bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case report of retroperitoneal liposarcoma
Authors: Bao Zicheng , Zhang Zhidong , Ding Pingan , Zhao Qun , Li Yong 
Published: September 2024

Background:
Retroperitoneal liposarcoma is a rare and complex tumor originating from the mesenchymal tissues, with no specific manifestations in the early stage, and a large tumor size in the late stage. Patients often consult a physician because of large abdominal mass, increased abdominal circumference, and abdominal pain, and rarely because of leukocytosis.

Patient concerns:
A 54-year-old female presented to our hospital with complaints of “abdominal distension for over 3 months, left lumbar pain for over 2 months.” Considering the comprehensive symptoms, examinations, computed tomography scans, and pathological results, the possibility of retroperitoneal liposarcoma is high.

Diagnoses:
Retroperitoneal liposarcoma with leukocytosis.

Interventions:
Open retroperitoneal mass excision along with transcystoscopic left ureteral Double-J Ureterl Stent Insertion tube placement and left nephrectomy.

Outcomes:
The postoperative pathological findings of the abdominal mass, combined with morphological and immunohistochemical results, are consistent with retroperitoneal liposarcoma. The patient had no recurrence in 7 months of postoperative follow-up conducted on the telephone and is now in continued follow-up.

Conclusion:
Retroperitoneal liposarcoma is highly malignant and prone to recurrence. Radical surgery is currently the primary treatment modality for patients with this condition. Analogous to cancer patients, those with elevated white blood cell counts and retroperitoneal liposarcoma may have poor prognoses, with a high likelihood of local recurrence and distant metastasis. Close postoperative follow-up is necessary. Therefore, regular postoperative review of blood routine may be a relatively economical and convenient method for the early detection of recurrence and metastasis of retroperitoneal liposarcoma.
Effect of denosumab, an anti-osteoporosis drug, on vascular calcification: A meta-analysis
Authors: Wang Di , Liu Tongqiang , Lu Jingkui , Xu Wei 
Published: September 2024

Background:
Denosumab is an effective drug for the treatment of osteoporosis. This meta-analysis was conducted to evaluate efficacy of denosumab on the treatment of vascular calcification (VC).

Methods:
Databases including PubMed, EMbase, the Cochrane Library, CNKI, Wanfang database were searched from the inception to January 10th, 2024. Eligible studies comparing denosumab versus no denosumab treatment on VC were included. Data were analyzed using Review Manager Version 5.3.

Results:
Five studies were included in this meta-analysis. Three were RCTs and 2 were non-randomized studies. As a whole, 961 patients were included in denosumab group and 890 patients were included in no denosumab group. The follow-up period was from 6 to 36 months. Compared with the no denosumab group, the denosumab group demonstrated a decrease on VC score or area in all enrolled patients (SMD −0.85, 95% CI −1.72–0.02, P = .05). In the subgroup of patients with non-CKD, there was no statistical difference between the denosumab and no denosumab group concerning the change of VC score (SMD −0.00, 95% CI −0.12–0.12, P = .98). In the subgroup of patients with CKD 3b-4, there was no significant difference between the denosumab and no denosumab group concerning the change of VC score (SMD 0.14, 95% CI −0.72–1.00, P = .75). In the subgroup of CKD patients undergoing dialysis, the denosumab group demonstrated a significant decrease on VC score or area compared with the no denosumab group (SMD −2.30, 95% CI −3.78–0.82, P = .002).

Conclusion:
Our meta-analysis revealed that denosumab did not show a very definite inhibitory effect on VC. However, denosumab showed the effective effect on inhibiting VC in CKD patients undergoing dialysis. More large RCTs are needed to verify these results.
Fibrodysplasia ossificans progressiva complicated with post traumatic and infectious myositis ossificans in masseter: A case report
Authors: Guan Yian , Ma Dongyang 
Published: September 2024

Rationale:
Myositis ossificans (MO) is characterized by benign heterotopic ossificans in soft tissues like muscles, which can be classified into nonhereditary MO and fibrodysplasia ossificans progressiva (FOP). Nonhereditary MO is characterized by ossification of the soft tissues after acute or repetitive trauma, burns, or surgical intervention. FOP is a rare and crippling disease characterized by congenital malformation of the big toe and heterotopic ossification in muscle. The majority of FOP’s musculoskeletal traits are associated with dysregulated chondrogenesis. The diagnosis is mainly based on clinical manifestation, imaging examination, and genetic analysis. There is still no effective treatment to cure or slow its progression. The best approach remains early diagnosis, conservative drug treatment, and injury prevention to avoid local ossification.

Patient concerns:
A 34-year-old male presented at our hospital because of trismus caused by ossification of the masseter muscle. In addition, he had serious stiffness and multiple bony masses throughout the body, which led to limited movement.

Diagnoses:
Based on the clinical manifestation of movement restriction, characteristic radiographic images of ossification of soft tissues, the genetic test showing a heterozygous molecule (c.974G > C, p.G325A) of the activin A receptor type I, the patient was diagnosed as FOP complicated with localized MO in masseter after trauma and infection.

Interventions:
The patient underwent the surgical resection of ossification in the masseter muscle, he was instructed to insist on mouth-opening exercises and take glucocorticoids and nonsteroidal anti-inflammatory medications after surgery.

Outcomes:
The symptoms of trismus are relieved, and eating can be basically achieved after surgery, while the symptoms of trismus recurred 2 years later.

Lessons:
Although FOP has unique clinical manifestations, its diagnosis may be difficult because of its rarity. Gene analysis is the main standard for diagnosis, while patients with different genotypic variations may show different clinical symptoms. Therapeutic interventions are still supportive and preventive, and surgery is not recommended except under certain circumstances.
Advanced upper urinary tract urothelial carcinoma is indistinguishable from renal infection by imaging: A case report
Authors: Chai Jiagui , Feng Runlin , Li Yuhang , Ke Changxing 
Published: September 2024

Rationale:
The current diagnostic approach for urinary tract urothelial carcinoma (UTUC) relies on symptoms and imaging. Nevertheless, the diagnosis can be challenging in advanced cases presenting with atypical imaging and symptoms. This article presents an unreported case with atypical imaging and symptoms to provide some experience in diagnosing advanced UTUC.

Patient concerns:
A 55-year-old male patient was admitted to the hospital with a 2-month history of persistent left scrotal pain and intermittent left lower back pain.

Diagnoses:
Computed tomography and magnetic resonance imaging revealed a left kidney infection. Paradoxically, the patient did not present with a fever, and the white blood cell count was within normal limits. To further clarify the diagnosis, urine cytology was performed. Surprisingly, malignant tumor cells were discovered. The diagnosis of UTUC was considered.

Interventions:
The patient underwent radical tumor resection.

Outcomes:
The surgery was successfully performed. The patient received regular chemotherapy after surgery. No recurrence was found during the follow-up.

Lessons:
This case is a rare and enlightening clinical scenario. When imaging reveals renal infection accompanied by varicocele or renal vein embolism, it is crucial to consider the possibility of advanced UTUC.
Clinical efficacy and safety of acupuncture combined with statin in dyslipidemia: A meta-analysis and system review
Authors: Liu Xinyu , Chen Kun , Chen Fujian 
Published: September 2024

Background:
This study aims to systematically evaluate the clinical efficacy and safety of acupuncture in combination with statin therapy compared to statin monotherapy for the treatment of dyslipidemia.

Methods:
A comprehensive search for relevant randomized controlled trials assessing the clinical efficacy of acupuncture and statin combination in the treatment of dyslipidemia was conducted. Databases including PubMed, EMbase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang database, and China Science and Technology Journal Database were searched up to October 27, 2023.

Results:
Sixteen Chinese-language studies involving a total of 1333 subjects were included for analysis. The meta-analysis revealed that the total effective rate of acupuncture combined with statin was significantly higher than that of statin alone (odds ratios = 3.32, 95% confidence intervals [CI] = 2.33 to 4.72). Furthermore, the combination of acupuncture with statin treatment resulted in a significant reduction in triglyceride levels (mean differences [MD] = −0.72 mmol/L, 95% CI = −1.05 to −0.4), total cholesterol levels (MD = −0.79 mmol/L, 95% CI = −1.07 to −0.51), low-density lipoprotein cholesterol levels (MD = −0.61 mmol/L, 95% CI = −0.95 to −0.27) and traditional Chinese medicine syndrome integral (MD = −1.32, 95% CI = −1.75 to −0.89), compared to statin treatment alone. Additionally, the high-density lipoprotein cholesterol level was higher in the combined acupuncture and statin treatment group than in the statin treatment alone group (MD = 0.44 mmol/L, 95% CI = 0.09 to 0.79). Notably, the rate of adverse reactions reported with combined acupuncture and statin treatment was lower than that with statin therapy alone.

Conclusion:
Our findings support the potential of acupuncture combined with statin as a viable clinical treatment option for dyslipidemia. However, it is important to note that current research on the mechanism of acupuncture for lipid-lowering has not yielded definitive results, and there are inherent biases in the conducted clinical studies.
Hemifacial spasms triggered by compression of tortuous anterior inferior cerebellar artery loop on the facial nerve in the internal auditory canal: A case report
Authors: Chen Shuide , Pan Siyuan , Richard Seidu A. , Lan Zhigang 
Published: September 2024

Rationale:
Hemifacial spasm (HFS) is triggered by neurovascular compression mostly at the root entry/exit zone of the facial nerve. HFS with the responsible blood vessel located in the internal auditory canal (IAC) is a very rare occurrence. In our case, the HFS was triggered by compression of the anterior inferior cerebellar artery (AICA) loop on the facial nerve in the IAC.

Patient concerns:
A 27-year-old female presented with a 5-year history of right-sided facial twitching with no obvious course. The frequency and severity of the attacks increases when the patient was anxious or agitated which severely affected her quality of life.

Diagnosis:
Preoperative 3D-TOF magnetic resonance imaging (MRI) evaluation of cranial nerves showed that the right AICA loop had a tortuous course within the IAC and compressed the facial nerve.

Intervention:
Microvascular decompression (MVD) surgery was carried out to separate the tortuous AICA loop and facial nerve in the IAC using a Teflon pad.

Outcomes:
The abnormal muscle response disappeared intraoperatively and 2-years follow-up revealed no recurrence of her symptomatology. She is current well and go about her daily activities with no neurological deficits.

Lesson:
The attachment of the facial nerve to the tortuous AICA loop coupled with the pulsatile impulse of tortuous AICA loop may have resulted in the entrapment and compression of the CN VII in the IAC.
Testosterone and the prevention of type 2 diabetes mellitus: therapeutic implications from recent trials
Authors: Wittert Gary , Umapathysivam Mahesh M. 
Published: September 2024

Purpose of review
Type 2 diabetes (T2D) is increasing to epidemic proportions and frequently associated with obesity and a low serum testosterone concentration in men. This review valuates recent randomized controlled trials (RCTs) investigating the effect of testosterone treatment on glycemic control and T2D prevention.

Recent findings
The 2-year Testosterone for the Prevention of Type 2 diabetes Trial (T4DM) study showed that in men aged 50 years and over with visceral obesity and impaired glucose tolerance, testosterone treatment on the background of a lifestyle intervention reduced T2D risk by 40%. The Testosterone Effects on Atherosclerosis Progression in Aging Men and Testosterone Trials demonstrated modest improvements in insulin sensitivity and body composition. However, the Testosterone Replacement Therapy for Assessment of Long-Term Vascular Events and Efficacy Response in Hypogonadal Men trial found no significant glycemic benefits over 2 years. Recent data from the Diabetes Prevention Program Outcome Study support the cost efficacy and durability of metformin.

Summary
In men at high risk of T2D, treatment with testosterone prevents the disease; however, there are caveats to its use and other approaches may be more applicable. Differences in trial designs, age groups, and outcome measures contribute to varying results. HbA1C is a suboptimal outcome measure. Future research should explore potential synergies between testosterone and GLP-1 receptor agonists in T2D management, while considering cost-effectiveness.
Hypoparathyroidism and assisted reproductive technology: considerations while undergoing ovarian hyperstimulation
Authors: Arkfeld Christopher K. , Mannstadt Michael , Mahalingaiah Shruthi 
Published: September 2024

Purpose of review
Hypoparathyroidism (hypoPTH) is a rare disease that requires diligent adherence to treatment regimens to prevent hypocalcemia but also treatment-induced hypercalcemia and hypercalciuria. The menstrual cycle, pregnancy, and lactation can all impact calcium homeostasis but there is little known regarding the impact of ovarian stimulation. Furthermore, the limited reports suggest no clear association between menstrual phase and calcium balance among those with hypoPTH. With increasing patient utilization of assisted reproductive technology (ART), there is a need for better understanding the care required for patients with hypoparathyroidism pursuing fertility technology.

Recent findings
There is currently no literature available on patients with hypoparathyroidism and the impact of controlled ovarian stimulation on calcium homeostasis. We present information regarding physiologic changes in pregnancy that impact calcium homeostasis and the first case presentation of a patient with hypoparathyroidism pursuing ART.

Summary
This article provides the first insights and guidance when providing fertility care for patients with hypoparathyroidism.
Comparison of anterior vs. posterior surgery for cervical myelopathy due to OPLL: a systematic review and meta-analysis
Authors: He Qicong , Lv Zhengpin , Hu Yaoquan , Chen Chao , Zhan Enyu , Wang Xuenan , Zhang Fan 
Published: September 2024

Study design:
Systematic review and meta-analysis.

Objective:
To compare the effectiveness and safety between the anterior and posterior approach, and identify the more effective surgical approach for treating ossification of the posterior longitudinal ligament (OPLL) in the cervical spine.

Method:
This meta-analysis searched three electronic databases (PubMed, Embase, Cochrane library), including 17 randomized and non-randomized controlled studies published since 2000–2023 that compared the effectiveness and safety of anterior and posterior surgical approaches for the treatment of ossification of the posterior longitudinal ligament. Japanese Orthopaedic Association (JOA) scores, functional recovery rates, excellent and good outcomes of the surgical approaches, Visual Analogue Scale (VAS), C2–C7 angle cobb and complication were analyzed. RevMan 5.3 was utilized for data analysis.

Results:
This study suggested that there were no statistically differences between the anterior group and posterior group in terms of preoperative JOA score [WMD=0.23, 95% CI, (−0.22, 0.67), P=0.32], preoperative VAS [WMD=0.03, 95% CI, (−0.24, 0.30)], postoperative VAS [WMD=−0.16, 95% CI, (−0.47, 0.15) P=0.97] function recovery rate of patients with canal narrowing ratio less than 50–60% [WMD=−1.54, 95% CI, (−4.46, 1.38), P=0.30]. The anterior group showed higher postoperative JOA score [WMD=0.99, 95% CI, (036,1.63) P<0.05], post C2–C7 angle cobb [WMD=2.62, 95% CI, (0.36, 4.87), P=0.02] as well as function recovery rate (regardless of canal narrowing ratio) [WMD=16.05, 95% CI, (14.08, 18.03), P<0.05], especially a significant higher function recovery rate of patients with canal narrowing ratio greater than 50–60% [WMD=19.32, 95% CI, (17.25, 21.40), P<0.05]. There was a significant difference between anterior group and posterior group in complication. [OR=0.12, 95% CI, (0.01, 0.24), P<0.05].

Conclusion:
Based on the study’s finding, The study suggested that when the conservative treatment for OPLL is unsatisfied, the surgical approach of entering through the anterior approach is a better choice. Nevertheless, it is still necessary to consider the specific situation of the patient. One of the next research directions is how to reduce the complications of anterior surgery.
Brown Adipose Tissue Improves Angiogenesis and M2 Macrophage Polarization in Burn Wounds by Activating IL-17 Signaling
Authors: Zhou Shaolong , He Yufei , Lin Jiayan , Yang Fei , Zhou Wenqing , Cai Junrong , Liao Yunjun , Lu Feng 
Published: September 2024

Background:
Burn wound healing is a complex physiological process that requires complicated regulation by different cells and tissues. Brown adipose tissue (BAT) plays a key role in the hypermetabolic response to severe burns. However, it is unclear whether BAT contributes to burn wound healing.

Methods:
Mice were divided into two groups: brown adipose tissue removal group (BR group) and control group. Burn wounds were created on the backs of mice (weighing 20–25g), who were exposed to 100°C hot water for 12 seconds using a homemade burn tube, resulting in a burned area measuring 10 mm in diameter. The treatments were applied once a day for 10 days. Full-thickness wound tissue was collected on days 1, 4, 7, 10, and analyzed by immunostaining of CD31，α-SMA+, F4/80 and CD206 (n = 3).

Results:
On days 4, 7, and 10, the wound healing rate of the control group was significantly higher than that of the BR group. In the histological analysis, evident inflammatory infiltration, severe collagen denaturation in the BR group. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that the IL-17 pathway was enriched and related genes were up-regulated in the heat map. Immunostaining and transcriptional analyses revealed that angiogenesis and fibroblast were enhanced in the control group, fewer CD206-positive M2 macrophages and higher levels of inflammatory infiltration in the BR group.

Conclusions:
Brown adipose tissue may reduce inflammatory signaling in burn wounds by increasing the IL-17A-HIF1α axis and driving M2 macrophage polarization.
Predictive modelling of Immunogenicity to Botulinumtoxin A Treatments for Glabellar Lines
Authors: Rahman Eqram , Carruthers Jean D A , Rao Parinitha , Yu Nanze , Philipp-Dormston Wolfgang G , Webb William Richard 
Published: September 2024

Introduction:
Botulinum toxin A (BoNT-A), derived from Clostridium botulinum, is widely used in medical and aesthetic treatments. Its clinical application extends from managing chronic conditions like cervical dystonia and migraine to reducing facial wrinkles. Despite its efficacy, a significant challenge associated with BoNT-A therapy is immunogenicity, where the immune system produces neutralising antibodies (NAbs) against BoNT-A, reducing its effectiveness over time. This issue is critical for patients requiring repeated treatments. The study aims to compare FDA-approved BoNT-A products, examining the factors influencing NAbs development using advanced machine learning techniques.

Method:
This research analysed data from randomised controlled trials (RCTs) involving five main BoNT-A products. The study selected trials based on detailed immunogenic responses to these treatments, particularly for glabellar lines. Machine learning models, including logistic regression, random forest classifiers, and Bayesian logistic regression, were employed to assess how treatment specifics and BoNT-A product types affect the development of NAbs.

Results:
Analysis of 14 studies with 8,190 participants revealed that dosage and treatment frequency are key factors influencing the risk of NAbs development. Among BoNT-A products, IncobotulinumtoxinA shows the lowest, and AbobotulinumtoxinA the highest likelihood of inducing NAbs. The study's machine learning and logistic regression findings indicated that treatment planning must consider these variables to minimise immunogenicity.

Conclusion:
The study underscores the importance of understanding BoNT-A immunogenicity in clinical practice. By identifying the main predictors of NAbs development and differentiating the immunogenic potential of BoNT-A products, the research provides insights for clinicians in optimising treatment strategies. It highlights the need for careful treatment customisation to reduce immunogenic risks, advocating for further research into the mechanisms of BoNT-A immunogenicity.
A 12-Year Analysis of Demand and Supply for Hand Surgery Training in the United States
Authors: Silvestre Jason , Chang Benjamin , Levin L Scott , Daly Charles A , Daley Dane N 
Published: September 2024

Introduction:
The consistent recruitment of quality applicants is critical to the integrity of the US surgical workforce. This study assesses the demand and supply for hand surgery training in the US.

Methods:
This was a cross-sectional analysis of US hand surgery fellowship applicants from 2012 to 2023. Data were obtained from the National Resident Matching Program. Primary outcomes were annual number of hand surgery fellowship applicants, training positions, training programs, and unfilled training positions. Temporal trends were assessed with linear regression.

Results:
The annual number of hand surgery programs (73 to 93, 27.4% increase, P<0.001) and training positions (150 to 193, 28.7% increase, P<0.001) increased over the study period while the annual number of applicants remained unchanged (199 to 198, P=0.431). The applicant-to-training position ratio decreased over the study period (1.3 to 1.0, P=0.001). The overall match rate increased (73.4% to 95.5%, P<0.001) along with the mean number of submitted ranks per applicant (8.2 to 14.9, P<0.001). The distribution of US allopathic graduates, (91.9%), US osteopathic graduates (4.6%) and international medical graduates (3.5%) was similar over the study period. The rate of applicants matching at their first-choice fellowship increased over the study period (28.1% to 38.4%, P=0.003) while the rate of unmatched applicants decreased (26.6% to 4.5%, P<0.001).

Conclusion:
There was consistent growth in the number of hand surgery programs and training positions without a commensurate increase in the number of interested applicants. Increased recruitment efforts are necessary to ensure adequate demand for available training positions in hand surgery.