bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between demographic factors and known risk factors with breast cancer in women aged 30–69
Authors: Jahani Mohammad-Ali , Ghasemi Behnaz , Soltani Seyed Amir , Naderi Malihe , Nikbakht Hossein-Ali , Hashemi Seyedeh Nikoo , Yazdani Charati Jamshid , Mahmoudi Ghahraman 
Published: May 2024

Background:
Breast cancer is one of the most important causes of cancer deaths in women. The present study was conducted to determine the relationship between demographic factors and known risk factors with breast cancer in women aged 30–69.

Method:
This case–control study was conducted with two matched and unmatched control groups. Three hundred fifty women aged 30–69 with breast cancer, 350 age-matched women without cancer, and 350 not age-matched women were included in the study. Controls were selected from the records of women whose breast cancer screening results were normal. Study subjects were evaluated regarding the risk factors for breast cancer. The data collection tool was a checklist including the risk factors investigated in the integrated health system. The collected data were analyzed utilizing SPSS22 software at a significance level of less than 0.05.

Results:
The average age in the case group was 46.63±11.77 years and 49.61±8.39 in the unmatched control group. The average age of marriage in the case group was 21.54±4.31, and the average age of women at first pregnancy in the case group was 24.06±3.39 years. In the case group, 163 people (46.57%) lived in the city, 221 people (63.14%) were over 40 years old, and 337 people (96.28%) were married. In multivariate analysis, the variable ‘age of marriage’ 0.821 (0.691–0.976) and ‘age of first pregnancy’ 1.213 (1.020–1.443) showed a significant relationship with breast cancer which were observed as predictors of breast cancer in comparison to the unmatched control group (P-value <0.05).

Conclusion:
The age of the first pregnancy and the type of delivery were observed as predictors of breast cancer. Therefore, by performing breast cancer screening in women who are exposed to these risk factors, early diagnosis of the disease and increasing the speed of their treatment can be significantly helped.
Risk of Parkinson’s disease among users of alpha-adrenergic receptor antagonists: a systematic review and meta-analysis
Authors: Lamichhane Pratik , Tariq Alina , Akhtar Asfia Neshat , Raza Mehnahil , Lamsal Arun Batsa , Agrawal Anushka 
Published: May 2024

Background:
Recent studies have tried to establish an association between the use of alpha-1-adrenergic receptor antagonists (A1ARAs) used in benign prostatic hyperplasia (BPH) and the risk of PD. The objective of the study is to compare the risk of Parkinson’s disease (PD) between terazosin/alfuzosin/doxazosin (TZ/AZ/DZ) users and tamsulosin users.

Methods:
PubMed, Google Scholar, and Embase were systematically searched from inception to April 2023. Observational studies comparing the risk of PD among patients using different types of A1ARAs were included in the meta-analysis. The primary outcome was the hazard ratio (HR) with a 95% CI for the risk of occurrence of PD among A1ARAs users of two different classes.

Results:
This study was based on a total of 678 433 BPH patients, out of which 287 080 patients belonged to the TZ/AZ/DZ cohort and 391 353 patients belonged to the tamsulosin cohort. The pooled incidence of PD was higher in tamsulosin users (1.28%, 95% CI: 1.04–1.55%) than in TZ/AZ/DZ drug users (1.11%, 95% CI: 0.83–1.42%). The risk of occurrence of PD was significantly lower in patients taking TZ/AZ/DZ than tamsulosin (n= 610,363, HR = 0.82, 95% CI = 0.71–0.94, P = 0.01; I2 = 87.4%).

Conclusion:
This meta-analysis demonstrated that patients with BPH who take TZ/AZ/DZ have a lower risk for developing PD than those who take tamsulosin.
The scientific knowledge of three large language models in cardiology: multiple-choice questions examination-based performance
Authors: Altamimi Ibraheem , Alhumimidi Abdullah , Alshehri Salem , Alrumayan Abdullah , Al-khlaiwi Thamir , Meo Sultan A. , Temsah Mohamad-Hani 
Published: May 2024

Background:
The integration of artificial intelligence (AI) chatbots like Google’s Bard, OpenAI’s ChatGPT, and Microsoft’s Bing Chatbot into academic and professional domains, including cardiology, has been rapidly evolving. Their application in educational and research frameworks, however, raises questions about their efficacy, particularly in specialized fields like cardiology. This study aims to evaluate the knowledge depth and accuracy of these AI chatbots in cardiology using a multiple-choice question (MCQ) format.

Methods:
The study was conducted as an exploratory, cross-sectional study in November 2023 on a bank of 100 MCQs covering various cardiology topics that was created from authoritative textbooks and question banks. These MCQs were then used to assess the knowledge level of Google’s Bard, Microsoft Bing, and ChatGPT 4.0. Each question was entered manually into the chatbots, ensuring no memory retention bias.

Results:
The study found that ChatGPT 4.0 demonstrated the highest knowledge score in cardiology, with 87% accuracy, followed by Bing at 60% and Bard at 46%. The performance varied across different cardiology subtopics, with ChatGPT consistently outperforming the others. Notably, the study revealed significant differences in the proficiency of these chatbots in specific cardiology domains.

Conclusion:
This study highlights a spectrum of efficacy among AI chatbots in disseminating cardiology knowledge. ChatGPT 4.0 emerged as a potential auxiliary educational resource in cardiology, surpassing traditional learning methods in some aspects. However, the variability in performance among these AI systems underscores the need for cautious evaluation and continuous improvement, especially for chatbots like Bard, to ensure reliability and accuracy in medical knowledge dissemination.
Post-intubation tracheal rupture treated surgically using a muscle graft from the Latissimus Dorsi: a rare disorder and review of literature
Authors: Haddad Sultaneh , Haneyah Farah , Jwainat Mu’taz Nader Ibrahim , Bayat Ghassan , Zakka Amjad , Albekaai Emad , Al-Rashdan Omar Abd Elfattah Ali , Daradkeh Basil , Abo Dakka Yamama , Shbat Mohamad , Chaban Hussain 
Published: May 2024

Introduction:
Post-intubation tracheal rupture (PiTR) is an extremely uncommon disorder. Pneumothorax, pneumomediastinum, hemorrhage, cutaneous emphysema, and sepsis are common clinical presentations that eventually result in organ failure and mediastinitis. Endoscopy and computed tomography (CT) are considered the gold standards for assessment and diagnosis.

Case presentation:
Here, the authors present a 96-year-old woman with asthma and ischemic heart disease presented to the Emergency Department with dyspnea following viral pneumonia. Despite initial treatment, her condition worsened, requiring tracheal intubation. Subsequent complications led to a diagnosis of tracheal rupture, requiring surgical repair. The procedure involved using a muscle graft from the Latissimus Dorsi muscle: which is a novel Surgical Technique as the authors have conducted a literature review.

Discussion:
Upon scrutinizing analogous cases delineated within the medical literature, it becomes evident that our patient manifests four distinct risk factors. These factors include gender, advanced age, asthma, and prolonged steroid use.
While the clinical manifestation and diagnostic methods for tracheal rupture are frequently consistent throughout cases, there is a significant variation in the surgical treatments used to treat the condition.

Conclusion:
More research should be conducted to investigate the use of muscle grafts as a treatment technique for tracheal rupture in the future.
Two cases of pituitary stalk interruption syndrome: importance of early detection and management
Authors: Zakkor Mohammed Deeb , Khana Firas , Abdulrazzak Mohammed , Kreid Sedra , Kayyali Alae , Al Hussein Hachem 
Published: May 2024

Introduction and importance:
Pituitary stalk interruption syndrome (PSIS) is a rare congenital condition affecting the pituitary gland and its stalk, leading to hormonal imbalances. PSIS can present with a wide range of symptoms, including delayed puberty and short stature.

Case presentation:
This paper discusses two cases of PSIS in patients with a history of growth hormone deficiency. The first case is of a 26-year-old male presenting with fatigue and loss of appetite, while the second case is of a 14-year-old male presenting with delayed puberty. Blood tests revealed hormonal imbalances, and a subsequent MRI confirmed the diagnosis of PSIS. Hormonal supplements were prescribed to manage the condition, and follow-up appointments were scheduled to monitor progress.

Clinical discussion:
PSIS can present with a wide range of symptoms, and can be diagnosed at different ages. Early diagnosis and management of PSIS are crucial to prevent long-term complications such as short stature, impaired cognitive function, and infertility. The use of hormonal supplements, as seen in both cases, is essential to manage the hormonal imbalances associated with PSIS. Testosterone replacement therapy is used to treat hypogonadism, while thyroxine and hydrocortisone are used to manage hypothyroidism and adrenal insufficiency, respectively.

Conclusion:
Early diagnosis and management of PSIS through hormonal supplements are crucial to prevent long-term complications. It is essential to monitor patients’ progress through follow-up appointments to ensure optimal management of the condition.
Clinical diagnosis of fat embolism syndrome with septic shock following polytrauma: a case report
Authors: Shahi Anil , Niraula Biraj , Santyan Bir B. , kafle Nischal , Gaud Shivendra K. , Gosain Dinesh , Gupta Manish , kharel Avash , khatri Mala 
Published: May 2024

Introduction and importance:
Fat embolism syndrome (FES) arises from the systemic effects of fat emboli in microcirculation. While sepsis is characterized by pathological, physiological, and metabolic abnormalities caused by infection. Septic shock is identified by elevated blood lactate (>2 mmol/l) and the need for vasopressors to maintain a mean arterial pressure of 65 mmHg or higher in the absence of hypovolemia.

Case presentation:
This case report discusses the clinical course and treatment of a 50-year-old male involved in a road traffic accident resulting in polytrauma. The patient presented with multiple fractures, hemopneumothorax, lung contusions, and rib fractures. He was then stabilized following which fractures were reduced and managed operatively. Postoperatively, the patient developed FES with septic shock, manifested by altered consciousness, petechial rashes, and respiratory distress. He was managed with intubation, chest drainage, and a combination of antibiotics, anticoagulants, and vasoactive agents. A tracheostomy was performed due to respiratory insufficiency. Following 29 days in the SICU, the patient’s condition was stabilized and shifted to the general ward for further management. He was discharged after 48 days, with a complete recovery and a 2-week follow-up. This case report depicts the challenges in the management of FES with septic shock following polytrauma.

Conclusion:
This case report is a comprehensive overview of FES complicated with septic shock. It highlights the importance of supportive care as the primary treatment modality, incorporating various medical interventions. The successful outcome and complete recovery of the patient underline the significance of prolonged monitoring, wound care, and physiotherapy.
Do Rib-Based Anchors Impair Chest Wall Motion in Early Onset Scoliosis (EOS)?
Authors: Tong Yubing , Udupa Jayaram K. , McDonough Joseph M. , Xie Lipeng , Wu Caiyun , Akhtar Yusuf , Hosseini Mahdie , Alnoury Mostafa , Shaghaghi Shiva , Gogel Samantha , Biko David M. , Mayer Oscar H , Torigian Drew A. , Cahill Patrick J. , Anari Jason B. 
Published: May 2024

ABSTRACTPurposeThere is a concern in pediatric surgery practice that rib-based fixation may limit chest wall motion in early onset scoliosis (EOS). The purpose of this study is to address the above concern by assessing the contribution of chest wall excursion to respiration before and after surgery.MethodsQuantitative dynamic magnetic resonance imaging (QdMRI) is performed on EOS patients (before and after surgery) and normal children in this retrospective study. QdMRI is purely an image-based approach and allows free breathing image acquisition. Tidal volume parameters for chest walls (CWtv) and hemi-diaphragms (Dtv) were analyzed on concave and convex sides of the spinal curve. EOS patients (1-14 years) and normal children (5-18 years) were enrolled, with an average interval of two years for dMRI acquisition before and after surgery.ResultsCWtv significantly increased after surgery in the global comparison including all EOS patients (p < 0.05). For main thoracic curve (MTC) EOS patients, CWtv significantly improved by 50.24% (concave side) and 35.17% (convex side) after age correction (p < 0.05) after surgery. The average ratio of Dtv to CWtv on the convex side in MTC EOS patients was not significantly different from that in normal children (p=0.78), although the concave side showed the difference to be significant.ConclusionChest wall component tidal volumes in EOS patients measured via QdMRI did not decrease after rib-based surgery, suggesting that rib-based fixation does not impair chest wall motion in pediatric patients with EOS.
Patients Recovering from COVID-19 who Presented Anosmia During their Acute Episode have Behavioral, Functional, and Structural Brain Alterations
Authors: Kausel Leonie , Figueroa-Vargas Alejandra , Zamorano Francisco , Stecher Ximena , Aspé-Sánchez Mauricio , Carvajal-Paredes Patricio , Márquez-Rodríguez Victor , Martinez-Molina Maria Paz , Román Claudio , Soto-Fernández Patricio , Valdebenito-Oyarzo Gabriela , Manterola Carla , Uribe Reinaldo , Silva Claudio , Henríquez-Ch Rodrigo , Aboitiz Francisco , Polania Rafael , Guevara Pamela , Muñoz-Venturelli Paula , Soto-Icaza Patricia , Billeke Pablo 
Published: May 2024

AbstractPatients recovering from COVID-19 commonly exhibit cognitive and brain alterations, yet the specific neuropathological mechanisms and risk factors that underlie these alterations remain elusive. Given the significant global incidence of COVID-19, identifying factors that can distinguish individuals at risk of developing medium or long-term brain alterations is crucial for prioritizing follow-up care. Here, we report findings from a sample of 100 patients who were affected by a respiratory infection during the COVID-19 pandemic. This sample comprised 73 adults with a mild to moderate SARS-CoV-2 infection (who did not require invasive ventilatory assistance) and 27 with infections attributed to other agents and no history of COVID-19. The participants underwent cognitive screening, a decision-making task to measure cognitive flexibility, and magnetic resonance imaging evaluations. We assessed two clinical factors during infection: the presence of anosmia and the requirement for hospitalization due to respiratory symptoms. Groups did not differ in age or cognitive performance, but clinical factors differentially affected task performance. Patients who presented anosmia during the acute episode exhibited more impulsive changes in alternatives after a shift in probabilities in the decision-making task, while patients who required hospitalization showed more perseverative choices. Interestingly, the presence of anosmia during SARS-CoV-2 infection correlated with several brain measures, including decreases in functional activity during the decision-making task, thinning of cortical thickness in parietal regions, and loss in white matter integrity in corticospinal tracts and parietal-thalamic fasciculi, among others. These results suggest that anosmia could be a risk factor for developing brain alterations after SARS-CoV-2 infection and may serve to identify at-risk populations for follow-up.
Prediction of antidepressant side effects in the Genetic Link to Anxiety and Depression Study
Authors: Li Danyang , Lin Yuhao , Davies Helena L. , Zvrskovec Johan Källberg , Wang Rujia , Armour Chérie , Jones Ian R. , McIntosh Andrew M. , Kingston Nathalie , Bradley John R. , Hübel Christopher , Kalsi Gursharan , Coleman Jonathan R. I. ,   the NIHR BioResource consortium, Hotopf Matthew , Eley Thalia C. , Vassos Evangelos , Iniesta Raquel , Breen Gerome 
Published: May 2024

AbstractAntidepressants are the most common treatment for moderate or severe depression. Side effects are crucial indicators for antidepressants, but their occurrence varies widely among individuals. In this study, we leveraged genetic and medical data from self-reported questionnaires in the Genetic Links to Anxiety and Depression (GLAD) study to build prediction models of side effects and subsequent discontinuation across three antidepressant classes (SSRI, SNRI, tricyclic antidepressant (TCA)) at the first and the last (most recent) year of prescription. We included 259 predictors spanning genetic, clinical, illness, demographic, and antidepressant information. Six prediction models were trained, and their performance was compared. The final dataset comprised 4,354 individuals taking SSRI in the first prescription and 3,414 taking SSRI, SNRI or TCA in the last year of prescription. In the first year, the best area under the receiver operating characteristic curve (AUROC) for predicting SSRI discontinuation and side effects were 0.65 and 0.60. In the last year of SSRI prescription, the highest AUROC reached 0.73 for discontinuation and 0.87 for side effects. Models for predicting discontinuation and side effects of SNRI and TCA showed comparable performance. The history of side effects and discontinuation of antidepressant use were the most influential predictors of the outcomes in the last year of prescription. When examining 30 common antidepressant side effect symptoms, most of them were differentially prevalent between antidepressant classes. Our findings suggested the feasibility of predicting antidepressant side effects using a self-reported questionnaire, particularly for the last prescription. These results could contribute valuable insights for the development of clinical decisions aimed at optimising treatment selection with enhanced tolerability but require replication in medical record linkage or prospective data.
Exposure to per- and polyfluoroalkyl substances and age-related macular degeneration in U.S. middle-aged and older adults
Authors: Kang Habyeong , Park Sung Kyun , Kim Dong Hyun , Choi Yoon-Hyeong 
Published: May 2024

AbstractDespite various health effects of per- and polyfluoroalkyl substances (PFAS) exposure, the association between PFAS exposure and age-related macular degeneration (AMD) has not been investigated. We aimed to assess associations of PFAS exposure with AMD, using data from 1,722 U.S. adults aged 40 years or more participating in the National Health and Nutrition Examination Survey 2005–2008 with complete data on PFAS measurement, AMD diagnosis, and covariates. Serum concentrations of PFAS, including perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS), were measured. An overall PFAS burden score was calculated using item response theory scoring. Individual PFAS concentration and overall PFAS burden score were categorized into low (reference), medium, and high groups. Diagnosis of AMD was based on retinal image examination. Any AMD was defined as the presence of early or late AMD. Survey-weighted logistic regression adjusted for potential confounders was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for presence of AMD according to PFAS exposure. Overall, 132 (6.5%) individuals were diagnosed as any AMD, including 115 (5.7%) individuals with early AMD. A significant dose-response association was observed between serum PFOS concentration and any AMD (p-trend=0.03), with a significant OR of 1.99 (95% CI: 1.05, 3.79) for the high group compared to the reference. Overall PFAS burden showed a non-monotonic association with any AMD, with a significant OR of 2.18 (95% CI: 1.18, 4.04) for the medium. Inverted U-shaped associations were observed by restricted cubic spline analyses. Also, early AMD showed similar patterns in PFOS and overall PFAS burden and additionally an inverted U-shape association in PFNA. Our findings suggest that exposure to PFAS estimated by serum PFOS and PFNA as well as overall PFAS burden might be a risk factor for AMD in middle-aged and older population.
EXPLORING THE PHYSICAL WELL-BEING OF BREAST CANCER PATIENTS IN KUMASI METROPOLIS: A QUALITATIVE STUDY
Authors: Sefah Victoria , Budu Hayford Isaac , Tano Priscilla Felicia , Lawer Emmanuel Kofi , Tano Emile Kouakou 
Published: May 2024

AbstractBackgroundYears back, cancer was thought to be a problem limited to the developed countries. Cancer is now a disease with lots of burden, leading cause of death and disability in developing countries. Physical health is very important for the overall well-being of breast cancer survivors, since it is the visible part of the dimensions of overall health and well-being. Prior studies have examined factors leading to late detection, financial burden and experiences of caregivers of breast cancer patients in Ghana, however, none of the studies have explored how breast cancer may specifically impact the physical well-being and the quality of life of these women. This study therefore seeks to explore how breast cancer impact the physical well-being and the quality of life of these women.MethodologyThe study site and setting was the Oncology directorate at Komfo Anokye Teaching Hospital where twelve respondents were recruited for the study. Breast care survivors were purposively sampled and interviewed (face-to-face) to explore how the BC has impacted on their physical wellbeing and their Quality of Life (QoL). Demographic data were obtained before the main interview. The interviews lasted between 30minutes to 45minutes. Data was analysed using thematic analysis of key information by using NVivo data management software.ResultsParticipants described their physical wellbeing according to the way they encountered the disease from the onset through to the treatment administration. Five sub-themes emerged, namely: Fatigue/bodily weakness: impaired functional ability: pain; distorted sleep; and fertility.ConclusionFatigue, impaired functional ability, pain, distorted sleep and fertility were consistent with constructs of the Quality of Life model. These physical symptoms negatively affected the total well-being of the BCSs.