bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human immunodeficiency virus/acquired immune deficiency syndrome antiretroviral therapy initiated on the same day in treatment-naïve people with human immunodeficiency virus: A comparative study of efficacy and regimen
Authors: Yuan Jing , Deng Changgang , Li Qisui , Sun Yanyu , Huang Wei , Zhang Wei , Liu Min 
Published: November 2024

Abstract

Background:
Rapid initiation of antiretroviral therapy (ART) is recommended by guidelines, however, real-world studies of same-day initiation of ART in China are limited, and an optimal treatment regimen has yet to be identified. The study aims to provide a realistic reference for rapid initiation of ART.

Methods:
We retrospectively analyzed the clinical data of treatment-naïve people with human immunodeficiency virus (PWHs) who were diagnosed and prescribed same-day ART initiation from January 1, 2021 to December 31, 2022 at Chongqing Public Health Medical Center. PWHs voluntarily chose an ART regimen that divided them into two groups: National Free Antiretroviral Treatment Program (NFATP)-recommended regimens group (2 nucleoside reverse transcriptase inhibitors + non-nucleoside reverse transcriptase inhibitors/protease inhibitors) and bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) group. The primary endpoint was the virological outcome of the two groups for same-day ART initiation at 24 weeks and 48 weeks. The secondary endpoints included changes in CD4 counts, maintenance of the original ART regimen at 48 weeks, and lipid levels and renal function at 48 weeks.

Results:
A total of 255 PWHs were included in the study, including 131 (51.4%) in the NFATP group and 124 (48.6%) in the BIC/FTC/TAF group. The overall virological suppression rates at 24 weeks and 48 weeks were 78.2% (165/211) and 95.4% (207/217), respectively. At 24 weeks, the virologic suppression rate in the NFATP group was lower than that in the BIC/FTC/TAF group (65.3% [66/101] vs. 90.0% [99/110], P <0.001). The median increase in the CD4 count was 198.0 (126.0–300.0) cells/μL at 24 weeks, with 182.0 (108.0–245.0) cells/μL in the NFATP group and 219 (132.0–316.0) cells/μL in the BIC/FTC/TAF group (P = 0.035). At 48 weeks, there was no significant difference in the virological suppression rate or CD4 count between the groups. The 48-week initial ART regimen retention rates and treatment retention rates were significantly higher in the BIC/FTC/TAF group than in the NFATP group (91.1% (113/124) vs. 71.8% (94/131), 99.2% (118/119) vs. 93.0% (120/129), respectively). In terms of safety, there were no significant changes from baseline in levels of creatinine, estimated glomerular filtration rate (eGFR), or lipids in either group at 48 weeks.

Conclusions:
ART initiation on the day of diagnosis is effective, safe, and feasible, with satisfactory rates of virologic suppression, 48-week initial ART regimen retention rates, and treatment retention rates in treatment-naïve PWHs. In our study, the early virologic suppression rate, CD4 cell counts, and treatment retention of the BIC/FTC/TAF regimens were significantly better than those of the NFATP regimens.
Landscape of respiratory syncytial virus
Authors: Duan Yuping , Liu Zimeng , Zang Na , Cong Bingbing , Shi Yuqing , Xu Lili , Jiang Mingyue , Wang Peixin , Zou Jing , Zhang Han , Feng Ziheng , Feng Luzhao , Ren Lili , Liu Enmei , Li You , Zhang Yan , Xie Zhengde 
Published: November 2024

Abstract
Respiratory syncytial virus (RSV) is an enveloped, negative-sense, single-stranded RNA virus of the Orthopneumovirus genus of the Pneumoviridae family in the order Mononegavirales. RSV can cause acute upper and lower respiratory tract infections, sometimes with extrapulmonary complications. The disease burden of RSV infection is enormous, mainly affecting infants and older adults aged 75 years or above. Currently, treatment options for RSV are largely supportive. Prevention strategies remain a critical focus, with efforts centered on vaccine development and the use of prophylactic monoclonal antibodies. To date, three RSV vaccines have been approved for active immunization among individuals aged 60 years and above. For children who are not eligible for these vaccines, passive immunization is recommended. A newly approved prophylactic monoclonal antibody, Nirsevimab, which offers enhanced neutralizing activity and an extended half-life, provides exceptional protection for high-risk infants and young children. This review provides a comprehensive and detailed exploration of RSV’s virology, immunology, pathogenesis, epidemiology, clinical manifestations, treatment options, and prevention strategies.
Chandelier-assisted bimanual technique for securing infusion in eyes with hazy media
Authors: Ramamurthy Srishti Raksheeth , Dave Vivek Pravin 
Published: November 2024

Purpose:
Hazy media with resultant difficulties in visualisation hamper the surgical approach and outcomes in various vitreoretinal surgical scenarios, including eyes with keratoprosthesis in situ. We propose a novel chandelier-assisted bimanual infusion using a flute needle to overcome the inability to secure infusion safely in such eyes.

Methods:
The surgical technique was performed with the assistance of chandelier illumination. The irrigation tubing from the vitrectomy machine was connected to a flute needle for infusion. A bimanual technique was utilized with the flute needle connected to infusion in one hand and the cutter in the other hand.

Results:
A 34-year-old monocular male patient with a keratoprosthesis in his seeing eye developed late-onset endophthalmitis with retroprosthetic membranes. The visual acuity had dropped from 20/20 to hand motions. Our novel bimanual technique helped secure infusion safely for vitrectomy. The patient recovered well to a visual acuity of 20/60 with a good anatomical outcome.

Conclusion:
Early vitrectomy may be essential for ensuring optimal outcomes in certain eyes with endophthalmitis. Surgical intervention in eyes with keratoprosthesis with secondary endophthalmitis is challenging due to difficulties in visualisation. This was overcome in our case with a novel bimanual chandelier-assisted technique for securing infusion.
Training in the Use of Myoelectric Prostheses Through the Combined Application of Immersive Virtual Reality, Cross-education, and Mirror Therapy
Authors: Calvo Sanz Jordi , Diaz Vela Mª Angeles , Jardón Huete Alberto , Bouallalene Jaramillo Karima , González-Román Loreto , Garrido-Pedrosa Jessica , Monné Cuevas Pol 
Published: November 2024

ABSTRACT

Introduction
During the rehabilitation process (RHB) of the patient with traumatic upper-limb amputation, the use of immersive virtual reality (IVR) facilitates the incorporation of the prosthesis into the body schema. This reinforces and enhances sensorimotor and cognitive stimulation to improve motor learning and motor patterns, while normalizing global gestures.

Objectives
The aims of this study were to implement retraining of gestural acquisition and prosthetic control in patients with upper-limb injuries and amputations through IVR, and to then incorporate this in the normalization of functional patterns in activities of daily living (ADLs) with the work of “cross-education” as well as the therapy of observation of actions—mirror therapy to enhance the joint effect of the approach with IVR.

Methods
Standard sessions were established for transradial and transhumeral trauma patients with upper-limb amputation and traumatic injuries within the rehabilitation treatment. During the sessions, games and virtual environment were used. The software ran in desktop mode using a “Leap Motion” or for immersive versions of 3D glasses (Oculus Rift S).

Results
The application of IVR in combination with conventional treatment obtained significant benefits for functionality. These included learning correct motor execution as well as motivational and emotional state with distal traumatic injuries and upper-limb amputations with or without myoelectric prosthesis, obtaining 5.6 on average on the GROC (global rating of change) scale.

Conclusions
Immersive virtual reality shows benefit for the normalization of motor learning of functional patterns in DLA and on the emotional, motivational level of the patient.

Clinical Relevance
The integrated combination of cross-education, mirror therapy, and immersive virtual reality may represent greater acquisition of motor patterns in the prosthetic training of patients with upper-limb amputation.
Rehabilitating Amputated Hallux with Dental Implant–Supported Double Magnet in Y-Bar–Retained Prosthesis
Authors: Solanki Neeti , Singh Saumyendra V. , Arya Deeksha , Raghuvanshi Snehkiran , Mishra Brijesh 
Published: November 2024

ABSTRACT

Introduction
Loss of hallux leads to aesthetic deficit and functional loss, with active push-off, weight-bearing ability, and pronation all being affected. Rehabilitation can be surgical or prosthetic; however, surgical alternatives can be unpredictable in terms of aesthetics and is not cost-effective. Therefore, prosthetic rehabilitation is often favored. However, loss of all 3 phalanges makes prosthetic rehabilitation challenging due to minimal scope of retention from the residual limb.

Materials and Methods
This technique presents a solution to this challenge, with an implant-supported, magnet-retained silicone prosthesis, having a novel abutment design, to provide dual (magnetic and frictional) retention.

Conclusions
The prosthetic design improved retention, facilitated easy handling by the patient, and prevented stress concentration on implant-bone interface.

Clinical Relevance
The prosthetic innovation improved retention during standing and walking, and increased the patient’s confidence to perform daily activities without fear of dislodgement.
An Unexpected Finding in an Adolescent Rowing Athlete With Angina Pectoris. A Case Report
Authors: Cotrim Nuno , Castilho Bruno , Cotrim Carlos , Guardado Jorge , Baquero Luís 
Published: November 2024

Abstract:
Significant intraventricular gradient development during exercise is rare, usually occurring with left ventricular hypertrophy. The etiopathogenesis consists of the increase in nonobstructive physiological gradients; ventricular cavitary obliteration with consequent end-systolic obstruction; and midsystolic obstruction caused by systolic anterior movement of the mitral valve compromising flow. A correlation between intraventricular gradient development and various symptoms has been established. Chest pain is common in children and is a frequent reason for referral to pediatric cardiologists. Despite the benign nature of most pediatric chest pain, extensive and costly cardiac evaluation is common in these patients. In the case presented here, we describe an adolescent rowing athlete with excruciating effort angina only during upright exercise, which was replicated while performing an exercise stress echocardiography.
Transcutaneous electrical stimulation of the stellate ganglion: A case report on its application in treating carotid sinus syndrome
Authors: Hou Taifu , Xu Mengya , Zhang Zhiguo 
Published: November 2024

Rationale:
Syncope is a common condition in emergency departments, posing a diagnostic challenge due to its multifactorial nature. Among the potential causes, carotid sinus hypersensitivity leading to carotid sinus syndrome (CSS) is a significant consideration that can severely impact patient quality of life. Despite its importance, establishing effective treatment methods for CSS has been difficult.

Patient concerns:
A 43-year-old male presented with recurrent episodes of syncope, which significantly affected his daily life and well-being.

Diagnoses:
After a thorough evaluation, the patient was diagnosed with CSS, a condition that can be difficult to pinpoint and requires specialized diagnostic procedures to confirm.

Interventions:
The patient was treated with stellate ganglion block therapy, a targeted intervention aimed at addressing the underlying cause of CSS. This treatment was administered over a 12-day period.

Outcomes:
Following the treatment, the patient’s symptoms showed gradual improvement, and he was discharged after meeting the clinical cure criteria. During a 7-month follow-up, he remained symptom-free.

Lessons:
The case highlights the effectiveness of transcutaneous stellate ganglion block therapy in treating CSS. It suggests that further research and clinical trials are needed to validate this treatment’s efficacy, potentially offering a new therapeutic option for patients suffering from CSS.
Identification of a novel BAAT frameshift mutation in a female child diagnosed with skeletal dysplasia: A case report
Authors: Nguyen Duc Quan , Can Thi Bich Ngoc , Vu Chi Dung , Tran Thi Anh Thuong , Nguyen Ngoc Lan , Nguyen Thi Kim Lien , Nguyen Van Tung , Nguyen Thanh Hien , Tran Thi Huong Giang , Nguyen Huy Hoang 
Published: November 2024

Rationale:
Skeletal dysplasias are a complex series of rare genetic disorders that cause irregular development of bones, joints, and cartilages in children. A total of 770 disorders associated with 41 groups of skeletal dysplasia have been documented, demonstrating a wide range of clinical manifestations and varying levels of severity. In addition to conventional methods, whole genome sequencing has emerged as a useful approach to pinpointing the underlying etiology of skeletal dysplasias.

Patient concerns:
A 13-month-old female was admitted to the hospital due to the symptoms of jaundice and failure to thrive.

Diagnoses:
The child was subjected to blood tests and a radiographic assessment. The blood chemistries revealed elevated levels of total bilirubin (178 µmol/L), bile acids (198 µmol/L), and low levels of serum calcium (1.69 mmol/L) and phosphate (0.8 mmol/L), along with irregular skeletal development in the forearms and legs, considering rickets and cholestasis.

Interventions:
Whole exome sequencing data of the proband revealed a homozygous mutation of c.388dupA in the BAAT (bile acid-CoA: amino acid N-acyltransferase) gene sequence. This mutation caused a frameshift in the amino acid of the BAAT protein, resulting in the pR130Kfs*12 variant. This mutation has been identified as the underlying cause of skeletal dysplasia in the proband.

Outcomes:
A novel frameshift mutation in the BAAT gene of a Vietnamese female child diagnosed with skeletal dysplasia has been studied by whole exome sequencing analysis.

Lessons:
This research reported a case of skeletal dysplasia caused by a frameshift mutation in the BAAT gene. The results of this study contribute to our understanding of the diverse factors that influence irregular skeletal development in children and provide genetic data to support clinical practice.
Long- and short-term effectiveness of traditional Chinese exercises in improving the overall physical capacity of patients with knee osteoarthritis: A systematic review and meta-analysis
Authors: Qiu Boyuan , Wang Weiwei , Tang Gangjian , Chai Sheng , Zhang Xuan , Zhou Pengwei , Ou Zhixue 
Published: November 2024

Background:
The increasing global popularity of traditional Chinese exercise (TCE) provides substantial evidence of its significant efficacy in treating knee osteoarthritis (KOA). To assess the impact of different types of TCE and varying exercise durations on KOA patients, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) on this topic.

Methods:
Two investigators extensively searched four electronic databases (PubMed, Embase, Cochrane, and Web of Science) from their inception until December 16, 2023, to identify all relevant RCTs on the use of TCE for KOA treatment. The included studies were assessed for risk of bias using the Cochrane Collaboration Risk of Bias Tool (CCRBT), and data analysis was performed using Stata 15.0.

Results:
A total of 20 RCTs, involving 1367 patients with KOA, met the inclusion criteria. Compared to the control group, TCE demonstrated significant improvement in three subscale scores of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Pain (SMD = −0.44; P = .0001); Stiffness (SMD = −0.35; P = .001); Physical function (SMD = −0.52; P = .0001)] and two subscale scores of the 36-item Short-Form (SF-36) [Physical score (WMD = 2.76; P = .001); Mental score (WMD = 2.49; P = .0001)] in KOA patients. Subgroup analysis showed that both long-term habitual exercise (over 12 weeks) and short-term exercise (within 12 weeks) were more effective than the control group in improving pain, joint stiffness, and physical function in KOA patients. Tai Chi, among the four TCE modalities analyzed, demonstrated improvements in all indicators.

Conclusion:
Based on the results of our meta-analysis, it can be concluded that both long-term and short-term TCE interventions are effective in alleviating the main symptoms of KOA and improving patients’ physical function. However, due to limited methodological quality and inconsistent outcome measures in the included RCTs, further high-quality RCTs with larger sample sizes and longer-term interventions are necessary to validate our findings before TCE can be recommended as a treatment for KOA.
A case report of Stevens–Johnson syndrome caused by omeprazole
Authors: Xu Yuanhang , Zhang Lingjuan , Shen Lin , Guo Xueyan 
Published: November 2024

Rationale:
Stevens–Johnson syndrome (SJS) is a rare but severe skin-mucosal reaction with a high mortality rate. It is characterized by sudden, painful blistering lesions on the skin, often accompanied by high fever and systemic toxicity. Lesions typically appear on the dorsal surfaces of the hands, feet, forearms, legs, and soles of the feet. They can also affect the conjunctiva, oral mucosa, labial mucosa, and vaginal mucosa. Patients may experience complications such as pneumonia, severe comorbidities, and liver and renal failure.

Patient concerns:
A 51-year-old female patient was admitted to the hospital due to “abdominal distention and skin yellowing for 20 days.” After using omeprazole, she developed a rash all over her body, and her liver function further deteriorated, ultimately leading to chronic acute liver failure.

Diagnoses:
The diagnosis included fever, rash suspected to be drug-induced, chronic and acute liver failure, and decompensation of post-Hepatitis B cirrhosis.

Interventions:
During hospitalization, suspected adverse drug reactions were discontinued, and symptomatic supportive treatment with methylprednisolone and fluid replacement was promptly provided.

Outcomes:
The patient’s symptoms and follow-up showed that the rash disappeared and liver and kidney function improved significantly after treatment.

Lessons:
We explored how chronic acute liver failure can cause immune system abnormalities and immune paralysis in patients, manifested as susceptibility to infection. This case report describes a drug-induced allergic reaction – SJS – in patients with chronic acute liver failure, as well as subsequent treatment, including hormone dosage and treatment duration. I hope this report will help enrich the relevant literature on drug-induced SJS combined with chronic and acute liver failure, laying the foundation for improving the survival rate of patients with the disease.
A case of necrotic pneumonia caused by Streptococcus pneumoniae was diagnosed using a pneumonia antigen test in BALF: A case report
Authors: Huang Yanjing , Guo Hongkun , Li Yiming 
Published: November 2024

Rationale:

Streptococcus pneumoniae is a common cause of community-acquired pneumonia. Currently, it is believed that many cases of pulmonary infection with negative results on pathogenic testing are caused by S. pneumoniae. There have been no reports of the detection of S. pneumoniae antigen in lung lavage fluid.

Patient concerns:
An elderly male patient with suboptimal fasting blood glucose control and a history of liver abscess.

Diagnosis:
Chest computed tomography (CT) revealed inflammatory lesions in both lungs with consolidation in the middle lobe of the right lung.

Interventions:
After admission, we collected alveolar lavage fluid in a timely manner and performed pneumococcal antigen detection and etiological testing.

Outcomes:
Prompt testing for pneumococcal antigen in bronchoalveolar lavage fluid yielded a positive clinical outcome. Subsequent analysis via bacterial culture of sputum and next-generation sequencing (mNGS) of BALF definitively identified S. pneumoniae as the etiological agent. Following the analysis of drug sensitivity test results from the identified pathogens, adjustments were made to the antibiotic regimen, and appropriate pus puncture drainage was performed. Subsequently, the patient’s condition improved, leading to discharge.

Conclusion:
The identification of S. pneumoniae antigen in bronchoalveolar lavage fluid may facilitate earlier and more precise diagnosis of pneumonia attributed to S. pneumoniae.
Transformed follicular lymphoma with laryngeal edema requiring tracheal intubation after tisagenlecleucel treatment: A case report
Authors: Shimazu Ryoma , Nakamura Nobuhiko , Goto Takayuki , Kaneda Yuto , Ikoma Yoshikazu , Matsumoto Takuro , Nakamura Hiroshi , Kanemura Nobuhiro , Shimizu Masahito 
Published: November 2024

Rationale:
Cytokine release syndrome (CRS) is a common adverse event of chimeric antigen receptor T (CAR-T) cell therapy. CRS is generally a systemic inflammatory reaction, but in rare cases, it can occur in specific body areas and is referred to as “local CRS (L-CRS).” A case of laryngeal edema due to L-CRS that required tracheal intubation because of the lack of response to tocilizumab (TCZ) and dexamethasone (DEX) is reported.

Patient concerns:
A 67-year-old woman with relapsed transformed follicular lymphoma was treated with CAR-T cell therapy. Although she had been given TCZ and DEX for CRS, neck swelling appeared on day 4 after infusion.

Diagnoses:
Laryngoscopy showed severe laryngeal edema, which was presumed to be due to L-CRS, since there were no other apparent triggers based on history, physical examination, and computed tomography.

Interventions:
Tracheal intubation was performed because of the risk of upper airway obstruction. Ultimately, 4 doses of tocilizumab (8 mg/kg) and 6 doses of dexamethasone (10 mg/body) were required to improve the L-CRS.

Outcomes:
On day 7, laryngeal edema improved, and the patient could be extubated.

Lessons:
The lessons from this case are, first, that CAR-T cell therapy may induce laryngeal edema in L-CRS. Second, TCZ alone may be ineffective in cervical L-CRS. Third, TCZ, as well as DEX, may be inadequate. In such cases, we should recognize L-CRS and manage it early because it may eventually progress to laryngeal edema that requires securing the airway.