bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ewing's sarcoma of the head and neck: differential diagnosis, treatment and outcomes
Authors: Nair Deepa , Thomas Linu , Patil Vasundhara 
Published: January 2025

Purpose of review
Ewing's sarcoma is a small round-cell tumour typically arising in the bones, and only rarely affecting soft tissues. These are rarely seen in the head and neck comprising 1–9% of all cases, making management of these tumours a challenge. This review aims to review the current literature to update the current diagnostic and treatment options in head and neck Ewing's sarcoma

Recent findings
The tumour is characterized in most cases by recurrent balanced translocations between the EWSR1 gene on chromosome 22 and genes belonging to the ETS family of transcription factors. Its main driver is the reciprocal translocation between the EWSR1 and FLI1 genes (EWSR1:FLI1). Molecular techniques for the detection of FET/ETS fusions are widely used to confirm the diagnosis. Newer entities like adamantinoma-like Ewing sarcoma have been recently described. The chemotherapy protocols also have changed following Euro Ewing 2012 study. Reclassification of margin status may help standardize treatment in these cases.

Summary
Head and neck Ewings sarcoma is an uncommon tumour, mainly affecting paediatric/adolescent male individuals. Histopathological diagnosis is often challenging and immunohistochemical markers and/or molecular tests are generally used. Several molecular techniques for the detection of FET/ETS fusions are widely used to confirm the diagnosis. Management of Ewing's consists of a multimodal treatment regimen, including surgical resection and/or local radiotherapy, as well as intensive multiagent chemotherapy. Increase in age and the presence of distant metastasis are associated with shorter survival times.
The Effects of Ultrasound-guided Corticosteroid Injection Compared to Mesenchymal Stem Cell Injection in Patients with Grade II and III Knee Osteoarthritis: A Randomized Double-blind Controlled Trial.
Authors: ZoghAli Masoumeh , Amini Naser , Babaei-Ghazani Arash , Forogh Bijan , Joghataei Mohammad Taghi , Babaei Mohammad Reza , Rikhtehgar Masih , Abdolmaleki Khatereh 
Published: January 2025

Abstract

Objective
This study investigated the effects of a single dose injection of mesenchymal stem cells (MSCs) under ultrasound guidance for knee osteoarthritis (KOA).

Design
The study included 30 subjects in the intervention group, who received the MSC injection and 27 in the control group who received triamcinolone. Various outcome measures, including pain levels, range of motion (ROM), and MRI parameters, were evaluated before the intervention and at different time points after treatment.

Result
The results showed that the MSC group experienced more effective improvements in outcome measures compared to the control group. Pain improvement was significantly different in the MSC group at 2 weeks, 4 weeks, and 24 weeks after the treatment. ROM in extension improved significantly in the MSC group after 4 weeks. Physical function improved significantly in both groups at different time points. Furthermore, the MSC group showed some positive changes in MRI parameters, but it can't be said definitively that they led to an increase in cartilage thickness.

Conclusion
In conclusion, the study suggests that a single dose injection of MSCs is safe and holds promise for long-term treatment of KOA. No significant negative effects were reported in either group as a result of the study.
The Incidence and Aetiology of Maxillofacial Trauma and Concomitant Traumatic Brain Injury in a Johannesburg Tertiary Hospital
Authors: Khan Faheema , Rikhotso Risimati E. 
Published: January 2025

Objective:
To investigate the incidence and etiology of maxillofacial trauma (MFT) and its association with traumatic brain injury (TBI).

Background:
Anecdotal evidence suggests that there is an association between MFT and TBI and that higher incidences of TBI are associated with frontal bone and mid-facial fractures. Despite the large volume of maxillofacial facial fractures treated in the authors' unit, no study has been undertaken to establish the relationship between TBI and maxillofacial fractures.

Methods:
This was a retrospective single-center cross-sectional study that was conducted on patients who presented at Charlotte Maxeke Academic Hospital emergency department with MFT and concomitant TBI over a period of 1 year (January 2019–January 2020). The primary predictor was maxillofacial fractures, which were classified into upper, middle, and lower thirds. The primary outcome variable was TBI indicated by the Glasgow Coma Scale (GCS) and Marshall computed tomography (CT) classification (radiological finding in CT).
Variables such as age, etiology, fracture type, and neurological injury indicated by the recorded GCS and Marshall CT classification (I–IV) were collected. Maxillofacial fractures were classified based on the anatomical location. The level of significance was set at P <0.05.

Results:
A total of 112 patients (102 males, 10 females) presented with MFT and concomitant TBI. The age group 30 to 39, followed by 20 to 29 years, was most affected. Respectively assault (n = 67), gunshots (n = 16), and falls (n = 16) were the main causes of injury. Supra-orbital rim fractures (P = 0.00193), frontal sinus fractures (P < 0.001,), and panfacial fractures (P < 0.001) were significantly associated with TBI. Severe TBI (GCS: 3–8) was associated with higher Marshall CT grading.

Conclusions:
Facial fractures affecting the upper third and panfacial fractures pose a significant risk for TBI. To identify TBIs, a multidisciplinary evaluation of facial fractures is recommended, especially in high-risk groups.
Monocyte Anisocytosis is Associated with Sepsis in Children with Suspected Infection
Authors: Yonker Lael M. , Badaki-Makun Oluwakemi , Alvarez-Carcamo Bryan , Cross Cody , Okuducu Yanki , Appleman Lori , Greatorex Jaime , Onu Rosemary E. , Santos Christine , Petherbridge Rachel , Foy Brody H. , Cereaga Diana , Naiman Melissa , Castro Iris , Haller Logan , Guthrie Lauren B. , Higgins John M. , Lewandrowski Kent B. , Irimia Daniel 
Published: January 2025

Abstract:

Background
Early, accurate determination of disease severity in an emergency setting is paramount for improving patient outcomes and healthcare costs. Monocyte anisocytosis, quantified as monocyte distribution width (MDW), has been shown to correspond with immune dysregulation. We hypothesize that MDW is broadly associated with illness severity related to sepsis and serious infection in children.

Methods
We designed a retrospective study to analyze MDW, as measured by UniCel DxH 900 analyzer, on whole blood samples that were collected from children presenting for medical care between 4/2020-9/2022. SIRS criteria and Pediatric Sequential Organ Failure Assessment (pSOFA) scores were calculated, and source of infection was documented. Outcomes were compared by t-test or ANOVA, and receiver operating characteristic (ROC) curves assessed accuracy of MDW in identifying sepsis in children.

Results
We analyzed samples from 394 children presenting with illness to two pediatric medical centers. MDW was significantly higher in children with sepsis (28.2 ± 7.8) than children with suspected or confirmed infection who did not display signs of sepsis (21.5 ± 5.2). A ROC curve comparing MDW of children with sepsis against infected children without sepsis displayed an area under the curve of 0.78, suggesting MDW may serve as a useful tool in identifying children with sepsis.

Discussion
When children present to the urgent care/emergency setting with signs of infection, MDW may serve as a prompt tool to aid clinicians in identifying those who are at high risk for severe illness and require closer monitoring/intervention compared to those who may be safely discharged home.
Effect and regulatory mechanism of SIRT6 on post-cardiac arrest brain injury in rats
Authors: Liu Jianxiong , Zhen Li , Yu Dihua , Wang Weiqing 
Published: January 2025

ABSTRACT

Aims
Brain injury occupies the predominant cause of neurological dysfunction and mortality after successful cardiopulmonary resuscitation (CPR) from cardiac arrest (CA). This study investigates the role and mechanism of Sirtuin 6 (SIRT6) in post-cardiac arrest brain injury in rats.

Methods
All rats were subjected to asphyxial CA followed by CPR. Two weeks before modeling, rats were infected with lentivirus containing oe-SIRT6 and oe-FOXO1 through lateral ventricular injection. qRT-PCR and Western blot quantified SIRT6 and FOXO1 expressions in brain tissues. Neurological deficit scores evaluated the neural function of rats at different time points, and water maze test assessed the changes in short-term learning and memory abilities. The survival status of rats 7 days after modeling was recorded. The pathological changes in brain tissues, inflammatory factors, and apoptosis were evaluated by H&E staining, ELISA, and TUNEL, respectively. Ch-IP measured the enrichment of SIRT6 and H3K9ac in the FOXO1 promoter.

Results
SIRT6 was poorly expressed while FOXO1 was highly expressed in CA/CPR rats. Elevation of SIRT6 expression alleviated neural function, behavioral ability, and survival rate, as well as abated pathological damage, inflammatory responses, and cell apoptosis in CA/CPR rats. Mechanistically, SIRT6 curbed FOXO1 transcription and expression by lowering the H3K9ac level in the FOXO1 promoter; FOXO1 overexpression abolished the improvement effect of SIRT6 overexpression on brain injury in CA/CPR rats.

Conclusions
Elevation of SIRT6 expression restrained the FOXO1 expression by diminishing the H3K9ac level in the FOXO1 promoter, thereby mitigating post-cardiac arrest brain injury in rats.
Monocytes and B cells Mediate Alterations in the Genetic Association Between Platelets and Sepsis via CLEC signaling pathway
Authors: Yang Hang , Feng Lin , Jiang Zhenjie , Xiao Yirong , Zeng Kai 
Published: January 2025

Abstract

Background Sepsis is a life-threatening condition characterized by multiple organ dysfunction. Blood cells abnormalities play a significant role in the onset and progression of sepsis; however, the potential causal relationship between platelets and sepsis remains unclear, as does whether immune cells mediate the interaction between platelets and sepsis. This study aims to explore the potential causal relationship between platelets and sepsis and analyze the mediating effect of immune cells. In addition, cell-to-cell communication was analyzed to explore the interaction between blood cells and immune cells.

Material and methods In this study, genome-wide association study (GWAS) data were utilized to examine the association between blood cells and sepsis. Two-sample mendelian randomisation (MR) and reverse MR were performed to investigate the potential causal relationship between blood cells and sepsis, with a specific focus on the relationship between platelets and sepsis. Subsequently, two-step MR was employed to identify the immune cells that mediate the interaction between platelets and sepsis and to assess their potential mediating effects. Cellchat software was used to analyze cell-to-cell communication.

Results The results of two-sample MR indicated that platelets were negatively correlated with sepsis (OR = 0.976, 95% CI 0.959-0.993, p = 0.005), suggesting that platelets have a protective effect against sepsis. Additionally, reverse MR demonstrated that sepsis had no significant effect on platelets (OR = 0.909, 95% CI 0.156-5.296, p = 0.916). The mediating effect analysis revealed that monocytes and B cells were important mediators in the relationship between platelets and sepsis. Notably, the correlation between platelets and sepsis shifted from negative to positive with the involvement of monocytes and B cells. The number and strength of cell-cell interactions were decreased in sepsis. Monocytes and B cells primarily regulate platelets through the CLEC signaling pathway, contributing to the pathogenesis of sepsis.

Conclusion This study confirmed the protective role of platelets in sepsis. Monocytes and B cells mediate changes in the genetic association between platelets and sepsis. Monocytes and B cells primarily interact with platelets via the CLEC pathway, thereby modulating the genetic association between platelets and sepsis. These findings indicate that thrombocytopenia, especially when accompanied by elevated monocytes and B cells, may serve as a potential marker for sepsis.
Solution AFM imaging and coarse-grained molecular modeling of yeast condensin structural variation coupled to the ATP hydrolysis cycle
Authors: Koide Hiroki , Kodera Noriyuki , Takada Shoji , Terakawa Tsuyoshi 
Published: January 2025

ABSTRACTCondensin is a protein complex that regulates chromatin structural changes during mitosis. It varies the molecular conformation through the ATP hydrolysis cycle and extrudes DNA loops into its ring-like structure as a molecular motor. Condensin contains Smc2 and Smc4, in which a coiled-coil arm tethers the hinge and head domains and dimerizes at the hinge. ATPs bind between the heads, induce their engagement, and are hydrolyzed to promote their disengagement. In the previous study, we performed solution atomic force microscopy (AFM) imaging of yeast condensin holo-complex in the presence of ATP and conducted flexible molecular fitting to the AFM image, obtaining the hinge structure with open conformation. However, it has yet to be clarified how the opening/closing of the hinge is coupled to the ATP hydrolysis cycle. In this study, we performed solution AFM imaging in the presence and absence of varying nucleotides, including AMP-PNP, ATPγS, and ADP. Furthermore, we conducted coarse-grained molecular dynamics simulations of a Smc2/4 heterodimer and selected the molecular structure that best represented each AFM image. Our results suggested that head engagement upon ATP binding is coupled to hinge opening. Also, the results indicated that the N-terminal region of Brn1, one of the accessory subunits, re-associates to the Smc2 head after ADP release. This study deepens our understanding of the conformational variation of yeast condensin driven by the ATP hydrolysis cycle.
Introducing and Testing Maternal Vulnerability Segmentation Tool (MVST) for Essential Service Utilization: Initial Evidence from Implementation Research in Oromia, Ethiopia
Authors: Lakew Yihunie , Tamene Habtamu , Kang Bee-Ah , Kapadia-Kundu Nandita , Kuka S. H , Rimal Rajiv 
Published: January 2025

AbstractIn Ethiopia, utilization of maternal health services, including antenatal care and health facility delivery remain low. This is particularly acute among women living with individual, social, and environmental vulnerabilities. This study aimed to develop and test a maternal vulnerability segmentation tool to enable community workers to identify pregnant women least likely to access maternal care services. Guided by Project Pathways’ Vulnerability Framework, predictors of maternal health service utilization were identified, and a 20-item questionnaire was developed from identified predictors. We employed exploratory and confirmatory factor analysis to create a latent variable called maternal vulnerability. Vulnerability items with acceptable internal reliability were tested to confirm association with antenatal care and institutional delivery through mediation regression analysis. A factor with eigenvalue greater than one was identified, which were further reduced and refined to 10, four for urban-rural residents, and six for a rural sample. This resulted in a root mean square error of approximation (RMSEA) values of between 0.01 to 0.08, comparative fit index (CFI) > 0.90, and Tucker Lewis index (TLI) value > 0.90. Women with higher vulnerability score were less likely to access antenatal care visits and more likely to deliver at home (p<0.01). Our data-driven work leveraging this tool provide guidance to effective programs in identifying underprivileged pregnant women to enable community workers to narrow maternal health service gaps in Ethiopia.What is already known on this topicNearly half of pregnant women are not using essential maternal services such as antenatal care and health facility delivery, placing their delivery and own health at risk.Pregnant women are least likely to use those services because of individual, social, economic, and environmental factorsWhat this study addsThis study provides new maternal vulnerability segmentation tools to identify women living with vulnerabilities for targeted interventions. It explains the extent to which intersecting vulnerability scores affect essential maternal service utilization.How this study might affect research, practice or policyThis study enables community health workers to classify pregnant women according to their degree of vulnerability, thus paving the way for developing well-targeted interventionsIt also calls for further research aimed at generating more validated vulnerability segmentation tools that effectively and efficiently address maternal vulnerabilities across different contexts in low-income and middle-income countries.
Spot Urine Protein to Creatinine Ratio in Patients with Urinary Tract Infection
Authors: Chauhan Mukesh , Suresh Babu SV 
Published: January 2025

AbstractIntroductionUntreated urinary tract infections (UTIs) can lead to complications, including renal deterioration due to upper urinary tract involvement. Proteinuria, characterized by excessive protein in the urine, is often indicative of kidney damage. The protein-to-creatinine ratio (P/C ratio) test is a convenient and reliable method for assessing proteinuria. This study aimed to evaluate the urine protein-to-creatinine ratio (UPCR) in UTI patients and its association with renal impairment.Materials and MethodsEighty patients with confirmed UTI and suspected proteinuria were recruited. Urine screening included pyuria (white blood cell presence) as an initial indicator of UTI, followed by microscopic examination of centrifuged urinary sediments. The urine supernatant was analyzed for protein using the urine strip method.ResultsAfter applying exclusion criteria, forty-six patients (n=46) were included in the statistical analysis. Of these, 26% had normal proteinuria (<15 mg/mM Cr), 35% had moderate proteinuria (15-50 mg/mM Cr), and 39% exhibited severe proteinuria (>50 mg/mM Cr). Patients were categorized into three stages (I, II, and III) with mean creatinine excretion values of 33.9 +/-13.9 mg/dL, 31.2 +/-17.2 mg/dL, and 29 +/-13.6 mg/dL, respectively, all significantly below the reference interval (168 +/-132 mg/dL).ConclusionIncreased urinary protein excretion correlates with heightened risk of renal complications, a leading factor in mortality. Urinary protein excretion was markedly elevated in Stage III patients. The P/C ratio proved to be a more accurate diagnostic marker within the urine profile, highlighting proteinuria in UTI patients as a potential risk factor for renal impairment.
Efficient Classification of Pulmonary Pneumonia and Tuberculosis Alongside Normal and Non-X-ray Images with Minimal Resources and Maximum Accuracy
Authors: Majumder Rifatul Islam 
Published: January 2025

1.1)AbstractPneumonia, primarily caused byStreptococcus pneumoniae, and tuberculosis (TB), caused byMycobacterium tuberculosis, continue to present significant global health challenges. Pneumonia is responsible for 14% of deaths among children under five, resulting in 740,180 fatalities annually [1]. Similarly, TB caused 1.25 million deaths in 2022, including 161,000 among individuals with HIV [2]. Misdiagnosis is a critical issue, with 22.3% of pneumonia cases being misidentified as TB [3], highlighting the need for accurate diagnostic tools. This study proposes a novel classification framework for chest X-ray (CXR) images, designed to identify four categories: normal, pneumonia, tuberculosis, and non-X-ray. By incorporating the “non-X-ray” class, the model enhances robustness by detecting outliers and unseen anomalies. The framework utilizes a pre-trained ResNet-18 convolutional neural network and a fine-tuned DenseNet-121, both trained with and without weighted loss function. The best-performing model achieved exceptional results, with 98.76% accuracy, 99.01% precision, and 99.03% recall, maintaining or surpassing class-wise performance. The model was trained on a curated dataset from multiple valid sources, containing 5,489 normal, 4,273 pneumonia, 4,197 tuberculosis, and 1,357 non-X-ray images. This framework has the potential to reduce misdiagnosis and improve healthcare delivery, particularly in resource-limited environments.
Sex differences in the coherence of PCL-5 and CAPS-5 assessments for Post-Traumatic Stress Disorder
Authors: Bakshi Bhavya , Nalloor Rebecca , McCall Vaughn , Vazdarjanova Almira 
Published: January 2025

AbstractThe clinician-administered Post Traumatic Stress Disorder (PTSD) scale (CAPS) is a clinical tool for the diagnosis and assessment of the severity of PTSD symptoms. It is widely accepted as the gold standard against which self-assessment tools, such as PCL, are usually evaluated. However, the clinician administered interviews are time and resource intensive, thus utilizing self-report measures is adopted as quicker and more practical to assess symptom severity. Although there have been demonstrations of the validity of PCL for PTSD diagnosis and assessment of symptom severity, PCL (including PCL-5 which is based on DSM-5 criteria) scores tend to overreport symptom severity sometimes leading to higher prevalence of PTSD diagnosis. The contributing factors for such discrepancies in reporting are poorly understood. Here we examined whether there are sex differences in the alignment of PCL-5 with CAPS-5. Our findings indicate that males often report higher PTSD symptom severity on PCL-5 which significantly deviates from a predicted correlation line based on their CAPS-5 scores. Female participants had no deviation from the predicted correlation line. Accordingly, 26.8% of males and only 11.4% of females had inaccurate PTSD status if they were evaluated on PCL-5 alone. Our data also shows that participants with military trauma have poor correlation when compared to participants with civilian trauma. These findings have important implications for appropriate PTSD symptom severity assessment especially for males and military populations. This has significant downstream implications as treatment adjustments, therapy recommendations, and disease management, relying heavily on symptom severity assessed by self-reported tools.