bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-352 Investigating the association between DMPK CTG repeats and female hypogonadism in patients affected by Type 1 Myotonic Dystrophy
Authors: Micaglio E , Riva A , Tamma A , Villa M , Sabatelli L , Cardani R , Benedetti S , Pappone C , Sorrentino U , Zuccarello D 
Published: July 2024

Abstract

Study question
Is DPKM CTG repeat size correlated with hypogonadism in female patients affected by type 1 Myotonic Dystrophy?

Summary answer
The size of CTG repeats in DPKM gene seems to be correlated with hypogonadism severity in female patients affected by type 1 Myotonic Dystrophy.

What is known already
Type 1 Myotonic Dystrophy (DMT1) is an autosomal dominant degenerative genetic disorder caused by CTG repeats in a single copy of DMPK gene. It is characterized by a broad phenotypic spectrum and a progressive course, involving primarily the muscular and endocrine systems. While DMT1 is a very well-known cause of male hypogonadism, the relationship between DMPK CTG repeats and female hypogonadism is almost unexplored yet.

Study design, size, duration
We performed a cross–sectional risk study in a cohort of 60 women, with a mean age of 31.5 years (18 to 45 years), referred to our Medical Genetics service for either suspected DMT1 or hypogonadism. The study duration was one year (from November 2022 to November 2023).

Participants/materials, setting, methods
We performed a DMPK–CTG analysis to investigate a possible correlation between CTG and hypogonadism. Based on the analysis, 11 women were diagnosed with DMT1 with associated hypogonadism, 11 with DMT1 without hypogonadism, 22 did not show DMPK expansion but were affected by hypogonadism, while the remaining 16 showed neither DMPK expansion nor hypogonadism. The patients affected by DMT1 performed standard karyotyping, FRAXA and FRAXE genetic testing to exclude alternative genetic causes of premature ovarian failure.

Main results and the role of chance
Our results, are indicative that the severity of hypogonadism in DMT1 patients may correlate with the size of CTG repeats. DMPK CTG repeats ranging from 150 – 1000 (range E2) were associated with milder forms of hypogonadism, while the patients having DMPK expansions within the E3 range (1000 CTG repeats or more) showed hypergonadotropic hypogonadism with both infertility and failure of medically assisted reproduction.

Limitations, reasons for caution
The female patients showing neither DMPK expansion nor hypogonadism did not perform other genetic analysis except DMPK-CTG testing. Moreover, due to the low sample size, our results did not reach statistical significance for a definitive conclusion.

Wider implications of the findings
To the best of our knowledge, this is the first study to show a possible correlation between female hypogonadism and DMPK CTG repeat size in female patients with type 1 myotonic dystrophy. These results, although preliminary, represent a first step in understanding a hitherto misrecognized clinical consequence of the disease.

Trial registration number
Not applicable
P-622 Prospectively randomized study of intraovarian injections of autologous platelet-rich plasma (PRP) into one alternating ovary in Primary Ovarian Insufficiency (POI)
Authors: Barad D  H , Patrizio P , Gayete-Lafuente S , Nicholas C , Albertini D , Gleicher N 
Published: July 2024

Abstract

Study question
Does intraovarian injection of autologous PRP affect ovarian function in women with POI?

Summary answer
Ovaries that were injected with PRP demonstrated a significant increase in follicles &gt;4mm in size compared to the untreated contralateral ovaries.

What is known already
The injection of PRP into ovaries has been reported to improve subsequent ovarian response to ovulation induction in women with POI and is now widely used in fertility centers in women with POI as well as in women with premature ovarian aging (POA). Prospectively randomized studies are, however, lacking.

Study design, size, duration
This is a Randomized Controlled Trial with recruitment from July 2018 - November 2023. 40 patients were screened; 34 qualified. POI was defined by amenorrhea among women &lt; 40 years old, with FSH &gt; 30 mIU/mL, undetectable AMH, and no follicles &gt;4mm. For each participant one ovary was randomly selected for treatment ( with the Sealed Envelope Ltd 2022 tool). The study was powered to detect a 20% response in the treated versus untreated ovary.

Participants/materials, setting, methods
For each patient (n = 34), 10mL of blood was drawn into ReganLab vacutainer and centrifuged. Platelets were re-suspended in 1.5mL of plasma. PRP was injected into the stroma of one randomly selected ovary under iv sedation and ultrasound control. Patients were followed with ultrasounds, estradiol, and FSH q3-4 days for two weeks. Our primary outcome was the development of new follicles &gt;4mm in the treated vs. untreated ovary, using Chi-Square.

Main results and the role of chance
Study population description: age 33.9±5.5 years (range 21-40.4 years); BMI 23.4±4.2; FSH 96.7±27.6 mIU/mL; AMH 0.019±0.03 ng/mL; length of amenorrhea 2.2 years (3 months-14 years). 10 patients developed no follicles &gt; 4 mm, 21/34 (62%) did develop follicles &gt; 4 mm in treated ovaries; 9/34 (26%) developed a follicle &gt; 4 mm in untreated ovaries (Chi-square = 8.59; P = 0.003). Most follicles developed without significant estradiol production; nine showed sufficient follicle development to initiate ovulation induction with initiation of gonadotropins, four produced eggs and one produced an embryo; one patient had four oocytes banked and resumed menses following PRP treatment for several months.

Limitations, reasons for caution
N/A

Wider implications of the findings
This demonstrates the first objective evidence that intraovarian PRP injections into POI ovaries initiate some follicle activation. Though the observed degree of activation was small, findings suggest that remaining follicles in women with POI can be activated through injections into ovaries, suggesting that better agents than PRP may be discovered.

Trial registration number
N/A
P-644 Effect of Letrozole co-stimulation with gonadotropin in women with normal ovarian reserve on oocyte maturation: a Randomized controlled trial
Authors: Laokirkkiat P , Hunsawongsakul D 
Published: July 2024

Abstract

Study question
To define whether letrozole co-stimulation with gonadotropin in normal-ovarian reserve women will improve the number of oocyte maturation.

Summary answer
Letrozole co-stimulation in normal ovarian reserve resulted in a reduced number of MII.

What is known already
Letrozole functions as an aromatase inhibitor. By inhibiting this enzyme, letrozole effectively lowers estrogen levels. Thus, letrozole prevents the estrogen-negative feedback to the HPO axis, which can increase the secretion of gonadotropins from the pituitary gland to promote folliculogenesis. The application of letrozole co-stimulation in women with a normal ovarian reserve is still debated.

Study design, size, duration
This study is an open-labeled, randomized controlled trial. Letrozole co-stimulation with gonadotropin in women with normal ovarian reserve. The RCT was conducted at the Fertility and Reproductive Biology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital in Thailand, from March 2023 to October 2023.

Participants/materials, setting, methods
One hundred forty-four infertile women 18-40 years old with normal ovarian reserve (AMH 1.2-7 ng/ml, AFC ≥ 5) were random to gonadotropin co-stimulation with letrozole 5 mg once daily (n = 72) and gonadotropin alone (n = 72). The number of MII oocytes, follicle-to-oocyte index, GDF-9 and BMP-15 in follicular fluid were assessed.

Main results and the role of chance
Letrozole co-stimulation resulted in a significantly reduced number of MII [8 (4,12) vs 9 (5, 15.8), p = 0.042] and the rate of MII [ 71.7(60, 83.8) vs 80 (66.7, 90), p = 0.013]. However, the number of retrieved oocytes [12 (6,16.8) vs. 12 (6,16), p = 0.335] and FOI [85.7 (57.4,107.5) vs 84.2 [61.8, 112.5], p = 0.396] remained unchanged. The total dose of gonadotropin in the letrozole group was no different from the control group [1,350 (1,200, 1,650) vs 1,500 (1,350, 1,718.8) I.U., p = 0.137]. The duration of ovarian stimulation was shortened in the letrozole group compared to the control group [9 (8, 10) vs 9 (8.3, 10) days, p = 0.027]. The letrozole and control group had a similar level of GDF-9 (0.036 ± 0.003 A.U. vs. 0.028 ± 0.004 A.U., p = 0.119, letrozole and control group, respectively) and BMP-15 (0.034 ± 0.002 A.U. vs. 0.033 ± 0.004 A.U., p = 0.923, letrozole and control group respectively) in follicular fluid.

Limitations, reasons for caution
This study was open-label, with limited generalizability due to 91% of ovarian stimulation being strict to the research protocol (r-FSH and antagonist protocol) and no pregnancy outcome.

Wider implications of the findings
The study showed no benefit of letrozole co-stimulation in women with normal ovarian reserve.

Trial registration number
TCTR20221125002
How Hot is too Hot? Metabolic Responses to Temperature Across Life Stages of a Small Ectotherm
Authors: Segura-Hernández Laura , Hebets Eileen A , Montooth Kristi L , DeLong John P 
Published: July 2024

Synopsis
To understand how global warming will impact biodiversity, we need to pay attention to those species with higher vulnerability. However, to assess vulnerability, we also need to consider the thermoregulatory mechanisms, body size, and thermal tolerance of species. Studies addressing thermal tolerance on small ectotherms have mostly focused on insects, while other arthropods, such as arachnids remain understudied. Here, we quantified the physiological thermal sensitivity of the pseudoscorpion Dactylochelifer silvestris using a respirometry setup with a ramping temperature increase. Overall, we found that D. silvestris has a much lower metabolic rate than other organisms of similar size. As expected, metabolic rate increased with body size, with adults having larger metabolic rates, but the overall metabolic scaling exponent was low. Both the temperature at which metabolism peaked and the critical thermal maxima were high (&gt;44°C) and comparable to those of other arachnids. The activation energy, which characterizes the rising portion of the thermal sensitivity curve, was 0.66 eV, consistent with predictions for insects and other taxa in general. Heat tolerances and activation energy did not differ across life stages. We conclude that D. silvestris has low metabolic rates and a high thermal tolerance, which would likely influence how all stages and sexes of this species could endure climate change.
Rhodomyrtone: a new anti-Staphylococcus aureus agent against resistant strains
Authors: Saravolatz Louis D , Pawlak Joan 
Published: July 2024

Abstract

Background
Rhodomyrtone is a novel plant-derived antibiotic compound originally isolated from Rhodomyrtus tomentosa leaf extract.

Objectives
To evaluate the activity of rhodomyrtone against a group of MRSA strains, including isolates with reduced susceptibility or resistance to vancomycin, daptomycin, linezolid and ceftaroline.

Methods
Broth microdilution testing was used to determine the MICs and MBCs of rhodomyrtone, fosfomycin, vancomycin, daptomycin, linezolid and ceftaroline.

Results
ROM had an MIC90 of 1 mg/L against 110 strains of MRSA from blood isolates as well as for all other isolates that were daptomycin resistant, VISA, VRSA or LRSA. The MBC90 were 4 mg/L across all groups tested. Among all S. aureus groups tested the ROM MBC did not exceed 8 mg/L.

Conclusions
Rhodomyrtone demonstrated excellent activity against MRSA as well as isolates with resistance or reduced activity to other anti-MRSA drugs including vancomycin, daptomycin and linezolid. Rhodomyrtone may have potential clinical utility when treating patients with infections caused by MRSA including those with reduced susceptibility to first-line anti-MRSA antimicrobial agents.
Constraining fundamental constants with fast radio bursts: unveiling the role of energy scale
Authors: Kalita Surajit 
Published: July 2024

ABSTRACT
Understanding physical mechanisms relies on the accurate determination of fundamental constants, although inherent limitations in experimental techniques introduce uncertainties into these measurements. This paper explores the uncertainties associated with measuring the fine-structure constant ($\alpha$) and the proton-to-electron mass ratio ($\mu$) using observed fast radio bursts (FRBs). We select 50 localized FRBs to quantify the effects of varying this fundamental coupling on the relation between dispersion measure and redshift. By leveraging independent measurements of dispersion measures and redshifts of these FRBs, we constrain the uncertainties in $\alpha$ and $\mu$ approximately to $\Delta \alpha /\alpha =1.99\times 10^{-5}$ and $\Delta \mu /\mu =-1.00\times 10^{-5}$ within the standard $\Lambda$CDM cosmological framework. Remarkably, these constraints improve nearly an order-of-magnitude when considering a dynamical dark energy model. This investigation not only yields one of the most stringent constraints on $\alpha$ and $\mu$ to date but also emphasizes the criticality of accounting for the energy scale of the system when formulating constraints on fundamental parameters.
Levosimendan versus Milrinone in Improving Pulmonary Hypertension after Cardiac Surgery
Authors: Abd El Aziz Fahmy Nabila Mohamed , Abd Elmalek Marcos Fady Adib , Hassan Gouda Hala Saeed , Malky Senada Marina Ghobrial 
Published: July 2024

Abstract

Background
Pulmonary hypertension is a multifactorial disease with a high morbidity and mortality, right ventricular function is the most important predictor of morbidity and mortality in patients suffering from pulmonary hypertension. Milrinone, a phosphodiesterase III inhibitor is commonly used during post cardiopulmonary bypass (CPB) period in combination with adrenaline or noradrenaline to decrease pulmonary artery pressure and to provide synergistic positive inotropic effect. Levosimendan is a calcium sensitizing agent with inotropic, pulmonary vasodilatory, and cardioprotective properties. This study compared levosimendan with milrinone in improving pulmonary hypertension after cardiac surgeries.

Objective
To compare between levosimendan and milrinone in improving pulmonary hypertension after cardiac surgeries.

Patients and Methods
In this study 40 Patients were assigned randomly by using a computer – generated table of random numbers, placing them in sealed envelopes, into two groups: Group M: 20 Patients were received milrinone Group L:20 Patients were received levosimandan.

Results
In this study we compared levosimendan vs milrinone, in levosimendan group there was more significant increase of post operative TAPSE, in milrnone group there was more significant decrease of PAP and RVSP. There was statistically significant difference groups received milrinone in pre, post operative AST, ALT as there was increase in post operative AST and ALT, groups were compared in demographic data (in terms of age, sex, weight and height) and there was no statistically significant difference between groups, were compared as regard CPB and type of surgery and there was no statistically significant difference between groups, were compared in post operative data (in terms of systolic, diastolic blood pressure, heart rate, SPO2, CVP, UOP and extubation time), there was no statistically significant difference between groups, were compared in kidney function (in term of pre and post operative serum creatinine), there was no statistically significant difference between groups, were compared in acid base data (in term of post operative PH), there was no statistically significant difference between groups, were compared in weaning from ventilators (within 24 hours post operative) and there was no statistically significant difference between groups.

Conclusion
We concluded that in levosimendan group there was more significant increase in post operative TAPSI, in milrinone group there was more significant decrease of PAP and RVSP and in milrinone group there was increase in post operative AST/ALT.
A Comparative Study between Sub-sartorial Canal Block and Femoral Nerve Block for Postoperative Analgesia after Arthroscopic Knee Surgery
Authors: Nashed Sherief Wadie , Ghaly Safaa Ishak , Mohammed Haggag Adham Magdy Ahmed , Ahmed Abd-elaleem Ali Ibrahim 
Published: July 2024

Abstract

Background
Knee arthroscopy is a common orthopedic procedure worldwide, despite its minimally invasive nature compared to the traditional knee surgery, post-arthroscopic pain may be severe, and the patients generally require a significant amount of opioid-based analgesics after such procedures. Femoral nerve block (FNB) is commonly used for analgesia inpatients undergoing knee or ankle surgery.

Aim of the Work
The aim of the study is to compare the analgesic efficacy and functional recovery of ACB and FNB in patients who have undergone knee arthroscopy.

Patients and Methods
In the period from April 2021 to October 2021 sixty patients who underwent Arthroscopic knee surgery were randomly allocated to one of two groups and comparative study was done. Group I (group FNB): patients received Femoral Nerve Block (FNB) after spinal anaesthesia, group II (group ACB): Patients received Sub-sartorial canal block (Adductor Canal Block) (ACB) after spinal anaesthesia. After the end of the surgery, the femoral nerve block or adductor canal block will be performed according to patient group allocation.

Results
During our study, it was found that ACB is equally effective with FNB in patient satisfaction for post operative analgesia (NRS at 4 hrs, 8 hrs, 12 hrs, 16 hrs, 20 hrs and 24 hrs was non-significant as P value was 0.3, 0.29, 0.1, 0.5, 0.35, 0.87 respectively) but ACB is more effective than FNB in post operative ambulation and rehabilitation after arthroscopic knee surgery (ACB ambulated after 180.7 ± 23.6 mins in ACB and 241.2 ± 29.12 mins in FNB with pvalue &lt;0.001). Numerous studies compared adductor canal block with femoral nerve block in motor power and analgesia.

Conclusion
Our study concluded that Adductor Canal Block is more effective than Femoral Nerve Block in post operative ambulation and equally effective with Femoral nerve block in patient satisfaction for post operative analgesia after arthroscopic knee surgery.
Ultrasound-Guided Quadratus Lumborum Block Using Bupivacaine versus Bupivacaine – Dexamethasone as Postoperative Analgesia in Laparoscopic Cholecystectomy
Authors: Helmy Mohamed Ahmed Hassan , Mohamed Gihan seif-elnasr , Abusinna Rasha Gamal , Noser Mohamed Abdallah 
Published: July 2024

Abstract

Background
The QLB is an effective analgesic technique for various abdominal wall incisions. The QLB covers T7 to L2 dermatomes by the spread of LA drugs either into the paravertebral space or in the thoracolumbar plane, through iliohypogastric and ilioinguinal nerves, A and C fiber nociceptors, mechanoreceptors and high-density network of lumbar sympathetic fibers.

Objective
To assess the analgesic sparing effect of adding Dexamethasone to Bupivacaine in Quadratus lumborum block in patients undergoing Laparoscopic cholecystectomy under general anesthesia.

Patients and Methods
Sixty patients scheduled for elective Laparoscopic cholecystectomy surgeries under general anesthesia were included in this study, they were divided into two groups. Group A (perineural dexamethasone and bupivacaine group) [n = 30] Those cases will receive 2ml volume of dexamethasone (8mg) combined with 18 ml of bupivacaine of 0.25% concentration. Group B (perineural bupivacaine group) [n = 30] Those cases will receive perineural 18 ml bupivacaine (0.25%) combined with 2 ml normal saline.

Results
At the end of this study we found that The addition of dexamethasone to bupivacaine in QLB in Laparoscopic cholecystectomy surgeries provides a prolonged duration of postoperative analgesia, with reduced analgesic requirements, a better quality of analgesia in terms of NRS compared to bupivacaine alone group.

Conclusion
The addition of dexamethasone to Bupivacaine in lateral QLB in Laparoscopic cholecystectomy surgery provides a prolonged duration of postoperative analgesia, with reduced analgesic requirements, a better quality of analgesia in terms of NRS compared to bupivacaine alone group.
Comparative Study between Dexmedetomidine and Nitroglycerin as a Hypotensive Agent and Their Effects on Bleeding in Functional Endoscopic Sinus Surgery
Authors: Nasr Nermeen Sadeq , El Haleem Ali Gehan Abd , Abdel Naiem Mohammad Abdel Mohsen , El Din Soliman Aisha Galal 
Published: July 2024

Abstract

Background
Rhino-sinusitis is commonly treated with FESS. However, there can be serious complications associated with this procedure during peri-operative period like orbital cellulitis, optic nerve injuries, meningitis, etc. Their incidence increases with excessive bleeding during surgery. So Controlled hypotension is used reducing arterial blood pressure 30-40% below its normal range.

Objective
Primary aim: Comparing Dexmedetomidine and Nitroglycerine for inducing controlled hypotension in patients undergoing FESS with recording total intraoperative fentanyl consumption and recording of total local vasoconstrictor used by the surgeon. Secondary aim: Assessment of time to full recovery after extubation with recording of time to first analgesic used after recovery and its total dose for the first 24 hours.

Materials and Methods
In this study we compare Demedetomidine and Nitroglycerine in achieving hypotensive anaesthesia. The study is conducted in Anesthesiology Department, Faculty of medicine, Ain shams University. The study period is 6 months. The sample size is 50 patients divided in two groups randomly (Group I and Group II). Each group has 25 patients. Group I received Demedetomidine. Group II received Nitroglycerine.

Results
we find that the mean HR was significantly lower in Group I compared to Group II at all the times of measurements. The MAP was significantly lower in Group I compared to Group II after infusion of study drugs, after induction of anesthesia, after intubation and 5 min after intubation. However, the desired MAP for intra-operative induced hypotension could be achieved in all the two groups. Also we find that intra-operative Fentanyl requirement is significantly reduced in the Dexmedetomidine group as compared to the other group. The patients in group I had a longer time to full recovery. We also observe a significant delay in the first postoperative analgesic request in group I as compared to group II. It has been shown that perioperative analgesic requirements are significantly reduced with intra-operative use of Dexmedetomidine infusion. The patients in the Dexmedetomidine group had significantly higher sedation scores compared to group II. The incidence of postoperative shivering was significantly lower in the Dexmedetomidine group. The most frequent reported side-effect with Dexmedetomidine is dry mouth, which can be easily managed.

Conclusion
Dexmedetomidine provided better hemodynamic stability and comparable operative field visibility to nitroglycerine during FESS. Dexmedetomidine provides an additional benefit of reducing the analgesic requirements and providing postoperative sedation.