bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current treatment for male infertility: an umbrella review of systematic reviews and meta-analyses
Authors: Ye Jian-Jun , Chen Ze-Yu , Wang Qi-Hao , Liao Xin-Yang , Wang Xing-Yuan , Zhang Chi-Chen , Liu Liang-Ren , Wei Qiang , Bao Yi-Ge 
Published: July 2024

Abstract
This umbrella review aimed to summarize and provide a general evaluation of the effectiveness of current treatments for male infertility and assess the quality of evidence and possible biases. An umbrella review of systematic reviews and meta-analyses available in PubMed, Web of Science, and Scopus, covering studies published up to October 2023, was conducted. Sperm concentration, morphology, and motility were used as endpoints to evaluate the effectiveness of the treatments. Of 2998 studies, 18 published meta-analyses were extracted, yielding 90 summary effects on sperm concentration (n = 36), sperm morphology (n = 26), and sperm motility (n = 28) on 28 interventions. None of the meta-analyses were classified as having low methodological quality, whereas 12 (66.7%) and 6 (33.3%) had high and moderate quality, respectively. Of the 90 summary effects, none were rated high-evidence quality, whereas 53.3% (n = 48), 25.6% (n = 23), and 21.1% (n = 19) were rated moderate, low, and very low, respectively. Significant improvements in sperm concentration, morphology, and motility were observed with pharmacological interventions (N-acetyl-cysteine, antioxidant therapy, aromatase inhibitors, selective estrogen receptor modulators, hormones, supplements, and alpha-lipoic acid) and nonpharmacological interventions (varicocele repair and redo varicocelectomy). In addition, vitamin supplementation had no significant positive effects on sperm concentration, motility, or morphology. Treatments for male infertility are increasingly diverse; however, the current evidence is poor because of the limited number of patients. Further well-designed studies on single treatment and high-quality meta-analysis of intertreatment comparisons are recommended.
Decannulation Dilemmas - Timing Tracheostomy Tube Removal in Children with Craniofacial Deformities - A Retrospective Study
Authors: Balaji S. M. , Balaji Preetha 
Published: July 2024

Abstract

Introduction:
Tracheostomy decannulation in children with craniofacial deformities poses challenges due to airway obstruction and the developing brain. This study aimed to compare decannulation outcomes based on age at tracheostomy and duration of cannulation so as to identify the best time for decannulation for children with long-term tracheostomy.

Methods:
This retrospective study included 12 children at a single centre who underwent decannulation after prolonged tracheostomy for craniofacial deformities. Data on demographics, clinical features, decannulation process and outcomes were collected. Children were divided into two groups: ≤6 years (n = 7) and >6 years (n = 5) at tracheostomy insertion.

Results:
All children underwent successful decannulation without immediate complications. One case of mild tracheomalacia and one of subglottic stenosis were treated pre-decannulation. Children ≤6 years demonstrated better post-operative adaptation in swallowing and speaking compared to the >6 years group. Notably, early and prolonged tracheostomy in the ≤6 years group was associated with easier adaptation post-decannulation. Social interaction was another challenge, particularly for the >6 years group.

Discussion:
The timing and duration of tracheostomy significantly impacts post-decannulation adaptation, likely due to factors such as neuroplasticity, muscle memory and psychological adjustment. This emphasises the need for comprehensive care, especially for older children. Early tracheostomy in children may allow them to adapt speech and swallowing skills, easing post-decannulation regain of skills. Conversely, older children with fully developed skills may struggle to relearn them after tracheostomy and decannulation. Age at tracheostomy and duration of cannulation influences decannulation outcomes in children with craniofacial deformities. Further research is crucial to develop targeted interventions for better post-operative care, particularly for older children.
The Progression and Prospects of the Gene Expression Profiling in Ovarian Epithelial Cancer
Authors: Srinivasamurthy Banushree Chandrasekhar , Ramamoorthi Subhashini 
Published: July 2024

Abstract
Ovarian cancer is one of the most common cancers with a high mortality rate among females worldwide. The understanding of the pathogenesis of the disease is highly important to provide personalized therapy to the patients. Ovarian cancer is as heterogeneous as colon and breast cancer which makes it difficult to treat. The development of gene signature is the only hope in providing targeted therapy to improve the survival of ovarian cancer patients. Malignant epithelial carcinomas are the most common cancers of the ovary with different histological and molecular subtypes and clinical behavior. The development of precursor lesions of ovarian carcinoma in the tubes and endometrium has provided a new dimension to the origin of ovarian cancers. The clinical utility of various gene signatures may not be logical unless validated. Validated gene signatures can aid the clinician in deciding the appropriate line of treatment.
Myomectomy: Choosing the Surgical Approach – A Systematic Review
Authors: Paredes Jhanice Sangdaan , Lee Chyi-Long , Chua Peng Teng 
Published: July 2024

Abstract
Myomectomy has evolved from open laparotomy to laparoscopy, hysteroscopy, VNOTES and robotic myomectomy. The surgical approach in doing myomectomy depends on the type and location of the myoma and the surgeon’s expertise. Minimally invasive surgery has been the preferred approach due to the benefit of shorter hospital stay, lesser postoperative pain, earlier recovery, minimal blood loss and the cosmetic appearance of the scar. The success of this procedure depends on the incision technique, enucleation, and blood loss prevention by using hemostatic techniques and suturing techniques. Performing myomectomy for a large uterine myoma is a laparoscopic challenge; however, with the use of Lee-Huang point (midpoint between umbilicus and xiphoid) as the primary insertion and camera port, one can easily navigate thru the abdominal cavity in case the uterus is huge obscuring the umbilical port. Laparoscopic Myomectomy can be safely and efficiently performed by experienced laparoscopic surgeons regardless of myoma size, number and location. Removal of large myoma specimen from the abdominal cavity through the laparoscope became a challenge after the use of power morcellator was abandoned. To overcome this problem, the large myoma is placed inside an Endo bag and its edges brought extracorporeally through the port site. The myoma is incised in a C-manner using a scalpel to reduce the size. Myoma can also be removed using in-bag power morcellation. Fertility preservation is the long-term aim of doing myomectomy instead of hysterectomy in the management of leiomyoma aside from alleviating symptoms of abnormal uterine bleeding, urinary frequency and abdominal pain.
A challenging case of scleral buckle-related restricted strabismus with unexpected good postoperative outcomes: A case report
Authors: Angrish Shreya , Malik Kiran Bala , Mishra Shreya , Ansari Anam , Singh Anupam 
Published: July 2024

Abstract
Strabismus surgery in a scleral buckle patient is a challenging task that requires precise planning and meticulous surgical skills to accomplish a successful outcome. We report a case of a 32-year-old male who presented with complaints of diminution of vision in the right eye (RE) for 23 years and outward deviation of RE for 5 years after blunt trauma with a ball. The patient was diagnosed with RE total retinal detachment (RD) with traumatic retinal dialysis. He underwent scleral buckling as RD surgery in 2004 followed by silicon oil removal 6 months later elsewhere. On ocular examination of the RE, the best corrected visual acuity was perception of light with accurate projection of rays in all four quadrants, there was grade III relative afferent pupillary defect with an exotropia of 20° on Hirschberg test. The prism bar reflex test revealed an exotropia of 50 prism diopters (PD) [Figure 1]. An anterior segment examination revealed posterior subcapsular and cortical cataracts. After taking a retina clinic opinion, the patient underwent uneventful RE cataract surgery with in-bag implantation of a foldable implant cataract surgery first, followed by strabismus surgery under a guarded visual prognosis. Clinically significant adhesion and the presence of the scleral buckle posed a magnificent challenge during the strabismus surgery. The plan was improvised to 8 mm lateral rectus recession with 4 mm hang loose recession irrespective of a large deviation under local anesthesia. To our surprise, a satisfactory primary position alignment within 10 PD (orthophoria) was achieved, which was maintained on subsequent follow-up visits. We report an interesting and challenging case of restrictive strabismus due to scleral buckle which emphasizes that surgical procedures and their outcomes may not always align with expectations. Therefore, it is necessary to adopt a flexible and customized approach to effectively manage such instances.
Resistance pattern observed in community-acquired urinary tract infection in children from a tertiary care hospital situated in a tribal district of eastern India
Authors: Mohanty Indrani , Mallick Manas R. , Sethy Geetanjali , Hotta Sasmita , Dash Manoj K. 
Published: July 2024

ABSTRACT

Background:
Community-acquired urinary tract infection (CA-UTI) is mostly treated empirically. There are limited studies on pediatric UTIs, their microbiological profile, and resistance patterns. Antimicrobial resistance and even multidrug resistance are on the rise among uropathogens in the pediatric population and may lead to complications in the long run. This study was done to know the microbiological profile and the resistance pattern of CA-UTI in the pediatric population of a tertiary care hospital in a tribal district of northern Odisha among children aged 5–14 years.

Methods:
A hospital-based cross-sectional study was done from January 2021 to June 2021. All cases aged between 5 and 14 years attending the pediatrics outpatient department suspected of UTI were included. Descriptive statistical analysis and regression analysis were done using the statistical software Stata SE 13.

Results:
Out of the total 311 cases, vomiting and pain in the abdomen were the most common clinical presentations. Significant bacterial growth was isolated in 74 samples. Escherichia coli (39.2%) was the predominant isolate. Resistance to cefotaxime (38.2%) and ciprofloxacin (36.4%) is highest and seen in both gram-positive and negative bacteria. Multidrug resistance was detected in 33.7% of the bacterial isolates.

Conclusion:
The present study highlights the problem of the rising resistance pattern of common bacterial pathogens causing CA-UTI in children. Further studies on genotypic resistance and appropriate measures are required to prevent the rapidly spreading resistance among these common uropathogens.
Emergence of mucormycosis in post-COVID infections in tertiary care hospital Warangal
Authors: Padmaja Goteti V. , Kumar Shanigarapu R. 
Published: July 2024

ABSTRACTIntroduction:Mucormycosis is an emerging fungal infection associated with high mortality, especially in post-COVID state. Mucormycosis, though fungal spores ubiquitous in the environment, is a clinical disease that occurs in immunocompromised conditions. However, the incidence of mucormycosis is enormously increased in post-COVID-19 infections and in those who are immunocompromised. It presents as rhino-orbital-cerebral mucormycosis. The diagnosis is done by KOH mount and culture on Sabouraud dextrose agar (SDA). The identification of post-COVID risk factors, clinical features, and KOH mount helps in early diagnosis. Early treatment helps in preventing progressive tissue invasion, surgical debridement and thus improves the outcome.Aims and Objectives:To establish etiological agents of mucormycosis.To establish the relation of diabetes mellitus, steroid usage, oxygen inhalation, and other risk factors in postCOVID patients suspected with mucormycosis.To study and establish associated high-risk factors for the sudden explosion of mucormycosis cases in post-COVID state.Material and Methods:The study was done on a total of 81 patients of suspected mucormycosis admitted at MGM Hospital and 20 controls of post-COVID patients over a period of 3 months. Demographic features, predisposing conditions, clinical features, culture characters, and radiological features were all obtained and analyzed.Results:The history of diabetes mellitus, steroid usage, and oxygen inhalation were analyzed. Among 81 debrided tissue samples received, 52 were KOH mount positive and out of them only 32 showed growths on SDA. Among them, 9 wereRhizopus, 13 wereMucor, and 10 were other species.Conclusion:Mucormycosis is a rare and uncommon disease in the past; However, in the COVID-19 pandemic, its association with post-COVID state is established. The common presentation of rhino-orbital-cerebral mucormycosis is dreadful; however, early diagnosis and prompt treatment in time will decrease mortality and morbidity remarkably.
Rehabilitation of an orbital defect using a silicone prosthesis with a custom ocular portion – A case report
Authors: Ramesh Janaki , Basapogu Sreeramulu , Pyla Vineela , Velamakuri Bharat C. 
Published: July 2024

ABSTRACT
The surgical removal of the orbit can be a psychologically traumatic event that may incapacitate patients. The prosthetic rehabilitation of such defects is complex and artistically driven. This case report describes the aesthetic rehabilitation of a patient who had undergone unilateral orbital exenteration due to COVID-19-associated rhino-orbital mucormycosis. This technique uses commonly available materials in the dental clinic and artists’ colors for the fabrication of a custom ocular portion of the silicone orbital prosthesis that closely matches the natural eye color of the patient.
Efficacy and safety of combination therapy (desmopressin with tolterodine) in nocturnal enuresis in children: An institutional experience
Authors: Bansal Rajan , Rahul Nekkanti , Qazi Ifrah A. , Pogula Veda Murthy Reddy , Reddy Sandeep K. 
Published: July 2024

ABSTRACT

Background:
Nocturnal enuresis is one of the most common problems of childhood. Desmopressin is started as a first-line treatment along with essential behavioral therapy like fluid restriction before bed and sleep hygiene. Given the high relapse rates seen with using desmopressin alone, the need of the hour is to reinforce its effects using another agent so that the remission is long-lasting.

Aim:
The aim is to look for efficacy and safety of treatment using combination therapy of desmopressin with tolterodine in nocturnal enuresis and further to look for the relapse rate with a structured withdrawal regimen.

Results:
A total of 150 patients of nocturnal enuresis were included in the study. Ninety patients (75%) were males, and 30 patients (25%) were females. The median age of patients was 12 years. Evaluation of the consequences at 1 month, 3 months, and 6 months revealed complete remission in 87 patients (72.5%), 105 patients (87.5%), and 105 patients (87.5%), respectively. After 12 months with desmopressin + tolterodine, it was found that 99 patients (82.5%) had complete remission, six patients (5%) had a relapse, and 12.5% of individuals still suffered from enuresis. The relapse rate on follow-up of 6 months after complete cessation of the treatment of 120 patients was 5% in combination therapy. The complication rate with combination therapy is 4.17%. There is no significant effect of gender or age on improvement with combination therapy.

Conclusion:
Desmopressin given in combination with tolterodine is safe and effective as combination therapy for treating nocturnal enuresis, and in most cases, long-term remissions can be achieved.
Is the current postgraduation batch less fortunate by missing the crucial junior resident 2 phase? A thought
Authors: Mukhida Sahjid , Kannuri Sriram , Das Nikunja K. , Patil Rajashri , Bhaumik Shalini 
Published: July 2024

ABSTRACT
During Covid-19 core areas of medical education have taken a beating. After the first wave of COVID 19, PG admissions took place between May and July 2020. Due to the second wave of COVID 19, NEET PG 2021 exam was conducted 9 months late. JR 2 phase is also the time when the PGs have interdepartmental and outside postings in other speciality and super speciality sections, but due to the unavailability of a new batch, this thing also got hampered as the departments were reluctant to send them. Most of the PG students were not able to start work on mandatory requirements for exam due to massive workload with availability of lesser workforce. The overall conclusion is that the current PG batch students are losers in their JR 2 phase of learning, training, and teaching and the reason behind that is constant delays due to litigations.
Can LLMs help with XML?
Authors: DeRose Steven J. 
Published: July 2024

LLMs have become popular for a huge range of tasks. They train over vast collections of text, yet largely discard markup of all kinds. Historically, many AI and NLP tools just stripped out not only explicit markup but even punctuation, case distinctions, or inflection. Recent work is a bit less drastic, but still commonly discards even simple notions like paragraphing, headings, block quotes, and notes. Likewise, few systems create output with any useful markup beyond paragraph breaks (if that). The conventions of written language leverage all these things, and it seems odd that LLMs should waste the opportunity of using them.
“Cleaning” to avoid inappropriate text is also ubiquitous and also leads to unintended consequences. Exclusion granularity is coarse – a work may be discarded because it (perhaps critically) includes a rude quote. Just like markup “cleaning,” text selection may get minimal and non-expert attention. Censorship is often done by word-list, or worse, string-list, and even the best-known lists seem almost random.
Underlying all these issues is the substitution of deceptively simple proxies for more complex and subtle goals. This is understandable especially at scale; but it has extensive and varied consequences. Such cleaning may seem to work fine, but we have little idea of precisely where, how often, and in how biased a way, it goes wrong. Figuring that out post facto is hard, in part because there is little transparency about any of these decisions and processes.
How can markup (broadly construed) and LLMs work better together? Why and how can LLMs make use of structure, both going in and coming out? Can LLMs help with structure-related questions and tasks? How can users construct effective prompts in this area? And finally, how does the semantic orientation of markup relate to LLM's probabilistic rather than semantic treatment of language? This paper begins to explore such questions.
ROLE OF COVID 19 PANDEMIC ON TALENT MANAGEMENT IN THE INSURANCE SECTOR
Authors: Kajwang Ben 
Published: July 2024

Purpose: In the recent years, the insurance industry has experienced accelerated change in technology and uncharted risks in because of the Covid-19 pandemic. This has raised the need for talented employees in the insurance sector who have been a scarce resource in the current business environment. Hence to manage these risks and trends and optimize the value of new technologies, the industry will need a new approach and strategy to attract and retain talent employees in order to improve their performance and remain competitive against their competitors. The purpose of this study was therefore to establish the role of Covid 19 pandemic on talent management in the insurance sector.
Methodology: A desktop literature review was used for this purpose. , a systematic search was carried out using Google Scholar, Semantic Scholar, and Research Gate. The study included relevant sources that were published between 2019 and 2022.
Findings: The study findings indicated that concluded that the revenue reductions and budget shortfalls caused by the COVID-19 crisis have resulted in significant talent management challenges in all industries including insurance firms. Under these difficult circumstances, most organizations have opted to downgrade and even completely abandon performance and talent evaluations and reviews. The fact that these practices are being discontinued demonstrates that many organizations do not implement state-of-the-science talent management systems but, instead, just performance appraisal. In contrast, talent management is particularly suited to address the many talent management challenges created by the COVID-19 crisis because it serves important administrative, strategic and communication, developmental, organizational maintenance, and documentation purposes. It was also found that measuring results in addition to behaviors, measuring adaptive performance, conducting stay interviews to retain top performers, implementing multisource performance management systems and using performance promoter scores not only help organizations address challenges during a crisis but also allow them to thrive after the crisis is over.
Recommendations: Based on the study findings, the study recommended that insurance firms should foster organizational citizenship behavior. This is because during a time of crisis or pandemic, OCB is important because employees are asked to contribute ideas to help the organization survive, and employees need to go out of their ways to use their talent, skills, networks, and innovativeness to do so. It as well recommended that during a crisis, human resource managers should conduct stay interviews focus on discovering what makes star performers decide to stay in the organization and provide information that managers can use to implement actions that will retain them. -management systems that can be realigned to track skills alongside employee performance.
The Impact of Activation Heating Rate on Pore Structure in Teak Sawdust-Derived Activated Carbon and Its Application in Methylene Blue Adsorption
Authors: Kade Suriadi I Gusti Agung , Putra Negara Dewa Ngakan Ketut , Tirta Nindhia Tjokorda Gede , Adi Atmika I Ketut , Budiana Penindra I Made Dwi , Gatot Karohika I Made 
Published: July 2024

Activated carbon (AC) is a multifunctional adsorbent with a high adsorption capacity because of its pore structure comprising a large pore volume and surface area. However, its pore structure properties are largely influenced by the chemical composition and manufacturing conditions of the raw material. This study examined the effect of activation heating rate parameter on pore structure and methylene blue adsorption in teak sawdust AC. The adsorbent was dehydrated, carbonized and activated at 105, 750 and 700 °C for 2 h, 50 min, and 6 to 14 °C/min, with a nitrogen flow rate of 200 mL/min for 50 min. Several characterizations were carried out to identify pore structure, proximate substance, functional groups, surface morphology, and methylene blue-adsorption capacity of AC. The results showed that activation heating rate with the best properties and capacity of MB adsorption were adsorbed at a peak of 10 °C/min. AC obtained has a C-C aromatic rings functional group, an amorphous crystal structure, an interplanar length of 3.03 Å, 75.74 % fixed carbon, pore surface area of 126.279 m2/g, pore volume of 0.235 cc/g, and a multimodal micropore-mesopore size distribution. This is in addition to adsorption capability of 13.48 mg/g for methylene blue.