bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing Script Concordance Test Items in Otolaryngology to Improve Clinical Reasoning Skills: Validation using Consensus Analysis and Psychometrics
Authors: Ganesan Sivaraman , Bhandary Shital , Thulasingam Mahalakshmy , Chacko Thomas Vengail , Zayapragassarazan Z. , Ravichandran Surya , Raja Kalaiarasi , Ramasamy Karthikeyan , Alexander Arun , Penubarthi Lokesh Kumar 
Published: August 2023

Background:
Script concordance testing is widely practiced to foster and assess clinical reasoning. Our study aimed to develop script concordance test (SCT) in the specialty of otolaryngology and test the validation using panel response pattern and consensus index.

Materials and Methods:
The methodology was an evolving pattern of constructing SCTs, administering them to the panel members, and optimizing the panel with response patterns and consensus index. The SCT’s final items were chosen to be administered to the students.

Results:
We developed 98 items of SCT and administered them to 20 panel members. The mean score of the panel members for these 98 items was 79.5 (standard deviation [SD] = 4.4). The consensus index calculated for the 98-item SCT ranged from 25.81 to 100. Sixteen items had bimodal and uniform response patterns; the consensus index improved when eliminated. We administered the rest 82 items of SCT to 30 undergraduate and ten postgraduate students. The mean score of undergraduate students was 61.1 (SD = 7.5) and that of postgraduate students was 67.7 (SD = 6.3). Cronbach’s alpha for the 82-item SCT was 0.74. Excluding the 22 poor items, the final SCT instrument of 60 items had a Cronbach’s alpha of 0.82.

Conclusion:
Our study revealed that a consensus index above 60 had a good item-total correlation and be used to optimize the items for panel responses in SCT, necessitating further studies on this aspect. Our study also revealed that the panel response clustering pattern could be used to categorize the items, although bimodal and uniform distribution patterns need further differentiation.
Diagnostic and Prognostic Significance of Serum Biomarkers – Serum Amyloid A and CYFRA 21-1 in Lung Cancer
Authors: Dhanurdhar Yera , Jagaty Suman Kumar , Subhankar Saswat , Behera Debasis 
Published: August 2023

Introduction:
Bronchogenic carcinoma is a leading cause of cancer-related death in men and women. Early diagnosis and treatment in these cases are essential for a better prognosis. Serum biomarkers such as serum amyloid A (SAA) and CYFRA 21-1 have generated encouraging results regarding their use in the diagnosis of these cases but data on their role in the Indian scenario are still lacking.

Aim:
The study aims to measure the levels of SAA and CYFRA 21-1 in various types of lung cancer and compare them with patients without lung cancer. It also aims to compare the values of these biomarkers before and after chemotherapy and correlate them with response to treatment.

Materials and Methods:
It was a prospective, case–control study conducted in the Department of Pulmonary Medicine, Government Medical College, Chandigarh. All histologically and/or cytologically proven lung cancer cases were included in the study group while patients with diseases other than lung cancer formed the control group. All patients were evaluated through a complete history and thorough clinical examination. Measurement of SAA and CYFRA 21-1 in blood was done by sandwich ELISA method. The patients in the study group were followed up regularly and the biomarkers were measured again after four cycles of chemotherapy. The response of tumors to chemotherapy was evaluated as per modified Response Evaluation Criteria in Solid Tumors criteria. The statistical analysis was carried out using SPSS version 19.0.

Results:
The study group and control group included 20 patients each. Hoarseness of voice and hemoptysis were significantly associated with lung cancer patients (P = 0.001 and P = 0.025, respectively). Serum levels above 8745 ng/ml for SAA and 2.55 ng/ml for serum CYFRA 21-1 were used as diagnostic biomarker in lung cancer. The serum levels of CYFRA 21-1 were found to be significantly raised in nonsmall cell carcinoma (NSCLC) in comparison to SCLC of lung. There was a statistically significant decrease in the serum levels of CYFRA 21-1 in lung cancer patients on C4 cycle of chemotherapy in comparison to C1 cycle (P = 0.014).

Conclusion:
SAA and CYFRA 21-1 could be valuable diagnostic biomarkers in lung cancer. CYFRA 21-1, in addition, could also be used as prognostic biomarker in lung cancer patients undergoing chemotherapy as it showed significant decrease after C4-cycle of chemotherapy. It can also be a potential biomarker to differentiate small cell and NSCLC.
Evaluation of the Brain Cellular Damage during Liver Transplantations
Authors: Deniz MN , Sezer E , Tetik A , Ulukaya S 
Published: August 2023

ABSTRACT

Background:
Neuroinflammation in patients undergoing major surgery can lead to neuronal damage, and neuronal damage can be detected through the measurement of biochemical markers of brain damage. S100 beta (S100 β), neuron-specific enolase (NSE), and glial fibrillary acidic protein (GFAP) levels are considered good biomarkers to detect brain damage that emerged with neurotoxicity.

Aim:
To evaluate neuronal damage during liver transplantations.

Materials and Methods:
After approval of the ethics committee and patient consents, preoperative and postoperative cognitive functions of 33 patients undergoing liver transplantation were measured using the Mini Mental State Examination (MMSE), whereas simultaneous neuronal damage was evaluated through the measurement of S100β, NSE, and GFAP levels.

Results:
There was no statistically significant difference between preoperative and postoperative MMSE. There was a statistically significant decrease in postoperative GFAP (P < 0.05) and a statistically significant increase in NSE (P < 0.05) compared to preoperative values. The decrease in S100β (P > 0.05) level was statistically insignificant.

Conclusions:
Neuroprotective approaches in anesthesia protocol protect patients from brain damage during liver transplantation and prevent the development of postoperative cognitive dysfunction. Since the significant increase in NSE levels during liver transplantations was deemed to have been associated with causes other than neuronal damage, NSE should not be evaluated as a marker of brain damage in these operations.
Long-Term Outcomes of Transcanalicular Laser Dacryocystorhinostomy Versus Endonasal Dacryocystorhinostomy and a Review of the Literature
Authors: Tokat T , Tokat S , Kusbeci T 
Published: August 2023

ABSTRACT

Objective:
The aim of this study was to compare the efficacy of endonasal dacryocystorhinostomy (EDCR) compared with transcanalicular laser DCR (TL-DCR).

Materials and Methods:
This retrospective study and systematic review included patients that underwent DCR for nasolacrimal duct obstruction at our tertiary academic care hospital between January 2013 and December 2017. TL-DCR and EDCR were performed on 42 (group 1) and 45 (group 2) patients, respectively. All patients were followed up for a minimum of 4 years after DCR. Success was defined as the complete disappearance of epiphora and the observation of fluid flow without any anatomic obstruction during lacrimal system irrigation.

Results:
This study included 87 patients who underwent DCR. Fourteen patients (18.7%) were male, and 61 (81.3%) were female. Groups 1 and 2 consisted of 42 and 45 patients who underwent TL-DCR and EDCR, respectively. Success was achieved by 78.5% and 84.4% in groups 1 and 2, respectively. Patients in both groups were followed up for at least 4 years. There was a significant difference in mean surgery time between groups: 33.8 ± 10.5 min vs. 69.9 ± 15.9 min for groups 1 and 2, respectively (P < 0.001).

Conclusion:
EDCR and TL-DCR without silicone stent have offered a high success rate in the long term. Furthermore, endonasal procedures have less surgery time and leave no scar. We observed that EDCR and TL-DCR are favorable methods in cases of nasolacrimal duct obstruction.
Proposed Grading System of Unilateral Cleft Lip to Predict Surgical Challenges
Authors: Onah II , Okwesili OR 
Published: August 2023

ABSTRACT

Background:
It is a common practice to subjectively categorize cleft lip deformities into narrow and wide cleft. The proposed grading of unilateral cleft lip can serve as a predictive factor of the difficulties to be encountered during repair and the expected outcome of surgery.

Materials and Methods:
This was a 5-years retrospective study of the records of 32 patients with unilateral cleft lip that presented to a single surgical unit. We grouped the patients based on the age at surgery. We calculated the alar base width ratios of the cleft to non-cleft sides, and this was used for grading. We graded the clefts using ratio of 1.00–1.50 for mild cleft, 1.51 to 2.00 for moderate cleft, 2.01–3.00 for severe cleft, and >3.00 for extensive cleft lip.

Results:
The youngest child was 1 month old, while the oldest was 50 years. Majority of the patients (17) were older than 2 years at the time of surgery. Only nine babies (28.1% of the patients) were able to have their surgery done within the age of 6 months. Those that had extensive unilateral cleft lip were 10 (31.3%). However, a total of 18 (56.3% of the patients) had cleft lips that were either mild or moderate grade.

Conclusion:
This grading of unilateral cleft lip helps in objective preoperative assessment of the severity and in predicting the difficulty expected during lip repair. It is also helpful in assigning clefts to trainees and in determining which patients should be referred to an experienced surgeon.
Knowledge and Attitude of Parents toward Child Dental Visits in a Rural Setting in Nigeria
Authors: Onyejaka NK , Onyekwere MP , Ezeigwe TJ , Iwuoha CE , Amobi EO , Etim SS 
Published: August 2023

ABSTRACT

Introduction:
The study determined the proportion of rural parents with good knowledge about and good attitude toward children making their first dental visit by their first birthday. It also assessed the association among age, sex, level of education, past dental visits of parents, and knowledge about and good attitude toward children making their first dental visit by their first birthday.

Materials and Methods:
This was a cross-sectional study that collected data from 115 parents in a rural setting using an interviewer-administered questionnaire. Data on age, sex, level of education, past dental visits, knowledge about, and attitude toward children making their first dental visit by their first birthday were collected from one of the parents of children aged 16 years and below. Socio-demographic factors associated with knowledge about and attitude to a child’s dental visit were considered significant at the level of P < 0.05 using the Chi-square test. Logistic regression was conducted to determine the predictor of good knowledge.

Results:
The age of the study participants ranged from 15 years to 63 years with a mean of 40 ± 15.51 years. Only 25 (21.7%) parents had visited the dentist. More females 31 (40.3%) than males 6 (15.8%) significantly (P = 0.008) had good knowledge of child dental visits while more males 12 (31.6%) than females 6 (7.8%) (P = 0.001) and a greater percentage of those with past dental visits 8 (32.0%) had significantly (P = 0.02) good attitude to child dental visit.

Conclusion:
More mothers had good knowledge of child dental visits, while more fathers and those with past dental visits had a good attitude toward child dental visits.
Comparison of Three Techniques in Bladder Stone Surgery: Which Technique is more Effective and Safe?
Authors: Yalçın K 
Published: August 2023

ABSTRACT

Background:
In our study, we aimed to compare the success and complication rates of percutaneous cystolithotripsy (PCCL), transurethral cystolithotripsy (TUCL), and Ho: YAG laser lithotripsy in the surgery of bladder stones that occurred due to various reasons.

Patients and Methods:
Patients diagnosed with single or multiple bladder stones with long axis larger than 2 cm, resulting for various reasons, were included in our study. Sizes of the stones, cystolithotripsy and discharge times, catheter removal times, complications observed, and the visual pain scale (VPS) were retrospectively evaluated separately from the surgical techniques implemented for accompanying patients and their data.

Results:
TUCL (group 1) was implemented in 40, PCCL (group 2) was implemented in 44, and transurethral Ho: YAG laser lithotripsy (group 3) was implemented in 30 of the 121 patients included in the study. The bladder stone long axe group 1 average was 3,7 cm (2,2–5,3), group 2 average was 3,74 cm (2,1–5,1), and group 3 average was 3,7 cm (2,3–4,7). Urethral stricture evolved in two patients who underwent TUCL. A statistically significant difference was observed on behalf of PCCL in terms of operation time. There was significance in the Ho: YAG laser cystolithotripsy group in comparison with VPS scores. No significant differences were found in terms of age, stone size, urethral catheter removal times, and discharge times. The average follow-up time was 6 months.

Conclusion:
Although all three methods were quite successful in bladder stone surgery, average cystolithotripsy times were significantly low in the PCCL technique. Thinking that the most common cause of bladder stone is BPH, it is stated that the suprapubic inserted tube ease the bladder drainage during transurethral resection of the prostate (TUR-P). In this way, the duration of the most common accompanying surgeries is shortened and performed more safely.
Effectiveness of neuro mobilisation on pain, range of motion, muscle endurance and disability in cervical radiculopathy: - a systematic review
Authors: Rafiq Shazia , Zafar Hamayun , Gillani Syed Amir , Razzaq Ayesha 
Published: August 2023

Objective: To assess the effects of the neural mobilisation technique on mobility, pain and disability in cervical radiculopathy patients, and to assess the functional activity level
Method: The systematic review was conducted from January 5 to July 5, 2022, and comprised search on Medline, PEDro, Cochrane Library and Embase databases for randomised controlled trials involving patients diagnosed with cervical radiculopathy that were published in the preceding 10 years in the English language. The search terms were divided into four classes by using the guideline for systematic reviews of trials of interventions in the Cochrane neck and back groups and related spinal disorders. Data was retrieved after the studies were subjected to quality assessment and risk of biasness.
Result: Of the 1563 studies initially found, 8(0.51%) were reviewed. No matter the approach or dosage used, manual therapy was successful in treating cervical radiculopathy symptoms in all investigations.
Conclusion: A multimodal strategy incorporating neural mobilisation appears to be the most successful short-term technique.
Key Words: Cervical radiculopathy, Neural mobilisation, Muscle endurance.
The limited use of Dexmedetomidine for subarachnoid blocks in Pakistan
Authors: Muhammad Mubariz  , Hira Hameed  
Published: August 2023

Respected Madam,
Dexmedetomidine is a selective alpha-2 adrenoceptor agonist. It acts by binding to the presynaptic alpha-2 adrenoceptors and inhibits the release of norepinephrine. Thereafter, it causes a decrease in the sympathetic tone and terminates the propagation of pain signals. As a result, the haemodynamic and the endocrine stress responses of the body to surgery and anesthesia are attenuated, the blood pressure and heart rate are decreased, and the requirement for other anaesthetic agents is reduced. These effects have meant that dexmedetomidine has been widely used prior to endotracheal intubation to optimize the patients and prevent the likelihood of hemodynamic adverse effects (1).
In addition to its use in general anesthesia, peri-operative physicians worldwide are now becoming increasingly aware of the dexmedetomidine’s potential usefor subarachnoid blocks. A few studies have documented the efficacy of intravenous (IV) dexmedetomidine in prolonging the duration of sensory and motor blockade induced by agents such as bupivacaine, prilocaine, and ropivacaine up to 4 hours (2), (3). Recent studies have found that intrathecal administration of dexmedetomidine in combination with the local anesthetic agent yields similar benefits (4). This has been attributed to the activation of presynaptic alpha2-A receptors at locus ceruleus and the termination of pain signal propagation via the medullospinal noradrenergic pathway (4). Therefore, it is no surprise that the use of dexmedetomidine in conjunction with local anesthetics for the subarachnoid block is common practice in peri-operative physicians throughout the globe.
While Pakistani peri-operative physicians are aware of the benefits of dexmedetomidine prior to endotracheal intubation (5), the same cannot be said for subarachnoid blocks induced in Pakistan. Peri-operative physicians in Pakistan are either yet to realize the potential benefits the use of dexmedetomidine can provide for subarachnoid blocks or still adhere to conventional spinal anesthesia practices. Since the effects of a conventional subarachnoid block last from 2 to 3 hours, in any case of a surgical adverse event that prolongs the surgery, severe pain, nausea, vomiting, and derangement of the hemodynamic status have been noted in patients. Often times, this results in a shift towards general anesthesia midway through the procedure. Ultimately, the postoperative stay is prolonged which directly impacts the clinical outcome and the quality of life for these patients.
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Influenza vaccination decreases the risk of cardiovascular disease (CVD) in end stage renal disease (ESRD) patients
Authors: Khan Noor Ayman , Afroz Amimah , Nusrat Butool 
Published: August 2023

Madam,
Influenza is a viral respiratory tract infection that causes symptoms such as fever, sore throat, cough and runny nose with a mostly self-limiting prognosis. However, it can cause an increased risk of hospitalization and mortality in high-risk groups such as those suffering from end-stage renal disease (ESRD) [1]. CVD is present in >50% of cases of ESRD and is associated with a 20 times greater relative risk of death than in the general population, particularly with patients infected with influenza [2] [3]. This is due to the dysfunctional immunity in those affected by chronic kidney disease.
The pathophysiology behind the influenza infection leading to CVD in ESRD patients is due to the rise of acute phase reactants in response to viral infection markers triggering a systemic inflammatory reaction. This reaction comprises damage to the endothelial cell lining of vessels, impaired vasodilation, dysfunctional platelet activation, and elevated pro-coagulation. In addition, the increased metabolic demand and altered coronary vascular tone can bring about disruption and instability of atherosclerotic plaques in coronary arteries, thus inducing an acute coronary syndrome. [1]
Using influenza vaccine can significantly lower the risk of CVD in ESRD patients. Currently, available influenza vaccines include inactivated, recombinant, and live-attenuated (LAIVs).[4] Inactivated vaccines contain either surface glycoproteins such as hemagglutinin (HA) and neuraminidase (NA) or whole viral protein without the lipid envelope or chemically inactivated virus, whereas recombinant vaccines are composed of genetically synthesized HA subunits and LAIVs have the whole virus with weakened pathogenicity. These vaccines are produced as either trivalent (with both, influenza A subtypes H1N1 andH3N2 and dominant influenza B of either Yamagata or Victoria lineage) or quadrivalent (having both influenza B lineages) vaccines.[4]
According to a population-based case-cohort study, annual influenza vaccinations have been seen to greatly reduce the hospitalisation rates for CVD in elderly patients with chronic kidney disease regardless of gender and influenza seasonality [5]. Moreover, it reduces the risk of CVD in patients with a hazard ratio of 0.74 for hospitalisation due to CVD among the vaccinated group compared to the non-vaccinated group, indicating a 26% lower risk and 35% reduction in overall mortality. [3]
Therefore, the protective mechanism of influenza vaccination may be beneficial in reducing the risk of hospitalisations and morbidity in ESRD patients by reducing the likelihood of cardiovascular-associated complications. Thus, it should be incorporated as an integral part of the management of ESRD.
ChatGPT: A New Era in Research Writing Assistance
Authors: Muhammad Osama  , Afridi Sabah 
Published: August 2023

The integration of artificial intelligence in everyday tasks is becoming prevalent, and its application has extended to academic and scientific writing. The utilization of large language models, such as ChatGPT, has gained significant traction among researchers and scientific writers in recent times. According to a recent article published in Nature, ChatGPT is capable of generating text that sounds both realistic and intelligent in response to user prompts (1). A recent study published in December 2022 evaluated the ability of ChatGPT, to execute complex cognitive tasks and generate text that is indistinguishable from text produced by humans. (2), suggesting that it can be difficult for researchers to distinguish between abstracts created by AI and original ones (1). Another study published in December 2022 showed that ChatGPT could generate precise and believable scientific abstracts (3).Likewise An additional study published in 2022 postulated that based on the analysis of ChatGPT's applications, capabilities, and limitations, it can significantly enhance academic research across a broad range of fields. (4). A recently published literature review using ChatGPT has been cited as an example of ChatGPT application in the field of scientific writing and research (5). Moreover, ChatGPT has also been used to write and publish editorials and research papers (1, 6, 7). Despite the benefits, some researchers are still evaluating the implications and effects of using these models in the long term. (1).
This letter aims to present the advantages of utilizing ChatGPT, a large language model developed by OpenAI, in the field of scientific writing. ChatGPT can help researchers in a various ways, including generating text, summarizing text, completing the text, editing text, and creating references, bibliography and citations. The most significant application of ChatGPT in scientific writing is text generation, as the model can be used to generate outlines, abstracts, and introductions to research papers. However, it is imperative to point out that ChatGPT cannot provide text with proper citations to research papers and sources. ChatGPT can also support researchers in the text summarization process, enabling them to extract meaningful information from vast amounts of text data like research papers or articles. Additionally, some researchers use ChatGPT to analyze large volumes of text data to gain deeper insights and knowledge, which is particularly useful in qualitative research and in writing literature reviews.
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