesh C. , Sultania Nidhi S. S. , Puhal Sudha , Bansal Kunal , Verma Devyani , Aggarwal Aditya , Singhal Suresh 
Published: November 2024

Abstract

Introduction:
Weaning of patient from ventilator and finally extubation is a challenge, especially in critical care setup. Though many parameters are available, based on which, the decision of extubation is taken but still many times, there is failure of weaning.

Aim:
We conducted a prospective observational study to look for diaphragm and abdominal muscle thickness, contraction, and lung ultrasound as indicator for weaning and extubation.

Material and Methods:
Patients of either gender aged between 20-50 years, who were on invasive mechanical ventilation for more than 48 hrs. and put on spontaneous breathing trial. A bedside ultrasound examination was performed. Abdominal expiratory muscle thickness, diaphragmatic excursion (DE), diaphragmatic thickness fraction (DTF) and lung ultrasound score (LUS) were measured.

Results:
12 patients had simple weaning pattern whereas 5 patients had difficult weaning and 8 patients had prolonged weaning. The mean value of DE was 1.97 cm, DTF- 2.3 mm. The mean value of SOFA score is significant between simple, difficult, prolonged weaning (2.24, 4.56, 7.33 respectively). The DE, which is 2.52, 1.26, 1.81 in simple difficult and prolonged weaning respectively is highly significant. The mean value of LUS was 8.34 and is significant in all weaning patterns. The highest sensitivity is found for SOFA score (84.62) with AUC of 0.88.

Conclusion:
Evaluation of patient with diaphragm thickness fraction (mean DTF of 26%) and diaphragm excursion (2.52 cm) with mean LUS score of 4.67 opens a new dimension to predict weaning in critically ill patients who are put on spontaneous breathing trial. The sequence of thickness of abdominal expiratory muscles adds to accuracy in successful weaning. Larger muti-center trials are required to make these parameters as a standard practice for weaning patients in critical care setup.
Comparative Efficacy of Antipsychotic Medication for Stereotypic Behavior in Autism Spectrum Disorder: A Systematic Review and Meta-analysis
Authors: Kattimani Shivanand , Selvarajan Sandhiya , Varadharajan Natarajan , Gopalakrishnan Prabhavaty 
Published: November 2024

Background:
Stereotypic movements in autism form core symptoms under the rubric of repetitive and restricted patterns of behavior.

Aim:
The systematic review was aimed to find which antipsychotic has better efficacy in treating stereotypic behavior in autism spectrum disorder.

Methods:
We searched for journal publications in the English from PubMed and Cochrane databases (CENTRAL), January 1992–June 2024, for randomized controlled trials that compared antipsychotics with a placebo of at least 6 weeks’ trial, with the outcome measure being a change in stereotypy score. Quality assessment of the included studies in the meta-analysis was done using Cochrane risk of bias tool version 2. We followed PRISMA guidelines for systematic review. The mean difference in change of stereotypy symptoms score was calculated between antipsychotic and placebo participants along with 95% confidence interval (CI) using the random-effects model.

Results:
146 studies were screened, and 25 studies were deemed eligible to retrieve full-length articles for review. A total of nine studies were included in the systematic review that had used aripiprazole, risperidone, or lurasidone as an antipsychotic. Six studies (n = 726) that had all data on mean difference in stereotypy scores on the Aberrant Behavior Checklist (ABC)-Stereotypy subscale and four studies (n = 554) that reported stereotypy scores using Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS)-Compulsions subscale were included in the meta-analysis. Antipsychotics showed a significant reduction in ABC-Stereotypy scores (−1.84 [−2.84, −0.85; 95% CI], Z = 3.83, P < 0.001) with moderate heterogeneity between the studies (I
2 = 53%). Whereas, antipsychotics did not show significant improvement in compulsions as measured on CY-BOCS (−0.87 [−1.89, 0.16; 95% CI], Z = 1.65, P = 0.10).

Conclusion:
Stereotypy in autism is difficult to measure, and no uniform measure exists. Trials are limited to short duration and limited to few antipsychotics. Among antipsychotics, risperidone has robust efficacy in reducing stereotypic behaviors.
Efficacy of Acceptance and Commitment Therapy in Social Anxiety Disorder: A Systematic Review and Meta-analysis
Authors: Mattikoppa Neha V. , Harshitha G. S , Yahiya Gazzali Kassim M. , Paluru Manasa Sudhir 
Published: November 2024

Background:
Acceptance and commitment therapy (ACT) is a novel third-wave therapy becoming popular in the management of various anxiety disorders. In this systematic review, we wish to gather the data that have been studied to determine the effectiveness of ACT in treating social anxiety disorder (SAD).

Methods:
This study followed standard systematic review guidelines and was registered with PROSPERO prior to undertaking the review. Databases, namely PubMed, PsycINFO, Ovid MEDLINE, and gray literature (ClinicalTrials.gov, BASE) with relevant keywords, were searched from inception to February 2024. Randomized controlled trials encompassing both clinical and nonclinical populations aged more than 10 years diagnosed with SAD were included. These trials compared ACT with wait list controls (n = 6) and cognitive behavioral therapy (n = 3). The primary outcome focused on the reduction of symptoms associated with social anxiety, while quality of life served as a secondary outcome. Measures of effect were determined through pre-test and post-test mean values, alongside their respective standard deviations. The random effect model was used to calculate pooled effect size. The quality of the included papers was assessed using Cochrane RoB-1. Covidence software was used for the initial selection of studies, and meta-analyses were performed using RevMan software.

Results:
From the initial 442 study records that were searched, finally 9 studies were included for the systematic review, of which 6 studies were found suitable for meta-analysis. The pooled estimate for studies comparing ACT with wait list found that the overall effect size for social anxiety symptoms was g = −1.28 (95% confidence interval of -1.88, -0.69) favoring ACT intervention significantly.

Conclusion:
This review found that ACT is efficacious in treating SAD. Most of the studies included were conducted in adolescent females. Varying ACT intervention modalities were incorporated, with the primary outcome assessed using a range of scales. The results of our meta-analysis should be interpreted with caution because of heterogeneity and smaller number of studies being included. ACT can be considered a psychotherapeutic option for the management of SAD.
Effectiveness of Repetitive Transcranial Magnetic Stimulation in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review and Meta-analysis
Authors: Malo Palash Kumar , Ghosh Aishwarya , Menon Anjana J. , Sandhya G. , Roy Dwaiti , Issac Thomas Gregor 
Published: November 2024

Background:
Dementia encompasses cognitive decline that significantly affects daily living. In recent years, there has been a notable shift toward nonpharmacological treatments, with transcranial magnetic stimulation (TMS) gaining attraction for its potential to enhance cognitive function in predementia and early Alzheimer’s Disease (AD). In this meta-analysis, we have integrated the results from different studies with varied protocols to explore the efficacy of repetitive TMS (rTMS) in improving cognitive functioning in people with mild cognitive impairment (MCI) and early AD.

Methods:
We used three databases, namely PubMed, MEDLINE, and PsycINFO. Studies until March 2024 were included. Mini–Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) were used to assess global cognition. A random-effects meta-analytical model was adopted, and Hedge’s g standardized mean differences (SMDs) and its 95% confidence intervals (CIs) were reported. The study protocol has been registered with PROSPERO (CRD42024507575).

Results:
Twenty-three studies were included in the meta-analysis. The mean (standard deviation) age of participants in studies using ADAS-Cog (71.8 [6.19] years) was found to be more than studies using MMSE (70.0 [6.72] years). Post-intervention MMSE scores were significantly better in active rTMS as compared to that of sham TMS (SMD [95% CI] =0.60 [0.15–1.04]; P = 0.009). However, the difference between the two study groups was not statistically significant for ADAS-Cog (−0.09 [−0.49 to 0.32]; [P = 0.67]). Sensitivity analyses for studies using MMSE also indicated that rTMS contributed to cognitive enhancement.

Conclusions:
The study found that active rTMS led to significant improvement in MMSE scores in people with MCI and early AD.
Efficacy of Antidepressants in Management of Depressive Symptoms in Dementia: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Pai R. Shantheri , Shashikala I. M. , Sudhakar P. Hasitha 
Published: November 2024

Background:
Dementia is associated with a complex array of neuropsychiatric manifestations which require consideration as they worsen the course of illness, especially in neurodegenerative etiologies. Depression and subsyndromal depressive symptoms are common in dementia, usually managed with antidepressants, but evidence is weak.

Objective:
The objective is to study the efficacy of antidepressants compared to placebo in management of depressive symptoms in dementia.

Methodology:
Electronic databases such as PubMed, MEDLINE, PsychINFO, ClinicalTrials.gov, BASE, and MedNar were searched from their date of inception to March 18, 2024, with appropriate search-terms. Randomized controlled trials (RCTs) that are double-blind in nature with placebo as comparator of dementia patients (Alzheimer’s disease [AD], Frontotemporal, Lewy body, and Parkinson disease dementia) treated with antidepressants for at least ≥ 4 weeks with severity of depressive symptoms measured on standardized rating scales were included. Studies with nonrandomized/nondouble-blind design, active drug or brain stimulation methods as comparator and nonneurodegenerative etiologies of dementia were excluded. Cochrane tool for risk of bias assessment, Covidence and Microsoft Excel for data extraction and review manager version 5.4.1 for data analysis were used.

Results:
Our search yielded 13(N) RCTs for systematic review, majority of which reported on AD (n = 12), selective serotonin reuptake inhibitors as intervention (n = 7), and high risk of bias (n = 9). Efficacy analysis using forest-plot with seven RCTs showed no statistically significant treatment effect (standardized mean differences [SMD] = −0.04, 95%confidence interval [−0.36, 0.27], Z = 0.26, P = 0.79) between intervention and placebo group. Substantial significant heterogeneity (I
2 = 74%, P < 0.001) was noted across studies.

Discussion:
Antidepressants administered for 6–13 weeks and different rating scales used to measure outcome in RCTs were possible reasons for heterogeneity. We conclude that antidepressants have not been found to be efficacious compared to placebo in management of depressive symptoms in dementia. Findings cannot be generalized to other etiologies as our analysis found limited data majorly on AD and RCTs with high risk or some concerns in the bias, thus throws a light on need for robust RCTs in this area.
Efficacy of Antidepressants in Depression in Breast Cancer: A Systematic Review and Meta-analysis
Authors: Chikkamath Vinuta C. , Kariyannavar Lingaraj , Rattehalli Ranganath , Pai B. Srinivas 
Published: November 2024

Background:
Breast cancer is the most common malignancy in women worldwide. Depression is a common psychological issue among these patients as they experience significant stress, and it impacts their quality of life. In this regard, the efficacy of antidepressants in depression for breast cancer is not studied.

Objective:
The objective of the study was to study the efficacy of antidepressants in the management of depression in breast cancer.

Methods:
Our databases included PubMed, MEDLINE, PsycINFO, Cochrane, Scopus, and Gray literature published in English. Studies included were randomized, placebo-controlled, double-blind trials of antidepressants for women diagnosed with breast cancer and depression. Studies were excluded if they were nonrandomized trials, had an active comparator, or if the antidepressant drug was not primarily used for depression. The severity of depressive symptoms was measured using standardized rating scales for depression. The risk of bias was assessed using the Cochrane risk of bias 2 tool. Covidence and Microsoft Excel were used for data extraction and RevMan 5.4.1 for efficacy outcome estimates, heterogeneity, and sensitivity analysis.

Results:
Of a total of 155 studies, 13 studies (9 parallel design and 4 crossover) met the inclusion criteria for systematic review and seven for meta-analysis involving 595 participants. The risk of bias assessment showed that five studies had low risk, four studies had some concerns, and four studies had high risk of bias. The antidepressants noted to have a favorable outcome were fluoxetine, paroxetine, mianserin, and mirtazapine. The pooled analysis (standardized mean difference [SMD] −0.28 [confidence interval = −0.56, 0.01] z = 1.87 [P = 0.06]) and subgroup analysis (selective serotonin reuptake inhibitor) did not favor antidepressants (SMD = −0.23 [−0.52, 0.07], z = 1.51, [P = 0.13]). Sensitivity analysis did not show a significant difference in outcome measures between antidepressants and placebo. Considerable heterogeneity, with a value of 69%, was found to be statistically significant (P = 0.003).

Conclusion:
We conclude that based on the available research, there was no evidence that antidepressants were superior to placebo in the management of depression in breast cancer. The possible reasons for heterogeneity are variations in the duration of study periods and antidepressant administration, different stages of breast cancer, and different scales used for assessing depression in RCTs.
Efficacy of Transcranial Direct Current Stimulation on Cognitive Function in Dementia and Mild Cognitive Impairment Secondary to Neurodegenerative Etiology: A Systematic Review and Meta-Analysis
Authors: Rangarajan Subhashini K. , Anupama V. V. , Sehrawat Megha , Mittal Apurva , Yashwanth G. , Sreeraj Vanteemar S. , Sivakumar Palanimuthu Thangaraju , Venkatasubramanian Ganesan 
Published: November 2024

Background:
Dementia is a chronic progressive illness with significant impairment in a person’s functioning ability. The currently available treatment options for dementia are limited in modifying disease progression. Non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) are emerging as potential treatment options for cognitive as well as behavioral symptoms in dementia. The objective of this systematic review and meta-analysis is to assess the efficacy of tDCS on cognitive function in mild cognitive impairment (MCI) and dementia due to neurodegenerative disorders to provide an update on the existing evidence considering an increasing number of trials using tDCS.

Methods:
The study was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines with a prespecified protocol registered in PROSPERO (CRD42024503852). The study selection was made through a search on databases such as PubMed, Ovid MEDLINE, APA PsycInfo, and Cochrane trials registry and a gray literature search on ClinicalTrials.gov. All randomized controlled trials that have used tDCS as a standalone intervention for cognitive impairment were included in the present study. Risk of bias (RoB) was assessed by the Cochrane RoB2 tool. Meta-analysis of outcomes was performed using RevMan software version 5.4. Pooled estimates of standardized mean difference (SMD) and 95% confidence interval (CI) were obtained for global cognition (primary outcome) and other domain-specific cognitive outcomes.

Results:
A total of 24 studies were finally included in the review. Most of the studies had “some concerns” with regard to the overall RoB. A total of 164 subjects in the true tDCS group and 151 subjects in the sham tDCS groups out of eight studies were analyzed for global cognitive outcome, giving a pooled SMD (95% CI) of 0.80 (0.35, 1.26), giving an overall effect of Z = 3.45 (P < 0.001), with I2 value of 72%, favoring true tDCS. On a sub-group analysis, a significant improvement was noted in the Alzheimer’s dementia group but not MCI.

Discussion:
The study findings suggest that tDCS is effective in improving global cognition in participants with Alzheimer’s dementia but not MCI. Owing to a smaller number of studies, the domain-specific cognitive outcomes could not be assessed effectively. There was a wide heterogeneity in the included studies in terms of tDCS stimulation protocols.
Epidemiological Changes in Acute Febrile Diseases after the COVID-19 Pandemic in Thailand
Authors: Prasertbun Rapeepun , Mori Hirotake , Hadano Yoshiro , Mahittikorn Aongart , Maude Rapeephan R. , Naito Toshio 
Published: November 2024

ABSTRACT.
Acute undifferentiated febrile illnesses (AUFIs) are short-duration infectious diseases with nonspecific symptoms. In Thailand, common AUFIs include dengue, malaria, leptospirosis, scrub typhus, and typhoid fever. This study aimed to determine the case numbers of AUFI etiologies in Thailand before coronavirus disease 2019 (COVID-19) (phase 1 from January 2018 to February 2020) and during the COVID-19 pandemic with preventive measures (phase 2 from March 2020 to April 2022), and the loosening of the preventive measures (phase 3 from May 2022 to December 2022). We used Thailand’s national database from 2018 to 2022 to determine the case numbers of AUFIs and geographic heat maps to identify endemic areas in Thailand. The case numbers of malaria, dengue, leptospirosis, typhoid, and scrub typhus significantly decreased during phase 2 (preventive measures) (P = 0.02), and cases of malaria and leptospirosis increased during phase 3 (loosened preventive measures) (P = 0.01). In 2022, malaria and leptospirosis increased by 39% and 48%, respectively, compared with the previous year. Malaria increased in western Thailand along the border between Thailand and Myanmar, where malaria preventive measures were insufficient, whereas leptospirosis increased in northern Thailand. The epidemiology of acute febrile diseases changes significantly depending on the global epidemic of infectious diseases such as COVID-19 and the implementation of preventive measures, such as face masks, hand hygiene, social distancing, and stay-at-home and lockdown measures.
Transcription and Copy Number Variation of Plasmodium falciparum var2csa among Nonpregnant Malaria Patients in Thailand
Authors: Chaikitgosiyakul Sethawud , Kuamsab Napaporn , Tia Taweesak , Putaporntip Chaturong , Jongwutiwes Somchai 
Published: November 2024

ABSTRACT.
Placental malaria is an important cause of fetomaternal morbidity and mortality among pregnant women infected with Plasmodium falciparum. The pathogenesis involves the binding of VAR2CSA on the surface of infected erythrocytes to chondroitin sulfate proteoglycans on syncytiotrophoblasts in the intervillous space of the placenta. Anti-VAR2CSA antibodies confer protection from adverse pregnancy outcomes in falciparum malaria; therefore, VAR2CSA is a strong vaccine candidate against placental malaria. To date, little is known about transcription of var2csa among isolates from male and nonpregnant patients in low transmission areas. In this study, transcription and copy number variation of var2csa were analyzed in 55 P. falciparum isolates from nonpregnant women, men and children with symptomatic malaria in five endemic provinces of Thailand. Reverse transcription polymerase chain reaction (PCR) detected var2csa transcripts in 43 (78.2%) blood samples. Multiple copies of var2csa were identified in 16 of 55 (29.1%) isolates by quantitative real-time PCR. Copy number variation of var2csa was not associated with the patients’ sex, age group, ethnicity, parasite genotypes, parasite density, and geographic origins. These data suggest that P. falciparum carrying multicopy var2csa had a wide geographic distribution in Thailand with a prevalence rate comparable to those observed in high transmission areas of Africa. The high prevalence of isolates from male and nonpregnant patients with var2csa transcription suggests that the transcription of this gene occurs naturally during blood stage infection. Whether VAR2CSA is expressed and immunogenic among nonpregnant falciparum malaria patients requires further study.