bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early and late assessment of renal allograft dysfunction using intravoxel incoherent motion (IVIM) and diffusion-weighted imaging (DWI): a prospective study
Authors: El-Ksas Mostafa , EL-Metwally Dina , Fahmy Dalia , Shebel Haytham 
Published: July 2024

Abstract
Purpose
To evaluate the ability of the Intravoxel Incoherent Motion (IVIM) and monoexponentially ADC in renal allograft function in the early and late phases of transplantation, and to predict their effectiveness in discrimination of the graft pathology.

Methods
This is a prospective study included participants scanned with quantitative diffusion and perfusion sequences on a 3-T MR scanner (Philips, Ingenia); the ADC and IVIM parameters; were calculated. Correlations and regression analysis with the eGFR, transplantation periods, and pathology were assessed.

Results
This study included 105 renal allograft recipients (85 males, and 20 females with mean age = 32.4 ± 11.9 years and age range = 22–61 years). There was a significant positive correlation between the whole parameters of the ADC and IVIM with eGFR however, the cortical parameters showed higher significant correlation coefficients (p < 0.001). Regression analysis revealed the most significant model can predict eGFR groups included cortical pseudo diffusion (D*) and cortical ADC (p < 0.001). In graft dysfunction eGFR was 61.5 ml/min and normal graft was 64 ml/min. This model demonstrates a high performance of an AUC 96% [0.93–0.97]. In the late transplantation, there is a higher correlation with D* compared to ADC, p-values = 0.001.

Conclusion
IVIM and ADC Values are significant biomarkers for renal allograft function assessment, cortical ADC, and D* had the highest performance even in situations with mild impairment that is not affect the eGFR yet as cases of proteinuria with normal eGFR. Furthermore, D* is superior to ADC in the late assessment of the renal transplant.

Graphical abstract
Tip Surgery in Dorsal Preservation Rhinoplasty: The Effect of Modified Low Septal Strip Septoplasty on Tip Plasty
Authors: Çelik Vasfi , Tuluy Yavuz , Çakır Bozkurt Gökçen 
Published: July 2024

Abstract

Background
The aim in tip surgery is to provide rotation, derotation, projection and deprojection. In this study, we aimed to show the effects of modified low septal strip septoplasty, septal extension graft, TIG technique and additional maneuvers on tip shape in dorsal preservation rhinoplasty (DPR) and to discuss our clinical results.

Patients and Methods
One hundred eighty-nine patients who underwent DPR with modified low septal strip septoplasty between November 2021 and August 2023 were included in the study. Demographic data, complications, revision surgeries and follow-up periods of the patients were analyzed retrospectively.

Results
The mean age of the patients is 29.58±9.04 (17-65). The mean follow-up period was 14, 50±2,98 months. Complications were observed in 1.1% of the patients (n=2/189). Revision surgery was performed in all these patients. Residual hump in 2 were observed and dorsum rasping was performed under local anesthesia. No tip revision was performed on any patient.

Conclusions
A strong tip fixation is achieved with the modified low septal septoplasty technique described in this publication, and when combined with septal extension graft, tongue in groove technique and other suture techniques, an effective and permanent tip plasty can be performed in DPR.

Level of Evidence II
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Recurrent pelvic organ prolapse after hysterectomy; a 10-year national follow-up study
Authors: Kuittinen Tea , Mentula Maarit , Tulokas Sari , Brummer Tea , Jalkanen Jyrki , Tomas Eija , Mäkinen Juha , Sjöberg Jari , Härkki Päivi , Rahkola-Soisalo Päivi 
Published: July 2024

Abstract
Purpose
Hysterectomy may be a risk factor for pelvic organ prolapse (POP). We assessed the risk of recurrent POP (operations and visits) after hysterectomy among women with previous POP. We also studied patient and operation related risk factors for POP recurrence.

Methods
This retrospective cohort study included 1697 women having previous POP diagnosis or POP at the time of hysterectomy (FINHYST 2006 cohort). Follow-up was until the end of 2016. The data was derived from the Finnish National Care register linked to the cohort. Hysterectomy approaches and other demographics were compared to the risk of a prolapse diagnosis and/or surgery. Cox regression model was used to identify hazard ratios.

Results
Following hysterectomy, a total of 280 women (16.5%) had a POP reoperation and 359 (21.2%) had an outpatient visit due to POP. Vaginal vault prolapse repair was the most common POP reoperation (n = 181, 10.7%), followed by anterior wall repair (n = 120, 7.1%). Median time to POP reoperation was 3.7 years. Hysterectomy approach did not affect reoperations or visits. Previous cesarean section and anterior repair during hysterectomy were associated with decreased risk, whereas concomitant sacrospinous fixation and uterus prolapse as the main indication led to increased risk of anterior/vault prolapse reoperations. Concomitant posterior repair decreased posterior reoperations and visits, but uterus weight over 500 g caused a fivefold increased risk of posterior prolapse visit. Residential status was associated with elevated risk of any POP reoperations and visits.

Conclusions
Approximately one out of five women suffering from POP ensue POP reoperation or visit after hysterectomy. These high rates are independent on hysterectomy approach, but probably indicate that hysterectomy may worsen previous pelvic floor dysfunction.
Bedside diagnosis of silent aspiration using mobile dynamic digital radiography: a preliminary study
Authors: Koyama Yuji , R.A. Yukuo Morohoshi , SLP Tetsuji Ohta , Toyokura Minoru , Mizuno Katsuhiro , Masakado Yoshihisa 
Published: July 2024

Abstract
Purpose
This study aimed to assess reliable options for bedside diagnosis of silent aspiration in the intensive care unit by examining the use of default grayscale images (DGI) obtained using a mobile, general-purpose, radiography system capable of dynamic digital radiography (M-DDR) and inverted grayscale images (IGI) of DGI.

Methods
This cohort study (exploratory and preliminary) involved 18 adult patients (mean age, 89.0 years) for whom a swallowing assessment request was received from their primary physicians. Fifty-six IGI videoclips were evaluated by three specialists using the penetration-aspiration scale (PAS), with the gold standard being the consensus reading of all three specialists. Another three speech-language pathologists (SLPs) assessed 56 DGI and IGI videoclips using the PAS. PAS scores 1 and 2 were classified as normal range, PAS scores 3–5 as pathological laryngeal penetration, and PAS scores 6–8 as aspiration. The correct rates with IGI and DGI were then determined, and the level of agreement of IGI and DGI evaluations was evaluated.

Results
The correct rate of all evaluators was 100% for normal range, 80–100% for pathological laryngeal penetration, and 83–100% for aspiration with IGI and 100% for normal range, 90% for pathological laryngeal penetration, and 83% for aspiration with DGI. The kappa coefficient for IGI and DGI showed almost complete agreement for abnormal conditions.

Conclusion
Dynamic imaging of swallowing 2–5 ml of liquid using M-DDR performed for elderly patients at the bedside showed that aspiration assessments by SLPs obtained from DGI videos immediately after imaging are acceptable.
Perichondritis of the auricle: bacterial or fungal? (A case series)
Authors: Hu Ming , Cheng Yan 
Published: July 2024

Abstract
Background
Suppurative perichondritis of the auricle is a common disease that can easily cause malformations if it develops into an uncontrolled infection. In nearly half of the cases, otolaryngologists cannot identify the pathogens involved.

Case presentation
In the present work, we described two cases of pyogenic perichondritis, with negative on conventional culture. However, using metagenomic next-generation sequencing (mNGS), we detected fungal infections in the patients and after the patients were given anti-fungal treatment, the patients achieved a good prognosis.

Conclusions
These cases highlighted the possibility that fungi might be the involved pathogens in patients who have had multiple negative bacterial cultures, and mNGS should be applied in these cases. mNGS could be used as a supplement to traditional culture methods.
Neurosteroids and translocator protein 18 kDa (TSPO) ligands as novel treatment options in depression
Authors: Riebel Marco , Brunner Lisa-Marie , Nothdurfter Caroline , Wein Simon , Schwarzbach Jens , Liere Philippe , Schumacher Michael , Rupprecht Rainer 
Published: July 2024

AbstractRecently, the gamma-aminobutyric acid (GABA) system has come into focus for the treatment of anxiety, postpartum depression, and major depressive disorder. Endogenous 3α-reduced steroids such as allopregnanolone are potent positive allosteric modulators of GABAA receptors and have been known for decades. Current industry developments and first approvals by the U.S. food and drug administration (FDA) for the treatment of postpartum depression with exogenous analogues of these steroids represent a major step forward in the field. 3α-reduced steroids target both synaptic and extrasynaptic GABAA receptors, unlike benzodiazepines, which bind to synaptic receptors. The first FDA-approved 3α-reduced steroid for postpartum depression is brexanolone, an intravenous formulation of allopregnanolone. It has been shown to provide rapid relief of depressive symptoms. An orally available 3α-reduced steroid is zuranolone, which also received FDA approval in 2023 for the treatment of postpartum depression. Although a number of studies have been conducted, the efficacy data were not sufficient to achieve approval of zuranolone in major depressive disorder by the FDA in 2023. The most prominent side effects of these 3α-reduced steroids are somnolence, dizziness and headache. In addition to the issue of efficacy, it should be noted that current data limit the use of these compounds to two weeks. An alternative to exogenous 3α-reduced steroids may be the use of substances that induce endogenous neurosteroidogenesis, such as the translocator protein 18 kDa (TSPO) ligand etifoxine. TSPO has been extensively studied for its role in steroidogenesis, in addition to other functions such as anti-inflammatory and neuroregenerative properties. Currently, etifoxine is the only clinically available TSPO ligand in France for the treatment of anxiety disorders. Studies are underway to evaluate its antidepressant potential. Hopefully, neurosteroid research will lead to the development of fast-acting antidepressants.
Psychosocial factors affect the occurrence of nonsuicidal self-injury in adolescents with major depressive disorder through chain mediation
Authors: Ren Tian , Wen Yujiao , Ma Lu , Qiao Dan , Li Gaizhi , Li Hong , Wang Xiao , Liu Zhifen 
Published: July 2024

AbstractIn the adolescent group, about half of adolescents with major depressive disorder (MDD) have NSSI. Psychosocial factors are associated with the development of NSSI. Clarifying the relationship between psychosocial factors and NSSI in adolescents with MDD can help us achieve early prevent. Demographic data, Hamilton Depression Scale-24 (HAMA24), childhood trauma questionnaire, emotional intelligence scale and interpersonal reactivity index were collected from 187 adolescents with MDD. Use ANOVA, Chi-square test, Binary Logistic Regression, Pearson correlation analysis, Mediation effect analysis and the Structural Equation Model for data analysis. The results of ANOVA showed that there was significant difference between the two groups in HAMD24 total score, impulsiveness, emotional intelligence, and empathy (p < 0.05). In the regression analysis, women, depression degree, motor impulsiveness (MI), personal distress (PD) and appraisal of other’s emotions empathy were the risk factors for MDD adolescents to produce NSSI behavior. Among the indicators that were significantly related to MDD and NSSI, MI and PD mediate the relationship between MDD and NSSI. The structural equation model showed that MDD, PD and MI had a direct impact on NSSI, but PD and MI had multiple intermediary effected in the relationship between MDD and NSSI. Emotional intelligence, emotional neglect and cognitive impulsiveness indirectly affected the occurrence of NSSI behavior. Impulsiveness, personal distress, emotional neglect, and emotional intelligence are important risk factors that affect NSSI behavior in adolescents with MDD, and they affect the occurrence of NSSI in adolescents with MDD through chain mediation.
Hippocampal hub failure is linked to long-term memory impairment in anti-NMDA-receptor encephalitis: insights from structural connectome graph theoretical network analysis
Authors: Hechler André , Kuchling Joseph , Müller-Jensen Leonie , Klag Johanna , Paul Friedemann , Prüss Harald , Finke Carsten 
Published: July 2024

Abstract
Background
Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is characterized by distinct structural and functional brain alterations, predominantly affecting the medial temporal lobes and the hippocampus. Structural connectome analysis with graph-based investigations of network properties allows for an in-depth characterization of global and local network changes and their relationship with clinical deficits in NMDAR encephalitis.

Methods
Structural networks from 61 NMDAR encephalitis patients in the post-acute stage (median time from acute hospital discharge: 18 months) and 61 age- and sex-matched healthy controls (HC) were analyzed using diffusion-weighted imaging (DWI)-based probabilistic anatomically constrained tractography and volumetry of a selection of subcortical and white matter brain volumes was performed. We calculated global, modular, and nodal graph measures with special focus on default-mode network, medial temporal lobe, and hippocampus. Pathologically altered metrics were investigated regarding their potential association with clinical course, disease severity, and cognitive outcome.

Results
Patients with NMDAR encephalitis showed regular global graph metrics, but bilateral reductions of hippocampal node strength (left: p = 0.049; right: p = 0.013) and increased node strength of right precuneus (p = 0.013) compared to HC. Betweenness centrality was decreased for left-sided entorhinal cortex (p = 0.042) and left caudal middle frontal gyrus (p = 0.037). Correlation analyses showed a significant association between reduced left hippocampal node strength and verbal long-term memory impairment (p = 0.021). We found decreased left (p = 0.013) and right (p = 0.001) hippocampal volumes that were associated with hippocampal node strength (left p = 0.009; right p < 0.001).

Conclusions
Focal network property changes of the medial temporal lobes indicate hippocampal hub failure that is associated with memory impairment in NMDAR encephalitis at the post-acute stage, while global structural network properties remain unaltered. Graph theory analysis provides new pathophysiological insight into structural network changes and their association with persistent cognitive deficits in NMDAR encephalitis.
Polarized running training adapted to versus contrary to the menstrual cycle phases has similar effects on endurance performance and cardiovascular parameters
Authors: Kubica Claudia , Ketelhut Sascha , Nigg Claudio Renato 
Published: July 2024

Abstract
Purpose
This study compared the effects of polarized running training adapted to the menstrual cycle (MC) phases versus polarized training adapted contrary to the MC on endurance performance and cardiovascular parameters.

Methods
Thirty-three naturally menstruating, moderately trained females (age: 26 ± 4 years; BMI: 22.3 ± 3.2 kg/m2; $$\dot{V}$$

V
˙

O2max/rel: 40.35 ± 4.61 ml/min/kg) were randomly assigned to a control (CON) and intervention (INT) group. Both groups participated in a load-matched eight-week running training intervention. In the INT, high-intensity sessions were aligned with the mid and late follicular phase, low-intensity sessions with the early and mid-luteal phase, and recovery with the late luteal and early follicular phase. In the CON, high-intensity sessions were matched to the late luteal and early follicular phase, and recovery to the mid and late follicular phase. Endurance performance and cardiovascular parameters were assessed at baseline and after the intervention.

Results
Twenty-six females completed the intervention. A repeated measures ANOVA determined no time × group interaction effect for any parameter. A significant time effect was found for maximal oxygen uptake (F(1,12) = 18.753, p = 0.005, ηp2 = 0.630), the velocity at the ventilatory threshold one (F(1,12) = 10.704, p = 0.007, ηp2 = 0.493) and two (F(1,12) = 7.746, p = .018, ηp2 = .413).

Conclusion
The training intervention improved endurance performance in both groups, with no further benefit observed from the MC-adapted polarized training in a group-based analysis. Replications with an extended intervention period, a larger sample size, and a more reliable MC determination are warranted.
Effects of the subtypes of apolipoprotein E on immune inhibition and prognosis in patients with Hepatocellular Carcinoma
Authors: Gao Bowen , Zhou Peiyun , Wang Li , Wang Zhutao , Yi Yong , Li Xian , Zhou Jian , Fan Jia , Qiu Shuangjian , Xu Yang 
Published: July 2024

Abstract
Purpose
To investigate whether prognosis of patients with hepatocellular carcinoma (HCC) is affected by the abundance and subgroups of myeloid-derived suppressor cells (MDSCs) as well as subtypes and expression of apolipoprotein E (apoE).

Methods
31 HCC patients were divided into three groups according to blood total apoE level for detecting the abundance of immunoregulatory cells by flow cytometry. Tumour tissue microarrays from 360 HCC patients were evaluated about the abundance and subgroups of MDSCs and the expression of apoE2, apoE3, apoE4 by immunofluorescence staining and immunohistochemistry staining. Survival analysis by means of univariate, multivariate COX regression and Kaplan-Meier methods of the 360 patients was performed based on clinical and pathological examinations along with 10 years’ follow-up data.

Results
The lower apoE group presented higher abundance of MDSCs in the peripheral blood of HCC patients than higher apoE group. The abundance of monocyte-like MDSCs (M-MDSCs) was higher in the apoE low level group than high level group (p = 0.0399). Lower H-score of apoE2 (HR = 6.140, p = 0.00005) and higher H-score of apoE4 (HR = 7.001, p = 0.009) in tumour tissue were significantly associated with shorter overall survival (OS). The higher infiltration of polymorphonuclear granulocyte-like MDSCs (PMN-MDSCs, HR = 3.762, p = 0.000009) and smaller proportion of M-MDSCs of total cells (HR = 0.454, p = 0.006) in tumour tissue were independent risk factors for shorter recurrence-free survival (RFS).

Conclusion
The abundance of MDSCs in HCC patients’ plasma negatively correlates with the level of apoE. The expression of apoE4 in HCC tissue indicated a poor prognosis while apoE2 might be a potential protective factor.
Drug-induced ER stress leads to induction of programmed cell death pathways of the malaria parasite
Authors: Unal Sinem , Kina Umit Y. , Kamil Mohd , Aly Ahmed S. I. , Palabiyik Bedia 
Published: July 2024

AbstractThe rapid emergence of drug resistance against the mainstream antimalarial drugs has increased the need for development of novel drugs. Recent approaches have embarked on the repurposing of existing drugs to induce cell death via programmed cell death pathways. However, little is known about the ER stress response and programmed cell death pathways of the malaria parasite. In this study, we treated ex vivo Plasmodium berghei cultures with tunicamycin, 5-fluorouracil, and chloroquine as known stress inducer drugs to probe the transcriptional changes of autophagy and apoptosis-related genes (PbATG5, PbATG8, PbATG12, and PbMCA2). Treatments with 5-fluorouracil and chloroquine resulted in the upregulation of all analyzed markers, yet the levels of PbATG5 and PbATG12 were dramatically higher in chloroquine-treated ex vivo cultures. In contrast, tunicamycin treatment resulted in the downregulation of both PbATG8 and PbATG12, and upregulation of PbMCA2. Our results indicate that the malaria parasite responds to various ER stressors by inducing autophagy- and/or apoptosis-like pathways.
Cardiac safety of ribociclib evaluated with 24-hour rhythm Holter electrocardiogram
Authors: Yasin Ayse Irem , Uluganyan Mahmut , Isleyen Zehra Sucuoglu , Topcu Atakan , Shbair Abdallah Tm , Simsek Melih , Besiroglu Mehmet , Ersoy Yeliz Emine , Türk Hacı Mehmet , Seker Mesut 
Published: July 2024

Abstract
Objective
We aimed to evaluate cardiac safety profile of ribociclib with 24-h rhythm Holter ECG.

Material and method
Forty-two female metastatic breast cancer patients were included in the study. Rhythm Holter ECG was performed before starting treatment with ribociclib and after 3 months of the treatment initiation.

Results
The mean age of the patients was 56.36 ± 12.73. 52.4% (n = 22) of the patients were using ribociclib in combination with fulvestrant and 47.6% (n = 20) with aromatase inhibitors. None of the patients developed cardiotoxicity. When the rhythm Holter results before and in third month of the treatment were compared, there was no statistically significant difference.

Conclusion
This is the first study evaluating effects of ribociclib treatment on cardiac rhythm with Holter ECG. The findings suggested ribociclib has a low risk of causing early cardiotoxicity.
Optimizing pre-copy live virtual machine migration in cloud computing using machine learning-based prediction model
Authors: Haris Raseena M. , Barhamgi Mahmoud , Nhlabatsi Armstrong , Khan Khaled M. 
Published: July 2024

AbstractOne of the preconditions for efficient cloud computing services is the continuous availability of services to clients. However, there are various reasons for temporary service unavailability due to routine maintenance, load balancing, cyber-attacks, power management, fault tolerance, emergency incident response, and resource usage. Live Virtual Machine Migration (LVM) is an option to address service unavailability by moving virtual machines between hosts without disrupting running services. Pre-copy memory migration is a common LVM approach used in cloud systems, but it faces challenges due to the high rate of frequently updated memory pages known as dirty pages. Transferring these dirty pages during pre-copy migration prolongs the overall migration time. If there are large numbers of remaining memory pages after a predefined iteration of page transfer, the stop-and-copy phase is initiated, which significantly increases downtime and negatively impacts service availability. To mitigate this issue, we introduce a prediction-based approach that optimizes the migration process by dynamically halting the iteration phase when the predicted downtime falls below a predefined threshold. Our proposed machine learning method was rigorously evaluated through experiments conducted on a dedicated testbed using KVM/QEMU technology, involving different VM sizes and memory-intensive workloads. A comparative analysis against proposed pre-copy methods and default migration approach reveals a remarkable improvement, with an average 64.91% reduction in downtime for different RAM configurations in high-write-intensive workloads, along with an average reduction in total migration time of approximately 85.81%. These findings underscore the practical advantages of our method in reducing service disruptions during live virtual machine migration in cloud systems.