bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 1 diabetes mellitus: retrospect and prospect
Authors: Addissouky Tamer A. , Ali Majeed M. A. , El Sayed Ibrahim El Tantawy , Wang Yuliang 
Published: April 2024

Abstract
Background
Type 1 diabetes (T1D) is an autoimmune disease leading to destruction of insulin-producing pancreatic beta cells. Both genetic and environmental factors contribute to pathogenesis. The incidence of T1D is increasing worldwide, with significant geographic and ethnic variations. Patients present with symptoms of hyperglycemia and diabetes complications.

Main body
In T1D, autoreactive T cells and autoantibodies destroy beta cells, causing insulin deficiency. Exogenous insulin therapy is essential but cannot replicate normal physiology. Management requires intensive lifestyle education on diet, exercise, glucose monitoring and avoiding complications, in addition to insulin. Novel therapies like immunotherapy, cell transplantation, artificial pancreas devices and AI algorithms aim to improve care. Strategies for reversing T1D involve combination immunotherapies to block autoimmunity and regenerate beta cells via stem cells or xenotransplantation.

Conclusion
While type 1 diabetes remains challenging, ongoing research provides hope. Elucidating individualized disease mechanisms and translating findings into precision prevention and treatment approaches are critical to improving long-term outcomes. Innovative and multi-targeted therapies may fundamentally change the trajectory of T1D.
New recommendations on cerebral venous and dural sinus thrombosis from the German consensus-based (S2k) guideline
Authors: Weimar C , Beyer-Westendorf J , Bohmann FO , Hahn G , Halimeh S , Holzhauer S , Kalka C , Knoflach M , Koennecke H-C , Masuhr F , Mono M-L , Nowak-Göttl U , Scherret E , Schlamann M , Linnemann B 
Published: April 2024

AbstractOver the last years, new evidence has accumulated on multiple aspects of diagnosis and management of cerebral venous and dural sinus thrombosis (CVT) including identification of new risk factors, studies on interventional treatment as well as treatment with direct oral anticoagulants. Based on the GRADE questions of the European Stroke Organization guideline on this topic, the new German guideline on CVT is a consensus between expert representatives of Austria, Germany and Switzerland. New recommendations include:• CVT occurring in the first weeks after SARS-CoV-2 vaccination with vector vaccines may be associated with severe thrombocytopenia, indicating the presence of a prothrombotic immunogenic cause (Vaccine-induced immune thrombotic thrombocytopenia; VITT).• D-dimer testing to rule out CVT cannot be recommended and should therefore not be routinely performed.• Thrombophilia screening is not generally recommended in patients with CVT. It should be considered in young patients, in spontaneous CVT, in recurrent thrombosis and/or in case of a positive family history of venous thromboembolism, and if a change in therapy results from a positive finding.• Patients with CVT should preferably be treated with low molecular weight heparine (LMWH) instead of unfractionated heparine in the acute phase.• On an individual basis, endovascular recanalization in a neurointerventional center may be considered for patients who deteriorate under adequate anticoagulation.• Despite the overall low level of evidence, surgical decompression should be performed in patients with CVT, parenchymal lesions (congestive edema and/or hemorrhage) and impending incarceration to prevent death.• Following the acute phase, oral anticoagulation with direct oral anticoagulants instead of vitamin K antagonists should be given for 3 to 12 months to enhance recanalization and prevent recurrent CVT as well as extracerebral venous thrombosis.• Women with previous CVT in connection with the use of combined hormonal contraceptives or pregnancy shall refrain from continuing or restarting contraception with oestrogen–progestagen combinations due to an increased risk of recurrence if anticoagulation is no longer used.• Women with previous CVT and without contraindications should receive LMWH prophylaxis during pregnancy and for at least 6 weeks post partum.Although the level of evidence supporting these recommendations is mostly low, evidence from deep venous thrombosis as well as current clinical experience can justify the new recommendations.This article is an abridged translation of the German guideline, which is available online.
Role of magnetic resonance imaging (MRI) in liver iron quantification in thalassemic (thalassemia major) patients
Authors: Seema Rohilla , Singh Chadha Kawaljeet , Anjali Verma , Singh Gill Paramjeet , Alka Yadav , Deepak Singla 
Published: April 2024

Abstract
Background
Iron overload is a major problem in beta thalassemia patients due to repeated blood transfusions. The liver is the first organ to be loaded with iron. An accurate assessment of iron overload is necessary for managing iron chelation therapy in such patients. Iron quantification by MRI scores over liver biopsy due to its non-invasive nature.

Methods
Fifty-one patients with thalassemia major were subjected to 3.0-T MRI. Multiecho T2* sequence was used to cover the entire liver. Region of interest (ROI) was placed in three areas with maximum signal change, and an average T2* value was obtained. Similarly, a single ROI was placed at the mid-interventricular septum in the heart, and T2* value was obtained. T2* values so obtained were converted to iron concentration with the help of a T2* iron concentration calculator. The liver iron values were correlated with serum ferritin value.

Results
There was a significant negative correlation between liver iron concentration (LIC) and T2* value of the liver (r =  − 0.895, p < 0.01) and between cardiac iron concentration (CIC) and T2* value of the heart (r =  − 0.959, p < 0.01). There was a slight positive correlation between LIC and serum ferritin (r = 0.642, p < 0.01) and no correlation between CIC and serum ferritin (r =  − 0.137, p = 0.354).

Conclusions
MRI is a useful tool to titrate the doses of chelating agents as it is accurate and non-invasive, does not involve radiation hazards and hence can be repeated as and when needed. Simultaneous assessment of cardiac iron overload is an added advantage of MRI.
Clinical Knowledge and Reasoning Abilities of AI Large Language Models in Anesthesiology: A Comparative Study on the American Board of Anesthesiology Examination
Authors: Angel Mirana C. , Rinehart Joseph B. , Cannesson Maxime P. , Baldi Pierre 
Published: April 2024

BACKGROUND:
Over the past decade, artificial intelligence (AI) has expanded significantly with increased adoption across various industries, including medicine. Recently, AI-based large language models such as Generative Pretrained Transformer-3 (GPT-3), Bard, and Generative Pretrained Transformer-3 (GPT-4) have demonstrated remarkable language capabilities. While previous studies have explored their potential in general medical knowledge tasks, here we assess their clinical knowledge and reasoning abilities in a specialized medical context.

METHODS:
We studied and compared the performance of all 3 models on both the written and oral portions of the comprehensive and challenging American Board of Anesthesiology (ABA) examination, which evaluates candidates’ knowledge and competence in anesthesia practice.

RESULTS:
Our results reveal that only GPT-4 successfully passed the written examination, achieving an accuracy of 78% on the basic section and 80% on the advanced section. In comparison, the less recent or smaller GPT-3 and Bard models scored 58% and 47% on the basic examination, and 50% and 46% on the advanced examination, respectively. Consequently, only GPT-4 was evaluated in the oral examination, with examiners concluding that it had a reasonable possibility of passing the structured oral examination. Additionally, we observe that these models exhibit varying degrees of proficiency across distinct topics, which could serve as an indicator of the relative quality of information contained in the corresponding training datasets. This may also act as a predictor for determining which anesthesiology subspecialty is most likely to witness the earliest integration with AI.

CONCLUSIONS:
GPT-4 outperformed GPT-3 and Bard on both basic and advanced sections of the written ABA examination, and actual board examiners considered GPT-4 to have a reasonable possibility of passing the real oral examination; these models also exhibit varying degrees of proficiency across distinct topics.
Parent-Child Incest and the Culture of Marriage in Colonial Guatemala
Authors: Saffa Sarah N. 
Published: April 2024

AbstractUtilizing criminal records from the secular courts, this article examines incidents of sexual relations between parents and their biological children or stepchildren—both of which were considered incestuous under Spanish law—to explore how marriage and the marital relationship could motivate or rationalize episodes of parent-child incest in colonial Guatemala. Examination of parent-child incest through this lens shows how sons and daughters could become entangled in the sexual and emotional lives of their parents, providing a more nuanced view of the lived experience of kinship in colonial Latin America. It also demonstrates how incestuous offenders and their peers could allude to the culture of marriage and the state of the conjugal bond to both subtly and explicitly diminish the incestuous aspects of a sexual encounter, rendering it more culturally intelligible in the process.
Stereoelectroencephalography Electrode Implantation for Inpatient Workup of Treatment-Resistant Depression
Authors: Starkweather Clara Kwon , Sugrue Leo P. , Cajigas Iahn , Speidel Benjamin , Krystal Andrew D. , Scangos Katherine , Chang Edward F. 
Published: April 2024

BACKGROUND AND OBJECTIVES:
Treatment-resistant depression is a leading cause of disability. Our center's trial for neurosurgical intervention for treatment-resistant depression involves a staged workup for implantation of a personalized, closed-loop neuromodulation device for refractory depression. The first stage (“stage 1”) of workup involves implantation of 10 stereoelectroencephalography (SEEG) electrodes bilaterally into 5 anatomically defined brain regions and involves a specialized preoperative imaging and planning workup and a frame-based operating protocol.

METHODS:
We rely on diffusion tractography when planning stereotactic targets for 3 of 5 anatomic areas. We outline the rationale and fiber tracts that we focus on for targeting amygdala, ventral striatum and ventral capsule, and subgenual cingulate. We also outline frame-based stereotactic considerations for implantation of SEEG electrodes.

EXPECTED OUTCOMES:
Our method has allowed us to safely target all 5 brain areas in 3 of 3 trial participants in this ongoing study, with adequate fiber bundle contact in each of the 3 areas targeted using tractography. Furthermore, we ultimately used tractography data from our stage 1 workup to guide targeting near relevant fiber bundles for stage 2 (implantation of a responsive neuromodulation device). On completion of our data set, we will determine the overlap between volume of tissue activated for all electrodes and areas of interest defined by anatomy and tractography.

DISCUSSION:
Our protocol outlined for SEEG electrode implantation incorporates tractography and frame-based stereotaxy.
Influence of Preoperative Motor Score and Patient Comorbidities on Transcranial Motor-Evoked Potential Acquisition in Intracranial Surgery: A Retrospective Cohort Study
Authors: Chen Adrian C. , Shah Harshal A. , Vilaysom Sabena , Ryan Casey , Kruse Aaron , D’Amico Randy S. , Silverstein Justin W. 
Published: April 2024

BACKGROUND AND OBJECTIVES:
Intraoperative neurophysiological monitoring plays a pivotal role in modern neurosurgery, aiding in real-time assessment of eloquent neural structures to mitigate iatrogenic neural injury. This study represents the largest retrospective series to date in monitoring corticospinal tract integrity during intracranial surgery with transcranial motor-evoked potentials (TCMEPs), focusing on the influence of demographic factors, comorbidities, and preoperative motor deficits on the reliability of intraoperative neurophysiological monitoring. While the impact of patient-specific factors affecting TCMEP monitoring in spine surgery is well-documented, similar insights for intracranial surgery are lacking.

METHODS:
A total of 420 craniotomy patients were retrospectively analyzed from electronic medical records from December 2017 to February 2023, excluding patients without preoperative Medical Research Council scores or medical histories. Using intrinsic hand muscles as a robust data set, 840 hand TCMEPs acquired during intracranial surgery were assessed. Demographic and clinical factors, including preoperative motor scores, were analyzed to identify associations with TCMEP acquisition and amplitude. Nonparametric statistics and multivariate regression analysis were employed.

RESULTS:
TCMEPs were successfully acquired in 734 (87.7%) patient hands, even in the presence of preoperative motor deficits in 13.9% of total patient hands. Preoperative motor scores did not predict the ability to acquire baseline TCMEPs (P = .6). Notably, older age (P < .001) and hypertension (P = .01) were independent predictors of lower TCMEP acquisition rates. Preoperative motor scores significantly influenced TCMEP amplitudes, with higher scores correlating with higher amplitudes (1771 [SD = 1550] eve vs 882 [SD = 856] μV, P < .0001). Older age (P < .001) and chronic kidney disease (P = .04) were also associated with reduced TCMEP amplitudes.

CONCLUSION:
Our investigation into TCMEPs during intracranial surgery demonstrated a notably high acquisition rate in hand muscles, irrespective of preoperative motor deficits. Preoperative motor scores reliably correlated with TCMEP amplitudes in a linear fashion while advanced age and renal disease emerged as independent predictors of lower TCMEP amplitudes.
Effective and Successful Control of Symptomatic Vertebral Hemangiomas With Epidural Extension Using Stereotactic Spine Radiosurgery
Authors: Patel Arpan A. , Lilly Daniel , Chao Samuel T. , Benzel Edward , Subramaniam Gandhivarma , Krishnaney Ajit , Suh John H. , Angelov Lilyana 
Published: April 2024

BACKGROUND AND OBJECTIVES:
We present our experience in the management of symptomatic vertebral hemangiomas with epidural extension (SVHEE) using spine stereotactic radiosurgery (SSRS).

METHODS:
An Institutional Review Board approved retrospective review of all SVHEE patients treated with SSRS at our institution (2007-2022) was performed. Baseline patient demographics, clinical presentation, lesion volume, and Bilsky grade (to directly evaluate the epidural component) were determined. Clinical and radiographic response and treatment outcomes were subsequently evaluated at first (∼6 months) and final follow-up.

RESULTS:
Fourteen patients with SVHEE underwent SSRS (16-18 Gy/1-fraction); the mean follow-up was 24 months. The median lesion volume (cc) was 36.9 (range: 7.02-94.1), 31.5 (range: 6.53-69.7), and 25.15 (range: 6.01-52.5) at pre-SSRS, first, and final follow-up, respectively. Overall volume reduction was seen in the last follow-up in all 14 patients, median 29.01% (range: 6.58%-71.58%). Bilsky score was stable or improved in all patients at the last follow-up when compared with pre-SSRS score. Patients who underwent both surgical decompression and SSRS (n = 9): 8 had improved myelopathic symptoms and pain and 1 had stable radiculopathy postintervention. In the 5 patients treated with SSRS monotherapy, 2 had stable radicular pain and the other 3 improved pain and numbness. No patients experienced adverse outcomes.

CONCLUSION:
To our knowledge, this represents the largest series of SVHEE patients treated with SSRS, either as monotherapy or part of a multimodal/separation surgery treatment approach. We demonstrate that SSRS represents a potentially safe and effective treatment option in these patients. However, larger prospective studies and longer follow-ups are necessary to further assess the role, durability, and toxicity of SSRS in the management of these patients.
“The Only Disability in Life is a Bad Attitude”
Authors: Burt Anna , Lite Randi 
Published: April 2024

Apply It!
After reading this article, the reader should be able to:
• Define “inspiration porn” and give an example
• Articulate both negative consequences and positive effects of inspirational images of disabled people in social media
• Use guidelines to differentiate positive versus negative posts of disabled people
• Understand the important role that exercise professionals can play in improving access and inclusion for disabled people in fitness and wellness spaces
Authors’ note: We have chosen to use identity-first language (disabled person) rather than person-first language (person with a disability) in this paper. We have chosen identity-first language as we believe it better reflects disability as an important piece of an individual’s identity that one can claim in pride.
Ashwagandha (Withania somnifera) - Its Antibacterial and Anticancer Activity
Authors: Mazurkiewicz Aleksandra , Mądry Wojciech , Kołodziej Magdalena , Męczyńska Joanna , Saiuk Nazarii , Kozicz Michał Andrzej , Seredyński Tomasz , Wojciechowska Adriana , Marcicka Justyna , Salasa Weronika 
Published: April 2024

Introduction
Ashwagandha, a traditional Indian plant, is gaining increasive attention from scientists worldwide due to its potential health benefits, especially in the context of its antibacterial and anticancer properties.
Aim of the study
The aim of this review was to discuss recent findings regarding the impact of Withania Somnifera on antibacterial effect and its potential applications in anticancer therapy.
Materials and methods:
The paper was created based on the Pubmed and Google Scholar database. The literature was reviewed using the keywards: ,,Ashwagandha”, ,,Withania Somnifera”, ,,antibacterial ”, ,,anticancer”, ,,side effects”, ,,breats cancer”.
Results
Studies have confirmed Withania Somnifera, exhibits significant anticacterial and anticancer effects. It inhibits the growth of both Gram-negative and Gram-positive bacteria. Futhermore, it demonstrates anticancer activity, especially in breast cancer, by stimulating apoptosis, induction of cytotoxic effects on cancerous cells and increasing cell sensitivity to radiation.
Conclusion
Despite promising results, futher research on the benefits of Ashwagandha, particulary in the long term, is essential. There is growing need of more research of the potencial benefits of Ashwagandha in the treatment of various disorders including cancer and bacterial infections and to develop more effective therapeutic strategies. The need for large randomized studies comparing long term clinical effectiveness is emphasized
Thermal Injuries in Children: A Literature-Based Overview
Authors: Wierzejska Natalia , Michalczewska Aneta , Fugas Agnieszka , Pach Magdalena , Nowak Agnieszka , Chmielowiec Zuzanna , Partyka Alicja , Dziedzic Mariola , Smykiewicz Karolina , Dobrzańska Justyna 
Published: April 2024

Burns are a significant cause of morbidity and mortality in children. While the majority of pediatric burns are not life-threatening, they can have a significant impact on a child's physical and psychological health. They pose a major social and financial burden, particularly in developing countries. The management of pediatric patients with thermal injuries requires a complex and multifaceted approach.
Pediatric burns constitute approximately 40-50% of all reported cases of severe burns. The most common etiologies of pediatric burns include scalds, contact burns, flames, and chemicals. From 80% to 90% of burns occurred at home and were accidental. Despite advancements in treatment, severe burns can lead to life-threatening complications, such as sepsis, multisystem organ failure, and hypermetabolic response or even death.
This article aims to provide a literature-based overview of pediatric burn trauma, outlining its unique characteristics, etiology, epidemiology, classification, and initial management.
A qualitative study of clinicians’ experience of a clinical trial for displaced distal radius fractures
Authors: Phelps Emma E. , Tutton Elizabeth , Costa Matthew L. , Achten Juul , Gibson Phoebe , Perry Daniel C. 
Published: April 2024

AimsThe aim of this study was to explore clinicians’ experience of a paediatric randomized controlled trial (RCT) comparing surgical reduction with non-surgical casting for displaced distal radius fractures.MethodsOverall, 22 staff from 15 hospitals who participated in the RCT took part in an interview. Interviews were informed by phenomenology and analyzed using thematic analysis.ResultsAnalysis of the findings identified the overarching theme of “overcoming obstacles”, which described the challenge of alleviating staff concerns about the use of non-surgical casting and recruiting families where there was treatment uncertainty. In order to embed and recruit to the Children’s Radius Acute Fracture Fixation Trial (CRAFFT), staff needed to fit the study within clinical practice, work together, negotiate treatment decisions, and support families.ConclusionRecruiting families to this RCT was challenging because staff were uncertain about longer-term patient outcomes, and the difficulties were exacerbated by interdisciplinary tensions. Strong family and clinician beliefs, coupled with the complex nature of emergency departments and patient pathways that differed site-by-site, served as barriers to recruitment. Cementing a strong research culture, and exploring families’ treatment preferences, helped to overcome recruitment obstacles.Cite this article: Bone Jt Open 2024;5(4):324–334.
Access of older people to primary health care in low and middle-income countries: A systematic scoping review
Authors: Dableh Saydeh , Frazer Kate , Stokes Diarmuid , Kroll Thilo 
Published: April 2024

Introduction
Ensuring access for older people to Primary Health Care (PHC) is vital to achieve universal health coverage, improve health outcomes, and health-system performance. However, older people living in Low-and Middle-Income Countries (LMICs) face barriers constraining their timely access to appropriate care. This review aims to summarize the nature and breadth of literature examining older people’s experiences with access to PHC in LMICs, and access barriers and enablers.

Methods
Guided by Arksey and O’Malley’s framework, four databases [CINAHL, Cochrane, PubMed, and Embase] were systematically searched for all types of peer-reviewed articles published between 2002 and 2023, in any language but with English or French abstract. Gray literature presenting empirical data was also included by searching the United Nations, World Health Organization, and HelpAge websites. Data were independently screened and extracted.

Results
Of 1165 identified records, 30 are included. Data were generated mostly in Brazil (50%) and through studies adopting quantitative designs (80%). Older people’s experiences varied across countries and were shaped by several access barriers and enablers classified according to the Patient-Centered Access to Healthcare framework, featuring the characteristics of the care delivery system at the supply side and older people’s attributes from the demand side. The review identifies that most access barriers and enablers pertain to the availability and accommodation dimension, followed by the appropriateness, affordability, acceptability, and approachability of services. Socio-economic level and need perception were the most reported characteristics that affected older people’s access to PHC.

Conclusions
Older people’s experiences with PHC access varied according to local contexts, socioeconomic variables, and the provision of public or private health services. Results inform policymakers and PHC practitioners to generate policies and services that are evidence-based and responsive to older people’s needs. Identified knowledge gaps highlight the need for research to further understand older people’s access to PHC in different LMICs.