bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Ramipril-Induced Angioedema and Solar Purpura
Authors: Oztas Kara Rabia , Sevimli Dikicier Bahar , Elcin Bilge 
Published: November 2024

ABSTRACT
This case report describes a patient who developed solar purpura after treatment for angioedema associated with ramipril, an angiotensin-converting enzyme inhibitor. The patient presented to the ED with angioedema. She had been using ramipril for 2 years. Two days after she was admitted, a malar “butterfly” rash occurred on her face and purpura on her lower lip and chin, as well as the extensor part of her forearm. After testing and review of the patient history, she was diagnosed with solar purpura and began topical corticosteroid and antiscar cream treatment. The patient’s lesions healed with an atrophic scar in 3 weeks. To the authors’ knowledge, this is the first such case to be reported in the literature.
In-Person and Video-Based Education: Do They Affect Pressure Injury Knowledge in Nursing?
Authors: İnangil Demet , Ertürk Nilüfer , Pakdil Elif Lale , Türkoğlu İlayda , Torun Özgül , Kabuk Ayşe 
Published: November 2024

ABSTRACT

OBJECTIVE
To determine how training on the nursing care of pressure injuries (PIs) affects knowledge levels and satisfaction.

METHODS
This study was semiexperimental, conducted in the form of a pretest and posttest in one group of 105 nurses working in a training and research hospital. The training took place in person and via video. All nurses included in the study group first received in-person training in 15-person groups followed by weekly video training for 4 consecutive weeks. Before training, investigators assessed the nurses’ PI knowledge using the Nurses’ Knowledge Level Assessment for PI Care (NKLAPIC; pretest). After the in-person module (posttest 1) and video-based module (posttest 2), investigators provided the NKLAPIC again. The independent-sample test, one-way analysis of variance, repeated-test-measures analysis of variance, Bonferroni test, and pairwise comparisons were used in data analysis.

RESULTS
Mean NKLAPIC scores were 47.71 ± 13.5 (out of 100 points) at pretraining, 68.5 ± 12.32 after the in-person training, and peaked at 72.38 ± 4.74 after video-based training (P < .001). Video-based training appeared to lead to a larger increase in knowledge levels than in-person training alone (P < .001). Further, although the average satisfaction score given to the in-person training was 3.97 ± 0.93, the same score for the online training was 4.12 ± 0.95 (P > .05).

CONCLUSIONS
Outcomes suggest that in-person training and video-based training regarding PI care improve the knowledge levels of nurses.
Keratoprosthesis of Brazil (KoBra): Preliminary Results of the First 2 Human Cases
Authors: Magalhães Otavio de Azevedo , Pereira Gomes José Alvaro , Pena de Oliveira Italo , de Castro Neto Jarbas Caiado , Schor Paulo 
Published: November 2024

Purpose:
We evaluated the clinical performance of a novel keratoprosthesis (KPro) named KoBra (Keratoprosthesis of Brazil) in patients with corneal blindness.

Methods:
Two-piece KPro was three-dimensionally (3D) printed using titanium alloy powder (Ti-6Al-4V) and polymethyl methacrylate (PMMA). The KPros were implanted unilaterally in 2 patients who had corneal disease that was not amenable to standard corneal transplantation. An autologous full-thickness corneal graft was used as the KPro carrier. Patients were examined for at least 16 months to evaluate retention and postoperative complications. Biomicroscopy and anterior segment optical coherence tomography (AS-OCT) were performed throughout the experiment to evaluate the relationship between the KPro and the carrier graft.

Results:
No intraoperative complications occurred during the surgeries, and the immediate postoperative period was uneventful. The implanted KoBra integrated well into all operated eyes, and clear optics without prothesis extrusion were maintained. The mean duration of the postoperative follow-up was 17 months (range 16–18 months). AS-OCT demonstrated the correct relationship of the device and carrier at the final follow-up in all cases.

Conclusions:
The first short-term clinical analysis demonstrated good outcomes associated with this new technology in 2 patients who were not amenable to standard corneal transplantation. Longer follow-up and additional implantations are necessary to better assess the safety and efﬁcacy of this device.
A Review of Cardiovascular Effects of Marijuana Use
Authors: Rezkalla Shereif H. , Kloner Robert A. 
Published: November 2024

Objective:
Cannabinoids exert their effects on body tissues via cannabinoid 1 (CB1) and cannabinoid 2 (CB2) receptors. Receptors are present in brain, myocardium, vascular endothelium, platelets, and adipose tissues. Under normal physiologic conditions, endocannabinoid effects are minimal. The use of exogenous cannabis leads to endothelial dysfunction and increases vascular thrombosis via CB1 receptor stimulation. On the other hand, CB2 receptors may have a beneficial anti-inflammatory response.

Review Methods:
We reviewed reports of the effects of cannabis on the cardiovascular system utilizing PUBMED from the last 20 years with emphasis on the most recent reports.

Summary:
Despite a plethora of reviews and some retrospective studies, there is a need for more definitive data regarding the effect of cannabis use on cardiovascular events (CVE). Marijuana does not appear to accelerate atherosclerosis. There is a suggestion that it may induce myocardial infarction in a small percentage of users, especially in male users, particularly during recent use. It has a possibility of increasing cerebrovascular events when combined with other risk factors such as tobacco use. There is an association between cannabis use and increased evidence of peripheral vascular disease. To have a definitive answer to the question of whether cannabis contributes to CVE, there is an urgent need for prospective controlled studies with patients presenting to academically oriented medical facilities with CVE following cannabis use for either medicinal or recreational use.
FACTORS AFFECTING ASPIRATION VOLUMES OF BACK-FLUSH NEEDLES AND INFUSION VOLUMES OF VITRECTOMY DEVICE
Authors: Mizuno Masaharu , Koto Takashi , Nakajima Kosuke , Ishida Tomoka , Inoue Makoto 
Published: November 2024

Purpose:
The stability of the eye is important during vitrectomy, which makes it important to balance the infusion rates (IRs) and the aspiration rates (ARs). The purpose of this study was to determine the effects of the IR from the vitrectomy device and the AR with back-flush needles.

Methods:
We compared the ARs of 25-gauge or 27-gauge back-flush needles manufactured by four companies. The AR of balanced salt solution (BSS), ethylene glycol mimicking subretinal fluid, and air was measured for each aspiration pressure. The IR of BSS and air was measured at different intraocular pressures.

Results:
The AR increased in proportion to the increase in the aspiration pressure, and it was positively correlated with the cross-sectional area of the soft tips and negatively with the total length of the soft tips. The IR of BSS and air increased in proportion to the increase in the intraocular pressures settings. The IR of BSS exceeded the AR of BSS and ethylene glycol for all parameters, but the IR of air could be less than the AR at some settings.

Conclusion:
The results suggest that the aspiration of air may cause a collapse of the eye under some settings.
Photoacoustic Microscopy Offers a New Perspective on Imaging of Vascular Anomalies: A Case Series of Venous Malformations
Authors: Tay Charmaine Jieying , Koh Mark Jean Aan , Toh Luke Han Wei , Wee Lynette Wei Yi , Su Bing , Tan Lucinda Siyun , Tey Hong Liang 
Published: November 2024

Objectives:
Vascular malformations are mostly benign but can potentially be life-threatening or function-threatening when involving vital structures or when associated with overgrowth syndromes. Yet, for these lesions that are predominantly cutaneous, diagnostic techniques like ultrasonography and magnetic resonance imaging may be inadequate in the characterization of these superficial lesions; leaving the alternative of invasive tissue biopsies.

Methods:
We explore an emerging imaging modality via the photoacoustic microscope, which relies on the optical properties of tissues—allowing the detection of hemoglobin, water, lipids, and other light-absorbing chromophores, resulting in greater contrast and spatial resolution than conventional ultrasonography. We detail a case series of 8 pediatric patients with venous malformations who presented at the Vascular Anomalies Clinic in KK Women’s & Children’s Hospital. The photoacoustic microscope device was applied to lesional and control skin in each patient, with measurements taken twice for each site.

Results:
Despite the small sample size, there was discernible visual and quantitative difference in vessel caliber and length between lesional and control skin—the majority of venous malformations had vessels with larger diameters and lengths than control vessels. Of sampled vessels, the diameter of vessels was larger in the lesional sample in 85.7% with a mean difference of +10.4 μm (P = .02); whereas 83.3% of studied vessels had longer vessel lengths in the lesional sample with a mean difference of +81.3 μm (P = .20).

Conclusion:
This descriptive case series serves as a pilot exploratory study to investigate vascular parameters (ie, vessel length and diameter) of venous malformations with an alternative noninvasive imaging tool like photoacoustic imaging, which provides higher resolution visualization and characterization of vessel architecture in superficial vascular anomalies. Subsequent studies building on this preliminary study data may be performed to compare venous malformations to other vascular anomalies. Future applications include the development of diagnostic algorithms for various vascular lesions to aid in rapid bedside diagnosis, visualization of the effects of treatment in real-time, and defining prognostic markers to determine response to treatment.
Progress towards effective vaccines for Chlamydia trachomatis
Authors: Collar Amanda L. , Frietze Kathryn M. 
Published: November 2024

Purpose of review
Effective vaccines to prevent sexually transmitted Chlamydia trachomatis (Ct) infection have eluded researchers for decades. However, recent studies of a promising vaccine in human trials, and emerging understanding of the complexity of the natural immune response to infection have provided hope for the eventual approval of a vaccine. This review highlights recent progress toward developing effective vaccines for Ct.

Recent findings
In 2019, the first-in-human Ct vaccine, CTH522, Phase I/IIB trial was reported. Recent studies of this vaccine and its derivatives have further established CTH522 as the lead vaccine against sexually transmitted Ct. A variety of vaccines have entered the preclinical development pipeline, with researchers reporting efforts to target non-MOMP antigens, include novel adjuvants in vaccine formulations, and use alternative routes of administration to increase efficacy.

Summary
While the approval of a vaccine for Ct is closer than ever, the need for careful consideration of future implementation is especially important for the successful clinical translation of Ct vaccines into humans.
Body Contouring With Electromagnetic Treatment Plus Radiofrequency
Authors: Swanson Eric 
Published: November 2024

Background
Electromagnetic treatments have recently been combined with radiofrequency to reduce the fat layer and simultaneously increase muscle thickness. Studies report treatment efficacy, using photographs and imaging methods.

Methods
A literature review was conducted. Measurement data were tabulated. The EmSculpt Neo device (BTL Industries, Boston, MA) was used in all studies.

Results
Seven studies evaluated the fat thickness and muscle thickness using either ultrasound (1 study) or magnetic resonance imaging methods (6 studies). The abdomen was treated in 2 studies. The other studies treated the lateral thighs, flanks, buttocks, inner thighs, and upper arms. The mean reduction in fat thickness was 8.0 mm, and the mean increase in muscle thickness was 5.5 mm. All 7 studies were authored by BTL medical advisors. Measured changes were likely within the margin of error and of questionable clinical relevance. Few adverse events were reported.

Discussion
Photographs were frequently not standardized, showing changes in treated areas, but unexplained changes in nontreated areas as well. The magnetic resonance imaging scans were affected by differing levels of the axial slice. Measured changes were incremental and likely not indicative of a true treatment effect. The scientific basis for efficacy is tenuous, both for fat reduction and muscle hypertrophy.

Conclusions
A scientific evaluation of the results fails to produce reliable evidence of a clinically meaningful result for this combination energy-based treatment. Financial conflict is a major factor. Liposuction remains the gold standard.
Tapered Submerged Implants in an Augmented Posterior Maxilla After Oroantral Fistula Closure
Authors: Aung Yoon Thu , Eo Mi Young , Mustakim Kezia Rachellea , Kim Soung Min 
Published: November 2024

Dental implantation in the posterior maxilla is challenging due to anatomic proximity to the sinuses, relative bone quality, and pre-existing sinus diseases. An oroantral fistula (OAF) acts as a pathologic pathway of bacteria and can cause sinus infections and complicate dental implant management. Bony augmentation between the sinus floor mucosa and the oral mucosa at the OAF closure site is another critical consideration. The purpose of this study was to elucidate the sequential patient management protocol from surgical closure of OAF and bone grafting to implant installation. The authors also aimed to evaluate the clinical effectiveness of dental implants in the augmented posterior maxilla. A retrospective study was designed for patients receiving the tapered bone-level dental implants in the posterior maxilla after OAF closure performed by a single surgeon at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, by applying specific inclusion criteria. Implant survival was determined by the presence of a functioning implant in the oral cavity at the time of assessment. In total, 13 implants were installed in 4 OAF patients with different etiologies. The method of OAF closure differed according to OAF cause and size. Three patients underwent concomitant modified endoscopic sinus surgery. Two patients underwent autogenous bone grafting from the ramus and symphysis, and 2 patients received sequential allogeneic onlay bone grafting. Implant survival was not affected by the type of graft material. The implant survival rate was 100%. An implant diameter of 4 mm (92.3%) and an implant length of 7 mm (69.23%) were most common. Careful separate sinus membrane and oral mucosa closure with sequential bone grafting between ensures stable and predictable outcomes for subsequent implantations. The tapered submerged implants, particularly the 7-mm length, can be reliably installed in the augmented posterior maxilla after OAF closure.
Causal Effect of Multi-cohort Circulating Proteome on the Risk of Aortic Aneurysm: A Mendelian Randomization Study
Authors: Zheng Yuan , Qin Lin , Ji Jiayu , Mo Huanqi , Wang Kan 
Published: November 2024

AbstractBackgroundThe pathogenesis of aortic aneurysm (AA) remains unclear, and there are no effective therapeutic drugs or targets. Circulating plasma proteins are considered biomarkers of AA and potential therapeutic targets for AA. This study aimed to systematically evaluate the causal effects of plasma proteins on AA using a multi-cohort Mendelian randomization (MR) approach.MethodsProtein quantitative trait loci (pQTLs) was obtained from 9 published proteome genome-wide association studies (GWAS) and AA GWAS data from the FinnGen cohort. Independent pQTLs were selected as instrumental variables (IVs). Two-sample MR analysis was performed using inverse-variance weighted, MR-Egger regression, weighted median, weighted mode, and simple mode methods. Heterogeneity and pleiotropy were assessed using Cochran’s Q test, I² statistic, MR-Egger intercept, MR-PRESSO, and Leave-one-out analysis. Steiger filtering was used to test the causal direction. Colocalization analysis and pQTL-eQTL overlap assessment were conducted to validate the findings. Pathway enrichment and drug target analyses were performed to explore the biological and clinical implications of the MR results.ResultsA total of 8,285 pQTLs for 4,421 proteins were retained as IVs. Using cis-pQTLs for IVs, MR analysis identified 154 proteins causally associated with TAA (76 protective factors and 78 risk factors) and 211 proteins with AAA (112 protective factors and 99 risk factors). Using cis-pQTLs+trans-pQTLs for IVs, MR analysis identified 236 proteins causally associated with TAA (113 protective factors and 123 risk factors) and 309 proteins with AAA (143 protective factors and 166 risk factors). The MR results showed no significant heterogeneity or pleiotropy. Steiger filtering confirmed the causal direction from circulating proteins to AA. Colocalization analysis found evidence of shared causal variants between multiple proteins and AA. The majority of AA-associated proteins had pQTLs overlapping with blood eQTLs or proxy eQTLs. Pathway enrichment analysis revealed that these proteins were involved in stress response, immune regulation, cytokine-cytokine receptor interaction, metabolic processes and so on. Nearly two-thirds of the causally related proteins were classified as druggable or potentially druggable targets.ConclusionsThis study identified a large number of potentially novel pathogenic proteins and therapeutic targets for AA, providing important references for elucidating the molecular pathogenesis of AA and advancing drug development.
Human-level information extraction from clinical reports with fine-tuned language models
Authors: Liu Longchao , Lian Long , Hao Yiyan , Pace Aidan , Kim Elaine , Homsi Nour , Pershad Yash , Lai Liheng , Gracie Thomas , Kishtagari Ashwin , Carroll Peter R , Bick Alexander G , Odisho Anobel Y , Chung Maggie , Yala Adam 
Published: November 2024

AbstractBackgroundExtracting structured data from clinical notes is a key bottleneck in developing AI tools for radiology and pathology. Manual annotation is labor-intensive and unscalable. An efficient, automated method for clinical information extraction with human-level performance is urgently needed.PurposeTo introduce a low-code open-source library,Strata, that facilitates fine-tuning, evaluating, and deploying large language models (LLMs) for structured data extraction from clinical reports.Materials and MethodsFour clinical datasets were annotated by a trained human annotator: 431 prostate MRI reports, 978 breast pathology reports, 238 kidney pathology reports, and 724 myelodysplastic syndrome (MDS) pathology reports. Datasets were split into training, development, and test sets. A second reader annotated the test set. We fine-tuned open-source LLMs (Llama-3.1 8B, Mistral-v0.3 7B) to extract variables from clinical reports. We evaluated zero-shot and fine-tuned open-source models, zero-shot GPT-4, and the second human annotator using exact match accuracy. Exact match accuracy assesses if all variables for a report were extracted correctly.ResultsThe second human annotator obtained exact match accuracies of 83.1 (95% CI 75.4, 88.5), 75.5 (95% CI 70.4, 80.3), 70.8 (95% CI 59.7, 80.6), and 85.8 (95% CI 80.7, 89.9) in the prostate, breast, kidney, and MDS test sets, respectively. Our fine-tuned Llama-3.1 8B model achieved human-level performance across all fine-tuning settings with exact-match test-set accuracies of 91.5 (95% CI 85.4, 95.4), 91.5 (95% CI 88.1, 94.2), 72.2 (95% CI 61.1, 81.9), and 89.4 (95% CI 84.9, 93.1) for prostate, breast, kidney, and MDS reports, respectively. We found that ≤ 100 training reports were needed to achieve human-level performance on these tasks.ConclusionStrata enables automated human-level performance in extracting structured data from clinical notes using ≤ 100 training reports.Summary StatementFine-tuned open-source LLMs achieved human-level performance in extracting structured outcomes from prostate MRI, breast pathology, kidney pathology, and myelodysplastic syndrome pathology reports, supporting diverse research applications.Key Results- Fine-tuned Llama-3.1 8B obtained human-level exact match accuracies in all four test sets.- 100, 95, 43, and 72 training reports from the breast pathology, kidney pathology, prostate MRI, and myelodysplastic syndrome pathology datasets were needed for fine-tuned Lamma-3.1 8B to achieve human-level performance.- Each fine-tuned model required 1-3 hours of training on a single A40 GPU, costing between $0.80 to $2.40 on a private cloud.
Genome-wide investigation of rare germline copy-number variants in retinoblastoma
Authors: Chapman Hannah Lesley M. , Kim Jung , Bess Jazmyn L. , Kim Sungduk , Albert Paul S. , Japkowicz Nathalie , Stewart Douglas R. , Boukouvalas Zois 
Published: November 2024

AbstractApproximately 8,000 children are diagnosed with retinoblastoma (Rb) globally each year, and the rate of survival as well as prognosis can differ greatly based on access to quality screening and treatment. Over 90% of patients with the inherited bilateral form of Rb have germline variantsRB1, whereas approximately 20-30% of the unilateral form of Rb harbor germline variants inRB1. In the following study, rare germline copy-number variants (CNVs) within and outside of theRB1gene were evaluated. Germline whole-genome sequencing (WGS) data from 134 Rb samples and 313 non-cancer controls of European ancestry were analyzed from the St. Jude Cloud. In an analysis of 1514 rare germline CNVs, non-negative matrix factorization (NMF) and Bayesian logistic regression identified 18 CNVs associated with Rb status. NMF analysis was used to reduce the high-dimensional feature space and resulted in 412 rare germline CNVs, one of which was found inRB1. A rare intronic germline CNV within theACDY9gene (OR= 3.29, 95% CI = 0.56 to 6.63) as well as an event within the intronic region of thePLXNC1gene (OR= 2.24, 95% CI = 0.87 to 3.67) were found. In an evaluation of gene function within the UCSC hg38 Fetal Gene Atlas,ACDY9has a role in eye photoreceptor cell development, andPLXNC1has a role in eye horizontal cell development; both cell types have a functional role in Rb development. These findings suggest novel rare germline CNVs outside of theRB1gene could be associated with Rb risk.