bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed Horner’s syndrome and acute stress disorder caused by a large dog bite on the neck: Case report
Authors: Dai Guoping , Yan Xin 
Published: December 2024

Rationale:
The occurrence of delayed Horner’s syndrome caused by a dog bite to the neck is rarely reported. Acute stress disorder (ASD) can easily be neglected when diagnosing this disease in trauma patients who cannot be effectively observed. The symptoms of Horner’s syndrome may not be readily detected in patients with ASD.

Patient concerns:
In this report, we present a rare case of a 55-year-old woman with delayed Horner’s syndrome and ASD who initially presented with an internal jugular vein injury caused by a large dog bite on her left neck.

Diagnosis:
Delayed Horner’s syndrome and ASD.

Interventions:
Neck exploration and internal jugular vein repair were performed under general anesthesia. After the occurrence of Horner’s syndrome and ASD, methylprednisolone and mecobalamin were administered to relieve edema and promote nerve repair, compound anisodine was injected once daily near the left superficial temporal artery to improve microcirculation, escitalopram oxalate and lorazepam were administered to treat anxiety and improve sleep, psychotherapy and narrative nursing were administered once a week.

Outcomes:
In the follow-up 4 months at the outpatient clinic after discharge, the patient’s Horner’s syndrome had not healed, but she did not complain of significant discomfort and affected appearance, and ASD did not recur or develop post-traumatic stress disorder.

Lessons:
Surgeons should be aware of the possibility of sympathetic nerve injury in patients with deep neck injury, especially in patients with internal jugular vein injury. Peripheral nerves should be explored during the operation. Attention should be paid to the possibility of delayed neurological symptoms and the prevention and treatment of ASD after operation.
A case report of fungal endocarditis presenting with low back pain as the initial symptom
Authors: Xu Haixia , Zhang Hang , Wu Jiacheng , Jin Libo 
Published: December 2024

Rationale:
Fungal endocarditis (FE) is a rare form of infective endocarditis. Compared to bacterial endocarditis, FE develops more slowly and insidiously, with nonspecific clinical manifestations, making diagnosis more challenging. Cases presenting with low back pain as the initial symptom are exceedingly rare, leading to a high risk of misdiagnosis or delayed diagnosis.

Patient concerns:
A 61-year-old male was admitted due to recurrent low back pain accompanied by fever for 2 months. He had no history of invasive procedures or immunosuppressive therapy.

Diagnoses:
The patient was diagnosed with FE.

Interventions:
The patient underwent surgical treatment, during which the excrescence was removed, and mitral valve replacement was performed. Postoperatively, he received a full course of antifungal therapy.

Outcomes:
Postoperatively, the patient experienced relief from low back pain and was afebrile. He was discharged after completing antifungal treatment and, upon follow-up after 1 year, had no recurrence of low back pain.

Lessons:
In this case, the patient initially presented with low back pain, which, despite the presence of fever and other signs of infection, did not readily suggest a cardiac etiology. This case highlights the importance of not being misled by superficial symptoms and underscores the need for comprehensive and accurate physical examinations and targeted investigations for proper diagnosis.
Intravascular large B-cell lymphoma arising in the pituitary gland: A case report
Authors: Jang Kyu Yun , Ahn Ae Ri 
Published: December 2024

Rationale:
Primary pituitary lymphoma is defined as a lymphoma that develops only in the pituitary gland without involvement of other areas.

Patient concerns:
We present the case of a 61-year-old female patient who underwent an endonasal transsphenoidal approach for the preoperative diagnosis of a pituitary macroadenoma based on radiological findings.

Diagnoses:
Microscopically, the capillaries were distended by tumor cells. The high-magnification view showed large cells with vesicular nuclei and single or multiple prominent nucleoli, with mitotic figures often observed within the intravascular space.

Interventions:
Immunohistochemical staining showed strong positivity for CD45 and pan-B cell markers such as CD19 and CD20. The postoperative diagnosis was intravascular large B-cell lymphoma of the pituitary gland.

Outcomes:
Next-generation sequencing revealed alterations in 12 genes: ARID5B, BCL2, CD79B, ETV6, HLA-B, LRRC7, MYD88, PIM1, POT1, PTPN11, RASA1, and SRSF2.

Lessons:
To our knowledge, this is the first case report of pituitary intravascular large B-cell lymphoma.
A Cross-Disciplinary Study of Facial Asymmetry in a Pre-Hispanic Mesoamerican Sculpture
Authors: Mansilla-Lory Josefina , Sandoval Hugo , Talavera Arturo , Pérez-Neri Iván , Pineda Carlos 
Published: December 2024

Background/Historical Perspective
Facial asymmetry has been recognized and represented in Mesoamerican and South American pre-Hispanic cultures.

Summary
This study aims to describe and contextualize an ancient pre-Hispanic stone face carving from the Early Postclassic Period (1200–1500 AD) discovered during excavations for the construction of what is now the National Rehabilitation Institute in Mexico City. The remarkable facial asymmetry of the artifact, suggesting facial paralysis, is a focal point for an interdisciplinary study combining bioarchaeology, anthropology, paleopathology, and rheumatology.

Conclusions
Although most causes of facial paralysis are idiopathic and pre-Hispanic Mesoamerican populations may have had a higher incidence of infections that could be the leading triggering cause, the potential connection between facial paralysis and rheumatic diseases in pre-Hispanic or pre-Columbian contexts is still a topic of ongoing investigation. This task remains highly relevant for rheumatologists who have traced the history and evolution of rheumatic diseases.

Future Research
To understand the potential causes of disabilities in ancient societies, a comprehensive, holistic, and transdisciplinary approach is needed, including evidence-based reviews to analyze the relationship between facial paralysis and rheumatic diseases.
Impact of Hypothermic Perfusion on Immune Responses and Sterile Inflammation in a Preclinical Model of Pancreatic Transplantation
Authors: Mesnard Benoit , Bruneau Sarah , Le Bas-Bernardet Stéphanie , Ogbemudia Etohan , Kervella Delphine , Masset Christophe , Neel Mélanie , Minault M. David , Hervouet M. Jeremy , Cantarovich Diego , Rigaud Jérôme , Badet Lionel , Friend Peter , Ploeg Rutger , Blancho Gilles , Hunter James , Prudhomme Thomas , Branchereau Julien 
Published: December 2024

Background.
In organ transplantation, cold ischemia is associated with sterile inflammation that subsequently conditions adaptive immunity directed against the grafts during revascularization. This inflammation is responsible for venous thrombosis, which is the main postoperative complication affecting graft function. Our aim was to investigate the modulation of immune responses and endothelial function of pancreatic grafts during cold ischemia using different preservation modalities.

Methods.
According to a preclinical porcine model of controlled donation after circulatory death, pancreatic grafts were preserved under hypothermic conditions for 24 h according to 4 modalities: static cold storage, hypothermic machine perfusion, hypothermic oxygenated perfusion at 21%, and 100%. Biopsies of the head and tail of the pancreas were performed during preservation. The first step involved a broad screening of the gene expression profile (84 genes) during preservation on a limited number of grafts. In the second step, a confirmation test was performed in all 4 groups.

Results.
Vascular endothelial growth factor gene expression showed a decrease during preservation in the hypothermic oxygenated perfusion 21% and 100% groups compared with the static cold storage group. In contrast, thrombomodulin gene expression showed an increase during preservation in the hypothermic oxygenated perfusion 21% and 100% groups compared with the static cold storage and hypothermic machine perfusion groups.

Conclusions.
We demonstrated that compared with static cold storage, hypothermic oxygenated perfusion is an effective modality for modulating endothelial function by increasing thrombomodulin expression and decreasing ischemia and vascular endothelial growth factor expression.
Common misconceptions held by health researchers when interpreting linear regression assumptions, a cross-sectional study
Authors: Jones Lee , Barnett Adrian , Vagenas Dimitrios 
Published: December 2024

AbstractBackgroundStatistical models are powerful tools that can be used to understand complex relationships in health systems. Statistical assumptions are a part of a framework for understanding analysed data, enabling valid inferences and conclusions. When poorly analysed, studies can result in misleading conclusions, which, in turn, may lead to ineffective or even harmful treatments and poorer health outcomes. This study examines researchers’ understanding of the commonly used statistical model of linear regression. It examines understanding around assumptions, identifies common misconceptions, and recommends improvements to practice.MethodsOne hundred papers were randomly sampled from the journal PLOS ONE, which used linear regression in the materials and methods section and were from the health and biomedical field in 2019. Two independent volunteer statisticians rated each paper for the reporting of linear regression assumptions. The prevalence of assumptions reported by authors was described using frequencies, percentages, and 95% confidence intervals. The agreement of statistical raters was assessed using Gwet’s statistic.ResultsOf the 95 papers that met the inclusion and exclusion criteria, only 37% reported checking any linear regression assumptions, 22% reported checking one assumption, and no authors checked all assumptions. The biggest misconception was that the Y variable should be checked for normality, with only 5 of the 28 papers correctly checking the residuals for normality.ConclusionThe prevalence of reporting linear regression assumptions remains low. When reported, they were often incorrectly checked, with very few authors showing any detail of their checks. To improve reporting of linear regression, a significant change in practice needs to occur across multiple levels of research, from teaching to journal reviewing. The focus should be on understanding results where the underlying statistical theory is viewed through the lens of “everything is a regression” rather than deploying rote-learned statistics.
Electrophysiological Correlates of Dynamic Cycling in Parkinson’s Disease
Authors: Joshi Prajakta , Shigo Lara , Smith Brittany , Kilbane Camilla W. , Guha Aratrik , Loparo Kenneth , Ridgel Angela L. , Shaikh Aasef G. 
Published: December 2024

AbstractObjectivePhysical exercise like dynamic cycling has shown promise in enhancing motor function in Parkinson’s disease (PD). We examined the underlying mechanisms of dynamic cycling in PD, emphasizing its impact on the activity of the subthalamic nucleus (STN), a pivotal region within the basal ganglia.MethodsThe investigation involved 100 dynamic cycling sessions conducted among nine PD individuals. Each participant underwent a maximum of 12 sessions over a four-week period. Local field potentials (LFPs) originating from the STN were recorded before and after cycling, utilizing DBS electrodes positioned within the nucleus. We evaluated both immediate and sustained impacts of dynamic cycling on LFP. The periodic LFP activity was assessed by determining the dominant spectral frequency and the power associated with that frequency. Aperiodic LFP activity was analyzed by calculating the 1/f exponent of the power spectrum.ResultsImmediate and sustained effects of dynamic cycling on LFPs were evaluated. While immediate changes were insignificant, long-term effects showed an increasing trend in power and the 1/f exponent of the power spectrum, a measure of fluctuation in the signal, in the dorsolateral region of the STN. Ventral region of the STN did not show a significant response to the exercise intervention.ConclusionThese results highlight the impact of dynamic cycling on STN neuronal activity in PD. Prolonged interventions, even without immediate changes, bring about significant modifications, emphasizing the role of extended exercise in PD management and neuroplasticity.SignificanceThese results highlight the impact of dynamic cycling showing changing in the STN neurophysiology in PD.HighlightsLong-term exercise intervention affects the dorsal STN, without any immediate change, while the ventral STN shows no response.Aperiodic exponent increases with exercise, mimicking the effect of dopaminePeriodic power also increases, behaving oppositely to its response to dopamine medication.
Cross Border Population Movement Patterns, Kenya, Uganda, and Rwanda, November 2022
Authors: King Patrick , Wanyana Mercy Wendy , Mayinja Harriet , Simbwa Brenda Nakafeero , Zalwango Marie Gorreti , Kobusinge Joyce Owens , Migisha Richard , Kadobera Daniel , Kwesiga Benon , Bulage Lilian , Gonahasa Doreen , Ahabwe Peter Babigumira , Nchoko Serah , Salat Edna , Weithaka Freshia , Gunya Oscar , Odhiambo Fredrick , Mutabazi Vincent , Habimana Metuschelah , Twagirimana Gabriel , Ndabarinze Ezechiel , Manishimwe Alexis , Itiakorit Harriet , Kadivani Samuel , Seib Katy , Whitney Ellen , Ario Alex Riolexus 
Published: December 2024

AbstractBackgroundThe frequent population movement across the five East African Countries poses risk of disease spread in the region. A clear understanding of population movement patterns is critical for informing cross-border disease control interventions.We assessed population mobility patterns across the borders of the East African states of Kenya, Uganda, and Rwanda.MethodsIn November 2022, we conducted Focus Group Discussions (FGDs), Key Informant Interviews (KIIs), and participatory mapping. Participants were selected using purposive sampling and a topic guide used during interviews. Key informants included border districts (Uganda and Rwanda) and county health officials (Kenya). FGD participants were identified from border communities and travellers and these included truck drivers, commercial motorcyclists, and businesspersons. During KIIs and FGDs, we conducted participatory mapping using Population Connectivity Across Borders toolkits. Data were analysed using grounded theory approach using Atlas ti 7 software.ResultsDifferent age groups travelled across borders for various reasons. Younger age groups travelled across the border for education, trade, social reasons, employment opportunities, agriculture and mining. While older age groups mainly travelled for healthcare and social reasons. Other common reasons for crossing the borders included religious and cultural matters. Respondents reported seasonal variations in the volume of travellers. Respondents reported using both official (4 Kenya-Uganda, 5 Rwanda-Uganda borders) and unofficial Points of Entry (PoEs) (14 Kenya-Uganda, 20 Uganda-Rwanda) for exit and entry movements on borders. Unofficial PoEs were preferred because they had fewer restrictions like the absence of health screening, and immigration and customs checks. Key destination points (points of interest) included: markets, health facilities, places of worship, education institutions, recreational facilities and business towns. Twenty-eight health facilities (10- Lwakhakha, Uganda, 10- Lwakhakha, Kenya, and 8- Cyanika, Uganda) along the borders were the most commonly visited by the travellers and border communities.ConclusionComplex population movement and connectivity patterns were identified along the borders. These were used to guide cross-border disease surveillance and other border health strategies in the three countries. Findings were used to revise district response and preparedness plans by strengthening community-based surveillance in border communities.
A Drift-Oriented Adaptive Framework for Concept Drift Detection in Large-Scale Internet-of-Medical-Things Data Streams
Authors: Maheshwari Vikash , Bt. Osman Nurul Aida , Daud Hanita , Kurniati Angelina Prima , Bt. Wan Yusoff Wan Nur Syahidah 
Published: December 2024

AbstractBackgroundThe rise of the Internet-of-Medical-Things (IoMT) and smart devices has led to a substantial increase in extensive data streams in the healthcare domain. The interconnected nature of medical devices introduces dynamic and evolving data patterns. However, this dynamism poses a significant challenge known as Concept Drift, particularly crucial in the medical field. Concept Drift reflects the inherent instability in data patterns over time. In medical applications, this challenge intensifies as sensors must seamlessly transition from general healthcare monitoring to handling critical situations like emergency ICU operations. The complexity deepens due to imbalanced data distributions inherent in e-health scenarios.MethodsThe study introduces an Adaptive Ensemble Framework (AEF-CDA) designed to detect and adapt to concept drift in large-scale medical data streams from IoMT. The framework incorporates adaptive data preprocessing, a novel drift-centric adaptive feature selection approach, the learning of base models, and the selection of models adapted to concept drift. Additionally, an online ensemble model is integrated to enhance concept drift adaptation.ResultsThe proposed AEF-CDA framework is evaluated using three public IoMT and IoT datasets. The experimental results demonstrate its superiority over contemporary methods, achieving a remarkable accuracy of 99.64% with a precision of 99.39%. These metrics surpass the performance of other approaches in the simulation.ConclusionIn conclusion, the research presents a robust solution in the form of the adaptive ensemble framework (AEF-CDA) to effectively address the challenges posed by concept drift in IoMT data streams. The demonstrated high accuracy and precision underscore the framework’s efficacy, highlighting its potential significance in the dynamic landscape of medical data analysis.
Acute Intermittent Hypoxia Induces Motor and Cognitive Plasticity in Persons with Relapsing Remitting Multiple Sclerosis
Authors: Sandhu Milap S. , Motl Robert W. , Rymer William Z. , LaVela Sherri L. 
Published: December 2024

AbstractBackgroundMS significantly impacts motor and cognitive function, yet therapies to effectively address these impairments remain limited. This study explores acute intermittent hypoxia (AIH) as a novel intervention for enhancing neuroplasticity and functional improvement in individuals with MS.ObjectiveTo examine the efficacy of a single AIH session in improving spinal motor output and cognitive performance in MS.MethodsA randomized, blinded, placebo-controlled and crossover study was done in 10 individuals with relapsing-remitting MS. Participants underwent both AIH and sham AIH on separate days. AIH consisted of 15 brief exposures of low oxygen (9% O2) alternating with normoxia (i.e., room air). Sham AIH comprised of normoxic episodes. Pre- and post-intervention evaluations included isometric ankle torque to assess motor strength and standardized tests to evaluate cognitive function.ResultsParticipants showed a significant increase in both plantarflexion and dorsiflexion ankle torque (p < .05), alongside significant enhancements in cognitive processing speeds as measured by the Symbol Digit Modalities Test (p < .01) after AIH. No changes were observed in auditory/verbal memory, and no adverse events were reported.ConclusionAIH presents a promising intervention for inducing neuroplasticity and improving rehabilitation outcomes in MS, suggesting the need for further exploration into its long-term impacts and mechanisms.
A computationally efficient method for dimensionality reduction in multi-channel spectral CT
Authors: Sandvold Olivia F. , Proksa Roland , Daerr Heiner , Perkins Amy E. , Brown Kevin M. , Koehler Thomas , Manjeshwar Ravindra M. , Noël Peter B. 
Published: December 2024

AbstractObjectiveMulti-channel spectral CT technology holds the promise of measuring incoming X-rays across various energy spectrums, significantly enhancing iodine imaging performance. Nonetheless, it necessitates the reduction of data dimensions, such as condensing multiple energy bins, to ensure processing times remain within clinically acceptable limits and to maintain compatibility with traditional two-dimensional material decomposition methodologies. This study presents an optimization strategy designed to efficiently integrate multi-channel spectral CT data, aiming to minimize the anticipated noise in the iodine domain across different system parameters influencing channel content.ApproachThe Cramer-Rao lower bound of variance (CRLB) was used to estimate the iodine domain noise for four two-input weighting schemes including kVp-switching compared to a four-input material decomposition noise estimate. Two of the four weighting schemes were optimized to contain weights that minimized the expected CRLB noise. A model of rapid kVp-switching x-ray tube and dual-layer detector were used to simulate acquisitions of a hybrid, combined technology multi-channel spectral CT system. The impact of the duty cycle ratio, or proportion of high kVp to low kVp, and the phantom size ranging from adult to pediatric were investigated.Main ResultsThe two-input weighting schemes with varying amounts of each spectral channel, optimized for low iodine noise, showed consistent low estimated noise performance within 0.27% difference to the ideal, four-input material decomposition results for all tested duty cycles in a standard adult-sized 300 mm water phantom. These schemes were always superior to kVp-switching regardless of duty cycle or phantom size. In the pediatric (150 mm) and large adult (400 mm) phantom cases, the two-input weighted schemes were within 1% difference to the ideal four-input noise estimator results on average, across all tested duty cycles.SignificanceAdvanced dimensionality reduction techniques, such as those presented in this work, that merge multi-channel spectral CT data illustrate a potential in improvement the accuracy of iodine contrast material measurement, while filling clinical specifications. This study also indicates the significant role that hybird spectral CT technologies could play in elevating the reliability of quantitative CT.