bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cone beam computed tomography changes upon oral appliance therapy for adult patients with obstructive sleep apnea: A non-randomized clinical trial
Authors: Khasawneh Lina , Al Mortadi Noor , Abu-Ishqair Eslam , Khassawneh Basheer , Alzoubi Karem H. 
Published: October 2024

Background:
Obstructive sleep apnea (OSA) is caused by narrowing or obstruction of the airway lumen at single or multiple levels of the airway, starting from the nasal cavity up to the larynx. Oral appliance therapy for the management of OSA is prescribed as an alternative treatment option for patients with mild to moderate OSA who fail to adhere to Continuous Positive Airway Pressure (CPAP) therapy. Treatment with oral appliances addresses the craniofacial deficiencies that cause OSA by providing means to mandibular advancement and palatal expansion, thus opening the airways and potentially preventing airway collapse during sleep. Imaging the upper airway is employed to investigate the narrowing or the obstruction in the airway. Three-dimensional imaging modalities such as cone beam computed tomography (CBCT) allow for detecting obstructions before commencing treatment and for evaluating changes in the upper airway dimensions after treatment. To evaluate the effect of the biomimetic oral appliance therapy (BOAT) device on the airway measurements taken from a CBCT before and after treatment in correlation with the changes in the AHI.

Trial design:
A non-randomized clinical trial.

Methods:
About 17 patients with mild-moderate OSA (9 males, 8 females; age, mean [SD]: 45.76 [10.31]) underwent BOAT therapy. Subjects had 2 months of follow-up visits, including examinations for progress and adjustment of the appliances. The mean apnea–hypopnea index (AHI) with no appliance in the mouth before BOAT and after treatment was recorded. The midpalate screw mechanism of the appliance was advanced once per week. The subjects were asked to wear the appliance for 10 to 12 h/d and night. Pre and Post CBCT were taken. Paired T-test was used to analyze the results.

Results:
The treatment duration was 15.4 ± 6.3 months. Before treatment, at the diagnosis stage, the mean AHI of the sample (n = 17) was 24.0. After treatment, the mean AHI fell by 5% to 22.8% (P = .019), indicating enhanced upper airway functions. Airway measurements from the CBCT were not statistically significant despite improvement in the polysomnographic parameters.

Conclusion:
CBCT is a valuable tool for airway assessment and the determination of upper airway anatomic risk factors for OSA.
From apoptosis to pyroptosis: A two-decade analysis of spinal cord injury systematic review
Authors: Yang Rui , Guo Yuhuai , Yin Hongna 
Published: October 2024

Background:
Spinal cord injury has a significant impact on patients’ physical and mental health, with cell death playing a key role in the pathology.

Methods:
The Web of Science Core Collection database was searched and screened according to inclusion criteria for publications between January 1, 2000 and December 31, 2023. Bibliometric analysis was conducted using bibliomatrix R-package, CiteSpace, and VOSviewer software.

Results:
A total of 2309 publications were identified, with a stable growth in the first 13 years and accelerated growth in the past decade, indicating an increasing trend in this field. These publications on cell death after spinal cord injury originated from 251 countries/regions. China contributed the most publications, with funding support primarily from China, and Wenzhou Medical University in China being the leading institution with the highest number of publications. Salvatore Cuzzocrea was the most influential author. The research direction in this field after 2000 mainly focused on topics such as apoptosis, autophagy, mesenchymal stem cells, mammalian target of rapamycin pathway, ferroptosis, functional recovery, neuronal regeneration, and NOD-like receptor protein 3.Current hot topics and future research trends revolve around extracellular vesicles including exosomes, extracellular vesicle-mediated mesenchymal stem cells, microRNA, autophagy, NOD-like receptor protein 3 inflammasome-mediated cell pyroptosis, and mechanisms of glial scar formation.

Conclusion:
Publications in this field have grown rapidly in the past 2 decades and are expected to keep increasing. Current hot topics include mesenchymal stem cells, apoptosis, autophagy, and ferroptosis. Future research will focus on extracellular vesicle-mediated mesenchymal stem cells, autophagy, inflammasome-mediated cell pyroptosis, and glial scar formation.
Appropriate linear stapler selection for avoiding postoperative pancreatic fistula after distal pancreatectomy: A retrospective cohort study
Authors: Naito Kei , Shinmura Kazuyasu , Suzuki Takayuki , Maeda Shintaro , Kuboki Satoshi , Ohtsuka Masayuki 
Published: October 2024

Background:
Despite the progress in surgical techniques and perioperative managements, the incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) remains high. Recently, pancreatic dissection using a linear stapler has been widely performed; however, risk factors influencing the occurrence of POPF after DP using a liner stapler is not fully understood. The purpose of this paper was to evaluate whether the relations between staple height and pancreatic thickness or main pancreatic duct (MPD) diameter influenced the incidence of POPF.

Methods:
Patients who underwent DP without other organ resections between 2015 and 2022 were retrospectively reviewed. Compression Index (CI) was defined as staple height/pancreatic thickness, and Suturing Index (SI) was defined as staple height/ MPD diameter.

Results:
In 51 patients undergoing DP, 16 patients (31.4%) developed POPF. ROC analyses revealed that lower CI and higher SI significantly increased the incidence of POPF, and the cutoff values were 0.186 and 0.821, respectively. Univariate and multivariate analyses revealed that CI ≤ 0.186 and SI ≥ 0.821 were independent risk factors for POPF after DP. Moreover, the incidence of POPF in patients fulfilling both CI > 0.186 and SI < 0.821 was 5.9%, which was extremely lower than in those without fulfilling the criteria (44.1%), suggesting that this new criteria in combination with CI and SI was an excellent predictor of POPF.

Conclusions:
It is possible that stapler cartridge selection using our new criteria in combination with CI and SI may reduce the incidence of POPF.
Diagnosis and treatment of 2 cases with cryptogenic stroke due to patent foramen ovale in children: A case report
Authors: Gong Jie , Zhang Huayong , Li Changjian , Zhang Yong 
Published: October 2024

Rationale:
Arterial ischemic stroke is a general term for necrosis of brain tissue due to insufficient blood supply to the brain from various causes. About 30% of these cases are of unknown origin and are known as cryptogenic strokes (CS).

Patient concerns:
We report 2 female patients, one 5 years and 5 months old and the other 6 years old. Both children had clinical manifestations of CS, and after ruling out other possible etiologies, we finally suspected that CS was associated with patent foramen ovale (PFO).

Diagnoses:
Case 1 was diagnosed with PFO, paradoxical embolism, and third-degree atrioventricular block, and case 2 was diagnosed with PFO, paradoxical embolism, and refractory mycoplasma pneumonia.

Interventions:
Case 1 underwent permanent pacemaker placement at the same time as PFO closure. Case 2 underwent conservative anticoagulation with poor therapeutic results and subsequently underwent PFO closure.

Outcomes:
Patient 1 underwent PFO closure, which resulted in relief of neurologic symptoms and no recurrence of neurologic symptoms after 10 months of follow-up. In case 2, the child’s neurologic symptoms improved after PFO closure.

Lessons:
Although most children with PFO do not require targeted interventions, a few cases involving PFO and CS may benefit from closure of the foramen ovale.
Bibliometric analysis of chondrocyte apoptosis in knee osteoarthritis
Authors: Zhang Hongxing , Yang Yao , Gao Minglei , Peng Jiafeng , Li Danyang , Zhu Junchen 
Published: October 2024

Background:
Apoptosis, a form of programmed cell death, plays a significant role in osteoarthritis; however, bibliometric studies in this field remain scarce. Bibliometrics provides a visual representation of research outcomes and trends, guiding future investigations.

Method:
Journal data from January 1, 2013, to December 31, 2023, in this field were obtained from the Web of Science (WOS) core database. Analysis was conducted using VOSviewer and CiteSpace.

Results:
Analysis revealed that over the past decade, 794 articles were published in 299 journals by 4447 authors from 49 countries and 877 institutions. The top contributors were China, the United States, and the United Kingdom. Zhuang Chao emerged as the most prolific author, and “osteoarthritis and cartilage” ranked as the most frequently cited journal. Keyword clustering focused on mechanisms, inflammation, and cartilage. The most-cited article was “chondrocyte apoptosis in the pathogenesis of osteoarthritis” in the “International Journal of Molecular Sciences.” Burst word analysis highlighted extracellular matrix, circular RNA, micro RNA, indicating current research hotspots.

Conclusion:
Utilizing bibliometrics and visual analysis, we explored the hotspots and trends in the field of chondrocyte apoptosis in osteoarthritis. Extracellular matrix, Circular RNA, Micro RNA, among others, are likely to become future research focal points and frontiers.
The mechanism of quercetin in treating intracerebral hemorrhage was investigated by network pharmacology and molecular docking
Authors: Zhang Zi-You , Lv Xiao-Yu , Zhou Xin-Pei , Xiang Hai-Tao , He Yu-Song , Li Xu-Yang , Yan Ting-Ting , Zhong Yang-Yang , Li Zhuang , Zhang Ben-Si 
Published: October 2024

Background:
The aim of this study was to explore the molecular mechanism of quercetin in the treatment of intracerebral hemorrhage.

Methods:
Quercetin target genes and intracerebral hemorrhage target genes were collected from 5 databases. After standardized conversion of the obtained target genes through uniprot database, cross genes of the 2 were obtained using Venny 2.1 online tool. Further, protein interaction relationships were obtained in the String database, and then core target genes were screened and visualized by Cytoscape software, and cross genes were enriched by GO and KEGG pathways. Finally, the active drug ingredients and target proteins were verified and visualized by computer.

Results:
In this study, 197 quercetin targets were identified as potential targets for the treatment of intracerebral hemorrhage, and 7 core target genes (TP53, STAT3, AKT1, SRC, JUN, TNF, and IL6) were screened. The GO and KEGG analyses further shed light on the molecular mechanisms underlying quercetin’s treatment of intracerebral hemorrhage, involving multiple biological processes and signaling pathways (such as cancer pathways, lipids, and atherosclerosis). The stable binding of quercetin to these 7 key targets was confirmed by molecular docking simulation.

Conclusion:
Quercetin may treat intracerebral hemorrhage through multi-target-multi-pathway mechanisms, including regulating apoptosis, inhibiting inflammatory response, inhibiting iron death, and regulating angiogenesis, which can help alleviate nerve damage caused by intracerebral hemorrhage
The prognostic role of survivin expression in breast cancer: A systematic review and meta-analysis
Authors: Bolat Kucukzeybek Betul , Kucukzeybek Yuksel , Basbinar Yasemin , Ellidokuz Hulya , Tekindal Mustafa Agah , Dinckal Cigdem , Tarhan Mustafa Oktay 
Published: October 2024

Background:
Breast cancer is a heterogeneous condition with variations in histopathological, genomic, and biological characteristics. Although clinicopathological prognostic factors and gene expression profiles are commonly used to guide treatment decisions in patients with breast cancer, there is still a need for new prognostic markers. One potential marker is survivin, a protein belonging to the apoptosis inhibitor family. However, studies examining the relationship between survivin and prognosis in breast cancer have yielded inconsistent results. This study aimed to evaluate the impact of survivin expression on the prognosis of breast cancer patients through a meta-analysis.

Methods:
Studies evaluating survivin expression were sourced from the PubMed, Embase, and Cochrane databases. We conducted a meta-analysis based on full-text articles that evaluated the relationship between survivin expression and survival by immunochemistry or polymerase chain reaction. The studies were initially divided into 2 groups based on the evaluation of overall survival (OS) and disease-free survival (DFS). Subsequently, each group was further categorized according to the method used to detect survivin expression. Statistical analyses for this study were conducted using Stata and JAMOVI.

Results:
After screening with keywords, we identified 24 retrospective studies evaluating OS and 15 retrospective studies evaluating DFS, which were included in the analysis. We found that the studies in the meta-analysis were not heterogeneous, and this remained consistent when categorizing the groups by survivin expression detection. Survivin expression was associated with OS (HR 1.23, 95% CI 0.81–1.65) and DFS (HR 0.89, CI 0.42–1.36), indicating poor prognosis. This significant relationship between survivin expression and survival persisted when the studies were categorized by the detection method, either immunohistochemistry or polymerase chain reaction.

Conclusion:
In this study, we evaluated the prognostic significance of survivin expression in patients with breast cancer through a meta-analysis. These results support the use of survivin expression as a prognostic marker in breast cancer, potentially guiding treatment decisions.
Fatal Zargar grade 3b corrosive injury after hydrochloric acid ingestion: A case report
Authors: Yu Ching-Hsiang , Su Yu-Jang , Lai Yen-Chun 
Published: October 2024

Rationale:
Caustic substance ingestion is an emergency and life-threatening condition as it leads to tissue damage, acidosis, and multiorgan failure. This study presents a case report of hydrochloric acid ingestion and notably dark-red urine output due to acute tubular necrosis.

Patient concerns:
A 59-year-old male presented with attempted suicide by ingesting 500 mL of hydrochloric acid (37%), and complained of severe abdominal pain and shortness of breath. Upon arrival, his vital signs showed a temperature of 34.3°C, blood pressure of 104/77 mm Hg, a pulse rate of 135 beats per minute, and the Glasgow Coma Scale E4V2M6. Following Foley catheter insertion, dark, bloody urine resulting from acute tubular necrosis was observed. His creatinine level was 1.1 mg/dL, and urinalysis showed 38 red blood cells per high-power field. Arterial blood gas analysis revealed metabolic acidosis.

Diagnoses:
The patient’s condition rapidly deteriorated in the emergency room, revealing diffuse circumferential ulceration with necrosis in the esophagus (Zargar score grade 3b). An exploratory laparotomy was performed for acidosis with intractable shock, revealing up to 1500 mL of bloody ascites, and ischemic changes with loss of peristalsis throughout the small bowel to the cecum.

Interventions:
Esophagostomy with T-tube insertion was performed. Notably, stomach necrosis with perforation was identified, prompting a surgical consultation for primary perforation closure.

Outcomes:
During the operation, the patient experienced hemodynamic instability. The family confirmed the “Do Not Resuscitate” status, and he died in a critical state.

Lessons:
For corrosive injuries, early endoscopy was crucial in assessing the extent of the damage and guiding treatment in this patient. It is essential to perform an early endoscopic examination in cases of acute nephrotoxic tubular necrosis following hydrochloric acid ingestion. Surgical intervention is warranted if necrosis is detected in the corrosive tissue.
Knowledge of emergency nurses and related factors toward geriatric: a cross-sectional study
Authors: Asri Azam Al-Sadat , Yeganeh Rastekanary Mohammad Reza , Maroufizadeh Saman , Ghorbani Vajargah Pooyan , Karkhah Samad , Javadi-Pashaki Nazila 
Published: October 2024

Background:
This study aimed to evaluate the geriatric knowledge of emergency nurses and related factors.

Materials and methods:
This cross-sectional study was conducted on nursing students at Guilan University of Medical Sciences in Iran. The objective was to assess the geriatric knowledge of nurses working in the emergency departments of educational and therapeutic centers in Rasht City. The sample was selected through a census sampling method, including all nurses employed in these departments. Data collection was carried out using a three-part questionnaire, which included sections on ‘personal and occupational characteristics’ and the ‘Questionnaire of Awareness about the Facts of Aging (FAQ)’.

Results:
A total of 190 emergency department nurses participated in this study. The mean age of the participants was 34.41 years (SD=6.37). The mean score for geriatric knowledge among the nurses was 6.58 (SD=2.24). No statistically significant associations were found between geriatric knowledge and the personal or occupational variables of the nurses. Also, the results showed that changes in nurses’ geriatric knowledge are explained to a small extent through personal and occupational characteristics.

Conclusion:
Overall, these results highlight the urgent need for targeted interventions to improve emergency nurses’ understanding of geriatric care. Furthermore, given the lack of significant correlations with demographic and occupational variables, future research should investigate additional factors that may influence emergency nurses’ knowledge in this area.
Solid-pseudopapillary neoplasm of the pancreas in a 12-year-old female: case report
Authors: Yadav Kundan Kumar , Yadav Krishna , Adhikhari Binaya , Yadav Pratibha , Yadav Prashant 
Published: October 2024

Introduction and importance:
A solid-pseudopapillary tumor of the pancreas is a rare solid neoplasm. It is an uncommon exocrine tumor that accounts for 1–3% of exocrine pancreatic tumors.

Case presentation:
The authors have reported two cases of solid-pseudopapillary neoplasm of the pancreas with a median age of 12 years, both in females with abdominal pain.

Clinical discussion:
Both cases are in females with different treatment modalities. The patient underwent distal pancreatectomy in the first case and enucleation of mass from the distal pancreas in the second case because the size of the tumor is 5 cm and does not involve the bile duct and major pancreatic duct.

Conclusion:
The authors discussed two cases of solid-pseudopapillary neoplasm of the pancreas both in a 12-year-old female—both the patients presented with abdominal pain. The patient underwent a different treatment. The diagnosis was confirmed by radiological investigation through non-contrast and contrast CT and supported by histopathology findings.
Fournier’s gangrene in voluminous inguinoscrotal herniation: Case report and review of literature
Authors: Pereira Magnum Adriel Santos , Lopes de Castro Gustavo , Freitas Jorge Barros , Martins Lincoln José Trindade , Filó Maitê Salem , Barroso André Renato Moura 
Published: October 2024

Introduction:
Fournier’s gangrene (FG) is a polymicrobial life-threatening infection that affects perineal region and may extend to genitalia and abdominal wall. Necrotizing fasciitis is a rare condition and its association with large inguinoscrotal hernia even rarer. With high mortality rate, some predisposing factors are diabetes and immunodeficiency.

Case presentation:
We report a case of a 48-year-old man with Fournier’s gangrene associated with voluminous inguinoscrotal herniation which evolved to hernia sac exposure after debridement.

Discussion:
FG pathophysiology initiates with a localized infection by a combination of gram positive, gram negative and anaerobic bacteria, and its advancing leads to local inflammatory response, thrombosis, blood flow reduction and ischemia. Diagnosis depends on clinical presentation and image evaluation.

Conclusion:
FG management has been standard in the literature, however its association with inguinoscrotal hernias have not been considered in guidelines. Early diagnosis and proper clinical and surgical treatment are fundamental to avoid life-threatening complications and morbidities.
Risk of second primary cancers in nodal non-Hodgkin lymphoma patients by primary lymph node location: a retrospective cohort population-based study
Authors: Hemade Ali , Hallit Souheil 
Published: October 2024

Background:
Non-Hodgkin lymphoma (NHL) is a diverse group of blood cancers with increasing incidence and survival rates due to advancements in treatment and early detection. However, NHL survivors are at significant risk of developing second primary cancers, which can adversely impact their long-term survival.

Methods:
This retrospective population-based cohort study utilized data from the Surveillance, Epidemiology, and End Results database, covering 17 geographic areas in the United States from 2000 to 2021. The authors included patients diagnosed with nodal NHL as a first primary cancer and excluded those diagnosed at autopsy or via death certificate only. Standardized Incidence Ratios, Absolute Excess Risks, and Person-Years at Risk were calculated to evaluate the risk of developing SPCs according to the primary lymph node site and stratified by latency periods following the initial NHL diagnosis.

Results:
The cohort included 54 012 NHL patients. The authors’ results showed that for most SPCs, the risk of development was different for different primary NHL lymph node locations. The highest risks were observed for thyroid cancer, acute myeloid leukemia, and Hodgkin lymphoma. Notably, the risk for thyroid cancer was highest in the first year post-diagnosis, while hematological malignancies such as acute myeloid leukemia and Hodgkin lymphoma showed elevated risks in the intermediate and late latency periods.

Conclusion:
NHL survivors are at an increased risk of developing SPCs, influenced by the primary lymph node site and latency period. These findings highlight the need for tailored surveillance strategies and preventive measures to mitigate the long-term risks of SPCs in NHL survivors. Further research is necessary to elucidate the underlying mechanisms and to develop targeted interventions for this high-risk population.