bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Problem-based Learning and Didactic Lecture as a Teaching–Learning Method among Undergraduate Medical Students: An Interventional Study
Authors: Anthony Leena , A Radha , T Indushree , Banerjee Swati 
Published: October 2024

Background Didactic Lecture (DL) is a teaching method that has been there for a long time in our educational system, but student involvement is minimal. Problem-based Learning (PBL) differs in that it involves students in the learning process. Various skills are learned, such as self-learning, group discussion, communication skills, teamwork and knowledge retention. Critical thinking, analysis and the ability to solve real problems are some benefits of PBL, which can help medical students understand clinical scenarios and analyse, interpret and come up with possible solutions based on sound knowledge. Thus, there is a need to assess the effectiveness of PBL in recall, interpretation and problem-solving skills as compared to the traditional lecture method, as there are very few Indian studies related to PBL in Indian medical students. Materials and Methods A non-randomised interventional study was carried out in the Department of Pharmacology at East Point Medical College, Bengaluru. Groups A and B, each with 60 medical students, participated in PBL and DL for either of the two competencies (myocardial infarction and iron deficiency anaemia). After the completion of the DL and PBL sessions, 20 multiple-choice questions (MCQs) were given to the students. The effectiveness of the teaching method was determined by comparing the mean scores of MCQs of both groups. Results The group scores were compared using an independent sample t-test and expressed as mean ± standard deviation. The total mean score of PBL for the topic myocardial infarction (11.00 ± 2.64, p value = .001) was statistically significant compared with the total mean score in the DL group (9.38 ± 2.52), and the total mean score of PBL for the topic iron deficiency anaemia (15.28 ± 3.53, p value = .001) was significant compared to the total mean score in the DL group (12.98 ± 3.61), respectively. The mean score for recall and problem-solving for the topic of myocardial infarction was statistically significant in the PBL group compared to the DL group. The mean score for recall, interpretation and problem-solving for the topic of iron deficiency anaemia was statistically significant in the PBL group compared with the DL group. Conclusion PBL showed marked improvement in recall, interpretation and problem-solving abilities compared with DL. So, including PBL as a teaching–learning method can promote active and student-centered learning.
“They Need to Feel Non-Judgmental”: Results of Participatory Photovoice Research to Inform Lung Cancer Screening Imagery
Authors: Hirsch Erin A. , Hoover Kaitlyn , Studts Jamie L. 
Published: October 2024

Introduction Effective communication and messaging strategies are crucial to raise awareness and support participants' efforts to adhere to lung cancer screening (LCS) guidelines. Health messages that incorporate images are processed more efficiently, and given the stigma surrounding lung cancer and cigarette smoking, emphasis must be placed on selecting imagery that is engaging to LCS-eligible individuals. This exploratory study aimed to identify person-centered themes surrounding LCS imagery. Materials and Methods This qualitative study leveraged a modified photovoice approach and interviews to define descriptive themes about LCS imagery. Study participants eligible for annual LCS who had a CT scan within 12 months were asked to select three images and participate in a semi-structured interview about photo selection, likes, and dislikes. Participants were also asked their opinions about images from current LCS communications featuring matches, smoke, and cigarettes. Data were analyzed using an inductive thematic approach. Results Data saturation was reached after thirteen individuals completed the photovoice activity; each participant selected three pictures resulting in a total of 39 images representing LCS. Over half (54%) of images selected contained lungs and only 4 (10%) contained smoking-related elements. Five main themes emerged: 1) images should focus on good news and early detection; 2) people should be relatable; 3) pictures with lungs can dually support lung health or invoke fear; 4) opportunity for education or awareness; and 5) should not be judgmental and induce stigma. Conclusions These findings suggest that LCS imagery should not contain negative or stigmatizing elements but instead be relatable and educational. This information can inform communication and messaging interventions and strategies for future LCS participation, awareness, and educational research.
Swirling Flow Quantification in Helical Stents Using Ultrasound Velocimetry
Authors: Ghanbarzadeh-Dagheyan Ashkan , van Helvert Majorie , van de Velde Lennart , Reijnen Michel M.P.J. , Versluis Michel , Groot Jebbink Erik 
Published: October 2024

Objective: Helical stents have been developed to treat peripheral arterial disease (PAD) in the superficial femoral artery (SFA), with the premise that their particular geometry could promote swirling flow in the blood. The aim of this work is to provide evidence on the existence of this swirling flow by quantifying its signatures. Materials and Methods: This study consists of in vitro and in vivo parts. For the in vitro part, 3 helical stent models of different helicity degrees and 1 straight model were fabricated, and the flow was assessed at the inlet and outlet of each model. For the in vivo part, only 1 patient, treated with the helical stent, was eligible to participate in the study. The stent implanted in the SFA of the patient was evaluated in 2 leg postures (straight and flexed), and flow was assessed in 12 locations along the SFA. The in vivo study was approved by an ethical board (NL80130.091.21) in the Netherlands. High-frame-rate ultrasound was used to acquire data from the regions of interest (ROIs), using microbubbles as contrast agents. After processing the data via a correlation-based algorithm (echo particle image velocimetry or echoPIV), the velocity vector field within each ROI was extracted and analyzed for parameters such as vector complexity and velocity profile skewedness. Results: The results show that in the outlet of the helical stents, when compared with the inlet, the flow vector field is more complex and the velocity profile is more skewed. For the in vivo case, the outcomes demonstrate more complexity and higher variability in the sign of skewedness inside the stent when compared with the flow in the proximal to the stent. Conclusions: Helical stents make the vector field of the flow more complex and the velocity profile more skewed, both of which are signatures of swirling flow. Further studies are needed to evaluate whether these features can benefit patients in terms of patency rates. Clinical Impact This study demonstrates that helical stent models alter the blood flow when compared with straight stent models. Particularly, the flow grows more complex and its velocity profile becomes more skewed, both of which hint at the existence of swirling flow inside the helical stent. These observations, alongside with population-based studies that are currently being carried out, may provide the evidence that helical stents have some advantages over straight stents for the patients.
Successful Pedal Bypass in a Patient With Pseudoxanthoma Elasticum
Authors: Väärämäki Suvi , Hautero Olli , Rajala Vesa , Nevalainen Pasi 
Published: October 2024

Objectives Pseudoxanthoma elasticum (PXE) is a rare metabolic disease, causing calcification in the arterial media layer and further peripheral artery disease (PAD). A high rate of failure has been reported after endovascular and open surgical management of PAD among patients with PXE. Critical limb ischemia (CLI) rarely develops in PXE, and there are only few reports of its treatment. Methods We present a case report of a 57 year-old female diagnosed with pseudoxanthoma elasticum (PXE). She presented with critical limb ischemia (CLI) and was successfully treated with pedal bypass using the great saphenous vein. Results Despite obtaining suboptimal outcomes through the initial approach of percutaneous transluminal angioplasty to treat critical limb ischemia, the subsequent bypass operation proved to be a success. At the first follow-up appointment at 1 month, the patient was asymptomatic and the ulceration had almost healed. The patient underwent an ultrasound examination at 3, 6, 12, and 24 months after discharge, and the surveillance was uncomplicated. Conclusions With a clear indication for surgery, limb-threatening ischemia can be successfully treated with distal bypass, if necessary, in patients with PXE similarly to atherosclerotic PADs. Appropriate diagnostic and surveillance imaging and the utilization of a multidisciplinary team are key components for effective management of PAD in patients with PXE.
Treating Prediabetes With Medications … or Not
Authors: Srivastava Sneha Baxi 
Published: October 2024

There is abundant evidence about the impact of physical activity on health. Many of the clinical guidelines include physical activity as a strong recommendation in treatment plans to optimize health outcomes; however it is necessary to consider the interaction between medications and physical activity. There are certain medical conditions, including cardiovascular disease, diabetes, pain and urinary incontinence that may directly impact physical activity as well as medications for those conditions can affect how a person can be physically active. Having individualized conversations with patients to determine ways to incorporate physical activity into their lives may lead to healthier outcomes.
The Vecta 46 intermediate catheter for mechanical thrombectomy of distal medium vessel occlusions: A single-center experience
Authors: Choi Joo Won , Qiao Yang , Mehta Tej I. , Clausen Thomas M. , Zhang Y. Jonathan , Tsappidi Samuel , Hui Ferdinand K. 
Published: October 2024

Introduction With emerging evidence supporting the clinical efficacy and safety of mechanical thrombectomy (MT) for distal medium vessel occlusions (DMVOs), MT devices specifically designed to navigate through smaller caliber and more delicate tortuous distal cerebrovasculature are required. This study describes our single-center experience using the AXS Vecta 46 intermediate catheter for first-line thromboaspiration of DMVOs. Methods We identified all patients who underwent MT using the Vecta 46 for first-line thromboaspiration for primary or secondary DMVOs. We collected baseline clinical data, angiographic and clinical outcomes, as well as procedural complications. The primary outcome in question was the rate of successful recanalization, which was defined as a modified Thrombolysis in Cerebral Infarction score of ≥2b. Results We identified 43 patients who underwent MT using the Vecta 46 catheter for thromboaspiration of 54 DMVOs. Intervened vessels included the M2 (23/54), M3 (19/54), and M4 (6/54) branches of the middle cerebral artery, A2 (1/54), A3 (1/54), and A4 (1/54) branches of the anterior cerebral artery, and P1 (1/54), P2 (1/54), and P4 (1/54) branches of the posterior cerebral artery. The median number of passes for primary DMVOs was 2 (IQR: 1–3) and 1 (IQR: 1–1.25) for secondary DMVOs. The rate of successful recanalization was 100% (18/18) for primary DMVOs and 80.6% (29/36) for secondary DMVOs. First-pass effect (FPE) was noted in 55.6% (30/54) of all primary and secondary DMVO cases. Improved short-term clinical outcomes were observed in both the primary (National Institute of Health Stroke Scale [NIHSS] shift: −5 [IQR: −14.25 to −0.25]) and secondary (NIHSS shift: −5 [IQR: −10 to −2]) DMVO groups. A total of six patients died during their hospitalization, though none were deemed procedural-related. Conclusions Our study demonstrates the safety and efficacy of the Vecta 46 intermediate catheter for thromboaspiration of both primary and secondary DMVOs, achieving high rates of successful recanalization and FPE.
Long-term subjective and objective outcomes after digital nerve repair: a cohort study
Authors: Evertsson Linda , Björkman Anders , Turesson Christina , Arner Marianne , Mellstrand Navarro Cecilia 
Published: October 2024

Digital nerve injuries are common, but few studies report long-term effects for the individual. The primary aim of this matched-pairs study comparing digital nerve injuries in border digits or central fingers was to investigate hand function 3–10 years after digital nerve repair, assessed using the Mini Sollerman test in 86 patients. Secondary outcomes were sensory function, range of motion, grip strength and patient-reported measures. No significant difference was seen in hand function between the groups, except for lower grip strength in patients with central finger injury. Tactile discrimination was achieved in 87%, with best results among participants aged less than 44 years. Touch perception was measurable in 99%. No statistically significant differences in sensory function were found between the groups. Patient-reported disability was low, with median Quick Disabilities of the Arm, Shoulder and Hand score of 5, but half of the patients reported neuropathic pain. Numbness and cold sensitivity were the symptoms graded worst after digital nerve injury. Level of evidence: III
Primary Stapedectomy: A Retrospective Review of Surgical Results Using a Cold Steel Technique and Pre-Operative CT Correlates
Authors: Hudson Thomas J. , Mijovic Tamara , Rappaport Jamie M. 
Published: October 2024

Importance Stapedectomy is an effective treatment option for patients with symptomatic otosclerosis. A common surgical technique today is laser stapedotomy, although the equipment required adds a significant cost to the procedure and may not be available in certain, particularly remote, centers. This study aimed to evaluate cold steel stapedectomy in a modern otology practice as a cost-effective and versatile alternative. Objective The primary objective was to evaluate the efficacy and safety of cold steel stapedectomy. The secondary objectives included characterizing the prevalence of relevant computed tomography (CT) findings and evaluating other factors such as piston size. Design A retrospective case series from April 2006 to November 2021. Setting A single tertiary care hospital in Montreal, QC, Canada. Participants Patients with suspected otosclerosis and no prior stapes surgery. Intervention Cold steel primary stapedectomy. Main Outcome Measures In primary analysis, change in pure tone thresholds, pure tone average (PTA), and complication rates were obtained. Secondary analysis measures included rates of relevant CT findings and change in PTA with piston size. Results A total of 302 cases were included in the analysis. The average change in air conduction PTA was a decrease of 27 dB, with 91% (276/302) having over 10 dB of improvement. The air-bone gap was closed to within 10 dB in 82% (248/302) of cases and within 20 dB in 96% (290/302) of cases. Overclosure occurred in 19% of cases, while only 4% resulted in worsened PTA bone conduction thresholds. In secondary analysis, 74% of CT scans demonstrated radiologic otosclerosis. Other findings included suspected superior semicircular canal dehiscence in 1.8%. Conclusion Cold steel stapedectomy was demonstrated to be a safe and effective technique, with audiometric results comparable to laser and drill studies in recent literature. It should be considered as a cost-effective and global health accessible alternative. Additionally, CT scans can provide valuable information in the pre-operative workup.
Closed-Loop Therapy and Sleep in Young People Newly Diagnosed With T1D and Their Parents
Authors: Madrid-Valero Juan J. , Scott Eleanor M. , Boughton Charlotte K. , Allen Janet M. , Ware Julia , Wilinska Malgorzata E. , Hartnell Sara , Thankamony Ajay , Randell Tabitha , Ghatak Atrayee , Besser Rachel E.J. , Elleri Daniela , Trevelyan Nicola , Campbell Fiona M. , Hovorka Roman , Gregory Alice M. 
Published: October 2024

Background: A diagnosis of type 1 diabetes in a young person can create vulnerability for sleep. Historically it has been rare for young people to be offered a closed-loop system soon after diagnosis meaning that studies examining sleep under these circumstances in comparison with standard treatment have not been possible. In this study, we examine sleep in young people (and their parents) who were provided with hybrid closed-loop therapy at diagnosis of type 1 diabetes versus those who receive standard treatment over a 2-year period. Methods: The sample comprised 97 participants (mean age = 12.0 years; SD = 1.7) from a multicenter, open-label, randomized, parallel trial, where young people were randomized to either hybrid closed-loop insulin delivery or standard care at diagnosis. Sleep was measured using actigraphy and the Pittsburgh Sleep Quality Index (PSQI) in the young people, and using the PSQI in parents. Results: Sleep in young people using hybrid closed-loop insulin delivery did not differ significantly compared with those receiving standard care (although there were nonsignificant trends for better sleep in the closed-loop group for 4 of the 5 sleep actigraphy measures and PSQI). Similarly, there were nonsignificant differences for sleep between the groups at 24 months (with mixed direction of effects). Conclusions: This study assessed for the first time sleep in young people using a closed-loop system soon after diagnosis. Although sleep was not significantly different for young people using closed-loop insulin delivery as compared with those receiving standard care, the direction of effects of the nonsignificant results indicates a possible tendency for better sleep quality in the hybrid closed-loop insulin delivery group at the beginning of the treatment.
Association of Continuous Glucose Monitoring–Derived Glycemia Risk Index With Cardiovascular Autonomic Neuropathy in Patients With Type 1 Diabetes Mellitus: A Cross-sectional Study
Authors: Jun Ji Eun , Lee You-Bin , Kim Jae Hyeon 
Published: October 2024

Background: The glycemia risk index (GRI) is a new composite continuous glucose monitoring (CGM) metric for weighted hypoglycemia and hyperglycemia. We evaluated the association between the GRI and cardiovascular autonomic neuropathy (CAN) and compared the effects of the GRI and conventional CGM metrics on CAN. Methods: For this cross-sectional study, three-month CGM data were retrospectively analyzed before autonomic function tests were performed in 165 patients with type 1 diabetes. CAN was defined as at least two abnormal results of parasympathetic tests according to an age-specific reference. Results: The overall prevalence of CAN was 17.1%. Patients with CAN had significantly higher GRI scores, target above range (TAR), coefficient of variation (CV), and standard deviation (SD) but significantly lower time in range (TIR) than those without CAN. The prevalence of CAN increased across higher GRI zones ( P for trend <.001). A multivariate logistic regression analysis, adjusted for covariates such as HbA1c, demonstrated that the odds ratio (OR) of CAN was 9.05 (95% confidence interval [CI]: 2.21-36.96, P = .002) per 1-SD increase in the GRI. TIR and CV were also significantly associated with CAN in the multivariate model. The area under the curve of GRI for the prediction of CAN (0.85, 95% CI: 0.76-0.94) was superior to that of TIR (0.80, 95% CI: 0.71-0.89, P for comparison = .046) or CV (0.71, 95% CI: 0.57-0.84, P for comparison = .049). Conclusions: The GRI is significantly associated with CAN in patients with type 1 diabetes and may be a better CGM metric than TIR for predicting CAN.
The anti-inflammatory effect of the extract and aristolactam BII isolated from aerial parts of Houttuynia cordata Thunb
Authors: Pham Ty Viet , Ho Duc Viet , Nguyen Nguyen Hoai , Tran Gia-Buu , Thao Tran Thi Xuan , Dat Nguyen Minh Thanh , Vo Nguyen Huy Hoang , Tran Kieu Anh , Do Bich Hang 
Published: October 2024

Objectives Houttuynia cordata Thunb., a member of the Saururaceae family, has been demonstrated to have potential in the treatment of different diseases. For the first time, aristolactam BII was isolated from the aerial part of Houttuynia cordata Thunb. and the anti-inflammatory effect of the extract and aristolactam BII was evaluated. Methods After using chromatography to separate and obtain the compound, Nuclear Magnetic Resonance was used to identify the compound. An in vivo model of carrageenan-induced paw edema on mice was performed to test the anti-inflammation of the extract and compound. Furthermore, a ligand docking experiment was performed to determine the binding free energy of aristolactam to inflammatory proteins including COX-1, COX-2. Results The findings showed that aristolactam BII effectively reduced the severity of the edema, similar to diclofenac, whereas the methanol extract showed low effectiveness. Particularly, the swelling rate of 50 mg/kg aristolactam BII treated mice was only 26.2 ± 7.1% (p < 0.01) after 5 h treatment. The in silico results described that aristolactam BII might inhibit COX-1 and COX-2 via creating h-bonds at the sites of Ser 530 residues. Conclusion Our results demonstrate the potential anti-inflammatory activity of aristolactam BII. This study would provide more fundamental knowledge about the bioactivities of aristolactam BII isolated from Houttuynia cordata.
The Wood-rot Basidiomycete Candolleomyces eurysporus VAST02.52 Produces a Versatile Peroxidase that Catalyses the Biotransformation of α-Pinene to Release Verbenone
Authors: Nghi Do Huu , Hong Minh Pham Thi , Hong Van Nguyen Thi , Quynh Dang Thu 
Published: October 2024

Background Versatile peroxidase (VP; EC 1.11.1.16) has recently emerged as a novel peroxidase highly valued in biotechnology due to its exceptional ability to oxidize a diverse range of substrates into value-added products. Objectives To gain insight into the versatile peroxidase system from fungi, this study was designed to purify and characterize a CeuVP from the newly isolated fungus Candolleomyces eurysporus and to investigate its involvement in the biotransformation of plant α-pinene. Materials and methods The fungal isolate was identified by analysis of the internal transcribed spacer region. VP-active protein was purified from liquid culture of C. eurysporus VAST02.52 by using fast protein liquid chromatography. The catalytic properties and stability of enzyme were studied for various substrates, different pH- and temperatures. Moreover, its involvement in the biotransformation of plant α-pinene was assessed by HPLC chromatography. Results CeuVP was successfully purified with 27.3-fold purity and a 20.9% yield by using three steps of anion exchange and size exclusion chromatography. The molecular weight of CeuVP was determined to be 40 kDa by SDS-PAGE electrophoresis. This pure enzyme exhibited optimal activity at pH 4.0 and 35 °C. CeuVP showed the highest specific activity of 231.6 U/mg against ABTS, followed by Mn2+ (205.8 U/mg), veratryl alcohol (112.7 U/mg), cathecol (77.8 U/mg), p-aminophenol (68.9 U/mg), RBBR (56.2 U/mg), 4-methoxyphenol (31.1 U/mg), guaiacol (18.3 U/mg), and Reactive Black 5 (12.9 U/mg). Moreover, CeuVP catalyzed the oxidation of α-pinene derived from the essential oil of Eucalyptus robusta to release verbenone as the sole metabolite after a 7 h incubation. Conclusions Versatile peroxidase ( CeuVP) from C. eurysporus VAST02.52 exhibits the highest specific activity against ABTS while also catalyzing oxidation of various substrates tested. Moreover, this study indicated that CeuVP could be effective in the bioconversion of α-pinene into verbenone, a promising compound with numerous applications in the flavors and fragrances industry.