bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD-1 Limits IL-2 Production and Thymic Regulatory T Cell Development
Authors: Caruso Breanna , Weeder Benjamin R , Thompson Reid F , Moran Amy E 
Published: March 2024

Abstract
Inhibitory proteins, such as programmed cell death protein 1 (PD-1), have been studied extensively in peripheral T cell responses to foreign Ags, self-Ags, and neoantigens. Notably, these proteins are first expressed during T cell development in the thymus. Reports suggest that PD-1 limits regulatory T cell (Treg) development, but the mechanism by which PD-1 exerts this function remains unknown. The present study expands the evaluation of murine PD-1 and its ligands in the thymus, demonstrating that some of the highest expressers of PD-1 and programmed death-ligand 1 are agonist selected cells. Surprisingly, we reveal a selective role for PD-1 in regulating the developmental niche only for Tregs because other agonist selected cell populations, such as NK T cells, remain unchanged. We also ruled out PD-1 as a regulator of proliferation or cell death of agonist selected Tregs and further demonstrated that PD-1–deficient Tregs have reduced TCR signaling. Unexpectedly, the data suggest that PD-1–deficient thymocytes produce elevated levels of IL-2, a Treg niche–limiting cytokine. Collectively, these data suggest a novel role for PD-1 in regulating IL-2 production and the concurrent agonist selection of murine thymic Tregs. This observation has implications for the use of checkpoint blockade in the context of cancer and infection.
Fractional CO2 laser as monotherapy or combined with platelet-rich plasma in the treatment of atrophic postacne scars: A narrative review
Authors: Tawfik Abeer Attia , Rageh Mahmoud A. 
Published: March 2024

Abstract
Acne scars are the unfortunate outcome of acne vulgaris. It is a common problem that faces many young adults and can cause severe distress and impair their quality of life. Different therapeutic modalities have been tried for atrophic acne scars; however, no standard treatment has been identified yet. In this review, we are focusing on fractional CO2 laser (FCL), whether used as monotherapy or combined with platelet-rich plasma (PRP), trying to highlight the efficacy and safety of such modalities in the treatment of atrophic acne scarring. PubMed, Embase, and Cochrane Library databases were used to search for relevant studies that were published in the period from January 2017 to December 2022. We used a combination of the following keywords: “acne scar,” “acne scars,” “modalities for acne scars” in addition to the names of additional therapies studied in this review, such as “laser and acne scars,” “plateletrich plasma,” “platelet-rich plasma,” “PRP,” and “platelet-rich plasma therapy and acne scars”. Twelve studies were found utilizing the use of FCL whether used as monotherapy or combined with PRP in the treatment of atrophic acne scarring. Most of the studies showed that acne scars improved with both treatment modalities, but the combination approach yielded better results with less incidence of side effects.
Genotoxicity in Analog and Smart Mobile Phone Users by Assessing Micronuclei in Oral Exfoliated Cells – A Comparative Study
Authors: Jeddy Nadeem , Sai Lakshmi LJ , Amutha S. , Radhika T. , Christopher M. , Priya M. 
Published: March 2024

Abstract

Aim:
The number of micronuclei in oral exfoliated buccal mucosal cells of analog (basic) and smart mobile phone users was evaluated and compared.

Materials and Methods:
The study population constituted 30 individuals using basic and smartphones within the age group of 45–55 years. They were divided into two groups: Group 1–15 participants using basic mobile phones and Group 2–15 participants using smart mobile phones. Exfoliated buccal mucosal cells were collected from both right and left buccal mucosa, stained with Papanicolaou stain, and evaluated microscopically for the estimation of micronuclei count. Mean micronuclei count was compared statistically between the study groups and also between the sides of frequent usage and opposite sides within the study groups.

Results:
There was a significant increase in the mean micronuclei count in Group 2 compared to Group 1 and the comparison of mean micronuclei count between the side of frequent phone usage (right side) and opposite side (left side) also showed significant difference in both Groups 1 and 2.

Conclusion:
Despite technological advance and high-end features, the use of smartphones causes more genotoxicity compared to basic model or analog phones. Although this technology-dominated era mandates use of such phones as a part of routine lifestyle, it is imperative to adopt safety precautions such as use of headphones while talking, carrying a separate pouch for mobile phones to minimize the genotoxic damage.
Assessment of Dietary Acid Load in Children with Chronic Kidney Disease: An Observational Study
Authors: Sravani Madhileti , Collins Sheeba , Iyengar Arpana 
Published: March 2024

Introduction:
Dietary acid load (DAL), which reflects the balance between acid- and alkaline-forming foods, is a modifiable risk factor for metabolic acidosis in CKD. Owing to the paucity of data in the Indian context, we undertook this cross-sectional study to estimate DAL and assess acid and alkaline food consumption in children with CKD2-5D (Chronic kidney disease stage 2 to 5 and 5D-those on hemodialysis).

Methods:
Clinical profile, dietary assessment of energy, protein intake/deficits, and macronutrients were noted and computed using software created by the division of nutrition, St John’s research institute based on Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines in clinically stable children with CKD2-5D. DAL was estimated using potential renal acid load (PRAL in mEq/day) = (0.49 × protein intake in g/day) + (0.037 × phosphorus-intake in mg/day) − (0.02 × potassium intake in mg/day) − (0.013 × calcium intake in mg/day) − (0.027 × magnesium intake in mg/day). A positive dietary PRAL (>0) favors acidic content and negative (<0) favors alkaline content. PRAL was stratified into quartiles for analysis. The association of various clinical and dietary parameters were analysed across these quartiles.

Results:
Eighty-one children [of mean age 122 ± 47 months; 56 (69%) boys, 29 (36%) on dialysis, 62 (77%) non-vegetarians] were studied. Twenty-eight (34%) were on bicarbonate supplements. A positive PRAL (9.97 ± 7.7 mEq/day) was observed in 74/81 (91%) children with comparable proportions in those with CKD2-5 and 5D [47/52 (90%) vs. 27/29 (93%) respectively, P > 0.05]. Protein intake was significantly higher in the highest quartile compared to the lowest quartile of PRAL in CKD2-5 (55 ± 16 g/day vs. 40 ± 14 g/day, P < 0.001) and 5D groups (47 ± 15 g/day vs. 25 ± 11 g/day, P = 0.002). A majority of the participants 60/81 (74%) consumed highly acidic and minimal alkali foods.

Conclusion:
In children with CKD2-5D, PRAL estimation revealed high DAL in the majority with a high consumption of acidic foods. These findings provide implications for appropriate dietary counseling in children with CKD.
A Narrative Review of Herbal Remedies for Managing Hirsutism
Authors: Ghanbarian Razieh , Ranjbai Maryam , Babaeian Mahmoud , Mazaheri Mohammad 
Published: March 2024

Abstract
Hirsutism is a condition that can have medical, social, and psychological implications, affecting 5% to 10% of women worldwide. Management options include cosmetic procedures and pharmacological interventions. However, medications used to treat hirsutism can have side effects, ranging from mild symptoms like nausea and headaches to more serious complications such as vascular clots, heart attacks, hepatotoxicity, osteoporosis, and effeminization of a male fetus. Therefore, this study aims to investigate the potential benefits of medicinal plants on hirsutism as a complementary approach, specifically whether they can be used as adjuvants to cosmetic procedures. Databases including Google Scholar, PubMed, Scopus, Embase, ISI, SID, and Mag Iran have been checked with related keywords from 2000 to 2023. Moreover, related articles were isolated. In total, ten trials were identified in the search. The results suggested that various herbs, including fennel, licorice, spearmint, saw palmetto, green tea, combination of Zingiber and neem, curcumin, and teupolioside have the potential as herbal remedies for hirsutism. However, further extensive well-designed studies involving a large sample size on the most promising herbs are necessary to determine their efficacy.
Utility of Visceral Adiposity Index and Lipid Accumulation Products to Define Metabolically-Unhealthy Polycystic Ovary Syndrome in Asian Indian Women - A Cross Sectional Study
Authors: Shreenidhi R. A. , Mahey Reeta , Rajput Monika , Cheluvaraju Rohitha , Upadhyay Ashish D. , Sharma Jai Bhagwan , Kachhawa Garima , Bhatla Neerja 
Published: March 2024

ABSTRACT

Background:
Polycystic ovary syndrome (PCOS) women are at risk of developing diabetes, cardiovascular disease and metabolic syndrome (MetS) due to insulin resistance (IR) and hyperandrogenism (HA). Both visceral adiposity index (VAI) and lipid accumulation product (LAP) are simple outpatient department-based metric tools that have been introduced to screen PCOS women who are metabolically unhealthy and are at risk of development of MetS.

Aims:
The aim of the study was to evaluate VAI and LAP in women with PCOS and to correlate them with metabolic and endocrine markers. The study also assessed these parameters amongst different PCOS phenotypes and determined their usefulness to define metabolically healthy PCOS (MH-PCOS) and metabolically unhealthy PCOS (MU-PCOS).

Settings and Design:
The design of the study was a cross-sectional study.

Materials and Methods:
Two hundred PCOS women were included in the study, and all the clinical, anthropometric, hormonal, biochemical and metabolic markers were assessed. The cohort was divided into MH-PCOS and MU-PCOS by the modified National Cholesterol Education Programme criteria. VAI and LAP were calculated and correlated with clinical, endocrine and metabolic parameters.

Statistical Analysis Used:
Univariate and multivariate logistic regression analysis was used to study the independent role of VAI and LAP to predict MetS. Adjusted and unadjusted odds ratios were calculated. Receiver-operating characteristic (ROC) analysis was done to define cut-offs in Asian Indian women.

Results:
VAI and LAP had good ability to correctly discriminate MU-PCOS from MH-PCOS (area under the curve [AUC] [95% confidence interval (CI)]: 0.89 [0.82–0.95]) and (AUC [95% CI [0.81–0.92] =0.86) using ROC, respectively. The sensitivity of VAI and LAP corresponding to the optimal cut-off of ≥2.76 and ≥48.06 (Youden) was 84.09% and 79.55%, respectively. Similarly, the specificity of VAI and LAP was 85.26% and 79.49%, respectively. VAI has a positive predictive value of 61.7% (95% CI [23.7%–40.3%]) and a negative predictive value of 95% (95% CI [88%–99.1%]). LAP has a positive predictive value of 53% (95% CI [40.3%–65.4%]) and a negative predictive value of 93.3% (95% CI [87.6%–96.9%]). PCOS women having VAI ≥ 2.76 had 19.3 times ([95% CI: 6.50–57.70]) more chance of developing MetS. PCOS women having LAP (≥48.06) have 3.7 times ([95% CI: 1.35–10.60]) more odds. There was no difference between ROC curves of VAI and LAP (P = 0.32).

Conclusion:
VAI cut-off ≥ 2.76 and LAP with a cut-off of ≥ 48.06 may be used as markers for predicting MetS amongst PCOS women.
Electroacupuncture Inhibited the Spinal Glial Activation in Neuropathic Pain via Glucagon-like Peptide-1/Glucagon-like Peptide-1 Receptor Signaling
Authors: Zhong Ke , Long Xiang , Wan Yun-Qiang , Zhou Yu 
Published: March 2024

Background:
The enhancement of glucagon-like peptide 1 (GLP-1)/GLP-1 receptor (GLP-1R) may be considered a novel therapeutic idea for neuropathic pain. Electroacupuncture (EA) has been widely used as an ideal nonpharmacological treatment for neuropathic pain, but the underlying mechanisms remain largely unknown. Therefore, we aim to explore whether repetitive EA stimulation could activate the spinal GLP-1/GLP-1R signaling in neuropathic pain.

Materials and Methods:
Paw withdrawal threshold and thermal withdrawal latency analyses were used to evaluate the effects of 2HZ/1 mA EA on pain-related behaviors of rats with spared nerve injury (SNI). Expressional levels of protein molecules in spinal dorsal horn were detected by Western blot and immunofluorescence staining.

Results:
Application of 2HZ/1 mA of EA at “ST36” and “SP6” effectively and persistently relieved nerve injury-induced pain hypersensitivity. Ionized calcium-binding adapter molecule 1 (Iba-1) and glial fibrillary acidic protein (GFAP) were highly expressed in the ipsilateral spinal dorsal horn of SNI rats but inhibited by EA. In addition, EA increased the expression levels of GLP-1 and GLP-1R in the ipsilateral spinal dorsal horn. Pharmacological activation of GLP-1R mimicked the analgesic effects of EA on pain hypersensitivity, whereas blocking of GLP-1R reversed these effects.

Conclusions:
These results revealed that 2HZ/1 mA of EA at “ST36” and “SP6” alleviated nerve injury-induced pain hypersensitivity via mechanisms possibly involving enhancement of GLP-1/GLP-1R signaling, which further suppresses spinal glial activation.
Dynamic Sleep Architecture Revealed: Sleep Auditory Evoked Potentials from N100 to P900
Authors: Atlı Sibel Kocaaslan , Inanc Gonca , Oniz Adile , Ozgoren Murat 
Published: March 2024

Background:
The research landscape in sleep is currently shifting toward minute changes in brain functioning during different stages. This fine approach necessitates a dynamic assessment as in the case of electrophysiology. The present study aimed to investigate brain responsiveness during different stages and times of nocturnal sleep using auditory evoked potentials (AEPs).

Materials and Methods:
Sleep recordings of 18 volunteer subjects were analyzed. During sleep recordings, auditory stimuli were presented in the ear channels. Sleep stages were scored according to the American Academy of Sleep Medicine system. AEPs were analyzed in nonrapid eye movement sleep stages. Alterations of N100, P200, N300, P450, N550, and P900 waveforms were investigated in the first and second halves of sleep duration.

Results:
N100 amplitude was higher in light sleep, both in the first and the second halves of the night (sleep duration). The amplitude of P900 was higher in the deep sleep stage in both halves. Significant amplitude reductions were found in N100, P200, P450, and P900 in the second half of the sleep.

Conclusions:
The changes found suggest that they are related to the dynamics of sensory processing to maintain functional sleep. The findings of the present study emphasize that in the course of sleep, both the proportions of sleep stages and the microarchitecture within the stages alter between the first and second halves of sleep.
To study the efficiency of high-flow nasal cannula in improving the arterial blood gas parameters in children admitted to pediatric intensive care unit with respiratory distress
Authors: Balleda Lokeswari , Kolla Sravani , Thimmapuram Chandrasekhara Reddy 
Published: March 2024

Abstract

Background:
In recent times, heated humidified high-flow nasal cannula has become increasingly popular and is now recognized as a standard respiratory support method for pediatric patients experiencing acute respiratory distress.

Aims and Objectives:
To study the correlation of high-flow nasal cannula (HFNC) with arterial blood gas (ABG) and clinical parameters.

Materials and Methods:
This prospective observational study included children aged 1 month to 14 years experiencing acute respiratory distress receiving HFNC support. Demographic information, vital signs, and ABG parameters were collected at four-time points: the first ABG at “0” h, indicating admission; the second ABG at “1” h, approximately 1 h after HFNC initiation; the third ABG at “12” h, as a follow-up after the initiation of respiratory support; and the fourth ABG at “24” h, representing daily monitoring for assessing the child’s condition and outcomes. The collected data was subjected to analysis.

Results:
The study included 133 children, of which 64.66% were male and 35.34% were female, with a mean age of 0.9 years (ranging from 0.3 to 3 years) and a mean weight of 7.8 kg (ranging from 4.7 to 11.8 kg). Over time, there was a statistically significant decrease in heart rate, respiratory rate, and the need for FiO2. Significant reductions in these parameters were observed within the first hour of initiating HFNC therapy, and improvements continued at 12 and 24 h compared to the baseline values (P value < 0.05). The study also revealed a decreasing trend in pCO2 and lactate levels over time. Statistically significant reductions in these parameters were noted at the first hour of HFNC initiation, and improvements persisted at 12 and 24 h compared to the baseline (P value < 0.05). On the other hand, there was an increasing trend in SpO2, pO2, base excess, and HCO3 over time. Significant increases in these parameters were observed at the first hour of HFNC initiation, and the positive trend continued at 12 and 24 h compared to the baseline (P value < 0.05).

Conclusion:
HFNC can serve as the primary noninvasive respiratory support for children facing respiratory distress. The majority of patients in our study demonstrated good tolerance to the HFNC. Notably, the utilization of HFNC resulted in a significant enhancement of the comfort scale among the participants. Positive changes were observed in vital parameters, comfort scale, and ABG parameters within just 1 h of initiating HFNC.
Monoclonal antibody therapies for aquaporin-4-immunoglobulin G-positive neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease
Authors: Tisavipat Nanthaya , Juan Hui Y. , Chen John J. 
Published: March 2024

Abstract:Monoclonal antibody therapies mark the new era of targeted treatment for relapse prevention in aquaporin-4 (AQP4)-immunoglobulin G (IgG)-positive neuromyelitis optica spectrum disorder (AQP4-IgG+NMOSD). For over a decade, rituximab, an anti-CD20 B-cell-depleting agent, had been the most effectiveness treatment for AQP4-IgG+NMOSD. Tocilizumab, an anti-interleukin-6 receptor, was also observed to be effective. In 2019, several randomized, placebo-controlled trials were completed that demonstrated the remarkable efficacy of eculizumab (anti-C5 complement inhibitor), inebilizumab (anti-CD19 B-cell-depleting agent), and satralizumab (anti-interleukin-6 receptor), leading to the Food and Drug Administration (FDA) approval of specific treatments for AQP4-IgG+NMOSD for the first time. Most recently, ravulizumab (anti-C5 complement inhibitor) was also shown to be highly efficacious in an open-label, external-controlled trial. Although only some patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) warrant immunotherapy, there is currently no FDA-approved treatment for relapse prevention in MOGAD. Observational studies showed that tocilizumab was associated with a decrease in relapses, whereas rituximab seemed to have less robust effectiveness in MOGAD compared to AQP4-IgG+NMOSD. Herein, we review the evidence on the efficacy and safety of each monoclonal antibody therapy used in AQP4-IgG+NMOSD and MOGAD, including special considerations in children and women of childbearing potential.
Teprotumumab in thyroid eye disease
Authors: Goldberg Hila , Malik Amina I. 
Published: March 2024

Abstract:
Thyroid eye disease (TED) is an inflammatory condition involving the periocular and orbital soft tissues, affecting most commonly patients with hyperthyroid disorders. Traditional treatments used for the active phase of the disease range from conservative lubrication for mild symptoms to systemic immunomodulating drugs for moderate-to-severe symptoms. Teprotumumab (Tepezza) is a monoclonal antibody with an inhibitory effect on insulin-like growth factor 1 and is the first Food and Drug Administration (FDA) approved targeted medical therapy for reducing the inflammatory signs and symptoms associated with TED. Two large multicenter, randomized, double-masked, placebo-controlled trials have confirmed the efficacy and safety of teprotumumab in patients with active, moderate-to-severe TED. Recent reports and publications have also demonstrated the efficacy of teprotumumab in a wider range of patients. In this review, we summarize the clinical features and pathophysiology of TED, disease course, and traditional management methods. We further detail the development of teprotumumab, the founding studies that brought it to its FDA approval, adverse events profile, and ongoing as well as future investigations.
Incidence of Raised Intra-Ocular Pressure Post Penetrating Keratoplasty at a Tertiary Care Hospital in Central India
Authors: Tiwari Sakshi , Shukla Durgesh , Chhawania Pramod Kumar , Dubey Harshita 
Published: March 2024

Background:
Penetrating keratoplasty (PK) is done for a variety of reasons, such as corneal opacity, bullous keratopathy, corneal stromal dystrophies, Fuchs' endothelial dystrophy, ectasia, and perforation. Management of raised intra.ocular pressure (IOP) after keratoplasty is necessary to maintain the visual outcome. The purpose of this study was to find the incidence of raised IOP after keratoplasty.

Material and Methods:
This prospective study was conducted on 67 eyes of 67 patients attending the ophthalmic out.patient department of the upgraded department of MY Hospital Indore from November 2021 to November 2022. One-way analysis of variance test, Chi-square test, and Fisher exact test were applied, and the P value was judged at 5% level of significance.

Results:
The main indication for PK was infectious keratitis (52.3%), corneal scars (32.8%), regrafts (7.5%), bullous keratopathy (5.9%), and staphyloma (2.9%). In this study, the overall incidence of raised IOP (>21 mmHg) was 25.37% (17 cases). Raised IOP was observed among the 20% of infectious keratitis, 27.3% of corneal scars, 40% of regraft, and 50% of bullous keratopathy. Steroid-induced rise in IOP (47.05%; n = 8) was the most common post-operative factor.

Conclusion:
Maximum cases in which PK was done were of infectious keratitis. Post PK rise in IOP is a serious complication that is significantly associated with an increased risk of graft failure and poor visual outcome. Thus, rise in IOP was associated with a significant reduction in the percentage of eyes achieving good visual acuity.