bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pure arterial malformation of the fetal PCA treated with flow diverter stent—case report and literature review
Authors: Josko Bilandzic , Kresimir Rotim , Ante Rotim , Nina Rotim , Branimir Culo , Vladimir Kalousek 
Published: August 2024

Introduction Thirty-three-year-old female underwent diagnostic work-up for chronic headaches. Case report Cerebral DSA on the right side showed fetal posterior cerebral artery (PCA) with unusually shaped arterial malformation on its proximal part. Malformation was formed by multiple convolutions and loops with no arteriovenous shunting. During endovascular procedure, flow diverter stent was placed in the right C6 segment. Patient was put on double antiaggregation therapy. Four weeks after procedure, patient was admitted to ER with signs of dyphasia. No recent ischemic lesions were detected on emergent magnetic resonance. Dyphasia resolved spontaneously. On follow-up magnetic resonance angiography 5 years after the procedure, main portion of malformation has diminished with slightly filling of posterior part supplied by right P1. Discussion Here, reported finding is consistent with previously described pure arterial malformation (PAM). Main intention of our treatment was to induce malformation remodeling with flow diverter placement. Two main risks arise when using flow diverters on fetal PCA region. Firstly, there is possibility of occluding fetal PCA alongside malformation. On the contrary, high flow through fetal PCA could hinder malformation thrombosis. Some case series reported high rate of fetal PCA occlusion without ischemic sequelae in the PCA teritory. Others consider flow diverters highly ineffective treatment for the fetal PCA aneurysms due to low rate of complete aneurysm occlusion. Conclusion We presented first reported case in which flow diverter was used to treat PAM. Slow malformation thrombosis leaves enough time for collateral circulation to recruit and supply territory of the vessel affected by the malformation.
Oscillometry reference values for children and adolescents
Authors: Valach Christoph , Wouters Emiel F. M. , Ofenheimer Alina , Pompilio Pasquale Pio , Gobbi Alessandro , Breyer Marie-Kathrin , Hartl Sylvia , Veneroni Chiara , Mraz Tobias , Schiffers Caspar , Burghuber Otto Chris , Karimi Ahmad , Gross Christoph , Irvin Charles , Breyer-Kohansal Robab 
Published: August 2024

BackgroundOscillometry devices allow quantification of respiratory function at tidal breathing but device-specific reference equations are scarce: the present study aims to create sex-specific oscillometric reference values for children and adolescents using the Resmon PRO FULL device.MethodsHealthy participants (n=981) aged 6 to 17 years of the Austrian LEAD general population cohort were included. Subjects had normal weight (body mass index ≤99th percentile) and normal lung volumes (total lung capacity (TLC) ≥ lower limit of normal). Oscillometry data were collected using a single frequency mode of 8 Hz. Sex-specific prediction equations were developed for total, inspiratory and expiratory resistance (R) and reactance (X) as well as for the modulus of impedance (Z) value using the LMS (lambda, mu, sigma) method. Height was used as a single covariate.ResultsReference equations for all oscillometry parameters were created for Caucasian children aged 6 to 17 years with a height span from 101 to 183 cm and a lung volume span from 1.7 to 8.8 L TLC.RandZvalues progressively decrease andXvalues increase with increasing height. Oscillometry parametersversuslung volume curves differ from thoseversusheight curves. Stratified for lung size, no sex differences are found for oscillometry parameters.ConclusionOur study provides reference values for oscillometry parameters in children and adolescents using strictly defined criteria for weight and lung volumes. No sex-related differences in oscillometry parameters corrected for height or lung size are found.
Reversal of inflammatory reprogramming by vasodilator agents in pulmonary hypertension
Authors: Kirillova Anna , Sethuraman Meena , Dong Xishuang , Kirdar Almina , Speyer Gil , Al Aaraj Yassmin , Watson Annie , Schneider Lily K. , Creager Michael D. , Lafyatis Robert , Okawa Satoshi , Kim Seungchan , Chan Stephen Y. 
Published: August 2024

BackgroundPulmonary arterial hypertension (PAH) is a deadly disease without effective non-invasive diagnostic and prognostic testing. It remains unclear whether vasodilators reverse inflammatory activation, a part of PAH pathogenesis. Single-cell profiling of inflammatory cells in blood could clarify these PAH mechanisms.MethodsWe evaluated a University of Pittsburgh Medical Center cohort consisting of idiopathic PAH (iPAH) and systemic sclerosis-associated PAH (sscPAH) patients and non-PAH controls. We performed single-cell RNA sequencing of peripheral blood mononuclear cells (PBMCs) from controls (n=3) and from PAH patients (iPAH and sscPAH) naïve to treatment (n=4), PAH patients 3 months after phosphodiesterase-5 inhibitor (PDE5i) treatment (n=7) and PAH patients 3 months after PDE5i+macitentan treatment (n=6). We compared the transcriptomes of five PBMC subtypes from iPAH and sscPAH to observe their serial responses to treatments. Furthermore, we utilised network analysis to illuminate the altered connectivity of biological networks in this complex disease.ResultsWe defined differential gene expression and perturbed network connectivity in PBMCs of PAH patients following treatment with PDE5i or PDE5i+macitentan. Importantly, we identified significant reversal of inflammatory transcripts and pathways in the combined PAH patient cohort after vasodilator therapy in every PBMC type assessed. The “glucagon signalling in metabolic regulation” pathway in monocytes was reversed after vasodilator therapyviatwo independent analysis modalities.ConclusionViaa systems-biology approach, we define inflammatory reprogramming in the blood of PAH patients and the anti-inflammatory activity of vasodilators. Such findings establish diagnostic and prognostic blood-based tools for tracking inflammatory progression of PAH and response to therapy.
Evaluation of e-Lung automated quantitative computed tomography biomarkers in idiopathic pulmonary fibrosis
Authors: George Peter M. , Rennison-Jones Christian , Benvenuti Giacomo , Sifostratoudaki Aliki , Ottink Finja A. , Bou-Zeid Wassim , Ledda Roberta E. , Abul Kadir Roqia F. , Johari Bushra , Fernandez Claire , Harston George W.J. , Joly Olivier , Gerry Stephen , Devaraj Anand 
Published: August 2024

BackgroundIn patients with idiopathic pulmonary fibrosis (IPF) there is a need to identify biomarkers that 1) are associated with increased risk of adverse outcome and 2) can be used to monitor treatment response or identify disease progression over time.MethodsTwo consecutive cohorts of patients with IPF were accessed from the Open Source Imaging Consortium database. Automated computed tomography (CT) biomarkers of disease severity incorporating fibrotic and pulmonary vascular features (the reticulovascular score and weighted reticulovascular score (WRVS)) were studied. Relationships between imaging biomarkers, lung function and survival were analysed.ResultsIn separate test and validation cohorts, 168 and 176 patients with IPF respectively (median survival 2.6 years) were studied. A threshold of WRVS ≥15% at baseline CT was most strongly associated with transplant-free survival (HR 3.00, 95% CI 1.47–6.10, p=0.002) when adjusted for baseline forced vital capacity (FVC) and age. In patients with 12-month follow-up CT and lung function tests (n=89) an increase in 3% of WRVS (the minimal clinically important difference) was also significantly associated with reduced survival independent of FVC, and outperformed visual evaluation of progressive fibrosis.ConclusionsWRVS is an automated CT biomarker which can identify patients with IPF at increased risk of progression and is able to reliably capture disease progression over time.
Evaluation of sperm DNA fragmentation index among infertile individuals: a comprehensive analysis of the associated factors—a cross-sectional study
Authors: Valipour Reza , Narouie Behzad , Jadidi Sajedeh , Dadpour Mehdi , Darzi Mohammad Mehdi , Torabinavid Parham , Radpour Negar , Momeni Hamidreza 
Published: August 2024

Abstract
Background
Ensuring the integrity of sperm DNA is of paramount importance for the production of healthy offspring. The process of sperm formation involves intricate molecular adjustments that condense and safeguard its genetic material. However, the risk posed by sperm DNA fragmentation (SDF) can impede natural and assisted fertility and may arise from various testicular and post-testicular factors. While there are recommendations against routine SDF testing, recent research has sparked debate by demonstrating the positive impact of such testing on fertility outcomes.

Objective
To identify the factors associated with SDF among infertile individuals.

Methods and materials
The medical records of infertile men referred to our hospital were comprehensively reviewed and included in the study as they met the inclusion criteria. Patients dissatisfied with participation in the study or those with incomplete medical records were excluded. The association of SDF, sperm analysis, and demographic characteristics were evaluated for further investigation.

Results
The average age of participants was 36.1 ± 8.1 years. The average semen volume was 2.5 ± 0.3 cc with a semen pH of 7.4 ± 0.2. The average sperm count was 10.9 ± 0.7 million, sperm motility was 36.9 ± 2.4%, and normal sperm morphology was 41.7 ± 2.7%. SDF levels below 15% were seen in 27.9%, between 15 and 30% in 32.4%, and above 30% in 39.7% of patients. Significant associations were found between the SDF and various factors in sperm analysis, including sperm count (P < 0.001), semen volume (P < 0.001), semen pH (P < 0.001), sperm motility (P < 0.001), normal sperm morphology (P < 0.001), and age (P < 0.001). Moreover, alcohol consumption (P = 0.04), smoking (P = 0.01), and the presence of varicocele (P = 0.03) were significantly associated with.

Conclusion
This study emphasizes the significance of SDF among individuals experiencing infertility and investigates its correlation with various sperm test parameters. It also sheds light on the vital roles played by factors such as age, smoking, alcohol consumption, and the presence of varicocele, which are highly likely to cause variations in SDF levels. The results of our research will add to the existing pool of knowledge on infertility and potentially have implications for clinical practice and the care of patients.
Changing trends in penile prosthesis implantation in China and an overview of postoperative outcomes from a single center
Authors: Zhang Chenwang , Bai Haowei , Shi Chenkun , Chen Huirong , Li Peng , Huang Yuhua , Chen Huixing , Zhao Fujun , Yao Chencheng , Li Zheng , Zhi Erlei 
Published: August 2024

Abstract
Background
Surgical penile prosthesis implantation (PPI) procedures have only recently been introduced to mainland China, with the overall number of such procedures having been conducted to date remaining relatively low. Accordingly, relatively little remains known with respect to the annual trends in PPI. Accordingly, this study was developed with the goal of clarifying these trends across different hospitals in mainland China, while also providing a single-center overview of post-PPI patient outcomes.

Results
To identify males in mainland China who had undergone PPI, a retrospective review of data from January 2019 – October 2023 was conducted. This approach revealed an increase in the total PPI caseload from 120 in 2019 to 413 within the first 10 months of 2023. Over this same interval, the number of surgeons performing PPI rose from 33 to 74. A retrospective review of the 112 patients who had undergone PPI at Shanghai General Hospital from 2019–2023 revealed that these patients had a median age of 39 [27–63] years, and PPI treatment led to a significant increase in median International Index of Erectile Function-5 (IIEF-5) scores from a baseline value of 10.23 ± 1.26 to a post-treatment value of 22.6 ± 2.73. The underlying causes of erectile dysfunction for these patients included vasculogenic factors (58/112; 51.8%), diabetes mellitus (21/112; 18.8%), and injuries to the spinal cord or pelvis (14/112; 12.5%). The overall rates of satisfaction with the PPI reported by patients and their partners were 93.0% and 90.4%, respectively, and the 3-year PPI survival rate for this cohort was 87%.

Conclusion
These data highlight a rising trend in the number of PPI being performed in China, with these steadily increasing rates since 2019 emphasizing the increasingly high levels of acceptance of this procedure by patients and clinicians as a means of treating erectile dysfunction. However, the expertise is restricted to a small number of surgeons. Even so, it is a safe and efficacious approach to managing severe erectile dysfunction for patients in China, and when performed by experienced surgeons based on standardized protocols, low complication rates can be achieved while providing patients and their sexual partners with high levels of satisfaction.
Pitfalls of single-study external validation illustrated with a model predicting functional outcome after aneurysmal subarachnoid hemorrhage
Authors: de Winkel Jordi , Maas Carolien C. H. M. , Roozenbeek Bob , van Klaveren David , Lingsma Hester F. 
Published: August 2024

Abstract
Background
Prediction models are often externally validated with data from a single study or cohort. However, the interpretation of performance estimates obtained with single-study external validation is not as straightforward as assumed. We aimed to illustrate this by conducting a large number of external validations of a prediction model for functional outcome in subarachnoid hemorrhage (SAH) patients.

Methods
We used data from the Subarachnoid Hemorrhage International Trialists (SAHIT) data repository (n = 11,931, 14 studies) to refit the SAHIT model for predicting a dichotomous functional outcome (favorable versus unfavorable), with the (extended) Glasgow Outcome Scale or modified Rankin Scale score, at a minimum of three months after discharge. We performed leave-one-cluster-out cross-validation to mimic the process of multiple single-study external validations. Each study represented one cluster. In each of these validations, we assessed discrimination with Harrell’s c-statistic and calibration with calibration plots, the intercepts, and the slopes. We used random effects meta-analysis to obtain the (reference) mean performance estimates and between-study heterogeneity (I2-statistic). The influence of case-mix variation on discriminative performance was assessed with the model-based c-statistic and we fitted a “membership model” to obtain a gross estimate of transportability.

Results
Across 14 single-study external validations, model performance was highly variable. The mean c-statistic was 0.74 (95%CI 0.70–0.78, range 0.52–0.84, I2 = 0.92), the mean intercept was -0.06 (95%CI -0.37–0.24, range -1.40–0.75, I2 = 0.97), and the mean slope was 0.96 (95%CI 0.78–1.13, range 0.53–1.31, I2 = 0.90). The decrease in discriminative performance was attributable to case-mix variation, between-study heterogeneity, or a combination of both. Incidentally, we observed poor generalizability or transportability of the model.

Conclusions
We demonstrate two potential pitfalls in the interpretation of model performance with single-study external validation. With single-study external validation. (1) model performance is highly variable and depends on the choice of validation data and (2) no insight is provided into generalizability or transportability of the model that is needed to guide local implementation. As such, a single single-study external validation can easily be misinterpreted and lead to a false appreciation of the clinical prediction model. Cross-validation is better equipped to address these pitfalls.
The population-level effects of omitting chemotherapy guided by a 21-gene expression assay in node-positive breast cancer: a simulation modeling study
Authors: Wojcik Kaitlyn M. , Caswell-Jin Jennifer L. , Wilson Oliver W.A. , Schechter Clyde , Kamil Dalya , Kurian Allison W. , Jayasekera Jinani 
Published: August 2024

Abstract
Background
A recent trial showed that postmenopausal women diagnosed with hormone receptor-positive, human epidermal growth factor receptor-2 (HER2)-negative, lymph node-positive (1–3 nodes) breast cancer with a 21-gene recurrence score of ≤ 25 could safely omit chemotherapy. However, there are limited data on population-level long-term outcomes associated with omitting chemotherapy among diverse women seen in real-world practice.

Methods
We adapted an established, validated simulation model to generate the joint distributions of population-level characteristics of women diagnosed with early-stage breast cancer in the U.S. Input parameters were derived from cancer registry, meta-analyses, and clinical trial data. The effects of omitting chemotherapy on 10-year distant recurrence-free survival, life-years, and quality adjusted life-years (QALYs) were modeled for premenopausal and postmenopausal women. QALYs were discounted at 3%. Results were evaluated for subgroups stratified by race and ethnicity. Sensitivity analyses included testing results across a range of inputs. The model was validated using the published RxPONDER trial data.

Results
In premenopausal women, the 10-year distant recurrence-free survival rates were 85.3% with chemo-endocrine and 80.1% with endocrine therapy. The estimated life-years and QALYs gained with chemotherapy in premenopausal women were 2.1 and 0.6, respectively. There was no chemotherapy benefit in postmenopausal women. There was no variation in the absolute benefit of chemotherapy across racial or ethnic subgroups. However, there were differences in distant recurrence-free survival rates, life-years, and QALYs across groups. Sensitivity analysis showed similar results. The model closely replicated the RxPONDER trial.

Conclusions
Modeled population-level outcomes show a small chemotherapy benefit in premenopausal women, but no benefit among postmenopausal women. Simulation modeling provides a useful tool to extend trial data and evaluate population-level outcomes.
Cooling during transportation of newborns with hypoxic ischemic encephalopathy using phase change material mattresses in low-resource settings: a randomized controlled trial in Hanoi, Vietnam
Authors: Tran Hang. T. T. , Tran Dien. M. , Le Ha. T. , Hellström-Westas Lena , Alfvén Tobias , Olson Linus 
Published: August 2024

Abstract
Objective
To determine the effectiveness of phase-change-material mattress (PCM) during transportation of newborns with hypoxic ischemic encephalopathy (HIE).

Study design
Randomized controlled trial of newborns with HIE from June 2016 to December 2019. Patients were randomized to transport with PCM or without PCM (control) when transferred to a cooling center in northern Vietnam. Primary outcome measure was mortality rate, secondary outcomes including temperature control and adverse effects.

Result
Fifty-Two patients in PCM-group and 61 in control group. Median rectal temperature upon arrival was 34.5 °C (IQR 33.5–34.8) in PCM-group and 35.1 °C (IQR 34.5–35.9) in control group (p = 0.023). Median time from birth to reach target temperature was 5.0 ± 1.4 h and 5.5 ± 1.2 h in the respective groups (p = 0.065). 81% of those transported with PCM versus 62% of infants transported without (p = 0.049) had reached target temperature within the 6-h timeframe. There was no record of overcooling (< 32 °C) in any of the groups. The was no difference in mortality rate between the two groups (33% and 34% respectively (p > 0.05)).

Conclusion
Phase-change-material can be used as a safe and effective cooling method during transportation of newborns with HIE in low-resource settings.

Trial registration
The study was retro-prospectively registered in Clinical Trials (04/05/2022, NCT05361473).
Peripheral endocannabinoids in major depressive disorder and alcohol use disorder: a systematic review
Authors: Fuentes J.J. , Mayans J. , Guarro M. , Canosa I. , Mestre-Pintó J.I. , Fonseca F. , Torrens M. 
Published: August 2024

Abstract
Background
Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) are two high-prevalent conditions where the Endocannabinoid system (ECS) is believed to play an important role. The ECS regulates how different neurotransmitters interact in both disorders, which is crucial for controlling emotions and responses to stress and reward stimuli. Measuring peripheral endocannabinoids (eCBs) in human serum and plasma can help overcome the limitations of detecting endocannabinoid levels in the brain. This systematic review aims to identify levels of peripheral eCBs in patients with MDD and/or AUD and find eCBs to use as diagnostic, prognostic biomarkers, and potential therapeutic targets.

Methods
We conducted a systematic literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines from the earliest manuscript until October 22, 2023, in three electronic databases. We included studies of human adults who had a current diagnosis of AUD and/or MDD and evaluated plasma or serum endocannabinoids. We carefully considered known variables that may affect endocannabinoid levels.

Results
We included 17 articles in this systematic review, which measured peripheral eCBs in 170 AUD and 359 MDD patients. Stressors increase peripheral 2-arachidonyl-glycerol (2-AG) concentrations, and 2-AG may be a particular feature of depression severity and chronicity. Anxiety symptoms are negatively correlated with anandamide (AEA) concentrations, and AEA significantly increases during early abstinence in AUD. Studies suggest a negative correlation between Oleoylethanolamide (OEA) and length of abstinence in AUD patients. They also show a significant negative correlation between peripheral levels of AEA and OEA and fatty acid amide hydrolase (FAAH) activity. Eicosapentaenoylethanolamide (EPEA) is correlated to clinical remission rates in depression. Included studies show known variables such as gender, chronicity, symptom severity, comorbid psychiatric symptoms, length of abstinence in the case of AUD, and stress-inducibility that can affect peripheral eCBs.

Conclusions
This systematic review highlights the important role that the ECS plays in MDD and AUD. Peripheral eCBs appear to be useful biomarkers for these disorders, and further research may identify potential therapeutic targets. Using accessible biological samples such as blood in well-designed clinical studies is crucial to develop novel therapies for these disorders.