bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcriptomics of Subcutaneous Tissue of Lipedema Identified Differentially Expressed Genes Involved in Adipogenesis, Inflammation, and Pain
Authors: Streubel Maria Karolin , Baumgartner Axel , Meier-Vollrath Ilka , Frambach Yvonne , Brandenburger Matthias , Kisch Tobias 
Published: November 2024

Background:
Lipedema is a disease typically affecting women with a symmetrical, painful fat distribution disorder, which is hypothesized to be caused by impaired adipogenesis, inflammation, and extracellular matrix remodeling, leading to fibrosis and the development of edema in lipedema subcutaneous adipose tissue. The pathogenesis and molecular processes leading to lipedema have not yet been clarified.

Methods:
A whole transcriptome analysis of subcutaneous tissue of lipedema stages I (n = 12), II (n = 9), and III (n = 8) compared with hypertrophied subcutaneous tissue (n = 4) was performed. Further data about hormonal substitution and body morphology were collected. The study is registered at ClinicalTrials.gov (NCT05861583).

Results:
We identified several differentially expressed genes involved in mechanisms leading to the development of lipedema. Some genes, such as PRKG2, MEDAG, CSF1R, BICC1, ERBB4, and ACP5, are involved in adipogenesis, regulating the development of mature adipocytes from mesenchymal stem cells. Other genes, such as MAFB, C1Q, C2, CD68, CD209, CD163, CD84, BCAT1, and TREM2, are predicted to be involved in lipid accumulation, hypertrophy, and the inflammation process. Further genes such as SHTN1, SCN7A, and SCL12A2 are predicted to be involved in the regulation and transmission of pain.

Conclusions:
In summary, the pathogenesis and development of lipedema might be caused by alterations in adipogenesis, inflammation, and extracellular matrix remodeling, leading to fibrosis and the formation of edema resulting in this painful disease. These processes differ from hypertrophied adipose tissue and may therefore play a main role in the formation of lipedema.
Current trends and challenges in infective endocarditis
Authors: Patel Shubh K. , Hassan Syed M. Ali , Côté Mahée , Leis Benjamin , Yanagawa Bobby 
Published: November 2024

Purpose of review
Infective endocarditis (IE) is a complex disease with increasing global incidence. This review explores recent trends in IE infection patterns, including healthcare-associated IE (HAIE), drug-use-associated IE (DUA-IE), multidrug-resistant organisms (MDROs), and challenges in managing prosthetic valve and device-related infections.

Recent findings

Staphylococcus aureus has emerged as the leading cause of IE, especially in HAIE and DUA-IE cases. Increasingly prevalent MDROs, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, pose further clinical challenges. Advances in molecular diagnostics have improved the detection of culture-negative endocarditis. The introduction of the AngioVAC percutaneous aspiration device promises to change the management of right and possibly some left sided IE. Multidisciplinary team management and early surgery have demonstrated improved outcomes including partnerships with psychiatry and addictions services for those with intravenous DUA-IE.

Summary
IE presents significant diagnostic and therapeutic challenges due to evolving infection patterns, MDROs, and HAIE. Early diagnosis using advanced imaging, appropriate early antimicrobial therapy, and multidisciplinary care, including timely surgery, are critical for optimizing patient outcomes.
Oral LPCN 1148 improves sarcopenia and hepatic encephalopathy in male patients with cirrhosis: A randomized, placebo-controlled phase 2 trial
Authors: Bruno Benjamin J. , Weavil Joshua C. , Ogle Jonathan , Chidambaram Nachiappan , Carey Elizabeth J. , Danford Christopher J. , Fricker Zachary P. , Galati Joseph S. , Lee William M. , Mantry Parvez S. , Shetty Kirti , DelConte Anthony , Patel Mahesh V. , Lai Jennifer C. , Sanyal Arun J. 
Published: November 2024

Background and Aims:
Sarcopenia is highly prevalent in patients with liver cirrhosis and is associated with adverse clinical outcomes, including HE. Androgen receptor agonists, androgen receptor agonists, can address these conditions through multimodal mechanisms of action; however, their safety and efficacy in patients with cirrhosis have not been well established.

Approach and Results:
In this multicenter, double-blind, phase 2 trial, men with sarcopenia and cirrhosis awaiting liver transplant were randomized 1:1 to receive either oral Androgen Receptor Agonist LPCN 1148 or placebo for 24 weeks (NCT04874350). The primary end point was the change from baseline to 24 weeks in skeletal muscle index measured by a CT scan of the L3 region, analyzed with a prespecified modified intent-to-treat population. The secondary end point was the number of overt HE events. Twenty-nine participants (mean age=59 y, MELD=17) received at least 1 dose of LPCN 1148 (n=15) or placebo (n=14). Baseline characteristics were similar between groups. Primary end point analysis demonstrated an increase in L3-skeletal muscle index measured by a CT scan of the L3 region in the LPCN 1148 group (n=15) compared to placebo (n=10), with a mean group difference of 4.4 cm2/m2 (95% CI: 1.3–7.4 cm2/m2, p=0.007). Participants in LPCN 1148 experienced fewer episodes of overt HE (Common Terminology Criteria for Adverse Events grade ≥2; p=0.02) than placebo. The number and severity of treatment-emergent adverse events were similar between arms.

Conclusions:
LPCN 1148 treatment improved sarcopenia and reduced the number of overt HE episodes in men with cirrhosis and sarcopenia awaiting liver transplant. These findings support additional research on the efficacy of LPCN 1148 in treating sarcopenia and preventing HE recurrence.
IDIOPATHIC RETINAL VASCULITIS, ANEURYSMS, AND NEURORETINITIS COMPLICATED BY CILIORETINAL ARTERY OCCLUSION: MULTIMODAL IMAGING AND 5-YEAR FOLLOW-UP
Authors: Ferreira Bruno F. A. , Sato Rodrigo H. , Conci Lívia S. , Nogueira Thiago M. , Freitas Vinícius A. P. , Martines Carolina M. , Júnior Hélio P. P. , Nakashima Yoshitaka , Souza Eduardo C. 
Published: November 2024

Purpose:
To describe a multimodal imaging and a 5-year follow-up of a case of cilioretinal artery occlusion (CLRAO) in a 40-year-old woman with idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome.

Methods:
Fundus photography, indocyanine green and fluorescein angiography, optical coherence tomography (OCT), OCT angiography (OCTA), and a literature review of retinal artery occlusions associated with IRVAN syndrome were performed.

Results:
Fundus examination revealed bilateral blurred margins of the discs and peri-vascular hard exudates. Fluorescein angiography (FA) demonstrated peripheral capillary nonperfusion areas in both eyes (OU). It also revealed an aberrant cilioretinal artery in the right eye (OD). OCT showed attenuation of the inner retinal layers and disruption of the outer retinal layers secondary to CLRAO in OD. OCTA allowed a clear identification of macular hypoperfusion in OU. Laser photocoagulation, along with anti-VEGF and corticosteroid intravitreal injections, was administered in OU. Best-corrected visual acuity remained stable, with no evidence of progression or development of neovascularization after a 5-year follow-up.

Conclusion:
IRVAN syndrome may be complicated by CLRAO, resulting in poor final visual acuity despite reperfusion of the occluded artery. In such cases, multimodal imaging allows the identification of complications such as macular atrophy on OCT and hypoperfusion areas that may not be detected on FA on OCTA.
Autologous Serum Tear Production in Anticoagulated Patients
Authors: Harrington Maya T. , Su Leon , Adamski Jill , Patel Dave R. , Shusko Alexander R. , Shen Joanne F. 
Published: November 2024

Purpose:
Autologous serum tears (ASTs) are produced from serum obtained by blood draw and used to treat severe dry eye diseases. Multiple cases of failed AST production occurred due to serum becoming a solidified, gel-like substance after centrifugation. The aim of this study was to identify risk factors associated with inability to compound AST.

Methods:
From January 2019 to December 2022, 99 patients received AST produced at Mayo Clinic in Arizona. Patient demographics, medical diagnoses, medications, laboratory results, and events surrounding blood draws were obtained through an IRB-approved retrospective chart review. The laboratory and pharmacy protocol procedures were observed in person after the occurrence of the last production issue.

Results:
Ten total clotted serum episodes occurred in 4 patients, each with multiple occurrences. The indication for AST was chronic ocular graft-vs-host disease (n = 3) and Sjögren syndrome (n = 1). Eighty percent of episodes were associated with either a systemic infection (n = 7) or pulmonary embolism (n = 1) within the prior month. At the time of blood draw, all 4 patients were treated with antiplatelet and/or anticoagulation medications, including rivaroxaban, apixaban, aspirin, and low–molecular-weight heparin.

Conclusions:
The AST protocol was increased from 30 to 60 minutes of resting time to allow clotting before centrifugation. Inadequate clotting during this stasis period likely resulted in fibrinogen remaining suspended in the serum, leading to solidified plasma instead of liquid serum. We hypothesize risk of inadequate clotting would be increased in patients taking anticoagulation or antiplatelet medications. Our recommendations include ensuring 60-minute collection tube resting time for all patients, including those on anticoagulation medication.
Kidney Stone Prevalence Among US Population: Updated Estimation from NHANES Data Set
Authors: Alibrahim Hidar , Swed Sarya , Sawaf Bisher , Alkhanafsa Mohammed , AlQatati Fadel , Alzughayyar Tareq , Abdeljawwad Abumunshar Namir Amer , Alom Mulham , Qafisheh Qutaiba , Aljunaidi Roa'a , Mosleh Osayd , Oum Muhamad , Bakkour Agyad , Barakat Lolwa 
Published: November 2024

Importance:
Kidney stones are a significant public health issue in the United States, affecting a substantial portion of the adult population. Understanding the prevalence and risk factors associated with this condition is crucial for developing effective prevention and treatment strategies.

Objective:
To estimate the prevalence of kidney stones among the US adult population and identify key demographic and health-related risk factors associated with the condition using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2020.

Design:
This was a cross-sectional study utilizing NHANES data from 2007 to 2020. The analysis reported here includes data collected over this 13-year period, with no additional follow-up duration.

Setting:
The study setting was population-based, utilizing a nationwide survey that is representative of the US civilian noninstitutionalized population.

Participants:
Participants were US adults aged 20 years and older. The final sample size consisted of 37,857 individuals.

Exposures:
In this observational study, the exposures of interest were the demographic and health-related factors that may influence the prevalence of kidney stones. These factors included age, gender, race/ethnicity, BMI, physical activity, smoking status, and medical diagnoses such as diabetes and hypertension. The study used preexisting data from the NHANES database, spanning from 2007 to 2020.

Main Outcomes and Measures:
The primary outcome measured was the prevalence of kidney stones among the study participants. The presence of kidney stones was determined based on participants’ responses to the question, “Have you ever had kidney stones?” in the NHANES survey.

Results:
The study included a final sample of 37,857 US adults after exclusions. Of these, 9.25% reported having had kidney stones. The prevalence was higher in men (54.8%) than in women (45.2%), and increased with age, peaking at 23.9% in individuals aged 70 years and older. Non-Hispanic White individuals had the highest prevalence of kidney stones at 52.5%. Physically inactive individuals and those with conditions such as hypertension (51.3%) and diabetes (22.7%) also showed higher prevalence rates.

Conclusions and Relevance:
The study concluded that kidney stones are a prevalent condition in the United States, affecting approximately 1 in 11 adults, with a higher incidence in older adults, men, non-Hispanic White individuals, and individuals with certain health conditions such as hypertension and diabetes. The findings underscore the importance of targeted public health interventions and preventive measures focusing on these high-risk groups.
A Comparison of Delivery Modalities for Pregnancy Clinical Care Management
Authors: Williams Kelly , Winger Mary , McIntyre Aisling , Domalakes Katie , Stevenson Heidi , Khouri Natasha 
Published: November 2024

Objective:
Given the high prevalence of maternal morbidity and mortality, it is imperative that maternal health interventions are comprehensively evaluated, so they can be scaled with fidelity. Community-based care management models focused on perinatal health care are a priority for health care systems and payers. Alternative care management delivery modalities, such as video visits, are needed to expand program reach amidst growing system-level challenges. This evaluation explores the feasibility, acceptability, and impact of video versus telephonic care in perinatal care management.

Methods:
Using a mixed methods approach, we implemented a quality improvement project to learn about the integration and impact of video-enabled care into the UPMC Health Plan “Pregnancy Clinical Support” (PCS) care management delivery model. Focus groups were conducted with PCS care managers (CMs) to explore their perspectives on video-visit integration. Video-only members were propensity scores matched to telephonic-only members; statistical comparisons were conducted to assess between-group differences in engagement.

Results:
PCS CMs discussed ways to structure effective video-visit onboarding, strengths, and drawbacks of video-enabled care, workflow integration challenges, and best practices for introducing video visits to members. Video-only members had significantly (P < 0.0001) more clinical sessions (2.56 ± 1.57 vs 2.05 ± 1.52) and longer case duration measured in calendar days (209 ± 80 vs 169 ± 94) during the 17-month project period than telephonic-only members.

Conclusion:
Evidence generated provides direct guidance on successfully integrating video visits into workflows of community-based CMs while improving engagement in care across diverse member populations.
Financial Well-Being of U.S. Military Veterans and Health Impact
Authors: Elbogen Eric B. , Serrano Bethzaida N. , Huang Jovin 
Published: November 2024

Objective:
Research has shown that psychosocial well-being in veterans, including financial status, is related to better clinical outcomes after leaving military service. The current study examines variables linking financial well-being to physical health in veterans and non-veterans and identifies financial variables related to veteran status.

Methods:
We analyzed data from the nationally representative 2021 Survey of Household Economics and Decisionmaking conducted by the U.S. Federal Reserve Board and compared the responses of veterans (N = 1176) to a non-veteran sample matched by age, sex, education, race, ethnicity, and geographic region (N = 1176).

Results:
Multivariable analyses revealed that although veterans and non-veterans were similar in many financial domains, veterans were more likely to spend money on the lottery and gambling, pay overdraft fees on bank accounts, and take out payday or pawn shop loans. Analyses showed over one-third (35%) of veterans reported credit card debt, significantly higher than non-veterans. In veterans and non-veterans, higher physical health ratings were related to higher income, lacking medical debt, living in a community of greater economic advantage, and having a rainy-day fund in case of financial emergencies. Ratings of one’s credit score were also significantly associated with ratings of one’s physical health, in both veterans and non-veterans.

Conclusions:
The data pinpoint specific financial domains to inform policy, education, and outreach aimed at improving veterans’ psychosocial well-being. The results also reveal that individual and environment-level financial variables were related to physical health in this national survey, demonstrating the value of assessing financial well-being in the context of medical care, for both veteran and non-veteran patients.
Presence of Sonographic Secondary Signs Without Visualization of Appendix Is Indicative of Appendicitis in Children Younger Than 5 Years
Authors: Keane Olivia A. , Smith Savannah R. , He Zhulin , Straub Evan T. , Short Heather L. , Riedesel Erica L. , Santore Matthew T. 
Published: November 2024

Purpose
Diagnosis of acute appendicitis is more difficult in children aged 0–4 years due to atypical clinical presentation, leading to delay in diagnosis and higher incidence of complications. Nonvisualization of the appendix on ultrasound increases diagnostic challenge. We examined the utility of standardized reporting of sonographic secondary signs of appendicitis in children younger than 5 years with nonvisualization of the appendix.

Methods
A retrospective cohort study of children younger than 5 years who underwent appendectomy following nonvisualization of the appendix on ultrasound from 2016 to 2022 was performed. Primary outcome was comparison of ultrasound and intraoperative findings. Two-sample t test and Wilcoxon sum-rank test compared continuous variables, and Fisher exact test compared categorical variables. Univariate and multivariate logistic regression analyses were performed to assess risk factors for complicated appendicitis in those with category 3 ultrasounds.

Results
Overall, 92 patients whose appendix was not visualized on ultrasound were included: 26 without secondary signs (category 2) and 66 with secondary signs (category 3). Significant differences in intraoperative findings between category 2 and category 3 patients existed (P < 0.001). On intraoperative assessment of patients with ultrasound category 2, 3.8% had no appendicitis, 46.2% had simple appendicitis, 34.6% had complicated appendicitis, and 15.4% underwent interval appendectomy. Conversely, of category 3 patients, 0% had no appendicitis, 7.6% had simple appendicitis, 48.5% had complicated appendicitis, and 43.9% underwent interval appendectomy. On logistic regression, in children with category 3 ultrasounds, presence of both fluid collection and free fluid as secondary signs was associated with intraoperative findings of complicated appendicitis. However, number of secondary signs was not significantly associated with increased likelihood of complicated appendicitis intraoperatively.

Conclusion
Presence of secondary signs without visualization of the appendix was shown to be indicative of appendicitis, with high suspicion for complicated appendicitis, in patients younger than 5 years. Further validation of the presence of secondary signs on right-lower-quadrant ultrasound may lead to more expedient diagnosis, reduction in cross-sectional imaging, and earlier treatment of complicated appendicitis.
Evaluation of Antivenom Therapy for Middle East Scorpion Envenomations
Authors: Kestenbom Inbal , Test Gidon , Kaplan Or , Bar-Moshe Shaked , Grupel Tal , Shilo Michael , Bilenko Natalya , Friger Michael , Maimon Michal S. , Scolnik Dennis , Glatstein Miguel M. 
Published: November 2024

Introduction
Scorpion envenomation is a leading cause of envenomation in our region. Antivenom has been used successfully to treat the systemic manifestations of envenomations inflicted by toxic scorpions. Toxic scorpions common in our area include Leiurus quinquestriatus, Androctonus australis, and Buthus occitanus. This study describes the outcomes of children envenomated by these scorpions, and treated with SCORPIFAV, a polyvalent scorpion antivenom F(ab’)2 (equine), used since 2016 at our institution.

Methods
A retrospective chart review of all children admitted with symptoms and signs of scorpion envenomation to Soroka University Medical Center, between September 1, 2019, and December 1, 2020, who received antivenom SCORPIFAV. Our center has a protocol mandating antivenom therapy for all patients manifesting autonomic excitation, agitation, and anxiety, or more pronounced symptoms, following suspected scorpion envenomation.

Results
Three hundred patients were seen in the pediatric emergency department for scorpion envenomation during the study period, and 49 required antivenom (SCORPIFAV) as per departmental policy. Four of 49 developed allergic reactions during antivenom treatment: 2 manifested minor skin rashes treated with antihistamines only, and a further 2 required intramuscular adrenaline. There were no deaths in the study cohort and all patients recovered fully, with complete resolution of symptoms, signs, and laboratory features.

Conclusions
Patients treated with antivenom exhibited rapid resolution of symptoms without severe hypersensitivity. We recommend broadened availability of antivenom at sites where it is needed.
Analyzing research trends and developments in osseointegration in patients with extremity amputations: Systematic bibliometric analysis and research recommendations
Authors: Saleib Raphael-Kyrillos M. , Pekbay Begüm , Verhofstad Michiel H. J. , Paping Maria A. , Van Vledder Mark G. , Van Waes Oscar J. F. 
Published: November 2024

Background:
Bone-anchored protheses (BAPs) by means of osseointegrated implants are increasingly being used in amputees with socket-related issues. Clinical advancements are being published by more and more centers worldwide. Although the number of publications and interest in BAP is growing, a systematic evaluation of scholarly output is lacking.

Objective:
To identify scholarly output, understand research trends and make research recommendations in the clinical field of BAP.

Methods:
Systematic searches in Medline All, Embase, Web of Science Core Collection, Cochrane Library, and Google Scholar were completed in February 2023. The results were deduplicated, screened, and assessed for quality by independent reviewers. Inclusion criteria were as follows: clinical studies and BAP in the extremities. Articles were excluded if they were animal or fundamental studies, nonclinical reports, had a study population less than 10 patients, or BAP was performed in areas other than extremities.

Results:
One hundred twelve articles were included and published between 1993 and 2023. An annual growth rate of 10.3% was found and research was published in 62 different journals. Prosthetics and Orthotics International, Clinical Orthopaedics and Related Research and The Bone & Joint Journal were the most prolific journals. Hagberg K, Aschoff HH, and Branemark R were major contributors to BAP research. Collaborations are predominantly among high-income countries. Main research trends were on rehabilitation, questionnaires, complication managements, and implant treatment.

Conclusions:
Research on BAP shows an increasing global trend, highlighting key research areas and authors. A unified global research agenda, stakeholders' collaborations, and consensus are essential for addressing knowledge gaps and development future direction of BAP.