bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two different viral proteins suppress NUCLEAR FACTOR-YC-mediated antiviral immunity during infection in rice
Authors: Tan Xiaoxiang , Wang Guoda , Cao Chen , Yang Zihang , Zhang Hehong , Li Yanjun , Wei Zhongyan , Chen Jianping , Sun Zongtao 
Published: February 2024

Abstract
Plant viruses have multiple strategies to counter and evade the host’s antiviral immune response. However, limited research has been conducted on the antiviral defense mechanisms commonly targeted by distinct types of plant viruses. In this study, we discovered that NUCLEAR FACTOR-YC (NF-YC) and NUCLEAR FACTOR-YA (NF-YA), 2 essential components of the NF-Y complex, were commonly targeted by viral proteins encoded by 2 different rice (Oryza sativa L.) viruses, rice stripe virus (RSV, Tenuivirus) and southern rice black streaked dwarf virus (SRBSDV, Fijivirus). In vitro and in vivo experiments showed that OsNF-YCs associate with OsNF-YAs and inhibit their transcriptional activation activity, resulting in the suppression of OsNF-YA-mediated plant susceptibility to rice viruses. Different viral proteins RSV P2 and SRBSDV SP8 directly disrupted the association of OsNF-YCs with OsNF-YAs, thereby suppressing the antiviral defense mediated by OsNF-YCs. These findings suggest an approach for conferring broad-spectrum disease resistance in rice and reveal a common mechanism employed by viral proteins to evade the host’s antiviral defense by hindering the antiviral capabilities of OsNF-YCs.
Evidence-based medicine or statistically manipulated medicine? Are we slaves to the P-value?
Authors: Goel Harsh , Raheja Divisha , Nadar Sunil K 
Published: February 2024

Abstract
First popularized almost a century ago in epidemiologic research by Ronald Fisher and Jerzy Neyman, the P-value has become perhaps the most misunderstood and even misused statistical value or descriptor. Indeed, modern clinical research has now come to be centered around and guided by an arbitrary P-value of &lt;0.05 as a magical threshold for significance, so much so that experimental design, reporting of experimental findings, and interpretation and adoption of such findings have become largely dependent on this “significant” P-value. This has given rise to multiple biases in the overall body of biomedical literature that threatens the very validity of clinical research. Ultimately, a drive toward reporting a “significant” P-value (by various statistical manipulations) risks creating a falsely positive body of science, leading to (i) wasted resources in pursuing fruitless research and (ii) futile or even harmful policies/therapeutic recommendations. This article reviews the history of the P-value, the conceptual basis of P-value in the context of hypothesis testing and challenges in critically appraising clinical evidence vis-à-vis the P-value. This review is aimed at raising awareness of the pitfalls of this rigid observation of the threshold of statistical significance when evaluating clinical trials and to generate discussion regarding whether the scientific body needs a rethink about how we decide clinical significance.
Daily light exposure profiles and the association with objective sleep quality in patients with Parkinson’s disease: The PHASE study
Authors: Obayashi Kenji , Saeki Keigo , Tai Yoshiaki , Yamagami Yuki , Esaki Yuichi , Yoshikawa Tadanobu , Sugie Kazuma , Kataoka Hiroshi 
Published: February 2024

Abstract

Study Objectives
Light information crucially influences sleep initiation and continuity. The purpose of this study was to compare daily light exposure between patients with Parkinson’s disease (PD) and non-PD older adults and evaluate the association of daily light exposure with objective sleep measures in patients with PD.

Methods
In this cross-sectional study of 189 outpatients with PD and 1101 community-dwelling older adults (controls), daily light exposure was measured using wrist light meters during the daytime and light meters set in the bedrooms during the nighttime, and objective sleep quality was measured by wrist actigraphy.

Results
The median duration of exposure to ≥ 1000 lux light was significantly shorter in patients with PD than in controls. The median nighttime light intensity was higher in patients with PD than in controls. Among patients with PD, multivariable analysis suggested that the highest quartile of exposure to ≥ 1000 lux light during the daytime was linked to significantly higher sleep efficiency (SE) by 8.0% and shorter wake after sleep onset (WASO) by 36.9 minutes than the lowest quartile. During the nighttime, the highest quartile of mean light intensity had significantly lower SE by 6.8%, longer WASO by 24.1 minutes, longer sleep onset latency, and higher fragmentation index, than the lowest quartile. Importantly, daytime and nighttime light levels were independently associated with objective sleep measures.

Conclusions
The present study illustrated that greater daytime light exposure and lower nighttime light exposure are significantly associated with better objective sleep measures in patients with PD.
A primer on the restorative therapies for erectile dysfunction: a narrative review
Authors: Narasimman Manish , Sandler Max , Bernstein Ari , Loloi Justin , Saltzman Russell G , Bernie Helen , Ramasamy Ranjith 
Published: February 2024

Abstract

Introduction
Erectile dysfunction (ED) is a common condition that affects millions worldwide. Patients and urologists alike are seeking alternative therapies that can provide long-lasting results in the treatment of ED. This review provides a comprehensive overview of restorative treatments available for ED, such as platelet-rich plasma, stem cell therapy, and shockwave therapy.

Objective
The aim of this narrative review is to provide a primer for urologists and general practitioners on the basics of implementing ED restorative therapies in their practice.

Methods
The PubMed, MEDLINE, and Google Scholar databases were searched for articles in the English language through August 31, 2023, that included key terms such as “erectile dysfunction,” “restorative therapy,” “shockwave therapy,” “platelet-rich plasma,” “stem cell therapy,” and “stromal vascular fraction.” Reference lists of selected studies were manually reviewed to find articles not identified by the initial database search.

Results
Shockwave therapy has demonstrated effectiveness in treating ED, with devices like the Medispec ED1000 and Storz Duolith showing statistically significant improvements in patient scores for International Index of Erectile Function (IIEF)–Erectile Function scores in clinical trials. In reported studies of platelet-rich plasma injections, a substantial percentage of patients reached a minimal clinically important difference in the IIEF–Erectile Function scale after treatment. Studies of ED treatment with stem cell therapy, while limited and with small sample sizes, have demonstrated encouraging improvements in patient scores for the abridged 5-item version of the IIEF after treatment.

Conclusion
Shockwave, platelet-rich plasma, and stem cell therapies are important, novel, noninvasive restorative treatments for ED that can provide relief for patients wishing to avoid a more invasive approach. While these therapies have shown promising results in clinical trials, more research is required to establish them as standardized and efficacious options in the management of ED.
Novel Uses of Methadone Under the “72-Hour Rule” to Facilitate Transitions of Care and Low-Dose Buprenorphine Induction in an Outpatient Bridge Clinic
Authors: Shahlapour Minaliza , Singh Sabetta , Christine Paul J. , Laks Jordana , Evans James , Farrell Natalija M. , Khan G. Karim , Taylor Jessica L. , Rozansky Hallie 
Published: February 2024

Background
Federal regulations restrict methadone for opioid use disorder (OUD) treatment to licensed opioid treatment programs (OTPs). However, providers in other settings can administer methadone for opioid withdrawal under the “72-hour rule” while linking to further care. Prior work has demonstrated that methadone initiation in a low-barrier bridge clinic is associated with high OTP linkage and 1-month retention rates. We describe 2 other novel applications of the 72-hour rule in which methadone withdrawal management facilitated linkage to inpatient hospitalization and outpatient buprenorphine induction.

Case Presentations
Patient 1 was a 46-year-old woman with OUD complicated by serious injection-related infections. Severe opioid withdrawal limited her ability to tolerate emergency department wait times and receive inpatient care. We administered methadone for opioid withdrawal in an outpatient bridge clinic immediately before emergency department referral; this enabled hospital admission for intravenous antibiotics and anticoagulation. Patient 2 was a 36-year-old man with OUD desiring buprenorphine treatment. He had been unable to complete traditional buprenorphine induction without experiencing precipitated withdrawal. Thus, we recommended a low-dose buprenorphine induction overlapping with a full opioid agonist. Given the patient's preference to stop using fentanyl immediately, he received 72 hours of methadone for withdrawal treatment during the induction phase and successfully transitioned to buprenorphine without significant concomitant fentanyl use.

Conclusion
In addition to facilitating OTP linkage, on-demand 72-hour methadone administration for opioid withdrawal can reduce barriers to acute medical care and buprenorphine treatment.
Traditional Versus Water-resistant Short Leg Casting: A Randomized Controlled Pilot Study
Authors: Carveth Stephen L. , Bomar James D. , Scott MaryLou , Rickert Kathleen D. , Upasani Vidyadhar V. 
Published: February 2024

Introduction:
We conducted a randomized controlled trial comparing fiberglass short leg casts with traditional cast padding to similar casts with water-resistant cast padding and recorded the opinion of the patient/caregiver and Orthopaedic Technicians (Ortho Techs) that applied and removed the casts.

Methods:
Subjects with an injury that would be treated with a short leg cast were enrolled and randomized into a traditional cast or a water-resistant cast. Following cast application, the Ortho Tech that applied the cast completed a questionnaire asking their opinion on ease of application, moldability, padding level, and time taken for application. Following the removal of the study cast, the Ortho Tech that removed the cast completed a questionnaire that included an assessment of skin condition and evidence of the patient poking items inside the cast, as well as their opinion of ease of padding removal, padding durability and longevity, and an overall quality assessment of the cast padding. Following cast removal, the patient (or caregiver) also completed a questionnaire asking for their assessment of comfort, the weight of the cast, itchiness, heat/sweat, smell, and satisfaction. Patients who were treated with an expanded polytetrafluoroethylene cast were also asked about their happiness with the cast’s water resistance and asked how long the cast took to dry.

Results:
Sixty patients were included in this study, thirty in each group. The water-resistant casts took longer to apply than the traditional casts (12.4±4.0 vs. 8.2±3.2 min, P<0.001). The Ortho Techs favored the traditional cast when it came to ease of application (P<0.001), moldability (P=0.003), ease of padding removal (P<0.001), padding durability (P=0.006), padding longevity (P=0.005), and their overall impression (P=0.014). The patients/caregivers responded similarly among the 2 groups for each survey question.

Conclusions:
Patients randomized into each cast type tolerated their cast similarly; however, the Ortho Techs involved in this study preferred the traditional cast.
Silicone Migration from Intact Saline Breast Implants
Authors: Azahaf Siham , Spit Karlinde A. , de Blok Christel J.M. , Bult Peter , Nanayakkara Prabath W.B. 
Published: February 2024

Summary:
Breast augmentation is a widely performed surgical procedure worldwide, predominantly using silicone gel-filled implants. Concerns have primarily revolved around ruptures and the potential health risks associated with leaked silicone from silicone gel-filled implants. Cases of silicone migration from the shell of saline breast implants remain scarce. This case report introduces a unique case of a 66-year-old patient with silicone migration from intact saline breast implants. The patient presented with a range of symptoms consistent with breast implant illness. Radiological findings suggested the presence of silicone in the axillary lymph nodes, despite the integrity of the implants, thereby confirming silicone migration. Histopathological evaluation revealed a foreign body reaction and the presence of silicone in the axillary lymph nodes. Given the saline filling, the source is likely the polydimethylsiloxane shell. The rarity of documented silicone migration from intact saline breast implants, especially in patients with breast implant illness, underscores the need for more research into the health implications of leaked silicone particles from breast implants.
Remote programming in stage I sacral neuromodulation: a Multi-Center prospective feasibility study
Authors: Jing Jibo , Meng Lingfeng , Zhang Yaoguang , Wang Xinhao , Zhu Wen , Wang Qingwei , Lu Li , Song Wei , Zhang Yifei , Li Yan , Ning Jiaxing , Wang Haoran 
Published: February 2024

Objective:
Sacral neuromodulation (SNM) has emerged as an effective therapy for refractory lower urinary tract dysfunction (LUTD). Remote programming holds promise in addressing the time and economic burdens associated with outpatient programming, especially for patients in the observation period following Stage I implant surgery (where the lead is implanted first without the pulse generator). The study aimed to explore the effectiveness and patient satisfaction of remote programming for Stage I SNM patients, and analyze the benefits patients gain from remote programming.

Methods:
This prospective study was conducted at multiple high-level clinical SNM centers in China. Patients requiring SNM implantation were enrolled and divided into two groups based on patient preference: remote programming (RP) group and outpatient control (OC) group. Patient attitudes toward RP were assessed through questionnaires, and the degree of symptom improvement was compared between the two groups to explore the usability of RP.

Results:
A total of 63 participants from 6 centers were included in the study, with 32 belonging to the RP group. The remote programming system presents a high level of usability (98%) and willingness (satisfaction rate: 96.83%) in result of questionnaire. RP showed a significant advantage in improving patients’ score of ICSI/ICPI (medianΔICSI/ICPI RP vs OC= -13.50 vs -2, P=0.015). And slightly ameliorate urinary symptoms such as pain (medianΔVAS RP vs OC= -1 vs 0, P= 0.164 ) and urgency ( medianΔOBASS -2.5 vs -1, P= 0,229), but the difference was not statistically significant. RP did not significantly impact the quality of life of patients (P=0.113), so do the rate of phase-two conversion (P= 0.926) or programming parameters.

Conclusion:
To the best of our knowledge, the presented study is the first multicenter research focusing on the remote programming of Stage I SNM patients. Through the clinical implementation and patient feedback, we demonstrate that remote programming is not inferior to in-person programming in terms of success rate, effectiveness, safety, and patient satisfaction.
Watch-and-Wait strategy vs. resection in patients with radiologic complete response after conversion therapy for initially unresectable hepatocellular carcinoma：a propensity score-matching comparative study
Authors: Li Binkui , Wang Chenwei , He Wei , Qiu Jiliang , Zheng Yun , Zou Ruhai , Lin Zhu , Shi Yunxing , Yuan Yichuan , Zhang Rong , Zhang Chao , Chen Minshan , Lau Wan Yee , Yuan Yunfei 
Published: February 2024

Background:
The optimal subsequent management for patients with initially unresectable hepatocellular carcinoma (uHCC) who have achieved complete response (CR) following conversion therapy remains unclear. This study aims to evaluate the feasibility and outcomes of the watch-and-wait (W-W) strategy versus surgical resection (SR) for these patients.

Materials and Methods:
This retrospective study reviewed patients with initially uHCC who underwent conversion therapy employing transarterial therapies combined with or without systemic therapies. Radiologic CR (rCR), clinical CR (cCR), and pathologic CR (pCR) were evaluated. Overall survival (OS) and progression-free survival (PFS) were compared between the W-W and SR groups.

Results:
Among 1880 patients with uHCC who underwent conversion therapy, 207 (11.0%) achieved rCR. Finally, we enrolled 149 patients meeting the inclusion criteria, including 74 receiving W-W strategy and 75 undergoing SR. Among the 149 patients with rCR, the W-W group demonstrated comparable 3-year OS rates to the SR group (80.9% vs 83.1%, P=0.77), but demonstrated inferior PFS rates (14.4% vs 46.5%, P=0.002). These results remained consistent after propensity score matching. For the 57 patients who achieved cCR, the W-W group exhibited comparable 3-year OS (88.1% vs 87.9%, P=0.89) and PFS rates (27.8% vs 40.8%, P=0.34) compared to SR group. Among the 75 patients in the SR group, 31 (41.3%) achieved pCR and 44 (58.7%) reached non-pCR. When compared with patients with pCR, those who achieved rCR in the W-W group showed comparable OS but inferior PFS rates. Moreover, patients who achieved rCR in the W-W group displayed both comparable OS and PFS rates to those with non-pCR.

Conclusion:
The W-W strategy offered comparable survival outcomes to surgical resection in patients with initially uHCC who achieved rCR or cCR after conversion therapy. For these patients, the W-W strategy could be offered as an alternative treatment option.
Ultrasound Biofeedback Increases Abdominal Muscle Activation in Golfers With a History of Low Back Pain
Authors: Skibski Andrew , Stout Jeffrey R. , Ingersoll Christopher D. , Mangum L. Colby 
Published: February 2024

Objectives:
To compare activation ratios of the transverse abdominis (TrA) during an abdominal draw-in maneuver (ADIM) and abdominal obliques during a golf swing, with and without ultrasound biofeedback, and to determine intrarater reliability of these ultrasound thickness measures.

Design:
Single-session crossover study.

Setting:
Laboratory.

Participants:
Sixteen adult golfers with 2 or more episodes of low back pain (LBP) in the past year.

Interventions:
Verbal cueing alone and verbal cueing with ultrasound biofeedback.

Main Outcome Measures:
Bilateral TrA activation ratios were calculated during an ADIM with and without ultrasound biofeedback. Activation ratios of the abdominal obliques were calculated bilaterally during golf swings with and without ultrasound biofeedback. Intraclass correlation coefficients (ICCs) were calculated for average thickness across all muscles and conditions for the nonbiofeedback trials.

Results:
Transverse abdominis activation ratios were significantly higher when ultrasound biofeedback was provided bilaterally (P < 0.001). Abdominal oblique activation ratios during the golf swing were also significantly higher with ultrasound biofeedback for the lead (P = 0.014) and trail (P < 0.001) sides. Intraclass correlation coefficient values ranged from 0.92 to 0.97 (P < 0.001).

Conclusions:
Ultrasound biofeedback can increase activation ratios of the TrA during a supine ADIM in adult golfers with a history of LBP. Postswing ultrasound biofeedback increases activation of the abdominal obliques during a golf swing in golfers with a history of LBP. Ultrasound thickness measures of the TrA and obliques have excellent intrarater reliability.
Chorea as the only presenting clinical feature of rheumatic fever: a case report
Authors: Thapa Santosh , Raut Ujwal , Shrestha Garima , Shah Sandesh , Helmu Mangal Bahadur 
Published: February 2024

Introduction and importance:
Sydenham’s chorea (SC), a major neurological manifestation of acute rheumatic fever (ARF), is commonly seen in young children and adolescents. It is characterized by rapid, unpredictable, involuntary, and nonpatterned contractions affecting mostly distal limbs. It can also be associated with clinical or subclinical carditis. SC has been reported as a major manifestation in only 3.87% cases of acute rheumatic fever in Nepal.

Case presentation:
The authors report a case of a 12-year-old boy with abnormal movement of his right hand and unsteady gait for 12 days. On examination, he had an abnormal hand grip with difficulty maintaining a tetanic contraction (Milkmaid’s grip). Laboratory investigations revealed increased anti-Streptolysin O titre and erythrocyte sedimentation rate. Echocardiography revealed subclinical carditis. After thorough clinical examination and pertinent investigations, the final diagnosis of ARF with SC was made.

Clinical discussion:
SC is a major clinical feature of rheumatic fever according to the revised Jones criteria. It is related to a previous Group A β-haemolytic Streptococcus pyogenes (GABHS) infection. Approximately 50–65% of the patients with rheumatic fever later develop clinically detectable carditis. Although a self-limiting condition, it might need treatment with antiepileptics, neuroleptics, and phenothiazines.

Conclusion:
Any child presenting with a movement disorder should also be considered for SC, necessitating additional testing, including a cardiovascular assessment. It needs to be distinguished from other causes of movement disorders as well as psychiatric conditions. Treatment is necessary for moderate to severe chorea that interfere with daily activities. Compliance with subsequent antibiotic prophylaxis is essential for avoiding future cardiac complications.
Limited significance of bicarbonate therapy in the treatment of diabetic ketoacidosis: a rare case report in the periphery of Nepal
Authors: Shrestha Pran , Gautam Ajaya Raj , Malla Sibika , Parajuli Susmita , K.C. Rupak 
Published: February 2024

Introduction and importance:
An uncontrolled hyperglycaemia accompanied by metabolic acidosis and an increase in total body ketone, if left untreated, has the potential to develop into complications, including diabetes ketoacidosis (DKA). Management of this complication with IV hydration, IV Insulin, and potassium (KCL) maintenance is a comprehensive approach. On the contrary, bicarbonate therapy is generally not regarded as a standard treatment due to its unfavourable outcome.

Case presentation:
The authors present a case of a 21-year-old female who was brought in a semiconscious state to the emergency department with complaints of pain in the abdomen, headache, and vomiting. DKA was diagnosed following the patient’s symptoms and arterial blood gas analysis report. She was managed with IV fluids, IV insulin, and KCL.

Clinical discussion:
Generally, pH less than 6.8 has a poor patient survival outcome. Here, the patient presented with pH less than 6.6, where she was managed with the standard regimen without the need to administer bicarbonate therapy.

Conclusion:
DKA is a life-threatening condition that can be precipitated by non-adherence to medications and infections with IV insulin and hydration playing a pivotal role in its management while bicarbonate offers no beneficial effect.