bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy of transcutaneous electronic acupoint stimulation for improving postoperative recovery after gynecologic surgery: A systematic review and meta-analysis
Authors: Ge Yueping , Zheng Jianhong 
Published: September 2023

Background:
This systematic review and meta-analysis aimed to evaluate the efficacy of transcutaneous electronic acupoint stimulation (TEAS) for improving postoperative recovery after gynecologic surgery.

Methods:
We performed a thorough search of 6 databases until March 2023, identifying 12 randomized controlled trials that met our predefined inclusion criteria and encompassed a total of 1510 patients. For continuous outcomes, we calculated the weighted mean difference (WMD), and for binomial outcomes, we used the risk ratio (RR). We evaluated heterogeneity among the included studies using Cochran I
2 and Q statistics, utilizing a random-effects model when the I
2 value exceeded 50%. To assess publication bias, we employed Egger test.

Results:
Our analysis found that TEAS significantly reduced the risk of postoperative nausea (RR: 0.60, 95% CI: 0.43–0.83, P = .002) and postoperative vomiting (RR: 0.54, 95% CI: 0.43–0.67, P < .001), visual analogue scale (WMD: −0.47, 95% CI: −0.76 to −0.17, P = .002), as well as shortened the time to first bowel movement (WMD: −18.43, 95% CI: −20.87 to −15.99, P < .001) and time to first flatus (WMD: −8.98, 95% CI: −12.46 to −5.51, P < .001) compared to the conventional group.

Conclusions:
Our findings suggested that TEAS may improve postoperative recovery following gynecologic surgery. However, to confirm these results, larger randomized controlled trials encompassing a more diverse range of patient populations are urgently required.
The combined orthodontic and restorative treatment for patients with malocclusion and dentition defects: A randomized controlled trial
Authors: Shen Yan , Jiang Xiongying , Yu Jing 
Published: September 2023

Background:
To explore the effects of a combined orthodontic and restorative approach on chewing, swallowing, and language function in patients with malocclusion and dental defects.

Methods:
A total of 112 patients with malocclusion and dentition defects admitted to the Lianyungang Hospital of Traditional Chinese Medicine from June 2019 to June 2022 were prospectively selected. The patients were divided into study and control groups using a simple random number table method, with 56 patients in each group. The control group received routine restoration, whereas the study group received a combination of orthodontic and restorative treatments. The chewing function, swallowing and language function, and gingival periodontal condition before and after treatment in both groups were compared using t-test or Wilcoxon test, while treatment satisfaction were compared using chi-square test or Fisher exact test.

Results:
After treatment, maximum area frame bite force/max movie force in both groups increased compared to before treatment, while occlusion time, bite force distrbution balance, and standard deviation hue decreased compared to before treatment. Moreover, maximum area frame bite force/max movie force in the study group was higher than that in the control group, whereas occlusion time, bite force distrbution balance, and standard deviation hue were lower than those in the control group (P < .05). The swallowing and language function scores of the study group were higher than those of the control group (P < .05). After treatment, the bleeding index, plaque index, and probing depth of both groups decreased compared to before treatment, and the study group was lower than the control group (P < .05). The treatment satisfaction of the study group (94.64%) was higher than that of the control group (82.14%) (P < .05).

Conclusion:
Adopting a combined orthodontic and restorative approach to intervene in patients with malocclusion and dentition defects is beneficial for improving their periodontal condition, effectively restoring chewing, swallowing, and language functions, and achieving high patient satisfaction.
Gonococcal endocarditis in a 32-year-old male: a rare presentation of an underrecognized disease – case report
Authors: Abu-Hilal Lila H. , Njoum Yumna , Jabbarin Farah M. , Barghouthi Duha I. , Hamamdah Abdullah , Bourini Mohammad , Mtour Sameer 
Published: September 2023

Introduction and importance:
Disseminated gonococcal infection (DGI) is an infrequent but serious complication of gonorrhea that can exhibit atypical symptoms. While rare, it can lead to infective endocarditis (IE), a condition that affects the heart valves and can result in severe and potentially life-threatening outcomes.

Case presentation:
We present a case of Neisseria gonorrhoeae-caused IE confirmed by blood culture and direct isolation from the aortic valve vegetation. Our patient experienced complications, including glomerulonephritis, respiratory failure, and positive troponin. Urgent surgery successfully removed a large vegetation, replaced the aortic valve, and improved cardiac function. Follow-up showed symptom resolution.

Clinical discussion:
DGI can present atypically with a triad of tenosynovitis, polyarthralgia, and rash, even without genitourinary symptoms. However, it can also present with nonspecific symptoms, leading to a later diagnosis of IE, as observed in our patient, who developed an aortic valve abscess and aortic regurgitation.

Conclusion:
This case provides important insights into the diagnosis and management of gonococcal endocarditis, emphasizing the significance of early recognition, timely intervention, and multidisciplinary collaboration in improving patient outcomes. It is imperative to have a high level of suspicion for this rare entity, given its high virulence and potential for severe complications.
A massive primary hydatid splenic cyst was successfully managed through open total splenectomy: a case report and review article
Authors: Mansour Marah , Nassar Kinan , Masri Mahmod , Kanas Mahmoud , Aldrea Fatima , Alzaylaa Yara , Salloum Hayan , Ahmad Youssef , Samha Raghad , Kanjawi Omar 
Published: September 2023

Background:
Cystic echinococcosis (CE) is a parasitic infection that is caused by the tapeworm Echinococcus granulosus. CE is very common, especially in the rural areas of developing countries. The most commonly affected organs by hydatid cysts are the liver and the lungs. However, the primary splenic hydatid cyst (PSHC) is a very rare manifestation of CE with an incidence of 0.5–8%.

Case presentation:
A 17-year-old female patient presented with abdominal pain which gradually increased over months, along with anorexia and vomiting. Computerized tomography showed a massive splenic cystic mass. An open total splenectomy was performed. By follow-up, the platelet count and a postoperative chest X-ray were normal. The patient was prescribed Albendazole and analgesics. The pathological study confirmed the diagnosis of PSHC.

Conclusion:
Despite the occurrence of PSHC being very rare, it is very important to take it into consideration, especially in endemic areas.
Median nerve schwannoma with a diagnostic delay of 8 years: a case report
Authors: Neupane Durga , Dahal Alok , Lageju Nimesh , Jaiswal Lokesh S. , Mahat Asim , Kafle Sujan , Poudel Prabhat , Pandit Narendra , Singh Surjan K. , Ghimire Sagun , Dhonju Kiran 
Published: September 2023

Introduction:
Schwannomas are benign tumors of the peripheral nerve sheath, and the median nerve is the most commonly involved nerve. These benign tumors of the peripheral nerve sheath are very rare; they are clinically and radiologically similar to most other benign swellings of the hand; thus, they are often misdiagnosed.

Case Presentation:
A 41-year-old lady presented with an 8-year-long history of swelling over the distal forearm. The tumor measured 3.5×3.5×3.5 mm and was located over the flexor aspect of the distal part of her right forearm. Schwannoma was suspected from the clinical presentation and imaging, but the final diagnosis was established only after the surgery and histopathological analysis. At the follow-up after 1 year, the patient is doing well and her symptoms have not recurred.

Conclusion:
Imaging characteristics of schwannoma can be misinterpreted as some other condition, making the preoperative diagnosis very difficult and important. Thus, clinicians should be aware of such swellings, especially those that have been unnoticed or misdiagnosed, and provide optimal diagnoses to confer good outcomes.
Dynamic Susceptibility Contrast-Enhanced Perfusion-Weighted Imaging in Differentiation Between Recurrence and Pseudoprogression in High-Grade Glioma: A Meta-analysis
Authors: Gu Xindong , He Xining , Wang Hualong , Li Jianhua , Chen Ruwei , Liu Hongen 
Published: September 2023

Introduction
In glioma patients that have undergone surgical tumor resection, the ability to reliably distinguish between pseudoprogression (PsP) and a recurrent tumor (RT) is of key clinical importance. Accordingly, this meta-analysis evaluated the utility of dynamic susceptibility contrast-enhanced perfusion-weighted imaging as a means of distinguishing between PsP and RT when analyzing patients with high-grade glioma.

Materials and Methods
The PubMed, Web of Science, and Wanfang databases were searched for relevant studies. Pooled analyses of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) values were conducted, after which the area under the curve (AUC) for summary receiver operating characteristic curves was computed.

Results
This meta-analysis ultimately included 21 studies enrolling 879 patients with 888 lesions. Cerebral blood volume–associated diagnostic results were reported in 20 of the analyzed studies, and the respective pooled sensitivity, specificity, PLR, and NLR values were 86% (95% confidence interval [CI], 0.81–0.89), 83% (95% CI, 0.77–0.87), 4.94 (95% CI, 3.61–6.75), and 0.18 (95% CI, 0.13–0.23) for these 20 studies. The corresponding AUC value was 0.91 (95% CI, 0.88–0.93), and the publication bias risk was low (P = 0.976). Cerebral blood flow–related diagnostic results were additionally reported in 6 of the analyzed studies, with respective pooled sensitivity, specificity, PLR, and NLR values of 85% (95% CI, 0.78–0.90), 85% (95% CI, 0.76–0.91), 5.54 (95% CI, 3.40–9.01), and 0.18 (95% CI, 0.12–0.26). The corresponding AUC value was 0.92 (95% CI, 0.89–0.94), and the publication bias risk was low (P = 0.373).

Conclusions
The present meta-analysis results suggest that dynamic susceptibility contrast-enhanced perfusion-weighted imaging represents an effective diagnostic approach to distinguishing between PsP and RT in high-grade glioma patients.
Effects of Specific Protective Resources on the Burnout Levels of Selected Visayan Medical Students from Online-Based Education during COVID-19 Pandemic: A Cross-Sectional Study
Authors: Arpilleda Jordan Joy , Bunal Julia Patricia , Rose Montano Margaret Therese , Torrenueva Lesly Marie , Acebes Ma. Jobelle , Homecillo Margaret Angeli , Salvador Juan Paolo , Tan Frances Gabrielle , Villanueva Zackaree Michael 
Published: September 2023

ABSTRACTBackgroundBurnout is a phenomenon characterized as a consistent state of being exhausted physically, mentally, and emotionally. Grit, tolerance for ambiguity, religiosity, and social support are protective factors that may mitigate burnout and improve life satisfaction. This study assessed the association between specific protective resources of students from a medical school in Visayas at all year levels with online-based education-related burnout during the COVID-19 pandemic.MethodsA total of 234 medical students from a medical school in Visayas during the academic year 2020-2021 were sampled using stratified random sampling technique. Demographics were obtained. Specific protective resources of grit, religiosity, social support and tolerance for ambiguity, and burnout symptoms were measured using validated online questionnaires. Protective associations of specific resources on burnout levels were assessed using multivariate logistic regression analysis. Predictive capabilities of resources with statistically significant protective effects were summarized using Receiving Operating Characteristic (ROC) curve.ResultsAll year levels experienced burnout based on Maslach Burnout Inventory-Student Survey (MBI-SS) subscales, with PBL 2 having the highest incidence comprising 33 respondents (49%). Majority of the students experienced moderate burnout on emotional exhaustion (44%) and low burnout on depersonalization (58%), while all of them had high burnout levels on the subscale of personal accomplishment (100%). Most students were moderately gritty (91%) and had high tolerance for ambiguity (98%), overall religiosity index (82%), and social support from significant others (68%); family (68%); and friends (76%). Grit, religiosity and social support had positive significant correlations and reductive effects to burnout. Tolerance for ambiguity did not show any significant relationship with burnout. Grit, religiosity and social support are good predictors of burnout. Grit had good diagnostic accuracy and discrimination. Religiosity and social support were moderately accurate predictors of burnout.ConclusionsGrit, religiosity and social support are significantly protective on burnout levels of medical students from online-based education during the COVID-19 pandemic.
Pilot Clinical Validation of a Machine Learning Platform for Noninvasive Smartphone-Based Assessment of Corneal Epithelial Integrity
Authors: Zhang Andrew Y. , Pratap Jayanth S. , Young James R. , Lui Joshua , Attari Kian , Srivastava Arnav A. , Wu Erica R. , Moreno Aracely D. , Miall Annie , Iyer Jay M. , Mantena Sreekar , Chandra Jay , Joshi Vineet P. , Jacobs Deborah S. 
Published: September 2023

ABSTRACTPurposeFluorescein staining (FS) is a standard method of assessing corneal epithelium (CE) integrity. However, the equipment and personnel required for FS may be unavailable in low-resource environments. We developed and validated a low-cost, noninvasive, and quantitative CE evaluation pipeline using a custom smartphone attachment and convolutional neural networks (CNNs).MethodsA 3D-printed smartphone attachment and placido disk illumination module was attached to a OnePlus 7 Pro smartphone. 26 smartphone-acquired images were obtained from 15 subjects, comprising a dataset including healthy eyes and corneal epitheliopathies of Oxford grade I-V. A classifier CNN was trained on 8 subjects (23,173 image patches) to identify areas of suspected epithelial disruption, and validated on 7 subjects (10,883 image patches). The fraction of disrupted corneal surface area (FDSA) was computed for each subject from the model output. Results were compared with FS slit lamp photos which were independently graded by two clinicians using the Oxford scheme.ResultsFDSA showed promise as a non-invasive marker of CE integrity, with mean FDSA in the Oxford >II cohort being higher than the Oxford ≤II cohort (p = 0.04andp = 0.09using Oxford scores from each clinician, respectively). Additionally, areas of CE disruption identified by our smartphone-based technique showed qualitative concordance with those revealed by FS.ConclusionsOur technique for smartphone-based CE imaging and automated analysis is a promising low-cost, noninvasive method to quantitatively evaluate the CE.Translational RelevanceThis tool can be used to evaluate ocular surface disease in low-resource regions.
Perspectives of Researchers and Clinicians on Patient and Public Involvement (PPI) in Preclinical Spinal Cord Research: An Interview Study
Authors: Carroll Pádraig , Dervan Adrian , McCarthy Ciarán , Beirne Cliff , Harte Geoff , O’Flynn Dónal , Quinlan John , Smith Éimear , Moriarty Frank , O’Brien Fergal J. , Flood Michelle 
Published: September 2023

AbstractStudy DesignQualitative studyObjectiveTo explore the perspectives of preclinical spinal cord researchers and clinicians involved in the treatment of spinal cord injury on patient and public involvement (PPI) in preclinical research.SettingPreclinical spinal cord injury research.MethodsSemi-structured interviews were conducted online to collect data that was analysed thematically.FindingsTwenty-two participants (11 clinicians and 11 preclinical researchers) were interviewed. Participants recognised the value of PPI in improving the relevance of preclinical spinal cord research and providing a source of motivation for lab-based research. The perceived distance between preclinical research and the day-to-day experiences of PPI contributors was identified as a major barrier. Inclusive practices and the highly networked and motivated community of people affected by spinal cord injury were noted as facilitators. Building strong partnerships was considered essential for successful PPI.ConclusionsWhile PPI has traditionally been more commonly associated with clinical research, participants identified the potential benefits of PPI in preclinical spinal cord research to provide context and improve research relevance and impact. Preclinical researchers should explore how PPI can be incorporated in their work.
Effectiveness of ReCOVery APP to improve the quality of life of Long COVID patients: a 6-month follow-up randomized clinical trial
Authors: Samper-Pardo Mario , Oliván-Blázquez Bárbara , León-Herrera Sandra , Sánchez-Arizcuren Rafael , Casado-Vicente Verónica , Sánchez-Recio Raquel 
Published: September 2023

ABSTRACTThe main objective of this study is to analyse the clinical efficacy of medium-term telerehabilitation in the recovery of patients with Long COVID using ReCOVery APP, administered in the Primary Health Care (PHC) setting. The second objective is to identify significant patterns associated with an improvement in their quality of life predicted by other study variables. To this end, a randomised clinical trial was conducted with two parallel groups of a total of 100 patients with Long COVID. The control group continued with their usual treatment (TAU), established by their primary care physician. The intervention group, in addition to continuing with their TAU, attended three sessions based on motivational methodology and used ReCOVery APP for six months. The main variable was quality of life. The results of this study concluded that ReCOVery APP was not significantly more effective in improving the quality of life of patients with Long COVID. There was low adherence of participants. However, linear regression analyses revealed significant patterns of improvement in overall quality of life and mental health predicted by time of use of the APP and the personal construct of self-efficacy. In addition, all participants significantly improved their physical and mental health over the duration of the intervention. In conclusion, meaningful use of the ReCOVery APP may contribute to improving the quality of life of patients with Long COVID, but strategies to improve adherence need to be encouraged.Trial Registration NoISRCTN91104012.
Human hippocampal ripples tune cortical responses in uncertain visual contexts
Authors: Frank Darya , Moratti Stephan , Sarnthein Johannes , Li Ningfei , Horn Andreas , Imbach Lukas , Stieglitz Lennart , Gil-Nagel Antonio , Toledano Rafael , Friston Karl J. , Strange Bryan A. 
Published: September 2023

AbstractTo be able to encode information efficiently, our perceptual system should detect when situations are unpredictable (i.e., informative), and modulate brain dynamics to prepare for encoding. Here we show, with direct recordings from the human hippocampus and visual cortex, that after exposure to unpredictable visual stimulus streams, hippocampal ripple activity increases in frequency and duration prior to stimulus presentation, indicating context and experience-dependent prediction of predictability. Pre-stimulus hippocampal ripples suppress changes in visual (occipital) cortex gamma activity associated with uncertainty, and modulate post-stimulus prediction error gamma responses in higher-level visual (fusiform) cortex to surprising (i.e., unpredicted) stimuli. These results link hippocampal ripples with predictive coding accounts of neuronal message passing—and precision-weighted prediction errors—revealing a mechanism relevant for perceptual synthesis and subsequent memory encoding.
Circulating PACAP levels are associated with altered imaging measures of entorhinal cortex neurite density in posttraumatic stress disorder
Authors: Granger Steven J , May Victor , Hammack Sayamwong E , Akman Eylül , Jobson Sydney A. , Olson Elizabeth A , Pernia Cameron D , Daskalakis Nikos P , Ravichandran Caitlin , Carlezon William A , Ressler Kerry J , Rauch Scott L , Rosso Isabelle M 
Published: September 2023

AbstractBackgroundPituitary adenylate cyclase-activating polypeptide (PACAP) regulates plasticity in brain systems underlying arousal and memory and is associated with posttraumatic stress disorder (PTSD). Research in animal models suggests that PACAP modulates entorhinal cortex (EC) input to the hippocampus, contributing to impaired contextual fear conditioning. In PTSD, PACAP is associated with higher activity of the amygdala to threat stimuli and lower functional connectivity of the amygdala and hippocampus. However, PACAP-affiliated structural alterations of these regions have not been reported. Here, we examined whether peripheral PACAP levels were associated with neuronal morphology of the amygdala and hippocampus (primary analysis), and EC (secondary analysis) using Neurite Orientation Dispersion and Density Imaging.MethodsSixty-four (44 female) adults (19 to 54 years old) with DSM-5 Criterion A trauma exposure completed the Clinician-Administered PTSD Scale (CAPS-5), a blood draw, and magnetic resonance imaging. PACAP38 radioimmunoassay was performed and T1-weighted and multi-shell diffusion- weighted images were acquired. Neurite Density Index (NDI) and Orientation Dispersion Index (ODI) were quantified in the amygdala, hippocampus, and EC. CAPS-5 total score and anxious arousal score were used to test for clinical associations with brain structure.ResultsHigher PACAP levels in blood were associated with greater EC NDI (β=0.31, q=0.034) and lower EC ODI (β=-0.30, q=0.042) and not hippocampal or amygdala measures. Neither EC NDI nor ODI was associated with clinical measures.ConclusionsCirculating PACAP levels were associated with altered neuronal density of the EC but not hippocampus or amygdala. These findings strengthen evidence that PACAP may impact arousal- associated memory circuits.