bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic dilemma in a patient with history of medullary thyroid carcinoma and abnormal serum liver enzymes; a case report with six years follow up
Authors: Rahmani Fatemeh , Tohidi Maryam , Azmoudeh-Ardalan Farid , Sadeghi Amir , Hadaegh Farzad 
Published: August 2023

Abstract
Background
Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor that originates from parafollicular C-cells. Calcitonin (Ctn) and carcinoembryonic antigen (CEA) are useful biomarkers for monitoring MTC cases.

Case presentation
Here, we describe a 48-year-old woman, who presented in 2014 with bilateral thyroid nodules. Report of fine needle aspiration was suspicious for MTC; initial laboratory evaluation showed serum Ctn level of 1567 pg/mL. After excluding type 2 multiple endocrine neoplasia syndrome clinically, total thyroidectomy and neck lymph node dissection were performed. The final histopathological diagnosis was right lobe MTC with neither vascular invasion nor lymph node involvement. On regular follow-up visits, Ctn and CEA levels have been undetectable, and repeated cervical ultrasonographic exams were unremarkable from 2014 to 2021. As liver enzymes became elevated in 2016, the patient was further evaluated by a gastroenterologist. Abdominopelvic ultrasonography revealed a coarse echo pattern of the liver parenchyma with normal bile ducts. A liver fibroscan showed a low fibrosis score (7kPa). The patient was recommended to use ursodeoxycholic acid. According to the progressive rise of liver enzymes with a cholestatic pattern in October 2020, a liver biopsy was performed that showed tiny nests of neuroendocrine-like cells with a background of primary biliary cholangitis (PBC). Immunohistochemical stainings were positive for chromogranin A (CgA), and synaptophysin and negative for Ctn, CEA, and thyroglobulin. Further imaging investigations did not reveal any site of a neuroendocrine tumor in the body. Considering normal physical exam, imaging findings, as well as normal serum levels of Ctn, CEA, CgA, and procalcitonin, the patient was managed as a PBC.

Conclusion
In follow-up of a patient with MTC, we reported progressively increased liver enzymes with a cholestatic pattern. Liver biopsy revealed nests of neuroendocrine-like cells with a background of PBC, the findings that might suggest acquiring neuroendocrine phenotype by proliferating cholangiocytes.
Evaluation of the masking ability, marginal adaptation, and fracture resistance of screw-retained lithium disilicate implant-supported crowns cemented to titanium bases versus preparable abutments
Authors: Kordi Ahmad Waled Mohamad , Salman Abdallah Ibrahim , Metwally Nayrouz Adel , Khamis Mohamed Moataz 
Published: August 2023

Abstract
Background
Straight preparable abutments and titanium bases (ti-base) can be used to support single-unit screw-retained lithium disilicate implant-supported restorations. The choice between using both abutments depends on many factors. The purpose of this in vitro study was to compare the masking ability, marginal adaptation, and fracture resistance of screw-retained lithium disilicate implant-supported crowns cemented to straight preparable abutments and ti-bases.

Methods
Twenty laboratory implant analogs (Straumann Bone Level; Straumann AG) were randomly divided into 2 groups (n = 10 each) according to the type of the abutment used. Preparable abutment group and ti-base group. Lithium disilicate crowns were used to restore the specimens. All specimens were subjected to thermocycling (from 5 to 55 °C for 2000 cycles) followed by cyclic loading (120 000 cycles). The vertical marginal gap between the abutment finish line and the most apical part of the crown was measured in (µm) by using a stereomicroscope after cementation and after thermocycling and cyclic loading. A spectrophotometer was used to evaluate the masking ability of the specimens after cementation. The load required to fracture the crowns was measured in Newtons (N) by using a universal testing machine after thermocycling and cyclic loading. The Shapiro-Wilk test of normality was used. The appropriate statistical test was used.

Results
Regarding the masking ability, the color difference (∆E) showed no statistically significant difference between the ti-base group (2.6 ± 0.2) and the preparable abutment group (2.6 ± 0.3) (P = .888). The average of the microgap values (µm) was greater in ti-basegroup after cementation (13.9 ± 9.2) than preparable group (7.63 ± 1.78) with no statistically significant difference between the 2 groups (P = .49). After cyclic loading and thermocycling, the average microgap values (µm) was significantly greater in the ti base group (21.3 ± 7.4) than in preparable group (13.3 ± 1.5) (P = .02). The load required to fracture the specimens was greater in the preparable group (1671.5 ± 143.8) than in the ti-base group (1550.2 ± 157.5) with no statistically significant difference between the 2 groups (P = .089).

Conclusion
The abutments used in the present study did not compromise the masking ability of the screw-retained lithium disilicate implant supported crowns. Moreover, the crowns cemented to preparable abutments had better marginal adaptation and higher fracture resistance when compared to those cemented to ti-bases.

Clinical implications
Straight preparable abutments are considered as an alternative to the ti-bases when restoring single screw-retained lithium disilicate implant-supported crowns with comparable fracture resistance, marginal adaptation, and masking ability.
Assessing the thyroid autoimmunity association with recurrent aphthous stomatitis
Authors: Karimi Fariba , Lavaee Fatemeh , Nematollahi Aida , Sahmeddini Sarina 
Published: August 2023

Abstract
Background
Recent investigations have highlighted autoimmune origins and abnormal immune responses; particularly those related to T cell-mediated immunity and elevated T lymphocyte cells in the oral mucosa. Therefore, we investigated the relationship between recurrent aphthous stomatitis (RAS) and autoimmune thyroid diseases (ATDs) in an Iranian population.

Methods
A cross-sectional study was performed on 102 patients diagnosed with ATD (cases) and 102 healthy patients (controls) who had been referred for the routine dental treatment. All participants were asked for the history of RAS and their age, gender, other systemic diseases, medications, and frequency of RAS in a year. Matching was performed based on the propensity scores for age and sex. In addition, the number of lesions in each recurrence in both groups was assessed and compared. The type of thyroid disease has been assessed for case participants and has been confirmed by the endocrinologist. The chi-square test, t-test, and Mann-Whitney U test were used to analyze the data using SPSS 18.

Results
Patients with ATD had higher RAS than healthy controls (P = 0.040). ATD patients had 1.93 times more risk for RAS, and the frequency of RAS in a year was 3.15times higher in these patients (P = 0.011). Moreover, the frequency of RAS was higher in patients with hypothyroidism than in those with hyperthyroidism. However, there were no significant differences in the size and the number of lesions between the groups.

Conclusion
The risk and frequency of RAS were significantly higher in patients with ATDs. This would provide valuable insights into the underlying mechanisms and potential treatment strategies for both conditions.
Berberine improves inhibitory avoidance memory impairment of Toxoplasma gondii-infected rat model of ketamine-induced schizophrenia
Authors: Gholizadeh Neghin , Dalimi Abdolhossein , Ghaffarifar Fatemeh , Nader-Mohammadi Mehryar , Molavi Parviz , Dadkhah Masoomeh , Molaei Soheila 
Published: August 2023

Abstract
Background
Memory impairment caused by Toxoplasma gondii infection has been documented. Berberine (BRB) is well known for its enhancing effects on memory and has shown promising results. However, the impact of BRB on T. gondii infection and schizophrenia-induced consolidation and reconsolidation memory impairment is still unclear. Here; we examined the effect of BRB on the inhibitory avoidance (IA) memory consolidation and reconsolidation impairment induced by T. gondii infection, and ketamine (Ket) as a pharmacological model of schizophrenia. Also; the brain-derived neurotrophic factor (BDNF) levels in the medial prefrontal cortex (mPFC) and hippocampus were analyzed.

Methods
Rats were infected with T. gondii RH strain or received Ket (30 mg/kg/day) intraperitoneally (i.p) for at least five consecutive days (as the model of schizophrenia). Then followed by oral administration with BRB (25 mg/kg/day) for five days. Finally, the IA memory retention test was examined 48 post-conditioning, and BDNF was measured.

Results
Results indicated IA memory impairment in T. gondii-infected animals since lower step-through latency (STL) was observed than in control animals. We found significant (P = 0.01, P = 0.001) elevations in STL and a significant decrease (P = 0.001) in total time spent in the dark area following BRB administration in infected and Ket-treated rats, indicating improvement (increased STL) in consolidation and reconsolidation memory. Moreover, BDNF levels were reduced (P = 0.01) in the hippocampus and mPFC regions of both T. gondii- infected and Ket-induced groups, which remarkably enhanced after BRB treatment. Furthermore; we found that BRB administration notably increased the mPFC BDNF levels in mPFC (P < 0.01) and hippocampus (P = 0.001) in the Ket-treated and rats infected with T. gondii.

Conclusion
Taken together; BRB may be a valuable preclinical treatment for improving memory impairment through BDNF expression in PFC and hippocampus, therefore; BRB is suggested for memory disturbances induced by T. gondii infection.
Medical specialty certification exams studied according to the Ottawa Quality Criteria: a systematic review
Authors: Staudenmann Daniel , Waldner Noemi , Lörwald Andrea , Huwendiek Sören 
Published: August 2023

Abstract
Background
Medical specialty certification exams are high-stakes summative assessments used to determine which doctors have the necessary skills, knowledge, and attitudes to treat patients independently. Such exams are crucial for patient safety, candidates’ career progression and accountability to the public, yet vary significantly among medical specialties and countries. It is therefore of paramount importance that the quality of specialty certification exams is studied in the scientific literature.

Methods
In this systematic literature review we used the PICOS framework and searched for papers concerning medical specialty certification exams published in English between 2000 and 2020 in seven databases using a diverse set of search term variations. Papers were screened by two researchers independently and scored regarding their methodological quality and relevance to this review. Finally, they were categorized by country, medical specialty and the following seven Ottawa Criteria of good assessment: validity, reliability, equivalence, feasibility, acceptability, catalytic and educational effect.

Results
After removal of duplicates, 2852 papers were screened for inclusion, of which 66 met all relevant criteria. Over 43 different exams and more than 28 different specialties from 18 jurisdictions were studied. Around 77% of all eligible papers were based in English-speaking countries, with 55% of publications centered on just the UK and USA. General Practice was the most frequently studied specialty among certification exams with the UK General Practice exam having been particularly broadly analyzed. Papers received an average of 4.2/6 points on the quality score. Eligible studies analyzed 2.1/7 Ottawa Criteria on average, with the most frequently studied criteria being reliability, validity, and acceptability.

Conclusions
The present systematic review shows a growing number of studies analyzing medical specialty certification exams over time, encompassing a wider range of medical specialties, countries, and Ottawa Criteria. Due to their reliance on multiple assessment methods and data-points, aspects of programmatic assessment suggest a promising way forward in the development of medical specialty certification exams which fulfill all seven Ottawa Criteria. Further research is needed to confirm these results, particularly analyses of examinations held outside the Anglosphere as well as studies analyzing entire certification exams or comparing multiple examination methods.
Intervention of pharmacist included in multidisciplinary team to reduce adverse drug event: a qualitative systematic review
Authors: Zaij Sarah , Pereira Maia Kelly , Leguelinel-Blache Géraldine , Roux-Marson Clarisse , Kinowski Jean Marie , Richard Hélène 
Published: August 2023

Abstract
Background
Preventable harm in healthcare is a growing public health challenge. In addition to the economic costs of safety failures, adverse drug events (ADE) may lead to complication or even death. Multidisciplinary care team involving a pharmacist appears to be an adequate response to prevention of adverse drug event. This qualitative systematic review aims to identify and describe multidisciplinary planned team-based care involving at least one pharmacist to limit or prevent adverse drug events in the adult patients.

Methods
To determine the type of interprofessional collaboration to prevent adverse drug event in which a pharmacist was involved, we conducted a qualitative systematic review of the literature of randomized controlled trials. Two independent reviewers screened trials in three databases: Medline, Web of Science, ScienceDirect. Prospective studies of at least three different health professionals’ interventions, one of whom was a pharmacist in the last five years were included. Two reviewers performed data extraction and quality appraisal independently. We used TIDieR checklist to appraise articles quality.

Results
In total 803 citations were retrieved, 34 were analysed and 16 full-text articles were reviewed. Only 3 studies published an implementation evaluation. More than half of the interventions (62%) targeted elderly patients including 6 whom lived in nursing homes. Studies outcomes were heterogeneous, and we did not perform a statistical analysis of the impact of these interventions. Most teams are composed of a physician/pharmacist/nurse trio (94%; 100%; 88%). Half of the teams were composed of the primary care physician. Other professionals were included such as physical therapists (25%), social worker (19%), occupational therapists (12%), and community health educator (6%). Multidisciplinary medication review was the most common intervention and was generally structured in four steps: data collection and baseline assessment, appraisal report by health professionals, a multidisciplinary medication review meeting and a patient follow-up.

Conclusions
The most common multidisciplinary intervention to prevent ADE in the adult population is the multidisciplinary drug review meeting at least the physician/pharmacist/nurse trio. Interventions target mostly elderly people in nursing homes, although complex chronic patients could benefit from this type of assessment.

Trial registration
PROSPERO registration: CRD42022334685.
CAR-T cells targeting CD38 and LMP1 exhibit robust antitumour activity against NK/T cell lymphoma
Authors: Li Hongwen , Song Wenting , Wu Jiazhuo , Shi Zhuangzhuang , Gao Yuyang , Li Jiwei , Han Lijuan , Zhang Jianxiang , Li Zhaoming , Li Yong , Zhang Mingzhi 
Published: August 2023

Abstract
Background
Natural killer/T cell lymphoma (NKTCL) is an aggressive lymphoma with a poor prognosis. Chimeric antigen receptor-transduced T (CAR-T) cell therapy has become a promising immunotherapeutic strategy against haematologic malignancies.

Methods
In this study, four CAR-T cell lines (CD38-CAR, LMP1-CAR, CD38-LMP1 tandem CAR 1 and CD38-LMP1 tandem CAR 2) were generated. The effect of CAR-T cells against NKTCL cells was evaluated both in vitro and in vivo. Expression of T cell activation markers and cytokines produced by CAR-T cells were detected by flow cytometry.

Results
The four CAR-T cell lines could effectively eliminate malignant NKTCL cells. They could be activated and produce inflammatory cytokines in a target-dependent manner. In vivo tests showed that the CAR-T cells exhibited significant antitumour effects in a xenotransplanted NKTCL mouse model.

Conclusions
In summary, four CAR-T cell lines exhibited significant cytotoxicity against NKTCL cells both in vitro and in vivo. These results indicated the effective therapeutic promise of CD38 and LMP1 CAR-T cells in NKTCL.
Quantifying ventilation by X-ray velocimetry in healthy adults
Authors: Siddharthan Trishul , Grealis Kyle , Kirkness Jason P. , Ötvös Tamás , Stefanovski Darko , Tombleson Alex , Dalzell Molly , Gonzalez Ernesto , Nakrani Kinjal Bhatt , Wenger David , Lester Michael G. , Richmond Bradley W. , Fouras Andreas , Punjabi Naresh M. 
Published: August 2023

Abstract
Rationale
X-ray velocimetry (XV) has been utilized in preclinical models to assess lung motion and regional ventilation, though no studies have compared XV-derived physiologic parameters to measures derived through conventional means.

Objectives
To assess agreement between XV-analysis of fluoroscopic lung images and pitot tube flowmeter measures of ventilation.

Methods
XV- and pitot tube-derived ventilatory parameters were compared during tidal breathing and with bilevel-assisted breathing. Levels of agreement were assessed using the Bland-Altman analysis. Mixed models were used to characterize the association between XV- and pitot tube-derived values and optimize XV-derived values for higher ventilatory volumes.

Measurements and main results
Twenty-four healthy volunteers were assessed during tidal breathing and 11 were reassessed with increased minute ventilation with bilevel-assisted breathing. No clinically significant differences were observed between the two methods for respiratory rate (average Δ: 0.58; 95% limits of agreement: -1.55, 2.71) or duty cycle (average Δ: 0.02; 95% limits of agreement: 0.01, 0.03). Tidal volumes and flow rates measured using XV were lower than those measured using the pitot tube flowmeter, particularly at the higher volume ranges with bilevel-assisted breathing. Under these conditions, a mixed-model based adjustment was applied to the XV-derived values of tidal volume and flow rate to obtain closer agreement with the pitot tube-derived values.

Conclusion
Radiographically obtained measures of ventilation with XV demonstrate a high degree of correlation with parameters of ventilation. If the accuracy of XV were also confirmed for assessing the regional distribution of ventilation, it would provide information that goes beyond the scope of conventional pulmonary function tests or static radiographic assessments.
Endophytic bacteria isolated from Urtica dioica L.- preliminary screening for enzyme and polyphenols production
Authors: Marchut-Mikołajczyk Olga , Chlebicz Magdalena , Kawecka Monika , Michalak Agnieszka , Prucnal Filip , Nielipinski Maciej , Filipek Jakub , Jankowska Michalina , Perek Zofia , Drożdżyński Piotr , Rutkowska Natalia , Otlewska Anna 
Published: August 2023

AbstractEndophytes, especially those isolated from herbal plants, may act as a reservoir of a variety of secondary metabolites exhibiting biological activity. Some endophytes express the ability to produce the same bioactive compounds as their plant hosts, making them a more sustainable industrial supply of these substances. Urtica dioica L. (common stinging nettle) is a synanthropic plant that is widely used in herbal medicine due to the diversity of bioactive chemicals it contains, e.g., polyphenols, which demonstrate anti-inflammatory, antioxidant, and anti-cancerous capabilities. This study aimed at isolating endophytic bacteria from stinging nettles for their bioactive compounds. The endophytic isolates were identified by both biochemical and molecular methods (16S rRNA) and investigated for enzymes, biosurfactants, and polyphenols production. Each of the isolated bacterial strains was capable of producing biosurfactants and polyphenols. However, three of the isolated endophytes, identified as two strains of Bacillus cereus and one strain of Bacillus mycoides, possessed the greatest capacity to produce biosurfactants and polyphenols. The derivatized extracts from culture liquid showed the 1.633 mol l−1 (9.691 mg l−1) concentration of polyphenol compounds. Therefore, the present study signifies that endophytic B. cereus and B. mycoides isolated from Urtica dioica L. could be a potential source of biosurfactants and polyphenols. However, further study is required to understand the mechanism of the process and achieve efficient polyphenol production by endophytic bacteria.
Efficacy of the spatial repellent product Mosquito Shield™ against wild pyrethroid-resistant Anopheles arabiensis in south-eastern Tanzania
Authors: Swai Johnson Kyeba , Soto Alina Celest , Ntabaliba Watson Samuel , Kibondo Ummi Abdul , Ngonyani Hassan Ahamad , Mseka Antony Pius , Ortiz Anthony , Chura Madeleine Rose , Mascari Thomas Michael , Moore Sarah Jane 
Published: August 2023

Abstract
Background
Spatial repellents that create airborne concentrations of an active ingredient (AI) within a space offer a scalable solution to further reduce transmission of malaria, by disrupting mosquito behaviours in ways that ultimately lead to reduced human-vector contact. Passive emanator spatial repellents can protect multiple people within the treated space and can last for multiple weeks without the need for daily user touchpoints, making them less intrusive interventions. They may be particularly advantageous in certain use cases where implementation of core tools may be constrained, such as in humanitarian emergencies and among mobile at-risk populations. The purpose of this study was to assess the efficacy of Mosquito Shield™ deployed in experimental huts against wild, free-flying, pyrethroid-resistant Anopheles arabiensis mosquitoes in Tanzania over 1 month.

Methods
The efficacy of Mosquito Shield™ transfluthrin spatial repellent in reducing mosquito lands and blood-feeding was evaluated using 24 huts: sixteen huts were allocated to Human Landing Catch (HLC) collections and eight huts to estimating blood-feeding. In both experiments, half of the huts received no intervention (control) while the remaining received the intervention randomly allocated to huts and remained fixed for the study duration. Outcomes measured were mosquito landings, blood-fed, resting and dead mosquitoes. Data were analysed by multilevel mixed effects regression with appropriate dispersion and link function accounting for volunteer, hut and day.

Results
Landing inhibition was estimated to be 70% (57–78%) [IRR 0.30 (95% CI 0.22–0.43); p < 0.0001] and blood-feeding inhibition was estimated to be 69% (56–79%) [IRR 0.31 (95% CI 0.21–0.44; p < 0.0001] There was no difference in the protective efficacy estimates of landing and blood-feeding inhibition [IRR 0.98 (95% CI 0.53–1.82; p = 0.958].

Conclusions
This study demonstrated that Mosquito Shield™ was efficacious against a wild pyrethroid-resistant strain of An. arabiensis mosquitoes in Tanzania for up to 1 month and could be used as a complementary or stand-alone tool where gaps in protection offered by core malaria vector control tools exist. HLC is a suitable technique for estimating bite reductions conferred by spatial repellents especially where direct blood-feeding measurements are not practical or are ethically limited.