bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thulium laser versus cold steel tonsillectomy: a prospective pilot study in adult patients
Authors: Baghdasaryan Manana K. , Mkhitaryan Gurgen K. , Misakyan Martin S. , Vermishyan Vahe V. , Tadevosyan Artashes E. , Bablumyan Aren Yu. , Poghosyan Anna Yu. 
Published: February 2024

Abstract
Background
The aim of this pilot study was to compare the operation time, intraoperative and postoperative bleeding, postoperative pain, and wound healing of the thulium RevoLix laser tonsillectomy method over the more commonly practiced cold steel tonsillectomy.

Methods
A prospective, single-blinded randomized pilot trial was conducted. Twenty-four adult patients with a mean age of 28.7 years with chronic recurrent tonsillitis were observed and underwent tonsillectomy. The patients were randomly assigned to have one tonsil removed with a thulium RevoLix laser 200, and the conventional cold steel tonsillectomy method was used for the other side.

Results
The tonsillectomy time from incision to hemostasis was 12.08 ± 0.77 (SE) min with the laser method and 10.92 ± 1.31(SE) min with the cold dissection method, with no statistically significant difference (P < 0.121). Intraoperative blood loss in the cold dissection method was 10.92 ± 1.31 ml, and 2.04 ± 1.62 ml was observed during laser treatment (P < 0.000, t = 8.363). In the cold steel tonsillectomy group, the pain score was significantly higher than that in the laser tonsillectomy group on the 7th and 12th postoperative days.

Conclusion
The use of the thulium RevoLix 200 laser for tonsillectomy in the present pilot study of 24 patients showed significantly better outcomes than those in conventional cold dissection methods in terms of intraoperative bleeding and postoperative pain; however, there was no statistically significant difference in other parameters, such as operational time and late postoperative bleeding. A large full-scale prospective study is needed to increase the generalizability and reliability of the results.

Clinical trial registration
ISRCTN16280803, registered on 25 March 2020,
https://www.isrctn.com/ISRCTN16280803.
Shear capacity of miniature beams with continuous staggered spiral stirrups
Authors: Youssef Ahmed , Mawaad Shereen , Salem Hamed 
Published: February 2024

AbstractScaled-down-reinforced concrete beams with rectangular staggered continuous spiral stirrups are experimentally investigated. Scale-down RC beams were considered in the current research due to ease of construction and economic feasibility. As the brittle shear failure should be avoided, continuous research trials have been conducted to find an effective technique to improve shear failure mechanism. Twenty-two beams were investigated for shear behavior under 4-point static push-over load considering the normal stirrups and compared with continuous staggered spiral ones. Stirrup spacing, shear arm ratio a/d, and shear reinforcement configurations are the main variables. All beams were designed and scaled down to be one-eighth of the full-scale beams. To minimize the size effect of using small-scale models, mortar was used instead of conventional concrete. The focus in this study was related to improved shear capacity, dissipated energy, and shear cracks propagation. It was found that using spiral reinforcement instead of normal one leads to a significant enhancement in shear capacity and dissipated energy by 33% and 45%, respectively. Therefore, the prototype RC model expected capacities were detailed calculated considering the scale-down factor used by authors. The experimental results were compared by calculated values according to international standard and specifications.
Redo extended thoracic aortic replacement from aortic root to descending aorta via anterolateral thoracotomy with partial sternotomy for graft infection
Authors: Okada Tasuku , Koda Yojiro , Yamanaka Katsuhiro , Okada Kenji 
Published: February 2024

AbstractA 59-year-old male underwent Bio-Bentall + total arch replacement with a frozen elephant trunk for acute type A aortic dissection before at another hospital. He was diagnosed as mediastinitis and previous graft infection, followed by wound closure with omental flap installation. However, the recurrent graft infection from the aortic root to the FET in the descending aorta was diagnosed by 18-fluorodeoxyglucose positron emission tomography. Redo modified Bio-Bentall procedure, total arch replacement, and descending aortic replacement for previous graft infection using anterolateral thoracotomy with partial sternotomy was successfully performed. Anterolateral thoracotomy with partial sternotomy provided not only the excellent exposure from the aortic root to the descending aorta but also sure myocardial protection with antegrade and selective delivery of cold crystalloid cardioplegia and stable brain protection with antegrade selective cerebral perfusion. The patient is doing well without recurrent of infection after 2 years of the operation.
Giant right atrial tumor following catheter ablation
Authors: Wada Takeshi , Hamamoto Hirotsugu , Miyamoto Shinji 
Published: February 2024

Abstract
Background
We report a rare case of a giant right atrial myxoma after catheter ablation.

Case presentation
A 74-year-old man presented with a fever of unknown origin three years after laser catheter ablation. Multimodal imaging revealed a giant tumor located in the right atrium, which was suspected to be malignant. Surgical resection was performed, and pathological examination revealed that the tumor was a myxoma.

Conclusions
Several cardiac myxoma cases after catheter ablation have been reported, suggesting a potential association between myxoma development and catheter ablation-related tissue injury.
Advancements in understanding chicken coccidiosis: from Eimeria biology to innovative control strategies
Authors: Gao Yang , Sun Pei , Hu Dandan , Tang Xinming , Zhang Sixin , Shi Fangyun , Yan Xinlei , Yan Wenchao , Shi Tuanyuan , Wang Si , Zou Jun , Yin Guangwen , Liu Xianyong , Dong Hui , Suo Xun 
Published: February 2024

AbstractCoccidiosis, an intestinal disease caused by Eimeria protozoan parasites, affects various animal species, and especially poses a significant threat to the poultry industry. The current primary control methods include anticoccidial drugs and vaccines. However, emerging challenges such as drug resistance and vaccine efficacy issues are rooted in the complex life cycle and species diversification of Eimeria. In this review, we first consolidate recent breakthroughs in understanding Eimeria biology, focusing on the parasite development and its intricate interactions with the host, notably its relationships with host immune cells and the gut microbiota. Furthermore, we provide an extensive summary of current control strategies for Eimeria infections. This includes an in-depth analysis of anticoccidial drugs, their mechanisms of resistance, and the increasing utilization of diverse anticoccidial vaccines to combat these challenges. Finally, we highlight the latest innovative strategies leading the way in coccidiosis control. Through an exploration of cutting-edge techniques, we also provide insights into future directions for effectively combating this disease. In conclusion, the future of coccidiosis control lies in the use of a multifaceted approach, integrating advanced biological insights with innovative therapeutic strategies. This review not only serves to enhance our understanding of Eimeria biology but also provides a valuable resource for researchers involved in developing and implementing strategies to manage and control coccidiosis, ensuring the health and productivity of poultry worldwide.
Management of Treatment Resistance in Patients With Advanced Epidermal Growth Factor Receptor–Mutated Lung Cancer: Personalization, Parsimony, and Partnership
Authors: Piper Vallillo Andrew J. , Viray Hollis , Feldman Jill , Rangachari Deepa 
Published: February 2024

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology , to patients seen in their own clinical practice.Patients with epidermal growth factor receptor ( EGFR)–mutated advanced non–small-cell lung cancer represent a distinct subgroup of individuals who can experience initially tolerable and durable effects with first-line EGFR-directed tyrosine kinase inhibitors. Unfortunately, acquired treatment resistance and cancer progression within the CNS are inevitable during the disease course and present a challenging transition in the care continuum. Next-line therapies generally require combinations of drugs and afford nuanced differences in clinical outcomes relative to the treatment experience, toxicity profile, and quality of life. Therapeutic stratification and modulation thus require further personalization and partnership with patients to identify key clinical, molecular, and human-specific factors to best guide optimal care.
Magnesium Supplementation Modulates T-cell Function in People with Type 2 Diabetes and Low Serum Magnesium Levels
Authors: Drenthen Linda C A , Ajie Mandala , de Baaij Jeroen H F , Tack Cees J , de Galan Bastiaan E , Stienstra Rinke 
Published: February 2024

Abstract

Context
Low magnesium levels, which are common in people with type 2 diabetes, are associated with increased levels of proinflammatory molecules. It is unknown whether magnesium supplementation decreases this low-grade inflammation in people with type 2 diabetes.

Objective
We performed multidimensional immunophenotyping to better understand the effect of magnesium supplementation on the immune system of people with type 2 diabetes and low magnesium levels.

Methods
Using a randomized, double-blind, placebo-controlled, 2-period, crossover study, we compared the effect of magnesium supplementation (15 mmol/day) with placebo on the immunophenotype, including whole blood immune cell counts, T-cell and CD14+ monocyte function after ex vivo stimulation, and the circulating inflammatory proteome.

Results
We included 12 adults with insulin-treated type 2 diabetes (7 males, mean ± SD age 67 ± 7 years, body mass index 31 ± 5 kg/m2, HbA1c 7.5 ± 0.9%) and low magnesium levels (0.73 ± 0.05 mmol/L). Magnesium treatment significantly increased serum magnesium and urinary magnesium excretion compared with placebo. Interferon-γ production from phorbol myristate acetate/ionomycin stimulated CD8+ T-cells and T-helper 1 cells, as well as interleukin (IL) 4/IL5/IL13 production from T-helper 2 cells was lower after treatment with magnesium compared with placebo. Magnesium supplementation did not affect immune cell numbers, ex vivo monocyte function, and circulating inflammatory proteins, although we found a tendency for lower high sensitivity C-reactive protein levels after magnesium supplementation compared with placebo.

Conclusion
In conclusion, magnesium supplementation modulates the function of CD4+ and CD8+ T-cells in people with type 2 diabetes and low serum magnesium levels.
24-hour Urine Calcium Predicts Reduced Fracture Incidence and Improved Bone Mineral Density After Surgery for Primary Hyperparathyroidism
Authors: Nilsson Martin , Åkesson Kristina E , Thier Mark , Nordenström Erik , Almquist Martin , Bergenfelz Anders 
Published: February 2024

Abstract

Context
Contemporary patients with primary hyperparathyroidism are diagnosed with milder disease than previously. Clinical and biochemical factors predictors with an impact on fracture incidence and bone mineral density after surgery have not been firmly established.

Objective
To investigate predictors of fracture incidence and bone mineral density preoperatively and after surgery for primary hyperparathyroidism (pHPT).

Design
Prospectively collected surgical cohort with matched population controls. Data were cross-linked with the Swedish National Patient Register, the Prescribed Drug Register, and the Cause of Death Register.

Setting
Tertiary referral center.

Patients or other participants
Seven hundred nine patients with successful parathyroidectomy for pHPT and 2112 controls matched on sex, age, and municipality were included in the study.

Main outcome measures
Fracture incidence, absolute change, and ≥2.77% increase in bone mineral density of femoral neck, L2–L4, and distal third of radius at 1-year follow-up.

Results
Patients with pHPT had an increased fracture incidence before surgery but not after pHPT surgery. Fracture incidence after surgery was inversely related to preoperative 24-hour urine calcium (incidence rate ratio for the highest tertile 220– mg/d 0.29, 95% confidence interval 0.11-0.73). Serum and 24-hour urine calcium, parathyroid hormone, osteocalcin, and adenoma weight were all associated with bone mineral density recovery after surgery.

Conclusion
Twenty-four-hour urine calcium is the most important biochemical variable to predict a decreased fracture incidence and improved bone mineral density after surgery for pHPT.
An Orally Efficacious Thyrotropin Receptor Ligand Inhibits Growth and Metastatic Activity of Thyroid Cancers
Authors: Sarkar Rhitajit , Bolel Priyanka , Kapoor Abhijeet , Eliseeva Elena , Dulcey Andrés E , Templin Jay S , Wang Amy Q , Xu Xin , Southall Noel , Klubo-Gwiezdzinska Joanna , Neumann Susanne , Marugan Juan J , Gershengorn Marvin C 
Published: February 2024

Abstract

Context
Thyroid-stimulating hormone (or thyrotropin) receptor (TSHR) could be a selective target for small molecule ligands to treat thyroid cancer (TC).

Objective
We report a novel, orally efficacious ligand for TSHR that exhibits proliferation inhibitory activity against human TC in vitro and in vivo, and inhibition of metastasis in vivo.

Methods
A35 (NCATS-SM4420; NCGC00241808) was selected from a sublibrary of &gt;200 TSHR ligands. Cell proliferation assays including BrdU incorporation and WST-1, along with molecular docking studies were done. In vivo activity of A35 was assessed in TC cell–derived xenograft (CDX) models with immunocompromised (NSG) mice. Formalin-fixed, paraffin-embedded sections of tumor and lung tissues were observed for the extent of cell death and metastasis.

Results
A35 was shown to stimulate cAMP production in some cell types by activating TSHR but not in TC cells, MDA-T32, and MDA-T85. A35 inhibited proliferation of MDA-T32 and MDA-T85 in vitro and in vivo, and pulmonary metastasis of MDA-T85F1 in mice. In vitro, A35 inhibition of proliferation was reduced by a selective TSHR antagonist. Inhibition of CDX tumor growth without decreases in mouse weights and liver function showed A35 to be efficacious without apparent toxicity. Lastly, A35 reduced levels of Ki67 in the tumors and metastatic markers in lung tissues.

Conclusion
We conclude that A35 is a TSHR-selective inhibitor of TC cell proliferation and metastasis, and suggest that A35 may be a promising lead drug candidate for the treatment of differentiated TC in humans.
Effect of Remimazolam Supplementation on Propofol Requirements During Hysteroscopy: A Double-Blind, Dose-Response Study
Authors: Zhou Yan-Hong , Li Shu-Xi , Li Lin , Deng Chun-Mei , Shen Jian-Jun , Wang Dong-Xin , Chen Xin-Zhong , Xu Li-Li 
Published: February 2024

BACKGROUND:
Propofol is commonly used for procedural sedation but may increase side effects in a dose-dependent manner. Remimazolam, an ultrashort-acting benzodiazepine, has been approved for procedural sedation but may delay awakening. This study tested the hypothesis that remimazolam as a supplement reduces effect-site propofol concentration (Ceprop) required to suppress response to cervical dilation in patients undergoing hysteroscopy.

METHODS:
One hundred and fifty patients who were scheduled for hysteroscopy were randomized to receive 0, 0.05, 0.1, 0.15, or 0.2 mg·kg–1 intravenous remimazolam, followed by a bolus of sufentanil 0.15 μg⋅kg–1, and a target-controlled propofol infusion. The initial target Ceprop was 3.5 μg·mL–1 and was increased or decreased in subsequent patients by steps of 0.5 μg·mL–1 according to whether there was loss of response to cervical dilation in the previous patient. We used up-down sequential analysis to determine values of Ceprop that suppressed response to cervical dilation in 50% of patients (EC50).

RESULTS:
The EC50 of propofol for suppressing response to cervical dilation was lower in patients given 0.1 mg·kg–1 (2.08 [95% confidence interval, CI, 1.88–2.28] μg·mL–1), 0.15 mg⋅kg–1 (1.83 [1.56–2.10] μg·mL–1), and 0.2 mg⋅kg–1 (1.43 [1.27–1.58] μg·mL–1) remimazolam than those given 0 mg⋅kg–1 (3.67 [3.49–3.86] μg·mL–1) or 0.05 mg⋅kg–1 (3.47 [3.28–3.67] μg·mL–1) remimazolam (all were P < .005). Remimazolam at doses of 0.1, 0.15, and 0.2 mg·kg–1 decreased EC50 of propofol by 43.3% (95% CI, 41.3%–45.5%), 50.3% (48.0%–52.8%), and 61.2% (58.7%–63.8%), respectively, from baseline (remimazolam 0 mg⋅kg–1). Propofol consumption was lower in patients given 0.1 mg⋅kg–1 (4.15 [3.51–5.44] mg·kg–1), 0.15 mg⋅kg–1 (3.54 [3.16–4.46] mg·kg–1), and 0.2 mg⋅kg–1 (2.74 [1.73–4.01] mg·kg–1) remimazolam than those given 0 mg⋅kg–1 (6.09 [4.99–7.35] mg·kg–1) remimazolam (all were P < .005). Time to anesthesia emergence did not differ significantly among the 5 groups.

CONCLUSIONS:
For women undergoing hysteroscopic procedures, remimazolam at doses from 0.1 to 0.2 mg·kg–1 reduced the EC50 of propofol inhibiting response to cervical dilation and the total propofol requirement. Whether the combination could improve perioperative outcomes deserves further investigation.
General Versus Nongeneral Anesthesia for Middle Meningeal Artery Embolization for Chronic Subdural Hematomas: Multicenter Propensity Score Matched Study
Authors: Salem Mohamed M. , Sioutas Georgios S. , Khalife Jane , Kuybu Okkes , Caroll Kate , Nguyen Hoang Alex , Baig Ammad A. , Salih Mira , Khorasanizadeh Mirhojjat , Baker Cordell , Mendez Aldo A. , Cortez Gustavo , Abecassis Zachary A. , Rodriguez Juan F. Ruiz , Davies Jason M. , Narayanan Sandra , Cawley C. Michael , Riina Howard A. , Moore Justin M. , Spiotta Alejandro M. , Khalessi Alexander A. , Howard Brian M. , Hanel Ricardo , Tanweer Omar , Tonetti Daniel A. , Siddiqui Adnan H. , Lang Michael J. , Levy Elad I. , Kan Peter , Jovin Tudor , Grandhi Ramesh , Srinivasan Visish M. , Ogilvy Christopher S. , Gross Bradley A. , Jankowitz Brian T. , Thomas Ajith J. , Levitt Michael R. , Burkhardt Jan-Karl 
Published: February 2024

BACKGROUND AND OBJECTIVES:
The choice of anesthesia type (general anesthesia [GA] vs nongeneral anesthesia [non-GA]) in middle meningeal artery embolization (MMAE) procedures for chronic subdural hematomas (cSDH) differs between institutions and left to care team discretion given lack of standard guidelines. We compare the outcomes of GA vs non-GA in MMAE.

METHODS:
Consecutive patients receiving MMAE for cSDH at 14 North American centers (2018-2023) were included. Clinical, cSDH characteristics, and technical/clinical outcomes were compared between the GA/non-GA groups. Using propensity score matching (PSM), patients were matched controlling for age, baseline modified Rankin Scale, concurrent/prior surgery, hematoma thickness/midline shift, and baseline antiplatelet/anticoagulation. The primary end points included surgical rescue and radiographic success rates (≥50% reduction in maximum hematoma thickness with minimum 2 weeks of imaging). Secondary end points included technical feasibility, procedural complications, and functional outcomes.

RESULTS:
Seven hundred seventy-eight patients (median age 73 years, 73.2% male patients) underwent 956 MMAE procedures, 667 (70.4%) were non-GA and 280 were GA (29.6%). After running 1:3 PSM algorithm, this resulted in 153 and 296 in the GA and non-GA groups, respectively. There were no baseline/procedural differences between the groups except radial access more significantly used in the non-GA group (P = .001). There was no difference between the groups in procedural technical feasibility, complications rate, length of stay, surgical rescue rates, or favorable functional outcome at the last follow-up. Subsequent 1:1 sensitivity PSM retained the same results. Bilateral MMAE procedures were more performed under non-GA group (75.8% vs 67.2%; P = .01); no differences were noted in clinical/radiographic outcomes between bilateral vs unilateral MMAE, except for longer procedure duration in the bilateral group (median 73 minutes [IQR 48.3-100] vs 54 minutes [39-75]; P < .0001). Another PSM analysis comparing GA vs non-GA in patients undergoing stand-alone MMAE retained similar associations.

CONCLUSION:
We found no significant differences in radiological improvement/clinical outcomes between GA and non-GA for MMAE.
Multiple HAPS-based space-air-ground network with FSO communication: a performance analysis
Authors: Singh Deepshikha , Swaminathan R. , Pham Anh. T. 
Published: February 2024

Due to the fact that the existing generation of wireless communication cannot possibly keep up with the current traffic explosion and emerging applications, research and development on next-generation (i.e., sixth generation, 6G) wireless technologies is being carried out worldwide. In this regard, it is anticipated that the space-air-ground (SAG) network with free space optics (FSO) communication can provide the terabits per second throughput necessary to sustain various potential 6G applications. However, FSO communications are susceptible to atmospheric turbulence, pointing errors, and beam scintillation effects. To remedy the severe atmospheric effects, we propose a multiple high-altitude platform station (HAPS)-based SAG network with a HAPS selection scheme. For the proposed system, we have derived the closed-form expressions for outage probability, average symbol error rate (SER), ergodic capacity, and outage capacity over Málaga distribution with pointing errors. Further, the asymptotic expressions for outage probability, average SER, and outage capacity were derived to enhance the comprehension of the system from a practical standpoint. It is observed from the numerical results that the multiple HAPS-based FSO system performs better than the existing HAPS-based FSO systems.
Optical design of a visible/short-wave infrared common-aperture optical system with a long focal length and a wide field-of-view
Authors: Yan Aqi , Chen Weining , Li Qianxi , Guo Min , Wang Hao 
Published: February 2024

Addressing the urgent need for long-distance dim target detection with a wide field-of-view and high sensitivity, this paper proposes a visible and short-infrared dual-band common-aperture optical system characterized by a broad field and extended focal length. To achieve system miniaturization and high-sensitivity target detection, the visible and infrared optical systems share a Ritchey-Chretien primary and secondary mirror. The primary optical path is segmented into visible light (0.45–0.75 µm) and short-wave infrared (SWIR) (2–3 µm) bands by a dichroic spectral splitter prism. The SWIR optical system utilizes four short-wave cooled infrared detectors, and wide-field stitching is achieved using a field-of-view divider. While ensuring the high cold-shield efficiency of cooled infrared detectors, this common-aperture optical system delivers visible and SWIR dual-band images with expansive fields, elongated focal lengths, and sizable apertures. The visible-light optical system has a focal length of 277 mm, a field-of-view of 2.3∘×2.3∘, and an entrance pupil diameter of 130 mm. Meanwhile, the SWIR optical system features a focal length of 480 mm, a field-of-view of 2.26∘×1.8∘ and an entrance pupil diameter of 160 mm. The design outcomes suggest that the imaging quality of the optical system approaches the diffraction limit. This visible/SWIR common-aperture optical system exhibits high sensitivity, a large field-of-view, compact structure, and excellent imaging quality, thereby meeting the requirements for long-distance dim target detection and imaging.