bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Low-dose Radiation-induced DNA Damage and Repair in 3D Printed Human Cellular Constructs
Authors: Chai Wenxuan , Kong Yunfan , Escalona Maria B. , Hu Chunshan , Balajee Adayabalam S. , Huang Yong 
Published: June 2023

Abstract
DNA double-strand breaks (DSBs) induced by ionizing radiation (IR) are considered to be the most critical lesion that when unrepaired or misrepaired leads to genomic instability or cell death depending on the radiation exposure dose. The potential health risks associated with exposures of low-dose radiation are of concern since they are being increasingly used in diverse medical and non-medical applications. Here, we have used a novel human tissue-like 3-dimensional bioprint to evaluate low-dose radiation-induced DNA damage response. For the generation of 3-dimensional tissue-like constructs, human hTERT immortalized foreskin fibroblast BJ1 cells were extrusion printed and further enzymatically gelled in a gellan microgel-based support bath. Low-dose radiation-induced DSBs and repair were analyzed in the tissue-like bioprints by indirect immunofluorescence using a well-known DSB surrogate marker, 53BP1, at different post-irradiation times (0.5 h, 6 h, and 24 h) after treatment with various doses of γ rays (50 mGy, 100 mGy, and 200 mGy). The 53BP1 foci showed a dose dependent induction in the tissue bioprints after 30 min of radiation exposure and subsequently declined at 6 h and 24 h in a dose-dependent manner. The residual 53BP1 foci number observed at 24 h post-irradiation time for the γ-ray doses of 50 mGy, 100 mGy, and 200 mGy was not statistically different from mock treated bioprints illustrative of an efficient DNA repair response at these low-dose exposures. Similar results were obtained for yet another DSB surrogate marker, γ-H2AX (phosphorylated form of histone H2A variant) in the human tissue-like constructs. Although we have primarily used foreskin fibroblasts, our bioprinting approach—mimicking a human tissue-like microenvironment—can be extended to different organ-specific cell types for evaluating the radio-response at low-dose and dose-rates of IR.
Vitrectomy for Vitreous Hemorrhage Associated with Retinal Vein Occlusion: Visual Outcomes, Prognostic Factors, and Sequelae
Authors: Wakabayashi Taku , Patel Neil , Bough Matthew , Nahar Ankur , Sheng Young , Momenaei Bita , Salabati Mirataollah , Mahmoudzadeh Raziyeh , Kuriyan Ajay E. , Spirn Marc J. , Chiang Allen , Hsu Jason , Fineman Mitchell S. , Regillo Carl D. , Sivalingam Arunan , Ho Allen C. , Gupta Omesh P. , Yonekawa Yoshihiro 
Published: June 2023

Abstract

Purpose:
To report the outcomes of pars plana vitrectomy (PPV) for vitreous hemorrhage (VH) associated with retinal vein occlusion (RVO) and to identify prognostic indicators.

Methods:
Interventional, retrospective consecutive case series between 2015 and 2021.

Results:
The study included 138 eyes of 138 patients (64 female and 74 male); 81 patients had branch RVO (BRVO) and 57 had central RVO (CRVO). The mean age was 69.8 years. The mean duration between the diagnosis of VH and surgery was 79.6±115.3 (range, 1-572) days. The mean follow-up was 27.2 months. The logMAR visual acuity significantly improved from 1.95±0.72 (Snellen equivalent, 20/1782) to 0.99 ± 0.87 (20/195) at 6 months and to 1.06±0.96 (20/230) at the final visit (both P<0.001). The visual acuity at 6 months improved by 3 or more lines in 103 (75%) eyes. Postoperative complications during follow-up included recurrent VH in 16 (12%) eyes (of which 8 eyes underwent reoperations), rhegmatogenous retinal detachment in 6 (4%) eyes, and new neovascular glaucoma in 3 eyes (2%). Worse final visual acuity was significantly associated with older age (P=0.007), concurrent neovascular glaucoma (P<0.001), CRVO (P< 0.001), worse preoperative visual acuity (P< 0.001), postoperative new neovascular glaucoma (P = 0.021), and postoperative retinal detachment (P< 0.001). The duration of VH was not associated with visual outcomes (P=0.684). Preoperative anti-VEGF injections and tamponade did not prevent postoperative recurrent VH.

Conclusions:
PPV is effective for VH associated with RVO, regardless of the duration of hemorrhage. However, pre-existing risk factors and postoperative sequelae may limit visual recovery.
Clinical value of soluble fms-like tyrosine kinase 1 (sFlt-1) in adult secondary hemophagocytic lymphohistiocytosis
Authors: Cheng Wanying , Wang Lingling , Gao Xin , Yin Guangli , Wang Jujuan , Shu Yongqian , Qiu Hongxia , Duan Limin 
Published: June 2023

Background:
Secondary hemophagocytic lymphohistiocytosis (sHLH) is a syndrome characterized by an excessive systemic inflammatory response, manifested by multiple organ dysfunction, lacking reliable immune biomarkers for predicting their inflammatory status and prognosis. Soluble fms-like tyrosine kinase 1 (sFlt-1) is associated with various inflammation-related diseases, including sepsis and severe organ failure.

Methods:
This study retrospectively included 32 adult sHLH patients diagnosed from January 2020 to December 2021. The expression of Flt-1 in peripheral blood CD14+ monocytes was detected by flow cytometry, and the level of plasma sFlt-1 was detected by ELISA.

Results:
In our study, the results of flow cytometry reveal that the Flt-1 expression on CD14+ monocytes of peripheral blood from sHLH patients was higher than that in normal control. In plasma samples of sHLH patients, sFlt-1 levels were 677.8 (463.2–929.7) pg/mL, significantly higher than in normal controls 377.18 (350.4–424.6) pg/mL and sepsis group 378.3 (257.0–499.1) pg/mL. Besides, a positive correlation was found between sFlt-1 and IL-6 in sHLH patients. The analysis of univariate Cox regression indicated that sFlt-1 >681.5 pg/mL demonstrated unfavorable overall survival (p = 0.022). Multivariate analysis demonstrated that sFlt-1 >681.5 pg/mL was an independent factor associated with OS (p = 0.041) after adjustment for confounders. Restricted cubic spline confirmed a linear and positive association between sFlt-1 and mortality risk.

Conclusion:
Retrospective analysis showed that sFlt-1 was a promising prognostic factor.
ChatGPT failed Taiwan’s Family Medicine Board Exam
Authors: Weng Tzu-Ling , Wang Ying-Mei , Chang Samuel , Chen Tzeng-Ji , Hwang Shinn-Jang 
Published: June 2023

Background:
Chat Generative Pre-trained Transformer (ChatGPT), OpenAI Limited Partnership, San Francisco, CA, USA is an artificial intelligence language model gaining popularity because of its large database and ability to interpret and respond to various queries. Although it has been tested by researchers in different fields, its performance varies depending on the domain. We aimed to further test its ability in the medical field.

Methods:
We used questions from Taiwan’s 2022 Family Medicine Board Exam, which combined both Chinese and English and covered various question types, including reverse questions and multiple-choice questions, and mainly focused on general medical knowledge. We pasted each question into ChatGPT and recorded its response, comparing it to the correct answer provided by the exam board. We used SAS 9.4 (Cary, North Carolina, USA) and Excel to calculate the accuracy rates for each question type.

Results:
ChatGPT answered 52 questions out of 125 correctly, with an accuracy rate of 41.6%. The questions’ length did not affect the accuracy rates. These were 45.5%, 33.3%, 58.3%, 50.0%, and 43.5% for negative-phrase questions, multiple-choice questions, mutually exclusive options, case scenario questions, and Taiwan’s local policy-related questions, with no statistical difference observed.

Conclusion:
ChatGPT’s accuracy rate was not good enough for Taiwan’s Family Medicine Board Exam. Possible reasons include the difficulty level of the specialist exam and the relatively weak database of traditional Chinese language resources. However, ChatGPT performed acceptably in negative-phrase questions, mutually exclusive questions, and case scenario questions, and it can be a helpful tool for learning and exam preparation. Future research can explore ways to improve ChatGPT’s accuracy rate for specialized exams and other domains.
Serum metabolomics analysis revealed metabolic disorders in Parkinson’s disease
Authors: Lan Tian-Tian , Chang Le , Hou Li-Wei , Wang Zhen-Zhen , Li Dong-Chu , Ren Zi-Han , Gu Tao , Wang Jian-Wen , Chen Gui-Sheng 
Published: June 2023

Background:
Parkinson’s disease (PD) is by now the second of the most prevalent neurodegenerative diseases in the world, and its incidence is increasing rapidly as the global population ages, with 14.2 million PD patients expected worldwide by 2040.

Methods:
We gathered a completion of 45 serum samples, including 15 of healthy controls and 30 from the PD group. We used non-targeted metabolomics analysis based on liquid chromatography-mass spectrometry to identify the molecular changes in PD patients, and conducted bioinformatics analysis on this basis to explore the possible pathogenesis of PD.

Results:
We found significant metabolomics changes in the levels of 30 metabolites in PD patients compared with healthy controls.

Conclusion:
Lipids and lipid-like molecules accounted for the majority of the 30 differentially expressed metabolites. Also, pathway enrichment analysis showed significant enrichment in sphingolipid metabolic pathway. These assessments can improve our perception on the underlying mechanism of PD as well as facilitate a better targeting on therapeutic interventions.
Neurenteric cyst of the craniovertebral junction treated to reduce recurrence using different strategies: Two case reports and a literature review
Authors: Park Sue-Jee , Hong Jong-Hwan , Han Moon-Soo , Moon Bong Ju , Koo Joo-Yeon , Lee Jung-Kil 
Published: June 2023

Rationale:
Neurenteric cysts are rare benign lesions that are usually located in the lower cervical and upper thoracic spine and extremely rare in the craniovertebral junction. It is generally challenging to completely remove the neurenteric cysts of the craniovertebral junction. We report the cases of 2 patients with neurenteric cyst in the ventral craniovertebral junction managed using different treatment strategies.

Patient concerns:
The first patient was a 64-year-old man. He man was admitted with headache, posterior neck pain, and a tingling sensation in both the forearms. The second patient was a 53-year-old woman. She was admitted with tingling sensations and numbness in both the hands and feet.

Diagnoses:
Cervical spine magnetic resonance imaging showed 2 intradural extramedullary cystic lesions in case 1 and a C2 to C3 intradural extramedullary cystic mass in case 2.

Interventions and outcomes:
The patient of the case 1 underwent a left C1 to C2 hemi-laminectomy and the cysts were completely removed. Eleven years after the surgery, there was no recurrence. In case 2, we performed a left C2 to C3 hemi-laminectomy and removed only a part of the outer membrane to enable sufficient communication with the surrounding normal subarachnoid space. After removing the cyst wall, the patient underwent C1 to 2 trans articular screw fixation to prevent cervical instability. Ten years after surgery, there was no recurrence of the cyst or new lesions.

Lessons:
Clinicians should consider neurenteric cyst in the differential diagnosis of arachnoid cyst or epidermoid cyst. If performing a complete surgical removal is difficult, partial surgical removal, using a cysto–subarachnoid shunt and stabilization, such as screw fixation, could be an alternative treatment option to reduce the risk of mortality and morbidity.
A giant lobular thoracic ganglioneuroma cause skeletal erosion: A case report and literature review
Authors: Zhuang Haoxiang , Ruan Zegang , Xu Chenyang 
Published: June 2023

Rationale:
Ganglioneuroma (GN) is a rare tumor that originates from neural crest cells and can manifest in any location along the sympathetic chain. It typically exhibits a circular or oval shape and does not invade the surrounding tissue destructively and the enormous lobular appearance and erosion of adjacent skeletal tissues are extremely infrequent among GN.

Patient concerns:
A 15-year-old girl presented to our thoracic surgery clinic with a large intrathoracic mass that was incidentally discovered on a chest X-ray. Further imaging with computed tomography and magnetic resonance imaging revealed a lobular profile and an aggressive growth pattern of the tumor, which destroyed the vertebral and rib bones. A tissue sample obtained by needle biopsy was subjected to histopathological analysis, which confirmed the diagnosis of a GN.

Diagnosis:
Thoracic (posterior mediastinal) GN and Hashimoto’s thyroiditis.

Interventions:
After thoracoscopic exploration, a thoracotomy was performed to excise the mass.

Outcomes:
The patient recovered well after surgery, had no major complications, and was discharged without any issues. Further follow-up is necessary to clarify the medium to long-term outcome.

Lessons:
Based on existing reports, thoracic GN rarely erodes adjacent bone tissue. By examining previously reported cases, we speculate that the lobular morphology of the tumor may be linked to the more aggressive biological behavior of GN. We also discovered that female patients may be more susceptible to bone erosion. However, further research and additional cases are required to confirm these potential associations.
MLC901 in hypoxic-ischemic brain injury patients: A double-blind, randomized placebo-controlled pilot study
Authors: Pakdaman Hossein , Gharagozli Koroush , Karamiani Faezeh , Shamsi Goushki Maryam , Moini Saman , Sobhanian Ali , Maghsoudlu Faeze , Esfandani Akram , Hosseini Mohammad Hossein , Amini Harandi Ali 
Published: June 2023

Background:
Hypoxic-ischemic brain injury (HIBI) is a disabling consequence of cardiopulmonary resuscitation, which has no direct treatment except supportive care. Many studies have used pharmacological agents to reduce or stop this disability. MLC901 is a traditional Chinese medicine showing neuroprotective and regenerative effects on focal and global ischemia in previous animal and human studies. We designed an experimental, randomized, double-blind, placebo-controlled study to analyze MLC901 efficacy in HIBI patients.

Methods:
In a randomized, placebo-controlled trial, 35 patients with HIBI were randomly designated to receive either MLC901 or placebo capsules 3 times per day over 6 months. We assessed the 2 groups by modified Rankin Scale and Glasgow Outcome Scale at baseline, and follow-up visits in 3rd month, and 6th-month after injury.

Results:
Thirty-one patients completed this study. There was no significant difference in baseline characteristics between the 2 groups as regards age, gender, time of resuscitation, the interval between injury and start of the intervention, and the length of intensive care unit stay. Both the placebo and intervention groups improved during the investigation. However, the Glasgow Outcome Scale and modified Rankin Scale scales were significantly improved in the MLC901 group compared to the placebo after 6 months (P < .05) with close to no adverse effects. No major side effect was reported.

Conclusion:
MLC901 has shown, compared to placebo, a statistically better improvement at 6 months in neurological functions of patients with HIBI.
ESR2 polymorphisms on prostate cancer risk: A systematic review and meta-analysis
Authors: Chang Xueliang , Wang Hu , Yang Zhan , Wang Yaxuan , Li Jingdong , Han Zhenwei 
Published: June 2023

Background:
This meta-analysis was performed to address the association of 2 ESR2 gene polymorphisms (rs1256049 and rs4986938) with susceptibility to cancer.

Methods:
An extensive literature search for eligible candidate gene studies published before May 10, 2022, was conducted in PubMed, Medline, and Web of Science. The search strategy was as follows: (ESR2 OR ERβ OR ER beta OR estrogen receptor beta) AND (polymorphism OR mutation OR variation OR SNP OR genotype) AND (PCa OR PC OR prostate cancer). Potential sources of heterogeneity were sought out via trial sequential analysis, subgroup, and sensitivity analysis.

Results:
Overall, a total of 10 articles involving 18,064 cases and 19,556 controls for 2 polymorphisms of the ESR2 gene were enrolled. In the stratified analysis of rs1256049, we found that Caucasians might be correlated with an increased risk of prostate cancer (PCa), while less susceptibility was found in Asians. We observed that rs4986938 was not associated with PCa risk.

Conclusion:

ESR2 rs1256049 polymorphism is associated with a higher risk of PCa in the Caucasian population and a lower risk of PCa in the Asian population.
A single-blind, randomized, crossover study on the efficacy of icatibant for sweating-induced dermal pain (icatibant for sweating-induced dermal pain)
Authors: Takahagi Shunsuke , Hide Michihiro , Aoyama Yumi , Fukunaga Atsushi , Murota Hiroyuki 
Published: June 2023

Introduction:
Severe dermal pain triggered by sweating stimuli, such as bathing, exercise, and mental stress, significantly affects patients’ daily lives. The pathomechanism underlying the sweating-induced dermal pain remains poorly understood and there exists no standard treatment for such pain. This study aims to evaluate the effectiveness of icatibant as an analgesic, a bradykinin B2 receptor antagonist, in treating sweating-induced dermal pain, and to establish the role of bradykinin in pain induction.

Methods/design:
A multicenter, exploratory, crossover, single-blinded, placebo-controlled randomized, comparative study will be conducted to evaluate the efficacy of subcutaneous icatibant injection (30 mg) in treating sweating-induced dermal pain. Ten patients will be enrolled and assigned randomly in a 1:1 ratio to either the icatibant-placebo or placebo-icatibant groups. The primary endpoint is the change in the visual analog scale scores for dermal pain induced by thermal load before and after treatment with icatibant or placebo. Secondary endpoints include changes in the duration of dermal pain, blood and plasma histamine levels, serum angiotensin-converting enzyme levels, and histological evaluation of skin tissue samples at the site of dermal pain.

Discussion:
The effectiveness of icatibant against sweating-induced dermal pain would provide clear evidence for the involvement of the bradykinin-bradykinin B2 receptor pathway in the pathogenesis of this condition. This finding may contribute to a better understanding of the underlying mechanisms of dermal pain associated with sweating stimuli and has the potential to improve patients’ quality of life by suggesting potential treatment options, specifically, using drugs that inhibit bradykinin or suppress its production.
Delayed rupture of traumatic anterior cerebral artery A4 segment aneurysm: A case report
Authors: Shi Yu , Sui Yihang , Chen Kai , Luo Wenzhang , Zhang Tianyu , Huang Changren , Bao Kunyang 
Published: June 2023

Rationale:
Delayed rupture of traumatic intracranial aneurysms is relatively rare, and traumatic anterior A4 segment aneurysms may be associated with trauma to the cerebral falx. The mortality rate in patients with delayed traumatic rupture of intracranial aneurysms is>50%. Therefore, early diagnosis and treatment are critical. Herein, we present a case of a patient who did not have an intracranial aneurysm on computed tomographic angiography (CTA) after admission. Subsequently, the patient consciousness deteriorated, and CTA revealed aneurysm and bleeding.

Patient concerns:
A 55-year-old man fell from a 3-meter-high truck and was unconscious. During the following few hours, the gradually regained consciousness. No intracranial aneurysms were found on CTA of the patient head immediately after admission.

Diagnoses:
The final diagnosis was delayed rupture of traumatic intracranial aneurysms.

Interventions:
The patient underwent endovascular and symptomatic treatments.

Outcomes:
The patient gradually recovered and was referred to the rehabilitation department for further treatment.

Lessons:
Considering the catastrophic consequences of the disease, we should review CTA or digital subtraction angiography many times after admission, and take appropriate surgical procedures in time.
Can acupuncture reverse oxidative stress and neuroinflammatory damage in animal models of vascular dementia?: A preclinical systematic review and meta-analysis
Authors: Wen Qin , Hong Xueqin , He Kunze , Liu Buping , Li Min 
Published: June 2023

Background:
Vascular dementia is a cognitive dysfunction syndrome caused by cerebral vascular factors such as ischemic stroke and hemorrhagic stroke. The effect of acupuncture on vascular dementia models is ambiguous, and there is controversy about whether acupuncture has a placebo effect. Oxidative stress and inflammation are the most essential mechanisms in preclinical studies of vascular dementia. However, there is no meta-analysis on the mechanism of vascular dementia in animal models. It is necessary to explore the efficacy of acupuncture through Meta-analysis of preclinical studies.

Methods:
Three major databases, PubMed, Embase and Web of Science (including medline), were searched in English until December 2022.The quality of the including literature was assessed using SYRCLE’s risk of bias tool. Review Manager 5.3 was used to statistically summarize the included studies and the statistical effect values were expressed by SMD. The outcomes included: behavioral tests (escape latency, number of crossings), pathological sections (Nissl and TUNEL staining), oxidative stress markers (ROS, MDA, SOD, GSH-PX) and neuroinflammatory factors (TNF-α, IL-1β, IL-6).

Results:
A total of 31 articles were included in this meta-analysis. The results showed that the escape latency, the contents of ROS, MDA, IL-1β, and IL-6 were decreased, and the contents of SOD and Nissl-positive neurons were increased in the acupuncture group as compared with the non-group (P < .05). Compared with the impaired group, the acupuncture group also had the above advantages (P < .05). In addition, the acupuncture group also increased the number of crossings and GSH-PX content, and decreased the expression of TUNEL-positive neurons and TNF-α (P < .05).

Conclusions:
From behavioral tests to slices and pathological markers in animal models of vascular dementia, it can be proved that acupuncture is effective in targeting oxidative stress and neuroinflammatory damage, and acupuncture is not a placebo effect. Nevertheless, attention needs to be paid to the gap between animal experiments and clinical applications.