bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative efficacy and safety of sitagliptin or gliclazide combined with metformin in treatment-naive patients with type 2 diabetes: A single-center, prospective, randomized, controlled, noninferiority study with genetic polymorphism analysis
Authors: Qin Min , Chao Lingxi , Liu Shiqun 
Published: January 2025

Background:
This study evaluates the efficacy and safety of sitagliptin versus gliclazide, combined with metformin, in treatment-naive patients with type 2 diabetes mellitus (T2DM) and glucotoxicity.

Methods:
In this single-center, randomized, controlled noninferiority trial, 129 treatment-naive patients with T2DM with glucotoxicity (fasting plasma glucose [FPG] ≥ 200 mg/dL and glycated hemoglobin ≥ 9.0%) were randomized to receive sitagliptin plus metformin (n = 66) or gliclazide plus metformin (n = 63) for 12 weeks. Sitagliptin and gliclazide were given for the first 4 weeks, followed by metformin monotherapy for 8 weeks. Efficacy end points included changes in glycemic control, body weight, and β-cell function at baseline, 4 weeks, and 12 weeks.

Results:
After 12 weeks, mean glycated hemoglobin reductions were 4.03% in the sitagliptin group and 4.13% in the gliclazide group, with a mean difference of −0.097 (95% confidence interval, −0.648 to 0.453), confirming noninferiority. Both groups showed significant FPG reductions at 4 weeks (P < .05). The sitagliptin group achieved faster glycemic targets, greater FPG and body weight reductions, and higher rates of FPG < 6.1 mmol/L (26.2% vs 5.7%; P = .012). No significant differences were observed in β-cell function or hypoglycemia incidence (P > .05). Genetic analysis showed specific single-nucleotide polymorphisms affected drug efficacy: dipeptidyl peptidase-4 rs2909451 TT and rs4664443 GG genotypes showed lower efficacy with sitagliptin, while GLP1R rs3765467 AG and KCNJ11 rs2285676 CC genotypes responded better to sitagliptin.

Conclusion:
Sitagliptin combined with metformin is noninferior to gliclazide combined with metformin in treatment-naive patients with T2DM with glucotoxicity. Genetic polymorphisms significantly affect drug efficacy, highlighting the importance of personalized medicine. The sitagliptin group achieved glycemic targets more quickly and had greater weight reductions without increased adverse effects.
Effects of intensive wearing face masks on patients with postinfectious cough: A randomized controlled trial
Authors: Lan Shan , Pan Lun , Qin Yang , Ma Lijie , Yi Hongyu 
Published: January 2025

Background:
Postinfectious cough was a common clinical symptom, which troubled patients and increased economic burden. The efficacy of pharmacotherapy for this symptom was unsatisfactory. This study aimed to explore the intervention effect of intensified mask-wearing on patients with post-upper respiratory tract infection cough and its role in reducing the economic burden of patients.

Methods:
As a randomized, controlled, single-blind trial, a total of 46 eligible patients with postinfectious cough were selected from local hospital, from November 2023 to February 2024. They were randomized into a control group (n = 21) and an experimental group (n = 25). Both groups received routine diagnosis and treatment, and the experimental group additionally received wearing medical surgical masks for >8 hours every day. All patients were followed up by on-site evaluation or telephone follow-up every 3 days for 3 weeks. We used a cough evaluation test to evaluate symptoms, recorded mask-wearing duration, and adjusted the treatment plan.

Results:
There were no statistically significant differences in age, gender, course of disease, cough severity, and time of wearing face masks in the early stage between 2 groups (P > .05). Three people (12.0%) in the experimental group were excluded from the study because of substandard wearing face masks. The average daily mask-wearing time of the experimental and control groups were: 9.7 ± 0.9 versus 1.2 ± 2.2 hours (P < .001). There was a statistically significant difference in cough severity scores between 2 groups on the 9th day of follow-up, 6.6 ± 2.0 versus 8.0 ± 2.5 (P < .05), the markedly effective and total effective rates were: 86.4% versus 57.1% and 31.81% versus 38.09 % (P <.05). The treatment time for all patients in 2 groups to achieve effectiveness was: 10.1 ± 4.6 versus 13.0 ± 4.1 days (P < .05). The final medical expenditure of 2 groups were 289.4 (185.2, 782.2) CNY versus 717.5 (548.5, 1582.2) CNY (P < .05).

Conclusion:
The compliance of patients with intensive wearing face masks was high. The intensive wearing of face masks had a good intervention effect on the treatment of postinfectious cough, which could effectively reduce cough symptoms of patients, shorten the course of the disease, and reduce medical expenditure.
Abdominal pain as a novel manifestation in children with PCDH19-related epilepsy: A case report
Authors: Hu Wandong , Zhao Fen , Ren Ying , Zhang Hongwei , Li Xiaoying 
Published: January 2025

Rationale:
PCDH19-related epilepsy manifested various clinical features, including febrile epilepsy, with or without intellectual disability, and psych-behavioral disorders. However, there are few studies demonstrating abdominal pain as the first symptom.

Patient concerns:
A 3-year-old Chinese girl presented with clustered seizures of fever sensitivity accompanied by abdominal pain.

Diagnoses:
After ultrasonography ruled out abdominal organic lesions, electroencephalographic (EEG) identified abdominal pain was a seizure feature. Trio whole-exome sequence demonstrated a de novo and heterozygous PCDH19 missense mutation (NM_001184880: c.824A>G, P.Y275C), which was confirmed by Sanger sequence. The final diagnosis were “PCDH19-related epilepsy; abdominal pain.”

Interventions:
At first, she was treated ineffectively by levetiracetam and valproate. Finally, she was provided with topiramate (TPM).

Outcomes:
The patient had gained seizure-free, and the follow-up EEG discharges were reduced.

Lessons:
Abdominal pain is a rare autonomic symptom in the setting of seizures. This report describes abdominal pain as a novel manifestation of PCDH19-related epilepsy and might expand its phenotypes spectrum. It also alerts us to perceive the abdominal pain characterized by seizures and early conduct EEG examination to clarify the nature of abdominal pain.
Distinct prognostic impacts of age-adjusted Charlson comorbidity index and geriatric nutritional risk index in patients with intraductal papillary mucinous neoplasm
Authors: Yuge Takuya , Murata Yasuhiro , Ito Takahiro , Hayasaki Aoi , Iizawa Yusuke , Fujii Takehiro , Tanemura Akihiro , Kuriyama Naohisa , Kishiwada Masashi , Mizuno Shugo 
Published: January 2025

The optimal surgical indication for intraductal papillary mucinous neoplasms (IPMN) remains highly contentious. We aimed to determine the preoperative predictive factors of malignancy and independent prognostic factors in patients with IPMN who underwent curative-intent resection. In this study, 104 patients with a pathological diagnosis of IPMN who underwent curative-intent resection were included. Multivariate regression and Cox proportional-hazards analyses were performed to identify the predictive factors for invasive intraductal papillary mucinous carcinoma (IPMC) and prognostic factors for overall survival (OS) after surgery. Among the 104 patients, 24 (23.1%) were pathologically diagnosed with invasive IPMC, and the remaining 80 had low-grade dysplasia or high-grade dysplasia. The presence of high-risk stigmata was an independent predictive risk factor for invasive IPMC. The age-adjusted Charlson comorbidity index (ACCI) (≥4/<4) and geriatric nutritional risk index (GNRI) (<99/≥99) were independent poor prognostic factors for OS (hazard ratio [HR]: 9.39; 95% confidence interval [CI]: 1.90–46.54; P = .006 and HR: 4.37; 95% CI: 1.07–17.86, P = .040, respectively). Forty patients with ACCI ≥ 4 (38.5%) had a significantly lower 5-year OS rate than those with ACCI < 4 (74.3 vs 98.2%, P < .001). Similarly, 29 patients with GNRI < 99 (27.9%) had a significantly lower 5-year OS rate than those with GNRI ≥ 99 (76.0 vs 95.1%, P < .001). These 2 factors were associated with significantly worse disease-specific survival after surgery.
The ACCI and GNRI emerged as independent prognostic factors after surgery in patients with IPMN. These findings highlight the importance of patient-conditional factors as valuable indicators for predicting favorable long-term survival outcomes after surgery and for facilitating a more precise assessment of surgical eligibility in patients with IPMN.
Word-of-mouth referrals between patients are a critical component of medical tourism for pediatric hematopoietic cell transplantation
Authors: Wen Yu-Chuan , Wang Yi-Lun , Pai Lan-Ni , Yang Shu-Ho , Chang Tsung-Yen , Chen Shih-Hsiang , Jaing Tang-Her 
Published: January 2025

The increasing popularity of medical tourism has sparked interest from policymakers, researchers, and the media. Factors influencing medical tourism include service quality, availability, economics, and cultural differences. This study aims to analyze the key factors that influence destination selection for medical tourists.
We conducted a thorough examination of hematopoietic cell transplantation (HCT) data from the pediatric population at our institution from 2006 onwards, focusing on the aspect of medical tourism. Most connections to services were made through encounters in patients’ daily lives and environments, such as word-of-mouth (WOM) from previously treated patients, family, or friends; connection through other services; referral from health care professionals; and seeing the service in their neighborhood. The results of our study indicate that the outcomes of these patients were comparable to those of patients with unrelated donor HCT who were not from an international background. Approximately 55% of our patients were referred to those who previously received treatment. Effective WOM referrals between patients are essential to the success of a medical tourism business. Patients referred to hospitals tend to have higher satisfaction rates and are more likely to become repeat customers. This ultimately leads to increased revenue and a stronger reputation in the industry. Additionally, positive feedback from satisfied patients can significantly enhance an organization’s reputation and attract more potential clients. Chinese tourists and Taiwanese people share language and history. Engaging in direct conversations with physicians regarding personal matters has proven to be more effective than depending on the translator. WOM referrals are critical components of the medical tourism industry. The results indicate that WOM referrals play an essential role in conveying patients’ experiences, leading to increased revenue and a stronger reputation in the industry.
Efficacy analysis of acupuncture and rehabilitation for traumatic spinal cord injury
Authors: Jiang Yue-Bo , Guan Ling , Li Ying , Shu Man , Cui Bin-Chuan , Huang Zong-Yue 
Published: January 2025

Background:
This study investigates the role and efficacy of acupuncture combined with rehabilitation therapy during the recovery phase of patients with traumatic spinal cord injury. Patients hospitalized in the acupuncture department of our center between December 1, 2019, and December 1, 2021, were enrolled.

Methods:
Participants were divided into an observation group (acupuncture and rehabilitation therapy) and a control group (rehabilitation therapy alone) based on their treatment sequence. Initially, 15 patients were allocated to each group; however, 3 patients in the observation group and 4 in the control group withdrew, leaving 11 and 12 patients in the respective groups. The observation group received combined acupuncture and rehabilitation therapy, while the control group received conventional rehabilitation therapy. Outcomes were evaluated using the American Spinal Injury Association score and classification, urodynamic data, SF-36 scale, Functional Independence Measure, and Barthel Index, analyzed through data mining techniques.

Results:
Posttreatment assessments revealed significant improvements in residual urine volume and detrusor pressure in the observation group (P < .05), whereas no significant changes were noted in the control group (P > .05). Both groups demonstrated improved motor function after treatment (P < .05), with the observation group showing significantly greater improvement (P < .05). Quality of life evaluations indicated substantial enhancement in physical pain, energy levels, general health, social functioning, perceived health changes, and mental health in both groups (P < .05).

Conclusion:
Acupuncture combined with rehabilitation therapy offers significant clinical benefits for patients with traumatic spinal cord injury. This approach effectively alleviates urinary and bowel dysfunction, accelerates motor function recovery, and improves overall quality of life, making it a valuable treatment option worthy of wider adoption.
How Does Diploic Space Thickness Change With Age?
Authors: Menville Jesse E. , Shinde Nidhi , Collins Scott , Woo Albert S. 
Published: January 2025

Background:
Cranial defects from trauma, surgery, or congenital conditions require precise reconstruction to restore cranial vault integrity. Autogenous calvarial grafts are preferred for their histocompatibility and biomechanical properties, but their success depends on a well-developed diploic space. Although prior studies have described overall skull thickness development, less is known about how diploic thickness changes through adulthood. This study aimed to quantify diploic thickness and density changes with age using computed tomography (CT) imaging.

Methods:
A retrospective review of an institution-wide imaging database was performed to identify patients who received CT scans for non-traumatic indications. A total of 110 patients, balanced by sex, were selected across 11 age groups spanning 10 to 109 years. Each patient’s skull was aligned to a standardized grid and segmented in 3-dimensional (3D) Slicer using consistent thresholding values to isolate the diploic space from the inner and outer cortical tables. Linear regression models were used to assess the effects of age and sex on diploic thickness.

Results:
No statistically significant trends were found between age and diploic thickness (r=−0.06; P=0.50. However, a near-significant trend of decreasing diploic thickness with age was observed in men (r=−0.25; P=0.05) but not in women (r=0.11; P=0.42). The posteromedial parietal region consistently showed the greatest thickness across all age groups. Diploic density also increased significantly with age (r=0.285; P=0.002), indicating progressive ossification of cancellous bone.

Conclusion:
Diploic thickness remains stable across the lifespan with slight sex-based differences. However, examination reveals that the density of the diploe increases over time, suggesting age-related changes in cancellous architecture. These findings highlight the importance of individual anatomical variations when harvesting autogenous calvarial grafts to optimize cranial reconstruction outcomes.
Clinical Outcomes and Donor-specific Antibody Rebound 5 y After Kidney Transplant Enabled by Imlifidase Desensitization
Authors: Jaffe Ian S. , Runström Anna , Tatapudi Vasishta S. , Weldon Elaina P. , Deterville Cecilia L. , Dieter Rebecca A. , Montgomery Robert A. , Lonze Bonnie E. , Mangiola Massimo 
Published: January 2025

Background.
Imlifidase is an IgG-cleaving endopeptidase conditionally approved in Europe for desensitization of highly sensitized patients before kidney transplantation. We present 5-y outcomes and donor-specific antibody (DSA) levels for clinical trial participants from a single site who received imlifidase for desensitization before incompatible transplantation (NCT02790437).

Methods.
Imlifidase was administered up to 24 h before living or deceased donor kidney transplantation. DSAs were monitored before transplantation, at days 7 and 28, and at 5 y posttransplant.

Results.
At 5 y, 7 of 8 participants were alive. One of these 7 had suboptimal graft function secondary to donor-derived disease but remained dialysis independent. Three participants had antibody-mediated rejection (AMR), which occurred in the first 30 d in all cases and was successfully treated. No new episodes of suspected or biopsy-proven AMR occurred after 30 d posttransplant. Seven participants had DSA rebound. DSAs commonly persisted 5 y posttransplant, although they were generally lower strength compared with pre-imlifidase. Dilution studies of sensitized serum enabled the identification of lower AMR risk phenotypes for persisting DSAs. Severe and/or opportunistic infections were not observed at greater than expected frequency.

Conclusions.
Five-year outcomes of imlifidase-enabled incompatible transplants are overall favorable. DSA rebound is common, but antibody strength lessens in the long term, and longitudinally persisting DSAs did not lead to premature graft failure.
Effectiveness of Propofol in Mitigation of Emergence Agitation Among Pediatric Patients Undergoing Elective Surgery Under General Anesthesia: Prospective Cohort Study
Authors: Gelgelo Kuchulo Geremu , Tessema Orissa Orkissa , Demissie Wondu Reta , Mekonin Gezahegn Tesfaye 
Published: January 2025

ABSTRACTIntroductionEmergence agitation is the abnormal mental status that develops as the result of anesthesia administration during the transition from unconsciousness to complete wakefulness. It is more common in pediatrics. It can cause serious life-threatening phenomena. Thus, preventing it would reduce the unwanted side effects and makes emergence smooth.ObjectiveAssess effectiveness of propofol in the mitigation of emergence agitation among pediatric patients undergone elective surgery under general anesthesia.MethodsThe study was conducted from October 1/2022 to December 30/ 2022 among pediatric patients aged 2-14 years who underwent elective surgery under general anesthesia. A total of 76 patients were enrolled and grouped into propofol and non-propofol with 38 patients in each. The incidence and severity of EA were assessed.Statistical analysis was done by SPSS version 26.0. P-value less than 0.05 was taken as statically significant.ResultThe overall incidence of EA in both groups was 48.7% (37%−60.4%). The incidence of EA in the propofol group and non-group was 34.2% (19.6%−51.4%) vs 63.2% (46%−78.2%) respectively p=0.012. There was a significant reduction in the severity of EA at time intervals of 5thand 15thminutes; P =0.012 vs 0.029 respectively. However, there was no significant difference in the severity of EA at the 30thminute between the groups; P=0.08. The RR of EA in the propofol group was 0.542 (95% CI: 0.327-0.896).ConclusionThe administration prophylactic propofol at the end of surgery is important in reducing both the incidence and severity of emergence agitation.
Vat Photopolymerization of Porous Scaffolds: Stabilization and Layer Thickness Control for Micron-Scale Accuracy
Authors: Chen Guoyao , Ratner Buddy D. 
Published: January 2025

AbstractVat Photopolymerization (VPP) holds much promise for producing biomaterial constructs such as porous scaffolds. However, achieving micron-scale pore dimensions with precision presents a challenge. This study offers an innovative approach to stabilize the silicone elastomer vat surface permitting micron-scale layer thickness accuracy to be maintained. Internal and surface contamination on the poly(dimethyl siloxane) (PDMS) vat surface were observed and effectively controlled with a pre-saturation methodology, and porous structures with cubical pores were then printed with varying layer thicknesses. These structures demonstrate the ability to achieve micrometric resolution and layer thicknesses as fine as 32 µm. A scaffold suitable forin vivoimplantation with 40 µm cubical pores was successfully printed within 5 hours using a stabilized PDMS vat surface. Additionally, the methodology’s adaptability to intricate non-linear edge porous structures underscores its versatility across X, Y, and Z-axis.
BellaVista: Open-Source Visualization for Imaging-Based Spatial Transcriptomics
Authors: Coles Annabelle M. , Liu Yuening , Kosuri Pallav 
Published: January 2025

AbstractImaging-based spatial transcriptomics can reveal gene expressionin situby locating and identifying individual RNA molecules at subcellular resolution. These datasets typically contain an abundance of information that when analyzed appropriately can reveal tissue organization across scales from molecules to entire organs. However, there is currently a lack of simple open-source tools that facilitate visualization, quality control, and custom spatial analysis.Here we introduce BellaVista, a lightweight open-source tool for interactive visualization and exploration of imaging-based spatial transcriptomics data. BellaVista natively supports data from Xenium (10x Genomics), MERSCOPE (Vizgen), and custom MERFISH platforms. By providing a simple means for simultaneous visualization of images, transcripts, and cell segmentation boundaries, we anticipate that BellaVista will accelerate accessibility, exploration and discovery in the rapidly expanding field of spatial biology. BellaVista is available athttps://github.com/pkosurilab/BellaVista.
Restrictor slows early transcription elongation to render RNA polymerase II susceptible to termination at non-coding RNA loci
Authors: Mimoso Claudia A. , Vlaming Hanneke , de Wagenaar Nathalie P. , Adelman Karen 
Published: January 2025

ABSTRACTThe eukaryotic genome is broadly transcribed by RNA polymerase II (RNAPII) to produce protein-coding messenger RNAs (mRNAs) and a repertoire of non-coding RNAs (ncRNAs). Whereas RNAPII is very processive during mRNA transcription, it terminates rapidly during synthesis of many ncRNAs, particularly those that arise opportunistically from accessible chromatin at gene promoters or enhancers. The divergent fates of mRNA versus ncRNA species raise many questions about how RNAPII and associated machineries discriminate functional from spurious transcription. The Restrictor complex, comprised of the RNA binding protein ZC3H4 and RNAPII-interacting protein WDR82, has been implicated in restraining the expression of ncRNAs. However, the determinants of Restrictor targeting and the mechanism of transcription suppression remain unclear. Here, we investigate Restrictor using unbiased sequence screens, and rapid protein degradation followed by nascent RNA sequencing. We find that Restrictor promiscuously suppresses early elongation by RNAPII, but this activity is blocked at most mRNAs by the presence of a 5’ splice site. Consequently, Restrictor is a critical determinant of transcription directionality at divergent promoters and prevents transcriptional interference. Finally, our data indicate that rather than directly terminating RNAPII, Restrictor acts by reducing the rate of transcription elongation, rendering RNAPII susceptible to early termination by other machineries.