bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased activation of the WNT pathway in brain tissue from patients with cortical dysplasia type IIb: genetics and functional aspects
Authors: Varella Fabio Jean , Xavier Fernando Antônio Costa , Zanirati Gabriele , Gonçalves João Ismael Budelon , Previato Thales Thor Ramos , Pazzin Douglas Bottega , Pereira-Neto Normando G. , Paglioli Eliseu , Martins William Alves , Palmini Andre , Santos Adriana Souza dos , Abreu José Garcia , Leichtweis Kamila Souto , Machado Denise C. , Costa Jaderson Costa , Marinowic Daniel Rodrigo 
Published: October 2024

Abstract

Focal Cortical Dysplasia (FCD) is a malformation of cortical development characterized by a heterogeneous group of lesions with high epileptogenic activity. The origin of FCD may be related to neuronal proliferation and differentiation, with the Wnt/β-catenin pathway being one of the main factors responsible for mediating these processes. Residual samples were obtained from the neocortex of five patients diagnosed with FCD type IIb who underwent surgery. For the control group, residual samples from patients with hippocampal sclerosis (HS) were used. The samples were used to evaluate relative gene expression levels, immunohistochemical characteristics, and the quantification of proteins related to the WNT pathway by Western blot. Gene expression analysis showed increased fold-changes in the genes LRP5, LRP6, DKK1, and DVL1. Immunohistochemistry analysis revealed that the FCD brain samples exhibited more staining for LRP6 compared to control brain tissue. All patients with FCD showed stronger staining for β-catenin. The increased gene expression of WNT pathway genes, combined with the intensified anti-LRP6 antibody staining and increased β-catenin staining, along with the reduced rate of β-catenin phosphorylation observed in patients with FCD, suggests a more pronounced activation of the WNT pathway.
Exploring the Correlation between Seizure Control and Serum Levels of Antiepileptic Drugs in Pediatric Patients with Epilepsy in Ethiopia: A Retrospective Cross-Sectional Study
Authors: Mante Bamlak Markos , Beyene Ayalew Moges , Lamboro Meskerem Abatkun , Woldu Minyahil Alebachew 
Published: October 2024

Abstract

Introduction: Antiepileptic drugs (AEDs) are frequently used to treat seizures; however, in settings with limited resources, the relationship between seizure control and the plasma levels of these medications in the paediatric population is still not well understood.
Purpose: This study investigated this correlation, aiming to optimize treatment strategies and enhance the well-being of children with epilepsy.
Methods: A retrospective cross-sectional design was employed in three Ethiopian hospitals from September 2021 to February 2022. Data from 81 participants were analysed, with a focus on sociodemographic and clinical characteristics and AED serum levels.
Results: Boys composed 69.1% of the sample, with an average age of 8.56 ± 4.35 years. Generalized seizures were predominant (54.3%). TDM was performed for valproic acid (13.7%), phenytoin (11.7%), phenobarbitone (8.7%), and carbamazepine (1.3%). Post-TDM, 48% of the patients underwent therapeutic interventions. A chi-square test revealed no significant relationship between seizure control and AED concentration (p=0.920). Correlation analysis revealed a fourfold increase in the odds of poor seizure control with antiepileptic polypharmacy (AOR=4.162, p=0.046) and a sevenfold increase with increasing seizure frequency (AOR=6.711, p=0.027). Fisher's exact test indicated a significant correlation between TDM results and AED effectiveness for phenobarbitone, phenytoin, and valproic acid. The lack of a direct correlation between AED concentrations and seizure control emphasizes the multifactorial nature of epilepsy management.
Conclusions: This study emphasizes the need for personalized treatment for pediatric epilepsy, considering factors such as seizure frequency and antiepileptic polypharmacy. This suggests that caution should be taken in antiepileptic polypharmacy and regular seizure frequency assessment. Further research is recommended for improved treatment guidelines.
Family caregivers burden and quality of life among gastric cancer patients: The mediating role of psychological resilience based on Lazarus's transactional model
Authors: Luo Mengjia , Lu Jv , Jing Yifan , Dai Yanran , Ji Gang , Wu Chao , Lang Hongjuan 
Published: October 2024

Abstract

Background
Currently, the incidence of gastric cancer in China is increasing, and with prolonged survival times, the nursing tasks and responsibilities that family caregivers need to undertake are becoming increasingly significant. The level of care provided by this group has a crucial impact on patients’ health-related outcomes. Therefore, decreasing caregivers’ life burden and improving their quality of life is vital for promoting patient recovery.
Purpose
The aim of this study was to investigate the effect of caregiver burden on the quality of life of patients with gastric cancer, and to explore the mediating role of psychological resilience in this relationship.
Methods
Data collection was conducted in the gastrointestinal surgery ward of a Grade III A hospital. 189 family caregivers of gastric cancer patients were surveyed using scales measuring caregiver burden, psychological resilience, and quality of life. Structural equation modeling was employed to validate the research hypotheses proposed, based on Lazarus’s transactional model.
Results
Caregiver burden was negatively correlated with psychological resilience and positively correlated with quality of life (p < .01). Psychological resilience plays a partial mediating role between caregiver burden and quality of life.
Conclusion
Caregiver burden is the key to predicting and reducing the quality of life of caregivers of gastric cancer patients. Psychological resilience is an intervention mechanism that explains how caregiver burden reduces caregiver quality of life in patients with gastric cancer.
Evaluating the Feasibility of Delayed Replantation: Report of 2 Cases
Authors: Nugraha Muhammad Hirzi , Hasan Cahya Yustisia , Haryosuwandito Erdananda 
Published: October 2024

Abstract

Introduction: Losing permanent teeth due to avulsion or extraction can affect patients psychologically and functionally. This condition can be managed through replantation, which involves implanting teeth into the socket. The success of avulsed tooth replantation is highly influenced by the choice of storage media, the duration of the tooth remains outside the socket, and the level of contamination. The key to successful replantation lies in the patient's condition, the donor tooth, and the recipient site.
Objective: To report the management of delayed replantation and its treatment outcomes in several cases.
Cases: The first case is an 11-year-old child who experienced avulsion of the left maxillary central incisor, which was replanted six days later. The second case is a 22-year-old woman who experienced avulsion of tooth 21 and underwent delayed replantation 15 hours later. Both avulsed teeth were treated with root canal treatment, with subsequent successful treatment outcomes afterward.
Conclusion: Delayed replantation treatment provided satisfactory results in all three cases. The replanted teeth showed no complaints, discoloration, or gingival swelling and were completely painless during each case's follow-up period. In Case 1, there was infra-positioning, ankylosis, and external resorption at the mesial alveolar crest of the tooth. Case 2 showed a well-functioning tooth, no periapical lesions, and satisfactory aesthetic results.
Structural and Functional Characteristics of Leptomeningeal Lymphatic Vessels in Leptomeningeal Metastases from Lung Cancer Patients
Authors: Hua Xiaoyu , Ye Minting , Liu Da , Li Hainan , Fan Chongzhu , Mai WenFeng , Jia Wuyi , Yu Xiaojun , Sun Mengnan , Liu Xiangning , Cai Linbo , Shi Changzheng , Lai Mingyao 
Published: October 2024

Abstract

Background: The purpose of this study is to explore whether there are lymphatic vessels in the human leptomeninges, and their potential role in the immune response to central nervous system tumors, in order to determine their significance in the field of tumor biology, especially the role they play in the growth, metastasis, and immune response of tumors.
Methods: We used immunohistochemistry and immunofluorescence techniques to examine the leptomeninges in 46 patients diagnosed with leptomeningeal metastasis in cerebrospinal fluid cytology (29 positive biopsy specimens, 17 negative) as well as 11 epilepsy patients. We visualized lymphatic vessels in the human leptomeninges using LYVE1 and PDPN antibodies, labeled tumor cells with CK, T cells with CD3, and blood vessels with CD31 and α-smooth muscle actin. By comparing the lymphatic vessel density and T cell count in tumor areas versus non-tumor areas, and observing whether there was infiltration of tumor cells into the lymphatic vessels, we analyzed the presence and function of human leptomeningeal lymphatic vessels.
Results: The research results confirmed the existence of lymphatic vessels in the human leptomeninges, with a significant increase in lymphatic vessel density and T cell count around the tumor compared to non-tumor areas (P < 0.05). At the same time, infiltration of tumor cells was observed within the lymphatic vessels.
Conclusions: These findings suggest that the lymphatic vessels in the leptomeninges not only structurally resemble extracranial brain lymphatic vessels, but also function similarly in tumor immune response and metastasis pathways. These findings challenge traditional understanding of immune responses to central nervous system tumors and provide important clues for further research on the role of intracranial lymphatic vessels in tumor biology.
Effect of systemic immunomodulatory therapies on mental health in atopic dermatitis: a systematic review and network meta-analysis
Authors: Liu Ming , Zhang Kaihua , yang Kelu , Gao Ya , Zheng Li , Tian Jinhui , Zhang Yang 
Published: October 2024

Abstract

Background: Atopic dermatitis (AD) is a prevalent chronic skin condition that may cause significant mental health challenges, including anxiety and depression. This study aimed to evaluate the effects of different systemic immunomodulatory therapies on the anxiety and depression in patients with AD.
Methods: We searched the MEDLINE (via Ovid, from 1946), EMBASE (via Ovid, from 1974), the Cochrane Central Register of Controlled Trials (CENTRAL), and the ClinicalTrials.gov from the date of their inception to June 1, 2024. We included randomized controlled trials (RCT) involving both children and adults with moderate-to-severe atopic AD receiving systemic immunomodulatory therapies. Network meta-analysis were performed using mean changes from baseline and their standard deviations (SDs) by Bayesian random effects model. All analyses were conduct using R version 3.6.3.
Results: Eighteen RCTs reported in 15 studies involving 7,784 patients were eligible. The risk of bias of two outcomes reported in each trial were low or probably low. Measured by Hospital Anxiety and Depression Scale, high-certainty evidence demonstrated that “Abrocitinib (200 mg, oral, qd)” (anxiety: MD -1.2, 95%CI: -1.7 to -0.69; depression: MD -1.1, 95%CI: -1.8 to -0.29), “Dupilumab (300 mg, subcutaneously, q1w)” (anxiety: MD -1.9, 95%CI: -2.4 to -1.4, depression: MD -1.8, 95%CI: -2.7 to -0.85), “Dupilumab (300 mg, subcutaneously, q2w)” (anxiety: MD -1.7, 95%CI: -2.2 to -1.2; depression: MD -1.6, 95%CI: -2.3 to -0.76), and “Lebrikizumab (250 mg, subcutaneously, q2w)” (anxiety: MD -1.6, 95%CI: -2.3 to -0.97, depression: MD -1.6, 95%CI: -2.5 to -0.58), were the most effective drugs for both anxiety and depression in both adults and children patients, respectively; “Baricitinib (4 mg, oral, qd)” (MD -1.1, 95%CI: -1.9 to -0.34) was only efficient with depression.
Conclusions: Systemic immunomodulatory therapy could significantly alleviate anxiety and depression in patients with AD, particularly with the subcutaneous administration of Dupilumab at a 300 mg dose.
Outcomes of Popliteal Artery Injuries in a Level 1 Trauma Centre: A 6-year review
Authors: Rensburg Kewen van , Steyn Wilme , Moeng Maeyane Steve , Cassimjee Ismail 
Published: October 2024

Abstract

Purpose To determine modifiable and non-modifiable factors contributing to limb loss in PAI the relevance and accuracy of published scoring systems for PAI within a South African State hospital.Methodology: Retrospective review of patients (> 18 years) with PAI, presenting to CMJAH trauma unit from 1 January 2017 to 31 December 2022.Results Sixty-four patient records were analysed. Thirty (46.9%) had blunt trauma and thirty-four (53.1%) had penetrating trauma. Gunshot wounds (GSW) were the most common mechanism of injury (MOI). Blunt PAI had a 40% amputation rate and penetrating trauma, 33.3%. Forty-seven (73.4%) had a delay to surgery of > 6 hours. The mean time to arrival at our emergency department was 478 min, and the mean time from arrival to surgery was 368 min (total delay of 838 min). The primary amputation rate was 28.6%, and 63.5% had successful limb salvage surgeries. The secondary amputation rate was 7.8%.Conclusion Compared to international literature, our rate of primary amputation is high (10% vs 28.8%) and prolonged ischaemia is the likely cause. Only 17 (26.6%) patients presented before 6 hours. Of the 45 patients that had an attempt at revascularisation, 7.8% had a secondary amputation. Thus, despite prolonged ischaemia, revascularisation should be attempted in patients with at least two viable compartments on fasciotomy. The MESS and POPSAVEIT scoring systems should not be relied on in patients with delayed presentations. Strengthening referral triage for suspected PAI to Level 1 Trauma centres directly will decrease the delays and likely improve the outcomes.
Benefits of Long-Term Combination Therapy with Sildenafil Citrate and Beraprost Sodium in a Dog with Pulmonary Hypertension
Authors: Jang Keunhwan , Han JungWoo , Cho Seung-Bum , Kim SuYeon , Oh Songju , Kim Ha-Jung 
Published: October 2024

Abstract

Background
Pulmonary hypertension, defined as sustained elevated pulmonary artery pressure, can lead to right-sided heart failure if untreated. While sildenafil citrate is a common treatment, recent findings suggest that its combination with beraprost sodium may enhance therapeutic efficacy in human medicine. This case report describes the successful management of canine pulmonary hypertension using combination therapy and suggests potential efficacy in veterinary medicine.
Case presentation
A 12-year-old, spayed female, Pekingese dog was referred to a veterinary medical teaching hospital owing to frequent episodes of syncope and exercise intolerance. On thoracic auscultation, a grade 4 heart murmur was detected on both sides of the chest, along with respiratory sinus arrhythmia. An electrocardiogram showed a right axis deviation, suggesting possible right ventricular hypertrophy. There were no abnormalities in heart size on thoracic radiographs. An increased contact area was observed between the sternum and the right heart in the lateral view owing to the enlarged right-sided heart. No significant pulmonary infiltration, tracheal collapse, or bronchial collapse was observed. Echocardiography revealed moderate tricuspid regurgitation and severe pulmonary hypertension. Based on clinical signs and diagnostic findings, the diagnosis was right-sided heart failure caused by brachycephalic obstructive airway syndrome (BOAS). The initial treatment plan included sildenafil citrate at 2mg/kg PO bid, pimobendan at 0.3mg/kg PO bid, enalapril at 0.5mg/kg PO bid, and furosemide at 1mg/kg PO bid. Despite taking medications for three months, the frequency of syncope episodes remained unchanged, and the pulmonary hypertension failed to improve. Therefore, beraprost sodium, a prostacyclin analog, was added to the treatment regimen. Thereafter, the dog’s clinical signs of syncope significantly improved, although the echocardiographic findings showed no change in tricuspid regurgitation and the severity of pulmonary hypertension (velocity 4.42m/s, pressure gradient 78.2mmHg). The dog maintained these improved clinical signs for 12 months, with a combination of sildenafil citrate at 3 mg/kg PO bid and beraprost sodium at 20 µg/kg PO bid.
Conclusions
This study showed that combining beraprost sodium with sildenafil significantly improved clinical symptoms in cases where sildenafil alone was ineffective, with no adverse effects observed over an extended treatment period.
Patient-Centric Diagnosis of Acute Leukemia: A Machine Learning Approach Utilizing Flow Cytometry Data
Authors: AGRAWAL RIMI , Kapadia Viral 
Published: October 2024

Abstract

As cancer incidence rises due to lifestyle factors, accurate and cost-effective leukemia diagnosis is crucial in medical diagnostics. Early identification of malignant leukocytes remains challenging, prompting this research to employ machine learning (ML) techniques. Using a flow cytometry test of blood cells which including Forward Scatter Signal, Forward Scatter Pulse Width Signal, Side Scatter Signal, and Side Fluorescence Signal, various ML algorithms (SVM, K-Nearest Neighbor, AdaBoost Algorithm, Logistic Regression, Decision Tree, Random Forest) are applied for individual patient diagnosis. This study underscores the significance of ML in processing leukemia flow cytometry test signals, enhancing accuracy, reducing diagnosis time, and offering cost-effective and safer diagnostic services. By utilizing ML-based approaches, clinicians and laboratory experts can potentially enhance the efficiency of Leukemia detection and classification. This article provides an in-depth review of current machine learning models used for detection and classification of Leukemia, highlighting their methodologies for discrete data of flow cytometry test, shedding light on their potential benefits and challenges. Overall, this research contributes to the ongoing efforts to improve Leukemia diagnosis through innovative and advanced computational approaches.
Broad-scale overdose education and naloxone distribution – 5-year follow-up of a regional program in Skåne County, Sweden
Authors: Troberg Katja , Isendahl Pernilla , Dahlman Disa , Håkansson Anders 
Published: October 2024

Abstract

Background
Opioid use disorder is a chronic disorder with a high risk of overdose related morbidity and mortality where a large proportion of these can be averted by timely administration of the antidote naloxone. For naloxone to be present when and where overdoses occur, broad-scale overdose education and naloxone distribution (OEND) must be established. A regional naloxone program was implemented in 2018, in Skåne County, Sweden. This five-year follow-up aims to describe all naloxone-related lay-person events and whether recommendations previously described in the literature were met and to further investigate events conducted by individuals reporting overdose reversals with naloxone on three or more occasions (‘Supersavers’).
Methods
Between June 2018 and June 2023, data was collected in six-month intervals from participating units (n = 52), containing information on trained individuals, gender, year of birth and distributed naloxone kits. Upon naloxone replenishment, patients were asked whether previous naloxone had been used for overdose reversals on someone else, or themselves, had been lost, stolen, or given to someone else.
Results
Training and initial kits had been provided to 2685 individuals at risk of own opioid overdose. Each of the 5900 naloxone kits distributed, contained two naloxone doses. Upon refill (n = 2364), naloxone had been used for overdose reversal in 39% (n = 926) situations. The minimum distribution target of 20 kits per annual opioid overdose death was met annually, while the target of enrolling > 100 individuals at-risk individuals per 100,000 population was first met during the second year. The core group of Supersavers represent 9% (n = 50) of those returning for refill and while reporting 54.5% (n = 292) of all overdose reversals.
Conclusions
Broad-scale naloxone training and distribution reaches a large proportion of individuals at risk of opioid overdose. A continuous focus and priority in supporting units with a high prevalence of individuals witnessing overdose events is of great importance as these individuals report a large proportion of overdose reversals. Likewise, it is of great importance to provide these individuals, i.e. Supersavers, with needed and sufficient support for their continued essential work intervening in overdose situations.
Trial Registration:
Naloxone Treatment in Skåne County – Effect on Drug-related Mortality and Overdose-related Complications, NCT03570099, registered 26 June 2018.
Removal of Cr(VI) in groundwater by controlled release materials based on nano zero-valent iron and activated carbon
Authors: Fu Zhi-hui , Chen Jia-yi , Chen Gang , Hu Cheng , Wang Ting , Qiao Xu-dong , Zhu Hong-na , Chen Hua-li 
Published: October 2024

ABSTRACT

The use of nano zero-valent iron (nZVI) materials for groundwater Cr(VI) removal encountered challenges of agglomeration and low removal efficiency. Controlled release materials (CRMs) gradually release reactive substances or reducing agents, prolonging the release time. Here, we report the development of novel CRMs containing nZVI and activated carbon (AC). During the removal of Cr(VI) in groundwater, the prepared AC/nZVI/CRMs slowly released nZVI, greatly reducing the agglomeration of nZVI. The adsorption capacity of AC-containing CRMs prolonged the residence time of Cr(VI) in water, improving the removal efficiency of the AC/nZVI/CRMs. We found that lower pH enhanced the removal of Cr(VI) by the AC/nZVI/CRMs from simulated groundwater. The removal efficiency of the AC/nZVI/CRMs was also affected by the simulated groundwater environment and decreased with the increasing flow rate of the groundwater. Our results suggested that these novel nZVI-containing CRMs minimized agglomeration during the removal of Cr(VI) by nZVI, exhibited enhanced efficiency under acidic conditions, and facilitated Cr(VI) removal from similar groundwater environments.