bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Study to Compare the Efficacy of Lower Urinary Tract Symptoms Visual Score versus International Prostate Symptom Score for Evaluating Men With Lower Urinary Tract Symptoms
Authors: VH Ashwath Venkataramana , V Shivakumar , Keshavamurthy Ramaiah 
Published: August 2024

Abstract

Aim and Objective
The number of men presenting with lower urinary tract symptoms (LUTS) to our institute’s outpatient department (OPD) is exceedingly high. Because most of the patients who visit the OPD are illiterate or undereducated, using advanced patient-based symptom measures such as the gold standard International Prostate Symptom Score (IPSS) is difficult. This calls for a less complicated grading scheme. Thus, our objective in this study is to evaluate the effectiveness of our institute’s lower urinary tract symptoms visual score (LUTS-V), a condensed score based on a visual scoring method that Silva et al. described.
Material and Methods
Silva et.al. [8] developed LUTS-V, a modified form of the visual prostate symptom score (VPSS). We prospectively instructed patients presenting with LUTS to the OPD to fill their LUTS-V and IPSS scores at their first OPD visit. We conducted our study over a period of eight months at the Institute of Nephro Urology, a tertiary center in Bangalore, Karnataka, India. We expressed data as medians and ranges, or absolute values and fractions. We tested the overall IPSS and LUTS-V scores for agreeability using Bland–Altman analysis, Spearman’s correlation plot, and the Pearson correlation coefficient. We evaluated diagnostic properties (criteria validity) in terms of sensitivity, specificity, and accuracy. We used uroflowmetry as a reference standard. We measured the time (in seconds) necessary for completion of each IPSS and LUTS-V questionnaire. We considered p < 0.05 as statistically significant.
Result
We included 280 patients in the study, ranging in age from 22 to 80 years with a mean age of 64.61 years. The patient cohort had a mean education of 7.41 years. Education status was inversely related to age according to the Pearson correlation coefficient (r = − 0.7122, p < .00001). We found that 3.2% of patients had mild symptoms, 86% had moderate symptoms, and 66.01% had severe symptoms. LUTS-V ranged from 1 to 12. We divided the patients into mild, moderate, and severe symptomatic groups and compared them with similar groups with the IPSS. Receiver operating characteristic (ROC) analysis gave us a cutoff of 4 points of LUTS-V for mild symptom and 9 points for severe symptoms. A cutoff less than 4 for mild symptoms yielded sensitivity of 73.68%, specificity of 99.23%, and accuracy of 97.5% (p = 0.001), whereas a cutoff more than 9 points for severe symptoms had high sensitivity of 95.35%, specificity of 83.07%, and accuracy of 86.3% (p = 0.0001). The patients took an average of 195 seconds to complete the IPPS, and many required help in understanding the IPSS score, whereas they took an average of 60.89 sec to complete the LUTS-V (p < 0.001).
Conclusion
LUTS-V is a simplified tool that has adequate comparability to the gold standard IPSS, which patients with a poor educational background can easily interpret.
Outcomes of bilateral temporomandibular joint arthroscopy: an international multicentric prospective study including 524 joints
Authors: Ângelo David Faustino , Ono Helcio Yogi , de Barros Romualdo Cardoso Monteiro , Maffia Francesco , Sanz David , Cardoso Henrique 
Published: August 2024

Abstract

Purpose: This study aimed to evaluate the efficacy of bilateral TMJ arthroscopy in patients with different Wilkes stages, comparing the results obtained in different arthroscopic levels on a larger scale, unifying similar populations.
Methods: A multicentric prospective clinical study was conducted in three TMJ departments performing temporomandibular joint surgery in Portugal and Brazil, with an enrolling window active from January 1, 2019, to December 1, 2022. The primary clinical outcome was TMJ pain evaluated through a visual analog scale. The secondary clinical outcome was the maximum mouth opening (MMO). TMJ arthroscopy was performed with a 1.9-mm arthroscope, including a video system with a 2.8-mm outer protective cannula.
Results: 262 patients, representing a total of 524 operated joints were enrolled. The mean age was 35.3 years. A significant decrease postoperatively in VAS pain was observed for all Wilkes stages. The lowest value of VAS pain was observed in Wilkes II compared to Wilkes III and IV. In the secondary outcome, MMO was observed to have a significant improvement in all Wilkes Stages.
Conclusion: in this multicentric study, bilateral TMJ arthroscopy was shown to be an effective procedure to reduce pain and increase maximum mouth opening in patients with different Wilkes stages, representing a valid minimally invasive solution.
Evolution of myocardial steatosis in patients with type 2 diabetes treated by GLP1 receptor agonists: LICAS study
Authors: Houbachi Lina , Walker Paul Michael , Fournel Isabelle , Ksiazek Elea , Petit Jean-Michel , Cochet Alexandre , Leclercq Thibault , Roger Antoine , Simoneau Isabelle , Bouillet Benjamin , Guenancia Charles 
Published: August 2024

Abstract

Background
The use of GLP1 receptor agonists is associated with a reduction in cardiovascular events in patients with type 2 diabetes (T2D). The mechanisms underlying this cardiovascular protection are not fully understood. We hypothesized that the reduction of intramyocardial fat content may be involved in the cardioprotective effect of GLP1 receptor agonists. Therefore, we aimed to evaluate the change in intramyocardial triglyceride content in patients with T2D treated with GLP1 receptor agonists.
Methods
This monocentric cohort study included patients with unbalanced T2D prior to the introduction of GLP1 receptor agonists. Patients underwent cardiac MRI coupled with NMR spectroscopy at baseline and six months after the introduction (M6) of a GLP1 receptor agonist to assess changes in intramyocardial triglyceride levels and morphological, functional, and cardiac tissue parameters. The relative delta (Δr) between baseline and M6 was calculated and analyzed by student test or sign test.
Results
Twenty-six patients (mean age = 62.2 ± 6.7 years, median HbA1c = 9.1%) fulfilled inclusion criteria and had both NMR measures. Compared with baseline, relative intramyocardial triglyceride levels significantly decreased after six months of treatment (mean Δr=-26% [95%CI:-39 ; -13]p = 0.003), as well as HbA1c (median Δr=-26% [IQR:25], p < 0.0001), body mass index (BMI) (mean Δr=-6% [-9 ; -4], p < 0.0001) and left ventricular mass (mean Δr= -6 [-12 ; -1] p = 0.02). The relative evolution of intramyocardial triglyceride content was not correlated with the relative evolution of HbA1c (r = 0.10) and BMI (r=-0.02).
Conclusions
We demonstrate, for the first time, a significant reduction in intramyocardial triglyceride content in patients with T2D after six months of treatment with GLP1 receptor agonists. The lack of correlation with reductions in HbA1c and BMI suggests a specific effect of GLP1 receptor agonists on myocardial steatosis, which might contribute to their previously demonstrated cardiovascular benefits.
Impact of tongue fat volume on obstructive sleep apnea in non-obese patients
Authors: Orestes Michael I. , Hill Gregory S. , Shih Robert , Collen Jacob F. , Feehs Kenneth R. , Montgomery Emily A. , Waring Katelyn M. , Watson Nora L. , Thomas Richard W. , Garibyan Lilit 
Published: August 2024

Abstract

Evidence suggests excess head and neck adipose tissue contributes to OSA, particularly in obese patients. Surgical treatments are often ineffective in this subset of the population. We sought to investigate the role of tongue fat in the normal and overweight populations. In this prospective cohort study, patients underwent overnight polysomnogram and MRI using a Dixon sequence. Volumetric reconstruction evaluated the size and distribution of tongue fat deposits in subjects with and without sleep apnea. The study included 86 patients; mean age of 42.2 (SD 11.2) years, 16% female. Average BMI 27.5 (SD 2.9), with 18.6% (n=16) normal BMI, 61.6% (n=53) overweight, 19.8% (n=17) obese. Logistic regression lines showed positive associations for BMI and age with AHI. No significant correlation was found between tongue fat volume or fraction and increased AHI nor presence of OSA. Although tongue volume and fat fraction were higher in patients with AHI ≥5, the difference was not statistically significant. This study suggests that tongue fat does not play a significant role in the pathophysiology of OSA in the non-obese (BMI<30) patient population. Therefore, selective treatments targeting tongue fat should focus on obese and morbidly obese patients.
Seed size-number trade-off exists in graminoids but not in forbs or legumes: A study from 11 common species in alpine steppe communities
Authors: zhou xiaolong , Duan Ronghua , Ren Zhengwei , Long Jian 
Published: August 2024

Abstract

Seed size and number are two important components of plant reproductive traits. Previous theoretical studies suggested that resource limitation led to a strong trade-off between seed size and seed number. However, empirical evidence from natural communities remains scarce. In this study, the relationships between seed size and seed number were tested in community level and in three functional groups- graminoids, forbs and legumes in a natural alpine steppe community in Tianshan Mountains. And the role of limiting resources in determining trade-off patterns was also examined by treating reproductive biomass of each species as a resource pool for producing seeds. Our results showed a significant trade-off between seed size and seed number at the community level. This trade-off was primarily determined by the graminoid group, while no negative relationships were observed in the forb and legume groups. Moreover, the graminoid group had lower reproductive biomass than the forb and legume groups, which indicates that the species in the graminoid group were more strictly limited by reproductive resources. In the future, more comprehensive studies are needed to test this trade-off pattern in other ecosystems and explore the underlying mechanisms in natural communities.
First Description of Alpha/Beta Values in Pediatric Medulloblastoma: Implications for Tailored Approaches in Radiation Oncology
Authors: Jazmati Danny , Sohn Dennis , Preugschas Ronja-Linda , Qin Nan , Bölke Edwin , Haussmann Jan , Schwarz Rudolf , Niggemeier Niklas David , Borkhardt Arndt , Babor Florian , Brozou Triantafyllia , Felek Melissa , Tamaskovics Balint , Melchior Patrick , Beez Thomas , Timmermann Beate , Remke Marc , Corradini Stephanie , Budach Wilfried , Matuschek Christiane 
Published: August 2024

Abstract

Background
Medulloblastoma is the most common malignant pediatric brain tumor, typically treated with normofractionated craniospinal irradiation (CSI) with an additional boost over about 6 weeks in children older than 3 years [1]. This study investigates the sensitivity of pediatric medulloblastoma cell lines to different radiation fractionation schedules. While extensively studied in adult tumors, these ratios remain unknown in pediatric cases due to the rarity of the disease.
Materials and Methods
Five distinct medulloblastoma cell lines (ONS76, UW228-3, DAOY, D283, D425) were exposed to varying radiation doses and fractionation schemes. In addition, ONS76 and UW2283-3 stably overexpressing MYC were analyzed. Alpha/beta values, representing fractionation sensitivity, were quantified using the linear-quadratic model of radiation survival.
Results
The study unveiled elevated alpha/beta ratios across diverse medulloblastoma cell lines, with a weighted mean alpha/beta value of 11.01 Gy (CI: 5.23–16.79 Gy). Neither TP53 status nor the levels of MYC expression influenced fractionated radiosensitivity. Furthermore, differences cannot be correlated with molecular subgroups (p = 0,07).
Conclusion
These in vitro findings strongly recommend normofractionated or hyperfractionated radiotherapy for paediatric medulloblastoma cases due to consistently high Alpha/Beta values across subgroups. Conversely, hypofractionated radiotherapy is not advisable within a curative approach. This study presents significant potential by enabling the estimation of radiobiological fractionations and dose effects in young, vulnerable patients, highlighting its importance for advancing patient-specific therapeutic strategies.
Endonasal Surgery High-Risk Carotid Injury Timeout Checklist: Implementation, Institutional Protocol and Experience
Authors: Barkhoudarian Garni , Pahlevani Mehrdad , Ratnam Seshaan , Mallari Regin Jay , Griffiths Chester , Kelly Daniel 
Published: August 2024

Abstract

Objective: Carotid artery injury is a rare, but major complication of endonasal operations. The morbidity and mortality of such a complication can be mitigated by preparedness and a clear plan set in place to address the hemorrhage expeditiously. This study examines the implementation of such a carotid injury timeout checklist and demonstrates its effectiveness in a patient with possible arterial injury.
Methods: A carotid injury timeout checklist was implemented for high risk endonasal procedures. The case selection was left to the surgeon, with guidelines including prior surgery, prior radiation, invasive tumors, and certain pathologies such as meningioma or chordoma. Factors affecting implementation were analyzed including tumor characteristics and patient history.
Results: Over a 12-month period, 103 endonasal operations were performed since the carotid artery injury timeout checklist was implemented, with 21 (20.4%) having a carotid artery injury timeout performed. Tumor characteristics that were associated with performing this timeout included Knosp grade (for pituitary adenomas, p=0.002), carotid artery encasement (p<0.001), extended approach (p<0.001), tumor size (p=0.05) and diagnosis (p<0.001). Re-operation and prior radiation were not factors for this cohort. The single carotid artery branch (hypertrophic vidian artery) injury that was sustained was easily and successfully managed, aided by preparation established via this protocol. The additional time necessary for this timeout to be performed was negligible with respect to the overall surgery length.
Conclusion: A carotid artery injury timeout can and should be successfully implemented for extended endonasal operations for pituitary and parasellar tumors with high risk factors including, but not limited to, carotid injury encasement, large tumor size and non-adenomatous diagnoses. A comprehensive plan for both intraoperative and perioperative management of the carotid injury is necessary to minimize the risk of morbidity and to deliver care expeditiously.
Is percutaneous vertebroplasty safe and effective in treating sacral compression fractures in patients with osteoporosis?
Authors: Qin Guangbing , Qin Zhao jie , Nong zhuo , Li Hao xi 
Published: August 2024

Abstract

Background: Percutaneous vertebroplasty (PVP) is widely used to treat osteoporotic thoracic and lumbar vertebral compression fractures. Currently, no study has indicated the clinical efficacy and safety of percutaneous vertebroplasty in the treatment of osteoporotic sacral compression fractures.
Measures: Pain symptoms and daily function were evaluated 1 day before surgery, 1 \ 7 \14 \0 days after surgery and 6 months after surgery, using the numerical rating scale (NRS) and Oswestry disability index (ODI). The presence of bone cement leakage was evaluated by reading postoperative imaging data.
Results: The study population comprised 72 patients (17 men and 55 women; 64–87 years).
All patients were followed-up for 1 day to 6 months. No postoperative complications, lumbago and back pain were significantly relieved in the patients, and the NRS and ODI scores were significantly improved compared with the preoperative values. At the last follow-up, none of the patients had evident sacral tail pain and were able to take care of themselves in daily life.
Conclusions:Early vertebroplasty can reduce pain symptoms, accelerate return to self-care, and limit related symptoms in patients with osteoporotic sacral compression fractures without surgical contraindications in accordance with modern enhanced recovery after surgery (ERAS).
Performance of GPT-4 in Oral and Maxillofacial Surgery Board Exams: Challenges in Specialized Questions
Authors: Warwas Felix Benjamin , Heim Nils 
Published: August 2024

Abstract

Purpose
The aim of this study was to evaluate the performance of GPT-4 in answering oral and maxillofacial surgery (OMFS) board exam questions, given its success in other medical specializations.
Methods
A total of 250 multiple-choice questions were randomly selected from an established OMFS question bank, covering a broad range of topics such as craniofacial trauma, oncological procedures, orthognathic surgery, and general surgical principles. GPT-4's responses were assessed for accuracy, and statistical analysis was performed to compare its performance across different topics.
Results
GPT-4 achieved an overall accuracy of 62% in answering the OMFS board exam questions. The highest accuracies were observed in Pharmacology (92.8%), Anatomy (73.3%), and Mucosal Lesions (70.8%). Conversely, the lowest accuracies were noted in Dental Implants (37.5%), Orthognathic Surgery (38.5%), and Reconstructive Surgery (42.9%). Statistical analysis indicated significant variability in performance across different topics, with GPT-4 performing better in general topics compared to specialized ones.
Conclusion
GPT-4 demonstrates a promising ability to answer OMFS board exam questions, particularly in general medical topics. However, its performance in highly specialized areas reveals significant limitations. These findings suggest that while GPT-4 can be a useful tool in medical education, further enhancements are needed for its application in specialized medical fields.
Compatibility Interactions between Anopheles gambiae and Plasmodium falciparum in a Malaria Endemic Region in Kisumu, Kenya
Authors: Onyango Shirley A. , Machani Maxwell G. , Ochwedo Kevin O. , Oriango Robin M. , Lee Ming-Chieh , Kokwaro Elizabeth , Afrane Yaw A. , Githeko Andrew K. , Zhong Daibin , Yan Guiyun 
Published: August 2024

Abstract

Insecticide resistance and outdoor transmission have reduced the effectiveness of existing malaria transmission prevention strategies. As a result, targeted approaches to support continuing malaria therapies, such as transmission-blocking vaccines, are required. Cross-sectional mass blood screening in children between 5 and 15 years was conducted in Chulaimbo, Kisumu, during the dry and wet seasons in 2018 and 2019. Plasmodium falciparum gametocyte carriers were identified by Microscopy. Subsequently, carries were used to feed colony bred Anopheles gambiae females in serum replacement and whole blood membrane feeding experiments. The infection prevalence was 19.7% (95% Cl: 0.003–0.007) with 95% of the infections being caused by P. falciparum. Of all confirmed P. falciparum infections, 16.9% were gametocytes. Thirty-seven paired experiments showed infection rates of 0.9% and 0.5% in the serum replacement and whole blood experiments, respectively, with no significant difference (P = 0.738). Six Pfs47 haplotypes were identified from 24 sequenced infectious blood samples. Hap_1 (E27D and L240I), Hap_2 (S98T0); Hap_3 (E27D); Hap_4 (L240I); Hap_5 (E188D); and Hap_6 without mutations. Haplotype 4 had the highest frequency of 29.2% followed by Hap_3 and Hap_6 at 20.8% each then Hap_1 with a frequency of 16.7%, whereas Hap_5 and Hap_2 had frequencies of 8.3% and 4.2% respectively. Varying frequencies of infectious Pfs47 haplotypes observed from genetically heterogeneous parasite populations in endemic regions illuminates vector compatibility to refracting P. falciparum using the hypothesized lock and key analogy. This acts as a bottleneck that increases the frequency of P. falciparum haplotypes that escape elimination by vector immune responses. The interaction can be used as a potential target for transmission blocking through a refractory host.
CAR-T therapy demonstrated safety and efficacy in relapsed/refractory diffuse large B-cell lymphoma patients complicated with hepatitis B related cirrhosis
Authors: Kong Danqing , Ping Nana , Zhu Qian , Zhang Xiao , Li Junhong , Zou Rui , Wu Depei , Jin Zhengming , Qu Changju 
Published: August 2024

Abstract

Chimeric antigen receptor T cell (CAR-T) therapy has demonstrated both efficacy and safety in relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients infected with hepatitis B virus (HBV). However, its applicability in individuals with liver cirrhosis remains largely unexplored due to the potential for unpredictable complications. Here, we report three cases (P1, P2, P3) of relapsed/refractory DLBCL with HBV-related cirrhosis treated with CAR-T cells infusion. P1 and P2 received CAR-T cells infusion following a conditioning regimen of fludarabine and cyclophosphamide (FC) for lymphodepletion; while P3 received SEAM (CCNU, etoposide, cytarabine, and melphalan) regimen and autologous stem cell transplantation bridging CAR-T cells infusion. P1 and P2 achieved rapid complete remission (CR), whereas P3 initially exhibited stable disease a month post-CAR-T infusion and subsequently achieved CR after local radiation salvage therapy and lenalidomide maintenance. With a median follow-up of 42 months after CAR-T, the progression free survival rate was 100%. Notably, during follow-up, these patients experienced complications associated with cirrhosis, including endoscopic variceal bleeding, HBV reactivation, or the diagnosis of hepatic malignancy. Our findings suggest that CAR-T therapy is highly effective for the treatment of DLBCL patients with HBV-related cirrhosis, albeit necessitating monitoring for potential hepatic complications.