bluuebunny/crossref_metadata_2025_split huggingface dataset:
A common symptom with an uncommon diagnosis
Authors: Velayutham Prabu , Davis Prem , Savery Nishanth , Vaigundavasan Ramprasath 
Published: September 2021

Abstract
Background
Nasopharyngeal carcinoma is one of the uncommon tumours and the most difficult tumour to diagnose at an earlier stage due to the clandestine and deceptive nature. The incidence is more common in men with a peak incidence of 50 to 60 years. The suspicion of tumour at the earliest stage is very helpful in reducing morbidity and mortality.

Case presentation
A 45-year-old female presented with right hemi cranial headache for 2years without any comorbidities for that she consulted many hospitals and got symptomatic and empherical treatment in which her symptoms resolved temporarily and recurred. We did diagnostic nasal endoscopy and found a smooth globular mass in the right nasopharynx with contrast enhanced computerised tomography mass extending into the muscle plane which was found with the confirmation of diagnosis as undifferentiated nasopharyngeal carcinoma by histopathological examination and treated accordingly.

Conclusion
Although the diagnosis of the nasopharyngeal carcinoma in the earlier stage is difficult, it is an imperative one because the prognosis depends upon the stage of the disease in which it has been diagnosed. The clinicians always should have a suspicion of the rare disease for a day-to-day unresolved symptom, because the earlier diagnosis and appropriate management helps in the prevention of the life-threatening complications of any disease.
Factors favoring neck metastasis in patients underwent laryngectomy for laryngeal cancer
Authors: Sabaa Mohamed Abd Elmottaleb , El Batawi Ahmed Mahmoud 
Published: September 2021

Abstract
Background
One third of all head and neck cancers are caused by laryngeal cancer. However, the incidence and prevalence rates have decreased over the past 3 decades. Neck metastasis from cancer larynx is important to be addressed as its presence greatly reduces the probability of survival. However, quality of life should be taken into consideration. Hence, it was important to analyze factors related to neck metastasis from primary laryngeal cancer to detect any change of tumor behavior with time.

Results
One hundred thirty-eight patients underwent concomitant neck dissection with laryngectomy (total or partial). Supraglottic tumors had the greatest share in the neck metastasis with a count of 11 (of 26 neck metastasis), representing 42% and a total value of 11 (of 30 total supraglottic cancer) representing a tendency of spread in 37% of the total case number. Tumor midline crossing was present in 77% cases (20 of 26) with positive nodes, representing a P value 0.05.

Conclusion
This study investigated different factors related to lymph node metastasis from primary laryngeal tumor. The most important factors were the site of the tumor and its relation to the midline.
Computationally repurposed drugs and natural products against RNA dependent RNA polymerase as potential COVID-19 therapies
Authors: Piplani Sakshi , Singh Puneet Kumar , Winkler David A. , Petrovsky Nikolai 
Published: September 2021

AbstractRepurposing of existing drugs and drug candidates is an ideal approach to identify new potential therapies for SARS-CoV-2 that can be tested without delay in human trials of infected patients. Here we applied a virtual screening approach using Autodock Vina and molecular dynamics simulation in tandem to calculate binding energies for repurposed drugs against the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp). We thereby identified 80 promising compounds with potential activity against SARS-Cov2, consisting of a mixture of antiviral drugs, natural products and drugs with diverse modes of action. A substantial proportion of the top 80 compounds identified in this study had been shown by others to have SARS-CoV-2 antiviral effects in vitro or in vivo, thereby validating our approach. Amongst our top hits not previously reported to have SARS-CoV-2 activity, were eribulin, a macrocyclic ketone analogue of the marine compound halichondrin B and an anticancer drug, the AXL receptor tyrosine kinase inhibitor bemcentinib. Our top hits from our RdRp drug screen may not only have utility in treating COVID-19 but may provide a useful starting point for therapeutics against other coronaviruses. Hence, our modelling approach successfully identified multiple drugs with potential activity against SARS-CoV-2 RdRp.
Clinical Utility of Anti-Mullerian Hormone in Pediatrics
Authors: Kanakatti Shankar Roopa , Dowlut-McElroy Tazim , Dauber Andrew , Gomez-Lobo Veronica 
Published: September 2021

Abstract

Context
Anti-Mullerian hormone (AMH) was originally described in the context of sexual differentiation in the male fetus but has gained prominence now as a marker of ovarian reserve and fertility in females. In this mini-review, we offer an updated synopsis on AMH and its clinical utility in pediatric patients.

Design and Results
A systematic search was undertaken for studies related to the physiology of AMH, normative data, and clinical role in pediatrics. In males, AMH, secreted by Sertoli cells, is found at high levels prenatally and throughout childhood and declines with progression through puberty to overlap with levels in females. Thus, serum AMH has clinical utility as a marker of testicular tissue in males with differences in sexual development and cryptorchidism and in the evaluation of persistent Mullerian duct syndrome. In females, serum AMH has been used as a predictive marker of ovarian reserve and fertility, but prepubertal and adolescent AMH assessments need to be interpreted cautiously. AMH is also a marker of tumor burden, progression, and recurrence in germ cell tumors of the ovary.

Conclusions
AMH has widespread clinical diagnostic utility in pediatrics but interpretation is often challenging and should be undertaken in the context of not only age and sex but also developmental and pubertal stage of the child. Nonstandardized assays necessitate the need for assay-specific normative data. The recognition of the role of AMH beyond gonadal development and maturation may usher in novel diagnostic and therapeutic applications that would further expand its utility in pediatric care.
Associations of Age at Menopause With Postmenopausal Bone Mineral Density and Fracture Risk in Women
Authors: Shieh Albert , Ruppert Kristine M , Greendale Gail A , Lian Yinjuan , Cauley Jane A , Burnett-Bowie Sherri-Ann , Karvonen-Guttierez Carrie , Karlamangla Arun S 
Published: September 2021

Abstract

Context
Menopause before age 45 is a risk factor for fractures, but menopause occurs at age ≥45 in ~90% of women.

Objective
To determine, in women with menopause at age ≥45, whether (1) years since the final menstrual period (FMP) is more strongly associated with postmenopausal bone mineral density (BMD) than chronological age and (2) lower age at FMP is related to more fractures.

Design and Setting
The Study of Women’s Health Across the Nation, a longitudinal cohort study of the menopause transition (MT).

Participants
A diverse cohort of ambulatory women (pre- or early perimenopausal at baseline, with 15 near-annual follow-up assessments).

Main Outcome Measures
Postmenopausal lumbar spine (LS) or femoral neck (FN) BMD (n = 1038) and time to fracture (n = 1554).

Results
Adjusted for age, body mass index (BMI), cigarette use, alcohol intake, baseline LS or FN BMD, baseline MT stage, and study site using multivariable linear regression, each additional year after the FMP was associated with 0.006 g/cm2 (P &lt; 0.0001) and 0.004 g/cm2 (P &lt; 0.0001) lower postmenopausal LS and FN BMD, respectively. Age was not related to FN BMD independent of years since FMP. In Cox proportional hazards regression, accounting for race/ethnicity, BMI, cigarette use, alcohol intake, prior fracture, diabetes status, exposure to bone-modifying medications/supplements, and study site, the hazard for incident fracture was 5% greater for each 1-year decrement in age at FMP (P = 0.02).

Conclusions
Years since the FMP is more strongly associated with postmenopausal BMD than chronological age, and earlier menopause is associated with more fractures.
The Relationship Between Continuous Glucose Monitoring and OGTT in Youth and Young Adults With Cystic Fibrosis
Authors: Chan Christine L , Pyle Laura , Vigers Tim , Zeitler Philip S , Nadeau Kristen J 
Published: September 2021

Abstract

Context
Early glucose abnormalities in people with cystic fibrosis (PwCF) are commonly detected by continuous glucose monitoring (CGM). Relationships between these CGM abnormalities and oral glucose tolerance testing (OGTT) in PwCF have not been fully characterized.

Objective
This work aimed to determine the relationship between CGM and common OGTT-derived estimates of β-cell function, including C-peptide index and oral disposition index (oDI) and to explore whether CGM can be used to screen for OGTT-defined prediabetes and cystic fibrosis–related diabetes (CFRD).

Methods
PwCF not on insulin and healthy controls aged 6 to 25 years were enrolled in a prospective study collecting OGTT and CGM. A subset underwent frequently sampled OGTTs (fsOGTT) with 7-point glucose, insulin, and C-peptide measurements. Pearson correlation coefficient was used to test the association between select CGM and fsOGTT measures. Receiver operating curve (ROC) analysis was applied to CGM variables to determine the cutoff optimizing sensitivity and specificity for detecting prediabetes and CFRD.

Results
A total of 120 participants (controls = 35, CF = 85), including 69 with fsOGTTs, were included. CGM coefficient of variation correlated inversely with C-peptide index (Cpeptide30-Cpeptide0/Glucose30-Glucose0) (r = –0.45, P &lt; .001) and oDIcpeptide (C-peptide index)(1/cpep0) (r = –0.48, P &lt; .0001). In PwCF, CGM variables had ROC – areas under the curve ranging from 0.43 to 0.57 for prediabetes and 0.47 to 0.6 for CFRD.

Conclusion
Greater glycemic variability on CGM correlated with reduced β-cell function. However, CGM performed poorly at discriminating individuals with and without OGTT-defined CFRD and prediabetes. Prospective studies are now needed to determine how well the different tests predict clinically relevant nonglycemic outcomes in PwCF.
Divergent Patterns of Antifracture Medication Use Following Fracture on Therapy: A Population-Based Cohort Study
Authors: Kline Gregory A , Morin Suzanne N , Lix Lisa M , Leslie William D 
Published: September 2021

AbstractContextFracture on therapy should motivate better antifracture medication adherence.ObjectiveThis study aimed to describe osteoporosis medication adherence in women before and following a fracture.MethodsThis retrospective cohort analysis of antifracture medication possession ratios (MPR) among women in the Manitoba BMD Registry (1996-2013) included menopausal women who started antifracture drug therapy after a dual-energy x-ray absorptiometry (DXA)-BMD assessment with follow-up for 5 years during which a nontraumatic fracture occurred at least 1 year after starting treatment. Linked prescription records determined medication adherence (estimated by MPR) in 1-year intervals. The variable of interest was MPR in the year before and after the year in which the fracture occurred, with subgroup analyses according to duration of treatment pre-fracture. We chose an MPR of ≥ 0.50 to indicate minimum adherence needed for drug efficacy.ResultsThere were 585 women with fracture on therapy, 193 (33%) had hip or vertebral fracture. Bisphosphonates accounted for 82.2% of therapies. Median MPR the year prior to fracture was 0.89 (IQR, 0.49-1.0) and 0.69 (IQR, 0.07-0.96) the year following the year of fracture (P &lt; 0.0001). The percentage of women with MPR ≥ 0.5 pre-fracture was 73.8%, dropping to 57.3% post-fracture (P &lt; 0.0001); when restricted to hip/vertebral fracture, results were similar (58.2% to 33.3%; P &lt; 0.002). Among those with pre-fracture MPR &lt; 0.5, only 21.7% achieved a post-fracture MPR ≥ 0.5.ConclusionsAlthough fracture on therapy may motivate sustained/improved adherence, MPR remains low or even declines after fracture in many. This could reflect natural decline in MPR with time but is paradoxical to expectations. Fracture on therapy represents an important opportunity for clinicians to reemphasize treatment adherence.
Mask, the Drosophila ankyrin repeat and KH domain-containing protein, affects microtubule stability
Authors: Martinez Daniel , Zhu Mingwei , Guidry Jessie J. , Majeste Niles , Mao Hui , Yanofsky Sarah T. , Tian Xiaolin , Wu Chunlai 
Published: September 2021

ABSTRACT
Proper regulation of microtubule (MT) stability and dynamics is vital for essential cellular processes, including axonal transportation and synaptic growth and remodeling in neurons. In the present study, we demonstrate that the Drosophila ankyrin repeat and KH domain-containing protein Mask negatively affects MT stability in both larval muscles and motor neurons. In larval muscles, loss-of-function of mask increases MT polymer length, and in motor neurons, loss of mask function results in overexpansion of the presynaptic terminal at the larval neuromuscular junctions (NMJs). mask genetically interacts with stathmin (stai), a neuronal modulator of MT stability, in the regulation of axon transportation and synaptic terminal stability. Our structure–function analysis of Mask revealed that its ankyrin repeats domain-containing N-terminal portion is sufficient to mediate Mask's impact on MT stability. Furthermore, we discovered that Mask negatively regulates the abundance of the MT-associated protein Jupiter in motor neuron axons, and that neuronal knocking down of Jupiter partially suppresses mask loss-of-function phenotypes at the larval NMJs. Taken together, our studies demonstrate that Mask is a novel regulator for MT stability, and such a role of Mask requires normal function of Jupiter.
Physical density estimations of single- and dual-energy CT using material-based forward projection algorithm: a simulation study
Authors: Li Kai-Wen , Fujiwara Daiyu , Haga Akihiro , Liu Huisheng , Geng Li-Sheng 
Published: September 2021

Objectives: This study aims to evaluate the accuracy of physical density prediction in single-energy CT (SECT) and dual-energy CT (DECT) by adapting a fully simulation-based method using a material-based forward projection algorithm (MBFPA). Methods: We used biological tissues referenced in ICRU Report 44 and tissue substitutes to prepare three different types of phantoms for calibrating the Hounsfield unit (HU)-to-density curves. Sinograms were first virtually generated by the MBFPA with four representative energy spectra (i.e. 80 kVp, 100 kVp, 120 kVp, and 6 MVp) and then reconstructed to form realistic CT images by adding statistical noise. The HU-to-density curves in each spectrum and their pairwise combinations were derived from the CT images. The accuracy of these curves was validated using the ICRP110 human phantoms. Results: The relative mean square errors (RMSEs) of the physical density by the HU-to-density curves calibrated with kV SECT nearly presented no phantom size dependence. The kV–kV DECT calibrated curves were also comparable with those from the kV SECT. The phantom size effect became notable when the MV X-ray beams were employed for both SECT and DECT due to beam-hardening effects. The RMSEs were decreased using the biological tissue phantom. Conclusion: Simulation-based density prediction can be useful in the theoretical analysis of SECT and DECT calibrations. The results of this study indicated that the accuracy of SECT calibration is comparable with that of DECT using biological tissues. The size and shape of the calibration phantom could affect the accuracy, especially for MV CT calibrations. Advances in knowledge: The present study is based on a full simulation environment, which accommodates various situations such as SECT, kV–kV DECT, and even kV–MV DECT. In this paper, we presented the advances pertaining to the accuracy of the physical density prediction when applied to SECT and DECT in the MV X-ray energy range. To the best of our knowledge, this study is the first to validate the physical density estimation both in SECT and DECT using human-type phantoms.
Zonal anatomy of the prostate using magnetic resonance imaging, morphometrics, and radiomic features: impact of age-related changes
Authors: Laschkar Sophie , Montagne Sarah , De Kerviler Eric , Roupret Morgan , Lucidarme Olivier , Cussenot Olivier , Renard Penna Raphaele 
Published: September 2021

Objective:
To evaluate the impact of age on the zonal anatomy of the prostate by MRI using morphometric and textural analysis.

Methods:
A total of 154 men (mean age: 63 years) who underwent MRI due to a high prostate-specific antigen (PSA) level were included retrospectively. At each MRI examination the following variables were measured: overall dimensions of the prostate (whole gland (WG), transitional zone (TZ), and peripheral zone (PZ)), and thickness of the anterior fibromuscular stroma (AFMS) and the periprostatic venous plexus (PPVP) on T 2 weighted images. Identical regions of interest (ROIs) were delineated on the apparent diffusion coefficient (ADC) map on the anterior (horn) and posterior part of the PZ. Textural (TexRAD®) parameter differences between TZ and PZ ROIs on T 2 weighted images were analyzed by linear regression. Results were correlated with age (distributed into five decades from 22 to 89 years).

Results:
Age was positively correlated with PSA level and glandular volumes (WG, TZ, and TZ/WG ratio; p &lt; 0.0001) and was negatively correlated with AFSM and PPVP thickness (p &lt; 0.0001). There was a positive correlation between ADC values of the PZ and age (p = 0.003) and between entropy of the TZ and PZ and age (p &lt; 0.001).

Conclusion:
Gradual variations in morphologic and textural features of the prostate were observed with age, mainly due to the increase in TZ volume while PZ volume tended to decrease. These modifications resulted in textural changes mainly at the expense of entropy.

Advances in knowledge:
Entropy could be relevant for studying the process of aging of the prostate.
Use of weight-based vs age-based groupings in the study of typical values of air kerma area product (PKA) for paediatric radiographs of chest and abdomen
Authors: Delakis Ioannis , Kelly Charlotte 
Published: September 2021

Objective: To compare age groupings versus weight groupings in the calculation of typical air kerma area product (PKA) values in paediatric X-ray exams of chest and abdomen in our hospital. Methods: Data were analysed from 687 abdominal and 1374 chest X-ray examinations. The PKA of exams was extracted with Radimetrics, and patient weights were collected from electronic records. Data were organised in different age groups and typical PKA values were estimated. The process was repeated by organising data in different weight groups. Results: Typical PKA values for the four younger age groups (<1m, 1m - < 4y, 4y - < 10y and 10y - < 14y) were comparable to typical values for their equivalent weight groups (<5 kg, 5–15 kg, 15–30 kg and 30–50 kg, respectively). However, typical PKA values at the late adolescent age group (14y - < 18y) were much lower than its equivalent weight group (>50 kg). Conclusions: Age and weight groupings were found at our site to be interchangeable for the calculation of typical paediatric PKA values. The only exception was the late adolescent group, whose weight distribution can account for the difference in typical PKA results within its equivalent weight group. Advances in knowledge: In calculating typical PKA values for radiological paediatric body examinations, departments must ascertain if using age groups, which is typical practice, is equivalent to using weight groups. Otherwise, results may misrepresent local practice.
Hemostasis using re-radiofrequency ablation for hepatic tract bleeding after ultrasound-guided percutaneous radiofrequency ablation of hepatic tumors
Authors: Song Kyoung Doo , Lee Min Woo , Rhim Hyunchul , Kang Tae Wook 
Published: September 2021

Objective: To evaluate the hemostatic efficacy of re-radiofrequency ablation (re-RFA) for hepatic tract bleeding after ultrasound-guided RFA of hepatic tumors. Methods: A total of 4679 percutaneous ultrasound-guided RFA procedures were performed for hepatic tumors at Samsung Medical Center between January 2012 and December 2020. We identified patients who had hepatic tract bleeding after RFA by reviewing radiologic reports and ultrasound images and investigated the measures taken to control the bleeding and their outcomes. We also identified patients who had a significant peritoneal hematoma on immediate post-RFA CT or underwent transarterial embolization to control hepatic bleeding after RFA of hepatic tumors. Results: In total, 91 patients with tract bleeding after RFA were identified. As initial measures to control the bleeding, external compression, re-RFA, and observation were performed in 71 (78%), 17 (19%), and 3 (3%) patients, respectively. Hemostasis using re-RFA was attempted to control tract bleeding in 40 patients as an initial measure or an additional measure after other initial efforts. In all 40 patients, the bleeding stopped after re-RFA on Doppler ultrasound, and there was no active bleeding on the immediate follow-up CT. During the study period, in the years when re-RFA was performed frequently, the number of transarterial embolizations to control tract bleeding and significant peritoneal hematoma formation tended to be low. Conclusion: Hemostasis using re-RFA of the needle tract is effective in controlling tract bleeding after ultrasound-guided RFA of hepatic tumors. Advances in knowledge: Re-RFA is a simple, safe, and effective method to control tract bleeding.
Tarlov cysts in back pain patients: prevalence, measurement method and reporting points
Authors: Shoyab Muhammad 
Published: September 2021

Objective: Determining the prevalence of Tarlov cysts in low back pain patients. Methods and materials: The picture archiving & communication system (PACS) & hospital information system (HIS) of a corporate hospital were retrospectively analyzed to determine the percentage of Tarlov cysts among patients undergoing spinal MRI for back pain over 3 years (January 2017 to December 2019). Results: 384 patients had undergone spinal MRI for back pain over the study period, and 25 of them (6.51%) had Tarlov cysts. Vast majority (15 cases) showed cysts located at S2/S3 level, and few were found at S1/S2 and other levels. Single cysts were found in most (=18) of the cases, while 7 cases of multiple / bilateral cysts were found. Cyst dimensions were higher in craniocaudal than anteroposterior or transverse directions. In case of multiple cysts, one or two cysts were noted as dominant, having higher dimensions than the others. The study data revealed no gender or age predilection. Conclusions: We conclude that including the entire sacrum with a T2 sagittal sequence in all MRI for low back pain can increase detection of Tarlov cysts, and thereby provide more data for further analysis. Advances in knowledge: We propose the concept of one “dominant” cyst when there are multiple Tarlov cysts. We recommend that diameter or size of Tarlov cysts be specified to their craniocaudal dimension. We also suggest reporting points for contextual structured reporting, viz. presence or absence of bony scalloping, neural foraminal narrowing, nerve root compression or extraforaminal extension.