bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical course for pancreatic necrosis and pancreatic pseudocysts due to severe acute or chronic pancreatitis
Authors: Fusco Stefano , Hanke Greta M. , Büringer Karsten , Minn Lisa , Blumenstock Gunnar , Schempf Ulrike , Götz Martin , Malek Nisar P. , Wichmann Dörte , Werner Christoph R. 
Published: November 2024

Background: The acute and chronic pancreatitis (CP) can lead to severe complications like walled-off necrosis, large symptomatic pseudocyst or multiorgan failure. The treatment of these complications is multivariate and can differ from conservative, symptomatic treatment or minimal-invasive, endoscopic transgastral stenting to transgastral necrosectomy. Objectives: This study aims to analyse the clinical course for patients that develop local complications of severe pancreatitis. Design: This is a retrospective observational single-centre study on 46 patients with severe pancreatitis. Methods: In this retrospective single-centre study, 46 out of 474 inpatients from January 2014 to December 2020, who were treated because of an acute or CP, developed acute pancreatitis complications and could be included. We analysed and compared the clinical course of different treatments (lumen apposing metal stents, transgastral double pigtail stent, endoscopic retrograde cholangiopancreatography, operation, conservative treatment) and different complications (walled-off necrosis (WON), pancreatic pseudocyst (PPC)). Results: Forty-six patients developed an acute complication due to severe pancreatitis. Twenty-seven patients developed a WON, while 19 patients suffered from PPC. 48% of the whole cohort had an alcoholic aetiology of pancreatitis. 78% were treated with antibiotics, 48% suffered from infected pancreatitis and 22% needed intensive care treatment. WON patients more often had a longer hospitalization of more than 21 days. PPC patients were correlated with an alcoholic aetiology, whereas WON patients were inversely correlated with an alcoholic aetiology. Increased lactate dehydrogenase, lipase, and C-reactive protein levels as well as leucocyte count could be associated with a higher probability to exhibit a WON instead of another local complication. The mortality rate was low with 7% in our study. Conclusion: WON and PPC differ in certain patients and laboratory characteristics such as aetiology, elevated laboratory values, antibiotic treatment or the duration of hospitalization. Invasive treatment is not required in all severe pancreatitis cases.
The Role of Delayed Imaging at MRI in Rare Non-enhancing Prostate Cancer Brain Metastases: A Case Report
Authors: Parillo Marco , Santucci Domiziana , Stiffi Massimo , Faiella Eliodoro , Beomonte Zobel Bruno , Mallio Carlo Augusto 
Published: November 2024

Brain metastases in prostate cancer are rare (<2% of cases). In magnetic resonance imaging, nearly all brain metastases exhibit contrast-enhancement, which may be affected by the time elapsed since the administration of the contrast agent. We discuss a case where the brain metastases in a patient with prostate cancer do not show a clear contrast-enhancement on magnetic resonance imaging using a standard brain metastases protocol. It also emphasizes the usefulness of delayed imaging in identifying blood–brain barrier damage. We present the case of a 69-year-old man diagnosed with prostate adenocarcinoma, currently in castration-resistant phase (last value of serum prostate-specific antigen: 45.1 ng/mL) with bone, mediastinal and inguinal lymph nodes, pulmonary, and hepatic metastases. In a contrast-enhanced whole-body computed tomography examination, the appearance of intra-axial brain lesions suspicious for metastases was documented. The subsequent contrast-enhanced brain magnetic resonance imaging showed the presence of 5 intra-axial lesions consistent with brain metastases. These lesions exhibited hyperintense signals in T2-fluid-attenuated inversion recovery images; after contrast agent administration, a ring-like contrast-enhancement was more clearly visible in T1-weighted images acquired later (about 15 minutes after contrast agent administration) than in those acquired earlier (about 5-7 minutes after contrast agent administration). In conclusion, for oncological subjects with multiple brain lesions lacking obvious contrast-enhancement using a standard magnetic resonance imaging protocol, we suggest acquiring late images. These might allow for the detection of even minimal post-contrast impregnation, improving confidence in the diagnosis of brain metastases.
Abnormal cochlear enhancement in Norrie disease
Authors: Barkovich Emil Jernstedt , Ferraciolli Suely Fazio , Jaimes Camilo 
Published: November 2024

Norrie disease (ND) is a rare x-linked disease with retinal and cochlear vascular abnormalities. Clinically, it is characterized by congenital blindness and progressive sensorineural hearing loss during adolescence. We present images of a 3 year old child with ND and normal hearing demonstrating bilateral cochlear enhancement on brain MRI, a finding which has not been previously reported. ND mouse models show progressive degeneration of the endolymph-producing stria vascularis (SV); we hypothesize that these changes allow gadolinium leakage into the endolymph. Our images indicate that cochlear enhancement precedes changes in hearing and suggest that temporal bone/internal auditory canal MR imaging should be considered in the evaluation of ND. Future studies are needed to characterize the temporal evolution of this cochlear enhancement and how it corresponds with hearing loss. Mouse models suggest that it may be a transient phenomenon and diminish as the SV degenerates further. As ND gene therapy trials approach clinical use, cochlear enhancement could aid candidate selection and provide insight into treatment effect.
Linking phenotype with obstructive sleep apnoea severity: A cross-sectional cephalometric and polysomnographic study of obstructive sleep apnoea patients
Authors: Hor Jocelyn KL , Yow Mimi , Wong Hung Chew , Toh Song Tar 
Published: November 2024

Background Cephalometric features have been identified as phenotypic traits of individuals with obstructive sleep apnoea (OSA). However, few studies have investigated how cephalometric parameters varied with OSA severity, especially in the Asian population. Objectives The aim of this study was to investigate the relationship between cephalometric parameters and severity of OSA in the Southeast Asian Chinese population. A novel cephalometric measurement, length of soft palate below the functional occlusal plane, was also studied. Methods In this retrospective cross-sectional study of 113 Southeast Asian Chinese patients with OSA diagnosed by overnight polysomnography, the association of cephalometric parameters with the apnoea-hypopnoea index (AHI) was evaluated, controlling for age, gender and body mass index (BMI). STROBE guidelines were used in this study. Results Positive association was found between age and AHI (Median Regression Coefficient = 0.26; 95% CI 0.07 to 0.44; p = 0.006). The distance of hyoid bone to mandibular plane was positively associated with AHI (Median Regression Coefficient = 0.58; 95% CI 0.05 to 1.11; p = 0.032), but the correlation did not reach statistical significance after Bonferroni correction ( p = 0.64) or adjustment for age, gender and BMI ( p = 0.106). Median regression analyses revealed a statistically significant negative correlation between facial axis angle and AHI (Median Regression Coefficient = −0.53; 95% CI - 1.04 to −0.01; p = 0.046), after adjusting for age, gender and BMI. Conclusion This study indicated that AHI was positively associated with age and negatively associated with facial axis angle.
Factors on medical clerkship students’ quality of life: A survey study
Authors: Astiarani Yunisa , Kristian Kevin , Ekaputra Anthony , Hardi Nicholas 
Published: November 2024

Introduction: Due to the higher demand for healthcare provision in Indonesia, increasing the number of medical schools in Indonesia was highly encouraged. Meanwhile, medical students were considered a susceptible population to a variety of issues that negatively impact their quality of life (QOL) in comparison to the general community. Objectives: The study aims to assess the QOL of Indonesian medical students during the clinical clerkship program (years 4–5) of their medical training while also exploring the association between the results and their ongoing rotation. Methods: The survey was conducted online to 311 students at a private medical school in Jakarta using the Indonesian version of WHOQOL-BREF. Participants’ characteristics, sleep duration, physical activity, and smoking history were also assessed to see if there was any association. Results: 82% of 311 registered clerkship students responded to the survey. In terms of overall QOL, being in a major department, 7–9 h of sleep duration, and owning a private vehicle increased the QOL. Conclusion: This study suggested that medical schools’ policies may consider sleep duration, travel time, transportation-related infrastructure, and social-related infrastructure to underpin students’ social relationships and, afterward, improve their QOL in intangible ways.
Comparison of Imaging Characteristics in Pediatric Patients With Trochlear Versus Medial Femoral Condyle Osteochondritis Dissecans
Authors: Tracey Olivia C. , Lijesen Emilie , Bram Joshua T. , Oji Nnaoma M. , Chipman Danielle E. , Fabricant Peter D. , Green Daniel W. 
Published: November 2024

Background: Although osteochondritis dissecans (OCD) lesions are well-described in the femoral condyles and have been associated with varus limb alignment, there is limited data on OCD lesions in the trochlea. Purpose: To compare the baseline imaging characteristics in pediatric patients with trochlear OCD with those with medial femoral condyle (MFC) OCD to understand whether measures of coronal plane alignment predispose to OCD development by anatomic location. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study retrospectively reviewed all pediatric patients (age ≤18 years) diagnosed with isolated trochlear OCD at a tertiary-care medical center from January 2016 to May 2023; all included patients had weight-bearing hip-to-ankle alignment radiographs. Hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), mechanical axis deviation (MAD), Caton-Deschamps Index (CDI), patellar tilt, and sulcus angle were measured on initial/preoperative anteroposterior and lateral knee radiographs. Tibial tubercle-trochlear groove (TT-TG) distance and OCD lesion size were measured on initial/preoperative magnetic resonance imaging sequences. Patients were 1 to 2 matched based on age (±2 years) and sex to a cohort with isolated MFC OCD. Results: A total of 18 extremities in 16 patients were included in the trochlear OCD cohort and matched to 36 extremities in the MFC OCD cohort. The mean age at the first clinical visit for all patients was 14.8 ± 1.5 years and did not differ significantly between the two groups ( P = .40). The extremities with trochlear OCD had significantly less varus HKA (1°± 2° vs −1°± 2°; P = .004) and MAD (4 ± 8 vs −3 ± 8 mm; P = .004) compared with the MFC cohort as well as lower mLDFA (86°± 2° vs 88°± 2°; P = .004). There were no differences in MPTA, CDI, patellar tilt, sulcus angle, TT-TG distance, or OCD lesion size between groups. Conclusion: Pediatric patients with trochlear OCD had statistically less varus coronal plane alignment compared with age- and sex-matched patients with MFC OCD, with the latter exhibiting more significant varus based on the HKA and MAD.
TIMP1 regulates ferroptosis in osteoblasts by inhibiting TFRC ubiquitination: an in vitro and in vivo study
Authors: Peng Bo , Feng Zhiwei , Yang Ao , Liu Jinmin , He Jinwen , Xu Lihu , Tian Cong , Sheng Xiaoyun , Wang Yaobin , Chen Rongjin , Wang Xingwen , Ren Xiaojun , Geng Bin , Xia Yayi 
Published: November 2024

Abstract
Background
In clinical practice, alterations in the internal environment of type 2 diabetes can significantly affect bone quality. While the increased risk of fractures among diabetic patients is well-established, the precise mechanisms by which hyperglycemia influences bone quality remain largely unclear.

Methods
Western blotting, immunohistochemistry (IHC), and micro-CT were used to examine ferroptosis-related protein expression and bone morphology changes in the bone tissues of type 2 diabetic mice. The CCK8 assay determined the optimal conditions for inducing ferroptosis in osteoblasts by high glucose and high fat (HGHF). Ferroptosis phenotypes in osteoblasts were analyzed using flow cytometry, Western blotting, and two-photon laser confocal microscopy. Transcriptomic sequencing of the control and HGHF groups, followed by bioinformatic analysis, identified and validated key genes. TIMP1 was knocked down in osteoblasts to assess its impact on ferroptosis, while TFRC expression was inhibited and activated to verify the role of TIMP1 in regulating ferroptosis through TFRC. The therapeutic effect of TIMP1 inhibition on osteoporosis was evaluated in a type 2 diabetic mouse model.

Results
The expression of TIMP1 is increased in type 2 diabetic osteoporosis. In vitro, TIMP1 knockout inhibited ferroptosis in osteoblasts induced by high glucose and high fat (HGHF). However, overexpression of TFRC reversed the ferroptosis inhibition caused by TIMP1 knockout. Suppression of TIMP1 expression alleviated the progression of osteoporosis in type 2 diabetic mice. Mechanistic studies suggest that TIMP1 regulates HGHF-induced ferroptosis in osteoblasts through TFRC.

Conclusion
This study demonstrates that TIMP1 expression is increased during type 2 diabetic osteoporosis and that TIMP1 promotes ferroptosis in osteoblasts by regulating TFRC. These findings suggest that TIMP1 is a promising novel therapeutic target for type 2 diabetic osteoporosis.
Perinatal presentation of Klinefelter syndrome and variants: take-home lessons for the urologist
Authors: Frownfelter Matthew , Zekan David , Al-Omar Osama , Abdelhalim Ahmed 
Published: November 2024

Abstract
Background
Klinefelter syndrome (KS) is a sex chromosome disorder usually diagnosed in adulthood during work-up for infertility or hypogonadism. Perinatal diagnoses are uncommon.

Case presentation
We report two newborn cases of KS with associated hypospadias and bilateral cryptorchidism suspected on prenatal genetic testing triggered by ambiguous genital appearance on prenatal ultrasound. Management is presented and the relevant literature on the prenatal and prepubertal presentation and management of KS is summarized.

Conclusions
Klinefelter syndrome can be suspected prenatally in patients with increased nuchal translucency or ambiguous genitalia. Cell-free DNA can establish prenatal diagnosis with good sensitivity and specificity. Early diagnosis allows for early initiation of multidisciplinary care, focused counseling, lifestyle modification, early androgen replacement, and cryopreservation during late puberty or early adulthood. Testosterone treatment during infancy was linked to improved phenotypic features of KS and better cognitive and behavioral outcomes.
Qualitative exploration of 3D printing in Swedish healthcare: perceived effects and barriers
Authors: Sag Olivya Marben , Li Xiang , Åman Beatrice , Thor Andreas , Brantnell Anders 
Published: November 2024

Abstract
Background
Three-dimensional (3D) printing produces objects by adding layers of material rather than mechanically reducing material. This production technology has several advantages and has been used in various medical fields to, for instance, improve the planning of complicated operations, customize medical devices, and enhance medical education. However, few existing studies focus on the adoption and the aspects that could influence or hinder the adoption of 3D printing.

Objective
To describe the state of 3D printing in Sweden, explore the perceived effects of using 3D printing, and identify barriers to its adoption.

Methods
A qualitative study with respondents from seven life science regions (i.e., healthcare regions with university hospitals) in Sweden. Semi-structured interviews were employed, involving 19 interviews, including one group interview. The respondents were key informants in terms of 3D printing adoption. Data collection occurred between April and May 2022 and then between February and May 2023. Thematic analysis was applied to identify patterns and themes.

Results
All seven regions in Sweden used 3D printing, but none had an official adoption strategy. The most common applications were surgical planning and guides in clinical areas such as dentistry, orthopedics, and oral and maxillofacial surgery. Perceived effects of 3D printing included improved surgery, innovation, resource efficiency, and educational benefits. Barriers to adoption were categorized into organization, environment, and technology. Organizational barriers, such as high costs and lack of central decisions, were most prominent. Environmental barriers included a complex regulatory framework, uncertainty, and difficulty in interpreting regulations. Technological barriers were less frequent.

Conclusions
The study highlights the widespread use of 3D printing in Swedish healthcare, primarily in surgical planning. Perceived benefits included improved surgical precision, innovation, resource efficiency, and educational enhancements. Barriers, especially organizational and regulatory challenges, play a significant role in hindering widespread adoption. Policymakers need comprehensive guidance on 3D printing adoption, considering the expensive nature of technology investments. Future studies could explore adoption in specific clinical fields and investigate adoption in non-life science regions within and outside Sweden.
Screening the Global Health Priority Box against Plasmodium berghei liver stage parasites using an inexpensive luciferase detection protocol
Authors: Nguyen Gia-Bao , Cooper Caitlin A. , McWhorter Olivia , Sharma Ritu , Elliot Anne , Ruberto Anthony , Freitas Rafael , Pathak Ashutosh K. , Kyle Dennis E. , Maher Steven P. 
Published: November 2024

Abstract
Background
Malaria, a disease caused by parasites of the genus Plasmodium, continues to impact many regions globally. The rise in resistance to artemisinin-based anti-malarial drugs highlights the need for new treatments. Ideally, new anti-malarials will kill the asymptomatic liver stages as well as the symptomatic blood stages. While blood stage screening assays are routine and efficient, liver stage screening assays are more complex and costly. To decrease the cost of liver stage screening, a previously reported luciferase detection protocol requiring only common laboratory reagents was adapted for testing against luciferase-expressing Plasmodium berghei liver stage parasites.

Methods
After optimizing cell lysis conditions, the concentration of reagents, and the density of host hepatocytes (HepG2), the protocol was validated with 28 legacy anti-malarials to show this simple protocol produces a stable signal useful for obtaining quality small molecule potency data similar to that obtained from a high content imaging endpoint. The protocol was then used to screen the Global Health Priority Box (GHPB) and confirm the potency of hits in dose–response assays. Selectivity was determined using a galactose-based, 72 h HepG2 assay to avoid missing mitochondrial-toxic compounds due to the Crabtree effect. Receiver-operator characteristic plots were used to retroactively characterize the screens’ predictive value.

Results
Optimal luciferase signal was achieved using a lower HepG2 seed density (5 × 103 cells/well of a 384-well microtitre plate) compared to many previously reported luciferase-based screens. While producing lower signal compared to a commercial alternative, this luciferase detection method was found much more stable, with a > 3 h half-life, and robust enough for producing dose–response plots with as few as 500 sporozoites/well. A screen of the GHPB resulted in 9 hits with selective activity against P. berghei liver schizonts, including MMV674132 which exhibited 30.2 nM potency. Retrospective analyses show excellent predictive value for both anti-malarial activity and cytotoxicity.

Conclusions
This method is suitable for high-throughput screening at a cost nearly 20-fold less than using commercial luciferase detection kits, thereby enabling larger liver stage anti-malarial screens and hit optimization make-test cycles. Further optimization of the hits detected using this protocol is ongoing.
Light at night exposure and risk of dementia conversion from mild cognitive impairment in a Northern Italy population
Authors: Filippini Tommaso , Costanzini Sofia , Chiari Annalisa , Urbano Teresa , Despini Francesca , Tondelli Manuela , Bedin Roberta , Zamboni Giovanna , Teggi Sergio , Vinceti Marco 
Published: November 2024

Abstract
Background
A few studies have suggested that light at night (LAN) exposure, i.e. lighting during night hours, may increase dementia risk. We evaluated such association in a cohort of subjects diagnosed with mild cognitive impairment (MCI).

Methods
We recruited study participants between 2008 and 2014 at the Cognitive Neurology Clinic of Modena Hospital, Northern Italy and followed them for conversion to dementia up to 2021. We collected their residential history and we assessed outdoor artificial LAN exposure at subjects’ residences using satellite imagery data available from the Visible Infrared Imaging Radiometer Suite (VIIRS) for the period 2014–2022. We assessed the relation between LAN exposure and cerebrospinal fluid biomarkers. We used a Cox-proportional hazards model to compute the hazard ratio (HR) of dementia with 95% confidence interval (CI) according to increasing LAN exposure through linear, categorical, and non-linear restricted-cubic spline models, adjusting by relevant confounders.

Results
Out of 53 recruited subjects, 34 converted to dementia of any type and 26 converted to Alzheimer’s dementia. Higher levels of LAN were positively associated with biomarkers of tau pathology, as well as with lower concentrations of amyloid β1−42 assessed at baseline. LAN exposure was positively associated with dementia conversion using linear regression model (HR 1.04, 95% CI 1.01–1.07 for 1-unit increase). Using as reference the lowest tertile, subjects at both intermediate and highest tertiles of LAN exposure showed increased risk of dementia conversion (HRs 2.53, 95% CI 0.99–6.50, and 3.61, 95% CI 1.34–9.74). In spline regression analysis, the risk linearly increased for conversion to both any dementia and Alzheimer’s dementia above 30 nW/cm2/sr of LAN exposure. Adding potential confounders including traffic-related particulate matter, smoking status, chronic diseases, and apolipoprotein E status to the multivariable model, or removing cases with dementia onset within the first year of follow-up did not substantially alter the results.

Conclusion
Our findings suggest that outdoor artificial LAN may increase dementia conversion, especially above 30 nW/cm2/sr, although the limited sample size suggests caution in the interpretation of the results, to be confirmed in larger investigations.