bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are dopamine agonists still the first-choice treatment for prolactinoma in the era of endoscopy? A systematic review and meta-analysis
Authors: Cai Xiangming , Zhu Junhao , Yang Jin , Tang Chao , Cong Zixiang , Ma Chiyuan 
Published: April 2022

Abstract
Background
For prolactinoma patients, dopamine agonists (DAs) are indicated as the first-line treatment and surgery is an adjunctive choice. However, with the development of surgical technique and equipment, the effect of surgery has improved. The aim of this study was to assess the efficacy and safety of surgery versus DAs in patients with different types of prolactinomas.

Methods
A systematic search of literature using Web of Science, PubMed, Cochrane Library, and Clinical Trial databases was conducted until July 12, 2019. Prolactinoma patients treated with DAs (bromocriptine or cabergoline) or surgery (microscopic or endoscopic surgery) were included. Outcomes included the biochemical cure rate, recurrence rate, prolactin level, improvement rates of symptoms, and incidence rates of complications. A random-effects model was used to pool the extracted data. Qualitative comparisons were conducted instead of quantitative comparison.

Results
DAs were better than surgery in terms of the biochemical cure rate (0.78 versus 0.66), but surgery had a much lower recurrence rate (0.19 versus 0.57). Full advantages were not demonstrated in improvement rates of symptoms and incidence rates of complications with both treatment options. In microprolactinoma patients, the biochemical cure rate of endoscopic surgery was equal to the average cure rate of DAs (0.86 versus 0.86) and it surpassed the biochemical cure rate of bromocriptine (0.86 versus 0.76). In macroprolactinoma patients, endoscopic surgery was slightly higher than bromocriptine (0.66 versus 0.64) in terms of the biochemical cure rate.

Conclusion
For patients with clear indications or contraindications for surgery, choosing surgery or DAs accordingly is unequivocal. However, for patients with clinical equipoise, such as surgery, especially endoscopic surgery, in microprolactinoma and macroprolactinoma patients, we suggest that neurosurgeons and endocrinologists conduct high-quality clinical trials to address the clinical equipoise quantitatively.
A Pilot Feasibility Study of Digital Health Coaching for Men With Prostate Cancer
Authors: Handley Nathan R. , Wen Kuang-Yi , Gomaa Sameh , Brassil Kelly , Shimada Ayako , Leiby Benjamin , Jackson Lindsey , McMorris Michael , Calvaresi Anne , Dicker Adam P. 
Published: April 2022

PURPOSE: Prostate cancer is the most common cancer among men in the United States. The majority of prostate cancer treatment occurs in the ambulatory setting, and patients and their caregivers take on significant responsibility for monitoring and managing treatment and disease-related toxicity. Digital health coaching has shown promise as a tool to positively influence outcomes. We completed a single-arm pilot study to assess the feasibility of digital health coaching in men with prostate cancer. METHODS: Men with a history of prostate cancer requiring treatment in the past 2 years were eligible for inclusion. Participants engaged in a 12-week health coaching program, consisting of a combination of at least one telephone call and up to four digital nudges (defined as content delivered via text, e-mail, or app on the basis of the participant's preference) per week. Prostate cancer–specific content addressed one of the following topics each week: fatigue, pain management, healthy eating, exercise, managing incontinence, sexual health, managing stress and anxiety, financial toxicity, goal setting during treatment, managing side effects, communicating with the health care team, and medication adherence. Services were provided at no cost to the participant. RESULTS: A hundred patients were consented for the study, and 88 enrolled. The feasibility threshold of 60% was met with 63 of the 88 enrolled individuals completing the 3-month program (proportion = 71.6%; 90% CI, 62.6 to 79.4; P = .016). CONCLUSION: Digital health coaching for men with prostate cancer is feasible. These findings support further evaluation of digital health coaching for men with prostate cancer in larger randomized controlled trials.
Autoimmune-Associated Seizures
Authors: Gillinder Lisa , Britton Jeffrey 
Published: April 2022

ABSTRACT

PURPOSE OF REVIEW
This article focuses on the seizure manifestations and presentations of autoimmune-associated epilepsy and acute symptomatic seizures in autoimmune encephalitis. It discusses the specificity of the various central nervous system autoantibodies and clarifies when their presence can be considered indicative of an immune etiology. Finally, current recommendations regarding patient selection for autoimmune antibody evaluation are reviewed, and an approach to immunotherapy is provided.

RECENT FINDINGS
Although autoimmune seizures are caused by a heterogeneous group of autoantibodies, key features reported in the literature should alert clinicians to the possible diagnosis. In particular, seizure characteristics including frequency, timing, duration, and symptomatology can provide vital clues to help differentiate autoimmune-associated seizures from other causes of epilepsy. Diagnostic certainty also requires an understanding and integration of the spectrum of clinical and paraclinical presentations, and several scoring systems have been developed that may be useful to aid the identification of autoimmune seizures.

SUMMARY
Seizures due to autoimmune etiology are increasingly encountered in clinical practice. It is critical that clinicians recognize immune seizure etiologies early in their course given they are often responsive to immunotherapy but are usually resistant to antiseizure medications. Currently, however, it is unfortunately not uncommon for autoimmune-associated seizure disorders to remain undiagnosed, resulting in missed opportunities to administer effective therapies. Efforts to better understand autoimmune seizure manifestations and treatment strategies are ongoing.
Update on Antiseizure Medications 2022
Authors: Abou-Khalil Bassel W. 
Published: April 2022

EDITOR’S NOTEABSTRACT
The article “Update on Antiseizure Medications 2022” by Dr Abou-Khalil was first published in the February 2016 Epilepsy issue of Continuum: Lifelong Learning in Neurology as “Antiepileptic Drugs,” and at the request of the Editor-in-Chief was updated by Dr Abou-Khalil for the 2019 issue and again for this issue.

PURPOSE OF REVIEW
This article is an update from the article on antiepileptic drug therapy (now referred to as antiseizure medication therapy) published in the two previous Continuum issues on epilepsy and is intended to cover the vast majority of agents currently available to the neurologist in the management of patients with epilepsy.
Treatment of epilepsy starts with antiseizure medication monotherapy. Knowledge of the spectrum of efficacy, clinical pharmacology, and modes of use for individual antiseizure medications is essential for optimal treatment for epilepsy. This article addresses antiseizure medications individually, focusing on key pharmacokinetic characteristics, indications, and modes of use.

RECENT FINDINGS
Since the most recent version of this article was published, two new antiseizure medications, cenobamate and fenfluramine, have been approved by the US Food and Drug Administration (FDA), and the indications of some approved medications have been expanded.
Older antiseizure medications are effective but have tolerability and pharmacokinetic disadvantages. Several newer antiseizure medications have undergone comparative trials demonstrating efficacy equal to and tolerability at least equal to or better than older antiseizure medications as first-line therapy for focal epilepsy. The list includes lamotrigine, oxcarbazepine, levetiracetam, topiramate, zonisamide, and lacosamide. Pregabalin was found to be less effective than lamotrigine. Lacosamide, pregabalin, and eslicarbazepine have undergone successful trials of conversion to monotherapy for focal epilepsy. Other newer antiseizure medications with a variety of mechanisms of action are suitable for adjunctive therapy. Antiseizure medications marketed since 2016 have benefited from the FDA policy allowing a drug’s efficacy as adjunctive therapy in adults to be extrapolated to efficacy in monotherapy. In addition, efficacy in adults can be extrapolated for efficacy in children 4 years of age and older. Both extrapolations require data demonstrating that an antiseizure medication has equivalent pharmacokinetics between its original approved use and its extrapolated use. Rational antiseizure medication combinations should avoid antiseizure medications with unfavorable pharmacokinetic interactions or pharmacodynamic interactions related to mechanism of action.

SUMMARY
Knowledge of antiseizure medication pharmacokinetics, efficacy, and tolerability profiles facilitates the choice of appropriate antiseizure medication therapy for patients with epilepsy.
EEG Essentials
Authors: Tatum William O. 
Published: April 2022

ABSTRACT

PURPOSE OF REVIEW
EEG is the best study for evaluating the electrophysiologic function of the brain. The relevance of EEG is based on an accurate interpretation of the recording. Understanding the neuroscientific basis for EEG is essential. The basis for recording and interpreting EEG is both brain site–specific and technique-dependent to detect and represent a complex series of waveforms. Separating normal from abnormal EEG lies at the foundation of essential interpretative skills.

RECENT FINDINGS
Seizures and epilepsy are the primary targets for clinical use of EEG in diagnosis, seizure classification, and management. Interictal epileptiform discharges on EEG support a clinical diagnosis of seizures, but only when an electrographic seizure is recorded is the diagnosis confirmed. New variations of normal waveforms, benign variants, and artifacts can mimic epileptiform patterns and are potential pitfalls for misinterpretation for inexperienced interpreters. A plethora of medical conditions involve nonepileptiform and epileptiform abnormalities on EEG along the continuum of people who appear healthy to those who are critically ill. Emerging trends in long-term EEG monitoring to diagnose, classify, quantify, and characterize patients with seizures have unveiled epilepsy syndromes in patients and expanded medical and surgical options for treatment. Advances in terminology and application of continuous EEG help unify neurologists in the diagnosis of nonconvulsive seizures and status epilepticus in patients with encephalopathy and prognosticate recovery from serious neurologic injury involving the brain.

SUMMARY
After 100 years, EEG has retained a key role in the neurologist’s toolkit as a safe, widely available, versatile, portable test of neurophysiology, and it is likely to remain at the forefront for patients with neurologic diseases. Interpreting EEG is based on qualitative review, and therefore, the accuracy of reporting is based on the interpreter’s training, experience, and exposure to many new and older waveforms.
Status of self-esteem in medical students at a college in Kathmandu: A descriptive cross-sectional study
Authors: Shrestha Bikal , Yadav Stuti , Dhakal Subodh , Ghimire Pooja , Shrestha Yubika , Singh Rathaure Ela 
Published: April 2022

Background: Self-esteem is vital to living a happy, confident and content life. Medical students experience various forms of stress due to academic, financial and social pressures which could affect their levels of self-esteem. This study aims to study the status of self-esteem among undergraduates of a medical college at Tribhuvan University, Nepal. Methods: After receiving the ethical approval from the Institutional Review Committee (IRC) of NAIHS; we conducted a descriptive cross-sectional study among the first- to fifth-year medical students from December 2020 to April 2021. 190 were selected for the study using a stratified random sampling technique. This study used the Rosenberg self-esteem scale to measure self–esteem of the participants. A Google Forms questionnaire was sent to the participants via email. Then, the data obtained were entered in the Google sheet and later analyzed using SPSS 27. A Chi-square test was used to identify potential differences in self-esteem scores among different variables. A p-value of < 0.05 was considered statistically significant. Results: This study included a total of 180 participants, among which, 18.9% (13.19% to 24.61%; at 95% CI) students showed low self -esteem. 74.4% (68.02% to 80.78%; at 95% CI) students had normal self-esteem and 6.7% (3.05% to 10.35%; at 95% CI) students had high self-esteem. The mean self-esteem score was 19.19 (15.01 to 23.37; at 95% CI). Female participants suffered more than males from low self-esteem, and third-year students had the highest percentage of low self-esteem (30.77%). Conclusion: The majority (74.4%) of medical students had normal self-esteem. However, 18.9% students had low self-esteem, among which, third-year students suffered the most (30.77%). Likewise, females exhibited higher prevalence of low self-esteem compared to males. Interventions to boost the level of self-esteem should be carried out to help medical students become confident and efficient doctors.
The association between FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a among chronic granulocytic leukemia patients treated with imatinib mesylate
Authors: Wardhani Shinta Oktya , Susianti Hani , Rahayu Puji , Yueniwati Yuyun Prabowowati , Fajar Jonny Karunia 
Published: April 2022

Background: The gene FOXO3a has been elucidated to govern the development of chronic granulocytic leukemia (CGL). Moreover, it has been suggested that the levels of FOXO3a in circulation are affected by the FOXO3a rs4946936 gene polymorphism. However, no study has assessed the correlation between the FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a. The objective of this study was to assess the association between the FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a in CGL patients treated with imatinib mesylate. Methods: A cross-sectional study was conducted from February 2019 to February 2020. The genotyping of FOXO3a rs4946936 gene polymorphism was conducted using PCR-RFLP, and the levels of FOXO3a were assessed using ELISA. The association between the FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a were assessed using multiple logistic regression. Results: A total of 60 CGL patients were assessed in our study. Among them, the CC, CT, and TT genotypes of the FOXO3a rs4946936 gene polymorphism were 35.0%, 48.3%, and 16.7% respectively. Our calculation revealed that elevated levels of FOXO3a were found in CGL patients with the CC genotype of the FOXO3a rs4946936 gene polymorphism. While we failed to clarify the association between either the CT or the TT genotype of FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a. Conclusion: Our study identifies that the CC genotype of the FOXO3a rs4946936 gene polymorphism affects the elevated levels of FOXO3a in CGL patients treated with imatinib mesylate.
Thyroid cancer incidence in the United Arab Emirates: a retrospective study on association with age and gender
Authors: Almansoori Asma , Busch Hauke , Bendardaf Riyad , Hamoudi Rifat 
Published: April 2022

Background: Thyroid cancer is the ninth most common malignancy worldwide, but the third most common malignancy in the United Arab Emirates (UAE). To our knowledge, this is the first UAE nationwide study aimed at presenting incidence rates of thyroid cancer at the national level of UAE based upon data from the national cancer registry and GLOBOCAN. Methods: Between 2011 and 2017, a total of 2036 thyroid cancer cases from UAE patients were registered, of which 75.3% were female and 24.7% male patients. Results: The results showed 6.6% increase in thyroid cancer cases in the UAE from 2011 to 2017 (p < 0.001) with a rise of approximately 400 cases per year from 2011 to 2040. Age standardized rate calculations showed increase in prevalence from 1.18 in 2011 to 4.32 in 2017 but decreases in incidence from 1.05 in 2011 to 0.15 in 2017. This trend is confirmed by the predictive model showing increase in incidence from 0.15 in 2017 to 0.64 by 2040. Gender was shown to be significantly associated with thyroid cancer. The female to male ratio was significantly higher in Emirati patients (4.86:1) (p < 0.001) than expat patients (2.47:1) (p < 0.01). Interestingly, expat patients contributed to the majority of thyroid cancer cases despite having lower female to male ratio. The age at diagnosis was significantly associated with thyroid cancer (p = 0.03) with the highest frequency diagnosed at 35-39 years of age. Globally, data from the predictive model showed that Asia had the highest rate of increase per year and UAE the lowest. Conclusions: The slight increase in thyroid cancer prevalence and incidence, together with the different female to male ratio and diagnosis at younger age warrants further investigation at the molecular level from UAE thyroid cancer patients to elucidate the molecular basis of thyroid cancer.
Point Tools of Geometric Modeling, Invariant Relating to Parallel Projection
Authors: Konopatskiy E. , Bezditnyi A. 
Published: April 2022

The purpose of this paper is to familiarize experts in geometric and computer modeling with specific tools for point calculus; demonstrate the possibilities of point calculus as a mathematical apparatus for modeling of multidimensional space’s geometric objects. In the paper with specific examples have been described the basic constructive tools for point calculus, having invariant properties relating to parallel projection. These tools are used to model geometric objects, including: affine ratio of three points of a straight line, intersection of two straight lines, intersection of a straight line with a plane, parallel translation and tangent to a curve. The theoretical foundations of point tools for geometric modeling, invariant relating to parallel projection, have been presented. For example, instead of traditional determination for straight lines intersection point by composing and solving a system of equations in coordinate form, zeroing of a moving triangle’s area is used. This approach allows to define geometric objects in multidimensional spaces keeping the symbolic representation of point equation, as well as to perform its coordinate-wise calculation at the last stage of modeling, which allows to significantly reduce computing resources in the process of solving the problems related to engineering geometry and computer graphics.
The local results of the research presented in this paper, which served as examples for the use of point calculation constructive tools, are: definition of the cubic Bezier curve as a curve of one relation in point and coordinate form; determination of excessive parameterization of the plane and bypass arcs based on it; determination of the tangent to the spatial curve by differentiation the original curve with respect to a current parameter, followed by parallel transfer of the obtained segment to the tangency point; the general point equation for the torso surface has been obtained on account of its definition as a geometric place of tangents to its cusp edge, and examples for the construction of torso surfaces based on the cubic Bezier curve and a transcendental space curve have been presented.
Use of Elastics in Orthodontics
Authors: Vesey Jennifer , Dillon Maria , Chadwick Stephen , Edwards Ian 
Published: April 2022

Intra-oral elastics are commonly used during orthodontic treatment and may be applied to several different clinical situations. They are useful for moving individual teeth, blocks of teeth and aiding growth modification. This article reviews the theory behind the use of intra-oral elastics and illustrates the theory with clinical examples.CPD/Clinical Relevance: Elastics are an essential adjunct to orthodontic treatment and have numerous clinical applications.
How COVID-19 has changed our Practice: Adapting to the New Normal
Authors: Prado Naomi , Dixon Carly , Barry Siobhan , Malik Ovais 
Published: April 2022

The COVID-19 pandemic has led to changes in all aspects of dentistry, from administration adjustments to vast alterations in training and clinical practice. This article highlights the impact the pandemic has had on paediatric dentistry and orthodontics, and to discuss the changes that have been implemented as a result. It is likely that some of these changes will be permanent and recognizing how to adapt our practice will allow us to continue to provide the best possible care to our patients. CPD/Clinical Relevance: It is in both the patients' and the clinicians' best interests to be fully informed of the effects that the COVID-19 pandemic has had, and how to adapt in order to continue to give the best possible care for our patients.
Horticultural Oil Thermotherapy Delivery System for Perennial Specialty Crops: A-Proof-of-Concept and Preliminary Results
Authors: Schrader Mark J. , Rathnayake Anura P. , Khot Lav R. 
Published: April 2022

HighlightsHorticultural oil thermotherapy sprayer was developed for use in perennial fruit crops.Prototype design included air-shear nozzles to spray at eight customized heights.Field evaluation provided adequate spray coverage.Abstract. Spray drift and residues of synthetic chemicals used in crop pest management are major concerns in agricultural industry. Therefore, exploration of alternative pest management technologies is necessary to minimize lasting pesticide residues without compromising biological efficacy. As such, this study reports the design and evaluation of a new horticultural oil thermotherapy (HOT) application system intended to increase biological efficacy of low-residue horticultural oils through addition of heat. A field-scale system has been constructed to apply thermotherapy onto tree fruit and berry crop canopies. This system uses a custom heating unit to preheat the spray liquid, reaching the nozzles at temperatures up to 99°C depending on application requirement. The spray delivery and temperature profiles generated by the prototyped HOT system were evaluated at three horizontal distances from the nozzle exit (0.6, 1.5, and 2.1 m) using a smart spray analytical system developed by our research group. Typical to tree fruit sprayers, higher spray delivery was collected at 0.6 m distance and trended to decrease with increasing distance from the nozzles. The spray plume temperature also decreased with increasing distance from the nozzle. The prototype was evaluated in a pear orchard providing adequate spray coverage at bottom (75% average at 1.2 m AGL) and middle (53% average at 2.4 m AGL) canopy zones. However, the coverage in the top canopy zone (3.6 m AGL) was less than 8% and will require adjustments to the nozzle assembly. Overall, configuration refinements and calibration adjustments will be required in the prototyped HOT system depending on the crop growth stage and canopy architecture for optimal application efficacy. The developed system, with due optimization, will be critical in providing evidence supporting the feasibility of HOT applications. Keywords: Alternative pest management, Application technology, Horticultural oil, Thermotherapy, Spray efficacy.