bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tadalafil versus pentoxifylline in the management of diabetic kidney disease: a randomized clinical trial
Authors: Hegazy Sahar Kamal , Amaar Walaa Ahmed , Hegab Wafaa Salah Mohamed 
Published: June 2024

Abstract
Aims
To investigate the efficacy and safety of tadalafil (TAD) versus pentoxifylline (PTX) in the management of diabetic kidney disease (DKD). Some animal studies and clinical trials reported that tadalafil and pentoxifylline have a reducing effect on different blood glucose parameters and lipid profiles which contribute to progress the patients with diabetes mellitus (DM) to DKD.

Methods
From February 2022 to March 2023, 90 patients with type 2 DM and DKD (micro-albuminuria) were enrolled in this randomized-controlled study. The patients were randomized into three equal groups: control group, TAD group, and PTX group. The three groups received traditional blood glucose lowering therapy + ramipril 10 mg PO. The TAD group also received tadalafil 20 mg PO every other day. The PTX group also received pentoxifylline 400 mg PO twice daily.

Results
Both TAD and PTX groups produced statistically significant improvement in the primary outcomes by a significant reduction in Urinary albumin/creatinine ratio (UACR) which was pronounced by a reduction percentage of—47.47%, −53.73% respectively. In addition to a significant decrease in Hemoglobin A1C (HbA1c) (mmol/mol), Fasting blood glucose (FBG), 2-h postprandial blood glucose (2-h PPG) (p < 0.001). Only the PTX group showed a significant increase in Cr Cl and a significant decrease in S. Cr (p < 0.001). Only the TAD group showed a significant increase in high-density lipoprotein—cholesterol (HDL-C) (p < 0.001), while the PTX group showed a significant decrease in low-density lipoprotein—cholesterol (LDL-C) (p-value 0.011), and triglyceride (p-value 0.002). Both TAD and PTX groups showed a decrease in tumor necrosis factor-α (TNF-α) which was significant only in the PTX group (p < 0.001). There was a significant increase in malondialdehyde (MDA) (p < 0.001), and an increase in urinary neutrophil gelatinase-associated Lipocalin (uNGAL) (p-value 0.850, 0.014 respectively) which was significant only in the PTX group.

Conclusions
The use of tadalafil or pentoxifylline may serve as an effective adjuvant therapy for patients with diabetic kidney disease.
Trial Registration: ClinicalTrials.gov identifier NCT05487755, July 25, 2022.
Artificial intelligence for MRI stroke detection: a systematic review and meta-analysis
Authors: Bojsen Jonas Asgaard , Elhakim Mohammad Talal , Graumann Ole , Gaist David , Nielsen Mads , Harbo Frederik Severin Gråe , Krag Christian Hedeager , Sagar Malini Vendela , Kruuse Christina , Boesen Mikael Ploug , Rasmussen Benjamin Schnack Brandt 
Published: June 2024

Abstract
Objectives
This systematic review and meta-analysis aimed to assess the stroke detection performance of artificial intelligence (AI) in magnetic resonance imaging (MRI), and additionally to identify reporting insufficiencies.

Methods
PRISMA guidelines were followed. MEDLINE, Embase, Cochrane Central, and IEEE Xplore were searched for studies utilising MRI and AI for stroke detection. The protocol was prospectively registered with PROSPERO (CRD42021289748). Sensitivity, specificity, accuracy, and area under the receiver operating characteristic (ROC) curve were the primary outcomes. Only studies using MRI in adults were included. The intervention was AI for stroke detection with ischaemic and haemorrhagic stroke in separate categories. Any manual labelling was used as a comparator. A modified QUADAS-2 tool was used for bias assessment. The minimum information about clinical artificial intelligence modelling (MI-CLAIM) checklist was used to assess reporting insufficiencies. Meta-analyses were performed for sensitivity, specificity, and hierarchical summary ROC (HSROC) on low risk of bias studies.

Results
Thirty-three studies were eligible for inclusion. Fifteen studies had a low risk of bias. Low-risk studies were better for reporting MI-CLAIM items. Only one study examined a CE-approved AI algorithm. Forest plots revealed detection sensitivity and specificity of 93% and 93% with identical performance in the HSROC analysis and positive and negative likelihood ratios of 12.6 and 0.079.

Conclusion
Current AI technology can detect ischaemic stroke in MRI. There is a need for further validation of haemorrhagic detection. The clinical usability of AI stroke detection in MRI is yet to be investigated.

Critical relevance statement
This first meta-analysis concludes that AI, utilising diffusion-weighted MRI sequences, can accurately aid the detection of ischaemic brain lesions and its clinical utility is ready to be uncovered in clinical trials.

Key Points

There is a growing interest in AI solutions for detection aid.

The performance is unknown for MRI stroke assessment.

AI detection sensitivity and specificity were 93% and 93% for ischaemic lesions.

There is limited evidence for the detection of patients with haemorrhagic lesions.

AI can accurately detect patients with ischaemic stroke in MRI.

Graphical Abstract
PET/CT deep learning prognosis for treatment decision support in esophageal squamous cell carcinoma
Authors: Song Jiangdian , Zhang Jie , Liu Guichao , Guo Zhexu , Liao Hongxian , Feng Wenhui , Lin Wenxiang , Li Lei , Zhang Yi , Yang Yuxiang , Liu Bin , Luo Ruibang , Chen Hao , Wang Siyun , Liu Jian-Hua 
Published: June 2024

Abstract
Objectives
The clinical decision-making regarding choosing surgery alone (SA) or surgery followed by postoperative adjuvant chemotherapy (SPOCT) in esophageal squamous cell carcinoma (ESCC) remains controversial. We aim to propose a pre-therapy PET/CT image-based deep learning approach to improve the survival benefit and clinical management of ESCC patients.

Methods
This retrospective multicenter study included 837 ESCC patients from three institutions. Prognostic biomarkers integrating six networks were developed to build an ESCC prognosis (ESCCPro) model and predict the survival probability of ESCC patients treated with SA and SPOCT. Patients who did not undergo surgical resection were in a control group. Overall survival (OS) was the primary end-point event. The expected improvement in survival prognosis with the application of ESCCPro to assign treatment protocols was estimated by comparing the survival of patients in each subgroup. Seven clinicians with varying experience evaluated how ESCCPro performed in assisting clinical decision-making.

Results
In this retrospective multicenter study, patients receiving SA had a median OS 9.2 months longer than controls. No significant differences in survival were found between SA patients with predicted poor outcomes and the controls (p > 0.05). It was estimated that if ESCCPro was used to determine SA and SPOCT eligibility, the median OS in the ESCCPro-recommended SA group and SPOCT group would have been 15.3 months and 24.9 months longer, respectively. In addition, ESCCPro also significantly improved prognosis accuracy, certainty, and the efficiency of clinical experts.

Conclusion
ESCCPro assistance improved the survival benefit of ESCC patients and the clinical decision-making among the two treatment approaches.

Critical relevance statement
The ESCCPro model for treatment decision-making is promising to improve overall survival in ESCC patients undergoing surgical resection and patients undergoing surgery followed by postoperative adjuvant chemotherapy.

Key Points

ESCC is associated with a poor prognosis and unclear ideal treatments.

ESCCPro predicts the survival of patients with ESCC and the expected benefit from SA.

ESCCPro improves clinicians’ stratification of patients’ prognoses.

Graphical Abstract
Fomes weberianus, 50 years of taxonomic confusion: lectotypification and taxonomic notes
Authors: Decock Cony , Cabarroi-Hernández Milay , Guzmán-Dávalos Laura , Kirk Paul M. , García-Beltrán José Ángel , Amalfi Mario 
Published: June 2024

AbstractFomes weberianus Bres. & Henn. ex Sacc. is currently the basionym of two very distinct polypores (Basidiomycota), Ganoderma weberianum (Polyporales) and Phylloporia weberiana (Hymenochaetales). This fact has led to almost fifty years of taxonomic confusion. Fomes weberianus was first lectotypified by Steyaert, who accepted the species as G. weberianum. However, studies of Weber’s original material in B, duplicate material in S, the protologue, and early interpretations of the name have shown that Steyaert’s choice conflicts with the protologue and early interpretations, and that his interpretation as a species of Ganoderma is erroneous. A new lectotype was designated and the species was re-described under the correct interpretation Phylloporia weberiana.
Sortilin and its potential role in cardiovascular pathology
Authors: Namitokov Alim 
Published: June 2024

Abstract
Background
This comprehensive review explores the multifaceted role of sortilin, a key receptor in lipid metabolism, within the context of cardiovascular diseases (CVDs), the leading cause of global mortality.

Main body
Sortilin, encoded by the SORT1 gene, is implicated in the pathogenesis of atherosclerosis, primarily through its regulation of low-density lipoprotein cholesterol (LDL-C) and very low-density lipoproteins (VLDL). The review delves into the biological functions of sortilin, emphasizing its critical role in lipid and cholesterol homeostasis and its influence on hepatic secretion of lipoproteins and atherogenesis. We highlight sortilin's pathophysiological significance in atherosclerosis, underscoring its involvement in lipid metabolism pathways and vascular inflammation, and its impact on macrophage functions in atherosclerotic plaque formation. The potential of sortilin as a therapeutic target is discussed, considering evidence that suggests its modulation could ameliorate atherosclerosis. The review also acknowledges current inconsistencies and gaps in the evidence, calling for more comprehensive patient studies and in-depth mechanistic research. Finally, the article outlines future research directions, focusing on understanding sortilin's specific cellular mechanisms in cardiovascular health, exploring its genetic variability, therapeutic implications, and its broader relevance to other diseases.

Conclusion
This review underscores the significance of sortilin as a biomarker and a promising target for therapeutic intervention in cardiovascular pathology, while advocating for continued research to fully unravel its complex role.
Artificial intelligent tools: evidence-mapping on the perceived positive effects on patient-care and confidentiality
Authors: Botha Nkosi N. , Ansah Edward W. , Segbedzi Cynthia E. , Dumahasi Victor K. , Maneen Samuel , Kodom Ruby V. , Tsedze Ivy S. , Akoto Lucy A. , Atsu Fortune S. 
Published: June 2024

Abstract
Background
Globally, healthcare systems have always contended with well-known and seemingly intractable challenges like safety, quality, efficient and effective clinical and administrative patient-care services. To firmly confront these and other healthcare challenges, the World Health Organisation proposed a full adoption of artificial intelligence (AI) applications into patient care to stimulate efficiency and guarantee quality in patient management.

Purpose
This review aimed to establish the extent and type of evidence of the positive effects of the use of AI tools in patient care. Thus, the review mapped evidence by using articles published between January 1, 2010, and October 31, 2023.

Methods
Consistent with the protocol by Tricco et al., a comprehensive literature search was executed from Nature, PubMed, Scopus, ScienceDirect, Dimensions, Web of Science, Ebsco Host, ProQuest, JStore, Semantic Scholar, Taylor & Francis, Emeralds, World Health Organisation, and Google Scholar. Upholding the inclusion and exclusion standards, 95 peer-reviewed articles were included in this review.

Findings
We report that the use of AI tools can significantly improve the accuracy of clinical diagnosis to guarantee better patient health outcomes. AI tools also have the ability to mitigate, if not eliminate, most of the factors that currently predict poor patient outcomes. Furthermore, AI tools are far more efficient in generating robust and accurate data in real time and can help ease and accelerate workflow at healthcare facilities.

Conclusion
If properly integrated into the healthcare system, AI will help reduce patients’ waiting time and accelerate the attainment of Sustainable Development Goals 3.4, 3.8, and 3.b. We propose that AI developers collaborate with public health practitioners and healthcare managers to develop AI applications that appreciate socio-cultural dimensions in patient care.
Operator growth and spread complexity in open quantum systems
Authors: Carolan Eoin , Kiely Anthony , Campbell Steve , Deffner Sebastian 
Published: June 2024

Abstract
Commonly, the notion of “quantum chaos” refers to the fast scrambling of information throughout complex quantum systems undergoing unitary evolution. Motivated by the Krylov complexity and the operator growth hypothesis, we demonstrate that the entropy of the population distribution for an operator in time is a useful way to capture the complexity of the internal information dynamics of a system when subject to an environment and is, in principle, agnostic to the specific choice of operator basis. We demonstrate its effectiveness for the Sachdev-Ye-Kitaev (SYK) model, examining the dynamics of the system in both its Krylov basis and the basis of operator strings. We prove that the former basis minimises spread complexity while the latter is an eigenbasis for high dissipation. In both cases, we probe the long-time dynamics of the model and the phenomenological effects of decoherence on the complexity of the dynamics.
The Public Power Observatory
Authors: Dawson Ashley 
Published: June 2024

Abstract
We are entering a period of abrupt and irreversible environmental change. Currently dominant assumptions about what is politically appropriate and realistic will be obliterated as vast masses of people find the conditions for their collective survival annihilated in coming decades. This article argues that it is imperative we deepen the debate about strategies to provoke revolutionary ruptures within the fossil-capitalist world system. We need viable strategies to generalize mutual aid and disaster communism, and these strategies must provide concrete solutions to the intersecting climate crises on different scales, from the local to the global. The abolition of fossil capital through the building of counterpower—in all senses of that term—should be a key strategic priority of the global movement for ecosocialism. The article discusses the Public Power NY campaign, which has established itself as a potent counterpower within the corporate-dominated US energy system. Constituted on the heels of the campaign's legislative success, the Public Power Observatory is an interdisciplinary formation dedicated to monitoring and building this counterpower and, in so doing, reclaiming the energy commons. The article discusses some of the suite of transmedia tools currently being developed by the Public Power Observatory.
Optimal Timing of Microsurgical Treatment for Ruptured Arteriovenous Malformations: A Systematic Review and Meta-Analysis
Authors: Orscelik Atakan , Musmar Basel , Matsukawa Hidetoshi , Ismail Mustafa , Elawady Sameh Samir , Assad Salman , Cunningham Conor , Sowlat Mohamed Mahdi , Spiotta Alejandro M. 
Published: June 2024

BACKGROUND AND OBJECTIVES:
The timing of microsurgical treatment (MST) for ruptured brain arteriovenous malformations (bAVM) is a contentious issue in the literature. This study aimed to investigate the impact of MST timing on outcomes in patients with ruptured bAVMs, considering MST with and without preoperative endovascular treatment (EVT).

METHOD:
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a comprehensive search was conducted across multiple databases, yielding 15 studies meeting the inclusion criteria. The timing was defined as the duration from the rupture of bAVM to the MST. The patients were divided into 4 different groups based on MST timing: <48 hours, <1 week, <2 weeks, and <1 month. The primary outcome was favorable outcome defined as a modified Rankin Scale score of 0 to 2 or a Glasgow Outcome Scale score of 4 to 5 in the last clinical follow-up. Secondary outcomes included periprocedural mortality and complete excision.

RESULTS:
MST time >48 hours were associated with a significantly higher favorable outcome rate (odds ratio: 9.71, 95% Cl: 3.09-30.57, P < .01) and a lower mortality rate (OR: 0.15, 95% Cl: 0.02-0.88, P = .04) compared with MST timing ≤48 hours. After exclusion of patients who underwent MST with preoperative EVT, MST time >48 hours had a significantly higher rate of favorable outcome (OR: 9.39, 95% CI: 2.53-34.89, P < .01).

CONCLUSION:
This meta-analysis suggests that delayed surgical intervention beyond 48 hours may be associated with improved favorable outcomes in patients who underwent MST with and without preoperative EVT for ruptured bAVMs.
Resilience After High-Grade Subarachnoid Hemorrhage: A Prospective Cohort Study on Quality of Life
Authors: Denneman Nadine , Post René , Coert Bert A. , van den Berg René , Verbaan Dagmar , Vandertop W. Peter 
Published: June 2024

BACKGROUND AND OBJECTIVES:
Treatment of patients who present with poor clinical condition is often postponed until neurological improvement is observed. Despite previous studies, it is still unclear how survivors perceive their quality of life (QoL). This study aimed to evaluate self-perceived QoL in patients with aneurysmal subarachnoid hemorrhage who present with poor clinical condition, as defined by World Federation of Neurosurgical Societies (WFNS) grades 4 to 5, compared with those who present in more favorable clinical condition (WFNS 1-3).

METHODS:
Between 2011 and 2021, 1160 patients with aneurysmal subarachnoid hemorrhage were admitted to the Amsterdam UMC. Among the 845 patients who survived, 537 participated in the QoL questionnaires. Patient characteristics, complications, EQ-5D questionnaires, modified Rankin Scale, and Hospital Anxiety and Depression Scale were analyzed using the nonparametric Mann-Whitney U test for continuous variables or the Pearson χ2 test for categorical variables.

RESULTS:
Of the 537 responders, 452 (84%) presented with low grade (WFNS 1-3) and 85 (16%) presented with high grade (WFNS 4-5). The high-grade group reported a self-perceived QoL score of 70 (of 100), while the low-grade group reported a score of 75 (P = .12). The mean EQ-5D index value was 0.74 for the high-grade group and 0.81 for the low-grade group (P < .01). In the high-grade group, 61 patients (72%) had a favorable outcome (modified Rankin Scale 0-3) compared with 419 (94%) in the low-grade group (P < .001).

CONCLUSION:
High-grade WFNS patients rated their QoL as satisfactory, with only a marginal 5-point difference on a 100-point scale compared with low-grade WFNS patients. In addition, almost three-quarters of high-grade WFNS survivors achieved a favorable outcome. Given that a subset of patients, despite presenting with a poor clinical condition, still achieve a favorable outcome, these findings reinforce our perspective advocating for early and comprehensive treatment.
Changes in mitochondrial distribution occur at the axon initial segment in association with neurodegeneration in Drosophila
Authors: Wodrich Andrew P. K. , Harris Brent T. , Giniger Edward 
Published: June 2024

ABSTRACT
Changes in mitochondrial distribution are a feature of numerous age-related neurodegenerative diseases. In Drosophila, reducing the activity of Cdk5 causes a neurodegenerative phenotype and is known to affect several mitochondrial properties. Therefore, we investigated whether alterations of mitochondrial distribution are involved in Cdk5-associated neurodegeneration. We find that reducing Cdk5 activity does not alter the balance of mitochondrial localization to the somatodendritic versus axonal neuronal compartments of the mushroom body, the learning and memory center of the Drosophila brain. We do, however, observe changes in mitochondrial distribution at the axon initial segment (AIS), a neuronal compartment located in the proximal axon involved in neuronal polarization and action potential initiation. Specifically, we observe that mitochondria are partially excluded from the AIS in wild-type neurons, but that this exclusion is lost upon reduction of Cdk5 activity, concomitant with the shrinkage of the AIS domain that is known to occur in this condition. This mitochondrial redistribution into the AIS is not likely due to the shortening of the AIS domain itself but rather due to altered Cdk5 activity. Furthermore, mitochondrial redistribution into the AIS is unlikely to be an early driver of neurodegeneration in the context of reduced Cdk5 activity.
Strength of motivation of 1st year dental students of a dental institution: A cross-sectional study
Authors: Fizzah Ali  , Ehsan Muhammad Tauqeer , Suhaib Fatima , Fatima Mariam 
Published: June 2024

Objective: The study aims to evaluate the motivation levels of dental students, with an emphasis on first-year BDS students, by utilizing the Strength of Motivation for Medical School (SMMS) questionnaire.
Methods: It was a descriptive cross-sectional quantitative study targeting 89 first-year BDS students enrolled at Lahore Medical and Dental College from 5th June to 18th August 2023. The Strength of Motivation for Medical School (SMMS) questionnaire was given to the participants after ethical board approval. Data analysis was done through SPSS version 26. The SMMS score was presented as the means standard deviation and an independent t-test was used to find the difference between the groups. The maximum score possible is 80 and the minimum is 16. The higher the score, the greater the strength of motivation.
Results: In this study, a total of 89 first-year BDS students completed motivation questionnaires, with 34.8% males and 65.2% females. The average age was 19.92±3.13. The overall Strength of Motivation Score (SMMS) averaged 45.53±6.82. Results indicated 9% low, 89.9% moderate, and 1.1% strong motivation. Females had a slightly higher mean SMMS (45.93±6.88) than males (44.80±6.76), but the difference was deemed insignificant (p = 0.462) via independent t-test.
Conclusion: Motivation is vital to achieving excellence in academic pursuits. Nevertheless, there isn’t a single criterion that can be utilized to assess success and motivation. Our primary focus must be on every possible outcome of success, not just the scoring criteria.
doi: https://doi.org/10.12669/pjms.40.7.9112
How to cite this: Ali F, Ehsan MT, Suhaib F, Fatima M. Strength of motivation of 1st year dental students of a dental institution: A cross-sectional study. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.9112
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ma quanto è brutta questa "Smart City"!
Authors: Umberto Cao  
Published: June 2024

La Smart City è una macchina, una sorta di città-computer nella quale l'hardware è costituito dagli edifici e dalle infrastrutture e il software dalla gestione digitale integrata delle comunicazioni immateriali. Insomma una città efficiente nel senso pieno della parola. Il problema si pone quando queste caratteristiche vengono considerate sufficienti a restituire qualità alla città. Una qualità urbana che discende meccanicamente dalla “efficienza” farebbe pensare più alla distopia della Metropolis di Fritz Lang che alla utopia della Città nuova di Sant'Elia.