bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tonic-clonic seizures induce hypersomnia and suppress REM sleep in mouse models of epilepsy
Authors: Wang Ruizhi , Teng Sasa , Turanchik Matt , Zhen Fenghua , Peng Yueqing 
Published: February 2025

Abstract
The reciprocal relationship between sleep and epilepsy has been reported by numerous clinical studies. However, the underlying neural mechanisms are poorly understood. Animal models of epilepsy are powerful tools to tackle this question. A lagging research area is the understudied sleep in epilepsy models. Here, we characterize sleep architecture and its relationship with seizures in a mouse model of sleep-related hypermotor epilepsy (SHE), caused by mutation of KCNT1. We demonstrated that nocturnal tonic-clonic seizures induce more NREM sleep but suppress REM sleep, resulting in altered sleep architecture in this mouse model. Importantly, the seizure number is quantitatively anti-correlated with the amount of REM sleep. Strikingly, this modulation of NREM and REM sleep states can be repeated in another mouse model of epilepsy with diurnal tonic-clonic seizures. Together, our findings provide evidence from rodent models to substantiate the close interplay between sleep and epilepsy, which lays the ground for mechanistic studies.
Diet-induced obesity alters the ovarian chemical biotransformation and oxidative stress response proteins both basally and in response to 7,12-dimethylbenz[a]anthracene exposure
Authors: Timme Kelsey , Inyang Imaobong , White Hunter E , Keating Aileen F 
Published: February 2025

Abstract
7,12-Dimethylbenz[a]anthracene (DMBA) is a polycyclic aromatic hydrocarbon that causes female infertility via DNA damage, and the ovary has the capacity to mitigate DMBA exposure via the action of proteins including the glutathione S-transferase (GST) family. Due to previous findings of DNA damage and a reduced ovarian chemical biotransformation response to DMBA exposure in hyperphagia-induced obese mice, this study investigated the hypothesis that diet-induced obesity would hamper the ovarian biotransformative response to DMBA exposure. Six-week-old C57BL6/J mice were fed either a normal rodent diet (L) or a high fat high sucrose diet (O) until the O group was ∼30% heavier than the L. Both L and O mice were exposed to either corn oil (C) or DMBA (1 mg/kg) for 7 d. Liver weight was increased (P &lt; 0.05) in obese mice exposed to DMBA but no effect on spleen weight, uterine weight, ovary weight, estrous cyclicity, or circulating 17β-estradiol and progesterone were observed. Primordial and preantral follicle numbers were higher (P &lt; 0.05) in the obese mice and there was a tendency (P = 0.055) for higher antral follicles in DMBA-exposed obese mice. The ovarian proteome was identified by LC-MS/MS analysis to be altered both by diet-induced obesity and by DMBA exposure with changes observed in levels of proteins involved in oocyte development and chemical biotransformation, including GST isoform pi. Fewer proteins were affected by the combined exposure of diet and DMBA than by a single treatment, indicating that physiological status impacts the response to DMBA exposure.
Ultra-widefield indocyanine green angiographic changes after photodynamic therapy in central serous chorioretinopathy. CERTAIN study report 3
Authors: Pauleikhoff Laurenz J.B. , Chang-Wolf Jennifer M. , Diederen Roselie M.H. , Moll Annette C. , Schlingemann Reinier O. , van Dijk Elon H.C. , Boon Camiel J.F. 
Published: February 2025

Purpose:
Venous overload choroidopathy (VOC), showing pachyvessels, choroidal intervortex venous anastomoses (CVA), asymmetric venous drainage (AVD), choroidal vascular hyperpermeability (CVH) and increased choroidal thickness (CT), is observed in the vast majority of central serous chorioretinopathy (CSC) patients based on ultra-widefield indocyanine green angiography (UWF ICGA). This report investigates how photodynamic therapy (PDT) alters signs of VOC.

Methods:
The CERTAIN study is a monocentric, retrospective study on consecutive CSC patients who underwent UWF ICGA. For this report, patients who underwent UWF ICGA twice were included. Two independent graders assessed changes in pachyvessels, CVA, AVD, CT and CVH when comparing pre- and post-PDT images of treated and untreated eyes.

Results:
In total, 38 eyes (19 patients) were included. Of those, 19 eyes had undergone PDT and 19 had not. PDT had no significant effect on pachyvessels, CVA, and AVD (all p > 0.05). Only CT (-51 ± 48 µm vs. 1 ± 43 µm, p = 0.006) and CVH within the PDT treatment area (79% vs. 0% reduced CVH, p < 0.0001) were significantly decreased in treated vs. untreated eyes.

Conclusion:
PDT reduced CT and CVH within the treatment area while not significantly altering the overall choroidal vascular architecture associated with VOC.
Comparison of Effectiveness and Tolerability of Clonidine and Trihexyphenidyl in Clozapine-Induced Hypersalivation
Authors: Pansawat Puangpet , Pansawat Wattanapong , Silaket Sipanut , Supapaan Teeraporn Sadira , Boonlue Tuanthon 
Published: February 2025

Abstract

Purpose/Background
Clozapine-induced hypersalivation is one of the most common bothersome adverse reactions of clozapine. The management strategies for this condition remain inadequately studied and understood. The objective of the study is to compare the effectiveness and tolerability of (1) trihexyphenidyl 5 mg/d, (2) clonidine 0.15 mg/d, or (3) a reduction of clozapine dosage by 25 to 50 mg/d for managing clozapine-induced hypersalivation

Methods/Procedures
A randomized, open-label, non–placebo-controlled clinical trial was conducted from December 2023 to May 2024. Eligible patients were randomly assigned to 1 of 3 groups. Primary outcomes were assessed using the Drooling Severity and Frequency Scale (DSFS) and the Nocturnal Hypersalivation Rating Scale (NHRS) at baseline, week 4, and week 8. Quality of life assessed using the pharmaceutical therapy for quality of life short version and adverse drug reactions were recorded as secondary outcomes.

Findings/Results
A total of 67 patients were randomly assigned to 1 of 3 treatment groups. By week 8, significant reductions in DSFS and NHRS scores were observed in all groups, with clonidine showing the greatest improvement. Trihexyphenidyl was also effective, whereas reducing clozapine dose resulted in more modest improvements. Quality of life improved significantly across all groups, with the greatest improvement observed in the clonidine group. The most common adverse effects were dry mouth, constipation, drowsiness, and dizziness.

Implications/Conclusions
Clonidine and trihexyphenidyl appear to be more effective options for managing clozapine-induced hypersalivation compared to clozapine dose reduction.
Depression, anxiety, and stress among USMLE aspirants: a cross-sectional survey
Authors: Khan QaisarAli , Belay NaodF. , Semakieh Bader , Aisha Marium , Khan Fahd Zafar , Wiyarta Elvan , Ain Hoor Ul , Hassan Laila , Khan Hamza Ali , Verma Ravina 
Published: February 2025

Background:
The United States Medical Licensure Examination (USMLE) represents a critical step for medical licensure in the United States, requiring extensive preparation that can lead to significant mental health challenges among aspirants. This study aims to explore the prevalence and contributing factors of depression, anxiety, and stress among USMLE aspirants.

Methods:
This cross-sectional survey investigates the prevalence and contributing factors of depression, anxiety, and stress among USMLE aspirants. We deployed a detailed online and paper-based questionnaire targeting a diverse pool of 321 medical students and graduates globally. The survey incorporated validated scales such as the Perceived Stress Scale, Generalized Anxiety Disorder 7-item scale, and Patient Health Questionnaire-9 to evaluate mental health statuses. Data analysis was conducted using SPSS, focusing on demographic correlations and mental health outcomes.

Results:
A total of 321 participant’s data were collected, out of whom 51.1% (n = 164) were male and 48.9% (n = 157) were female. 91.3% (n = 293) were International Medical Graduates (IMG), while 8.7% (n = 28) were American Medical Graduates (AMG), educational status results show undergraduates 38.6% (n = 124) and graduates 61.4% (n = 197). Participants were interviewed through a validated questionnaire, and 75.1% (n = 241) had depression, 71.96 (n = 231) had anxiety, (n = 16) had low stress, (n = 231) had moderate, and (n = 66) had severe perceived stress.

Conclusion:
Our study reveals a high prevalence of depression, anxiety, and stress among USMLE aspirants, with significant variations across demographic subgroups and chosen medical specialities.
Comparing surgical outcomes of subcutaneous-flap vs. subplatysmal-flap techniques in total open thyroidectomy: a cohort study
Authors: Samsami Majid , Nematihonar Behzad , Shafiei Mohammad , Tahmasbi Hamed , Tavakoli Shervin , Kouchak Hosseini Seyed Pedram , Adinevand Ehsan , Toutounchi Alireza Haghbin 
Published: February 2025

Introduction:
Various minimally invasive open thyroidectomy techniques have been introduced in surgical centers worldwide, aiming to improve cosmetic outcomes. The conventional open thyroidectomy method involves creating a subplatysmal flap through a horizontal incision, which requires cutting the platysma muscle and anterior jugular veins. This study evaluates a modified open total thyroidectomy technique that uses a subcutaneous flap instead of a subplatysmal flap and compares its outcomes with those of the conventional method.

Methods:
This observational cohort study included 120 patients from 10 years experience of tertiary medical center. Outcomes were compared between the subcutaneous flap (MTT) group and the subplatysmal flap (CTT) group.

Results:
The modified technique increased the duration of surgery, with the flap type significantly affecting operation time (P = 0.016). However, there was no significant difference in hospital stay length between the two groups (P = 0.268). The incidence of hematoma and skin ischemia was lower with the subcutaneous flap. No significant differences were observed between the groups in terms of seroma formation, infection, keloid formation, or hypertrophic scars (P>0.05).

Conclusion:
The findings suggest that the subcutaneous flap technique is safe and does not make additional risks or complications. Additionally, it appears to offer advantages in specific outcomes.
Giant Uterine Leiomyoma Causing Severe Hemodynamic Instability
Authors: Almasarweh Saed , Buderath Paul , Rusch Peter , Ingenwerth Marc , Kimmig Rainer 
Published: February 2025

BACKGROUND:
Uterine leiomyomas occasionally manifest as giant leiomyomas, displaying exceptional sizes within the uterus and abdominal cavity. These massive growths, although rare because of increased patient awareness, can severely distort pelvic structures and pose life-threatening complications by compressing adjacent organs. We report a case of a patient who presented with severe hemodynamic instability, cardiac arrest, and multiorgan failure caused by a giant 54.8-kg uterine leiomyoma, representing the heaviest weight ever reported in the literature in surviving patients so far.

CASE:
This article documents a case of a 56-year-old woman with a giant uterine leiomyoma in critical condition characterized by multiorgan failure and acute kidney injury necessitating urgent surgical intervention. A laparotomy and subsequent total abdominal hysterectomy were performed. Histopathologic examination revealed a giant uterine leiomyoma. Postoperatively, the patient underwent intensive care management followed by rehabilitation, exhibiting significant clinical recovery.

CONCLUSION:
Managing giant uterine leiomyomas demands a multidisciplinary approach, emphasizing tailored treatment strategies and specialized surgical expertise. The case report describes one of the largest leiomyomas in the literature, underscoring its rarity, and highlights the significance of timely diagnosis and appropriate interventions.
Posttraumatic Stress Disorder and Pregnancy Outcomes
Authors: Lutgendorf Monica A. , Tyagi Radhika , Edwards Sarah , Deering Shad , Raiciulescu Sorana , Walton Robert B. , Pates Jason A. , Napolitano Peter G. , Ieronimakis Nicholas 
Published: February 2025

OBJECTIVE:
To evaluate the prevalence and effect of posttraumatic stress disorder (PTSD) on pregnancy outcomes among individuals with military health care.

METHODS:
This was a prospective cohort study of pregnant individuals receiving care at a military tertiary care center from 2014 to 2018. Participants were screened for PTSD with the PTSD Checklist for civilians and for military service members, as well as for traumatic experiences, combat exposure, risk drinking, and depression. Pregnancy outcomes included preterm birth, fetal growth restriction, preeclampsia, gestational diabetes mellitus, hypertensive disorders of pregnancy, outpatient visits, and neonatal intensive care unit admissions.

RESULTS:
Among 1,467 pregnant individuals, 1,145 were retained: 298 (26.0%) military service members and 847 (73.9%) civilian family members. A total of 108 individuals screened positive for PTSD: 21 (7.0%) military service members and 87 (10.3%) civilians. Individuals who screened positive for PTSD had a 17-fold increased likelihood for depression (50.9% vs 5.5%, odds ratio [OR] 17.84, 95% CI, 11.24–28.33), a fivefold increased likelihood for risk of alcohol use (14.8% vs 3.0%, OR 5.64, 95% CI, 2.97–10.69), and a greater number of outpatient visits (median 18 vs 22.5, P=.007). Pregnancy complications were not different between military service members and civilians or those who screened positive for PTSD.

CONCLUSION:
Screening results positive for PTSD are associated with positive screen results for depression and risk of alcohol use during pregnancy, with no differences in outcomes. Although we identified no differences in pregnancy outcomes based on PTSD screening results, comorbidities of traumatic stress such as depression and alcohol use disorder may have long-term consequences on maternal and fetal health. Further research is warranted to understand the effect of behavioral health disorders on pregnancy.
Impact of fracture type on conversion to total hip arthroplasty following surgical repair of acetabular fractures: a systematic review and meta-analysis
Authors: Collins Andrew P. , Kubsad Sanjay , Firoozabadi Reza 
Published: February 2025

Abstract

Objectives:
The objective of this study was to perform a meta-analysis of risk factors of conversion to total hip arthroplasty (THA) after operative fixation of acetabular fractures.

Methods:
This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources included PubMed, MEDLINE, EMBASE, and Cochrane Library, which were screened from inception to 2024.

Study Selection:
Inclusion criteria were studies comparing risk factors of conversion to THA following acetabular fracture (OTA/AO 62A, B, C) surgical fixation.

Data Extraction:
Studies were assessed by the risk of bias and methodologic quality of evidence tools designed by the Cochrane Methods Bias Group and Cochrane Statistical Methods Group.

Data Synthesis:
Meta-analyses were conducted with a random-effects model using IBM SPSS Statistics Version 29.0.2.0. One-factor-at-a-time sensitivity analyses were conducted.

Results:
Twelve studies (1951 patients) were included. Based on the Judet and Letournel classification system, patients with associated fracture patterns were more likely to require conversion to THA than those with elementary patterns (risk ratio [RR] = 1.55, P = 0.013). Patients with posterior wall involvement (including posterior wall, posterior column with posterior wall, and transverse with posterior wall patterns) were more likely to require subsequent THA than those without posterior wall involvement (RR = 1.58, P < 0.001). Patients who presented with hip dislocation and acetabular dome impaction and comminution were at higher risk of THA (RR = 1.15 and 1.19, respectively; P < 0.001, both). Owing to heterogeneity in reported findings, there were insufficient data to assess the impact of the quality of reduction, restoration of the articular surface, time since acetabular fixation, and patient demographic factors on conversion to THA.

Conclusions:
This study aids in the identification of patients who may require early THA for posttraumatic arthritis based on fracture and injury patterns at presentation. Acetabular fractures with posterior wall involvement and those with associated fracture patterns are associated with a higher rate of conversion to THA. Injuries with acetabular dome impaction and comminution and hip dislocation are also significantly associated with conversion to THA.

Level of Evidence:
Level III. See Instructions for Authors for a complete description of levels of evidence.
Efficacy, safety, and pharmacokinetics of lenacapavir oral bridging when subcutaneous lenacapavir cannot be administered
Authors: Ogbuagu Onyema E. , Avihingsanon Anchalee , Segal-Maurer Sorana , Wang Hui , Jogiraju Vamshi K. , Singh Renu , Rhee Martin S. , Dvory-Sobol Hadas , Sklar Peter A. , Molina Jean-Michel 
Published: February 2025

Objective:
To assess efficacy, safety and pharmacokinetics (PK) of oral lenacapavir (LEN) when used as oral bridging (OB) between delayed subcutaneous (SC) LEN injections.

Design:
Posthoc analysis of participants in two clinical trials of SC LEN for HIV-1 treatment who required OB when LEN SC dosing was interrupted.

Methods:
Oral LEN [300 mg once weekly (QW)] was initiated within 2 weeks of the next scheduled injection (dosing interval: 26 weeks). Efficacy, safety, and PK were assessed every 10–12 weeks.

Results:
Overall, 139 participants received ≥1 dose of oral 300 mg QW LEN plus other antiretrovirals. Median duration of OB was 19 weeks in both clinical trials. By missing = excluded analysis, over 95% of participants maintained virologic suppression (HIV-1 RNA <50 copies/ml) at Weeks 10, 20, and 30. Treatment-emergent AEs (TEAEs) were similar to those with SC LEN (excluding injection site reactions). No Grade ≥3 or serious TEAEs were considered related to oral LEN. Throughout OB, mean LEN plasma concentrations and lower bound 90% confidence intervals (CIs) were consistently above inhibitory quotient 4 (4-fold in-vitro protein binding-adjusted 95% effective concentration). OB adherence (by pill count) was ≥95% in the majority of participants in both clinical trials.

Conclusions:
High rates of virological suppression were maintained during OB. Oral 300 mg QW LEN was well tolerated and provided adequate plasma concentrations to bridge SC LEN dosing. This analysis supports using 300 mg QW LEN for OB when SC LEN treatment is interrupted.
Prognostics Factors to Avoid Eye Injuries in Angle Grinders
Authors: Ke Wang , Gu Kaiming , Zhu Suhui , Wu Jianhao , Dai Yan 
Published: February 2025

Objective:
To analyze the clinical characteristics and prognostic factors of eye injuries caused by angle grinders over 2 years.

Methods:
Clinical data from 36 hospitalized patients (36 eyes) with eye injuries caused by angle grinders were collected. The causes of injury, types of trauma, and prognoses were analyzed.

Results:
Among the 36 patients (36 eyes), 34 were male (34 eyes) and 2 were female (2 eyes), with ages ranging from 19 to 66 years. The time from injury to medical consultation was within 12 hours in 29 cases, between 12 and 24 hours in 6 cases, and over 24 hours in 1 case. Primary emergency globe repair surgery was performed within 8 hours of admission in 23 cases, while 29 cases required secondary surgical interventions. Preoperative visual acuity was recorded as no light perception to 0.05 in 13 cases, 0.05 to 0.1 in 10 cases, 0.1 to 0.3 in 9 cases, and >0.3 in 4 cases. Postoperative best-corrected visual acuity was <0.05 in 10 cases, 0.05 to 0.1 in 13 cases, 0.1 to 0.3 in 7 cases, and >0.3 in 6 cases.

Conclusion:
Eye injuries caused by angle grinders are often complex, involving both ocular adnexa and globe injuries, with multiple sites of intraocular trauma. A high proportion of patients require secondary surgical interventions. Factors affecting visual outcomes include the location and type of injury, time to medical consultation, presence of infectious endophthalmitis, and intraocular foreign bodies.
Accessory Infraorbital Foramen: Prevalence in the Mexican Population by Tomographic Study
Authors: Elizarrarás-Alonso Brenda , Malagón-Hidalgo Héctor O. , García-Cano Eugenio , Flores-Hernández José Gabriel , Menéndez-Arzac Rodrigo A. , Lavareda-Santana Marco A. 
Published: February 2025

Objective:
The accessory infraorbital foramen (AIOF) has been reported to have a prevalence of up to 47.6% in the global population. Cadaveric studies have observed that components of the infraorbital neurovascular bundle may emerge through the AIOF. The objective of this study was to determine the prevalence of the AIOF in the Mexican population.

Methods:
A cross-sectional, observational, descriptive epidemiological study was conducted, analyzing skull computed tomography (CT) scans with three-dimensional reconstruction from 345 randomly selected Mexican patients performed between 2015 and 2022. The presence of the AIOF was assessed, including its area, location, laterality, and number. Descriptive statistical analysis was performed using IBM SPSS Statistics version 25.0.

Results:
The presence of the AIOF was found in 17.8% (58 cases), with 11% in men and 6.8% in women. The majority of cases (73.9%) had a superomedial location. The AIOF was found bilaterally at 48.3%, on the left side at 41.4%, and on the right side at 10.3%. Of these, 96.6% were single, and 3.4% were double; no triple or quadruple AIOFs were observed. The average area of the AIOF was 2.9 mm².

Conclusions:
Awareness of the presence of the AIOF is crucial for preventing inadvertent injuries to the infraorbital neurovascular bundle during procedures involving the infraorbital area, both medical and surgical, thereby reducing the risk of complications. The use of three-dimensional tomographic reconstruction offers more accurate and precise knowledge when planning these procedures.