bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of collagenase Clostridium histolyticum combination therapies for Peyronie’s disease: a systematic review and meta-analysis
Authors: Guo Yicheng , Yang Yingying , Mao Qiancheng , Liu Hongquan , Wang Tianqi , Sun Fengze , Wu Jitao , Cui Yuanshan 
Published: April 2024

Abstract

Introduction
Peyronie’s disease (PD) is a common penile disorder characterized by the formation of fibrous noncompliant hard nodules in the tunica albuginea of the penis. Collagenase Clostridium histolyticum (CCH) is an injectable drug that treats PD by enzymatically degrading plaque interstitial collagen. CCH has been used in patients with varying curvature, as well as in the acute and stable phases of the disease, through a variety of treatment regimens and combinations. We carried out a systematic review and meta-analysis to assess the efficacy of CCH combination therapies for PD.

Methods
We selected 4 observational comparative studies and 3 randomized controlled trials including 532 participants from the PubMed, Embase, and Cochrane databases (until December 2023) to evaluate the efficacy of CCH combination therapies for PD. The primary outcome was clinical efficacy as evaluated by improvement in penile curvature and penile length, as well as by scores on the Peyronie’s Disease Questionnaire (PDQ) for symptom bother, penile pain, and psychological symptoms. Continuous data were represented by mean difference (MD) and 95% CI. All data were analyzed by Review Manager version 5.3.

Results
For penile length (MD, 0.81 cm; 95% CI, 0.17-1.45; P = .01), PDQ symptom bother (MD, –1.02; 95% CI, –1.83 to –0.21; P = .01), and PDQ penile pain (MD, –0.93; 95% CI, –1.50 to –0.36; P = .001), CCH combination therapy showed significantly greater improvements vs CCH monotherapy. However, in the other indicators, penile curvature and PDQ psychological symptoms, there was no significant difference between the therapies.

Conclusion
This meta-analysis supports that CCH combination therapies can partially increase penile length and ameliorate symptom bother and penile pain to some extent. However, CCH combination therapies still need to be evaluated through more high-quality research.
Efficacy and Safety of Gabapentinoids for Acute Herpes Zoster Neuralgia
Authors: Li Yinluo , Long Xingzhen , Luo Fengrong , Zhang Jiarui , Sun Shaoqin , Du Pengqiang , Yang Hongtao , Chen Qi , Sheng Changcheng , Bai Xue 
Published: April 2024

Objective:his study aimed to systematically evaluate the clinical efficacy of gabapentin and pregabalin in the treatment of acute herpes zoster neuralgia, including pain control and the occurrence of adverse effects.Method:A systematic computerized search was conducted in October 2023 in PubMed, Embase, Web of Science, Cochrane Library, VIP, CNKI, and Wanfang databases. Data from randomized controlled trials comparing gabapentin analogs for the treatment of acute herpes zoster neuralgia were searched. Endpoints were visual analog scores (VAS) and adverse effects at 1, 2, and 4 weeks. Data from studies that met the inclusion criteria were extracted for meta-analysis and sensitivity analysis using Revman 5.4 and Stata16.Results:The study included 292 patients from 6 RCTs. Of these, 118 were in the gabapentin-treated group, 37 were in the pregabalin-treated group, and 137 were in the placebo-controlled group. The gabapentin group showed superior pain reduction compared to the placebo group (P<0.05), but adverse events were more frequent.Conclusion:Gabapentin can effectively reduce acute herpes zoster neuralgia in patients. Pregabalin requires additional randomized controlled trials to supplement the analysis.PROSPERO Registration:CRD42023446643.
Screw Diameter and Use of a Washer Affect Symptomatic Implant Removal Rates in Pediatric Medial Epicondyle Fractures
Authors: Siebert Matthew J. , Zhang Emily , Stephens Senah E. , Wey Aaron J. , Eppich Kaleb , Presson Angela P. , Holmes Stephanie M. , Makarewich Christopher A. 
Published: April 2024

Objective:
Medial epicondyle fractures are a common pediatric injury. When operative, cannulated partially threaded screws, with or without a washer, are commonly utilized. These implants may need to be removed after full healing if symptomatic. There is mixed evidence regarding the influence of a washer on rates of implant removal, and the influence of screw size has not been studied. We aim to determine the rate of symptomatic deep implant removal for each fixation type and identify factors associated with the need for removal.

Methods:
This was an IRB-reviewed, retrospective, case-cohort study. Patients treated at our institution between January 1, 2004 and December 31, 2019, age 18 years old or younger, with a medial epicondyle fracture managed operatively with 4.0 or 4.5 mm cannulated screws with or without washers were included. Patients with multiple operative ipsilateral elbow fractures and those who underwent implant removal for reasons other than pain or irritation were excluded. Removal rates were compared between screw sizes (4.0 vs 4.5 mm), as well as with and without a washer using a Cox proportional hazards model.

Results:
In total, 151 patients met the inclusion criteria, 54 with symptomatic hardware removed and 97 without symptomatic hardware removed. A significantly higher number of patients treated with 4.5 mm screws compared with 4.0 mm screws underwent removal of symptomatic deep implants (50% vs 30%, P = 0.033). In a multivariable Cox regression model adjusting for age and ulnar nerve status, when no washer was used, the hazard ratio (HR) for symptomatic hardware removal for 4.5 mm screws was 2.92 times the HR for 4.0 mm screws (95% CI: 1.35-6.29). When a 4.0 mm screw was used, the HR for symptomatic hardware removal for a washer was 3.24 times the HR without a washer (95% CI: 1.53-6.84).

Conclusion:
Implant removal rates are influenced by screw size and the use of a washer. These results may help guide implant choice and counsel families regarding the rate of symptomatic implant removal.

Level of Evidence:
Level III—therapeutic level, case-control study.
Concurrent Validity of PROMIS and LD-SRS Scores in Pediatric Patients With Lower Limb Differences
Authors: Sabharwal Samir , Coufal Sarah , Less Justin , Sabharwal Sanjeev 
Published: April 2024

Background:
We sought to assess the concurrent validity of select Patient Reported Outcomes Measurement Information System (PROMIS) domains and Limb Deformity-Scoliosis Research Society (LD-SRS) scores.

Methods:
We prospectively administered PROMIS-25 (including anxiety, depression, fatigue, pain interference, peer relationships, and physical function) and LD-SRS questionnaires to 46 consecutive pediatric patients with lower limb differences, presenting to a single surgeon for reconstruction. Concurrent validity between various subdomains of the 2 outcome measures was assessed through Pearson’s correlation, with significance defined as P <0.05. The strength of correlation was interpreted by Evans criteria: absolute r value <0.20 indicating very weak correlation; 0.20 to 0.39, weak; 0.40 to 0.59, moderate; 0.60 to 0.79, strong; and 0.8 or greater indicating very strong correlation.

Results:
The LD-SRS Pain, Function, and Mental Health domains most strongly correlated with the PROMIS pain interference (r=−0.79, P<0.001), physical function (r=0.74, P<0.001), and anxiety (r=-0.68, P <0.001) domains, respectively. In addition, LD-SRS pain strongly correlated with PROMIS physical function (r=0.61, P<0.001) and LD-SRS function with PROMIS pain interference (r=−0.72, P<0.001). All PROMIS domains significantly correlated with total LD-SRS scores. PROMIS pain interference (r=-0.79, P <0.001), physical function (r=0.67, P <0.001), and fatigue (r=-0.60, P <0.001) domains demonstrated the strongest correlations with the total LD-SRS score.

Conclusions:
The significant concurrent validity between LD-SRS and multiple PROMIS domains suggests considerable overlap, and perhaps redundancy, between these 2 outcome measures. Given the high degree of concordance and the advantage of computer adaptive testing (CAT) in mitigating administrative burden and survey fatigue, along with the ability to compare outcomes across a wider group of children with a variety of underlying diagnoses, select PROMIS domains may be a viable alternative to LD-SRS score for assessing patient-reported outcomes when treating pediatric patients with lower limb deformities. A larger, multi-center study including pediatric patients with lower limb differences from a diverse background, including age, etiology, native language, and ethnicity, would be helpful to externally validate our findings.

Level of Evidence:
Level—I
Recent advances in multimodal imaging in tetralogy of fallot and double outlet right ventricle
Authors: Singh Aakansha Ajay Vir , Yoo Shi-Joon , Seed Mike , Lam Christopher Z. , Valverde Israel 
Published: April 2024

Purpose of review
In the ever-evolving field of medical imaging, this review highlights significant advancements in preoperative and postoperative imaging for Tetralogy of Fallot (TOF) and double outlet right ventricle (DORV) over the past 18 months.

Recent findings
This review showcases innovations in echocardiography such as 3D speckle tracking echocardiography (3DSTE) for assessing right ventricle-pulmonary artery coupling (RVPAC) and Doppler velocity reconstruction (DoVeR) for intracardiac flow fields evaluation. Furthermore, advances in assessment of cardiovascular anatomy using computed tomography (CT) improve the integration of imaging in ablation procedures. Additionally, the inclusion of cardiac magnetic resonance (CMR) parameters as risk score predictors for morbidity, and mortality and for timing of pulmonary valve replacement (PVR) indicates its significance in clinical management. The utilization of 4D flow techniques for postoperative hemodynamic assessment promises new insights into pressure mapping. Lastly, emerging technologies such as 3D printing and 3D virtual reality are expected to improve image quality and surgical confidence in preoperative planning.

Summary
Developments in multimodality imaging in TOF and DORV are poised to shape the future of clinical practice in this field.
Treatment of transthyretin cardiac amyloidosis
Authors: Bampatsias Dimitrios , Wardhere Abdirahman , Maurer Mathew S. 
Published: April 2024

Purpose of review
Tafamidis is currently the only approved disease-modifying treatment for ATTR-CM. However, there have been important developments in the treatment of ATTR-CM, as the results of two phase 3 trials were published and several other trials are in their final stages. In this review, we summarize current and future therapies for ATTR-CM.

Recent findings
Recently, acoramidis, a TTR stabilizer has been proven to be effective in reducing mortality and morbidity compared to placebo in the ATTRibute-CM trial. Additionally, patisiran, an RNA silencer, preserved functional capacity and quality of life compared to placebo in the APOLLO-B trial. However, the FDA declined to approve patisiran for ATTR-CM. The results of phase 1 trial of ALXN2220, an antiamyloid antibody raise hope for reversal of myocardial damage by amyloid depletion. Phase 3 trials evaluating the efficacy of different RNA silencers, gene editing with CRISPR-Cas9, and other anti-amyloid antibodies are ongoing.

Summary
Therapies targeting different mechanism in the pathophysiology of ATTR-CM provide new alternatives for treating patients with ATTR-CM. Future research should focus on comparing their effectiveness, the potential of combined treatment with agents from different classes and on identifying the patients who will benefit most from each class of medication.
Ultrasound-based steatosis grading system using 2D-attenuation imaging: An individual patient data meta-analysis with external validation
Authors: Hobeika Christian , Ronot Maxime , Guiu Boris , Ferraioli Giovanna , Iijima Hiroko , Tada Toshifumi , Lee Dong Ho , Kuroda Hidekatsu , Lee Young Hwan , Lee Jeong Min , Kim So Yeon , Cassinotto Christophe , Maiocchi Laura , Raimondi Ambra , Nishimura Takashi , Kumada Takashi , Kwon Eun Young , Jang Jong Keon , Correas Jean-Michel , Valla Dominique , Vilgrain Valérie , Dioguardi Burgio Marco 
Published: April 2024

Background and Aims:
Noninvasive tools assessing steatosis, such as ultrasonography-based 2D-attenuation imaging (ATI), are needed to tackle the worldwide burden of steatotic liver disease. This one-stage individual patient data (IPD) meta-analysis aimed to create an ATI-based steatosis grading system.

Approach and Results:
A systematic review (EMBASE + MEDLINE, 2018–2022) identified studies, including patients with histologically or magnetic resonance imaging proton-density fat fraction (MRI-PDFF)–verified ATI for grading steatosis (S0 to S3). One-stage IPD meta-analyses were conducted using generalized mixed models with a random study-specific intercept. Created ATI-based steatosis grading system (aS0 to aS3) was externally validated on a prospective cohort of patients with type 2 diabetes and metabolic dysfunction–associated steatotic liver disease (n=174, histologically and MRI-PDFF–verified steatosis). Eleven enrolled studies included 1374 patients, classified into S0, S1, S2, and S3 in 45.4%, 35.0%, 9.3%, and 10.3% of the cases. ATI was correlated with histological steatosis (r = 0.60; 95% CI: 0.52, 0.67; p < 0.001) and MRI-PDFF (r = 0.70; 95% CI: 0.66, 0.73; p < 0.001) but not with liver stiffness (r = 0.03; 95% CI: −0.04, 0.11, p = 0.343). Steatosis grade was an independent factor associated with ATI (coefficient: 0.24; 95% CI: [0.22, 0.26]; p < 0.001). ATI marginal means within S0, S1, S2, and S3 subpopulations were 0.59 (95% CI: [0.58, 0.61]), 0.69 (95% CI [0.67, 0.71]), 0.78 (95% CI: [0.76, 0.81]), and 0.85 (95% CI: [0.83, 0.88]) dB/cm/MHz; all contrasts between grades were significant (p < 0.0001). Three ATI thresholds were calibrated to create a new ATI-based steatosis grading system (aS0 to aS3, cutoffs: 0.66, 0.73, and 0.81 dB/cm/MHz). Its external validation showed Obuchowski measures of 0.84 ± 0.02 and 0.82 ± 0.02 with histologically based and MRI-PDFF–based references.

Conclusions:
ATI is a reliable, noninvasive marker of steatosis. This validated ATI-based steatosis grading system could be valuable in assessing patients with metabolic dysfunction–associated steatotic liver disease.
Two Decades of Department of Veterans Affairs Traumatic Brain Injury Care and Benefits for Veterans of Post-9/11 Conflicts
Authors: Whiteneck Gale , Williams William , Almeida Emily , Bidelspach Douglas , Culpepper William , Picon Linda M. , Eagye CB , Dr Mellick David 
Published: April 2024

Objective:
To describe the background, methodology, and results of the congressionally mandated Department of Veterans Affairs (VA) Traumatic Brain Injury (TBI) Veterans Health Registry.

Setting:
Veterans Health Administration (VHA) and Veterans Benefit Administration (VBA).

Participants:
A total of 441 639 Veterans of post-9/11 conflicts who exhibited symptoms associated with TBI and sought care or benefits from the VA between September 2001 and September 2021. Design: Retrospective analysis of VHA and VBA administrative records.

Main Measures:
(1) VA/Department of Defense Identity Repository to identify Veterans with a deployment to the Southwest Asia theater of operations; (2) the VA TBI Screening and Evaluation Program data; (3) Inpatient and Outpatient Encounter data; and (4) an extract of the VBA Corporate Database to identify Veterans filing benefit claims based on TBI.

Results:
An unduplicated total of 441 639 post-9/11 Veterans were identified in the Registry via three different pathways to entry: 369 909 Veterans through a positive TBI Screen, 253 177 Veterans receiving healthcare including a TBI diagnosis, and 108 541 Veterans filing TBI disability claims. Among Veterans reporting current TBI symptoms who completed a clinical evaluation, a diagnosis of TBI was confirmed by a TBI specialist in 68.7% of the cases. The TBI severity of confirmed cases was classified as mild in 86.6% of the cases, moderate in 8.3%, and severe in 4.1%. The TBI Registry Veterans were hospitalized 66 503 times and seen 1 521 898 times as outpatients in VHA facilities with diagnoses including TBI. Among Veterans filing TBI disability claims, 67.3% were adjudicated as service-connected.

Conclusion:
The VA TBI Health Registry has identified over 440 000 Veterans of post-9/11 conflicts who presented to the VA for care or benefits with TBI symptomatology. This large number and the volume of TBI health care and benefits provided over the two decades since 9/11 demonstrate the need for the VA’s strong ongoing focus on screening, evaluation, and rehabilitation of TBI.
Quorum sensing: An emerging role for Vibrio infection and host defense
Authors: Lin Hao-Nan , Huang Xian-Hui , Miao Xin-Jun , Hu Wei-Lin , Lou Yong-Liang , Xie Dan-Li 
Published: April 2024

Abstract
Quorum sensing (QS) is a mechanism that allows bacteria to regulate various physiological and biochemical functions by secreting, sensing and responding to signaling molecules called autoinducers (AIs). In Vibrio species, QS plays a crucial role in modulating different biological characteristics. QS can influence the formation of biofilms, which are communities of bacteria encased in a protective matrix. It also controls flagella formation and motility, ensuring that Vibrio spp. can move efficiently in response to environmental cues. Additionally, QS in Vibrio spp. regulates the production of different virulence factors based on cell density. This enables the bacteria to adjust their virulence strategies accordingly, enhancing pathogenicity. QS also influences the interaction between Vibrio spp. and their host. Following infection by Vibrio spp., QS can affect the host immune response and colonization processes. Understanding the role of QS in these interactions is crucial for unraveling the complex dynamics between Vibrio spp. and the host. In summary, research on QS in Vibrio spp. has revealed its significance in regulating various biological phenotypes, controlling virulence factor production and affecting host defense. It provides valuable insights into the intricate mechanisms underlying microbial behavior, host adaptation and Vibrio spp. pathogenesis.
VAULT: vault accuracy using deep learning technology: new image-based artificial intelligence model for predicting implantable collamer lens postoperative vault
Authors: Nasser Taj , Hirabayashi Matthew , Virdi Gurpal , Abramson Andrew , Parkhurst Gregory 
Published: April 2024

Purpose:To develop an accurate deep learning model to predict postoperative vault of phakic implantable collamer lenses (ICLs).Setting:Parkhurst NuVision LASIK Eye Surgery, San Antonio, Texas.Design:Retrospective machine learning study.Methods:437 eyes of 221 consecutive patients who underwent ICL implantation were included. A neural network was trained on preoperative very high–frequency digital ultrasound images, patient demographics, and postoperative vault.Results:3059 images from 437 eyes of 221 patients were used to train the algorithm on individual ICL sizes. The 13.7 mm size was excluded because of insufficient data. A mean absolute error of 66.3 μm, 103 μm, and 91.8 μm were achieved with 100%, 99.0%, and 96.6% of predictions within 500 μm for the 12.1 mm, 12.6 mm, and 13.2 mm sizes, respectively.Conclusions:This deep learning model achieved a high level of accuracy of predicting postoperative ICL vault with the overwhelming majority of predictions successfully within a clinically acceptable margin of vault.
The safety and efficacy of neoadjuvant immunochemotherapy following laparoscopic gastrectomy for gastric cancer: a multicentre real-world clinical study
Authors: Sun Yu-Qin , Zhong Qing , Lv Chen-Bin , Zhu Ji-Yun , Lin Guang-Tan , Zhang Zhi-Quan , Wu Dong , Weng Cai-Ming , Chen Qiu-Xian , Lian Ming-Qiao , Zeng Wei-Ming , Zhang Yong-Bin , Chen Qi-Yue , Lin Jian-Xian , Xie Jian-Wei , Li Ping , Zheng Chao-Hui , Lu Jun , Cai Li-Sheng , Huang Chang-Ming 
Published: April 2024

Background:
The safety and efficacy of neoadjuvant immunochemotherapy (nICT) for locally advanced gastric cancer (LAGC) remain controversial.

Methods:
Patients with LAGC who received either nICT or neoadjuvant chemotherapy (nCT) at 3 tertiary referral teaching hospitals in China between January 2016 and October 2022 were analyzed. After propensity-score matching (PSM), comparing the radiological response, pathological response rate, perioperative outcomes, and early recurrence between the two groups.

Results:
After PSM, 585 patients were included, with 195 and 390 patients comprising the nICT and nCT groups, respectively. The nICT group exhibited a higher objective response rate (79.5% vs. 59.0%; P<0.001), pathological complete response rate (14.36% vs. 6.41%; P=0.002) and major pathological response rate (39.49% vs. 26.15%; P=0.001) compared with the nCT group. The incidence of surgical complications (17.44% vs. 16.15%, P=0.694) and the proportion of perioperative textbook outcomes (80.0% vs. 81.0%; P=0.767) were similar in both groups. The nICT group had a significantly lower proportion of early recurrence than the nCT group (29.7% vs. 40.8%; P=0.047). Furthermore, the multivariable logistic analysis revealed that immunotherapy was an independent protective factor against early recurrence [odds ratio 0.62 (95% CI 0.41–0.92); P=0.018]. No significant difference was found in neoadjuvant therapy drug toxicity between the two groups (51.79% vs. 45.38%; P=0.143).

Conclusions:
Compared with nCT, nICT is safe and effective, which significantly enhanced objective and pathological response rates and reduced the risk for early recurrence among patients with LAGC.

Trial registration:
Clinical Trials.gov.
DNA damage, obesity and obesity-related health complications: what are new data telling us?
Authors: Włodarczyk Marta , Nowicka Grażyna 
Published: April 2024

Purpose of review
Obesity is associated with increased DNA damage, which may in turn contribute to the development of obesity-related complications. DNA damage can also affect adipocyte biology, resulting in increased adiposity. Carefully managed weight loss programs can reverse this process. This article surveys new data that support these contentions.

Recent findings
Whole exome sequencing analyses have identified rare variants linked to high BMI and adiposity. Two of the identified genes are linked to DNA damage and DNA repair, suggesting that DNA damage itself may play a role in the cause of obesity. It has also been recognized that obesity increases DNA damage in breast tissue of carriers of BRCA mutations and rates of tumour formation in BRCA1+ mice, indicating effect of obesity on cancer development in high-risk populations. In addition, obesity promotes cancer cell chemoresistance by decreasing fatty acid oxidation involved in cellular DNA damage response, leading to apoptotic cellular death. Obesity is also associated with a reduced capacity of oocytes to repair sperm DNA damage, leading to lower in-vitro fertilization rates in women with obesity.

Summary
DNA damage and cellular responses to DNA damage can be both the result and the cause of obesity and can strongly influence the development and treatment of obesity-associated diseases.