bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on the differential diagnosis of benign and malignant breast lesions using a deep learning model based on multimodal images
Authors: Du Yanan , Wang Dawei , Liu Menghan , Zhang Xiaodong , Ren Wanqing , Sun Jingxiang , Yin Chao , Yang Shiwei , Zhang Li 
Published: April 2024

ABSTRACTObjective:To establish a multimodal model for distinguishing benign and malignant breast lesions.Materials and Methods:Clinical data, mammography, and MRI images (including T2WI, diffusion-weighted images (DWI), apparent diffusion coefficient (ADC), and DCE-MRI images) of 132 benign and breast cancer patients were analyzed retrospectively. The region of interest (ROI) in each image was marked and segmented using MATLAB software. The mammography, T2WI, DWI, ADC, and DCE-MRI models based on the ResNet34 network were trained. Using an integrated learning method, the five models were used as a basic model, and voting methods were used to construct a multimodal model. The dataset was divided into a training set and a prediction set. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the model were calculated. The diagnostic efficacy of each model was analyzed using a receiver operating characteristic curve (ROC) and an area under the curve (AUC). The diagnostic value was determined by the DeLong test with statistically significant differences set at P < 0.05.Results:We evaluated the ability of the model to classify benign and malignant tumors using the test set. The AUC values of the multimodal model, mammography model, T2WI model, DWI model, ADC model and DCE-MRI model were 0.943, 0.645, 0.595, 0.905, 0.900, and 0.865, respectively. The diagnostic ability of the multimodal model was significantly higher compared with that of the mammography and T2WI models. However, compared with the DWI, ADC, and DCE-MRI models, there was no significant difference in the diagnostic ability of these models.Conclusion:Our deep learning model based on multimodal image training has practical value for the diagnosis of benign and malignant breast lesions.
Enhanced recovery after surgery for percutaneous CT-guided microwave ablation of lung tumors: A single-center retrospective cohort study
Authors: Peng Huajian , Wang Meijing , Lu Shuyu , Liu Jun , Zhang Yanan , Fu Zongwang , Li Changqian , Huang Yihua , Guo Jianji , Xu Zhanyu , Yang Nuo 
Published: April 2024

ABSTRACTBackground:The feasibility and safety of enhanced recovery after surgery (ERAS) for percutaneous computed tomography (CT)-guided microwave ablation (MWA) for treating lung nodules remain unclear.Methods and Materials:A total of 409 patients with lung tumors treated at the Department of Thoracic Surgery, First Affiliated Hospital of Guangxi Medical University from August 2020 to May 2023 were enrolled. Perioperative data, including baseline characteristics, operation time, postoperative pain score (visual analog scale [VAS]), hospitalization expenses, postoperative complications, total hospital stay, and patient satisfaction, were observed and recorded.Results:No perioperative mortality occurred in either group and complete ablation was achieved in all patients. Patients in the ERAS group had significantly shorter hospital stays (P< 0.001), reduced operation times (P= 0.047), lower hospitalization expenses (P< 0.001), lower VAS scores (P< 0.001), and fewer complications (P= 0.047) compared with the traditional group.Conclusions:ERAS for percutaneous CT-guided MWA (ERAA) is safe, effective, and feasible for the treatment of lung nodules.
Immunostimulatory effects of thermal ablation: Challenges and future prospects
Authors: Liu Peng , Wei Zhigang , Ye Xin 
Published: April 2024

ABSTRACT
This literature explores the immunostimulatory effects of thermal ablation in the tumor microenvironment, elucidating the mechanisms such as immunogenic cell death, tumor-specific antigens, and damage-associated molecular patterns. Furthermore, it outlines critical issues associated with thermal ablation-induced immunostimulatory challenges and offers insights into future research avenues and potential therapeutic strategies.
Safety and clinical efficacy of microwave ablation combined with percutaneous vertebroplasty in the treatment of multisegmental spinal metastases
Authors: Wang Zhilong , Zuo Taiyang , Lin Wenli , Liang Yining , Jiang Fangzhou , Li Yibing 
Published: April 2024

ABSTRACTObjective:To evaluate the safety and efficacy of microwave ablation (MWA) combined with percutaneous vertebroplasty (PVP) in the treatment of multisegmental (2–3 segments) osteolytic spinal metastases.Materials and Methods:This study comprised a retrospective analysis of data from 20 patients with multisegmental (2–3 segments) osteolytic spinal metastases who received MWA combined with PVP. The visual analog scale (VAS) score, Oswestry Disability Index (ODI) score, Quality of Life Questionnaire-Bone Metastases 22 (QLQ-BM22), and local recurrence before and after the operation were measured. The occurrence of complications was observed to evaluate safety.Results:All operations were completed successfully with no serious complications. Transient nerve injury occurred in two cases, but recovered after symptomatic treatment. The bone cement leakage rate was 13.9% (6/43). The mean baseline VAS scores were 7.25 ± 0.91 before treatment and 7.25 ± 0.91, 3.70 ± 1.12, 2.70 ± 0.73, 2.40 ± 0.68, 2.25 ± 0.71, and 2.70 ± 0.92 at 1 day, 1 week, 1, 3, and 6 months after treatment; all values were significantly lower (P< 0.001). The mean baseline ODI score decreased from 56.90 ± 9.74 before treatment to 41.90 ± 7.09, 38.10 ± 7.93, and 38.80 ± 10.59 at 1, 3, and 6 months after treatment, respectively; all values were significantly lower (P< 0.001). The average QLQ-BM22 baseline score decreased from 54.10 ± 5.36 before treatment to 44.65 ± 5.22, 43.05 ± 4.78, 42.30 ± 4.06, and 42.15 ± 5.47 at 1 week, 1, 3, and 6 months after treatment; all values were significantly lower (all P < 0.001). The postoperative survival time of all patients was >6 months. In three patients, four vertebral segments recurred 6 months after operation.Conclusion:MWA combined with PVP is a safe and effective treatment for multisegmental osteolytic vertebral metastases that can effectively relieve pain, improve spinal function, improve quality of life, and delay tumor progression. However, it is a long operation, necessitating good preoperative preparation and effective intraoperative pain relief measures.
Radiotherapy for patients with esophageal cancer aged 80 years or older: A 16-year experience
Authors: Zhai Tiantian , Huang Ruihong , Zhan Yizhou , Xu Liangyu , Yu Yuanxiang , Guo Longjia , Chen Jianzhou , Su Chuanghuang , Chen Chuangzhen 
Published: April 2024

ABSTRACT

Purpose:
Radiotherapy (RT) plays an important role in esophageal cancer (EC) patients aged ≥80 years. However, the survival modality and prognostic factors remain poorly understood. Thus, this study aimed to evaluate the tolerance and long-term overall survival (OS) of patients aged ≥80 years who were diagnosed with EC and underwent definitive RT.

Materials and Methods:
A total of 213 consecutive patients with EC over 80 years old who were treated with curative intent RT between February 1999 and December 2015 at our institution were retrospectively reviewed. The clinical prognostic variables were analyzed against OS in univariate analyses using log-rank tests and in a multivariate model using Cox regression proportional hazards analysis.

Result:
The median patient age was 82 (range: 80–94) years. Atotal of 192 patients (90.1%) completed the definitive RT (median: 60 Gy, range: 50–72 Gy), and 11 patients had grade 4 or higher acute toxicity, including esophagitis, a cardiac event, infections, and sudden death. Atotal of 168 deaths (78.9%) were observed with a median follow up of 47 months (range: 0-153 months). The OS rates were 50.3%, 17.6%, and 13.2% at 1, 3, and 5 years, respectively. Multivariable analysis identified that tumors located in the cervical and upper thorax, a shorter tumor lesion, RT treatment of 50–60Gy, and a better response to treatment were the factors associated with longer OS.

Conclusion:
Definitive RT could be considered as an effective treatment for patients with EC who are older than 80 years, and 50–60 Gy seems to be a reasonable dose for these patients.
Impact strength of heat-cured acrylic resin after immersion in tobacco leaf (Nicotiana tabacum L.) effervescent tablets: An experimental study
Authors: Kristiana Dewi , Parnaadji Rahardyan , Adena Afif Surya , Wulan Happy Ramadhani 
Published: April 2024

Abstract

Aim:
To determine the effect of immersing heat-cured acrylic resin on tobacco leaf extract (TLE) effervescent tablets 75% on the impact strength.

Materials and Methods:
This research used an experimental design. Rectangular acrylic resin with a size of 60 mm × 12 mm × 3 mm, according to American Standards for Testing and Materials, was used. The samples were divided into three groups: immersed in distilled water as a negative control group, immersed in a solution of TLE effervescent tablets with a concentration of 75%, and immersed in commercially available dental cleansers as a positive control group. The immersion of the samples was carried out for 16 days which was equivalent to cleaning 30 min per day for 2 years. TLE effervescent tablets were compared with commercially available dental cleansers. Next, the impact strength of the sample was tested.

Results:
The one-way analysis of variance test results showed a P-value <0.005, that is, a significant difference in each treatment group’s impact strength of heat-cured acrylic resin denture bases. The results of the post hoc test (least significance difference; LSD) showed that there is no significant difference in the impact strength of immersed acrylic in 75% TLE effervescent tablets with aquades compared to denture commercially available dental cleansers.

Conclusions:
75% TLE effervescent tablets as a denture cleanser have the effect of reducing the impact strength of heat-cured acrylic resin type with a soaking time of 16 days, which is equivalent to cleaning 30 min per day for 2 years. The limitation of this research is the type of heat-cured acrylic used only from one brand, maybe different brands will give different results, so further testing is needed to prove it.
Comparative evaluation of third-generation LED-light curing units and their effect on bulk-fill composites—An in vitro study
Authors: Puri Aakansha , Prathap M S , Jayaprakash K , Sreegowri  , Jose Jeslee A 
Published: April 2024

Abstract

Aim:
Comparing the effectiveness of third-generation light-emitting diode light-curing devices and their impact on bulk-fill composites is the primary purpose of this study.

Materials and Methods:

In vitro investigation was carried out on a total of 32 samples of two bulk-fill composites. Four groups (n = 8) were formed. Half of the specimens of Tetric® N-Ceram Bulk Fill and Palfique Bulk Flow composites were randomly selected and cured from top with Bluephase® N LED light curing unit (LCU), and the remaining half with FlashMax P3 WS 4W LED LCU, following instructions provided by the manufacturer. The samples were assessed for degree of conversion (DoC) and microhardness after being submerged in distilled water solution and kept in an incubator for 24 h at 37°C. The two LED LCUs were compared. Standard deviation and mean were used to describe the data. Utilizing the Kruskal–Wallis test, the groups were compared. The independent sample t test was used to evaluate the differences in values between the top and bottom surfaces, and the Bonferroni post hoc test was used for multiple comparisons. The DoC and microhardness were correlated, and this was evaluated using Pearson’s correlation test.

Results:
The mean values for both parameters were statistically different when the two composites were cured with the LED-LCUs. Both the bulk-fill composites showed better mechanical properties when cured with Bluephase N® LED-LCU.

Conclusions:
Bluephase N® LED-LCU showed better performance than FlashMax P3 WS 4W. The bulk-fill composites showed significant differences in both parameters when cured with the two LED-LCUs.
Perceived barriers in digitalizing oral health promotion: Phenomenological study among Malaysian dental public health specialists
Authors: Luai Amirul Faiz , Radzi Nawwal Alwani Mohd , Sabri Budi Aslinie Md 
Published: April 2024

Abstract

Aim:
The ascent of digital health promotion, encompassing telemedicine, teledentistry, mHealth, eHealth, mOralHealth, and social media, underscores the necessity for its adoption in advancing health promotion. Identifying barriers in digitalizing health promotion aids in overcoming obstacles and facilitating the effective integration of digital technologies for improved healthcare and health outcomes. Hence, this study aims to identify barriers to digitalizing oral health promotion among Malaysian dental public health specialists.

Materials and Methods:
Eight dental public health specialists from different ministries in Malaysia participated in the interviews using semi-structured questionnaires. The interviews were transcribed and analyzed using NVivo software.

Results:
Thematic analysis identified three major themes with 19 sub-themes, totaling 51 occurrences across the interviews. Among these three major themes, the availability of a supportive environment or infrastructure was the most discussed among the respondents. Among all sub-themes, respondents perceived those facilities, resources, and infrastructure (n = 6); and poor internet connection and stability (n = 6) as significant barriers to adopting and implementing digitalized oral health promotion.

Conclusions:
This study provides a distinctive contribution to stakeholders, offering insights into the impediments hindering dental students and professionals from embracing digital health promotion. The study findings can be utilized as a guide to facilitate the integration of digital dentistry and address the related issues within a broader context, guided by existing regulatory frameworks.
Evaluation of IL-1β and CRP mRNA expression levels by RT-PCR in postorthodontic treatment patients with temporomandibular joint disorders: a cross-sectional Study
Authors: Ismah Nada , Bachtiar Endang Winiati , Purwanegara Miesje Karmiati , Tanti Ira , Mardiati Endah 
Published: April 2024

Abstract

Aim:
Temporomandibular joint disorder (TMD), which affects the masticatory muscles, temporomandibular joint, and surrounding tissues, can manifest as inflammation. This study aims to explore the expression levels of the inflammatory biomarkers, interleukin (IL)-1β and C-reactive protein (CRP), in TMD patients who have undergone orthodontic treatment.

Materials and Methods:
Buccal swabs from 105 postorthodontic treatment patients were analyzed using real-time polymerase chain reaction to assess the expression levels of IL-1β and CRP in each group after messenger ribonucleic acid extraction. Patients were also examined using the Diagnostic Criteria for TMD (DC/TMD) to determine if they met the criteria for a TMD diagnosis. The TMD group was subdivided into three categories based on the DC/TMD.

Results:
The study included 37 patients who did not develop TMD (group 0) and 68 participants who developed TMD after orthodontic treatment, including 17 with pain-related TMDs (group 1), 29 with intra-articular TMDs (Group 2), and 22 with combined pain-related and intra-articular TMDs (group 3). CRP expression was higher than IL-1β in groups 1 and 2, and IL-1β expression was higher than CRP in group 3. The Kruskal–Wallis test showed that IL-1β and CRP expression levels in groups 1, 2, and 3 were not statistically different. Sex and adult age had considerable effects on the occurrence of TMD in patients after orthodontic treatment.

Conclusions:
Higher IL-1β expression was found in postorthodontic treatment patients with more complex TMD. This study strengthens the evidence of inflammation through IL-1β and CRP expression in individuals with TMD, especially after orthodontic treatment
Hypertension Management in Pre- and Post Percutaneous Coronary Intervention Patients: An Expert Opinion of Cardiologists from India
Authors: Kumar Arram Sreenivas , Kumar Viveka , Shah Chetan P. , Kasturi Sridhar , Birla Ashish , Revankar Santosh , Yadav Neeraj Kumar 
Published: April 2024

Introduction:
Despite recent advancements in hypertension management, a significant portion of the population in India still has uncontrolled blood pressure (BP), particularly post percutaneous coronary intervention (PCI). This paper fulfils the gap between post-PCI and hypertension management, ensuring hypertension is well-controlled before, during, and after PCI.

Methods:
Cardiologists (interventional, n = 256; noninterventional, n = 336) throughout India who treated hypertensive patients, post PCI were invited to participate in a survey and virtual meetings. The perception and practices in managing these patients and strategies to improve BP control were captured.

Results:
Out of 593 cardiologists, 57.5% opined that heart failure (HF) was more common in patients with hypertension indicated for PCI. The target BP after PCI for patients aged <65 years and >65 years was recommended to be 121–130/80 mmHg by 39% of experts while 131–140/90 mmHg by 33.2% of experts, respectively, with a target heart rate of 60–80 bpm. Angiotensin II receptor blockers (ARBs) were considered the most effective antihypertensive agent in different comorbid conditions. Metoprolol and bisoprolol were the most preferred cardio-selective beta-blockers for both post-PCI and HF. A combination of ARBs and beta-blockers after the intervention was suggested in hypertensive patients with coronary artery disease and diabetes mellitus (57.0%), stroke (41.1%), and HF (44.9%).

Conclusions:
Managing BP and heart rate in patients with hypertension post-PCI is important. In monotherapy, ARBs followed by beta-blockers and angiotensin-converting enzyme inhibitors, were the most preferred antihypertensive agents in these patients with different comorbid conditions. While a combination of ARB and beta-blocker was preferred in patients with PCI and multiple comorbidities.
Hippocampal characteristics among children with calcified neurocysticercosis
Authors: Rohilla Seema , Tyagi Shristi , Bala Kiran , Kaushik Jaya Shankar 
Published: April 2024

Abstract

Aim:
The aim of this article is to describe the hippocampal characteristics among children with calcified neurocysticercosis (cNCC).

Materials and Methods:
This cross-sectional study was conducted among children with epilepsy aged 3–14 years diagnosed with cNCC. Patients showing evidence of cNCC, with prior serial imaging evidence of active NCC, were enrolled. Eligible participants were subjected to magnetic resonance imaging (MRI)-based protocol and sleep-deprived electroencephalography. Hippocampal characteristics on the MRI were described.

Results:
A total of 31 children with mean (SD) age of 10.3 (3.2) years with cNCC were enrolled in the study. We observed that 42% (13/31) of children with cNCC had borderline (10–20% difference in the volumes of right and left hippocampi) (n = 8) or clear (>20% difference) (n = 5) hippocampal atrophy. Among 31 children with cNCC, 27 (87.1%) had nidus within the lesion and 21 (67.7%) had perilesional gliosis.

Conclusion:
Children with cNCC are at risk of seizure recurrence on tapering anti-seizure medications. Our study with limited sample size revealed that hippocampal atrophy and perilesional gliosis are prevalent among children with cNCC, predisposing them to the risk of epilepsy.
Prevalence of frailty among chronic respiratory disease patients
Authors: Ramanathan RM PL , Muthusamy Sivaguru , Kumar Krishna J , Krishnan Anusuya 
Published: April 2024

Background:
Although frailty is one of the aging syndromes, it can occur at a younger age and in individuals with organ diseases. Identifying frailty and pre-frailty in patients with chronic respiratory diseases (CRDs) is an emerging assessment in the field of pulmonary medicine and rehabilitation. The aim of this study was to find out the prevalence of frailty among chronic respiratory disease patients.

Methods:
A single centre cross-sectional survey study with a total population of 381 patients, adults aged 18–90 years presenting to the pulmonology OPD was included based on the inclusion and exclusion criteria. Primary data collected were demographics, medical history, including comorbidities, use of long-term oxygen therapy (LTOT), BiPAP (Bilevel Positive Airway Pressure), previous hospital admissions, medication history and frailty assessment were done using the Fried frailty index.

Results:
Univariate analysis showed that sex, ECHO abnormality, patients using LTOT, BiPAP, home nebulizers and patients who did not attend the pulmonary rehabilitation programme had a significant association with frailty. Multivariate analysis showed that female sex, LTOT use and older age were significantly associated with frailty.

Conclusion:
Frailty is frequent in CRD patients regardless of age. The prevalence of frailty has an association with female sex, patients using LTOT, and home BiPAP.
The Use of Antiepileptic Drug for Postcranioplasty Seizure: A Systematic Review and Meta-analysis
Authors: Putra Kevin Kristian , Niryana I Wayan 
Published: April 2024

Introduction:
Cranioplasty, a common procedure following craniectomy, aims to repair cranial defects resulting from various causes, including trauma and raised intracranial pressure. Despite its routine application, cranioplasty is associated with complications, notably seizures. The incidence of postcranioplasty seizures (PCS) and the role of antiepileptic drug (AED) prophylaxis remain underexplored. This meta-analysis aims to evaluate the impact of AED prophylaxis on both early and late PCS.

Methods:
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic literature search on PubMed, Europe PMC, ClinicalTrials.gov, and EMBASE, yielding 1292 articles. Eligibility criteria included randomized clinical trials (RCTs) in English reporting PCS incidence with or without AED prophylaxis. The risk of bias was assessed using Cochrane’s RoB 2 tool. Statistical analysis employed RevMan 5.4 software.

Results:
Of the initially identified articles, two RCTs met the inclusion criteria, involving a total of 497 cases. AED prophylaxis significantly reduced the risk of early PCS (risk ratio [RR]: 0.15, confidence interval [CI]: 0.06–0.37, P < 0.0001), with no heterogeneity (I
2 = 0%, P = 0.78). However, there was no significant difference in late PCS incidence between the intervention and control groups (RR: 0.32, CI: 0.06–1.56, P = 0.16). No significant differences in abnormal liver function or blood test results were observed between groups.

Conclusion:
AED prophylaxis significantly reduces the risk of early PCS following cranioplasty, but its effectiveness in preventing late PCS remains uncertain. Further studies are warranted to determine optimal AED regimens and address the limitations of the current meta-analysis.