bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proinflammatory and Prothrombotic Conditions in JAK2V617F-Positive MPN: A Case of Lemierre’s Syndrome in Essential Thrombocythemia
Authors: Izumi Takuya , Takano Kosuke , Nagao Shigeki , Tachi Noriaki , Sato Sho , Nakagawa Masaya , Sone Takehiro , Takada Kohei , Ogata Hiraku , Saito Keita , Kato Shoichiro , Maekawa Takaaki , Yoshimi Akihide , Kobayashi Shinichi , Kimura Fumihiko 
Published: December 2024

Abstract

Lemierre’s syndrome (LS) represents a rare yet potentially life-threatening systemic infection, characterized by thrombophlebitis of the internal jugular vein and abscess formation in distant organs. It typically follows episodes of tonsillitis or other infections of the oropharyngeal region. Pulmonary complications, including septic pulmonary emboli, are common. Essential thrombocythemia (ET) is a chronic myeloproliferative neoplasm (MPN) sometimes associated with the JAK2V617F mutation, which predisposes patients to thrombotic events. A 66-year-old male with JAK2V617F-positive ET presented with severe pulsatile pain radiating from the right temporal region to the occipital area following a recent dental infection. Although pain management was administered, the pain continued to persist. Computed tomography of the chest revealed multiple subpleural nodules, raising suspicion for septic pulmonary emboli. Further investigation with gadolinium-enhanced magnetic resonance imaging identified a thrombus extending from the right sigmoid sinus into the internal jugular vein, consistent with cerebral venous thrombosis. The patient was diagnosed with LS, complicated by septic thrombosis. Blood cultures yielded alpha-hemolytic streptococcus. Empirical antimicrobial therapy combined with anticoagulation was initiated, resulting in a gradual improvement of symptoms, including the resolution of fever and pain. Follow-up imaging confirmed the resolution of both the infection and thrombosis. This is the first reported case of LS in a patient with JAK2V617F-positive ET. The coexistence of LS and JAK2V617F-positive MPN highlights the potential interplay between proinflammatory and prothrombotic conditions associated with the JAK2V617F mutation.
Family Stress and Child BMIz during the COVID-19 Pandemic: Exploring the Mediating Effects of Cortisol
Authors: Douglas Sabrina , Laila Amar , Tremblay Paul , Buchholz Andrea , Miller Alison , Pare Shannon , Gunn Elizabeth , Duncan Alison , Ma David , Vallis Lori , Morrison Katherine , Haines Jess 
Published: December 2024

Abstract

Previous research has suggested that children who are exposed to chronic stress are at greater risk for childhood obesity, however little research has examined the mechanism of this association. This study aimed to investigate the association between family and household stress during the COVID-19 pandemic and children’s BMIz, and whether children’s hair cortisol concentration (HCC) mediates this association. This study used baseline data from 228 children 2–6 years from the Family Stress Study, a prospective cohort study of families with children 2–6 years. Parents responded to an online survey which assessed family and household stressors including family functioning, home chaos, financial insecurity, parental depression, parenting stress, stressful life events, and COVID-19 stressors. A total family chronic stress index score was calculated from parents’ responses on these measures. Hair samples were collected from children to assess their HCC. The Hayes PROCESS mediation macro was used to assess the total, direct, and indirect effect of the family chronic stress index on child BMIz, adjusting for household income and child ethnicity/race. We found that the family chronic stress index was associated with higher child BMIz (b = 0.979, 95% CI = 0.346–1.611), but this association was not mediated by children's HCC (b = 0.0005, CI=-0.047–0.067). Future research should investigate the validity of using hair cortisol to measure chronic stress among children younger than 6 years and explore other mechanisms of how chronic stress is associated with children’s weight outcomes, parenting practices that influence children’s eating behaviour or physical activity, or children’s weight-related behaviours.
Acute Left Main Coronary Artery Occlusion with South African Flag Sign on Electrocardiogram: A Case Report
Authors: Zhong Fangming , LIN Baiqing , Zhang Qifeng 
Published: December 2024

Abstract

Background: The South African flag sign(SAFS) in electrocardiogram(ECG) indicates that the patient may have acute high lateral wall myocardial infarction typically linked to first diagonal branch occlusion, which has not been reported in Left Main Coronary Artery(LMCA) occlusion.
Case Presentation: A 69-year-old female with primary hypertension presenting with chest pain for 1.5 hours. Initial ECG findings indicated SAFS, suggesting a high lateral myocardial infarction initially believed to involve the first diagonal branch. However, emergent coronary angiography revealed an unexpected complete occlusion of the LMCA with no collateral flow (thrombolysis in myocardial infarction [TIMI] flow grade 0). The patient underwent successful percutaneous coronary intervention, which restored optimal blood flow (TIMI grade III). The patient was managed with a comprehensive medication regimen, leading to an uneventful recovery and discharge without complications. Follow-up assessments at one and six months showed no adverse cardiac events or symptoms.
Conclusions: This case underscores the need for heightened clinical vigilance when interpreting ECG with SAFS, as it may indicate more severe coronary artery pathology. The report also suggests a reevaluation of the diagnostic utility of SAFS in identifying the site and severity of coronary artery occlusions.
Clinical Characteristics of Patients with Urosepsis: A Descriptive Study Based on the MIMIC-IV Database
Authors: Hu Haopu , Bian Xiaolong , Ni Runfeng , Tian Cong , Wang Mingrui , Ji Jiaxiang , Lai Chin-hui , Lai Shicong , Xu Tao , Hu Hao 
Published: December 2024

Abstract

Objective
This study aimed to compare the clinical characteristics of urosepsis patients with those having other types of sepsis, extract key clinical insights, and identify potential future research avenues.
Material and Methods
Data from 32,971 anonymized records in the MIMIC-IV database were analyzed. Among these, 6,141 patients met the inclusion criteria for sepsis. A comparative analysis was conducted, followed by univariate and multivariate Cox regression analyses to assess in-hospital mortality.
Results
The analysis included 1,418 urosepsis patients and 4,723 non-urosepsis patients. Urosepsis predominantly affected older individuals, particularly women, with a higher prevalence of comorbidities such as myocardial infarction, congestive heart failure, renal disease, severe liver disease, diabetes mellitus, and AIDS. Laboratory evaluations indicated lower white blood cell counts, neutrophil levels, and neutrophil-to-lymphocyte ratios (NLR) in urosepsis patients. The main pathogens in urosepsis were gram-negative bacteria (44.0%) and fungi (21.9%), whereas non-urosepsis was mainly caused by Gram-positive bacteria (57.2%). Regression analysis showed advanced age and elevated lactate levels as significant predictors of in-hospital mortality in urosepsis. The use of vasoactive agents appeared to improve prognosis. Current SOFA and SAPS II scores are inadequate for evaluating urosepsis severity.
Conclusions
Urosepsis is characterized by a higher prevalence in women, older age, and more comorbidities. Organ failure is less severe than in other sepsis types, resulting in a relatively improved prognosis. Advanced age and elevated lactate levels are independent risk factors, while early vasopressor administration may protect urosepsis patients. Current scoring systems have limited applicability to this population.
Extracts of carica papaya L. and capsicum annuum L. showed comparable efficacy to piperazine citrate and levamisole hydrochloride in treatment of poultry helminths
Authors: Zirintunda Gerald , Kateregga John , Nalule Sarah , Biryomumaisho Savino , Omujal Francis , Okwee-Acai James , Vudriko Patrick 
Published: December 2024

Abstract

Background
In rural smallholder poultry production systems, commercially available anthelmintic drugs are generally expensive, and in some instances ineffective because of resistance developed against. We report on the phytochemical properties and efficacy of crude extracts of carcia papaya and capsicum annuum against natural helminth infections of chicken in …….. District, Eastern ………..
Methods
An experiment was set to evaluate efficacy of crude extracts of C. papaya and C. annuum against natural poultry helminths infections. Commercially available formulations of levamisole and piperazine were used as control treatments. Faecal egg count reduction (FECR) tests were used to measure efficacy of the treatments.
Results
On gas chromatograph mass spectrometry (GC-MS) analysis of CPLa showed sterols (13%), Vitamin C (42%), Triterpenoids (6%). CPLe contained pyranones (20.3%), phenolics (3.1%), glycosides (2.2%), diterpenoids (4.9%), lipids (45.04%), triterpenoids (3.5%) and steroids (1.4%). Gas Chromatography-mass Spectrometry (GC-MS) analysis of CAFa gave lipids (45.04%), alkanes (27.7%) and alkaloids (8.2%). CAFe showed glycosides (3.61%), lipids (50.16%), pyranones (3.55%) and alkaloids (22.73%). In the in-vitro assays; 0.08g/ml of each of the extracts had immobilized more than 50% of adult A. galli after five hours. The ranking of the in-vivo average FECR was Levamisole hydrochloride > CPLa > CAFa > CAFe > CPLe > piperazine citrate with the percentage reductions of 98.67 ± 2.309, 97.67 ± 2.517, 79.67 ± 1.528, 76.33 ± 1.528, 54.00 ± 2.00, 35.67 ± 2.082 respectively.
Conclusion
The GC-MS analysis of the analysed plants shows presesnce of terpenoids, phenolics and alkaloids which are known for anthelmintic action. All the extracts caused higher FECR than piperazine. The presence of Vitamin C in CPLa resulted in it being as good as levamisole. Combinations of anthelmintics with Vitamin C are recommended and toxicological studies before recommendation of these alternatives.
Demographics and Coronary Angiographic Patterns in Young Adults in a Sub-Saharan Referral Hospital
Authors: Abdi Ishak Ahmed , Arin Can Baba 
Published: December 2024

Abstract

The objective of this study was to determine the demographic and Coronary Angiographic trends in young adults diagnosed significant coronary artery disease (CAD) at a referral hospital, Somalia. We performed a retrospective cross-sectional study in 81 patients who were 40 years of age or younger and underwent coronary angiography from October 2022 to October 2024. Results: The analysis showed a majority of male patients (74%) with an average age at 33.6 years. Nearly two thirds of patients (67.1%) had a history of smoking and more than half used Khat (55.6%); No risk factors were identified in 12.5% of the patients. Additionally, other notable risk factors included hypertension (27.2%), diabetes (13.6%), and Dyslipidemia (12.3%), indicating a multifactorial etiology of CAD in this population. The most frequent clinical presentation was ST-segment elevated myocardial infarction (STEMI) observed in 61% of the patients, with single-vessel disease being more common and almost two thirds involving left anterior artery (LAD). Smoking duration was significantly correlated with vessel involvement (r = 0.265, p = 0.017) and khat use showed an independent association to number of affected vessels (p = 0.044). Conclusion — these findings confirm the increasing burden of CAD among young people in sub-Saharan Africa and support a public health approach to preventive measures.
Recombinant Zoster Vaccine Used to Prevent Recurrent Shingles in an Adolescent Renal Transplant Recipient
Authors: Nikfarjam Niloufar , Grimm Paul C. 
Published: December 2024

Abstract

Shingles, a reactivation of the varicella virus, is more common in immunosuppressed patients. Children with chronic or end-stage kidney disease may not respond effectively to live varicella vaccination, making it controversial post-transplant. Antiviral treatments for shingles can be nephrotoxic, and reducing immunosuppression to enhance immune responses may risk transplant rejection. Recombinant Zoster Vaccine (RZV) was initially FDA-approved for immunosuppressed adults over 50. We present a case of an adolescent who, after receiving the live varicella vaccine with IgG seroconversion, developed recurrent shingles post-kidney transplant and varicella seronegative status. Antiviral treatments and reduced immunosuppression contributed to graft loss. Post-second transplant, shingles recurred, leading to off-label RZV administration while fully immunosuppressed. Post-RZV, there were no rejection or shingles episodes, and strong IgG seroconversion occurred. Following RZV treatment, the Advisory Committee on Immunization Practices revised guidelines in 2021 to include RZV for adolescents over 19, potentially benefiting pediatric transplant recipients.
Establishing and Validating a Risk Model for In-hospital Mortality Within 60 Days Under ICU Treatment for Tuberculosis in China
Authors: Hou Keke , He Jianglin , Li Tao , Li Xiu , Zhang Na 
Published: December 2024

Abstract

Background
Tuberculosis (TB) is the leading cause of death from a single infectious disease. Current studies on TB patient mortality risk factors in intensive care are old and scarce. We aimed to create a model to predict in-hospital mortality risk for TB patients in ICU and identify mortality risk factors.
Methods
TB patients' data from 2016 to 2020 admitted to the ICU were collected retrospectively and randomly split into derivation and validation groups at a 7:3 ratio. The main outcome was 60-day in-hospital mortality. Analyses included Cox, nomogram, decision curve, and Kaplan‒Meier methods.
Results
A total of 848 patients were included (594 in the derivation group and 254 in the validation group). A total of 106 (17.85%) patients died in the derivation group. Multivariate Cox regression analysis revealed that sputum smear, severe pneumonia, c-TnI, mold, age, diastolic blood pressure (DBP), and tracheotomy were independent risk factors for 60-day in-hospital mortality in ICU patients with TB, and the prognostic index (PI) was defined as follows: PI = 0.0084 × Age − 0.0026 × DBP + 2.1988 × Severe pneumonia1 + 0.9094 × Tracheotomy1 + 1.2253 × Sputum smear1 + 0.826 × Mold1 + 0.5147 × c-TnI. Decision curve analysis (DCA) diagrams showed that the diagnostic probabilities of the derivation and validation groups were 0–70% and 0–58% respectively, with high model application accuracy and net benefit. Receiver operating characteristic (ROC) curve analysis revealed that the PI could predict death with good sensitivity (0.830) and specificity (0.867), and the cutoff value was 0.195 (the area under the curve (AUC) was 0.894, 95% CI: 0.865 to 0.924). K‒M analysis revealed that the proportion of deaths was increased when the PI was ≥ 0.195.
Conclusion
The nomogram-based prediction model of mortality within 60 days in TB patients in the ICU showed good discrimination and accuracy, and is of great clinical value for screening patients at high risk of death to support the development of intervention strategies for ICU patients with TB and to reduce mortality.
Early Impact of Maternal Voice Stimulation on Cortical Recovery and Neurodevelopment in Neonates with Severe Asphyxia
Authors: Zhang Qinfen , Jin Wenjie 
Published: December 2024

Abstract

Objective
This study aimed to evaluate the effects of maternal voice stimulation on cortical activity, physiological stabilization, and neurodevelopmental outcomes in neonates with severe asphyxia.
Methods
A total of 72 neonates were enrolled and divided into three groups: severe asphyxia with maternal voice intervention (SM, n = 23), severe asphyxia with standard care (SC, n = 19), and normal controls (NC, n = 30). The SM group received 15-minute sessions of structured maternal voice playback three times daily for 10 days. EEG power spectral density (PSD) was analyzed across the 0–8 Hz frequency ranges before and after the intervention. Neurodevelopmental outcomes were assessed at one year using the Gesell Developmental Scale. Physiological parameters, including heart rate, respiratory rate, and oxygen saturation, were monitored during intervention sessions.
Results
The SM group showed significant increases in overall PSD within the 0–8 Hz frequency range following the intervention (P < 0.05), achieving levels comparable to the NC group, while no improvement was observed in the SC group. Maternal voice stimulation also stabilized physiological parameters, with significant reductions in heart rate and respiratory rate and improvements in oxygen saturation (P < 0.05). At one year, the SM group demonstrated developmental quotients comparable to the NC group across motor, adaptive, and language domains, whereas the SC group exhibited significant delays (P < 0.05).
Conclusion
Maternal voice stimulation enhances cortical activity, stabilizes vital signs, and supports neurodevelopmental recovery in neonates with severe asphyxia. This intervention offers a promising, non-invasive approach to improving outcomes for high-risk neonates in neonatal intensive care units.
Misdiagnosis of the Polymorphous Low-Grade Neuroepithelial Tumor of the Young as Ganglioglioma，A Case Report
Authors: Lai Lijuan , Li wei , Song Guojun , Yang Xuefeng , Ou Shizhao , Chen Chao , Chen Xia , Qian Hong , Tang Yanfen 
Published: December 2024

Abstract

Background
PLNTY traditionally manifests as an epileptogenic subtype, posing challenges in differential diagnosis. The low incidence of PLNTY and the similarity of its clinical presentation and imaging features with other types of neuroepithelial tumors have made it important to diagnose PLNTY accurately.
Case presentation
We report here an unusual case of a PLNTY in a 14-year-old girl who was admitted to the hospital with acute headache, nausea, and vomiting, initially misdiagnosed as ganglioglioma on imaging, and then diagnosed as pleomorphic low-grade neuroepithelial tumor (PLNTY) on surgical and pathological analyses. The patient did not present with typical epileptic symptoms, PLNTY is a rare adolescent low-grade brain tumor with imaging manifestations similar to those of other neuroepithelial tumors, which is easy to lead to misdiagnosis.
Conclusion
PLNTY is a class of adolescent low-grade neuroepithelial tumors with good prognosis. Definitive diagnosis of PLNTY is of great significance to avoid over-treatment and improve the quality of survival in pediatric and adolescent patients.
Assessment of rhizosphere microbial activity using optimized RNA extraction coupled with universal ribosomal RNA (rRNA) depletion techniques
Authors: Tamrakar Kipa , Miller P. Winston , Dolan Maureen C. , Wijeratne Asela 
Published: December 2024

Abstract

The rhizosphere microbiome plays a crucial role in plant health and fitness. However, there is a lack of studies focusing on the microbial functions responsible for modulating rhizosphere dynamics. Metatranscriptomics, which analyzes gene expression patterns in a heterogeneous community, is a powerful tool to evaluate microbial functional activity. A key challenge in this process is obtaining high-quality RNA, which is complicated by the soil complex matrix in soil. The next crucial step involves the removal of highly abundant ribosomal RNA (rRNA), as its presence can dominate sequencing results and obscure the detection of messenger RNA (mRNA) expression. Conventional library preparation methods often struggle to efficiently remove rRNA from a complex mix of prokaryotic and eukaryotic organisms, further complicating mRNA isolation. To overcome these limitations, we have developed an optimized method for extracting RNA from soybean rhizosphere microbes and followed by universal rRNA depletion to create rRNA-free samples for sequencing. These samples were sequenced using an Illumina high-throughput sequencer, and our data confirmed the successful removal of rRNA, allowing for the assembly of transcripts to assess microbial activity. This RNA sample preparation method, combined with our optimized extraction technique, provides a valuable approach for studying rhizosphere microbes that in turn holds exciting potential for advancing soil health assessments and understanding plant-microbe pathogen interactions.
Associations between vitiligo and allergic diseases: a bidirectional two-sample Mendelian randomization study
Authors: Zhang Ri , Shi Zeqi , Nie Xiaoqi , Wei Yujia , Li Dong 
Published: December 2024

Abstract

Background
Growing evidence shows a significant association between vitiligo and several allergic diseases. However, the real causality remains unclear considering the susceptibility of epidemiological studies to residual confounders.
Methods
We conducted a bidirectional two-sample Mendelian randomization (MR) analysis to investigate the relationship between vitiligo and seven common allergic diseases including atopic dermatitis (AD), allergic rhinitis, allergic contact dermatitis, allergic conjunctivitis, allergic purpura, asthma and urticaria by leveraging publicly available genome-wide association study (GWAS) summary data. The selection of instrumental variables conformed strictly to a series of preset inclusion and exclusion criteria. The multiplicative random-effect inverse variance weighted (IVW) method was used to assess the causal association. The Cochran’s Q test, MR-Egger intercept test, and leave one-out analysis were conducted to identify heterogeneity and pleiotropy.
Results
Allergic contact dermatitis (OR 1.13, 95% CI 1.03–1.24, p = 0.013) and urticaria (OR 1.22, 95% CI 1.04–1.44, p = 0.016) contributed to developing vitiligo. On the other side, vitiligo showed protective effect on developing AD (OR 0.98, 95% CI 0.96-1.00, p = 0.015), allergic conjunctivitis (OR 0.98, 95% CI 0.95-1.00, p = 0.044), allergic rhinitis (OR 0.97, 95% CI 0.95–0.99, p = 0.017), allergic purpura (OR 0.91, 95% CI 0.83–0.99, p = 0.030) and asthma (OR 0.97, 95% CI 0.95-1.00, p = 0.033).
Conclusions
Our findings indicated causal effect of allergic diseases on vitiligo and protective role of vitiligo on developing allergic diseases, facilitating more comprehensive management for vitiligo patients with co-morbidities and dermatologists' assessment of patient prognosis.