bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exosomes released from immature neurons regulate adult neural stem cell differentiation through microRNA-7a-5p
Authors: Sun Xiujian , Chen Yexiang , Zhang Ying , Cheng Tiantian , Peng Huisheng , Sun Yanting , Liu Jing-gen , Xu Chi 
Published: December 2024

Abstract
Exosomes in the hippocampal dentate gyrus (DG) are essential for modulating the cell signaling controlling the neural differentiation of hippocampal neural stem cells (NSCs), which may determine the level of hippocampal adult neurogenesis. In the present study, we found that exosomes secreted by immature neurons may promote the neuronal differentiation of mouse NSCs in vitro. By miRNA sequencing, we discovered that miR-7a-5p was significantly lower in exosomes from differentiated immature neurons than those from undifferentiated NSCs. By modulating the level of miR-7a-5p, the mimic and inhibitor of miR-7a-5p could either inhibit or promote the neuronal differentiation of NSCs, respectively. Moreover, we confirmed that miR-7a-5p affected neurogenesis by directly targeting Tcf12, a transcription factor responsible for the differentiation of NSCs. The siRNA of Tcf12 inhibited neuronal differentiation of NSCs, while overexpression of Tcf12 promoted NSC differentiation. Thus, we conclude that the miR-7a-5p content in neural exosomes is essential to the fate determination of adult hippocampal neurogenesis and that miR-7a-5p directly targets Tcf12 to regulate adult hippocampal neurogenesis.
Multilevel factors influence the use of a cardiovascular disease assessment tool embedded in the electronic health record in oncology care
Authors: Kepper Maura M , Gierbolini-Rivera Raúl D , Weaver Kathryn E , Foraker Randi E , Dressler Emily V , Nightingale Chandylen L , Aguilar Aylin A , Wiseman Kimberly D , Hanna Jenny , Throckmorton Alyssa D , Craddock Lee Simon 
Published: December 2024

Abstract
Digital health tools are positive for delivering evidence-based care. However, few studies have applied rigorous frameworks to understand their use in community settings. This study aimed to identify implementation determinants of the Automated Heart-Health Assessment (AH-HA) tool within outpatient oncology settings as part of a hybrid effectiveness-implementation trial. A mixed-methods approach informed by the Consolidated Framework for Implementation Research (CFIR) examined barriers and facilitators to AH-HA implementation in four NCI Community Oncology Research Program (NCORP) practices participating in the WF-1804CD AH-HA trial. Provider surveys were analyzed using descriptive statistics. Interviews with providers (n = 15) were coded using deductive (CFIR) and inductive codes by trained analysts. The CFIR rating tool was used to rate each quote for (i) valence, defined as a positive (+) or negative (−) influence, and (ii) strength, defined as a neutral (0), weak (1), or strong (2) influence on implementation. All providers considered discussing cardiovascular health with patients as important (61.5%, n = 8/13) or somewhat important (38.5%, n = 5/13). The tool was well-received by providers and was feasible to use in routine care among cancer survivors. Providers felt the tool was acceptable and usable, had a relative advantage over routine care, and had the potential to generate benefits for patients. Common reasons clinicians reported not using AH-HA were (i) insufficient time and (ii) the tool interfering with workflow. Systematically identifying implementation determinants from this study will guide the broader dissemination of the AH-HA tool across clinical settings and inform implementation strategies for future scale-up hybrid trials.
Perioperative management of patients with mediastinal mass syndrome
Authors: Hachenberg Thomas , Schilling Thomas , Kretzschmar Moritz 
Published: December 2024

Purpose of the review
The mediastinal mass syndrome (MMS) can occur after induction of anesthesia, intraoperatively or even days after the surgical procedure. The focus of this review is on the management of pediatric and adult patients with a significant mediastinal mass.

Recent findings
The age distribution of patients with mediastinal lesions suggests a bimodal shape, with an increased incidence among children under 10 years old and adults aged 60–70 years old. The traditional approach to avoid general anesthesia and mechanical ventilation has been challenged recently. Induction of general anesthesia may be achieved by a titrated intravenous infusion of propofol, with the patient positioned in a semi-sitting position. Mechanical ventilation with a prolonged I:E ratio, low respiratory rate and rigid or flexible bronchoscopy to stent the obstructed airway can facilitate expiration of tidal volume. Continuous video bronchoscopy recordings of the compromised portion of the airway have shown that positive pressure ventilation and neuromuscular blockade can induce an increase in the mean airway patency score.

Summary
Meticulous planning, implementation of anesthetic management protocols and protocols for emergency situations are essential to guarantee patient safety with a mediastinal mass.
Sensitivity and Specificity of Slit-Lamp Demodex Infestation Detection in Patients With Blepharitis
Authors: Eskenazi-Betech Ruth , Zatarain-Barrón Naomi C. , Graue-Hernandez Enrique O. , Ramirez-Miranda Arturo , Kahuam-López Nicolás , Navas Alejandro 
Published: December 2024

Purpose:
To determine whether the sensitivity and specificity of detecting Demodex infestation using slit-lamp examination are comparable with those of light microscopy.

Methods:
We evaluated 22 eyelids of 22 patients with clinical signs and symptoms of blepharitis that suggested Demodex infestation. Two lashes with cylindrical dandruff were epilated from each lid and mounted on a glass slide. A coverslip was mounted on each slide, then placed on a strip of white paper, and examined on a slit lamp with a 90D lens attached. Number of mites per lash were documented. The slides were then examined under a light microscope. The same procedure was followed with a control group. Results were evaluated per lash and per patient.

Results:
Twenty-two patients were included, 11 were men, with an average age of 54.8 years. A total of 176 epilated lashes were examined. Mean total Demodex count per lash was 0.9 ± 1.3 mites by slit-lamp examination and 1.22 ± 1.73 by light microscopy. Corresponding values per patient were 7.3 ± 4.4 and 9.7 ± 7.18. Correlation between Demodex counts by slit lamp and light microscopy was mildly positive and statistically significant per patient (8 lashes, r= 0.69, P < 0.001). Analysis of positive/negative results yielded 43.2% with a positive result for slit lamp and 51.7% for light microscopy. The sensitivity of the slit-lamp examination for the presence of Demodex per patient was 96.6%, with a specificity of 90.9%; the positive predictive value was 91.6%, and the negative predictive value was 95.2%.

Conclusions:
Demodex infestation in patients with blepharitis and cylindrical dandruff can be confirmed using a slit lamp. This technique demonstrates diagnostic performance that is noninferior to that of light microscopy.
Meralgia Paresthetica: An Anatomical Review and Surgical Case Presentation Utilizing a Robotic Exoscope
Authors: Kurtzman Joey S. , Barnett Joshua , Feng Rui , Taub Peter J. , Margetis Konstantinos 
Published: December 2024

Background:
Meralgia paresthetica (MP) is a neuropathic condition marked by pain, tingling, and numbness in the anterolateral thigh, primarily caused by compression of the lateral femoral cutaneous nerve (LFCN). Although compression often occurs beneath the inguinal ligament, anatomical variations can lead to different entrapment sites. Treatments range from conservative measures to surgical decompression, depending on symptom severity. This study provides an anatomical review of the LFCN and presents a unique case of MP where the LFCN was compressed by the sartorius fascia rather than the typical site beneath the inguinal ligament. The study also explores the use of the Synaptive Modus X robotic exoscope for surgical decompression.

Methods:
This article presents a case study of a man in his 40s with a 15-year history of chronic MP symptoms, where the LFCN was atypically compressed by the sartorius fascia. Surgical decompression was performed using the robotic exoscope, a device offering high-definition, 3-dimensional visualization.

Results:
At 13 weeks postoperatively, the patient experienced improvement in thigh sensation and no pain. He returned to baseline ambulation with no complications. The exoscope allowed precise identification of the LFCN’s anatomy and compression site, proving effective in enhancing surgical precision.

Conclusions:
This is the first report of primary LFCN decompression using the Synaptive Modus X exoscope. The device provides excellent visualization, ergonomic benefits, and educational advantages, making it a valuable alternative to traditional microscopes and loupes in nerve decompression and other microsurgical procedures. Further studies are needed to assess its cost-effectiveness and broader applications in plastic surgery.
Management of Synthol-induced Fibrosis
Authors: Nassar Aref , Osseis Michael , Sleilati Fadi , Nasr Marwan , Abou Zeid Samer 
Published: December 2024

Summary:
Site enhancement oils, such as synthol, are sometimes used by bodybuilders to artificially increase muscle size and shape. However, these injections can lead to severe complications, including fibrosis, infections, and impaired muscle function. We report the case of a 45-year-old male patient who presented with severe fibrosis and recurrent infections in the pectoral region following synthol injections. The patient experienced several episodes of infection in the left pectoral area, which were treated with antibiotics, resulting in indurated, erythematous skin. The patient underwent surgical removal of the fibrotic tissue under general anesthesia. This case highlights the severe complications associated with synthol injections and underscores the importance of a meticulous surgical approach to manage these complications. Excision of fibrotic tissue is essential for reducing the risk of reinfection and restoring a normal appearance while carefully weighing the extent of tissue removal to avoid unnecessary damage to healthy structures. Preparing for potential blood loss and balancing the extent of tissue removal with the need to preserve normal function and appearance are crucial for successful outcomes.
Age-dependent differences in FIB-4 predictions of fibrosis in patients with MASLD referred from primary care
Authors: Sung Shuen , Al-Karaghouli Mustafa , Tam Matthew , Wong Yu Jun , Jayakumar Saumya , Davyduke Tracy , Ma Mang , Abraldes Juan G. 
Published: December 2024

Background:
Fibrosis 4 (FIB-4) is widely used to triage patients with metabolic dysfunction–associated steatotic liver disease. Given that age is part of FIB-4, higher scores may be expected in the elderly population. This led to the proposal of using a higher threshold of FIB-4 to triage patients aged ≥65. Our main objective is to evaluate how age modifies the association between the FIB-4 index and disease severity based on the vibration-controlled transient elastography (VCTE) “rule of 5s.”

Methods:
In this cross-sectional study, we prospectively analyzed data from a primary care referral pathway. We used liver stiffness measurement by VCTE as a reference standard for liver risk. We modeled with ordinal regression the exceedance probabilities of finding different liver stiffness measurement thresholds according to FIB-4, and how age modifies FIB-4 predictions.

Results:
Nine hundred eighty-five participants with complete data were used for modeling. Participants aged ≥65 had a higher prevalence of advanced liver disease estimated by VCTE and higher FIB-4 values than those <65 (85.9% vs. 20.2% for FIB-4 ≥1.3, and 46.5% vs. 6.5% for FIB-4 ≥2.0). In participants age ≥65, the negative predictive value for VCTE ≥10 kPa of FIB-4 <1.3 was 100% versus FIB-4 <2.0 was 83%. Age significantly modified FIB-4–based prediction of fibrosis, but predictions at a threshold of 1.3 or 2 were only minimally altered. For higher FIB-4 threshold (ie, 2.7), age strongly modified FIB-4 predictions of liver stiffness measurement.

Conclusions:
Age does not relevantly modify FIB-4 predictions when using the common threshold of 1.3. Our data suggest no rationale for increasing the FIB-4 threshold to 2 for undergoing further testing in patients aged ≥65. However, the meaning of a FIB-4 of 2.7 strongly changes with age. This cutoff for ages over 65 is not enough to define high-risk and would not warrant direct referral.
Gaps in Knowledge Relevant to the “ICNIRP Guidelines for Limiting Exposure to Time-Varying Electric, Magnetic and Electromagnetic Fields (100 kHz TO 300 GHz)”
Authors:   International Commission on Non-Ionizing Radiation Protection (ICNIRP)
Published: December 2024

Abstract
In the last 30 y, observational as well as experimental studies have addressed possible health effects of exposure to radiofrequency electromagnetic fields (EMF) and investigated potential interaction mechanisms. The main goal of ICNIRP is to protect people and the environment from detrimental exposure to all forms of non-ionizing radiation (NIR), providing advice and guidance by developing and disseminating exposure guidelines based on the available scientific research on specific parts of the electromagnetic spectrum. During the development of International Commission on Non-Ionizing Radiation Protection’s (ICNIRP’s) 2020 radiofrequency EMF guidelines some gaps in the available data were identified. To encourage further research into knowledge gaps in research that would, if addressed, assist ICNIRP in further developing guidelines and setting revised recommendations on limiting exposure, data gaps that were identified during the development of the 2020 radiofrequency EMF guidelines, in conjunction with subsequent consideration of the literature, are described in this Statement. Note that this process and resultant recommendations were not intended to duplicate more traditional research agendas, whose focus is on extending knowledge in this area more generally but was tightly focused on identifying the highest data gap priorities for guidelines development more specifically. The result of this distinction is that the present data gap recommendations do not include some gaps in the literature that in principle could be relevant to radiofrequency EMF health, but which were excluded because either the link between exposure and endpoint, or the link between endpoint and health, was not supported sufficiently by the literature. The evaluation of these research areas identified the following data gaps: (1) Issues concerning relations between radiofrequency EMF exposure and heat-induced pain; (2) Clarification of the relation between whole-body exposure and core temperature rise from 100 kHz to 300 GHz, as a function of exposure duration and combined EMF exposures; (3) Adverse effect thresholds and thermal dosimetry for a range of ocular structures; (4) Pain thresholds for contact currents under a range of exposure scenarios, including associated dosimetry; and (5) A range of additional dosimetry studies to both support future research, and also to improve the application of radiofrequency EMF exposure restrictions in future guidelines.
Successful surgical management of symptomatic antenatally diagnosed congenital pulmonary airway malformation: A case report
Authors: Mansour Marah , Naksho Abdulmonem , Abboud Yazan , Saqa Bayan , Yousif Mayas Ali 
Published: December 2024

Background:
Congenital pulmonary airway malformations (CPAM) are rare developmental malformations of the lung with a prevalence of only 0.81/10,000. The exact cellular mechanisms are not fully understood yet. CPAM is often diagnosed on prenatal ultrasound (90% sensitivity and 77% specificity), around the second gestational trimester.

Case presentation:
A 30-year-old female had a routine ultrasound in the 13th gestational week which revealed cystic changes in the fetal left lung, along with mild polyhydramnios. This was monitored for the term of the pregnancy which ended with cesarean delivery at 39th week. The delivered baby had respiratory distress, needed an incubator for 24 hours, and underwent an open left lower lobectomy before being discharged home without any complications on follow-up.

Discussion and Conclusion:
Routine obstetric ultrasound is important in detecting CPAM and should be followed up routinely throughout the pregnancy. Management of CPAM is debatable and varies from conservative to invasive approaches. This case report emphasizes the significance of early prenatal diagnosis and timely surgical treatment, especially in resource-limited settings, in improving patient outcomes, while also contributing to a better understanding of this rare congenital condition.
Head-to-Head Comparison of 68Ga-DOTATATE and 18F-FDG PET in EBV-Positive Nonkeratinizing Nasopharyngeal Carcinoma
Authors: Qi Mengfang , Zhou Ping , Huang Shuhui , Su Minggang , Peng Xingchen , Huang Rui 
Published: December 2024

Purpose
The aim of this study was to compare the clinical application value of 68Ga-DOTATATE and 18F-FDG PET/CT in Epstein-Barr virus (EBV)–positive nonkeratinizing nasopharyngeal carcinoma.

Patients and Methods
Patients underwent 18F-FDG and 68Ga-DOTATATE PET scans. The lesion numbers, tracer parameters, and primary tumor volume derived from contrast-enhanced MRI, 18F-FDG, and 68Ga-DOTATATE PET were compared. The correlation between clinical characteristics and PET parameters as well as the predictive value of PET parameters were analyzed.

Results
The median maximum standard uptake values (SUVmax) of 18F-FDG and 68Ga-DOTATATE in all 26 primary tumors was 15.00 and 9.73, respectively (P = 0.001). 68Ga-DOTATATE PET was superior to 18F-FDG PET in detecting intracranial and skull base involvement. The primary tumor volume of 68Ga-DOTATATE with 35% SUVmax as the threshold had the highest consistency with that of contrast-enhanced MRI. 68Ga-DOTATATE and 18F-FDG PET/CT detected 103/108 (95.4%) and 101/108 (93.5%) regional lymph nodes metastases (P = 0.552), and the median SUVmax was 6.05 and 10.81, respectively (P < 0.001). Furthermore, 68Ga-DOTATATE PET/CT detected more distant metastases than 18F-FDG (89/92 [96.7%] vs 54/92 [58.7%], respectively, P < 0.001). The plasma EBV DNA was positively correlated with the total metabolic tumor volume, lesion glycolysis, somatostatin receptor–expressing tumor volume, and lesion somatostatin receptor expression (all P values <0.05). The PET parameters in the non–objective response rate group were higher than those in the objective response rate group (all P values >0.05).

Conclusions

68Ga-DOTATATE PET/CT is a promising imaging modality for detecting primary and metastatic EBV-positive nonkeratinizing nasopharyngeal carcinoma and delineating primary tumor boundary.
Congenital transmission of Chagas disease: The role of newborn therapy on the disease’s dynamics
Authors: Boukaabar Meriem , Oduro Bismark , Chataa Paul 
Published: December 2024

AbstractChagas disease, also known as American trypanosomiasis, is caused by a protozoan blood-borne pathogen called Trypanosoma cruzi. The World Health Organization (WHO) has classified Chagas as one of 21 neglected tropical diseases present in the world and estimates that 6-7 million people are currently infected with Chagas. Congenital transmission of Chagas disease contributes to a significant amount of new infections, especially in endemic areas where 22.5% of new infections are due to congenital transmission. In this paper, we investigate the impact of congenital transmission on the dynamics of Chagas disease through a mathematical model. Specifically, we examine how treatment and the efficacy of the therapy for newborns impact the progression and spread of Chagas disease.The influence of newborn therapy on the dynamics of the model is thoroughly investigated, both theoretically and numerically. The results illustrate the importance of an effective treatment for newborns in reducing infected cases of the Chagas. We observed that if vector transmission can be controlled, then at least 41% of the newborns need to be treated to curb the disease, and varying the newborn treatment rate and its efficacy significantly shapes the disease’s spread. The finding further shows that the therapy given to newborns is not sufficient but necessary to curb the transmission of Chagas disease, and a comprehensive approach that includes vector and vertical transmission control strategy is essential for eradicating Chagas disease.
Seroprevalence of measles and varicella in healthcare workers in Chonburi province, Thailand between October 2022 and January 2023
Authors: Katanyutanon Apirat , Thanasopon Wichai , Sonthichai Chaninan , Angsuwatcharakorn Piyada , Chansaenroj Jira , Nakabut Ratchathorn , Naritpavalun Sarandhorn , Prasitsomsakul Yanathep , Surakhot Paranyu , Pompim Phuvich , Wanlapakorn Nasamon , Poovorawan Yong 
Published: December 2024

AbstractIntroductionHealth care workers (HCWs) face the risk of contracting and transmitting vaccine-preventable infectious diseases (VPDs). Therefore, it is crucial to evaluate the immune status of HCWs against certain VPDs, such as measles and varicella zoster virus (VZV). This study aimed to determine age-specific seropositivity rates of anti-measles and anti-VZV IgG in HCWs working in Chonburi province, Thailand, and to develop a measles and varicella vaccination policy for Thai HCWs.MethodsA total of 266 HCWs in Chonburi Province, Thailand, were enrolled in this study between October 2022 and January 2023. Participants were divided into six age groups: 21-30, 31-40, 41-50, 51-60, 61-70, and >70 years. Anti-measles and anti-VZV IgG levels were evaluated using commercial ELISA kits (EUROIMMUN, Lübeck, Germany).ResultsThe overall seropositivity rates for measles and varicella were 85.0% and 81.2%, respectively. The lowest seropositivity rates for both measles and varicella were found among the 21-30-year-old group. Furthermore, seropositivity rates increased with age, reaching 100% among people over the age of 60 years.ConclusionsTo prevent measles and VZV outbreaks in HCWs, it is crucial to implement catch-up measles and varicella vaccination programs, particularly among HCWs younger than 30 years of age.
Alexander Disease: Screening andin silicofunctional characterization of variants on candidate gene
Authors: Malakar Surajit , Das Tathagata , Yadav Vikrant , Sahu Anurag , Das Parimal 
Published: December 2024

AbstractBackgroundAlexander disease is a rare neurological ailment caused by the degeneration of the white matter of the brain accompanied with the formation of Rosenthal fibers, a unique cytoplasmic inclusion within astrocytes (non-nerve tissue) in the brain. Till to date only heterozygousde novomutation in Glial Fibrillary Acidic Protein (GFAP) gene is found to be associated for the disease phenotype.Methods and Resultthe aim of our study was to determine the genetic basis of an Indian-origin juvenile AxD patient with pathological symptoms of macrocephaly and psychomotor delay followed by regression, spastic parapresis and feeding difficulty. The patient was screened for mutation in candidate gene for AxD by Whole Exome Sequencing and the detected variants were further reconfirmed by Sanger sequencing. The clonicopathological feature were investigated and two heterozygous missence variants (c.983T>C and c. 626G>A) were indentify in GFAP gene of the patient. Familial screenings of both of these variants were predicted to be pathogenic or damaging by variousin silicomethods and prediction tools.ConclusionThis altered GFA protein get accumulated in cytoplasm of the astroglial cells, leading to formation of Rosenthal fibers, which impairs cell function. Future study, however, would be helpful to understand the functional mechanism of these variant in formation of Rosenthal fibers leading to AxD pathophysiology.