bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Significance of Rapid Eye Movement Sleep Behavior Disorder in Neurodegenerative Diseases
Authors: Bhatti Karandeep S , Kaleru Thanmai , Vankeshwaram Varun , Maheshwary Ankush , Khan Safeera 
Published: February 2024

Background:
Rapid eye movement (REM) sleep behavior disorder (RBD), a parasomnia, after being diagnosed, can predict the emergence of an alpha-synuclein-associated neurodegenerative disease (NDD) in 20-45% and 92% of patients within 5 and 14 years, respectively. RBD is less common in tauopathies, and the studies to evaluate its association with polyglutamine diseases have been very few.

Objective:
To revisit our knowledge on the significance of RBD in the emergence of NDDs and to review the recent updates in the potential biomarkers, which can help predict the risk of phenconversion into NDDs in idiopathic RBD (iRBD) patients. We also aimed to look at the potential neuroprotective therapies that can potentially be used earlier in iRBD patients.

Methods:
We conducted a review of the papers, after selecting them from the PubMed database. After a thorough screening, 51 articles were chosen to be included in this review.

Results and Conclusion:
The prospective studies showed that the risk of phenoconversion of iRBD into overt NDDs increased over the longer duration of follow up. Magnetic resonance imaging (MRI) findings, Electroencephalographic findings along with subtle motor signs, autonomic dysfunction, impaired olfaction, and color vision, among others, can be used to predict the onset of an NDD in iRBD. Phytocannabinoids showed a possible neuroprotective effect in animal studies. Considering how RBD is the antecedent of NDDs, there is a need for additional studies to better understand the utility of the aforementioned biomarkers and institute potential neuroprotective therapies early in the process.
Infectious Spondylodiscitis of the Lumbar Spine
Authors: Hohenberger Christoph , Schmidt Nils-Ole , Doenitz Christian , Ullrich Odo Winfried , Schebesch Karl-Michael 
Published: February 2024

Background:
Infectious spondylodiscitis of the lumbar spine is a common serious disease for which evidence-based therapeutic concepts are still lacking.

Objective:
This retrospective study compared the impact of the health status of patients on the length of hospital stay with regard to the treatment concept, i.e., antibiotic therapy or antibiotic therapy in combination with fixation surgery.

Patients and Methods:
The study included 54 consecutive patients with infectious spondylodiscitis of the lumbar spine who had been treated at our clinic between 2004 and 2013. Records included patient demographics, concomitant diseases, the neurological status and treatment modality, and the length of hospital stay.

Results:
40 men and 14 women with a mean age of 64.2 (30-89) years were included. 13 patients were only treated with antibiotics (group A), 7 patients with abscess decompression (group B), 18 patients with early dorsal fusion (<10 days after admission) (group C), and 16 patients with late dorsal fusion (≥10 days after admission; group D). Patients undergoing early dorsal fusion had a significantly shorter hospital stay (33.2 days) than patients undergoing late dorsal fusion (57.0 days), P = 0.016. Mean hospital stay of patients treated with antibiotics was 30.3 days, that of patients receiving abscess decompression 57.8 days. Patients receiving only antibiotics had a significantly lower CRP level at admission than patients undergoing early fusion, P < 0.05.

Conclusion:
Patients with one or more relevant chronic concomitant diseases showed faster recovery, shorter hospital stays, and earlier return to daily routine after early dorsal fusion than after late dorsal fusion or abscess evacuation alone.
Exosomal PTEN as a Predictive Marker of Aggressive Gliomas
Authors: Patnam Sreekanth , Samal Rasmita , Koyyada Rajeswari , Joshi Partha , Singh Anula D , Nagalla Balakrishna , Soma Madan R , Sannareddy Rajesh R , Ippili Kaushal , Raju Subodh , Boola Ratnam G , Lath Rahul , Ranjan Alok , Ghosh Siddharth , Balamurugan M , Ray Amitava , Manda Sasidhar V 
Published: February 2024

Background:
Liquid biopsies have emerged as convenient alternative diagnostic methods to invasive biopsies, by evaluating disease-specific biomarkers and monitoring the disease risk noninvasively. Phosphatase and tensin homolog deleted in chromosome 10 (PTEN) is a potent tumor suppressor, and its deletion/mutations are common in gliomas.

Objective:
Evaluate the feasibility of non-invasive detection of PTEN and its downstream genes in serum exosomes of glioma patients.

Materials and methods:
PTEN, Yes-associated-protein 1 (YAP1), and lysyl oxidase (LOX) transcript expression were monitored through polymerase chain reaction (PCR) in serum exosomes and their paired tumor tissues. The impact of PTEN and its axis genes expression on the overall survival (OS) was monitored.

Results:
Out of the 106 glioma serum samples evaluated, PTEN was retained/lost in 65.4%/34.6% of the tumor samples while it was retained/lost in 67.1%/32.9% of their paired exosomal fractions. PTEN expression in both tissue and paired exosomal fractions was observed in 48.11% of the samples. Sanger sequencing detected three mutations (Chr10: 89720791(A>G), Chr10:89720749(C>T), and Chr10:89720850(A>G). Both PTEN-responsive downstream genes (YAP1) and LOX axis were upregulated in the PTEN-deficient samples. PTEN loss was associated with poor survival in the glioma patients (hazard ratio (HR) 0.68, confidence interval (CI): 0.35–1.31, P = 0.28). The OS of the exosomal PTEN cohort coincided with the tumor-tissue PTEN devoid group (HR 1.08, CI: 0.49–2.36, P = 0.85). While, old age yielded the worst prognosis; gender, location, and grade were not prognostic of OS in the multivariate analysis.

Conclusions:
PTEN and its responsive genes YAP1 and LOX can be detected in serum exosomes and can serve as essential tools for the non-invasive evaluation/identification of aggressive gliomas.
Impact of Stellate Ganglion Block in the Management of Cerebral Vasospasm
Authors: Samagh Navneh , Panda Nidhi B. , Gupta Vivek , Bharti Neerja , Tripathi Manjul , Bhagat Hemant , Chhabra Rajesh K. , Jangra Kiran , Luthra Ankur 
Published: February 2024

Background:Stellate ganglion block (SGB) causes blockage of sympathetic nerve activity, which may lead to intracerebral vessel dilatation and relieve cerebral vasospasm in patients of aneurysmal subarachnoid hemorrhage (aSAH).Objective:The aim of this study was to evaluate the efficacy and safety of SGB to relieve cerebral vasospasm on clinicoradiological parameters.Materials and Methods:We prospectively included 20 patients with clinical and angiographic evidence of vasospasm post aneurysmal clipping. Cerebral blood flow velocity and Lindegaard ratio were assessed using transcranial Doppler (TCD). Location of vasospasm, vessel diameter, vasospasm severity, parenchymal filling time, and venous sinus filling time were assessed on digital subtraction angiography (DSA). Patients received ultrasound-guided SGB with 10 mL of 0.5% bupivacaine on the ipsilateral side of the vasospasm. After 30 minutes, the neurological status, TCD, and DSA parameters were reevaluated.Results:After SGB, there was statistically significant reduction in the middle cerebral artery (MCA) peak systolic velocity (P= 0.005), mean flow velocity (P= 0.025), and Lindegaard ratio (P= 0.022) on TCD. We observed significant dilatation in the mean vessel diameter measured at the mid-M1 segment of MCA (P= 0.003) and mid-A1 segment of ACA (P= 0.002) on DSA. The mean parenchymal filling time and mean venous sinus filling time decreased nonsignificantly after SGB (P= 0.163/0.104). Neurological improvement was observed in five (25%) patients.Conclusion:SGB has positive clinicoradiological influence in the management of cerebral vasospasm of large vessels. However, its effect on cerebral microvasculature is limited and needs a larger database for further analysis.
Strategies for humanizing technology in health profession education
Authors: Yusoff Muhamad Saiful Bahri 
Published: February 2024

ABSTRACT
Technology is rapidly advancing and becoming increasingly critical in the health profession education. Therefore, it is crucial to prioritize the humanization of its implementation to provide students with a personalized, meaningful, and supportive learning experience. Various strategies can be employed to achieve this goal, including humanizing learning institutions, leveraging the urbanization of higher education, revitalizing educational ecosystems, and preparing health-care learners for a changing world. In addition, it is essential to understand the needs of students, use technology as a complementary tool, foster a sense of community, provide training and support, and consider accessibility to ensure the equitable and effective implementation of these strategies. By collaboratively working to humanize technology in health profession education, we can provide students with the education they deserve to excel in their careers.
Polytetrafluoroethylene Infection-related Sepsis in Liver Transplant Recipients
Authors: Jothimani Dinesh , Devarajan Vidya , Kumar Sweatha , Sampath Santhosh , Rela Mohamed 
Published: February 2024

Abstract
Synthetic vascular grafts are commonly used in liver transplantation. Polytetrafluoroethylene (PTFE) grafts should be monitored for infectious complications that require percutaneous drainage or graft removal. Herein, we report three cases of PTFE graft infection in living-donor liver transplant recipients. Two of the three patients presented with bacteremia and one of the patients had culture-negative sepsis, and fluorodeoxyglucose-positron emission tomography/computed tomography in all three cases suggested synthetic vascular graft infection with thrombosis. Two of the three patients developed PTFE graft infection with thrombosis within 1–4 months of transplantation, and the third patient developed it 9 months posttransplantation. Timely detection of infection and appropriate antibiotic therapy preserved the graft function. When unexplained bacteremia or persistent fever occurs in patients with liver transplants, prosthetic material should be considered as a focus, and appropriate imaging, culture, and antibiotic therapy will help in preserving graft function. Although the gold standard treatment is the removal of infected tissue, our patients did remarkably well with conservative management.
Clinical Problem Solving: A Case of Complicated Staphylococcal Infection
Authors: Bende Tejas , Rao Vineet , Deore Tushar , Bhalerao Suryabhan , Joe Geethu , Shaha Kunal , Soman Rajeev 
Published: February 2024

Abstract
A 61-year-old male with diabetes mellitus and cervical spondylosis presented with severe neck pain and fever. Magnetic resonance imaging spine showed prevertebral abscess and spondylodiscitis. Blood culture done elsewhere grew Staphylococcus aureus. On further evaluation, Positron emission tomography-computed tomography showed prevertebral collection with air foci within. Differential diagnosis based on possible clinical scenarios is discussed in the case. This case report highlights the importance of accurate identification of susceptibility of Staphylococcal aureus, off label use of joint infection multiplex polymerase chain reaction, targeted antibiotic therapy, timely surgical intervention, and de-escalation to oral therapy.
Comparative evaluation of antimicrobial efficacy of triple antibiotic paste and amoxicillin clavulanate paste as an intracanal medicament against Enterococcus faecalis: An in vitro study
Authors: Sasikala Dhandayuthapani , Baghkomeh Parisa Norouzi , Farzan Jamaluddin Mohammed 
Published: February 2024

Background:
Triple antibiotic paste (TAP) is the commonly used intracanal medicament against Enterococcus
faecalis. Amoxicillin clavulanate paste (ACP) is recommended as a “fall-back” antibiotic when traditional dental antibiotics fail. Literature comparing the antimicrobial efficacy of TAP and ACP in eradicating E.
faecalis from the root canal system is sparse; hence, this in vitro study was conducted to evaluate and compare the antimicrobial efficacy of TAP and ACP as an intracanal medicament for endodontic treatment of single-rooted permanent teeth against E.
faecalis.

Materials and Methods:
This in
vitro, experimental study evaluated 60 root samples obtained from extracted single-rooted human permanent teeth. The canal diameter was enlarged and subsequently infected with E.
faecalis for 21 days. Four groups of the contaminated samples were treated with TAP, ACP, calcium hydroxide (positive control), and saline (negative control), respectively. Dentinal shavings were collected at the end of the 1st, 7th, and 10th day and inoculated in agar plates. The number of colony-forming units was determined, and the data were statistically analyzed using the Kolmogorov–Smirnov and Shapiro–Wilks test. P <0.05 was considered statistically significant.

Results:
The mean number of E.
faecalis colony counts across all 3 test days demonstrated that TAP exhibited the highest inhibition of bacterial growth, followed by ACP which is not statistically significant (P = 1.00).

Conclusion:
Considering the limitations of this in vitro study, the findings suggest that ACP could be an effective alternative intracanal medicament to TAP for endodontic therapy.
Evaluation of apical transportation and centering ability of three single-file systems in severely curved canals using micro-computed tomography
Authors: Hasheminia Seyed Mohsen , Soltani Samaneh , Mohamadian Fateme , Saatchi Masoud , Sadeghi Seyed Mohsen 
Published: February 2024

Background:
This study aimed to compare the apical transportation and centering ability of One Curve, HyFlex EDM, and EdgeFile X1 in curved mesiobuccal and mesiolingual canals of mandibular first molars.

Materials and Methods:
In this in vitro experimental study, 60 mesiobuccal and mesiolingual canals of the mandibular first molars with a minimum length of 19 mm and 25°–40° curvature were randomly divided into three groups (n = 20) for root canal preparation with One Curve, HyFlex EDM, and EdgeFile X1. After access cavity preparation and confirming the glide path, the baseline micro-computed tomography (micro-CT) scans were obtained, and the root canals were instrumented with the respective systems according to the manufacturers’ instructions. Apical transportation and centering ability were assessed at 1, 3, 5, and 7 mm from the apex by comparing pre- and postinstrumentation micro-CT scans. One-way ANOVA, independent t-test, and Duncan's post hoc test were used to statistically compare the groups, and data were analyzed by SPSS version 24 (alpha = 0.05).

Results:
The three groups were not significantly different regarding apical transportation at 5 and 7 mm from the apex (P > 0.05). At 1 mm level, One Curve caused significantly lower apical transportation; while, at 3 mm level, HyFlex EDM resulted in significantly higher apical transportation (P < 0.05). No significant difference was noted in the centering ability of the three groups at 1, 3, and 5 mm from the apex (P > 0.05). At 7 mm level, EdgeFile X1 showed significantly lower centering ability (P < 0.05).

Conclusion:
One Curve caused lower canal transportation in the apical third compared with EdgeFile and HyFlex EDM, but no significant difference was noted among the three in the coronal third of the roots.
Comparison of coronal sealing of flowable composite, resin-modified glass ionomer, and mineral trioxide aggregate in endodontically treated teeth: An in-vitro study
Authors: Tavakoli Mahla , Araghi Solmaz , Fathi Amirhossein , Jalalian Shahriar 
Published: February 2024

Background:
Coronal seal is one of the essential factors that affects the success of endodontic treatment and reinforces the apical seal. The intra-orifice barrier is an efficient alternative approach to decrease coronal leakage in endodontically treated teeth and various materials have been used for this purpose. This study aimed to compare the coronal sealing of flowable composite, resin-modified glass ionomer (RMGI), and mineral trioxide aggregate (MTA) in endodontically treated teeth.

Materials and Methods:
In this in vitro study, 35 single-canal canine teeth were divided into five groups, including flowable composite, RMGI, MTA, positive control, and negative control groups. The teeth were filled with restorative materials according to the factory's instructions. Afterward, the samples were immersed in 2% methylene blue dye solution for 1 week at 37°C and 100% humidity condition. Finally, the teeth were sectioned longitudinally and dye penetration was measured using a stereomicroscope with ×10. Data were analyzed with Kolmogorov–Smirnov and Kruskal–Wallis tests (α = 0.05).

Results:
The positive control group showed the highest amount of dye penetration compared to other groups (12.34 ± 0.46). Dye penetration in the MTA group was significantly lower (4.25 ± 0.31) compared to the RMGI group (5.94 ± 0.24) (P = 0.02). Moreover, while the dye penetration in the MTA group was lower than in the flowable composite group (5.65 ± 0.26), the difference was not statistically significant (P = 0.12).

Conclusion:
MTA reduces the coronal leakage and provides an acceptable coronal seal in endodontically treated teeth, especially compared to RMGI, and therefore, using MTA as an intra-orifice barrier increases the endodontic treatment success rate.
Comparison of intelligent development (IQ & EQ) of children with cleft lip and palate
Authors: Maryan Rasool Esmaeili , Feizbakhsh Masood , Esmaeilian Zohreh , Sedaghati Golnoosh 
Published: February 2024

Background:
Attention to the issue of intelligence and its promotion in children with cleft lip and cleft palate (CL and CP) is necessary to reduce their injuries in life. This study aimed to determine the intelligence quotient (IQ) and emotional intelligence (EQ) in children with CL and CP in comparison to healthy children.

Materials and Methods:
In this descriptive study, 140 children, including 70 children with CL and CP, were selected from the Children treated in Craniofacial and Cleft Research Center, Spearman correlation, ANOVA and 70 healthy children were selected from the Pediatric Dentistry Department of Isfahan University, in the age range of 5–9 years. After obtaining the consent of the children's parents, the Raven IQ questionnaire and the Mayer and Salovey EQ questionnaire were given to the children. Data were analyzed by the Pearson correlation coefficient tests (α =0.05).

Results:
EQ score in healthy children was significantly higher than in children with CL and CP (P < 0.001). The percentage of IQ cognitive intelligence in healthy children and children with CL and CP was not significantly different (P = 0.641). In healthy children, no significant relationship was observed between cognitive intelligence IQ and EQ (r = 0.018, P = 0.882). However, among children with CL and CP, there was a significant inverse relationship between cognitive intelligence IQ and EQ (P < 0.001, r = −0.526).

Conclusion:
CL and CP have no effect on IQ in children, but it does affect EQ.
Direct immunofluorescence (DIF) versus immunohistochemical (IHC) staining of complements and immunoglobulins (Ig) in pemphigus group
Authors: Rana Deepika , Khurana Nita , Mandal Shramana , Sahoo Bijay Laxmi 
Published: February 2024

ABSTRACT

Introduction:
Pemphigus is a group of bullous disorders of the skin characterized by the formation of autoantibodies present in the intercellular junction of the epidermis. Diagnosis is made by clinical, histopathological examination, and DIF. As DIF needs frozen sections, fluorescent tagged antibodies, UV light microscope for examination, and trained personnel, its non-availability makes a definitive diagnosis challenging.

Aims and Objectives:
To evaluate the utility of IHC staining of complements and Ig in cases of Pemphigus.

Materials and Methods:
Twenty-six diagnosed cases of Pemphigus were stained by Peroxidase immunohistochemical method using monoclonal antibody to IgG, IgA, IgM, IgG4, C3, C4 d with DAB as chromogen. Pemphigus cases include twenty of pemphigus vulgaris (PV), four cases of pemphigus foliaceous (PF), and two of pemphigus vegetans (Pveg). Positivity was defined as the deposition of Ig and complements as distinct, continuous brown staining of keratinocytes at intercellular junctions.

Result:
On IHC total of 20 PV 17 showed positivity (85%) for IgG, 11 (55%) C4d, 19 (95%) C3d, and 16 (80%) IgG4 deposits at the intercellular junction of the epidermis. All cases of PF showed a deposit of IgG, with three (75%) cases for IgG4, C3d, and C4d. Both cases of Pveg showed positivity for IgG and C4d while one case was negative for IgG4 and C3d. The overall IgG, C3, IgG4, and C4d expression for pemphigus was seen in 88%, 88%, 76.9%, and 61.5% of cases. The relation between these markers, combination of IgG and C3, was best related to each other (P value = 0.80). The sensitivities for IgG, IgG4, and C3 were 77.8%%, 73%, and 73% resp.

Conclusion:
We conclude that IHC is a useful tool in the diagnosis of PV with the highest sensitivity of IgG and C3d. The combination of IgG and C3d could replace the DIF in almost all of our cases, so IHC on FFPE sections be used as an alternative method to DIF.
Preoperative evaluation of red blood cell distribution width as a promising biomarker for discriminating between benign and malignant breast tumors and assessing breast cancer activity
Authors: Thakur Ajay Singh , Indoria Chandrashekhar , Sahu Ruby , Kujur Pratima , Gahine Renuka 
Published: February 2024

ABSTRACT

Background:
The red cell distribution width (RDW) has been recognized as a new prognostic factor in various pathophysiological states including breast cancers. The aim of this study was to compare the RDW values between patients diagnosed with benign and malignant breast tumors and to evaluate the potential of elevated RDW as a biomarker for breast cancer activity.

Materials and Methods:
A cross-sectional study compared RDW values in age-matched cohorts diagnosed with benign and malignant breast lesions and correlated them with prognostic factors for malignant breast tumors. The study excluded individuals with inflammatory disorders, pre-neoplastic disease, hematological disorders, or those taking immunosuppressive or anti-inflammatory medications. The RDW values were measured using an automated hematology analyzer. The study’s statistical analysis was conducted using SPSS software at a significance level of 0.05.

Results:
RDW demonstrated a statistically significant elevation in the cohort of patients with malignant breast tumors, those with metastatic breast tumors, a greater number of infiltrated axillary lymph nodes, larger tumor diameter, and a higher grade of the primary tumor mass.

Conclusions:
The findings of this study suggest that RDW has the potential to serve as a biomarker for assessing breast cancer activity and could offer substantial advantages in clinical contexts. The present study is not without limitations, and the authors suggest that a larger multicenter prospective study be conducted to further validate it’s efficacy over an extended duration.
A rare case of neglected parasitic zoonosis
Authors: Noufal Amal , Mukundan Aiswarya , John Reena 
Published: February 2024

ABSTRACT
Infections caused due to zoonotic hookworms are rare and are often under reported. Here we report a case of diarrheal disease caused by Ancylostoma ceylanicum, an important emerging zoonotic hookworm. There is limited knowledge about the epidemiology and disease burden of A. ceylanicum infections in Kerala. A 50-year-old male patient presented with complaints of loose stools for past five weeks. The laboratory investigations revealed a high total WBC count and eosinophil count. Diagnostic colonoscopy showed numerous worms which were identified as A. ceylanicum. Timely diagnosis aided in successful treatment of the patient. Improvement in diagnostic tools and awareness enable accurate and early detection of this neglected but emerging pathogen.