bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Utility of CTNNB1 (c.121A&gt;G) Mutation in Circulating Tumor DNA in Egyptian Patients with Hepatocellular Carcinoma: A Case-Control Study
Authors: Abdallah Nourhan Mohamed , Abdelhakam Dina A , Salah Manar , Montasser Iman , Hamdy Perihan , Salem Ramy 
Published: July 2024

Abstract

Background
Hepatocellular carcinoma (HCC) is the most common malignancy of the liver and with 782,000 new cases annually and 600,000 deaths/year globally. In Egypt, HCC causes a significant public health problem with a rising incidence as it is strongly linked to viral hepatitis mainly HCV. CTNNB1 mutations is one of the most common genetic alterations in HCC. Our aim is to investigate the clinical utility of CTNNB1 (rs121913412) single nucleotide variation (SNV) in ctDNA in patients with early and late-stage HCC in comparison to chronic HCV patients and healthy controls.

Methods
All participants were subjected to history taking, clinical evaluation, laboratory investigations including liver profile, kidney function tests, alfa-fetoprotein. Additionally, complete blood counts and coagulation profile were done. Child and Model for End-Stage Liver Disease (MELD) scores were calculated, BCLC staging was done for each patient and radiological protocol for HCC (spiral triphasic CT or MRI). Genotyping of rs121913412 CTNNB1 (c.121A&gt;G) on extracted DNA from blood samples was done using Real Time PCR System.

Results
Thirty patients with HCC on top of HCV were recruited including 14 early HCC and 16 with advanced HCC in addition to non-HCC group including 10 HCV-positive patients and 10 healthy controls. All participants have undergone laboratory investigations and radiological protocol for HCC cases. Genotyping of rs121913412 CTNNB1 (c.121A&gt;G) in peripheral blood samples using RT-PCR for all cases was done. The genotype AA was detected in 27out of 30 (30%) of the cases while 3 HCC cases out of 30 (10 %) were positive for the CTNNB1 p.T41A mutation; AG phenotype (heterozygous), no cases showed GG phenotype. In HCV- positive patients’ group and healthy controls none were positive for the CTNNB1 mutation all showed wild AA genotype. No significant differences in the genotype (AA, AG, GG) distribution between HCC and non-HCC groups (χ2=3.619, p = 0.0571). The frequency of AA vs AG + GG genotype was considerably higher in cases when compared to controls however no statistical significance was detected (χ2=3.619, p = 0.0571). Distribution of A vs G allele in cases compared to controls showed statistically significant difference (χ2=4.571, p = 0.0325).

Conclusion
In this study we were not able to prove the clinical utility of CTNNB1 rs121913412 in Egyptian HCC patients. Further large multi-centric studies are needed to explore the clinical utility of ctDNA in assessment of tumor-specific hotspot somatic mutations in genes including CTNNB1, TERT and TP53 genes that can be identified in the peripheral blood of HCC patients. Comparison studies utilizing both ctDNA and DNA extracted from HCC tissue samples are recommended.
Effect of TAMSULOSIN on Sexual Dysfunction in Patients Complaining of Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia
Authors: El-Zayat Tarek Mostafa , Mahmoud Mahmoud Ahmed , Eissa Azab Shady Kamal 
Published: July 2024

Abstract

Background
Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) and Erectile Dysfunction are common disorders of advancing age.

Aim and Objectives
The aim of the study was to assess the effect of Tamsulosin on sexual function in patients complaining of LUTS suggestive of BPH.

Subjects and Methods
We evaluated the sexual function, erectile & ejaculatory, of patients enrolled in the study using validated questionnaires. This evaluation was done before treatment with Tamsulosin and 3 months later, comparing the Pre & Post-Treatment scores.

Results
There was a statistically significant deterioration of orgasmic function domain of IIEF between Pre & Post-Treatment. However, no significant changes were noticed with the other IIEF domains. Also according to the MSHQ-EjD-SF, there was a significant deterioration in the ejaculation domain and ejaculation bother domain.

Conclusion
Tamsulosin was found to be with higher risk for decreasing the orgasmic frequencies and the ejaculation for patients suffering from BPH.
Gemcitabine versus Bacillus Calmette-Guérin (BCG) in Non Muscle Invasive Transitional Cell Carcinoma of the Bladder after Trans-Urethral Resection
Authors: El Zayat Tarek Mostafa , Mahmoud Mahmoud Ahmed , Elawady Hossam Mohamed , Toma Michael Saed 
Published: July 2024

Abstract

Background
To overcome Bacillus Calmette–Guérin (BCG) shortage and its side effect several studies have compared the safety and efficacy of intravesical gemcitabine with (BCG) for non-muscle invasive bladder cancer. The aim of this work is to evaluate the efficacy of Gemcetabine as a local intravesical treatment of superficial TCC in reducing the risk of recurrence and progression after TURBT in comparison to BCG.

Patients and Methods
This single blind controlled randomized study Included 82 patients which randomly divided into 2 groups by 1:1 method.Each group included 41 patients, group I will receive gemcitabine. Group II will receive BCG.These patients were diagnosed with superficial bladder tumor (TCC) after TURBT. These patients were followed in the out-patient clinic in the Department of Urology Ain Shams University Hospital and 6th October Health Insurance Hospital during the period from 2017 till 2021.

Results
After 1 year of follow up 67.6% of group I on the other hand 63.4% of group II were free of tumors. As regard tumor progression, only 2.7% of group I patient had tumor progression while 4.9% of group II had tumor progression but all of these results were statistically not-significant with P. value 0.475. As regard side effects after 1 year of follow up. Regarding dysuria 24 patients 96% in group (I) complained of mild dysuria. On the other hand, 39 patients 95.1 % in group (II) complained of dysuria, 9 of them 21.9 % had sever dysuria and 30 patients 73.2 % had mild dysuria. which was statistically not significant with P. value 0.078. Urine analysis was done after treatment. 33 patients (89.2%) had pus cells in the patients of group I while in group II, all patients had pus cells in urine analysis, which was statistically significant with (P. value 0.046).

Conclusion
Gemcitabine was associated with nearly similar efficacy and a clinically significant better toxicity profile compared with BCG. Intravesical gemcitabine is a promising drug that may be an option in treating patients with non muscle invasive bladder cancer.
Reliability of a Modified Watson-Jones Classification for Tibial Tubercle Fractures in Children
Authors: Bradley Taylor , Crowe Mary , Mayassi Hani , Patel Jay , Tamai Junichi , Mehlman Charles T. 
Published: July 2024

Objectives:
The first case report describing a pediatric fracture of the tibial tubercle was published in 1852 in the Medical Times and Gazette, a Journal of Medical Science, literature, criticism, and news. A century later, in 1955, Sir Watson-Jones introduced the first classification system for this fracture. Despite the existence of several classification systems for pediatric tibial tubercle fractures in the medical literature, a crucial aspect of their validation—reliability and reproducibility—has not yet been systematically evaluated.

Methods:
In this study, a modified Watson-Jones (mWJ) classification system of tibial tubercle fractures in children was assessed for intraobserver and interobserver variability. Using the mWJ classification, 3 board-certified pediatric orthopaedic surgeons and 3 orthopaedic surgery residents, classified thirty tibial tubercle fractures based on anteroposterior and lateral radiographs on 2 separate occasions in a 2-week duration. Further comparison was made to evaluate the impact of advanced imaging, specifically computed tomography or magnetic resonance imaging, on diagnostic reliability and reproducibility.

Results:
The study found substantial intraobserver reliability of the mWJ classification based on radiographs alone, with a Cohen weighted kappa (κw) coefficient of 0.733. When advanced imaging was utilized, the reliability of the classification improved to κw = 0.783. Similarly, interobserver reliability demonstrated substantial consistency among observers when using radiographs alone (κw = 0.69) and improved agreement with advanced imaging (κw = 0.75). Notably, there was no significant difference in reliability scores between senior-level attendings and residents when analyzed as separate groups.

Conclusion:
Fracture classification systems are clinically relevant tools that help organize and transfer knowledge efficiently, provide treatment guidance, propose prognostic expectations, and improve communication in academic literature. The present study demonstrated substantial reproducibility of an mWJ fracture classification system both between and within individual surgeon raters.

Level of Evidence:
Level III—diagnostic.
The Law of Diminishing Returns in the Integrated Plastic Surgery Residency Match: A Deeper Look at the Numbers
Authors: Elemosho Abdulaziz , Sarac Benjamin A. , Janis Jeffrey E. 
Published: July 2024

Background:
The highly competitive nature of the integrated plastic surgery residency match justifies the need for objective data that provide insights into some of the residents’ selection criteria. Many studies have sought to provide information on these criteria, but to our knowledge, none has described the inflection point where the match probability does not further increase. Although our study provides this information to potential applicants, it will also help them assess and optimize their chances of a successful match.

Methods:
We pooled and analyzed the data available on matched and unmatched integrated plastic surgery applicants on the national residency match program database between 2016 and 2022.

Results:
Step 2 score of 250 or more (P < 0.0001), number of publications more than 15 (P = 0.0007), number of research experiences five or more (P = 0.018), number of contiguous ranks more than 10 (P < 0.0001), number of volunteer experiences five or more (P < 0.0001), being a US MD applicant (P < 0.0001), and Alpha Omega Alpha membership (P < 0.0001) were all associated with increased probability of matching into the integrated plastic surgery program. Match probability did not further increase after 15 publications, five research experiences, 15 contiguous ranks, and 10 volunteer experiences have been reached. Having a PhD (P = 0.149) or a non-PhD graduate degree (P = 0.07) was not associated with increased match probability.

Conclusion:
The law of diminishing returns sets in for applicants to the integrated plastic surgery match after 15 publications, 15 contiguous ranks, five research experiences, and 10 volunteer experiences have been reached.
Anxiety Symptoms and Disease Severity in Parkinson Disease
Authors: Whitmarsh Ainslie , Protea Suzy , Gibson Jessie S. 
Published: July 2024

ABSTRACT

BACKGROUND: Anxiety is prevalent in Parkinson disease (PD), negatively affecting quality of life for patients and their families. Targeted anxiety interventions are needed that account for variables such as disease severity; however, there is insufficient evidence regarding the trajectory of anxiety along the disease course. OBJECTIVE: The aim of this study was to investigate the association between disease severity and anxiety symptoms in a PD sample. METHODS: This descriptive study used secondary data analyses of data from a web-based survey study of individuals with PD in the United States. Participants were 21 years or older, had access to the Internet, and were given a diagnosis of PD (N = 72). We performed multiple regression analyses to assess the relationship between patient-reported disease severity and anxiety symptoms. RESULTS: There was a statistically significant association between disease severity and anxiety symptoms in people with PD, after controlling for all 5 explanatory variables (sex, age, wearing off, disease severity, and disease duration) (P < .001). Age and wearing off PD medication also had statistically significant, although smaller, effects on anxiety symptoms (P < .05). CONCLUSION: Disease severity was related to increased anxiety symptoms among individuals with PD. Anxiety intervention research is needed, and future studies should account for variations in disease severity and medication effects in both intervention and study design.
Wildland Firefighter Work History and Clinical Indicators of Cardiovascular Health
Authors: Hasan Md. Zahid , Semmens Erin O. , Navarro DuBose Kathleen , McCray L. Kaili , Noonan Curtis W. 
Published: July 2024

Objective
To determine the association between the occupational history as a wildland firefighter (WFF) and clinical indicators of cardiovascular health.

Methods
Among 2862 WFFs, we evaluated associations between the number of total days assigned on fire and high-risk categories of three clinically measured cardiovascular indicators.

Results
Almost one-third (32%) of WFFs had one or more clinical measures that would place them in high-risk categories for body mass index, blood pressure, and total cholesterol. WFF work history was associated with some of these measures: odds ratio (and 95% confidence interval) for highest versus lowest tertile of days on fire were 1.4 (1.2, 1.8) and 1.2 (1.0, 1.5) for high-risk categories of body mass index and cholesterol, respectively.

Conclusion
More frequent screening and targeted health promotion programs for WFFs are warranted to increase awareness of cardiovascular risk and prevention strategies.
Quality Assessment of a Virtual Post Offer Placement Assessment in Employee Occupational Health Services
Authors: Minter Sarah , Hainy Caitlin , Swift Melanie , Yee Claire , Meyers Jon , Nos Anna , Breeher Laura 
Published: July 2024

Objective
The rise in remote work and increased access to technology allow opportunity for virtual onboarding. The aim of this project was to assess the quality of virtual onboarding versus the traditional in-person onboarding.

Methods
A multidisciplinary team utilized a survey to evaluate staff and new hire candidate satisfaction with the in-person versus virtual post offer placement assessment (POPA).

Results
The virtual POPA process maintained a high-level of quality and satisfaction among new hire healthcare candidates compared to in-person onboarding, with shorter appointment times. Employee Occupational Health Services staff and new hire candidates reported a preference for the virtual POPA process over traditional in-person onboarding.

Conclusions
The virtual POPA option reduced the length of appointments and maintained satisfaction and quality of service.
Clinical Outcomes of Endoscopic Butterfly Inlay Cartilage Myringoplasty
Authors: Joo Hye Ah , Choi Hyeon Chang , Lee Dong Kyu , Ahn Joong Ho , Park Hong Ju , Chung Jong Woo , Kang Woo Seok 
Published: July 2024

Objective
To review a 3-year case series of endoscopic butterfly inlay cartilage myringoplasty performed by a single surgeon (W.S.K.) and analyze the clinical surgical outcomes.

Study Design
Retrospective study.

Setting
Tertiary care academic center.

Patients
We enrolled 60 ears with tympanic membrane (TM) perforation, receiving endoscopic inlay butterfly myringoplasty between 2019 and 2022.

Main outcomes and Measures
We reviewed patients' demographics, size and location of TM perforation, operation time, complications, and postoperative pain evaluated by the numerical rating scale (NRS). We analyzed the graft uptake success rate in 5 weeks and the perforation closure rate in 4 months after surgery. We also compared the air-bone gap (ABG) before and after the surgery.

Results
Among the 60 ears included, the mean age was 57.0 years, and 78.3% (47 of 60) had small perforations. The average operation time was 48.9 ± 11.5 minutes, and the postoperative NRS was 2.0 ± 1.6. The immediate graft uptake success rate evaluated at postoperative 5 weeks was 96.7% (58 of 60), with myringitis occurring in three ears. Except for 11 patients lost to follow-up, the perforation closure rate evaluated at postoperative 4 months was 100% (49 of 49). The mean ABG significantly improved from preoperative status (8.87 ± 5.51 dB HL) to postoperative 4 months (6.22 ± 6.03 dB HL) (p = 0.019).

Conclusions
A single surgeon's success rate for endoscopic butterfly inlay cartilage myringoplasty was almost 100%. This surgical procedure is safe and effective, with a high graft success rate.
Management of Bleeding and Thrombotic Complications During Pediatric Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference
Authors: Rintoul Natalie E. , McMichael Ali B.V. , Bembea Melania M. , DiGeronimo Robert , Patregnani Jason , Alexander Peta M.A. , Muszynski Jennifer A. , Steffen Katherine , Gehred Alison , Lyman Elizabeth , Cheifetz Ira M. ,   for the Pediatric Extracorporeal Membrane Oxygenation (ECMO) Anticoagulation Collaborative (PEACE), in collaboration with the Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric ECMO subgroup of PALISI and the Extracorporeal Life Support Organization (PediECMO)
Published: July 2024

OBJECTIVES:
To derive systematic-review informed, modified Delphi consensus regarding the management of bleeding and thrombotic complications during pediatric extracorporeal membrane oxygenation (ECMO) for the Pediatric ECMO Anticoagulation CollaborativE Consensus Conference.

DATA SOURCES:
A structured literature search was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021.

STUDY SELECTION:
The management of bleeding and thrombotic complications of ECMO.

DATA EXTRACTION:
Two authors reviewed all citations independently, with a third independent reviewer resolving conflicts. Twelve references were used for data extraction and informed recommendations. Evidence tables were constructed using a standardized data extraction form.

DATA SYNTHESIS:
Risk of bias was assessed using the Quality in Prognosis Studies tool. The evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. Forty-eight experts met over 2 years to develop evidence-based recommendations and, when evidence was lacking, expert-based consensus statements for the management of bleeding and thrombotic complications in pediatric ECMO patients. A web-based modified Delphi process was used to build consensus via the Research And Development/University of California Appropriateness Method. Consensus was defined as greater than 80% agreement. Two good practice statements, 5 weak recommendations, and 18 consensus statements are presented.

CONCLUSIONS:
Although bleeding and thrombotic complications during pediatric ECMO remain common, limited definitive data exist to support an evidence-based approach to treating these complications. Research is needed to improve hemostatic management of children supported with ECMO.
Recommendations on Monitoring and Replacement of Antithrombin, Fibrinogen, and Von Willebrand Factor in Pediatric Patients on Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference
Authors: Zantek Nicole D. , Steiner Marie E. , Teruya Jun , Kreuziger Lisa Baumann , Raffini Leslie , Muszynski Jennifer A. , Alexander Peta M. A. , Gehred Alison , Lyman Elizabeth , Watt Kevin ,   for the Pediatric ECMO Anticoagulation CollaborativE (PEACE), in collaboration with the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, the Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric ECMO subgroup of PALISI and the Extracorporeal Life Support Organization (PediECMO)
Published: July 2024

OBJECTIVES:
To derive systematic review informed, modified Delphi consensus regarding monitoring and replacement of specific coagulation factors during pediatric extracorporeal membrane oxygenation (ECMO) support for the Pediatric ECMO Anticoagulation CollaborativE.

DATA SOURCES:
A structured literature search was performed using PubMed, Embase, and Cochrane Library (CENTRAL) databases from January 1988 to May 2020, with an update in May 2021.

STUDY SELECTION:
Included studies assessed monitoring and replacement of antithrombin, fibrinogen, and von Willebrand factor in pediatric ECMO support.

DATA EXTRACTION:
Two authors reviewed all citations independently, with conflicts resolved by a third reviewer if required. Twenty-nine references were used for data extraction and informed recommendations. Evidence tables were constructed using a standardized data extraction form.

DATA SYNTHESIS:
Risk of bias was assessed using the Quality in Prognosis Studies tool. The evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. A panel of 48 experts met over 2 years to develop evidence-based recommendations and, when evidence was lacking, expert-based consensus statements. A web-based modified Delphi process was used to build consensus via the Research And Development/University of California Appropriateness Method. Consensus was defined as greater than 80% agreement. We developed one weak recommendation and four expert consensus statements.

CONCLUSIONS:
There is insufficient evidence to formulate recommendations on monitoring and replacement of antithrombin, fibrinogen, and von Willebrand factor in pediatric patients on ECMO. Optimal monitoring and parameters for replacement of key hemostasis parameters is largely unknown.
Comparing Prefabricated and 3D Printed Foot Orthoses for the Management of Flat Foot Condition: A Randomized Controlled Trial
Authors: Bari Abu Zeeshan , Ahmed Naveed , Farhan Muhannad , Al-Shenqiti Abdullah , Zafar Muhammad Sohail 
Published: July 2024

Abstract

Objective
To investigate the short-term effects of 3D-printed and prefabricated foot orthoses on the management of flat feet.

Design
In this single-blinded study, 63 patients with flat feet were enrolled via convenience sampling. They were randomly assigned to the control and experimental groups, receiving prefabricated and customized 3D-printed foot orthoses, respectively. The assessment tools included a Visual analog scale (VAS) and a modified Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. The patients scored their pain at weeks 0 and 4 using the VAS. At the end of week 4, patients completed the modified version of the QUEST questionnaire to record their satisfaction with the orthosis.

Results
VAS scores at week 0 for the two groups were not statistically significant (p > 0.05). At week 4, the VAS scores of the experimental group reduced significantly (p < 0.001), whereas the VAS scores of the control group remained statistically insignificant (p > 0.05). Modified QUEST questionnaire analysis revealed higher satisfaction with orthosis comfort and effectiveness in the experimental group than in the control, while factors like orthosis dimensions, weight, and durability did not differ significantly between groups.

Conclusions
Customized 3D-printed orthoses effectively reduced pain and enhanced patient satisfaction with comfort and effectiveness in 4 weeks.