bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inter- and intra-tumoral heterogeneity on [68Ga]Ga-DOTA-TATE/[68Ga]Ga-DOTA-TOC PET/CT predicts response to [177Lu]Lu-DOTA-TATE PRRT in neuroendocrine tumor patients
Authors: Gadens Zamboni Camila , Dundar Ayca , Jain Sanchay , Kruzer Marc , Loeffler Bradley T. , Graves Stephen A. , Pollard Janet H. , Mott Sarah L. , Dillon Joseph S. , Graham Michael M. , Menda Yusuf , Shariftabrizi Ahmad 
Published: November 2024

Abstract
Background
Indices of tumor heterogeneity on somatostatin receptor PET/CT scans may potentially serve as predictive biomarkers of treatment efficacy in neuroendocrine tumor (NET) patients undergoing [177Lu]Lu-DOTA-TATE PRRT.

Methods
NET patients who underwent [177Lu]Lu-DOTA-TATE therapy at the University of Iowa from August 2018 to February 2021 were retrospectively evaluated. Radiomic features on the pre-PRRT somatostatin receptor PET/CT were evaluated using a custom MIM Software® LesionID workflow. Conventional PET/CT metrics of tumor burden, such as somatostatin receptor expression and tumor volume, were calculated in addition to the indices of tumor heterogeneity for each lesion (intra-lesional) and then summarized across all lesions throughout the body (inter-lesional). Endpoints included post-PRRT 24-month time to progression (TTP) and overall survival (OS). Cox regression models were used to assess the predictive ability of the imaging factors on post-PRRT 24-month TTP and OS. LASSO-penalized Cox regression was used to build a multivariable model for each outcome.

Results
Eighty patients with a mean age of 65.1 years were included, with most (71.3%) completing 4 cycles of PRRT. Median TTP was 19.1 months, and OS at 60 months was 50%. A large degree of variability between patients was evidenced for imaging features related to somatostatin receptor expression. On multivariable analysis, total receptor expression and mean liver-corrected SUVmean were selected for 24-month TTP. The model was not able to significantly predict progression (C-statistic = 0.58, 95% CI 0.50–0.62). Total receptor expression and mean skewness were selected for OS. The resulting model was able to significantly predict death (C-statistic = 0.62, 95% CI 0.53–0.67), but the predictive ability was limited, as evidenced by the low C-statistic.

Conclusions
Our exploratory analysis provides preliminary results showing that imaging indices of inter- and intra-tumor heterogeneity from pretreatment PET/CT images may potentially predict treatment efficacy in NET patients undergoing [177Lu]Lu-DOTA-TATE therapy. However, prospective evaluation in a larger cohort is needed to further assess whether a comprehensive characterization of tumor heterogeneity within a patient can help guide treatment decisions.
Lifestyle discussions facilitate self-management in RA: a qualitative study of patients’ perceptions
Authors: Drake af Hagelsrum Klara , Larsson Ingrid , Bremander Ann , Einarsson Jon T. , Lindqvist Elisabet , Mogard Elisabeth 
Published: November 2024

Abstract
Background
Healthy lifestyle habits (regular physical activity, a healthy diet, no smoking and non-hazardous alcohol consumption) alongside pharmacological treatment can lower the risk of cardiovascular diseases and improve symptoms and quality of life in patients with rheumatoid arthritis (RA). Therefore, healthcare professionals in rheumatology care are urged to discuss lifestyle habits with all patients. The aim of this study was to explore patients’ perceptions of lifestyle discussions in early rheumatology care.

Methods
Individual interviews were conducted with 20 patients with RA, 14 women and six men, aged 23 to 77 years, and with a mean disease duration of 2.4 years. All lifestyle discussions were performed during the first year with RA. A qualitative content analysis was performed.

Results
An overarching theme emerged, exploring how patients with RA perceived lifestyle discussions as facilitating self-management. Three categories illustrated this: (1) the usefulness of lifestyle discussions depended on the individual patient’s preferences and prioritization for lifestyle support; (2) the design of lifestyle discussions should be based on a person-centred approach, incorporating personalized lifestyle information and providing structured and recurrent support; (3) the outcomes of lifestyle discussions should contribute to enhanced knowledge and motivation for making healthy lifestyle changes.

Conclusion
Lifestyle discussions in early rheumatology care should, according to patients with RA, be based on a person-centred approach, be tailored to each patient’s preferences and needs, and have outcomes focusing on patient support for healthy lifestyle changes, all essential elements to facilitate self-management. The present findings can be used to guide the development and implementation of more person-centred lifestyle approaches targeted to facilitate lifestyle changes and benefit cardiovascular disease risk management in early rheumatology care.
A case of double aneuploidy of Down and Klinefelter syndrome in an Indian infant: a detailed case report
Authors: Patel Sunny Kumar Jignesh Kumar , Sheikh Shagufa , Banerjee Birendranath 
Published: November 2024

Abstract
Background
A variation in the number of chromosomes can lead to chromosomal disorders. These chromosomal aberrations might be related to autosomes or sex chromosomes. The most common chromosomal aberrations that are sex-linked and autosomal are Klinefelter syndrome and Down syndrome, respectively. However, the worldwide occurrence of double chromosomal aneuploidy in a single individual is relatively exceptional event and random meiotic nondisjunction events result in double aneuploidy, which causes trisomy of two distinct chromosomes. The clinical manifestations vary depending on whether aneuploidy is dominant or an amalgam of both. Moreover, double aneuploidy including autosome and sex chromosome is not often documented. In this paper, we document a case of Down–Klinefelter double aneuploidy syndrome in an Indian infant hospitalized to the neonatal care unit.

Case presentation
A full-term 9-month-old male infant born to a 36-year-old female with classical clinical signs of Down syndrome like epicanthus, a depressed nasal bridge, a flat face, small ears, an open mouth, thick lower lip vermilion, a protruding tongue, and a short neck was referred for cytogenetic examination, revealing a rare karyotype of 48, XXY, + 21.

Conclusion
Down–Klinefelter syndrome is a rare chromosomal anomaly with unique characteristics, often displaying only Down syndrome-like traits at birth. Early diagnosis can be challenging due to the lack of noticeable symptoms until puberty. Early cytogenetic investigation can detect double aneuploidy, improving the affected person's quality of life and educating family members about potential medical and psychosocial difficulties.
Pai syndrome associated with vomer agenesis: case report with review of literature
Authors: Nibhanupudi Kamala Manogna , Sankaravadivel Saradha Preethi , Padmanaban Elamparidhi , Amirthalingam Umamageswari , Varadane Avinesh , Balavaitheeswar R. L. 
Published: November 2024

Abstract
Background
Frontonasal Dysplasia (FND) is an uncommon developmental defect affecting the midface, leading to abnormal facial development. Pai Syndrome is a part of the frontonasal dysplasia spectrum, is typically marked by median cleft lip, cutaneous polyps, and midline central nervous system lipomas. Pai Syndrome is also associated with various intracranial abnormalities. This is the first documented case of Pai Syndrome in a female patient with concurrent vomer agenesis.

Case presentation
A 17-year-old female with persistent nasal obstruction and a history of median cleft lip and palate surgery was found to have deviated nasal septum and nasal mass. CT revealed polypoidal thickening in the left maxillary sinus, an incomplete nasal septum with a defect, and lipoma in the nasal septum. There was also pericallosal lipoma with bracket calcification and partial agenesis of the corpus callosum. Ophthalmologic evaluation showed hypertelorism. The diagnosis was consistent with frontonasal dysplasia, potentially Pai Syndrome or a variant.

Conclusion
The presence of midline nasal lipomas or masses should raise concerns about Pai Syndrome and other frontonasal dysplasia. Additional imaging is necessary to detect associated congenital abnormalities, which aids in accurately diagnosing Pai Syndrome and planning surgical treatments.
Cardiac myxomas: a review of current treatment approaches and emerging molecular therapies
Authors: Ashinze Patrick , Banerjee Suvam , Egbunu Emmanuel , Salawu Wuraola , Idris-Agbabiaka Abdullaah , Obafemi Eniola , Olajuwon Tolulope Joseph , Chukwu Bethrand , Aremu Sikiru Ademola , David Olafisoye-Oragbade Oluwatosin , Alausa Hamdallah Modupe , Iwaloye Folayemi Abiodun 
Published: November 2024

Abstract
Background
Cardiac myxomas are the most common primary cardiac tumors, predominantly located in the left atrium. These benign tumors can obstruct blood flow, cause embolization, or produce systemic symptoms like fever. Diagnostic tools such as echocardiography play a critical role in their identification, while surgical resection remains the primary curative treatment. Although recurrence is rare, it occurs more frequently in patients with genetic predispositions, such as the Carney complex. The risk of life-threatening complications such as embolism and sudden death necessitates prompt diagnosis and management. Despite the success of surgical treatment, recent advances have introduced minimally invasive techniques and novel molecular therapies, particularly for recurrent cases.

Main body
The epidemiology of cardiac myxomas highlights their rarity, with an incidence of 0.5–1 per million individuals annually. They are classified based on location, morphology, and whether they are sporadic or syndromic. Histologically, they originate from multipotent mesenchymal cells and present as gelatinous or solid masses. The genetic implicants, especially in familial cases, involve certain gene mutations, disrupting signaling pathways and leading to tumorigenesis. Diagnosis primarily relies on imaging, with transthoracic echocardiography being the first-line modality. Surgical resection, typically via median sternotomy, remains the gold standard treatment with a low recurrence rate. However, emerging molecular therapies, including gene editing, epigenetic interventions, stem cell therapy, and immunotherapy, offer promising avenues for managing complex or recurrent cases even though they are mostly in conceptual and preclinical phases. These molecular approaches target specific genetic and signaling pathways involved in myxoma formation and recurrence, and though they remain in experimental stages, the advent of gene therapy in oncology makes them the next best choice to watch out for.

Conclusions
While surgical resection remains curative in most cases, recurrence, particularly in familial syndromes, requires vigilant monitoring and innovative treatments. Emerging molecular therapies show potential in offering personalized treatment options, although they are still inchoate. Further research is needed to improve delivery systems and minimize the challenges associated with these therapies, paving the way for more effective management strategies.
Rational design of cobalt oxide nanocubes arrays on Ni foam as durable and robust electrocatalyst for urea electro-oxidation
Authors: Ismail Mona M. , Farghali Ahmed A. , El-Deen Ahmed G. 
Published: November 2024

Abstract
Background
Cobalt oxide (Co3O4) is a promising electrocatalyst for efficient urea electro-oxidation, tackling power consumption and environmental challenges. The controllable design of free-standing Co3O4 nanostructures grown on Ni foam (NF) substrates was achieved using a green and facile hydrothermal approach. Different reducing agents were applied to synthesize various morphological structures of Co3O4, including nanoparticles, nanowires, and nanocubes (NCs) morphologies.

Results
The as-fabricated electrodes were investigated as electrocatalysts for enhanced urea electro-oxidation. Because of its 3D nanostructure with minimal agglomeration and a large interfacial surface area with adequate electroactive sites, the Co3O4 NCs/NF had the best energy conversion efficiency of any electrode toward the urea oxidation process. These distinctive features facilitated the electron and urea routes used in the urea electro-oxidation process. It had a low-onset potential of 194.2 mV (vs. Hg/HgO) and a current density of 90.2 mA cm−2 in a 1 M KOH electrolyte. The electrocatalyst demonstrated excellent anodic activity for urea electro-oxidation with an onset potential of 196.7 mV and a current density of 256.1 mA cm−2 in 1 M KOH + 0.3 M urea concentration. Furthermore, the Co3O4 NCs/NF exhibited long-term stability, as shown by chronoamperometry and stepwise tests after 3600 s in the presence of urea under various operating conditions.

Conclusions
Compared to all the fabricated Co3O4 nanostructures, the Co3O4 nanocubes revealed the highest electrocatalytic performance toward urea electro-oxidation in all concentrations. Therefore, Co3O4 NCs/NF is a promising, robust, and efficient electrocatalyst for direct urea fuel cell applications.
Effectiveness and optimal dosage of physiotherapy interventions for Bell palsy: a case study
Authors: Kaushik Himani , Choudhary Avi , Sethi Pooja 
Published: November 2024

Abstract
Background
Bell palsy is a sudden facial nerve paralysis that affects many individuals annually. It significantly impacts patients and their families, leading to a reduced quality of life if left untreated. The International Classification of Functioning, Disability, and Health (ICF) framework focuses on outcome measures, functional limitations, and overall quality of life of the patients. Early diagnosis is crucial for effective management of the condition. In order to standardize clinical practice and contribute to recommendations of certain interventions, this paper focuses on the optimal dosage of physiotherapy intervention for Bell palsy patients, which includes exercise therapy and electrotherapy.

Case presentation
An Indian 33-year-old male visited our physiotherapy department 15 days after being diagnosed with right-sided Bell palsy with unknown aetiology. His chief complaints were right-eye dryness, facial pain, drooping of the face, and difficulty performing facial activities. The outcome measures are the strength duration curve (SD curve), House-Brackmann grading, manual muscle testing, and visual analogue scale (VAS) scale. The physiotherapy intervention includes two primary components: electrotherapy and exercise therapy.

Conclusion
The Kabat rehabilitation technique, along with nerve stimulation and an active exercise regimen, is significantly effective in treating Bell palsy, and the outcome measures show significant improvement with optimal therapy dosage.
Tumor energy metabolism: implications for therapeutic targets
Authors: Hu Youwu , Liu Wanqing , Fang WanDi , Dong Yudi , Zhang Hong , Luo Qing 
Published: November 2024

AbstractTumor energy metabolism plays a crucial role in the occurrence, progression, and drug resistance of tumors. The study of tumor energy metabolism has gradually become an emerging field of tumor treatment. Recent studies have shown that epigenetic regulation is closely linked to tumor energy metabolism, influencing the metabolic remodeling and biological traits of tumor cells. This review focuses on the primary pathways of tumor energy metabolism and explores therapeutic strategies to target these pathways. It covers key areas such as glycolysis, the Warburg effect, mitochondrial function, oxidative phosphorylation, and the metabolic adaptability of tumors. Additionally, this article examines the role of the epigenetic regulator SWI/SNF complex in tumor metabolism, specifically its interactions with glucose, lipids, and amino acids. Summarizing therapeutic strategies aimed at these metabolic pathways, including inhibitors of glycolysis, mitochondrial-targeted drugs, exploitation of metabolic vulnerabilities, and recent developments related to SWI/SNF complexes as potential targets. The clinical significance, challenges, and future directions of tumor metabolism research are discussed, including strategies to overcome drug resistance, the potential of combination therapy, and the application of new technologies.
Cellular diversity of human inner ear organoids revealed by single-cell transcriptomics
Authors: Rumbo Mireia , Alsina Berta 
Published: November 2024

ABSTRACT
Human inner ear organoids are three-dimensional tissular structures grown in vitro that recapitulate some aspects of the fetal inner ear and allow the differentiation of inner ear cell types. These organoids offer a system in which to study human inner ear development, mutations causing hearing loss and vertigo, and new therapeutic drugs. However, the extent to which such organoids mimic in vivo human inner ear development and cellular composition remains unclear. Several recent studies have performed single-cell transcriptomics on human inner ear organoids to interrogate cellular heterogeneity, reveal the developmental trajectories of sensory lineages and compare organoid-derived vesicles to the developing human inner ear. Here, we discuss the new insights provided by these analyses that help to define new paths of investigation to understand inner ear development.
Why Wages Don’t Fall in Jobs with Incomplete Contracts
Authors: Fongoni Marco , Schaefer Daniel , Singleton Carl 
Published: November 2024

We investigate how the incompleteness of an employment contract—discretionary and noncontractible effort—can affect an employer’s decision about cutting nominal wages. Using matched employer-employee payroll data from Great Britain linked to a survey of managers, we find support for the main predictions of a stylized theoretical framework of wage determination: nominal cuts are at most half as likely when managers believe that their employees have significant discretion over how they do their work, although the involvement of employees, via information sharing, reduces this correlation. We also describe how contract incompleteness and wage cuts vary across different jobs. These findings provide the first observational quantitative evidence that managerial beliefs about contractual incompleteness can account for their hesitancy over nominal wage cuts. This has long been conjectured by economists based on anecdotes, qualitative surveys, and laboratory and field experiments. This paper was accepted by Marie Claire Villeval, behavioral economics and decision analysis. Funding: M. Fongoni acknowledges funding under the “France 2030” Investment Plan managed by the Agence Nationale de la Recherche [Grant ANR-17-EURE-0020] and funding from the Excellence Initiative of Aix-Marseille University—A*MIDEX. C. Singleton thanks the Economic and Social Research Council and Administrative Data Research UK [Grant ES/T013877/1] for funding the Wage and Employment Dynamics Project. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2023.02297 .
Amyopathic dermatomyositis with a rapidly progressing interstitial pneumonia
Authors: Logvinova Darija , Žentiņa Dace , Ivanova Kristīne , Buliņa Inita , Kravale Zaiga 
Published: November 2024

Background: Clinically amyopathic dermatomyositis (CADM) is a rare subtype of idiopathic inflammatory myositis often linked with the presence of autoantibodies targeting melanoma differentiation-associated protein 5 (MDA5). Patients with CADM are at increased risk of developing rapidly progressing interstitial lung disease, which significantly increases both morbidity and mortality compared to other forms of inflammatory myopathies. While there is no standardized treatment regimen, current therapeutic strategies are generally focused on combination immunosuppressive therapies. Despite early diagnosis and immunosuppressive therapy, the disease remains highly aggressive and is associated with a poor prognosis. Case report: This report describes the case of a 63-year-old previously healthy male who developed acute interstitial pneumonia. Polymerase chain reaction testing for pneumonia pathogens and routine autoimmune antibody screening were both negative. Despite treatment with corticosteroids and broad-spectrum antibiotics, the patient’s condition continued to deteriorate. A multidisciplinary team was assembled, and a myositis antibody panel was ordered, which led to the diagnosis of anti-MDA5 associated clinically amyopathic dermatomyositis. The patient was initiated on treatment with cyclophosphamide, intravenous immunoglobulin, and a calcineurin inhibitor. However, his condition remained critical, and he ultimately succumbed to respiratory failure. Conclusion: In all cases of rapidly progressive interstitial pneumonia of unclear aetiology, anti-MDA5-associated interstitial lung disease should be considered, regardless of the presence or absence of extrapulmonary manifestations. Despite early recognition and aggressive immunosuppressive therapy, patients with anti-MDA5-associated rapidly progressive interstitial lung disease face a mortality risk of up to 80%. A multidisciplinary approach, with collaboration between specialized centres, is crucial for early diagnosis and timely initiation of treatment.
La memòria dels objectes. El llegat material dels escenaris de conflicte; el cas de les fosses comunes
Authors: Maeso Blanco Lorena 
Published: November 2024

Les troballes d’objectes que es recuperen durant les exhumacions en fosses comunes tenen un valor cabdal de gran importància per la mateixa pertinença i càrrega sentimental de l’objecte en si, però també per les dades d’informació que els experts en poden extreure i posteriorment estudiar. Els objectes són segurament la prova tangible d’una humanitat que acompanya a les restes òssies exhumades i que, com a tals, tenen el que simbòlicament es pot anomenar com el ‘poder’ d’explicar el passat en un moment present o fer de nexe entre passat-recent.

Aquest article té per objectiu assentar les bases d’una anàlisi i reflexió al voltant de les possibilitats de fer servir aquests objectes materials en clau didàctica i emmarcats dins del patrimoni de memòria i de l’arqueologia del conflicte. Per fer-ho, es vol centrar el focus en l’estudi de casos de diverses pràctiques didàctiques fetes a partir d’exhumacions en fosses comunes de conflictes bèl·lics contemporanis, tot centrant una primera part en les fosses de la guerra civil a Espanya.

S’analitzarà quins usos dels objectes poden ser efectius en l’actualitat per donar a conèixer al conjunt de la ciutadania i a les comunitats educatives, des d’una visió professional i científica, però també divulgativa, una temàtica complexa i delicada sovint no exempta de problemàtiques. Quins recursos i estratègies s’han emprat i quines noves vies de divulgació podrien tenir cabuda. Es vol fer èmfasi a investigar quines diferències i similituds podem trobar en altres processos patrimonialitzadors de la memòria. Explorar quina finalitat se n’ha tret dels objectes recuperats i si aquestes pràctiques poden contribuir a la recuperació de la memòria històrica i a la conscienciació de l’impacte que suposa per una comunitat un conflicte bèl·lic.