bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFICACY OF EPIDERMAL GROWTH FACTOR RECEPTOR TYROSINE KINASE INHIBITOR IN TREATING CHOROIDAL METASTASIS FROM NON–SMALL-CELL LUNG CANCER
Authors: Chee Arnold S.H. , Mak Andrew C.Y. , Kam Ka Wai , Li Molly S.C. , Ho Mary , Brelen Marten E. , Chen Li Jia , Yip Wilson W.K. , Young Alvin L. 
Published: November 2024

Background/Purpose:
To describe the clinical characteristics of choroidal metastasis in patients with non–small-cell lung carcinoma and report treatment outcomes following targeted therapy versus conventional radiotherapy and/or chemotherapy.

Methods:
A retrospective review was conducted in 2 hospitals in Hong Kong between 2013 and 2023. Outcomes included tumor response and visual function following treatment.

Results:
A total of 25 eyes of 21 Chinese patients with choroidal metastasis secondary to metastatic non–small-cell lung carcinoma were identified. The majority of patients were nonsmokers. At the time of diagnosis, 88% of eyes were visually symptomatic with a mean visual acuity of 20/100. There were 52% of tumors locating within the macula. Tyrosine kinase inhibitor monotherapy, tyrosine kinase inhibitor with radiotherapy, and radiotherapy and/or chemotherapy groups were observed to demonstrate similar tumor response from 1 month and comparable ocular progression-free indices. Untreated patients had deteriorated vision without any tumor response. The tyrosine kinase inhibitor monotherapy group achieved the most rapid and differential vision gain than other groups.

Conclusion:
Tyrosine kinase inhibitor achieved durable disease control in epidermal growth factor receptor mutation-positive non–small-cell lung carcinoma patients with choroidal metastasis, while improving visual function. Tyrosine kinase inhibitor can be considered as an alternative to conventional orbital radiotherapy or chemotherapy for these patients in view of the rapid visual recovery.
OUTCOMES IN EYES WITH RETAINED LENS FRAGMENTS UNDERGOING PARS PLANA LENSECTOMY AND SCLERAL-FIXATED INTRAOCULAR LENS INSERTION
Authors: Durrani Asad F. , Momenaei Bita , Martin Jonathan L. , Wakabayashi Taku , Hamdan Saif A. , Gupta Omesh P. , Garg Sunir J. , Khan Mohammed A. , Mehta Sonia , Vander James , Ho Allen C. , Kuriyan Ajay E. ,   for the Secondary IOL Outcomes Study Group
Published: November 2024

Purpose:
To report the visual outcomes and complications in eyes with retained lens fragments following cataract surgery undergoing pars plana lensectomy and scleral-fixated intraocular lens (SFIOL) insertion.

Methods:
Patients with retained lens fragments who underwent pars plana vitrectomy, pars plana lensectomy, and SFIOL insertion from January 2015 to December 2022 were included. The visual acuity outcomes and complication rates were compared between those receiving sutured versus sutureless SFIOL insertion as well as those undergoing SFIOL insertion at the time of pars plana vitrectomy and pars plana lensectomy versus those undergoing SFIOL insertion during subsequent surgery.

Results:
Sixty-five eyes of 65 patients were included. The median (interquartile range) preoperative logarithm of the minimum angle of resolution visual acuity was 2.3 (2–2.3; Snellen: HM). The median logarithm of the minimum angle of resolution visual acuity improved to 0.14 (Snellen: 20/100), at the most recent follow-up (P < 0.001, Hodges–Lehmann estimator: 1.56, 95% confidence interval −1.30 to −1.71). There was no statistically significant difference in visual acuity outcomes and complication rates, including cystoid macular edema, corneal edema, and retinal detachment, regardless of technique or timing of SFIOL insertion.

Conclusion:
In this retrospective study with a small sample size, similar visual acuity outcomes and complication rates were observed regardless of the timing or technique of SFIOL insertion.
Using Four-Component Instructional Design to Create an Interactive Point-of-Care Ultrasound Curriculum for Physician Associate Students
Authors: Dawkins Stacy , Cooper Shannon , Wilcox James , Morrow Eryn , Mayall Hayley , Rebman Rebecca 
Published: November 2024

Introduction
Many physician assistant/associate (PA) programs lack point-of-care ultrasound (POCUS) education in the PA curricula and a standardized approach to ultrasound training. The four-component instructional design (4C/ID) model merges 4 concepts for developing effective instructional design content for complex content delivery, such as ultrasound. This research study created an interactive, 2-part ultrasound curriculum with an instructional designer for PA students using the 4C/ID model.

Methods
Two interactive ultrasound curriculum models were created from the 4C/ID model using a knowledge-based precurriculum quiz, learning tasks with online modules and recordings, part-task practice with ultrasound experts, skills checkoffs, and a postcurriculum quiz including questions on students' perspectives of ultrasound. Two-tailed paired t-test analysis assessed the effectiveness of training.

Results
Evaluation of prelearning and postlearning quizzes demonstrated multiple statistically significant assessments supporting the use of instructional design technology for a PA program's ultrasound curriculum.

Discussion
This small study demonstrated that the 4C/ID model may be beneficial for PA POCUS training. The 2-part interactive curriculum improved PA student competency of ultrasound principles and applications and increased confidence for future clinical use of ultrasound.
Classical Medical Cases of Doubt Narrative Foreclosure and Mediation in Traditional Chinese Medicine
Authors: JING Jiangang , JIANG Jiacheng , WANG Yilin 
Published: November 2024

Abstract
Narrative foreclosure is a phenomenon highlighted within the Chinese narrative medicine system, characterized by a state in which individuals become overly suspicious due to certain events in their development, leading to profound concerns about their health and safety. This article employs the logical discourse framework of Chinese narrative medicine to illustrate the experiences of various patients exhibiting typical instances of narrative foreclosure in traditional Chinese medicine (TCM) cases, such as Bei Gong She Ying (杯弓蛇影 to see a bow reflected in a cup as a snake), Wu Qiu Zhi Chong (吴球治虫 Wu Qiu treats worms), and Fa Jing Qu She (法靖驱蛇 Fajing drives away snakes). It explores how TCM practitioners leverage narrative wisdom to facilitate patients in dispelling their internal doubts through the concept of Bu Yao Wei Yao (不药为药 healing diseases without medicine). Through these medical cases, the article advocates for the significance of narrative competencies among medical practitioners in diagnosing and treating patients, alongside the use of pharmaceuticals and surgical interventions. Additionally, it outlines the prospects for the future development of narrative approaches in TCM.
Experience sharing of a case of dual atrioventricular nodal non-reentrant tachycardia: Case report
Authors: Gao Yixuan , Wang Yan , Zhao Ranzun , Yang Du , Chen Lei , Shi Bei 
Published: November 2024

Rationale:
Tachycardia is a common arrhythmia in clinical practice, and its pathogenesis is mostly related to reentry. However, there are also a few tachycardia that are not related to reentry. Actively clarifying the pathogenesis of these non-reentry related tachycardia is of great significance for its treatment.

Patient concerns:
A 55-year-old female patient presented with recurrent palpitations with a fastest heart rate of 180 beats/minute 10 years ago.

Diagnosis:
Dual atrioventricular nodal non-reentrant tachycardia (DAVNNT).

Interventions:
DAVNNT can be cured by radiofrequency ablation of atrioventricular nodal slow path modification.

Outcomes:
The tachycardia has stopped.

Conclusion:
DAVNNT is a rare disease in clinical practice. Its characteristic is not reentration-related arrhythmias, but the phenomenon of increased heart rate caused by electrical conduction down the double pathway of atrioventricular nodal tract and subsequent pathway. Electrophysiological examination helps to clarify the diagnosis and pathogenesis, and catheter ablation can cure the disease.
Shwachman–Diamond syndrome: A case report
Authors: Liu Zumiao , Tang Qing , Chen Xiuqi , Huang Li , Lan Liancheng , Lv Zili , Yang Xia , Shan Qingwen 
Published: November 2024

Rationale:
Shwachman–Diamond syndrome (SDS) is a rare autosomal recessive genetic disease, the diagnosis is a big challenge for clinician, as the clinical manifestations of the disease are diverse. Here, we report a girl who diagnosed with SDS with the symptoms of recurrent fever, elevated transaminase levels, and granulocytosis. The aspects of diagnosis and treatment were discussed and a literature review was conducted.

Patient concerns:
A 15-month-old girl admitted to our hospital because of recurrent fever, granulocytopenia, and elevated transaminase levels.

Diagnosis and interventions:
The compound heterozygous variant of Shwachman–Bodian–Diamond syndrome c.258 + 2T > C:p.84Cfs3 and c.96C > G:p.Y32* were detected after sequencing the blood samples from the patient and her parents. Finally, she was diagnosed with SDS and she was treated with compound glycyrrhizin, granulocyte-colony stimulating factor, and antibiotic in the case of co-infection.

Outcomes:
During the follow-up, her liver function showed the level of transaminases decreased and she rarely had infection after the age of 15 months although neutropenia is still present.

Lessons:
Patients with SDS lacks typical clinical symptoms, which presents a huge challenge for clinicians. Genetic testing techniques is playing an important role in the diagnosis of diseases. This patient without typical clinical manifestations such as exocrine pancreatic insufficiency and skeletal abnormality, we report this case aimed to strengthen the understanding of the disease.
When anaphylactic shock meets epinephrine and blood lactate increases: A case report
Authors: Zhang Zhi-Rong , Shen Ying-Ying , Yi Ru-Qin , Feng Wen , Chen Wei , Li Cheng-En , Fan Zhao-Kun 
Published: November 2024

Rationale:
Anaphylactic shock, a severe and rapid systemic allergic reaction, poses significant treatment challenges. Epinephrine, the first-line treatment, effectively reverses symptoms but can complicate the clinical picture by elevating lactate levels, blurring the distinction between shock-induced hypoperfusion and drug-induced metabolic effects.

Patient concerns:
A 26-year-old female presented with anaphylactic shock following an antibiotic infusion, experiencing chest tightness, hypotension, and pulmonary edema, without significant past medical history apart from a noted allergy to fish and shrimp.

Diagnoses:
Anaphylaxis was diagnosed based on clinical presentation and supported by imaging that revealed pulmonary edema, despite normal troponin levels and electrocardiogram.

Interventions:
Treatment included 0.5 mg of intramuscular epinephrine and 5 mg of intravenous dexamethasone, with subsequent intubation and mechanical ventilation in the intensive care unit. An intravenous epinephrine infusion was also administered for hemodynamic support.

Outcomes:
While epinephrine resolved the pulmonary edema and stabilized circulation, it led to a significant, albeit transient, increase in lactate levels, which normalized following discontinuation of epinephrine, indicating the metabolic effect of the drug rather than ongoing tissue hypoperfusion.

Lessons:
This case illustrates the importance of recognizing epinephrine-induced lactate elevation in anaphylactic shock, necessitating a nuanced interpretation of lactate dynamics. Clinicians must differentiate between lactate elevations due to tissue hypoperfusion and those arising from epinephrine’s pharmacologic effects to optimize patient care.
Robot-assisted resection of ganglion cell neuroma with a diameter of 78 mm: A case report
Authors: Zhang Qipeng , Liang Hengrui , Li Jiayang , Li Shouzhuo , Xu Enwu 
Published: November 2024

Rationale:
Intrathoracic paragangliomas are typically found within the intricate posterior mediastinal region adjacent to the vertebrae, often presenting with substantial volume. Surgical excision of such tumors presents formidable challenges and is conventionally performed via open surgical procedures.

Patient concerns:
In this report, we present the case of a 53-year-old female patient who presented with the discovery of a left intrathoracic mass during a routine physical examination approximately 1 month prior. She complained of chest tightness and chest pain.

Diagnoses:
She complained of chest tightness and chest pain. Magnetic resonance imaging of the chest and brachial plexus revealed a mass adjacent to the left upper lung hilum, measuring approximately 78 × 63 × 72 mm. The initial suspicion leaned towards a benign lesion. Notably, there was slight compression of the left first thoracic nerve root and mild compression of the middle and lower trunks of the left brachial plexus. Based on the morphological features of the tumor and imaging findings, we suspected its benign nature.

Interventions:
We opted for robot-assisted thoracic surgery to resect the mediastinal tumor.

Outcomes:
Subsequent postoperative pathology confirmed the diagnosis as a paraganglioma. The patient did not experience any notable complications post-surgery, and a 6-month follow-up revealed no signs of recurrence.

Lessons:
The successful application of the robot-assisted thoracic surgery surgical technique underscores its efficacy in minimally invasive resection of sizable intrathoracic tumors situated in the posterior mediastinum.
Pleomorphic adenoma of hard palate: Review of updated literature and “case report”
Authors: AlSahman Lujain , Alghamdi Osama , Albagieh Hamad , AlRefai Ali , AlSahman Roba , Alnafea Shatha 
Published: November 2024

Rational:
Pleomorphic adenoma (PA) is a rare benign tumor mainly affecting the major salivary glands, known for its diverse histological appearances that can mimic malignancies. When it occurs in the hard palate it present diagnostic and management challenges compared to other sites due to the anatomical location and potential proximity to critical structures. This case reports a rare presentation PA starting as an ulcer, alongside a review of rare cases of PA reported in last 5 years. We aim to highlight clinical challenges and emphasize the need for awareness in diagnosis of this diverse entity amongst the clinicians before reaching a definitive conclusion.

Patient concerns:
A 41-year-old female reported an asymptomatic large swelling on the right side of the posterior palatal region. Clinical diagnosis revealed a firm, rubbery, and non-tender swelling of approximately 4 cm × 4 cm diameter. A triangular incisional biopsy was performed to confirm the diagnosis.

Diagnosis:
The histopathological evaluation confirmed the presence of a PA with a well-encapsulated and compressed salivary gland. A wide surgical dissection was made to remove the entire encapsulated tumor mass, including the mucoperiosteum and eroded bone of the palate. The borderline of the tumor was carefully identified in the surrounding healthy tissue. The hemostasis was obtained using a simple interrupted suture.

Lesson:
The diagnosis of PA is difficult as it usually involves extensive squamous and mucous metaplasia, confusing it with malignant disorders. Histopathological and clinical examinations are important for differentiating this lesion from other tumors. Complete surgical excision is reported as the first line of treatment.
Diffusion-weighted MR image analysis based on gamma distribution model for differentiating benign and malignant brain tumors
Authors: Soleimani Zeinab , Saboori Masih , Abedi Iraj , Irannejad Maziar , Khanbabapour Saeid 
Published: November 2024

Background:
Considering the invasiveness of the biopsy method, we attempted to evaluate the ability of the gamma distribution model using magnetic resonance imaging images to stage and grade benign and malignant brain tumors.

Methods:
A total of 42 patients with malignant brain tumors (including glioma, lymphoma, and choroid plexus papilloma) and 24 patients with benign brain tumors (meningioma) underwent diffusion-weighted imaging using five b-values ranging from 0 to 2000 s/mm2 with a 1.5 T scanner. The gamma distribution model is expected to demonstrate the probability of water molecule distribution based on the apparent diffusion coefficient. For all tumors, the apparent diffusion coefficient, shape parameter (κ), and scale parameter (θ) were calculated for each b-value. In the staging step, the fractions (ƒ1, ƒ2, ƒ3) expected to reflect the intracellular, and extracellular diffusion and perfusion were investigated. Diffusion <1 × 10‐4 mm2/s (ƒ1), 1 × 10‐4 mm2/s < Diffusion > 3 × 10‐4 mm2/s (ƒ2), and Diffusion >3 × 10‐4 mm2/s (ƒ3); in the grading step, fractions were determined to check heavily restricted diffusion. Diffusion lower than 0.3 × 10‐4 mm2/s (ƒ11). Diffusion lower than 0.5 × 10‐4 mm2/s (ƒ12). Diffusion lower than 0.8 × 10‐4 mm2/s (ƒ13).

Results:
The findings were analyzed using nonparametric statistics and receiver operating characteristic curve diagnostic performance. Gamma model parameters (κ, ƒ1, ƒ2, ƒ3) showed a satisfactory difference in differentiating meningioma from glioma. For b value = 2000 s/mm2, ƒ1 had a better diagnostic performance than κ and apparent diffusion coefficient (sensitivity, 88%; specificity, 68%; P < .001). The best diagnostic performance was related to ƒ3 in b = 2000 s/mm2 (area under the curve = 0.891, sensitivity = 83%, specificity = 80%, P < .001). In the grading step, ƒ12 (area under the curve = 0.870, sensitivity = 92%, specificity = 72%, P < .001) had the best diagnostic performance in differentiating high-grade from low-grade gliomas with b = 2000 s/mm2.

Conclusion:
The findings of our study highlight the potential of using a gamma distribution model with diffusion-weighted imaging based on multiple b-values for grading and staging brain tumors. Its potential integration into routine clinical practice could advance neurooncology and improve patient outcomes through more accurate diagnosis and treatment planning.
Study of obesity research using machine learning methods: A bibliometric and visualization analysis from 2004 to 2023
Authors: Gong Xiao-wei , Bai Si-yu , Lei En-ze , Lin Lian-mei , Chen Yao , Liu Jian-zhong 
Published: November 2024

Background:
Obesity, a multifactorial and complex health condition, has emerged as a significant global public health concern. Integrating machine learning techniques into obesity research offers great promise as an interdisciplinary field, particularly in the screening, diagnosis, and analysis of obesity. Nevertheless, the publications on using machine learning methods in obesity research have not been systematically evaluated. Hence, this study aimed to quantitatively examine, visualize, and analyze the publications concerning the use of machine learning methods in obesity research by means of bibliometrics.

Methods:
The Web of Science core collection was the primary database source for this study, which collected publications on obesity research using machine learning methods over the last 20 years from January 1, 2004, to December 31, 2023. Only articles and reviews that fit the criteria were selected for bibliometric analysis, and in terms of language, only English was accepted. VOSviewer, CiteSpace, and Excel were the primary software utilized.

Results:
Between 2004 and 2023, the number of publications on obesity research using machine learning methods increased exponentially. Eventually, 3286 publications that met the eligibility criteria were searched. According to the collaborative network analysis, the United States has the greatest volume of publications, indicating a significant influence on this research. coauthor’s analysis showed the authoritative one in this field is Leo Breiman. Scientific Reports is the most widely published journal. The most referenced publication is “R: a language and environment for statistical computing.” An analysis of keywords shows that deep learning, support vector machines, predictive models, gut microbiota, energy expenditure, and genome are hot topics in this field. Future research directions may include the relationship between obesity and its consequences, such as diabetic retinopathy, as well as the interaction between obesity and epidemiology, such as COVID-19.

Conclusion:
Utilizing bibliometrics as a research tool and methodology, this study, for the first time, reveals the intrinsic relationship and developmental pattern among obesity research using machine learning methods, which provides academic references for clinicians and researchers in understanding the hotspots and cutting-edge issues as well as the developmental trend in this field to detect patients’ obesity problems early and develop personalized treatment plans.
Enhancing rural healthcare through internet-based remote collaborative outpatient services: A comprehensive evaluation in Changzhi, Shanxi Province
Authors: Zhao Hu , Zhang Zhichao , Tang Jie 
Published: November 2024

Background:
The advancement of digital technology, particularly telemedicine, has become crucial in improving healthcare access in rural areas. By integrating cloud computing and mHealth technologies, Internet-based Collaborative Outpatient Clinics offer a promising solution to overcome the limitations of traditional healthcare delivery in underserved communities.

Methods:
A trial was conducted in 4 counties of Changzhi City in Shanxi Province, China. The system extended to 495 rural communities and served over 5000 rural residents. Deep learning algorithms were employed to analyze medical data patterns to increase the accuracy of diagnoses and the quality of personalized treatment recommendations.

Results:
After the implementation of the system, there was a significant improvement in the satisfaction levels of rural residents regarding medical services; the accuracy of medical consultations increased by 30%, and the convenience of medical access improved by 50%. There was also a notable enhancement in overall health management. Satisfaction rates among healthcare professionals and rural inhabitants were over 90% and 85%, respectively, indicating that the system has had a significant positive impact on the quality of health-care services.

Conclusion:
The study confirms the feasibility of implementing telemedicine services in rural areas and offers evidence and an operational framework for promoting innovative healthcare models on a large scale.