bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinically relevant findings on 24-h head CT after acute stroke therapy: The 24-h CT score
Authors: Zhang Bowei , King Andrew J , Voetsch Barbara , Silverman Scott , Schwamm Lee H , Ji Xunming , Singhal Aneesh B 
Published: September 2024

Background: Routine head computed tomography (CT) is performed 24 h post-acute stroke thrombolysis and thrombectomy, even in patients with stable or improving clinical deficits. Predicting CT results that impact management could help prioritize patients at risk and potentially reduce unnecessary imaging. Methods: In this institutional review board (IRB)-approved retrospective study, data from 1461 consecutive acute ischemic stroke patients at our Comprehensive Stroke Center (n = 8943, 2012–2022) who received intravenous thrombolysis or endovascular therapy, exhibited stable or improving 24-h exams, and underwent 24-h follow-up head CT per standard acute stroke care guidelines. CT reports 24 h post-stroke were reviewed for edema, mass effect, herniation, and hemorrhage. The primary outcome was any clinically relevant 24-h CT finding that led to changes in antithrombotic treatment or blood pressure goals, extended intensive care unit (ICU) stays or hospitalizations, neurosurgical interventions, or administration of mannitol or hypertonic saline. Multivariable logistic regression identified independent predictors of clinically meaningful CT abnormalities. A 24-h CT score was developed and cross-validated. Results: The mean age was 70 years, with 47% women. The median National Institutes of Health Stroke Scale (NIHSS) score at admission was 12 (interquartile range (IQR): 6–18). Stroke-related abnormalities on 24-h CT were present in 325 patients (22.2%), with 183 (12.5%) showing clinically relevant findings. Age, admission NIHSS, and blood glucose levels were independent predictors of clinically relevant 24-h CT findings. The final model C statistic was 0.72 (95% confidence interval (CI): 0.68–0.76) in the derivation cohort and 0.72 (95% CI: 0.67–0.75) in bootstrapping validation. The 24-h CT score was developed using these predictors: NIHSS score 5–15 (+3); NIHSS score ⩾16 (+5); age < 75 years (+1); admission glucose ⩾ 140 mg/dL (+1). The prevalence of clinically relevant CT findings was 4.3% in the low-risk group (24-h CT score ⩽ 4), 11.3% in the medium-risk group (score 5), and 21.4% in the high-risk group (score ⩾ 6). The 24-h CT score demonstrated good calibration. Conclusion: In patients undergoing thrombolysis or thrombectomy who undergo routine 24-h head CT despite remaining clinically stable or improving, only one in eight prove to have 24-h head CT findings that impact management. The 24-h CT score provides risk stratification that may improve resource utilization. Data access statement: A.S. and B.Z. have full access to the data used in the analysis in this article. Deidentified data will be shared after ethics approval if requested by other investigators for purposes of replicating the results.
A comparison of McGrath video laryngoscope and Macintosh laryngoscope during nasotracheal intubation: A randomised controlled study
Authors: Gangishetty Alekhya , Jonnavithula Nirmala , Geetha Singam , Muthyala Harshini , Peetha Hareesh 
Published: September 2024

Background: Nasotracheal intubation is challenging for anaesthesiologists in faciomaxillary injuries due to the anticipated difficult airways. The effectiveness of a non-channelled McGrath video laryngoscope was compared with a conventional Macintosh laryngoscope during nasotracheal intubation. Methods: Sixty American Society of Anaesthesiologists I–II patients aged between 18 and 60 years of both sexes undergoing elective faciomaxillary surgeries from September 2019 to February 2020 were prospectively randomised into two groups (Macintosh laryngoscope Group, McGrath video laryngoscope Group) of 30. The primary outcome was ease of intubation (Modified Intubation Difficulty Scale) and Nasotracheal intubation time (T1 time: from nostril to nasopharynx, T2 time: from nasopharynx until the first ETCO2, total time: T1 + T2). The secondary outcomes were Cormac Lehane grade, additional manoeuvres requirement, intubation failure, tracheostomy incidence and associated complications. Results: T1, T2 and total (T1 + T2) time (mean ±  SD) were statistically prolonged in the McGrath video laryngoscope than Macintosh laryngoscope group, with p = 0.044, p = 0.000 and p = 0.000, respectively. The McGrath video laryngoscope facilitated a better laryngoscopic view (p = 0.002), favourable intubation difficulty scale scores, less lifting force (p = 0.002), reduced lip trauma (p = 0.002) and decreased Magill’s forceps use (p = 0.002) than the Macintosh laryngoscope group. Conclusion: Despite longer intubation time, the non-channelled McGrath video laryngoscope offered favourable intubating conditions with superior glottis view, less lifting force and reduced Magill’s forceps requirement, causing decreased airway trauma, lower intubation difficulty scale scores than Macintosh laryngoscope for nasotracheal intubation.
Bowel preparation after mid-gut tubing enhanced the efficacy and compliance of magnetic resonance enterography in Crohn’s disease: a randomized controlled trial
Authors: Wang Yun , Dai Min , Zheng Minghui , Jin Yan , Wen Quan , Cui Bota , Zhang Zulun , Zhu Jianguo , Zhang Faming 
Published: September 2024

Background: Magnetic resonance enterography (MRE) has become a routine intestinal imaging examination for Crohn’s disease (CD). Sufficient bowel preparation is fundamental for MRE. Objectives: To compare the efficacy and compliance of bowel preparation between through a mid-gut tube and oral administration for MRE in CD. Design: This was an open-label, prospective, multicenter, randomized controlled trial. Methods: Eligible patients were randomized at a 1:1 ratio into an oral group (bowel preparation by oral administration) and a tubing group (bowel preparation through a mid-gut tube). Bowel preparation for MRE included bowel cleaning and bowel distention. The primary outcomes were the degree of discomfort and grade of bowel distention. The secondary outcomes were diagnostic accuracy rate through MRE, mental stress, and bowel preparation method preference. Results: A total of 95 CD patients were included in the final analysis. Subjects in the tubing group complained of less vomiting during bowel preparation than those in the oral group ( p < 0.05). The degree of nausea and bloating during bowel cleaning for MRE was lower in the tubing group than in the oral group (all p < 0.05). The distention grade was higher in the tubing group compared to the oral group in the splenic flexure of the colon and rectosigmoid colon. The tubing group demonstrated a higher overall diagnostic sensitivity in ulcers compared to the oral group ( p = 0.048). Additionally, bowel preparation via the mid-gut tube ameliorated mental stress ( p = 0.020) and increased bowel preparation preference ( p < 0.001). Conclusion: Bowel preparation through the mid-gut tube enhanced the efficacy and compliance for MRE in CD. This study highlighted the concept of physician-patient satisfaction using mid-gut tube for proper bowel preparation for MRE, enteral nutrition and microbial therapy. Trial registration: ClinicalTrials.gov, NCT03541733, registered 5 May 2018.
A comprehensive prediction model of drug-refractory epilepsy based on combined clinical-EEG microstate features
Authors: Zhang Jinying , Zhu Chaofeng , Li Juan , Wu Luyan , Zhang Yuying , Huang Huapin , Lin Wanhui 
Published: September 2024

Background: Epilepsy is a chronic neurological disorder characterized by recurrent seizures that significantly impact patients’ quality of life. Identifying predictors is crucial for early intervention. Objective: Electroencephalography (EEG) microstates effectively describe the resting state activity of the human brain using multichannel EEG. This study aims to develop a comprehensive prediction model that integrates clinical features with EEG microstates to predict drug-refractory epilepsy (DRE). Design: Retrospective study. Methods: This study encompassed 226 patients with epilepsy treated at the epilepsy center of a tertiary hospital between October 2020 and May 2023. Patients were categorized into DRE and non-DRE groups. All patients were randomly divided into training and testing sets. Lasso regression combined with Stepglm [both] algorithms was used to screen independent risk factors for DRE. These risk factors were used to construct models to predict the DRE. Three models were constructed: a clinical feature model, an EEG microstate model, and a comprehensive prediction model (combining clinical-EEG microstates). A series of evaluation methods was used to validate the accuracy and reliability of the prediction models. Finally, these models were visualized for display. Results: In the training and testing sets, the comprehensive prediction model achieved the highest area under the curve values, registering 0.99 and 0.969, respectively. It was significantly superior to other models in terms of the C-index, with scores of 0.990 and 0.969, respectively. Additionally, the model recorded the lowest Brier scores of 0.034 and 0.071, respectively, and the calibration curve demonstrated good consistency between the predicted probabilities and observed outcomes. Decision curve analysis revealed that the model provided significant clinical net benefit across the threshold range, underscoring its strong clinical applicability. We visualized the comprehensive prediction model by developing a nomogram and established a user-friendly website to enable easy application of this model ( https://fydxh.shinyapps.io/CE_model_of_DRE/ ). Conclusion: A comprehensive prediction model for DRE was developed, showing excellent discrimination and calibration in both the training and testing sets. This model provided an intuitive approach for assessing the risk of developing DRE in patients with epilepsy.
Low pre-immunotherapy forced vital capacity is associated with poor outcomes in non-small cell lung cancer patients receiving immunotherapy regardless of prior treatment history
Authors: Lim Jeong Uk , Kang Hye Seon , Yeo Chang Dong , Kim Ju Sang , Kim Sung Kyoung , Kim Jin Woo , Kim Seung Joon , Lee Sang Haak 
Published: September 2024

Background: Many patients with lung cancer have underlying chronic lung diseases. We assume that baseline lung functions might also affect the prognosis of non-small cell lung cancer (NSCLC) patients receiving immunotherapy. Objectives: We aimed to assess the impact of pretreatment clinical parameters, including lung function measures such as forced vital capacity (FVC), on the prognosis of patients with NSCLC following immune checkpoint inhibitors (ICIs) therapy. Design: Retrospective multicenter study. Methods: Study subjects were consecutively selected from a multicenter cohort of patients with NSCLC who were undergoing immunotherapy. Patients were selected regardless of their initial cancer stage and prior treatment. The primary outcome was immunotherapy-related overall survival (iOS), defined as the duration from the initiation of immunotherapy to the time patients were censored. Spirometry values were acquired before bronchodilator application and were performed within the year before the first ICI treatment Results: We selected 289 patients for evaluation. The median iOS was 10.9 months (95% confidence interval (CI), 7.5–14.3). Programmed death-ligand 1 (PD-L1) expression, tested by SP263, was <1% in 20.9%, 1%–49% in 44.3%, and ⩾50% in 32.6% of the patients. ICI was used most often as second-line treatment (70.2%), followed by first line (13.1%), and third line (11.4%). In the Kaplan–Meier analysis, the median iOS of the low FVC group was significantly shorter than that in the preserved FVC group (6.10 (95% CI, 4.45–7.76) months vs 14.40 (95% CI, 10.61–18.34) months, p < 0.001)). A Cox regression analysis for iOS showed that age, poor performance status, PD-L1 expression measured by SP263, stage at diagnosis, and FVC (% predicted) were independent predictive factors. When we replaced FVC (%) in the multivariable analysis with forced expiratory volume in 1 s (%), diffusing lung capacity for carbon monoxide (DLco; %), or DLco (absolute), each of the pulmonary function factors showed a significant association with iOS. Conclusion: Pre-immunotherapy FVC (%) predicted immunotherapy-related outcomes in NSCLC patients, regardless of initial stage at diagnosis and prior treatment modalities.
Regenerative Variability of Human Juvenile Chondrocyte Sheets From Different Cell Donors in an Athymic Rat Knee Chondral Defect Model
Authors: Matsukura Keisuke , Kondo Makoto , Metzler Nicolas F. , Ford Adam J. , Maak Travis G. , Hutchinson Douglas T. , Wang Angela A. , Sato Masato , Grainger David W. , Okano Teruo 
Published: September 2024

Purpose This study aimed to establish a combined histological assessment system of neo-cartilage outcomes and to evaluate variations in an established rat defect model treated with human juvenile cartilage-derived chondrocyte (JCC) sheets fabricated from various donors. Methods JCCs were isolated from the polydactylous digits of eight patients. Passage 2 (P2) JCC sheets from all donors were transplanted into nude rat chondral defects for 4 weeks (27 nude rats in total). Defect-only group served as control. Histological samples were stained for safranin O, collagen 1 (COL1), and collagen 2 (COL2). (1) All samples were scored, and correlation coefficients for each score were calculated. (2) Donors were divided into “more effective” and “less effective” groups based on these scores. Then, differences between each group in each category of modified O’Driscoll scoring were evaluated. Results (1) Modified O’Driscoll scores were negatively correlated with %COL1 area, and positively correlated with %COL2 area and COL2/1 ratio. (2) Four of 8 donors exhibited significantly higher modified O’Driscoll scores and %COL2 areas. JCC donors were divided into two groups by average score values. Significant differences between the two groups were observed in modified O’Driscoll categories of “Nature of predominant tissue,” “Reconstruction of subchondral bone,” and “Safranin O staining.” Conclusion The combined histological evaluation method is useful for detailed in vivo efficacy assessments of cartilage defect regeneration models. Variations in histological scores among juvenile cartilage-derived chondrocyte donors were correlated to the quality of regenerated cartilage hyaline structure and subchondral bone remodeling observed in the nude rat defect model.
Successful correction of flat-chested kitten syndrome in two littermate kittens
Authors: Fusi Jasmine , Bagardi Mara , Bassi Jessica , Ferrari Francesco , Veronesi Maria Cristina 
Published: September 2024

Case summary Two 18-day-old domestic shorthair kittens presented with dyspnoea, mild cyanosis, heart murmur, lung pattern, abnormal crawling and a marked dorsoventral flattening of the thorax. Deformity of the thoracic wall without pectus excavatum was diagnosed. Cardboard corsets tailored to each kitten were applied. This gave immediate respiratory relief, easing distress and pain. After 10 days, clinical and radiographic monitoring revealed normalisation of the shape of the chest wall with an improvement in general condition. At 6 months of age, clinical examination showed normal growth and development of both kittens, with a normal thoracic profile and shape also seen on radiographs. Relevance and novel information Data about flat-chested kitten syndrome and its aetiopathogenesis, treatment and outcome are scarce, but there is significant experience among breeders that is shared through online communities. High mortality rates are reported. The use of a cardboard splint appears to be novel in the published literature; in this case report, it proved to be a rapid and easy solution. For this reason, cardboard splints could be considered as a first approach for the clinical management of flat-chested kitten syndrome.
Transforaminal Endoscopic Decompression Alone Versus Limited Decompression/Fusion in the Treatment of Adult Degenerative Scoliosis: A Retrospective Study
Authors: Zhang Yao , Lin Wancheng , Lian Xin , Ding Lixiang , Song Jipeng 
Published: September 2024

Study Design A retrospective study. Objectives To investigate and compare the clinical and radiographical outcomes of endoscopic decompression alone and limited decompression/fusion surgery in the treatment of adult degenerative scoliosis (ADS). Methods Follow-up data of 53 patients with lower limb radiculopathy associated with ADS who underwent focal surgical treatment were collected (endoscope group: 31 patients treated by transforaminal endoscopic decompression alone; fusion group: 22 patients who underwent limited decompression/fusion). The following data were retrospectively analyzed and compared between the two group: the demographics, Lenke-Silva level, radiographic parameters, surgical data, visual analogue scale (VAS) for back/leg pain, the Oswestry disability index (ODI), and the modified MacNab criteria. Results The mean follow-up period was 15.68 ± 3.26 months. The most frequent Lenke-Silva level was I in the endoscope group, and III in the fusion group. Preoperative Cobb angle in the endoscope group was significantly lower than that in the fusion group (23.92 ± 9.06 vs 39.58 ± 13.12, P < 0.05). All patients exhibited improved VAS and ODI scores postoperatively ( P < 0.05). At the last follow-up, the Cobb angle had progressed by 1.51° in the endoscope group, whereas radiographic parameters were significantly improved in the fusion group. The reoperation and complication rate in the endoscope group were lower than those in the fusion group. The satisfaction rate post-surgery was comparable between the two groups. Conclusions For patients with focal ADS, both limited decompression/fusion and transforaminal endoscopic decompression are viable treatment options. Advanced transforaminal endoscopic techniques enable effective decompression of the symptomatic foramen with minimal complication risk and negligible deformity progression, even in cases of significant scoliosis. While limited fusion surgery can achieve comparable clinical outcomes, it offers inferior deformity correction.
Impact of Sexual Cognition and Sexual Anxiety on the Mental Health of Married and Unmarried Population in India
Authors: Jaisawal Manish Kumar , Kumari Rajbala , Rai Gaurav Kumar 
Published: September 2024

Background: Negative sexual cognition and sexual anxiety create a substantial amount of distress and guilt in an individual, which in turn can lead to reduced well-being. However, the impact of sexual cognition and sexual anxiety on mental health are less researched topics, especially in the Indian context. Aim: To investigate the effect of sexual cognition and sexual anxiety on mental health. Method: 124 participants of age range 18–35 years were recruited using purposive sampling method. Sexual Cognition Checklist, Sexual Anxiety Inventory, and Mental Health Inventory were used to assess sexual cognition, sexual anxiety, and mental health respectively. Results: Mental health was significantly negatively associated with sexual anxiety and negative sexual cognition. Also, a significant positive correlation was found between positive sexual cognition and mental health. Negative sexual cognition and sexual anxiety emerged as significant predictors, accounting for approximately 20% and 6% of the variance in mental health, respectively. Finally, an independent sample t-test suggests that males and females significantly differ in their level of sexual cognition, mental health, and sexual anxiety. Conclusions: Negative sexual cognition and sexual anxiety are associated with poor mental health while positive sexual cognition is associated with better mental health. Unmarried Indian women tend to experience more negative sexual cognition and sexual anxiety than married women.
Inflammatory plasma protein levels are elevated years before sarcoidosis diagnosis: a nested case–control study in Sweden
Authors: Arkema Elizabeth V. , Sachs Michael C. , Dominicus Annica , Eklund Anders , Smed-Sörensen Anna , Grunewald Johan , Blomberg Anders 
Published: September 2024

BackgroundSarcoidosis is an immune-mediated inflammatory disease whose natural development is not well understood. We aimed to determine if inflammatory plasma protein levels are elevated before sarcoidosis diagnosis compared to controls. Furthermore, we investigated which proteins are increased and how long before diagnosis they are increased.MethodsCases with sarcoidosis and controls matched 2:1 on sex, birthdate, subcohort and sample date were identified in the Northern Sweden Health and Disease Study to perform a nested case–control study. Cases were validated and included if they provided one or more plasma samples at least 2 years before sarcoidosis diagnosis. Plasma protein levels were measured using the Olink Inflammation panel and expressed in normalised protein expression values. Unconditional logistic regression models adjusted for age, sex, subcohort and time since sampling were used to estimate log odds ratios with 95% confidence intervals for each protein overall and by time to diagnosis. p-values were adjusted for multiple comparisons using the Benjamini–Hochberg method.ResultsWe included 152 cases and 341 controls. Mean time between sample and sarcoidosis diagnosis was 13.4 years. 44 proteins were significantly elevated prior to sarcoidosis compared to controls in multivariable-adjusted analyses. The 10 proteins with the lowest p-values were CCL-3, CCL-19, cub domain-containing protein 1, CXCL9, CXCL10, interferon-γ, interleukin-12B, monocyte chemoattractant protein-3, tumour necrosis factor (TNF), and TNF receptor superfamily 9. Fewer proteins were associated with sarcoidosis in samples taken longer before diagnosis. Restricting to samples taken ≥10 years prior to sarcoidosis diagnosis, 27 proteins remained statistically significant.ConclusionSeveral inflammatory proteins were elevated in plasma many years before sarcoidosis onset compared to controls, revealing a pre-clinical phase characterised by inflammation.