bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing ChatGPT’s Responses to Otolaryngology Patient Questions
Authors: Carnino Jonathan M. , Pellegrini William R. , Willis Megan , Cohen Michael B. , Paz-Lansberg Marianella , Davis Elizabeth M. , Grillone Gregory A. , Levi Jessica R. 
Published: April 2024

Objective: This study aims to evaluate ChatGPT’s performance in addressing real-world otolaryngology patient questions, focusing on accuracy, comprehensiveness, and patient safety, to assess its suitability for integration into healthcare. Methods: A cross-sectional study was conducted using patient questions from the public online forum Reddit’s r/AskDocs, where medical advice is sought from healthcare professionals. Patient questions were input into ChatGPT (GPT-3.5), and responses were reviewed by 5 board-certified otolaryngologists. The evaluation criteria included difficulty, accuracy, comprehensiveness, and bedside manner/empathy. Statistical analysis explored the relationship between patient question characteristics and ChatGPT response scores. Potentially dangerous responses were also identified. Results: Patient questions averaged 224.93 words, while ChatGPT responses were longer at 414.93 words. The accuracy scores for ChatGPT responses were 3.76/5, comprehensiveness scores were 3.59/5, and bedside manner/empathy scores were 4.28/5. Longer patient questions did not correlate with higher response ratings. However, longer ChatGPT responses scored higher in bedside manner/empathy. Higher question difficulty correlated with lower comprehensiveness. Five responses were flagged as potentially dangerous. Conclusion: While ChatGPT exhibits promise in addressing otolaryngology patient questions, this study demonstrates its limitations, particularly in accuracy and comprehensiveness. The identification of potentially dangerous responses underscores the need for a cautious approach to AI in medical advice. Responsible integration of AI into healthcare necessitates thorough assessments of model performance and ethical considerations for patient safety.
Enhancing adherence to recommended food practices in Norwegian kindergartens: The role of knowledge and application of national guidelines for food and meals
Authors: Fjæra Kristin E , Lekhal Ratib , Helseth Sølvi , Småstuen Hagen Milada , Lekhal Samira 
Published: April 2024

Aim: This study sought to investigate the relationship between knowledge and the practical application (including grocery lists, meal plans and food-related pedagogical plans) of Norwegian national guidelines for food and meals in kindergartens, together with the quality of food served in adherence to these guidelines. The study also examined the frequency of daily meals provided and the quality of food served. Moreover, it explored whether pedagogical staff’s knowledge of these guidelines was linked to their practical application. Method: Data were collected from 324 kindergarten staff members by means of a web-based questionnaire distributed to both public and private kindergartens in Norway between 2018 and 2020. Univariate and multivariate linear regression analyses were employed to explore associations between pedagogical staff knowledge of the content of national guidelines and food quality in line with national guidelines. Results: Of the 324 participating kindergartens, two-thirds were private providers and one-third were public. A total of 155 kindergartens were in eastern Norway, 41 in mid-Norway, 50 in the west, 48 in the south and 26 in northern Norway. The study found that pedagogical staff’s knowledge and the use of national guidelines were positively associated with better food quality and adherence to guidelines for food and meals in kindergartens. In addition, the frequency of daily meals provided by kindergartens was associated with food quality. Conclusions: An association was found between pedagogical staff’s knowledge and application of national guidelines for food and meals, and the quality of food served in adherence to these guidelines. In addition, a correlation was observed between the frequency of meals provided by a kindergarten and food quality. These findings suggest that stressing the development of a better understanding of the content of national guidelines for food and meals could potentially enhance food and meal practices in kindergartens, but further research to explore this possibility is warranted.
Improved tricuspid regurgitation after transcatheter aortic valve replacement is associated with better survival: Systematic review and meta-analysis with reconstructed time-to-event data
Authors: Naito Noritsugu , Takagi Hisato 
Published: April 2024

Background This meta-analysis compared survival outcomes among patients experiencing improvement in untreated significant tricuspid regurgitation (TR) following transcatheter aortic valve replacement (TAVR) for severe aortic stenosis, in contrast to those without improvement. Methods MEDLINE and EMBASE were searched through January 2024. Pooled hazard ratios (HR) with 95% confidence intervals (CI) were computed. Employing network meta-analysis, a comparison involving four post-procedural TR categories (improved, no improvement, worsened, and no change) was executed. Subsequently, these categories were amalgamated into two groups (less TR after TAVR and same or greater TR after TAVR), and a standard meta-analysis was conducted. Kaplan-Meier curves depicting long-term all-cause mortality were reconstructed utilizing individual patient data derived from the studies. Results A systematic review identified seven non-randomized studies encapsulating 698 patients. Network meta-analysis revealed that improved TR after TAVR correlated with significantly lower long-term all-cause mortality compared to the remaining cohorts. Similarly, pooled all-cause mortality of standard meta-analysis demonstrated significant reduction in patients whose TR was sub-baseline than those exhibiting same or greater TR after TAVR (HR [95% CI] = 0.43 [0.32-0.58], p < .01). The hazard ratio, derived from reconstructed time-to-event data, showed a lower long-term all-cause mortality in patients with less TR after TAVR relative to the other cohort (HR [95% CI] = 0.46 [0.32-0.67], p < .01). Conclusion This meta-analysis revealed that improved TR after TAVR correlates with superior long-term survival. The benefits of simultaneous or staged intervention on the tricuspid valve in individuals undergoing TAVR warrant validation in future investigations.
Percutaneous tendon dry needling and thrust manipulation as an adjunct to multimodal physical therapy in patients with lateral elbow tendinopathy: A multicenter randomized clinical trial
Authors: Dunning James , Mourad Firas , Bliton Paul , Charlebois Casey , Gorby Patrick , Zacharko Noah , Layson Brus , Maselli Filippo , Young Ian , Fernández-de-las-Peñas César 
Published: April 2024

Objective The purpose of this study was to assess the effects of adding electrical dry needling and thrust manipulation into a multimodal program of exercise, mobilization, and ultrasound in patients with lateral elbow tendinopathy. Design Randomized, single-blinded, multicenter, parallel-group trial. Setting Thirteen outpatient physical therapy clinics in nine different US states. Participants One hundred and forty-three participants (n = 143) with lateral elbow tendinopathy were randomized. Intervention Cervical spine manipulation, extremity manipulation, and percutaneous tendon electrical dry needling plus multimodal physical therapy (n = 73) or multimodal physical therapy (n = 70) alone. Main measures The primary outcome was elbow pain intensity and disability as measured by the Patient-Rated Tennis Elbow Evaluation at baseline, 1 week, 4 weeks, and 3 months. Secondary outcomes included the Numeric Pain Rating Scale, Tennis Elbow Functional Scale, Global Rating of Change, and medication intake. Results The 2 × 4 analysis of covariance demonstrated that individuals with lateral elbow tendinopathy receiving electrical dry needling and thrust manipulation plus multimodal physical therapy experienced significantly greater improvements in disability (Patient-Rated Tennis Elbow Evaluation: F = 19.675; P < 0.001), elbow pain intensity (Numeric Pain Rating Scale: F = 22.769; P < 0.001), and function (Tennis Elbow Function Scale: F = 13.269; P < 0.001) than those receiving multimodal physical therapy alone at 3 months. The between-group effect size was large for pain and disability (Patient-Rated Tennis Elbow Evaluation: standardized mean difference = 1.13; 95% confidence interval: 0.78, 1.48) in favor of the electrical dry needling and thrust manipulation group. Conclusions The inclusion of percutaneous tendon electrical dry needling and thrust manipulation into a multimodal program of exercise, mobilization and ultrasound was more effective than multimodal physical therapy alone in individuals with lateral elbow tendinopathy. Trial Registration: www.clinicaltrials.gov NCT03167710 May 30, 2017.
Association between non-penetrative sexual activities and depression in women with vaginismus: a cross-sectional study
Authors: Yavuzkir Şeyda , Aslan Melike , Yurt Nurdan , Baykara Sema 
Published: April 2024

Objective This cross-sectional study aimed to explore the association between non-penetrative sexual activities (NPSA) and depression levels in women diagnosed with vaginismus. Methods A cross-sectional retrospective study was conducted between March 2016 and June 2019, after approval by the Fırat University Faculty of Medicine ethics committee. Participants comprised married women referred to our female sexual dysfunction outpatient clinic with vaginismus. Diagnosis of vaginismus was established following comprehensive evaluations, including gynecological examination and psychiatric assessment. Sociodemographic data and Beck Depression Inventory (BDI) scores were collected. We compared depression levels between women who engaged in NPSA and those who did not. Results Of the 75 women with primary vaginismus included in the study, 18 did not engage in any NPSA and 57 engaged in at least one NPSA. The average BDI score of those who engaged in NPSA was significantly lower than those who did not. A negative correlation was found between the number of NPSA engaged in and BDI scores (r = −0.494). Conclusions Women with vaginismus had high depression scores, but engaging in NPSA was associated with lower depression levels. The findings suggest that incorporating NPSA into clinical interventions may be beneficial for managing depression in women with vaginismus.
Knowledge of mother-to-child transmission of HIV among women living with HIV in Malawi
Authors: Antabe Roger , Sano Yujiro , Kangmennaang Joseph 
Published: April 2024

Objectives To reduce the incidence of mother-to-child transmission (MTCT) of HIV in Malawi, interventions have been created for women to be informed about the MTCT of HIV and for women living with HIV to be entered into the HIV care cascade to ensure safer deliveries. Our study aimed to examine the effectiveness of these strategies by exploring the determinants of adequate knowledge of MTCT of HIV among women living with HIV in Malawi. Methods We used the 2015-16 Malawi Demographic and Health Survey data and applied logistics regression analysis to explore the determinants of adequate knowledge of MTCT of HIV among women living with HIV. Results Our findings estimated that 75% of women living with HIV possessed adequate knowledge of MTCT of HIV. We also found that compared to those with no formal education, women with primary education (OR = 1.88, 95% CI = 1.04, 3.41) and secondary education or higher (OR = 2.61, 95% CI = 1.21, 5.62) were more likely to have adequate knowledge of MTCT of HIV. Furthermore, women who were resident in rural areas (OR = 2.97, 95% CI = 1.58, 5.57), were more likely to have adequate knowledge of MTCT of HIV relative to those in urban areas. Finally, women who had adequate HIV knowledge (OR = 1.85, 95% CI = 1.19, 2.89) and those who rejected the endorsement of HIV stigma and discrimination (OR = 2.30, 95% CI = 1.39, 3.81) were more likely to have adequate knowledge about the MTCT of HIV. Conclusion Based on our findings, there is an urgent need to offer women living with HIV in Malawi the opportunity to increase their knowledge of MTCT of HIV if the country is to make progress towards the elimination of MTCT of HIV as part of the overall strategy to contain new HIV infections in the country.
Risk factors for hospitalization in Mexican patients with systemic lupus erythematosus
Authors: García-Cañas Iveth Eunice , Cuevas-Orta Enrique , Herrera-Van Oostdam David Alejandro , Abud-Mendoza Carlos , Group LUNPOS 
Published: April 2024

Introduction Systemic lupus erythematosus (SLE) is an autoimmune disease that often requires hospitalization. Most hospitalizations are due to infections and/or disease activity, for which several risk factors have been described in non-Mestizo patients. Objective To identify risk factors for hospitalization in patients with systemic lupus erythematosus (SLE). Methods This was an observational case-control study of patients with SLE in San Luis Potosí, Mexico, evaluated from January 2019 to October 2020. We compared hospitalized lupus patients with non-hospitalized lupus patients. We used descriptive statistics and logistic regression to describe potential risk factors. Results Of a total of 202 patients, 89 (45.1%) were hospitalized; these patients were younger, had shorter disease duration, higher disease activity scores (systemic lupus erythematosus disease activity index-SLEDAI), and more accumulated damage than non-hospitalized patients. The primary reasons for hospitalization were disease activity (60.7%), kidney disease, infection, and drug toxicity (5.6%). Multivariate analysis revealed several risk factors associated with hospitalization, including elevated creatinine, C-reactive protein, neutrophil levels, and constitutional symptoms, while prolonged international normalized ratio (INR), longer stay in the intensive care unit (ICU), and vasopressor use were associated with mortality. The use of antimalarials was a protective factor against hospitalization. Survival analysis revealed that patients with hospital-acquired infections had a lower probability of survival. Conclusions Disease activity was the most common reason for hospitalization; kidney, constitutional, and hematological factors were associated with hospitalization; and the use of antimalarial was a protective factor for hospitalization.
Oral lesions of systemic lupus erythematosus: A collaborative Latin American study
Authors: de Arruda José Alcides Almeida , Villarroel-Dorrego Mariana , Freire Clara Herrera , Molina-Ávila Ignacio , Pimentel-Solá Juan Martin , Gilligan Gerardo , Piemonte Eduardo , Panico René , Panico Juan Cruz Romero , Aranda-Romo Saray , Tejeda-Nava Francisco Javier , Israel Mônica Simões , Cunha John Lennon Silva , de Medeiros Vanessa Alves , Nonaka Cassiano Francisco Weege , Alves Pollianna Muniz , Cavalcante Israel Leal , Ventura José Victor Lemos , de Lima Fernanda Silva , Drumond Victor Zanetti , Abreu Lucas Guimarães , Silva Tarcília Aparecida , Fonseca Felipe Paiva , Mesquita Ricardo Alves , Martínez-Flores René , Cordero-Torres Karina , Ahumada-Ossandón Richard , Guzmán Jorge , Toro Raiza , Xavier-Júnior José Cândido Caldeira , Sousa-Neto Sebastião Silvério , Arantes Diego Antônio Costa , Mendonça Elismauro Francisco , Palma Victor de Mello , de Oliveira Márcia Gaiger , Visioli Fernanda , Ortega Karem L , Tenório Jefferson R , de Andrade Bruno Augusto Benevenuto 
Published: April 2024

Background Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease that may affect the oral mucosa. The variable spectrum of oral lesions observed in SLE can pose challenges in diagnosis, particularly when the lesions occur in isolation. The aim of this study was to describe the oral lesions occurring in patients with SLE from Latin America. Methods This collaborative record-based study involving 11 oral and maxillofacial pathology and medicine services across Venezuela, Argentina, Chile, Brazil, and Mexico describes the clinicopathological profile of SLE-related oral lesions. Results Seventy patients with SLE and oral lesions were included in the study. The majority were females (75.7%; female/male ratio: 3.1:1) and white (62.1%), with a mean age of 38.4 years (range: 11–77 years). The most common site of oral lesions was the hard/soft palate (32.0%). Clinically, oral lesions predominantly presented as ulcers (26.6%), erosions (26.6%), and white lesions (23.4%). Isolated oral lesions occurred in 65.2% of individuals, while cutaneous manifestations occurred in 80.3%. The main clinical diagnostic hypothesis in 71.4% of cases was an immune-mediated disease. Oral biopsies followed by histopathological analysis were performed in 50 cases. Conclusion Oral lesions of SLE exhibit a variety of clinical and histopathological features. A key point in diagnosis is that unusual oral changes without an obvious local cause may indicate a possible systemic condition presenting with oral lesions. A multidisciplinary approach, which includes regular oral examination, is warranted to identify oral lesions and provide treatment.
Safety and Effectiveness of Abre Self-Expanding Venous Stent for Treatment of Superior Vena Cava Syndrome
Authors: An Thomas J. , McNamara Stephanie L. , Ardestani Ali , Zurkiya Omar , Cahalane Alexis , Stecker Michael S. , Epelboym Yan , Burch Ezra , Desai Khanant , Kalva Sanjeeva P. 
Published: April 2024

Purpose Superior vena cava (SVC) syndrome is a constellation of symptoms that results from partial or complete SVC obstruction. Endovascular SVC stenting is an effective treatment for SVC syndrome with rapid clinical efficacy and low risk of complications. In this study, we assess the technical and clinical outcomes of a cohort of patients with SVC syndrome treated with the AbreTM self-expanding venous stent (Medtronic, Inc, Minneapolis, MN, USA). Methods An institutional database was used to retrospectively identify patients with SVC syndrome treated with AbreTM venous self-expanding stent placement between 2021-2023. Patient demographic data, technical outcomes, treatment effectiveness, and adverse events were obtained from the electronic medical record. Nineteen patients (mean age 58.6) were included in the study. Thirteen interventions were performed for malignant compression of the SVC, 5 for central venous catheter-related SVC stenosis, and 1 for HD fistula-related SVC stenosis refractory to angioplasty. Results Primary patency was achieved in 93% of patients (17/19). Two patients (7%) required re-intervention with thrombolysis and angioplasty within 30 days post-stenting. Mean duration of clinical and imaging follow-up were 228.7 ± 52.7 and 258.7 ± 62.1 days, respectively. All patients with clinical follow-up experienced significant improvement in clinical symptoms post-intervention. No stent related complications were identified post-intervention. Conclusions Treatment of SVC syndrome with the AbreTM self-expanding venous stent has high rates of technical and clinical success. No complications related to stent placement were identified in this study.
Exploring the Structural Plasticity Mechanism of Corticospinal Tract during Stroke Rehabilitation Based Automated Fiber Quantification Tractography
Authors: Zhang Haojie , Zhao Jun , Fan Lingzhong , Wu Xia , Li Fang , Liu Jingya , Bai Chen , Li Xingzhu , Li Bingjie , Zhang Tong 
Published: April 2024

Background Corticospinal tract (CST) is the principal motor pathway; we aim to explore the structural plasticity mechanism in CST during stroke rehabilitation. Methods A total of 25 patients underwent diffusion tensor imaging before rehabilitation (T1), 1-month post-rehabilitation (T2), 2 months post-rehabilitation (T3), and 1-year post-discharge (T4). The CST was segmented, and fractional anisotropy (FA), axial diffusion (AD), mean diffusivity (MD), and radial diffusivity (RD) were determined using automated fiber quantification tractography. Baseline level of laterality index (LI) and motor function for correlation analysis. Results The FA values of all segments in the ipsilesional CST (IL-CST) were lower compared with normal CST. Repeated measures analysis of variance showed time-related effects on FA, AD, and MD of the IL-CST, and there were similar dynamic trends in these 3 parameters. At T1, FA, AD, and MD values of the mid-upper segments of IL-CST (around the core lesions) were the lowest; at T2 and T3, values for the mid-lower segments were lower than those at T1, while the values for the mid-upper segments gradually increased; at T4, the values for almost entire IL-CST were higher than before. The highest LI was observed at T2, with a predominance in contralesional CST. The LIs for the FA and AD at T1 were positively correlated with the change rate of motor function. Conclusions IL-CST showed aggravation followed by improvement from around the lesion to the distal end. Balance of interhemispheric CST may be closely related to motor function, and LIs for FA and AD may have predictive value for mild-to-moderate stroke rehabilitation. Clinical Trial Registration. URL: http://www.chictr.org.cn ; Unique Identifier: ChiCTR1800019474.
Low-frequency electroacupuncture exerts antinociceptive effects through activation of POMC neural circuit induced endorphinergic input to the periaqueductal gray from the arcuate nucleus
Authors: Wang Qian , Li Zhonghao , Nie Dengyun , Mu Xinru , Wang Yuxuan , Jiang Yongwei , Zhang Yongchen , Lu Zhigang 
Published: April 2024

It has been widely recognized that electroacupuncture (EA) inducing the release of β-endorphin represents a crucial mechanism of EA analgesia. The arcuate nucleus (ARC) in the hypothalamus is a vital component of the endogenous opioid peptide system. Serving as an integration center, the periaqueductal gray (PAG) receives neural fiber projections from the frontal cortex, insular cortex, and ARC. However, the specific mechanisms how EA facilitates the release of β-endorphin within the ARC, eliciting analgesic effects are yet to be elucidated. In this study, we conducted in vivo and in vitro experiments by transcriptomics, microdialysis, photogenetics, chemical genetics, and calcium imaging, combined with transgenic animals. Firstly, we detected 2 Hz EA at the Zusanli (ST36) increased the level of β-endorphin and transcriptional level of proopiomelanocortin (POMC). Our transcriptomics profiling demonstrated that 2 Hz EA at the ST36 modulates the expression of c-Fos and Jun B in ARC brain nuclear cluster, and the transcriptional regulation of 2 Hz EA mainly occur in POMC neurons by Immunofluorescence staining verification. Meaning while, 2 Hz EA specifically activated the cAMP-PKA-CREB signaling pathway in ARC which mediating the c-Fos and Jun B transcription, and 2 Hz EA analgesia is dependent on the activation of cAMP-PKA-CREB signaling pathway in ARC. In order to investigate how the β-endorphin produced in ARC transfer to integration center PAG, transneuronal tracing technology was used to observe the 2 Hz EA promoted the neural projection from ARC to PAG compared to 100 Hz EA and sham mice. Inhibited PAGGABA neurons, the transfer of β-endorphin from the ARC nucleus to the PAG nucleus through the ARCPOMC-PAGGABA neural circuit. Furthermore, by manipulating the excitability of POMC neurons from ARCPOMC to PAGGABA using inhibitory chemogenetics and optogenetics, we found that this inhibition significantly reduced transfer of β-endorphin from the ARC nucleus to the PAG nucleus and the effectiveness of 2 Hz EA analgesia in neurological POMC cyclization recombination enzyme (Cre) mice and C57BL/6J mice, which indicates that the transfer of β-endorphin depends on the activation of POMC neurons prefect from ARCPOMC to PAGGABA. These findings contribute to our understanding of the neural circuitry underlying the EA pain-relieving effects and maybe provide valuable insights for optimizing EA stimulation parameters in clinical pain treatment using the in vivo dynamic visual investigating the central analgesic mechanism.