bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of continuous positive air pressure on intraocular pressure in patients with obstructive sleep apnea during the split-night study: An open-label randomized controlled trial
Authors: Fukutome Takero , Kuze Manami 
Published: April 2023

Background:
Intraocular pressure (IOP) is known to increase at midnight, when continuous positive airway pressure (CPAP) is initiated in split-night CPAP titration (SN-CPAP titration), in patients with obstructive sleep apnea (OSA); therefore, possible excessive increase in the IOP should be investigated. However, related studies on this topic are scarce. OSA causes increases and decreases in the IOP; however, its fluctuation during sleep remains unclear. Therefore, we determined the timing of these fluctuations in the IOP during sleep at night.

Methods:
This study included 25 patients with OSA. A 7-hour period of night sleep was divided into first (Sleep-1) and second halves (Sleep-2). Patients were randomly divided into the SN (natural breathing during Sleep-1, CPAP applied during Sleep-2) and C (without CPAP) groups. IOP was measured using the iCare Pro before Sleep-1 and after Sleep-1 and Sleep-2. The main hypothesis was that IOP would be significantly higher in the SN group than in the C group. The sub-hypothesis was that the effects of OSA on IOP are manifested at different times. The correlation is shown as Pearson’s r for normally distributed data or Spearman’s rho for non-normally distributed data. The difference between the SN and C groups in the time course of IOP during the night’s sleep was analyzed using repeated-measures analysis of variance. A P value of <.05 was considered significant.

Results:
No significant difference was found in IOP between the groups, but the SN group showed a significantly increased IOP during Sleep-2 (post hoc Bonferroni test). The apnea–hypopnea index inversely correlated with IOP changes in Sleep-1 and positively correlated with those in Sleep-2.

Conclusion:
This study does not support our main hypothesis that SN-CPAP titration promotes the effect of CPAP in increasing IOP. However, an expected range of the effect of increased CPAP on IOP has also been suggested. IOP-lowering and IOP-raising effects were predominant in the first and second halves of sleep in OSA, thereby providing a new perspective on measured IOP and supporting the subhypothesis.
Thyroid hormone resistance resulting from a novel mutation in the THRB gene in a Chinese child: A case report
Authors: Feng Jinhua , Lin Shuangzhu , Wang Wei , Chen Qiandui , Wang Wanqi , Li Jiayi , Wang Xinyao 
Published: April 2023

Introduction:
Thyroid hormone resistance (RTH) (mim # 188570) is a rare autosomal dominant genetic disorder characterized by reduced thyroid hormone response in target tissues. The clinical manifestations of RTH vary from no symptoms to symptoms of thyroid hormone deficiency to symptoms of thyroid hormone excess.

Patient concern and clinical findings:
A 24-month-old girl presented with growth retardation, tachycardia, and persistently elevated thyroid hormones despite antithyroid treatment.

Diagnosis/Intervention/Outcomes:
The patient was diagnosed with RTH, after whole exon gene sequencing, found a de novo missense mutation (c.1375T > G,p.Phe459Val) in a novel locus of the thyroid hormone receptor beta gene. She had only mild growth retardation, so the decision was made to monitor her development without intervention. At her last follow-up at 5 years and 8 months of age, she continued to show growth retardation (−2 standard deviation below age-appropriate levels), in addition to delayed language development. Her comprehension ability and heart rate have remained normal.

Conclusions:
We report a mild case of RTH caused by a novel thyroid hormone receptor beta gene mutation. RTH should be considered in the differential diagnosis of abnormal serum thyroxine levels during neonatal screening.
Health literacy status among community in the protected area: A protocol for systematic review and meta-analysis
Authors: Abd Kadir Nor Aziah , Azzeri Amirah , Mohd Noor Mohd Iqbal , Kefeli Zurina , Abdullah Muhammad Fuad , Ramlee Mohd Noor Afiq , Jaafar Mohd Hafiz 
Published: April 2023

Background:
Adequate health literacy is necessary for individuals as it enables them to readily acquire information, process it, and apply it to health-related decisions. Various factors including geographical area will determine the disparity in health literacy status. Communities living in protected areas have limited health literacy and health status owing to a lack of access to infrastructure and medical facilities. Existing studies have discussed health literacy among various populations disproportionately affected by certain diseases. However, research remains underdeveloped, and the causal factors are largely untested. This research aims to better understand how population living conditions especially those who are living in protected areas are affected and exposed to limited health literacy.

Method:
This study will comprehensively review full-text papers published between 2013 and 2023. We will search 3 databases, PubMed, SCOPUS, and Web of Science, using the keyword search strategy to find articles related to the issue. Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used to guide the selection of relevant studies. The results will then be assessed using the standard Cochrane Quality assessment method. The outcome is addressed in light of a narrative synthesis that utilizes a theme category and focuses on each component’s main conclusions.

Result:
This protocol describes the planned scope and methodology for the systematic review and meta-analysis that will provide current evidence on; The status of health literacy among the community in protected areas and; The effect of Protected Areas on health literacy according to their types and characteristics.

Conclusion:
Meta-analysis of low-to-high health literacy status will benefit the development of policy recommendations for protected areas.
A comparative study of magnifying endoscopy with narrow-band image and endocytoscopy in the diagnosis of gastric neoplasm: a pilot study
Authors: Yoo In Kyung , Park Jun Chul , Lee Hyuk , Yeniova Abdullah Ozgur , Lee Jeong Hoon , Yon Dong Keon , Cho Joo Young , Lee Wan-Sik 
Published: April 2023

Background/aims
Endoscopic technologies have recently advanced to optimize the detection and diagnosis of gastric lesions. Endocytoscopy aids in the virtual realization of histology. Herein, we aimed to investigate gastric lesions using single-stain endocytoscopy and compare them using magnifying endoscopy with narrow-band imaging (ME-NBI) in terms of diagnostic yield in vivo.

Methods and methods
In the present prospective study, we registered 24 patients with gastric neoplasms and retrospectively reviewed their images. Three endoscopists reviewed the images of gastric neoplasms using white light, ME-NBI, and endocytoscopy. The diagnostic yield of endocytoscopy in early gastric cancer (EGC) was assessed using histopathology as the gold standard.

Results
Endocytoscopy was performed in 24 patients with gastric neoplasms. Of these, 15 patients had adenocarcinomas, while nine patients had low-grade dysplasia. The sensitivity, specificity, and accuracy of endocytoscopy for EGC detection were reported as 80.0% [95% confidence interval (CI), 51.9–95.7], 66.7% (95% CI, 58.4–91.9), and 75.0% (95% CI, 53.3–90.2) by endoscopist A; 80.0% (95% CI, 51.9–95.7), 44.4% (95% CI, 13.7–78.8), and 66.7% (95% CI, 44.7–84.4) by endoscopist B; and 93.3% (95% CI, 68.1–99.8), 55.6% (95% CI, 21.2–86.3), and 79.2% (95% CI, 57.9–92.8) by endoscopist C; these findings were not inferior to NBI. The inter-observer agreement, κ statistic = 0.67 (95% CI, 0.43–0.90) was favorable.

Conclusion
Endocytoscopy aid in the diagnosis of EGC because of its better sensitivity and accuracy compared to NBI or white-light imaging. However, further large-scale studies are required to confirm our findings.
Safety, hesitancy of coronavirus disease 2019 vaccination and pandemic burden in patients with inflammatory bowel disease: data of a national study (ESCAPE-IBD)
Authors: Principi Mariabeatrice , Macaluso Fabio Salvatore , Todeschini Alessia , Facciotti Federica , Contaldo Antonella , Castiglione Fabiana , Nardone Olga Maria , Spagnuolo Rocco , Doldo Patrizia , Riguccio Gaia , Conforti Francesco Simone , Viganò Chiara , Ascolani Marta , Fiorino Gionata , Correale Carmen , Bodini Giorgia , Milla Monica , Scardino Giulia , Vernero Marta , Desideri Federico , Caprioli Flavio , Mannino Mariella , Rizzo Giuseppe , Orlando Ambrogio ,   Italian Group for the study of Inflammatory Bowel Disease (IG-IBD)
Published: April 2023

Background and aims
The purpose of this study was to present data on the safety of anti- severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in a cohort of inflammatory bowel disease (IBD) patients of an ongoing multicenter study (ESCAPE-IBD) sponsored by the Italian Group for the study of Inflammatory Bowel Disease (ClinicalTrials.gov Identifier: NCT04769258).

Methods
Anti-SARS-CoV-2 vaccination was administrated to 809 IBD patients. Interviews were conducted to report adverse events related to vaccination. Of these 809, 346 patients were surveyed on the pandemic burden and the main reason for hesitancy in coronavirus disease 2019 vaccination. The chi-square test was used to compare categorical variables. Logistic regression was used to assess the relationship between disease-related characteristics and the onset of adverse events.

Results
About 45% of patients had at least one side effect, following the first dose (10%), the second (15%), and both doses (19%). All the adverse events were mild and lasted only a few days. Logistic regression analysis revealed that female sex (P < 0.001), younger age (P = 0.001), seroconversion (P = 0.002), and comorbidity (P < 0.001) were significantly associated with adverse events. The survey showed that the main concerns were the possibility of adverse event (33%). Almost all patients (99%) felt safer having been vaccinated at their IBD reference center.

Conclusion
The vaccine reactions experienced in IBD patients were mostly self-limited. We found high acceptance and good safety of SARS-CoV-2 vaccination in our cohort.
Pathogenic factors of cognitive dysfunction after liver transplantation: an observational study
Authors: Zhou Yongpeng , Huang Jun , Si Zhongzhou , Zhou Qin , Li Liwen 
Published: April 2023

Objectives
Neurocognitive complications significantly reduce long-term health-related quality of life in patients undergoing liver transplantation; however, few studies have focused on their perioperative cognitive status. The authors designed a prospective observational study to determine the incidence and risk factors of posttransplant cognitive dysfunction.

Methods
This study included patients with end-stage liver disease who were on the liver transplantation waiting list. We performed an investigation with a neuropsychological battery before and 1 week after the successful transplant, analyzed the changes, and further explored the complicated perioperative factors that contribute to cognitive dysfunction.

Results
A total of 132 patients completed all the investigations. Compared with healthy controls and preoperative cognitive performance, 54 patients experienced deterioration, 50 patients remained unchanged, and 28 patients showed rapid improvement. Logistic regression analysis showed that age [odds ratio (OR) = 1.15, 95% confidence interval (CI, 1.07–1.22), P < 0.001], the model for end-stage liver disease (MELD) score [OR = 1.07, 95% CI (1.03–1.13), P = 0.038], systemic circulation pressure [OR = 0.95, 95% CI (0.91–0.99), P = 0.026] within the first 30 min after portal vein opening, and total bilirubin concentration [OR = 1.02, 95% CI (1.01–1.03), P = 0.036] on the seventh day post-transplant were closely related to the deterioration of cognitive function.

Conclusion
The incidences of deterioration, maintenance, and improvement in cognitive function were 40.9%, 37.9%, and 21.2%, respectively. Increasing age, higher MELD score, lower perfusion pressure in the early stage of the new liver, and higher total bilirubin concentration postoperatively may be independent pathogenic factors.
Administration of maximum dose of mucolytic solution before upper endoscopy – a double-blind, randomized trial
Authors: Stepan Michal , Fojtík Petr , Psar Robert , Hanousek Martin , Sabol Marek , Zapletalova Jana , Falt Premysl 
Published: April 2023

Objective
The aim of the study was to demonstrate that an administration of mucolytic solution with a maximum dose of simethicone and n-acetylcysteine before upper endoscopy improves mucosal visibility compared to a group without administration of mucolytic solution or water.

Methods
This study was a double-blind, randomized controlled trial. Patients were randomized into four groups, with the administration of 100 ml of water + 600 mg n-acetylcysteine + 400 mg simethicone, 100 ml of water + 400 mg n-acetylcysteine + 20 mg simethicone, 100 ml of water, and without any water or mucolytic solution. During the examination, a total of 10 images were taken in the defined areas. The overall visibility score was given by the sum of the 0–5 scores of the five areas and was assessed by the endoscopist performing the procedure and the blinded endoscopists using static images.

Results
A total of 129 patients were randomized. The group of patients did not differ in age, sex distribution, and indications significantly. The overall visibility score as assessed by the endoscopist performing the procedure was significantly higher in the group with the maximum dose of mucolytic solution compared to the group without solution or water (18.9 ± 2.9 vs. 16.6 ± 3.3, P = 0.023). This difference was not evident by the blinded evaluation of static photographs.

Conclusion
Administration of mucolytic solution with a maximum dose of n-acetylcysteine and simethicone before upper endoscopy improved mucosal visibility in the upper gastrointestinal tract compared with the group without any preparation while evaluated by performing endoscopist.
Comparison of the role of 18F-fluorodeoxyglucose PET/computed tomography and 68Ga-labeled FAP inhibitor-04 PET/CT in patients with malignant mesothelioma
Authors: Güzel Yunus , Kömek Halil , Can Canan , Kaplan İhsan , Kepenek Ferat , Ebinç Senar , Büyükdeniz Mehmet Perver , Gündoğan Cihan , Oruç Zeynep 
Published: April 2023

Objective
In this study, we aimed to compare the role of 68Ga-labeled FAP inhibitor (68Ga-FAPI)-04 PET/computed tomography (CT) and 18F-fluorodeoxyglucose (18F-FDG) PET/CT in the evaluation of primary tumor and metastases in patients diagnosed with malignant mesothelioma.

Materials and methods
Our prospective study included 21 patients with histopathological diagnosis of malignant mesothelioma who underwent both 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT imaging between April 2022 and September 2022. Maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis, tumor-to-background ratio (TBR) and highest SUVpeak (HPeak) values and lesion numbers were calculated from primary and metastatic lesions on FDG and FAPI PET/CT images. Findings obtained from FAPI and FDG PET/CT were compared.

Results
More lesions were detected in 68Ga-FAPI-04 PET/CT compared to 18F-FDG PET/CT in primary tumor and lymph node metastases. Statistically significantly higher SUVmax and TBR values were found with FAPI PET/CT (primary lesion SUVmax and TBR, P = 0.001 and P < 0.001, respectively; lymph node SUVmax and TBR, P = 0.016 and P = 0.005, respectively). With FAPI PET/CT, upstage was observed according to tumor-node-metastasis staging in a total of seven patients including three patients with pleural origin, three patients with peritoneal origin and one patient with pericardial origin.

Conclusion
In addition to the stage change with 68Ga-FAPI-04 PET/CT in malignant mesothelioma patients, a statistically significant superiority was observed in SUVmax, TBR and volumetric parameters in primary tumors and metastases.
Correlation between metabolic uptake of F-18-FDG-PET/computed tomography and thyroglobulin level in differentiated thyroid cancer patients with suspected recurrence
Authors: Askar Hebatallah A.A. , Farghali Rana M. , Mekkaway Mohamed A. , Bashank Nahla M. 
Published: April 2023

Objective
Our objective is to determine if there is correlation between serum thyroglobulin and SUVmax of the main lesion detected in F18-FDG-PET/CT scan, in differentiated thyroid cancer (DTC) patients with suspected recurrence.

Methods
All DTC patients enrolled in this prospective study, received at least one dose of radioactive iodine. During follow-up, they are suspected to have a recurrence due to elevated tumor markers although negative iodine whole-body scans. For all patients, F18-FDG-PET/CT scanning was performed. A 3D volume of interest was generated over the liver and main lesion to obtain maximum standardized uptake value (SUVmax). We calculated the lesion/liver ratio. Follow-up and/or histopathological examination were the gold standard. Pearson’s correlation coefficient was calculated between thyroglobulin and SUVmax of the main lesion.

Results
Sixty-eight patients were recruited in this study. F18-FDG-PET/CT identified suspicious malignant lesions in 42 patients, equivocal in 18 patients, while 8 patients showed no abnormal findings. Fifty-two, 6, 8, and 2 patients were true positive, true negative, false positive, and false negative respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 72%, 57% 87%, 35%, and 69% respectively. The median SUVmax and lesion/liver ratio were significantly higher in the malignant lesions than that of benign lesions (3.9 vs. 1.3 and 1.45 vs. 0.54 respectively). We found that the main lesion SUVmax and lesion/liver ratio have a positive moderate correlation with thyroglobulin (0.338 and 0.325 respectively).

Conclusion
In DTC patients with suspected recurrence, SUVmax of F18-FDG-PET/CT lesion showed a moderate positive correlation with serum thyroglobulin.
Dropped nucleus postintravitreal injection with intact anterior capsule: a case report
Authors: Al-Latayfeh Motasem M. , Shehada Reham 
Published: April 2023

Introduction and importance:
The aim was to describe a case of inadvertent posteriorly dislocated lens nucleus after intravitreal injection (IVI) for diabetic retinopathy, highlighting the importance of adherence to the standard protocol of IVI.

Case presentation:
A 58-year-old female with uncontrolled type 2 diabetes mellitus presented with decreased vision bilaterally. At presentation, the anterior segment of both eyes showed nuclear sclerosis +2. Fundus examination of the left eye was not visible due to diffuse vitreous hemorrhage, for which an intravitreal ranibizumab injection was given. She presented for follow-up 3 weeks later; an aphakic left eye was discovered during the examination. A dropped nucleus was diagnosed, and the patient underwent an uneventful pars plana vitrectomy with removal of the dropped nucleus and implantation of a sulcus three-piece intraocular lens. Postoperatively, the vision had improved from hand motion to 6/18. Clinical discussion: this case presentation reports an unusual complication of a dropped lens nucleus after IVI. It highlights the possibility of inadvertent lens trauma in such a procedure and the importance of proper adherence to standards to avoid such a complication.

Conclusion:
This rare complication highlights the importance of carefully following IVI guidelines in the hands of experienced ophthalmologists and the need for meticulous supervision for ophthalmology residents because it is not a risk-free procedure.
Microvascular proliferation in arteriovenous malformation of the hand worsens during pregnancy: a case report
Authors: Utami Amalia M. , Horbach Sophie E.R. , Meijer-Jorna Lorine B. , Waas Ingeborg S.E. , de Boer Onno J. , van der Wal Allard C. , van der Horst Chantal M.A.M. 
Published: April 2023

Introduction and Importance:
Arteriovenous malformations (AVMs) are rare congenital disorders characterized by episodes of disproportionate growth that can cause pain and severe bleeding, with microvascular proliferation (MVP) associated with these episodes. Hormonal influences can also worsen the symptoms in patients with AVM.

Case presentation:
This case report presents a female patient with congenital vascular malformations of the left hand since birth, whose symptoms worsened during puberty and pregnancy, ultimately leading to amputation of the left hand due to unbearable pain and loss of function. Pathologic analysis revealed substantial MVP activity within the tissues of the AVM, with an expression of receptors for estrogen, growth hormone, and follicle-stimulating hormone in the vessels of the AVM, including MVP areas. Resected materials not related to pregnancy revealed chronic inflammation and fibrosis but hardly any MVP.

Discussion and conclusion:
These findings suggest a role for MVP in the progressive growth of AVM during pregnancy, with a potential role for hormonal influences. The case highlights the relationship between AVM symptoms and size during pregnancy and the pathological findings of MVP areas within the AVM with hormone receptor expression on proliferating vessels in resected materials.
Washout-Computed Tomography Discriminates Pulmonary “Fat-poor” Hamartomas From Neuroendocrine Neoplasms
Authors: Volterrani Luca , Perrella Armando , Bagnacci Giulio , Di Meglio Nunzia , Di Martino Vito , Bertelli Paolo , Bellan Cristiana , Mazzei Maria A. , Luzzi Luca 
Published: April 2023

Purpose:
Pulmonary hamartomas (HAs) and neuroendocrine neoplasms (NENs) are often impossible to discriminate using high-resolution computed tomography (CT) as they share morphologic features. This challenge makes differential diagnosis crucial as HAs are invariably benign, whereas NENs must be considered malignant, thus requiring them to be evaluated for surgical excision.
Our aim was, therefore, to develop a simple method to discriminate between pulmonary “fat-poor” HAs and NENs using contrast-enhanced CT (CECT).

Materials and Methods:
Between September 2015 and December 2021, 95 patients with a histologically proven diagnosis of lung NENs (74) and HAs (21) and who underwent a preoperative CECT scan were initially identified through a review of our pathologic and radiologic databases. Among these, 55 cases (18 HAs and 37 NENs), which have been studied with biphasic CECT, were ultimately selected and reviewed by 3 radiologists with different levels of experience, analyzing their morphologic and enhancement features.
The enhancement analysis was performed by placing a region of interest within the lesion in noncontrast (NCp), postcontrast (PCp, 55 to 65 s after intravenous contrast injection), and delayed phases (Dp, 180 to 300 s). A subgroup of 35 patients who underwent 18FDG-PET/CT was evaluated in a secondary analysis.

Results:
HU values were significantly different between NENs and HAs in the PCp (P<0.001). NCp and Dp attenuation values did not show significant differences in the 2 groups. Differences in values of HUs in PCp and Dp allowed to discriminate between NENs and HAs.

Conclusion:
Wash-out analysis, ΔHU (PCp-Dp), can perfectly discriminate pulmonary “fat-poor” HAs from NENs.