bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Examination of Rehabilitation Factors Associated With Discharge Location After Spine Surgery for Cauda Equina Syndrome
Authors: Baumann Anthony N. , Mahajan Arushi , Callaghan Megan E. , Kuo Andy , Furey Christopher G. , Cheng Christina W. 
Published: December 2024

Introduction:
Cauda equina syndrome (CES) is a serious medical condition affecting the lumbosacral spine that requires emergent surgical intervention to relieve symptoms and prevent lasting neurological deficits. Previous studies have shown discharge location after CES surgery may have been associated with increased complications and poor outcomes. The purpose of this study is to evaluate factors associated with home or nonhome discharge after surgery for CES to assist with appropriate discharge planning by the medical interdisciplinary team.

Review of Literature:
Little data exist regarding factors associated with discharge location after surgery for CES.

Subjects:
One hundred fourteen patients who had surgery for CES in a hospital setting.

Methods:
This study is a retrospective case control study. Surgery for CES was performed by both orthopedic surgeons and neurosurgeons. Main outcome measure was discharge to home (n = 61) or a nonhome location (n = 53). Data recorded include age, gender, type of surgery performed, preoperative symptoms, postoperative symptoms, and level of participation in physical therapy in the hospital. Statistical analysis included logistic regression with odds ratio (OR) and 95% confidence intervals (CI).

Results:
Total patients (n = 114) had a mean age of 55.4 ± 18.1 years with 52.6% being male. Some factors associated with home discharge after surgery for CES via univariate analysis included no preoperative bowel/bladder symptoms (OR = 3.12; 95% CI = 1.19-8.19; P = .02), higher preoperative motor score (OR = 2.40; 95% CI = 1.40-4.12; P = .002), increased postoperative motor score (OR = 3.67; 95% CI = 1.62-8.30; P = .002), increased first distance walked (OR = 1.06; 95%CI = 1.02-1.09; P = .002), and increased total distance walked over LOS (OR = 1.01; 95%CI = 1.00-1.01; P = .0001). Multivariate analysis showed that decreased total distance walked during acute care hospital admission was associated with nonhome discharge (P < .02).

Discussion and Conclusion:
There are various factors associated with particular discharge locations after CES surgery, such length of hospital stay, preoperative bowel and bladder function, extremity strength scores, and ability to ambulate after surgery with physical therapy. As discharge location may impact patient outcomes, it is important identify which rehabilitation factors may be associated with patient discharge location after surgery for CES.
Using the Delphi method to propose foods for special medical purposes health effect evaluation indicators
Authors: Ren Peng , Wang Hai-Yue , Li Zeng-Ning 
Published: December 2024

Abstract

Objective
The Delphi method was used to propose health effect evaluation indicators to assess foods for special medical purposes (FSMPs). This lays the foundation for the formation of a big data model for human health testing, as well as a big data platform for the health and safety evaluation of special medical foods.

Methods
The Delphi method was used to conduct two rounds of expert consultation on the constructed FSMP health effect evaluation indicators.

Results
Ten major items were identified after two rounds of expert consultation. Among these, there were 10 primary entries, 32 secondary entries, 50 tertiary entries, and 28 quaternary entries.

Conclusion
The complete list of evaluation indicators contains 10 entries, which can comprehensively and systematically monitor adverse reactions to the use of FSMPs. The present findings lay the foundation for a big data platform to evaluate the health and safety of special foods.
The emerging role of fasting-mimicking diets in cancer treatment
Authors: Zhai Yu-Jia , Si Pei-Yao , Liu Ming-Li , Huang Lan 
Published: December 2024

Abstract
Cancer is one of the most common causes of morbidity and mortality worldwide. The high demand for specific nutrients and the sensitivity to nutritional deficiencies are newly recognized features of cancer cells. Dietary interventions can suppress tumor demand for particular nutrients and alter certain nutrients to target a tumor's metabolic vulnerability. Cyclic fasting or fasting-mimicking diets (FMDs) are popular approaches that can reduce nutrient intake over a specific period. Accumulating evidence suggests that FMDs attenuate tumor growth by altering the energy metabolism of cancer cells. Furthermore, FMDs potentiate the sensitivity of tumors to conventional cancer treatments and limit adverse events. Recent findings also highlight the potential value of FMDs in boosting antitumor immune surveillance. However, clinical trials regarding the impact of FMDs on cancer patients remain limited and controversial. Here, we provide the latest information on the effects of FMDs on cancer progression and treatment, focusing on future clinical applications.
Rehabilitation interventions for malnutrition in head and neck cancer patients: Current state and future directions
Authors: Zhang Hao-Miao , Yu Li-Li 
Published: December 2024

Abstract
Head and neck cancer and the approaches used to treat it can cause symptoms such as mucositis, alteration or loss of taste, dysphagia, and xerostomia, which makes the incidence of malnutrition in head and neck cancer patients higher than in the general population of cancer patients. Malnutrition in patients with head and neck cancer is associated with the occurrence of treatment-related adverse events, an increase in overall economic cost, a decline in quality of life, and a poor prognosis. Therefore, rehabilitation interventions for malnutrition are necessary throughout the course of the disease. However, the importance of rehabilitation interventions for malnutrition in patients with head and neck cancer has not been fully recognized, and the optimal methods and timing of interventions are unclear. This article provides an overview of rehabilitation interventions for malnutrition, including nutritional supplementation, exercise-based interventions, nutritional counseling and cognitive improvement, and drug therapy, and discusses their advantages and disadvantages as well as potential future directions.
Development and validation of a nomogram for predicting the probability of serious complication in esophageal cancer patients after esophagectomy
Authors: Chong Fei-Fei , Huo Zhen-Yu , Zhang Meng-Yuan , He Xiu-Mei , Luo Si-Yu , Liu Jie 
Published: December 2024

Abstract

Background
Esophagectomy remains a procedure with one of the highest complication rates. This study aimed to develop and validate a model of nomogram for predicting the probability serious postoperative complications for the postoperative esophageal cancer (EC) patients.

Methods
An observational study was conducted at Daping Hospital, China, encompassing 529 postoperative EC patients from December 2014 to November 2023. We integrated independent prognostic factors to craft a predictive model, specifically a nomogram, designed to forecast the risk of severe postoperative complications.

Results
The incidence of serious complications for postoperative EC patients was 58.1%. A total of seven variables, including age, gender, bleeding volume during the operation (P = 0.035), operating time (P = 0.031), the Nutritional Risk Screening 2002 (NRS 2002) score (P = 0.027), the perioperative nutrition screen (PONS) score (P = 0.018), and cystatin C levels (P < 0.001), were applied to draw the nomogram of predicting serious complications after esophagectomy. The accuracy of predictive value for the model was quantified by Harrell’s C index at 0.690 (95% confidence interval = 0.596–0.785, P < 0.001).

Conclusion
We developed a nomogram system to demonstrate exceptional predictive capabilities for postoperative EC patients in forecasting the risk of serious complications. These results also emphasize the predictive value of the preoperative nutritional risk screening with NRS 2002 and PONS in EC patients undergoing esophagectomy.
Mitochondrial dysfunction and programmed cell death in osteosarcoma
Authors: Zhang Ke , Jiang Ming-Yang , Liu Kai-Cheng , Dai Yong-Heng , Bo Zhan-Dong 
Published: December 2024

Abstract
Osteosarcoma is the most prevalent primary malignant bone tumor, primarily affecting adolescents aged 15–25 years. It is characterized by a high recurrence rate, poor prognosis, and lack of important biomarkers. Significant mitochondrial dysfunction in osteosarcoma cells has been widely reported by recent studies. Dysfunctional mitochondria occupy an important position in cellular metabolic reprogramming, immune microenvironment regulation, and programmed cell death. Therefore, targeting mitochondrial dysfunction may represent a new mechanism to overcome therapeutic barriers in the treatment of osteosarcoma and provides crucial target molecules for further development of targeted therapies and immunotherapies. The present article summarizes the recent reports of mitochondrial dysfunction in osteosarcoma and links it to various programmed cell death mechanisms, aiming to provide the basis for further clinical practice.
Associations of Perceived Privacy at the Workplace With Short Sickness Absences in a Cohort of Finnish Office Workers
Authors: Haapakangas Annu , Ropponen Annina , Tulenheimo-Eklund Elina , Ruohomäki Virpi , Reijula Kari 
Published: December 2024

Objective
To investigate perceived task privacy in 2022 associated with short (1–3 days) self-certified sickness absence (SA) in 2023.

Methods
A prospective cohort of 1400 Finnish office workers with survey data in 2022 about, for example, task privacy, telework, and office type were linked with employer-owned register data of SA in 2022–2023. Poisson regression models were used to obtain risk ratios with 95% confidence intervals.

Results
Each one-unit increase in task privacy was associated with a less likely short SA (risk ratio, 0.83–0.89; 95% confidence interval, 0.74–0.97), also across the amount of telework in 2022. The association was only statistically significant in activity-based offices.

Conclusions
Each one-unit increase in perceived task privacy at the office was associated with less likely short, self-certified, 1–3 days SA. Task privacy is an important factor to be considered in offices.
Double diabetes as a new challenge in diabetes categorization: Case reports
Authors: Karki Manoj , Bashyal Subodh , Devkota Sudhan , Sharma Aprajita , Rayamajhi Bidhata , Shrestha Ritika 
Published: December 2024

Rationale:
Double diabetes, characterized by the coexistence of insulin resistance and autoimmune pancreatic β-cell destruction, is often underrecognized due to overlapping features of type 1 and type 2 diabetes.

Patient concerns:
Two female patients presented with elevated blood sugar levels during their second trimester of pregnancy. Both required insulin therapy during pregnancy to manage hyperglycemia.

Diagnoses:
Initially diagnosed as gestational diabetes mellitus, further investigations postpregnancy revealed autoimmune markers such as anti-glutamic acid decarboxylase 65 positivity and low c-peptide levels, confirming type 1 diabetes in both patients along with features of insulin resistance.

Interventions:
Both patients were treated with insulin therapy during pregnancy. Postdelivery, one achieved blood sugar control through lifestyle modifications, while the other required continued basal-bolus insulin therapy following an episode of diabetic ketoacidosis.

Outcomes:
Both patients achieved glycemic control. One transitioned off insulin, while the other remained on insulin therapy.

Lessons:
Double diabetes can masquerade as gestational diabetes and is prone to misdiagnosis. Early identification through autoimmune testing, c-peptide levels, and clinical vigilance is critical for timely and accurate management.
Rehabilitation of functional neurological disorder with lower limb powered robotic exoskeleton: A case report
Authors: Tham Shuen-Loong , Ong Ruth Choo Li , Ratha Krishnan Rathi 
Published: December 2024

Rationale:
Functional neurological disorder (FND) is a disabling and challenging condition that straddles Neurology and Psychiatry. Prolonged symptoms in FND are associated with poor functional outcome. Multidisciplinary management often involves physiotherapy in assisting with rehabilitation of the motor dysfunction associated with this condition. Despite many motor training approaches and strategies being described and trialed, successful outcome remains challenging.

Patient concerns:
Impaired ambulatory function (i.e., short-distance walking with rollator frame and ankle-foot-orthoses on level ground) despite 2 years of physical therapy.

Diagnoses:
FND with prolonged lower limb weakness and sensory loss following a road traffic accident.

Interventions:
Lower limb powered robotic exoskeleton (PRE) followed by conventional physiotherapy in ambulatory training.

Outcomes:
Three sessions of physical therapy training with lower limb PRE resulted in significant functional improvements. The patient achieved independence in walking without any gait-aid. Progress was made in walking tolerance, balance and lower limb strength. Six-minute and 10-m walk tests improved approximately 3- and 4-fold, respectively. Consequent conventional physiotherapy treatment saw to further improvements. Ambulatory and functional gains were maintained and bettered 9 months on.

Lessons:
PRE can be beneficial as an adjunctive training device for motor training in patients with FND.
Advances in basic and translational research into nasopharyngeal carcinoma
Authors: Li Zhe , Chen Yupei , Ma Jun 
Published: December 2024

Abstract
According to the International Cancer Research Institute of the World Health Organization data, nasopharyngeal carcinoma (NPC) remains a significant health concern, particularly in regions such as Southeast Asia and southern China. Recently, substantial progress has been made in the field of basic and translational research on NPC, enhancing our understanding of the molecular mechanisms underlying the disease and paving the way for precise therapeutic approaches. This review summarizes the advances in NPC research, focusing on key areas that include radiotherapy and chemotherapy resistance and tumor metastasis, microenvironment, metabolism, microbiome, and biomarkers. Additionally, future research directions in NPC are discussed to provide valuable insights to advance the field further.
Age-Related Differences Between Juvenile and Adult Autoimmune Inflammatory Myopathies
Authors: Kaplan Melike Mehveş , Tekin Zahide Ekici , Çelikel Elif , Güngörer Vildan , Karagöl Cüneyt , Öner Nimet , Polat Merve Cansu , Öztürk Didem , Özçelik Emine , Ekici Mehveş Işıklar , Dağlı Pınar Akyüz , Erten Şükran , Acar Banu Çelikel 
Published: December 2024

Background
Clinical features and prognosis of autoimmune inflammatory myopathies (AIMs) can vary depending on the age of disease onset. The aim of this study was to compare the demographic characteristics, clinical features, laboratory findings, and long-term prognosis of juvenile and adult AIMs.

Methods
Patients diagnosed with AIM between 2009 and 2023 in the pediatric rheumatology and rheumatology departments of our hospital were included in this medical records review study. Demographic characteristics, clinical features, laboratory findings, treatments, and prognosis of juvenile and adult AIM patients were compared with statistical methods.

Results
Of the 94 patients diagnosed with AIM, 34 (36.2%) patients were juvenile and 60 (63.8%) patients were adult. At the time of diagnosis, while Gottron papules, dysphonia, and subcutaneous edema were more common in juvenile patients, fever was more common in adult patients (p = 0.003, p = 0.05, p = 0.005 p = 0.05, respectively). During follow-up, while calcinosis was more common in juvenile patients, lung involvement and malignancy were more common in adult patients (p = 0.022, p = 0.009, p = 0.006, respectively). The methylprednisolone pulse therapy requirement was significantly higher in juvenile patients (p = 0.0001). Clinically inactive disease was more common in juvenile patients (p = 0.01).

Conclusions
AIM with different onset ages is associated with distinct clinical manifestations and outcomes. The present study reported that in AIM patients, lung involvement and malignancy increase with age while clinically inactive disease decreases.
Pancreatic Intraepithelial Neoplasia Revealed by Diffusion-Tensor MRI
Authors: Bilreiro Carlos , Fernandes Francisca F. , Simões Rui V. , Henriques Rafael , Chavarrías Cristina , Ianus Andrada , Castillo-Martin Mireia , Carvalho Tânia , Matos Celso , Shemesh Noam 
Published: December 2024

Objectives
Detecting premalignant lesions for pancreatic ductal adenocarcinoma, mainly pancreatic intraepithelial neoplasia (PanIN), is critical for early diagnosis and for understanding PanIN biology. Based on PanIN's histology, we hypothesized that diffusion tensor imaging (DTI) and T2* could detect PanIN.

Materials and Methods
DTI was explored for the detection and characterization of PanIN in genetically engineered mice (KC, KPC). Following in vivo DTI, ex vivo ultrahigh-field (16.4 T) MR microscopy using DTI, T2* was performed with histological validation. Sources of MR contrasts and histological features were investigated, including histological scoring for disease burden (lesion span) and severity (adjusted score). To test if findings in mice can be translated to humans, human pancreas specimens were imaged.

Results
DTI detected PanIN and pancreatic ductal adenocarcinoma in vivo (6 KPC, 4 KC, 6 controls) with high discriminative ability: fractional anisotropy (FA) and radial diffusivity with area under the curve = 0.983 (95% confidence interval: 0.932–1.000); mean diffusivity and axial diffusivity (AD) with area under the curve = 1 (95% confidence interval: 1.000–1.000). MR microscopy with histological correlation (20 KC/KPC; 5 controls) revealed that sources of MR contrasts likely arise from microarchitectural signatures: high FA, AD in fibrotic areas surrounding lesions, high diffusivities within cysts, and high T2* within lesions' stroma. The strongest histological correlations for lesion span and adjusted score were obtained with AD (R = 0.708, P < 0.001; R = 0.789, P < 0.001, respectively). Ex vivo observations in 5 human pancreases matched our findings in mice, revealing substantial contrast between PanIN and normal pancreas.

Conclusions
DTI and T2* are useful for detecting and characterizing PanIN in genetically engineered mice and in the human pancreas, especially with AD and FA. These are encouraging findings for future clinical applications of pancreatic imaging.
Clinical Value of 18F-(2S,4R)-4-Fluoroglutamine PET/CT in Glioma
Authors: Xu Xiaoxia , Zhao Heqian , Liu Futao , Xie Qing , Yang Jianhua , Li Shouwei , Yang Zhi 
Published: December 2024

Propose
The aim of this study was to evaluate the clinical application value of 18F-FGln PET/CT in glioma.

Patients and Methods
Patients with suspected gliomas by MRI were included in this study. Static and/or dynamic brain 18F-FGln PET/CT was performed. The PET parameters SUVmax, SUVmean, MTV, and TLG were evaluated.

Results
Twenty-three patients were included in the analysis. Nineteen of 23 patients were positive for 18F-FGln PET. The SUVmax of high- and low-grade gliomas were 4.75 ± 2.21 and 1.00 ± 0.66 (P < 0.001), respectively. FGln-PET SUVmax, SUVmean, and TLG all showed statistically significant correlations with glioma grade, with correlation coefficients (r) of 0.667 (P < 0.001), 0.693 (P < 0.001), and 0.487 (P = 0.021), respectively. Additionally, the SUVmax, SUVmean, and TLG exhibited higher distinguishing performance for glioma grade by receiver operating characteristic curve analysis. The areas under the receiver operating characteristic curve of SUVmax, SUVmean, and TLG were 0.976 (95% confidence interval [CI], 0.918–1) (P = 0.002), 0.976 (95% CI, 0.918–1) (P = 0.002), and 0.835 (95% CI, 0.628–1.000) (P = 0.026), respectively. For glioma isocitrate dehydrogenase (IDH) mutation status, the SUVmax of IDH wildtype and mutant glioma were 2.95 ± 1.99 and 6.13 ± 2.16 (P = 0.005), respectively. The SUVmean and SUVmax had good-to-satisfactory performance for IDH status with the area under the receiver operating characteristic curve of SUVmax and SUVmean of 0.885 (95% CI, 0.734–1.000) (P = 0.009) and 0.942 (95% CI, 0.828–1) (P = 0.002).

Conclusions
Although we do not assert that 18F-FGln PET/CT imaging is satisfactory in the differential diagnosis of glioma, we revealed its potential for identifying the stage of gliomas and the IDH mutation status and propose that glutamine-based PET imaging enables the assessment of metabolic nutrient uptake of gliomas to assist clinical diagnosis and treatment of patients.
Pyomyositis Due to a Rare Fungal Infection—Findings on 68Ga-NOTA UBI PET/CT
Authors: Ravindra Shubha Gadde , Damle Nishikant Avinash , Babu Pyata Vikram , Bhadu Danveer , Singh Gagandeep 
Published: December 2024

Abstract
It is very rare to see fungal arthritis and pyomyositis in immunocompetent patients. Here, we report a case of Scedosporium infection in an immunocompetent patient with interesting 18F-FDG PET/CT and 68Ga-NOTA UBI PET/CT findings.
Beyond the Standard Meal
Authors: Wulfeck Madison K. , Ramis Phil , Hillman Andrew , Nielsen Patrick , Rohren Eric M. 
Published: December 2024

Rationale
Standardized guidelines for meals used in adult gastric emptying studies (GES) have been available since 2009; however, there is still great variability in the diets that are clinically used in these studies. The purpose of this retrospective study is to perform an observational analysis of GES meals that are used within a national radiology practice to assess for compliance. It is hypothesized that despite having well-validated standardized meal protocols, there remains great variability in its use and interpretation.

Methods
This retrospective observational analysis included 11,458 GESs and their associated reports. GES meals were divided into 5 categories including solid, liquid, dual liquid and solid, alternative meals, and other. Further analysis was performed on the solid and liquid meal GESs. The total amount of studies performed with each meal was collected as well as the percentages of the results of each study categorized as normal, delayed, rapid, and limited.

Results
A total of 10,602 studies were included in the analysis, which included 9974 solid meals and 628 liquid meals. Of the solid meal type, the standard recommended meal was used most often followed by the protein variant meal. The oatmeal protocol had the least number of delayed results; however, there was otherwise a similar distribution of results for the remaining solid meal variants. The most common liquid meal utilized the nutritional drink or protein shake, and compared with the solid meal types, there were less rapid or limited results.

Conclusions
Variability remains in clinical practice regarding the type of meal that is used in GESs as well as in the interpretation of the study. Continued reinforcement of the standardized solid meal diet and validated cutoff values for interpretation remains crucial until there is increased validation and standardization of other diets.