bluuebunny/crossref_metadata_2025 huggingface dataset:
Spread through air spaces may predict early progression after salvage surgery for EGFR-mutant advanced lung adenocarcinoma treated with targeted therapy
Authors: Liu Yu-Wei , Lai Wei-An , Hung Jen-Yu , Lee Yen-Lung , Chiang Hung-Hsing , Lee Jui-Ying , Li Hsien-Pin , Chou Shah-Hwa , Yang Chih-Jen
Published: December 2024

Objective:
Salvage resection for residual lung cancer harboring epidermal growth factor receptor (EGFR) mutations following EGFR-tyrosine kinase inhibitor (TKI) treatment is gaining traction for its survival benefits. However, the impact of pathological factors on survival remains unclear.
Methods:
Between 2013 and 2023, we retrospectively reviewed 34 patients with advanced lung adenocarcinoma who received EGFR-TKI therapy. After a median TKI treatment duration of 9.1 months, all patients demonstrated either partial response (n=27) or stable disease (n=7) before salvage surgery. Demographic, pathological outcomes, progression-free survival (PFS), and overall survival (OS) were analyzed.
Results:
Among the 34 patients, six (17.6%) achieved a pathological complete response (pCR) and nine (26.5%) had a major pathological response (MPR). Additionally, 11 patients (32.4%) exhibited spread through air spaces (STAS), and lymphovascular invasion (LVI) was observed in nine patients (26.5%). The 3-year PFS and OS rates were 55.5% and 73.2%, respectively. No significant differences in PFS or OS were observed regarding TKI generation, mutation type, pCR, MPR, or LVI. However, Kaplan-Meier analysis revealed that STAS was associated with shorter PFS compared to non-STAS cases (p=0.011). In multivariate analysis, STAS was identified as an independent prognostic factor for PFS (hazard ratio: 1.63, 95% CI: 1.17–30.78, p=0.034). No significant prognosticators were found for OS in univariate or multivariate analyses.
Conclusion:
While salvage surgery following TKI treatment is feasible and prolongs survival by removing residual primary tumor with potential TKI resistance, STAS may contribute to a higher risk of early progression. This finding warrants further investigation and tailored treatment strategies.
The role of the contralesional primary motor cortex in upper limb recovery after stroke: A scoping review following PRISMA-ScR guidelines
Authors: Suputtitada Peerapat , Costa Valton , Fregni Felipe
Published: December 2024

Background
Stroke often results in motor impairments, with recovery involving complex interactions between the lesioned (ipsilesional) and non-lesioned (contralesional) hemispheres. This scoping review investigates the role of the contralesional primary motor cortex (M1) in motor recovery of the paretic upper limb following stroke, examining its structural and functional changes and compensatory roles.
Methods
A systematic search for scoping review was conducted in PubMed, Embase, Web of Science, and Google Scholar following PRISMA-ScR guidelines. Studies examining contralesional M1 contributions to upper limb recovery in humans and animal models were included. Data were extracted, synthesized qualitatively, and assessed for risk of bias using SYRCLE and Cochrane tools.
Results
A total of 38 studies were included in the analysis, consisting of 34 focused on stroke patients and 4 utilizing animal models. The findings revealed the dual and task-specific role of the contralesional primary motor cortex (M1) in upper limb recovery after stroke. In patients with severe motor impairments, contralesional M1 supported recovery through compensatory mechanisms, such as increased neuronal recruitment and functional reorganization. However, in cases with mild impairments, its activation was associated with inhibitory effects on ipsilesional reorganization, potentially delaying optimal recovery. Animal studies provided evidence of structural and functional plasticity, including dendritic remodeling and enhanced neuronal connectivity, which paralleled improvements in motor function. In human studies, contralesional M1 activation was task-dependent, with pronounced engagement during demanding tasks and unimanual movements. Ipsilateral motor deficits, including reduced dexterity, strength, and coordination, were commonly reported and underscored the disrupted interhemispheric dynamics influencing recovery. Neuromodulation techniques showed promise in modulating interhemispheric interactions and enhancing motor outcomes. These results emphasize the complex interplay between compensatory and inhibitory processes mediated by contralesional M1 in stroke recovery.
Conclusion
The contralesional M1 plays a complex, task-specific role in upper limb recovery after stroke, acting as both a compensatory resource and a potential inhibitory factor. Future research should stratify patients by impairment severity to refine therapeutic approaches.
Robotic trans-abdominal retromuscular hernia repair: mid-term outcomes and Surgical Site Occurrence (SSO) analysis in 120 patients
Authors: Ferraro Luca , Formisano Giampaolo , Salaj Adelona , Giuratrabocchetta Simona , Petz Wanda , Toti Francesco , Bianchi Paolo Pietro
Published: December 2024

Background
Robotic surgery has become a popular method for treating ventral hernias due to its promising perioperative outcomes. However, the long-term results of this approach are still unclear. In this study, 120 patients underwent robotic trans-abdominal retromuscular mesh placement (r-TARM) with a mean follow-up period of 18.1 months. This study aims to evaluate the feasibility of the robotic approach reporting peri-operative and mid-term outcomes. Additionally, we examined possible risk factors that may contribute to the development of surgical site occurrences (SSOs).
Methods
Between January 2021 and September 2023, 120 patients underwent r-TARM for midline hernias, including 39 primary, 71 incisional, and 10 recurrent cases. A retrospective analysis was performed. A logistic regression model was used to identify possible patient risk factors for SSO’s development.
Results
The average operative time was 153.5 ± 47.2 minutes, and there were no open or laparoscopic approach conversions. The mean length of hospital stay was 1.9 ± 0.9. We observed SSO in 16 patients (13.3%). One patient (0.8%) required angiographic embolization due to post-operative parietal bleeding. The mean follow-up time was 18.1 ± 7.8 months, and we observed hernia recurrence in only 1 (0.8%) patient. The logistic regression model did not identify any possible risk factors for SSO.
Conclusions
r-TARM is a safe and effective method for treating ventral hernias not requiring posterior component separation. Our results indicate that patient and hernia characteristics were not predictive of SSO. Mid-term outcomes are encouraging, though longer follow-up is needed.
Oncomelania lorelindoensis: the intermediate host of Sulawesis's Schistosoma japonicum
Authors: Nelwan Martin L.
Published: December 2024

Background
Oncomelania lorelindoensis is the intermediate host of Sulawesi’s Schistosoma japonicum. Schistosoma japonicum in Sulawesi originated from Anhui Guichi, China. Oncomelania lorelindoensis is one of the species in the genus Oncomelania. In this study, I report a study of Oncomelania lorelindoensis as the intermediate hosts of Sulawesi schistosomiasis japonica, their distributions in Sulawesi, and the control of O. lorelindoensis.
Results
Proto-Oncomelania originated in eastern Indonesia, Sulawesi. It spread to the Philippines, Japan, and China and then gave rise to Oncomelania. It is the intermediate host of Schistosoma japonicum. Five species are found in the genus Oncomelania, namely O. hupensis, O. lorelindoensis (formerly O. hupensis lindoensis), O. minima, O. robertsoni, and O. quadrasi. Further sequencing reveals that O. robertsoni has one subspecies, i.e., O. robertsoni robertsoni. Oncomelania lorelindoensis occurs in and around Lore Lindu National Park: the Bada Valley, the Lindu Valley, and the Napu Valley, Central Sulawesi. It may have occurred in the Kulawi Valley and the Palu Valley, Sigi Regence, Central Sulawesi Province. Control of O. lorelindoensis can use mechanic techniques, molluskicides, and genetic manipulation techniques.
Conclusions
Oncomelania lorelindoensis is found in Central Sulawesi, Indonesia. It occurs in the Bada Valley and the Napu Valley of Poso Regence and the Lindu Valley of Sigi Regence. It may also have occurred in other regions around Lore Lindu National Park. The intermediate host of Sulawesi S. japonicum is O. lorelindoensis. Subspecies in O. robertsoni should be named O. robertsoni robertsoni.
The predictive value of triglyceride-glucose index combined with non–high-density lipoprotein cholesterol in coronary heart disease
Authors: Zhang Chunge , Zhang Hui , Zhang Zewen , Sheng Yao , Ji Ningning
Published: December 2024

Background and aims: To explore the predictive value of the triglyceride-glucose（TyG）index combined with non–high-density lipoprotein cholesterol(Non-HDL-C) in coronary atherosclerotic heart disease ( CHD ).
Methods and Results: We retrospectively collected patients who were suspected of CHD and underwent coronary angiography in Yiwu Central Hospital and collected medical history, other serum biochemical evaluation and echocardiography from the enrolled population, Non-HDL-C and TyG indices were calculated, and their correlation with Gensini score was analyzed. Logistic regression analysis was used to analyze the risk factors of coronary heart disease, and ROC curves were plotted to assess the predictive value of CHD in subjects with single or multiple indices. TyG index and Non-HDL-C were higher in patients with CHD than in patients without CHD (P<0.05), and they were independent risk factors for the development of CHD after logistic regression analysis. Hypertension, diabetes, Non-HDL-C, TyG index, and Gensini score were positively correlated. The areas under the ROC curves for TyG index and Non-HDL-C for the diagnosis of coronary heart disease were 0.719 (95 % CI 0.675-0.763) and 0.652 (95 % CI 0.605-0.700), respectively, and the area under the ROC curve plotted with the joint equation of the two was 0.724 (95 % CI 0.681-0.768), which can better predict the occurrence of coronary heart disease.
Conclusion: TyG index and Non-HDL-C are independent risk factors for the occurrence of coronary heart disease, and the combination of the two can better predict the occurrence of coronary heart disease.
“I am sick, but that’s not all that I am”: patient perspectives on psychological adaptation to inborn errors of immunity
Authors: Beers Breanna J. , Davidson Hannah R. , Lewis Katie L. , Setzer Michael R. , Walkiewicz Magdalena A. , Similuk Morgan N.
Published: December 2024

Inborn errors of immunity (IEI) are rare heritable disorders of the immune system predisposing to atypical infections, autoimmunity, inflammation, and risk of malignancy. Adaptation is the process of incorporating stressful experiences into one’s life; these experiences may include onset of illness, receiving a diagnosis, or suffering without a diagnosis. Poor adaptation is linked to adverse outcomes including psychiatric comorbidities and decreased well-being. Most people with chronic illnesses and rare diseases adapt to their condition with time, but little is known about how this happens. We seek to address this gap in knowledge by investigating features of successful adaptation to IEI over time to help providers facilitate this process among those who struggle. We interviewed 20 self-reportedly well-adapted adults with IEI about their experiences of adaptation. We identified three overarching themes. First, many participants grappled with shame and loss but ultimately integrated their illness into their lives through acceptance, gratitude, and self-compassion. Second, knowledge and choice contributed to participants’ perceived control, but most participants were also forced to acknowledge the limits of that control when confronting unpredictable symptoms. Finally, social relationships could influence adaptation either positively or negatively. Notably, many participants found meaning in giving back to their communities, especially by educating others about their condition. Ultimately, participants showed that adaptation to life with IEI is complex and ongoing, requiring frequent recalibration to emerging challenges in new life stages. We provide recommendations to providers to help the results of this study shape their discussions with patients.
Diffused Multi-scale Generative Adversarial Network for low- dose PET images reconstruction
Authors: Yu Xiang , Hu Dao Yan , Yao Qiong , Fu Yu , Zhong Yan , Wang Jing , Tian Mei , Zhang Hong
Published: December 2024

Purpose: The aim of this study is to reconstruct low-dose PET (L-PET) images to full-dose PET (F-PET)images based on our Diffused Multi-scale Generative Adversarial Network (DMGAN) to resolve the trade-off between lowering radiation exposure and sustaining diagnostic accuracy.
Methods: The proposed method including two modules: the diffusion generator and the u-net discriminator. The goal of the first module is to get different information from different levels, enhancing the generalization capability of the generator to the image and improving the stability of the training. Generated images are inputted into the u-net discriminator, extracting details from both overall and specific perspectives to enhance the quality of the reconstructed F-PET images. We conducted evaluations encompassing both qualitative assessments and quantitative measures. In terms of quantitative comparisons, we employed two metrics, structure similarity index measure (SSIM) and peak signal-to-noise ratio (PSNR) to assess the performance of diverse methods.
Results: The proposed approach demonstrated the highest PSNR and SSIM values outperforming all compared methods, which improved PSNR by at least 6.2% over the other methods. Compared to other methods, the synthesized full-dose PET image generated by our method exhibits a more precise voxel-level metabolic intensity distribution, leading to a sharper and clearer visualization of the epileptic focus.
Conclusions: The proposed method can restore original details from low-dose PET images, surpassing the performance of other models trained on identical datasets, which can resolve the conflict between minimizing radiation exposure and sustaining diagnostic accuracy.
An unexpected find of multifocal extranodal marginal zone lymphoma
Authors: Bosch Glenn Van den , Develter Mieke , Willemse Johan , Boes Juul , Somers Katia , Douven Ulrike
Published: December 2024

In this case report we describe a patient who was diagnosed with extranodal marginal zone lymphoma (EMZL) at two different body sites, namely at the mucosa of the stomach and the lung. Since the patient presented with a main complaint of dyspnoea, this was a rather unexpected medical finding. To our knowledge, this is even the first case of multifocal EMZL in which the coexistent involvement of the stomach and lung is extensively documented. All medical and technical investigations that were performed during diagnosis and staging are described whilst discussing the typical characteristics of these kind of lymphomas as stated in current guidelines and literature.
Down-regulation of HSPB1 and MGST1 promote ferroptosis and impact immune infiltration in diabetic cardiomyopathy
Authors: Xie Yaoli , Liang Bin , Meng Zhijun , Guo Rui , Liu Caihong , Yuan Yi , Mu Wei , Wang Yajing , Cao Jimin
Published: December 2024

Diabetic cardiomyopathy (DCM) is a leading cause of death in diabetic patients. Current therapies do not adequately resolve this problem and focus only on the optimal level of blood glucose for patients. Ferroptosis plays an important role in diabetes mellitus and cardiovascular diseases. However, the role of ferroptosis in DCM remains unclear. Differentially expressed ferroptosis-related genes (DE-FRGs) were identified by intersecting GSE26887 dataset and the Ferroptosis Database (FerrDb). The associations between the DE-FRGs and immune cells in DCM, estimated by CIBERSORTx algorithm, were analyzed. Using flow cytometry (FCM) to evaluated the infiltration of immune cells of myocardial tissues. The expression of DE-FRGs, Glutathione peroxidase 4 (GPX4) and Solute carrier family 7 member 11 (SLC7A11) were examined by real-time quantitative PCR and western blotting. 3 DE-FRGs were identified, which are Heat shock protein family B (small) member 1 (HSPB1), Microsomal glutathione S-transferase 1 (MGST1) and solute carrier family 40 member 1 (SLC40A1) respectively, and they were closely linked to immune cells in DCM. In vivo, the levels of CD8 + T cells, B cells and Treg cells were significantly decreased in the DCM group, while the levels of CD4 + T cells, M1 cells, M2 cells and monocytes were increased. Diabetes significantly decreased HSPB1 and MGST1 levels and increased ferroptosis compared to normal group. Furthermore, ferroptosis inhibitor ferrostatin-1 (Fer-1) alleviated high-fat diet (HFD)-induced cadiomyocyte injury and rescued the ferroptosis. This study suggests that ferroptosis related gene HSPB1 and MGST1 are closely related to immune cell infiltration, which may become therapeutic targets for DCM.
Facile synthesis of hierarchical morphology highly porous carbon cobalt oxide composite from one-step carbonization of bio-waste for energy storage application
Authors: Ba Abdullah , Nagaraju Y S , Ganesha H , Veeresh S , Suresh D S , Vijaykumar S P , Sharanappa Sapna , Devendrappa H
Published: December 2024

A new strategy made to have a low-cost highly porous carbon electrode material by using bio-waste date seeds is activated with potassium hydroxide (KOH) for the synthesis of porous carbon cobalt oxide composite (PCCo) by facile one-step carbonization, and achieved high specific capacitance. The characterization of PCCo composite was done by powder X-ray diffraction, Fourier transform infrared spectrometer, field emission scanning electron microscopy, high-resolution transmission microscopy, and Raman spectroscopy techniques to confirm the changes in the chemical formation of the composite. The obtained PCCo composite has a porous structure with carbon frameworks and uniformly dispersed Co3O4 nanoparticles. This hierarchical architecture offers good ion/electron transport channels for better electrochemical characteristics.The maximum specific capacitance was found to be 548.4 F/g at a scan rate of 10 mV/s, and also from the galvanostatic charge-discharge curve, it was 696.8 F/g at a current density of 1.5 A/g. Additionally, capacitance retention is 84.4% and coulombic efficiency is 97% even after 5000 cycles. The energy density is 47.4 Wh kg-1 and the power density is 853.2 W kg-1. These results suggest that porous carbon composites are cost-effective, technologically unique, and eco-friendly for environmental supercapacitor applications.
Genome-wide phylogenetic analysis and expansion of gene families involved in detoxification in Smittia aterrima and Smittia pratorum (Diptera, Chironomidae)
Authors: Mao Bin , Zheng Yue , Xiao Yunli , Yang Kaixia , Shangguan Jingru , Shen Mi , Sun Hao , Fang Xiangliang , Fu Yue
Published: December 2024

Smittia aterrima and Smittia pratorum are important indicator insects for aquatic environments, showing extensive tolerance to the environment. However, the genome-wide phylogenetic relationships and characteristics of the detoxification mechanisms in S. aterrima and S. pratorum remain unclear. Based on the genomes of the two species obtained in our preliminary studies and nine genomes from the NCBI database, we found that chironomids diverged from other mosquitoes approximately 200 million years ago (MYA), and S. aterrima and S. pratorum diverged about 30 MYA according to phylogenetic analysis. Gene family evolution analysis showed significant expansion of 43 and 15 gene families in S. aterrima and S. pratorum, respectively, particularly those related to detoxification pathways. Positive selection analysis reveals that genes under positive selection are crucial for promoting environmental adaptation. Additionally, the detoxification-associated gene families including Cytochrome P450 (CYP), Glutathione S-transferases (GST), ATP-binding cassette (ABC), carboxylesterase (CCE), and UDP-glucuronosyltransferase (UGT) were annotated. Our analysis results show that these five detoxification gene families have significantly expanded in the chironomid genomes. This study highlights the genome evolution of chironomids and their responses to mechanisms of tolerance to environmental challenges.
Design, synthesis and biological evaluation of novel 1,2,3-triazoles chromone-oxime derivatives as potent indoleamine 2,3-dioxygenase 1 inhibitors
Authors: Fan Zi-Han , Huang Ri-Zhen , Liu Jia-Jia , Li Mei-Shan , Jing Xiao-Teng , Wang Heng-Shan
Published: December 2024

A series of chromone-oxime derivatives containing 1,2,3-triazole moieties were designed, synthesized and evaluated for their IDO1 inhibitory activities. These compounds displayed moderate to good inhibitory activity against IDO1 with IC50 values in low micromolar range. Among them, compound D20 displayed the most potent IDO1 inhibitory activities (hIDO1 IC50 = 0.084 µM, HeLa IDO1 IC50 = 0.059 µM) and was selected for further investigation. Surface plasmon resonance analysis confirmed that compound D20 directly interacted with IDO1 protein with a KD value of 0.57 µM. Molecular docking study revealed the oxygen atom in chromone-oxime moiety of compound D20 coordinated to the heme iron, and the 1,2,3-triazole group formed a hydrogen bond with the key residue ARG231. The UV spectra showed that D20 induced a Soret peak shift from 404 to 415 nm. Furthermore, compound D20 exhibited no cytotoxicity at its effective concentration in MTT assay. In summary, our study suggested that chromone-oxime derivatives containing 1,2,3-triazole moieties might serve as a potential agent for the further development of IDO1 inhibitors.
Genetically predicted levels of lithocholate sulfate mediate the association between the inflammatory factor MMP-1 and ischemic stroke
Authors: Zhang Zibin , Tian Jialong , Pang Xiaojun , Chen Huai , Jin Xuhong , Wei Yuyu
Published: December 2024

Background
This study aimed to investigate the causal relationship between the levels of the inflammatory factor matrix metalloproteinase-1 (MMP-1) and ischemic stroke (IS) and further examine the role of the metabolite lithocholate sulfate (LSL) as an intermediary factor.
Methods
We conducted a two-sample Mendelian randomization (MR) analysis on genetically predicted MMP-1 (14,744 samples) and IS (39,818 cases and 271,817 controls) using single nucleotide polymorphisms (SNPs) associated with research factors from the Genome-wide Association Study (GWAS) database. In addition, we calculated the LSL-mediated effect of MMP-1 on IS using multistep MR.
Results
Our MR analysis revealed that the genetic prediction of MMP-1 increased the risk of IS (inverse variance weighted analysis odds ratio (OR): 1.0852, 95% confidence interval (CI): 1.0311–1.1421, P-value = 0.0017). However, our inverse MR analysis revealed that the genetically predicted IS was not statistically significant for the risk of MMP-1 (OR: 1.0335, 95% CI: 0.9540–1.1197, P-value = 0.4198). The genetically predicted mediating effect of LSL on MMP-1 was − 0.00708 (95% CI: -0.0168–0.00265).
Conclusion
Our study not only revealed that MMP-1 is a risk factor for IS but also demonstrated for the first time that LSL might serve as a protective factor against IS. We further explored the possibility that MMP-1 might mediate the occurrence of IS through LSL and calculated the effect of LSL as a mediator. In clinical practice, greater attention should be paid to the impact of inflammatory factors on IS outcomes through blood metabolites as mediators. Further experiments are required to validate our findings.
Ultrasensitive MXene-Based Electrochemical Biosensor for Squamous Cell Carcinoma Antigen Detection
Authors: Jin Ju , Fang Xiaoqing , Ai Xue , Wang Jingjing
Published: December 2024

Squamous cell carcinoma antigen (SCCA) serves as a critical biomarker for cervical cancer, and its early detection is pivotal for enhancing patient outcomes. While traditional methods such as cytological screening and ELISA are established, their high costs and limited sensitivity hinder their widespread adoption for large-scale screening. In this study, we present an MXene-based electrochemical sensor (MX-iEC-SCCA) that markedly improves sensitivity and stability through the superior conductivity and extensive surface functional groups of MXene. The sensor demonstrates a detection range for SCCA from 0.01 pg/mL to 10 ng/mL, with an exceptional detection limit of 0.0036 pg/mL. Reproducibility tests reveal a relative standard deviation (RSD) of 1.51%, with a minimal signal decrease of 0.3% over five weeks, underscoring its stability. In experiments with standard plasma samples, the biosensor demonstrated a robust correlation with target values (R² = 0.9787). Analysis of 15 low-concentration and 16 high-concentration plasma samples yielded highly significant t-test results (p = 3.74E-06 < 0.01). ROC curve analysis further validates the sensor’s efficacy, with an AUC of 0.982, specificity of 0.933, and sensitivity of 0.866. These findings highlight the remarkable reliability and potential of MX-iEC-SCCA for SCCA detection, positioning it as a precise and efficient tool for the early diagnosis of cervical cancer and other malignancies.
Discordant lymphoma characterized by the coexistence of diffuse large B-cell lymphoma in the brain and mantle cell lymphoma in the colon, rectum, and bone marrow.
Authors: Yamaguchi Kyosuke , Yamamoto Go , Watanabe Otoya , Kageyama Kosei , Kaji Daisuke , Taya Yuki , Nishida Aya , Ishiwata Kazuya , Takagi Shinsuke , Yamamoto Hisashi , Asano-Mori Yuki , Uruga Hironori , Ito Shinji , Takazawa Yutaka , Wake Atsushi , Uchida Naoyuki , Taniguchi Shuichi
Published: December 2024

We describe a rare case of discordant lymphoma characterized by the coexistence of diffuse large B-cell lymphoma (DLBCL) in the brain and mantle cell lymphoma (MCL) in the colon, rectum, and bone marrow. A 63-year-old male patient with consciousness impairment and gait disturbance was admitted to our institution. Head computed tomography scan and contrast-enhanced magnetic resonance imaging showed a mass in the right temporal lobe and rectal wall thickening. Brain biopsy revealed DLBCL, and bone marrow and rectum biopsy showed MCL. According to a polymerase chain reaction analysis of immunoglobulin heavy-chain gene rearrangements using brain and bone marrow specimens, the two lesions were clonally unrelated lymphomas. After five cycles of R-MPV (rituximab, methotrexate, procarbazine, vincristine) therapy and three cycles of R-ESHAP (rituximab, etoposide, cytarabine, cisplatin, methylprednisolone) therapy, the patient received autologous hematopoietic stem cell transplantation using R-MEAM (rituximab, ranimustine, etoposide, cytarabine, melphalan) regimen after bridging therapy with ibrutinib. In addition, he received whole-brain irradiation at a dose of 40 Gy in 20 fractions as consolidation therapy. He did not relapse within 3 years of transplantation. To the best of our knowledge, this is the first case report of DLBCL and MCL coexistence.
Structural and Vascular Assessment of the Optic Nerve Head and Macula in Chronic Chagas Disease
Authors: Agra Cristiana L. M. , Ventura Camila V. , Fonte Letícia D. , Oliveira Marcela R. V. , Leal Marília , Assunção Maria Elisa L. S. M. , Cavalcanti Maria da Glória A. M. , Alves Silvia M . M. , Soares Ana Karine , Ventura Liana V. , Prata Tiago S.
Published: December 2024

Chagas disease (CD), a parasitic infection, may have ocular repercussion in its cardiological form, since history of heart disease of other etiologies has already been established as a risk factor for neuropathies and maculopathies. The aim of the present study was to investigate preclinical structural and vascular optic nerve head (ONH) and macular parameters in chronic CD patients. Chagasic patients and healthy subjects (n = 19) were evaluated with optical coherence tomography, optical coherence tomography angiography and Laguna ONhE® software. The main outcome measures were the glaucoma discriminant factor, average peripapillary retinal nerve fiber layer thickness, ganglion cell complex thickness, peripapillary vascular density (VD), foveal and parafoveal thickness, foveal avascular zone area, and total foveal and parafoveal VD from the superficial and deep capillary plexus that were compared between the two groups. No significant differences were observed among the studied variables. Although our findings suggest that the cardiovascular dysfunction resulting from chronic CD does not seem to cause significant structural or vascular preclinical changes to the ONH and the macula, the results herein can benefit the chagasic population and provide important information about the progression of the disease and its systemic complications.
Constructing Machine Learning-Based Risk Prediction Model for Osteoarthritis in Population Aged 45 and Above (NHANES 2011-2018)
Authors: FU YUN , Yu Yaming , Chen Weichao
Published: December 2024

Background: Osteoarthritis is a widespread chronic joint disease, becoming increasingly common in prevalence among individuals over the age of 45. This condition not only leads to joint pain and dysfunction but also significantly disrupts the patients’ daily life. Therefore, the objective of this study is to develop an interpretable machine learning model for predicting the risk of osteoarthritis in individuals aged 45 and above.
Methods: This study utilized data from the National Health and Nutrition Examination Survey(NHANES) from 2011 to 2018, including a total of 2980 individuals. The dataset was randomly divided into a training set (n=2235) and a validation set (n=745). Five machine learning algorithms were employed to develop the predictive model for osteoarthritis. The SHapley Additive exPlanation (SHAP) method was used to interpret the ML algorithms and identify the factors that made the most significant contribution to the prediction outcomes.
Results: A total of 2980 individuals were included, with an average age of 60 years, of whom 605 were diagnosed with osteoarthritis. Twenty-four variables were included in the modeling, and five machine learning algorithms were used to predict the risk of osteoarthritis. After feature selection using Recursive Feature Elimination(RFE), the CatBoost model with 20 variables showed the best prediction performance. The most influential predictors were Gender, Age, BMI, Waist circumference, and Race.
Conclusion: This study demonstrates that the CatBoost model with 20 variables can effectively predict the occurrence of osteoarthritis.
Potential Retinal Imaging Markers for Moyamoya Disease: Changes in Retinal Microvasculature and Thickness
Authors: Wei Hong , Chen Cheng , Qian Xian-Zhe , Ge Qian-Min , Hu Jin-Yu , Hong Qi , Peng Rui , Wang Xiao-Yu , Zeng Yan-Mei , Ling Qian , Zou Jie , He Liang-Qi , Chen Xu , Shao Yi
Published: December 2024

Moyamoya disease (MMD) is a structural abnormality of the cerebral vasculature characterized by cerebral ischemia, and is rare but its incidence is increasing. Digital subtraction angiography (DSA) of the brain is the primary means of diagnosing and evaluating this disease. But its high price and invasiveness limit its use as a monitoring tool for disease progression. As a non-invasive test for ophthalmic disorders, the optical coherence tomography angiography (OCTA) is widely used. In addition to ophthalmic diseases, OCTA has also been used in some neurological diseases. The aim of this study was to assess fundus changes in patients with MMD by OCTA and to investigate whether these changes could be a diagnostic and assessment marker for MMD. This study evaluated cerebral vessels, superficial macular capillary vessel density (SMC-VD) and macular retinal thickness (MRT) in subjects in the non-operated group (nGO), operated group (OG) and healthy controls (HC) using DSA, OCTA and other techniques. Analyses of variance (ANOVA) and Bonferroni post hoc analysis were used to calculate statistical differences between the three groups. Correlations between SMC-VD and MRT were assessed using Pearson correlation analysis. In addition, the ability of the SMC-VD and the MRT to distinguish MMD from HC was analyzed using receiver operating characteristic (ROC) curves. We found that the SMC-VD and MRT in the nOG group were significantly lower than those in the HC group and had not returned to normal levels at one month postoperatively. In the nOG, the SMC-VD and MRT were positively correlated in the Full region (6*6 mm) and in the Inner region (3*3 mm), and in many subregions they showed high ability to distinguish MMD from HC. The above findings indicate significant reduction in the SMC-VD and the MRT in patients with MMD even in the absence of ocular clinical manifestation. Most importantly, SMC-VD and MRT have a strong ability to distinguish between MMD patients and HC, suggesting that OCTA, a relatively inexpensive and non-invasive method, is useful in assessing cerebrovascular changes in MMD patients.
Cognitive and Neurophysiological Impact of Autonomous Sensory Meridian Response: Heart Rate Variability-Guided Responder Classification
Authors: Wang In-Nea , Kim Hayom , Kim Hakseung , Yoon Ho-Jin , Park Jun-Su , Kim Jung Bin , Kim Dong-Joo
Published: December 2024

Autonomous Sensory Meridian Response (ASMR) is a sensory phenomenon characterized by tingling sensations starting at the scalp and extending down the neck and limbs. Despite increasing research on ASMR, studies on its cognitive and physiological effects remain limited. Individual differences in ASMR responsiveness underscore the need to distinguish between ASMR responders and non-responders. Herein, we investigated the effects of ASMR on cognitive function and neurophysiological changes and objectively distinguished ASMR responders and non-responders using heart rate variability (HRV) indices. Participants were exposed to auditory ASMR triggers composed of natural sounds for 5 minutes. Before and after the ASMR trigger, cognitive function was assessed using the Mini-Mental State Examination, and neurophysiological and physiological changes were observed by recording electroencephalogram (EEG) and electrocardiogram. We found that ASMR exposure led to two cognitive improvements: faster completion of the Trail Making Test Part B and better word recall during delayed recall tasks. EEG analysis revealed increased power spectral density in the Fz and Pz regions across all frequency bands after ASMR, significant increases in resting-state functional connectivity, and enhanced parasympathetic activity indicators. Altogether, ASMR may enhance executive function and memory recall, with HRV indicators aiding in identifying individuals who benefit from ASMR.
Reduction corporoplasty for idiopathic acquired aneurysmal dilatation of the corpora cavernosa: surgical management of the ‘Bullfrog syndrome’. Case report.
Authors: Sempels Maxime , Andrianne Robert , Waltregny David , Triffaux François
Published: December 2024

Background: Penile deformities are heterogeneous and due to various causes.
Among these deformities, acquired enlargement of the penis is a rare condition and can be disastrous for sexual life. Only scattered cases of acquired penile girth increase have been published with different names, and the surgical management of this condition remains not clear.
Case presentation: We report a case of idiopathic acquired aneurysmal dilatation of the corpora cavernosa, which we called ‘bullfrog syndrome’. Evaluation included a penile doppler ultrasound and a magnetic resonance imaging, which revealed true aneurysmal dilatation of the corpora in their middle and distal portions, occurring only during erection. Conclusion: We describe an innovative surgical technique of corporoplasty to treat this penile disfiguration. Our technique included a corpora cavernosa plication and a polypropylene mesh support. The patient was satisfied and reported a normally shaped penis, an intact erectile function and no recurrence.
Worm-eaten-like osteolytic changes in multiple bones of the foot following stable ankle fracture: A case report and literature review
Authors: Wu Haotian , Yao Liqing , Yang Xue , Zhou Yao , Chen Zihan
Published: December 2024

Objective Stable fractures of the ankle joint are common in rehabilitation departments, often resulting in foot and ankle joint dyskinesia. Patients with ankle fractures usually experience pain, stiffness, swelling, limited mobility, lower extremity muscle weakness, and walking abnormalities. However, no reports have been published on stable ankle fractures causing polyostotic osteolytic changes in the foot and the subsequent formation of free bone fragments. In this case report, we described a case of a stable fracture of the right lateral malleolus with pathological alterations characterized by worm-eaten-like osteolytic changes in the distal right tibia, talus, calcaneus, and navicular bones, accompanied by the rare development of free bone fragments in the lateral ankle.
Method & Conclusion After an extensive literature review and thorough patient assessment, we concluded that the probable pathological cause was atherosclerosis affecting multiple blood vessels throughout the body due to risk factors such as hypertension and hyperlipidemia. Additionally, the localized trauma-induced fracture led to the foot and ankle swelling and altered bone stress loading, further triggering a cascade of vascular inflammatory reactions and sympathetic excitation within the already atherosclerotic blood vessels. Moreover, these effects were exacerbated by early inappropriate immobilization, which resulted in ischemia and hypoxia of the bone tissues in the injured area. Ultimately, all these factors contributed to the impaired healing of the ankle fracture and osteoporosis development in multiple foot bones. This case report presents a rare manifestation of a common condition, aiming to enhancethe decision-making process of cliniciansand facilitate the formulation ofbetter clinical diagnostic and therapeutic strategies.
Enhancement of inter-/intra-reader agreement using the Prostate Imaging Reporting and Data System version 2.1 for prostate cancer detection in magnetic resonance imaging/transrectal ultrasound software fusion prostate biopsy
Authors: Song Won Hoon , Kim Tae Un , Ryu Hwa Seong , Yun Mi Sook , Park Sung-Woo
Published: December 2024

Purpose: This study evaluated inter-/intra-reader agreement with PI-RADS version 2.1 to improve the detection rate of prostate cancer.
Methods: We enrolled 210 patients who underwent multiparametric magnetic resonance imaging (mpMRI) for clinically suspected or diagnosed prostate cancer. Four readers, including two urologists, viewed patients’ mpMRI and scored PI-RADS between two sessions. Inter-and intra-reader agreements were evaluated using Fleiss's Kappa coefficient (κ), agreement coefficient 1 (AC1), and percentage of agreement(PA).
Results: The overall inter-reader agreement between all readers was moderate (κ=0.466, AC1=0.522, and PA=0.610). The overall inter-reader agreement improved in the second session. The agreement for peripheral zone (PZ) lesions was higher than that for transitional zone (TZ) lesions. At a PI-RADS cut-off of 4, the agreement for PZ lesions was almost perfect (PA=0.888) and higher than that for TZ lesions. The inter-reader agreement for lesions with a PI-RADS ≥ 4 and Gleason score ≥ 7 was almost perfect (AC1=0.960 and PA=0.964). The intra-reader agreement for lesions overall and PI-RADS ≥ 4 lesions were substantial(AC1=0.601) and almost perfect (PA=0.876), respectively.
Conclusion: Readers achieved moderate agreement for PI-RADS version 2.1 and benefitted from training sessions. Feedback, training, and multidisciplinary discussions also improved inter-reader agreement. Our study can provide guidance, updates, and further steps for the standardization and improvement of PI-RADS scoring.
Barriers and facilitators to integration of screening for hypertension, diabetes mellitus and dyslipidaemia, among adult people living with HIV at district hospital ART clinics in Southern Malawi
Authors: Katundu Kondwani G.H. , Mukhula Victoria , Matemvu Zaithwa , Mtonga Angel J. , Kasanda-Ndambo Myness , Lubanga Adriano F. , Malenje Monalisa G. , Nyangulu Wongani , momba Grace , Triulzi Isotta , Kalanga Noel , Mipando Mwapatsa , Nyondo-Mipando Alinane Linda , Hosseinipour Mina C.
Published: December 2024

Background
Atherosclerotic cardiovascular diseases (ASCDs) are a significant health concern globally and in Sub-Saharan Africa (SSA), particularly for people living with HIV (PLWH). Hypertension, diabetes mellitus (DM), and dyslipidaemia significantly increase the risk of ASCDs, and integrating screening for these conditions in public health facilities remains challenging in Malawi. This study aimed to explore the barriers and facilitators to integrating screening for hypertension, DM and dyslipidaemia among adult PLWH at district hospital ART clinics in Southern Malawi.
Methods
This was mixed-methods study conducted between November 2021 and April 2022. Quantitative data was collected from retrospective ART clinic records from between 2016 and 2020 (n = 875) from five district hospital ART clinics and informed the subsequent qualitative data collection, guided by the Consolidated Framework for Implementation Research (CFIR) in three purposively selected district hospital ART clinics. The qualitative aspect included in-depth interviews, focus group discussions, and key informant interviews. Non-participant observations were also conducted to assess the availability of functional screening equipment. Descriptive statistics were used to analyse the quantitative data while the qualitative data was analysed using thematic analysis.
Results
One district hospital ART clinic facility only performed the screening for hypertension and DM (40% and 9.84% at the commencement of ART and 39.4% and 5.14% in 2021). Facilitators for integration included time efficiency, patient information integration, existing infrastructure utilization, organisational incentives and training. Barriers included clinic flow delays, additional strain on a limited workforce, lack of prioritization and resources, increased workload and inadequate knowledge. PLWH expressed fear of screening and diagnosis without available medication.
Conclusion
The study found poor integration of hypertension, DM and dyslipidaemia screening among PLWH in Southern Malawi, but highlighted opportunities for successful implementation. Our study emphasizes the feasibility of the intervention and the importance of coordination between HIV and NCD care services in low-income settings such as Malawi.
Clinical Feasibility of MRI-guided In-Bore Prostate Biopsies at 0.55T
Authors: Kaur Tejinder , Jiang Yun , Seiberlich Nicole , Hussain Hero , Wells Shane , Wei John , Caoili Elaine , Gulani Vikas
Published: December 2024

Objective
In-bore MRI-guided biopsy allows direct visualization of suspicious lesions, biopsy needles, and trajectories, allowing accurate sampling when MRI-ultrasound fusion biopsy is not feasible. However, its use has been limited. Wide-bore, lower-field, and lower-cost scanners could help address these issues, but their feasibility for prostate biopsy is unknown. The purpose of our study was to evaluate the feasibility of in-bore MRI-guided prostate biopsy using a large-bore (80cm), 0.55T scanner.
Materials and Methods
Nineteen participants (68 ± 10 years) with suspected prostate cancer (PCa) were recruited for this Institutional Review Board (IRB) approved study (May 2023 -October 2024). Prebiopsy diagnostic scans and intra-procedural T2-weighted images were used for lesion localization. PSA levels, lesion sizes, cancer detection rates, positive core volume percentage, ISUP (International Society of Urological Pathology) grade groups (GG), positive volume cores, skin to target distances, and procedure durations were reported.
Results
Seventeen participants underwent biopsies (four transrectal, thirteen percutaneous). Two participants were excluded. Twenty lesions (mean size 1.95 ± 1.29 cm) were biopsied which showed various GG cancers (GG1, GG2, GG3, GG4, and GG5), with positive cores ranging from 10%-100%. 20% of the lesions were benign. Compared with the previous biopsy results, 11.7% of participants had a GG upgrade, 17.6% had an upgrade in positive core volume, 17.6% had negative biopsies and 47% of biopsy-naïve participants had new cancer detections. No upgrade was observed in 5.8% cases. One new cancer was detected near a hip prosthesis due to reduced imaging artifacts. Average total procedure time was 77 ± 21 minutes for transrectal and 74 ± 22 minutes for percutaneous biopsies, with times to first core at 45 ± 15 and 53 ± 14 minutes, respectively.
Conclusion
Identifying and accurately targeting suspicious prostate lesions is feasible using a 0.55T MRI scanner.
Endoscopic Surgery for Primary Empty Sella Syndrome: The "7 E" Technique
Authors: Villalonga Juan F. , Castillo Andrea L. , Pailler Jose I. , Martinez-Font Agustín , Campero Alvaro
Published: December 2024

Introduction:
Extradural reconstruction of the sellar floor is indicated in patients with primary empty sella syndrome and visual deficits without any other apparent cause. Our team in Tucumán has developed an endoscopic technique called the "7 E" (i.e., endoscopic endonasal approach, exposure, extradural, elevate, egress, embed, exclude). This technique involves the exposure of the sella turcica using a Guanti Bianchi approach and reconstructing the sellar floor with heterologous material. This study aims to present the preliminary results of the "7 E" technique.
Materials and Methods
A prospective study was conducted from January 2020 through April 2024 at a single center in Tucumán, Argentina. All surgical procedures were performed by the same surgeon. Patients with idiopathic primary empty sella syndrome and confirmed visual deficits were included, excluding those with other causes of visual deficits. An endoscopic endonasal approach and reconstruction of the sellar floor with heterologous material were used. Patients were evaluated pre- and postoperatively with MRI and visual field testing.
Results
Thirteen female patients with a mean age of 48.31 years were included. Nine patients (69.2%) had excellent visual field improvement, three (23.1%) had acceptable results, and one (7.7%) showed worsening. Regarding headaches, ten patients (76.9%) showed significant improvement. Three patients presented complications: one with panhypopituitarism and two with transitory diabetes insipidus.
Conclusion
The "7 E" technique proved effective in treating primary empty sella syndrome without associated increased intracranial pressure.