bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Treatment of Cosmetic Lower Eyelid Adverse Events After Injection of Hyaluronic Acid Gel Fillers
Authors: Fagien Steven 
Published: April 2024

Abstract

Background
Nonsurgical blepharoplasty has been considered as an unmet need particularly for the large potential population of patients who are not interested in or ready for surgery and is generally performed by all providers who offer injectable agents in their practice. Although favorable outcomes can be achieved in most areas of the face, the lower eyelid has shown to be less forgiving and a source of overwhelming unsatisfactory outcomes. Although providers often disclose to their patients that undesirable cosmetic adverse events can be reversed with the injection of hyaluronidase, a larger experience has suggested that this application is not always successful.

Objectives
The author describes an algorithm for the resolution of refractory adverse events using a combination of intraoperative, high-dose, hyaluronidase with lower blepharoplasty.

Methods
From June 2016 to present, 70 consecutive patients, 65 females and 5 males, with ages ranging from 31 to 76 years, presented with unsatisfactory results after they received an injection of a hyaluronic acid (HA) product elsewhere. They were treated with lower blepharoplasty in conjunction with intraoperative “high-dose” transconjunctival hyaluronidase injections.

Results
All patients showed significant but varied improvement after this treatment when, in most situations, in-office, percutaneous injection of hyaluronidase was insufficient.

Conclusions
The combination of intraoperative injection of high-dose hyaluronidase and (upper and/or) lower blepharoplasty can lead to satisfactory outcomes in patients with chronic lower eyelid edema after HA gel injections to the lower eyelid prove ineffective.

Level of Evidence: 4
Increasing melanoma incidence with unchanged mortality: more sunshine, better treatment, increased diagnostic activity, overdiagnosis or lowered diagnostic threshold?
Authors: Nielsen Jesper Bo , Kristiansen Ivar Sønbø , Thapa Subash 
Published: April 2024

Abstract

Background
Increasing melanoma incidence with less increasing mortality is observed in several countries. This discrepancy is not well understood.

Objectives
In this study, our aim was to discuss factors [ultraviolet radiation (UVR) exposure, melanoma treatment, diagnostic activity, overdiagnosis, pathologists’ diagnostic threshold and clinicians’ propensity to remove suspect skin lesions] that might influence melanoma incidence and mortality in Denmark.

Methods
This was a register study with the number of melanocyte-related lesions and melanoma mortality based on comprehensive national pathology and mortality databases for the period 1999–2019. We investigated melanocyte-related diagnoses and mortality in a population of 5.5 million with a national healthcare system. Age-adjusted melanoma mortality and age-adjusted incidence of benign naevi, atypical lesion, or melanoma in situ and of invasive melanoma were computed for data analysis.

Results
In total, 1 434 798 biopsies were taken from 704 682 individuals (65% female). The mean age at biopsy was 39.8 years in males and 37.6 in females. In males and females, the incidence of invasive melanoma increased by 87% during the period 1999–2011. During the subsequent period it increased by 9% in males but remained unchanged in females. The incidence of melanoma in situ increased by 476% in males and 357% in females during the study period, while the increases for atypical melanocytic lesions were 1928% and 1686%, respectively. Biopsy rates increased by 153% in males and 118% in females from 1999 through 2011 but fell by 20% in males and 22% in females during the subsequent period. Mortality varied slightly from year to year without any significant time trend for males or females. We identified no evidence of increased UVR exposure over the latest 30 years in Denmark. Immunotherapy of advanced melanoma was introduced in Denmark in 2010 and came into general use in 2014.

Conclusions
Comprehensive national data demonstrate increasing melanoma incidence correlated with increasing biopsy rates, but with no change in mortality. Previously suggested explanations for such a trend are a lowered threshold of melanoma diagnosis among pathologists, increased diagnostic activity in the presence of overdiagnosis and improved melanoma treatment. Because the study is observational and we have more explanatory factors than outcomes, the findings do not warrant conclusions about causal relationships.
Gasdermin E-mediated keratinocyte pyroptosis participates in the pathogenesis of psoriasis by promoting skin inflammation
Authors: Li Yingfei , He Yi , Yang Fangyuan , Liang Rongmei , Xu Wenchao , Li Yehao , Cheng Jingbo , Liang Baozhu , Tang Ming , Shi Xingliang , Zhuang Jian , Luo Minshuang , Li Liuying , Zhang Ruilin , Liu Huijuan , Jie Hongyu , Li Xing , Han Xinai , Sun Erwei , Zhai Zeqing 
Published: April 2024

Abstract

Background
Psoriasis is a common chronic inflammatory disease with an unclear aetiology. Keratinocytes in psoriasis are susceptible to exogenous triggers that induce inflammatory cell death.

Objectives
To investigate whether gasdermin E (GSDME)-mediated pyroptosis in keratinocytes contributes to the pathogenesis of psoriasis.

Methods
Skin samples from patients with psoriasis and from healthy controls were collected to evaluate the expression of GSDME, cleaved caspase-3 and inflammatory factors. We then analysed the data series GSE41662 to further compare the expression of GSDME between lesional and nonlesional skin samples in those with psoriasis. In vivo, a caspase-3 inhibitor and GSDME-deficient mice (Gsdme–/–) were used to block caspase-3/GSDME activation in an imiquimod-induced psoriasis model. Skin inflammation, disease severity and pyroptosis-related proteins were analysed. In vitro, tumour necrosis factor (TNF)-α-induced caspase-3/GSDME-mediated pyroptosis in the HACAT cell line was explored.

Results
Our analysis of the GSE41662 data series found that GSDME was upregulated in psoriasis lesions vs. normal skin. High levels of inflammatory cytokines such as interleukin (IL)-1β, IL-6 and TNF-α were also found in psoriasis lesions. In mice in the Gsdme–/– and caspase-3 inhibitor groups, the severity of skin inflammation was attenuated and GSDME and cleaved caspase-3 levels decreased after imiquimod treatment. Similarly, IL-1β, IL-6 and TNF-α expression was decreased in the Gsdme–/– and caspase-3 inhibitor groups. In vitro, TNF-α induced HACAT cell pyroptosis through caspase-3/GSDME pathway activation, which was suppressed by blocking caspase-3 or silencing Gsdme.

Conclusions
Our study provides a novel explanation of TNF-α/caspase-3/GSDME-mediated keratinocyte pyroptosis in the initiation and ­acceleration of skin inflammation and the progression of psoriasis.
Laparoscopic liver resection versus radiofrequency ablation for small hepatocellular carcinoma: randomized clinical trial
Authors: Song Juxian , Cao Li , Ma Kuansheng , Li Jianwei , Wang Xiaojun , Chen Jian , Zheng Shuguo 
Published: April 2024

Abstract

Background
The aim of this study was to compare the efficacy of laparoscopic liver resection versus radiofrequency ablation for treatment of small hepatocellular carcinoma.

Methods
This single-centre RCT was conducted at a tertiary referral centre in China. Patients with small hepatocellular carcinoma who had a single nodule no larger than 5 cm, or up to three nodules of 3 cm or smaller, were eligible. Patients were assigned randomly in a 1 : 1 ratio to either laparoscopic liver resection or radiofrequency ablation. Blinding was not attempted. Sample size calculations led to 75 patients per group. The primary outcome was overall survival, and the secondary outcome was recurrence-free survival.

Results
Seventy-five patients were included in each group. Overall survival (HR 1.26, 95% c.i. 0.69 to 2.30; P = 0.451) and recurrence-free survival (HR 1.34, 0.86 to 2.08; P = 0.189) did not differ between the resection and ablation groups. The 1-, 3- and 5-year overall survival rates were 94.7, 80.0, and 74.7% respectively after laparoscopic liver resection versus 93.3, 78.7, and 67.9% after radiofrequency ablation. Corresponding recurrence-free survival rates were 78.7, 61.3, and 51.6%, and 69.3, 53.3, and 41.0%, respectively.

Conclusion
For small hepatocellular carcinoma, percutaneous radiofrequency ablation provides therapeutic effects similar to those of laparoscopic liver resection.

Registration number
NCT02243384 (http://www.clinicaltrials.gov).
IL-22, a vital cytokine in autoimmune diseases
Authors: Li Jiajin , Wu Zhen , Wu Yuxin , Hu XinYu , Yang Jun , Zhu Dacheng , Wu Mingyue , Li Xin , Bentum-Ennin Lutterodt , Wanglai Hu 
Published: April 2024

Summary
Interleukin-22 (IL-22) is a vital cytokine that is dysregulated in various autoimmune conditions including rheumatoid arthritis (RA), multiple sclerosis (MS), and Alzheimer’s disease (AD). As the starting point for the activation of numerous signaling pathways, IL-22 plays an important role in the initiation and development of autoimmune diseases. Specifically, imbalances in IL-22 signaling can interfere with other signaling pathways, causing cross-regulation of target genes which ultimately leads to the development of immune disorders. This review delineates the various connections between the IL-22 signaling pathway and autoimmune disease, focusing on the latest understanding of the cellular sources of IL-22 and its effects on various cell types. We further explore progress with pharmacological interventions related to targeting IL-22, describing how such therapeutic strategies promise to usher in a new era in the treatment of autoimmune disease.
Genomic testing identifies monogenic causes in patients with very early-onset inflammatory bowel disease: a multicenter survey in an Iranian cohort
Authors: Eslamian Golnaz , Jamee Mahnaz , Momen Tooba , Rohani Pejman , Ebrahimi Sarehossadat , Mesdaghi Mehrnaz , Ghadimi Soodeh , Mansouri Mahboubeh , Mahdaviani Seyed Alireza , Sadeghi-shabestari Mahnaz , Fallahpour Morteza , Shamsian Bibi Shahin , Eslami Narges , Sharafian Samin , Dara Naghi , Nasri Peiman , Amini Niloufar , Enayat Javad , Fallahi Mazdak , Ghasemi Hashtrodi Leila , Shojaei Mohammad , Guevara Becerra Martha , Uhlig Holm H , Chavoshzadeh Zahra 
Published: April 2024

Abstract
Patients with very early-onset inflammatory bowel disease (VEO-IBD) may present because of underlying monogenic inborn errors of immunity (IEI). Strong differences have been observed in the causes of monogenic IBD among ethnic populations. This multicenter study was carried out on 16 Iranian patients with VEO-IBD. We reviewed clinical and basic immunologic evaluation including flow cytometry and immunoglobulin levels. All patients underwent clinical whole exome sequencing (WES). Sixteen patients (8 females and 8 males) with a median age of 43.5 months were enrolled. The median age at the onset of symptoms was 4 months. Most patients (12, 75%) had consanguineous parents. Chronic non-bloody diarrhea (13, 81.3%) and perianal diseases including perianal abscess (6, 37.5%), anal fissure (6, 37.5%), or anal fistula (2, 12.5%) were the most common manifestations. WES identified a spectrum of genetic variants in 13 patients (81.3%): IL10RB (6, 37.5%), MVK (3, 18.8%), and CASP8, SLC35C1, G6PC3, and IKBKB in 1 patient, respectively. In 3 patients (18.7%), no variant was identified. Flow cytometry identified a spectrum of abnormalities that helped to assess the evidence of genetic diagnosis. At the end of the survey, 3 (18.8%) patients were deceased. This high rate of monogenic defects with a broad spectrum of genes reiterates the importance of investigating IEI in patients with infantile-onset IBD.
Consistency of metabolite associations with measured glomerular filtration rate in children and adults
Authors: Li Taibo , Grams Morgan E , Inker Lesley A , Chen Jingsha , Rhee Eugene P , Warady Bradley A , Levey Andrew S , Denburg Michelle R , Furth Susan L , Ramachandran Vasan S , Kimmel Paul L , Coresh Josef 
Published: April 2024

ABSTRACT

Background
There is interest in identifying novel filtration markers that lead to more accurate GFR estimates than current markers (creatinine and cystatin C) and are more consistent across demographic groups. We hypothesize that large-scale metabolomics can identify serum metabolites that are strongly influenced by glomerular filtration rate (GFR) and are more consistent across demographic variables than creatinine, which would be promising filtration markers for future investigation.

Methods
We evaluated the consistency of associations between measured GFR (mGFR) and 887 common, known metabolites quantified by an untargeted chromatography- and spectroscopy-based metabolomics platform (Metabolon) performed on frozen blood samples from 580 participants in Chronic Kidney Disease in Children (CKiD), 674 participants in Modification of Diet in Renal Disease (MDRD) Study and 962 participants in African American Study of Kidney Disease and Hypertension (AASK). We evaluated metabolite–mGFR correlation association with metabolite class, molecular weight, assay platform and measurement coefficient of variation (CV). Among metabolites with strong negative correlations with mGFR (r &lt; −0.5), we assessed additional variation by age (height in children), sex, race and body mass index (BMI).

Results
A total of 561 metabolites (63%) were negatively correlated with mGFR. Correlations with mGFR were highly consistent across study, sex, race and BMI categories (correlation of metabolite–mGFR correlations between 0.88 and 0.95). Amino acids, carbohydrates and nucleotides were more often negatively correlated with mGFR compared with lipids, but there was no association with metabolite molecular weight, liquid chromatography/mass spectrometry platform and measurement CV. Among 114 metabolites with strong negative associations with mGFR (r &lt; −0.5), 27 were consistently not associated with age (height in children), sex or race.

Conclusions
The majority of metabolite–mGFR correlations were negative and consistent across sex, race, BMI and study. Metabolites with consistent strong negative correlations with mGFR and non-association with demographic variables may represent candidate markers to improve estimation of GFR.
Detection and classification of mandibular fractures in panoramic radiography using artificial intelligence
Authors: Yari Amir , Fasih Paniz , Hosseini Hooshiar Mohammad , Goodarzi Ali , Fattahi Seyedeh Farnaz 
Published: April 2024

Abstract

Objectives
This study evaluated the performance of the YOLOv5 deep learning model in detecting different mandibular fracture types in panoramic images.

Methods
The dataset of panoramic radiographs with mandibular fractures was divided into training, validation, and testing sets, with 60%, 20%, and 20% of the images, respectively. An equal number of control images without fractures were also distributed among the datasets. The YOLOv5 algorithm was trained to detect six mandibular fracture types based on the anatomical location including symphysis, body, angle, ramus, condylar neck, and condylar head. Performance metrics of accuracy, precision, sensitivity (recall), specificity, dice coefficient (F1 score), and area under the curve (AUC) were calculated for each class.

Results
A total of 498 panoramic images containing 673 fractures were collected. The accuracy was highest in detecting body (96.21%) and symphysis (95.87%), and was lowest in angle (90.51%) fractures. The highest and lowest precision values were observed in detecting symphysis (95.45%) and condylar head (63.16%) fractures, respectively. The sensitivity was highest in the body (96.67%) fractures and was lowest in the condylar head (80.00%) and condylar neck (81.25%) fractures. The highest specificity was noted in symphysis (98.96%), body (96.08%), and ramus (96.04%) fractures, respectively. The dice coefficient and AUC were highest in detecting body fractures (0.921 and 0.942, respectively), and were lowest in detecting condylar head fractures (0.706 and 0.812, respectively).

Conclusion
The trained algorithm achieved promising results in detecting most fracture types, particularly in body and symphysis regions indicating machine learning potential as a diagnostic aid for clinicians.
Predictors of treatment response in lymphogenic metastasized papillary thyroid cancer: a histopathological study
Authors: van Kinschot Caroline M J , Oudijk Lindsey , van Noord Charlotte , Korevaar Tim I M , van Nederveen Francien H , Peeters Robin P , van Kemenade Folkert J , Visser W Edward 
Published: April 2024

Abstract

Background
Lymph node metastases in papillary thyroid cancer (PTC) increase the risk for persistent and recurrent disease. Data on the predictive value of histopathological features of lymph node metastases, however, are inconsistent. The aim of this study was to evaluate the prognostic significance of known and new histopathological features of lymph node metastases in a well-defined cohort of PTC patients with clinically evident lymph node metastases.

Methods
A total of 1042 lymph node metastases, derived from 129 PTC patients, were reexamined according to a predefined protocol and evaluated for diameter, extranodal extension, cystic changes, necrosis, calcifications, and the proportion of the lymph node taken up by tumor cells. Predictors for a failure to achieve a complete biochemical and structural response to treatment were determined.

Results
The presence of more than 5 lymph node metastases was the only independent predictor for a failure to achieve a complete response to treatment (odds ratio [OR] 3.39 [95% CI, 1.57-7.33], P &lt; .05). Diameter nor any of the other evaluated lymph node features were significantly associated with the response to treatment.

Conclusions
Detailed reexamination of lymph nodes revealed that only the presence of more than 5 lymph node metastases was an independent predictor of failure to achieve a complete response to treatment. No predictive value was found for other histopathological features, including the diameter of the lymph node metastases. These findings have the potential to improve risk stratification in patients with PTC and clinically evident lymph node metastases.
Nausea, vomiting and conflict in pregnancy
Authors: Crespi Bernard J 
Published: April 2024

Abstract
Nausea and vomiting in pregnancy (NVP) is heritable, common and aversive, and its extreme, hyperemesis gravidarum (HG), can be highly deleterious to the mother and fetus. Recent influential studies have demonstrated that HG is caused predominantly by high levels of Growth-Differentiation Factor 15 (GDF15), a hormone produced by the placenta in substantial amounts. This work has led to calls for therapeutic modulation of this hormone to reduce GDF15 levels and ameliorate HG risk. I describe three main lines of evidence relevant to the hypothesis that GDF15 production is typically adaptive for the fetus, in the context of enhanced placental invasion, reduced rates of miscarriage and preterm birth and higher birth weight. These considerations highlight the medical implications of maternal-fetal conflict, in the context of tradeoffs between aversive symptoms during gestation, rare disorders of pregnancy with major adverse effects and moderate fitness-enhancing benefits to fetuses.
Is Reiki effective in reducing heart rhythm, cortisol levels, and anxiety and improving biochemical parameters in individuals with cardiac disease? Randomized placebo-controlled trial
Authors: Bektas Akpinar Nilay , Ozcan Yüce Ulviye , Cansız Gizem , Yurtsever Dilek , Özkanat Cemaynur , Unal Nursemin , Sabanoglu Cengiz , Altınbas Akkas Özlem , Yurtsever Sabire 
Published: April 2024

Abstract

Aims
The aim of this study was to examine the effect of Reiki in patients with cardiac disease.

Methods and results
This study was a single-blind, pre–post-test, randomized, placebo-controlled study. Patients from the cardiology outpatient clinic of a training and research hospital were randomized into three groups: Reiki (n = 22), sham (placebo) (n = 21), and control (no treatment) (n = 22). Data were collected using a personal information form, biochemical parameters, cortisol levels, Beck Anxiety Inventory, and electrocardiography analysis. The Reiki group received Reiki to nine main points for 30 min, while the sham Reiki group received the same points during the same period without starting the energy flow. On Day 2, distance Reiki was performed for 30 min. After 1 week, the researchers administered the Beck Anxiety Inventory, assessed the biochemical parameters and cortisol levels, and analysed the electrocardiography again. Of the patients, 52.3% were male and 47.7% were female, and the mean age (years) was 60.45 ± 9.67 years. The control group had a significantly higher post-test cortisol level than the other groups (P = 0.002). According to the post hoc analysis, there was a significant difference between the Reiki vs. control groups and sham vs. control groups (P = 0.002). The control group had a significantly higher post-test cortisol level than the pre-test cortisol level (P = 0.008). Reiki group had a significantly lower mean post-test Beck Anxiety Inventory score than the other groups (P &lt; 0.001). There was no difference between the electrocardiography results of the groups (P &gt; 0.05).

Conclusion
Reiki reduces blood cortisol levels and anxiety levels in patient with cardiac diseases.

Registration
ClinicalTrials.gov: NCT05483842
Personalized pulmonary vein isolation with very high-power short-duration lesions guided by left atrial wall thickness: the QDOT-by-LAWT randomized trial
Authors: Falasconi Giulio , Penela Diego , Soto-Iglesias David , Francia Pietro , Saglietto Andrea , Turturiello Dario , Viveros Daniel , Bellido Aldo , Alderete Jose , Zaraket Fatima , Franco-Ocaña Paula , Huguet Marina , Cámara Óscar , Vătășescu Radu , Ortiz-Pérez José-Tomás , Martí-Almor Julio , Berruezo Antonio 
Published: April 2024

Abstract

Aims
Pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) using very high-power short-duration (vHPSD) radiofrequency (RF) ablation proved to be safe and effective. However, vHPSD applications result in shallower lesions that might not be always transmural. Multidetector computed tomography-derived left atrial wall thickness (LAWT) maps could enable a thickness-guided switching from vHPSD to the standard-power ablation mode. The aim of this randomized trial was to compare the safety, the efficacy, and the efficiency of a LAWT-guided vHPSD PVI approach with those of the CLOSE protocol for PAF ablation (NCT04298177).

Methods and results
Consecutive patients referred for first-time PAF ablation were randomized on a 1:1 basis. In the QDOT-by-LAWT arm, for LAWT ≤2.5 mm, vHPSD ablation was performed; for points with LAWT &gt; 2.5 mm, standard-power RF ablation titrating ablation index (AI) according to the local LAWT was performed. In the CLOSE arm, LAWT information was not available to the operator; ablation was performed according to the CLOSE study settings: AI ≥400 at the posterior wall and ≥550 at the anterior wall. A total of 162 patients were included. In the QDOT-by-LAWT group, a significant reduction in procedure time (40 vs. 70 min; P &lt; 0.001) and RF time (6.6 vs. 25.7 min; P &lt; 0.001) was observed. No difference was observed between the groups regarding complication rate (P = 0.99) and first-pass isolation (P = 0.99). At 12-month follow-up, no significant differences occurred in atrial arrhythmia-free survival between groups (P = 0.88).

Conclusion
LAWT-guided PVI combining vHPSD and standard-power ablation is not inferior to the CLOSE protocol in terms of 1-year atrial arrhythmia-free survival and demonstrated a reduction in procedural and RF times.