bluuebunny/crossref_metadata_2025_split huggingface dataset:
The pathways of unaccompanied foreign minors evaluated by the social workers: a case study in Italy
Authors: Terzera Laura , Bonomi Paolo 
Published: October 2024

AbstractSocial workers, who are responsible for unaccompanied minors (UAM), have in-depth knowledge of those minors’ backgrounds and the reception pathways they follow. The social workers support key aspects of UAM integration such as learning the host country’s language, school integration and vocational training. Via 566 interviews collected through a survey carried out in collaboration with the Municipality of Milan, we asked social workers to provide an overall evaluation of the progress of each reception path, to test a synthetic indicator capable of effectively measuring UAM progress. We confirmed the reliability of this indicator, as the results correlated with outcomes used in the literature to assess UAM pathways, such as learning the host country's language, uninterrupted schooling and training, and deviant behaviour related to crime and drug abuse. We used ordinal logistic regression to identify the UAM characteristics associated with the overall operator’s evaluation. Our analysis showed that the duration of stay in Italy before and after the start of the reception process had an impact on the social workers’ evaluations, as did certain pre-arrival characteristics such as country of origin, years of study in the home country and underlying motivations for migrating. Finally, the psychological vulnerability of a significant number of UAM, often linked to traumatic experiences leading to migration or experienced during the journey, significantly penalises the success of reception pathways.
Novel EXT1 variants cause divergent symptom severity in multiple cartilaginous exostoses: a family report
Authors: Atasever Yildirim Gozde , Anlas Ozlem , Kisla Ekinci Rabia Miray 
Published: October 2024

Abstract
Background
Multiple cartilaginous exostoses (MCE) are a rare genetic disorder characterized by multiple osteochondromas in the metaphysis of long bones.
Case Presentation.
We report a 15-year-old male patient, his father, and his brother, all presenting varied severity of the same symptom. The patient exhibited symptoms since infancy, with osteochondromas affecting mobility and causing joint deformities. Whole exome sequencing identified a pathogenic NM_000127.3(EXT1):c.1056 + 2 T > G and a likely pathogenic NM_000127.3(EXT1):c.1047G > T variant in the EXT1 gene, both novel.

Conclusions
Despite three decades since the discovery of the EXT1 gene, MCE diagnosis may be delayed until adolescence or adulthood. This report contributes to clinical understanding, emphasizing the importance of early diagnosis, genetic analysis, and potential treatment approaches, to mitigate long-term deformities and complications in MCE patients.
Intercoronary communication: a rare coronary anomaly
Authors: Adimoulame Seenu Prasanth , Palakshachar Anand , Ramalingam Rangaraj , Moorthy Nagaraja , Kumbhalkar Anushree 
Published: October 2024

Abstract
Background
Intercoronary communication also known as coronary arcade or coronary cascade is a rare coronary artery anomaly with an incidence of only 0.002% in patients undergoing angiography. This case emphasizes the importance of recognizing this rare anomaly and highlights its clinical significance.

Case presentation
We report a case of intercoronary communication in a 56-year-old female who presented with acute chest pain and ST-segment depression in the lateral leads. High-sensitivity troponin-T was elevated and transthoracic echocardiography revealed normal left ventricular function with no regional wall motion abnormality. Hence, the diagnosis of acute coronary syndrome – non-st-elevation myocardial infarction was considered. Coronary angiography revealed a 95% focal stenosis in the major obtuse marginal artery (OM). The right coronary artery (RCA) angiogram revealed a single abnormal channel communicating the right posterolateral branch (PLV) and the distal left circumflex artery (LCX) with retrograde opacification of the proximal LCX, left main coronary artery (LMCA) and left aortic sinus. After she underwent revascularization with the drug-eluting stent to the OM. CT-coronary angiography confirmed the presence of intercoronary communication (ICC) between the right posterolateral branch and the distal LCX artery. No active intervention was done for the ICC. Over a year of follow-up, our patient remained asymptomatic.

Conclusions
Angiographically and anatomically, collaterals and intercoronary communications should be differentiated. Obstructive coronary artery disease leads to the development of collaterals, which are typically less than 1 mm in diameter, multiple and tortuous. However, ICC tends to be single and straight, usually seen without obstructive disease with unidirectional or bidirectional flow. Histologically, collaterals consist of endothelium supported by poorly organized collagen, muscle and elastic fibers. Meanwhile, ICCs resemble epicardial vessels in that they have a well-defined muscular layer. This case emphasizes the importance of recognizing this rare coronary anomaly and distinguishing it from collaterals to help in accurate diagnosis. Although they can provide an efficient blood supply to the jeopardized myocardium and can aid as a channel during coronary interventions, they can also cause myocardial ischemia by coronary steal.
Early structural valve deterioration following transcatheter aortic valve implantation in a patient with Scheie syndrome: a case report
Authors: Yanagino Yusuke , Kainuma Satoshi , Toda Koichi , Kawamura Ai , Kawamura Takuji , Yoshioka Daisuke , Taira Masaki , Shimamura Kazuo , Miyagawa Shigeru 
Published: October 2024

Abstract
Background
Scheie syndrome, an attenuated subtype of mucopolysaccharidosis type I, is a rare storage disease that causes progressive glycosaminoglycans (GAGs) accumulation. Cardiovascular disorders determine the prognosis, and cardiac valve abnormalities are the most common cause. The patients are usually young so mechanical valve replacement is often performed, but because of the features of this disease, the surgical treatment is very risky. Recently, transcatheter aortic valve implantation (TAVI) has been reported as an alternative choice for aortic stenosis, but optimal choice is still unclear. Here, we introduce a patient that underwent TAVI and refer to the histological finding of a biological valve extracted in relation to GAGs accumulation.

Case presentation
A 54-year-old woman with Scheie syndrome underwent valve surgeries three times throughout her whole life. At age 41, she received a mitral valve replacement with a mechanical valve for mitral stenosis. She promptly developed severe diastolic dysfunction and low output syndrome after the release of aortic clamping, thus requiring temporary mechanical circulatory support4. At age 51, she suffered from heart failure due to severe aortic stenosis and underwent TAVI because conventional aortic valve replacement (AVR) was deemed too risky. Three years later, her heart failure relapsed, and an echocardiogram unexpectedly revealed thickened bioprosthetic valve leaflets and a significant pressure gradient across the valve, consistent with early structural valve deterioration. AVR was performed via median sternotomy with a mechanical valve. As with the first operation, she presented refractory heart failure requiring mechanical circulatory support and was meticulously managed. However, she steadily showed worsening of multiple organ systems and died 9 days after the operation. Pathological autopsy and histological examination revealed accumulation of tissue with GAGs on the leaflets of the bioprosthetic valve of TAVI, which may have been the cause of early structural valve deterioration.

Conclusion
For patients with Scheie syndrome, a biological valve can be compromised by the accumulation of GAGs, thereby causing early SVD. These findings may support valve selection for these high-risk patients.
Self-Nanoemulsifying/ Self-Assembled Cubic Nanoparticles Lyophilized Tablet: A Novel Biphasic Release Approach to Enhance the Bioavailability of a Lipophilic Drug
Authors: Farag Michael M. , El-Sebaie Wessam , Basalious Emad B. , El-Gazayerly Omaima N. 
Published: October 2024

AbstractThis study aimed to prepare a combined self-nanoemulsifying and self-assembled cubic nanoparticles (SNE/SAC) lyophilized tablet eliciting biphasic release pattern escorted with enhanced bioavailability for drugs hampered with slow dissolution and poor absorption. The antimuscarinic Darifenacin hydrobromide (DRF) was selected as a model drug used to treat overactive bladder-associated nocturia. The DRF-SNE/SAC lyophilized tablet was prepared so that upon reconstitution a mixture of DRF-loaded cubic nanoparticles and nanoemulsion dispersion is obtained. The nanoemulsion portion is responsible for the fast release followed by controlled release of the remaining dose loaded in cubic nanoparticles. A comparative pharmacokinetic study adopting randomized crossover design in male albino rabbits versus marketed product Frequefenacine® tablet was performed. Half of the dose (52.05% ± 4.21%) was rapidly released in the first 4 h followed by sustained release of the remaining drug where (90.16% ± 8.85%) was released in 24 h. The tested system showed 2.45 folds higher % relative bioavailability and 1.57 folds higher Cmax with 1.62 longer residence time relative to reference product. The results endow the ability of the developed DRF-SNE/SAC lyophilized tablet to be considered as a propitious approach for the treatment of overactive bladder-associated nocturia without midnight dose administration.
Graphical Abstract
Effect of Liquid Load Level and Binder Type on the Tabletability of Mesoporous Silica Based Liquisolids
Authors: Appelhaus Jan , Steffens Kristina E. , Wagner Karl G. 
Published: October 2024

AbstractMesoporous silica offers an easy way to transform liquids into solids, due to their high loading capacity for liquid or dissolved active ingredients and the resulting enhanced dissolution properties. However, the compression of both unloaded and loaded mesoporous silica bulk material into tablets is challenging, due to poor/non-existing binding capacity. This becomes critical when high drug loads are to be achieved and the fraction of additional excipients in the final tablet formulation needs to be kept at a minimum. Our study aimed to investigate the mechanism of compression and tabletability dependent on the Liquid Load Level of the silica and type of filler/binder in binary tabletting mixtures. To this end, Vivapur® 101, FlowLac® 90, Pearlitol® 200 SD and tricalcium citrate tetrahydrate were selected and mixed with Syloid® XDP 3050 at various Liquid Load Levels. Compaction characteristics were analysed using the StylOne® Classic 105 ML compaction simulator. Additionally, the Overall Liquid Load (OLL) was defined as a new critical quality attribute for liquisolid tablets. The Overall Liquid Load allows straightforward, formulation-relevant comparisons between various fillers/binders, liquid components, and silica types. Results indicate strong binding capacity and high plasticity of the fillers/binders as key components for successful high liquid load silica tablet formulation. A volumetric combination of 30% Vivapur® 101 and 70% 0.75 mL/g loaded Syloid® XDP 3050 proved to be the most effective mixture, achieving an Overall Liquid Load of 36–41% [v/v] and maintaining a tensile strength of 1.5 N/mm2 with various liquid vehicles.
Graphical Abstract
Breakfast Habits in Patients Using Levothyroxine: Patient Experiences and Preferences
Authors: Willems Jeresa I A , van Twist Daan J L , Luu Inge H Y , Bianchi Rutgert , Peeters Robin P , Tummers-de Lind van Wijngaarden Roderick F A 
Published: October 2024

Abstract

Background
Levothyroxine (LT4) is recommended to be ingested in a fasting state, 30-60 minutes before breakfast to avoid interactions with food and drugs. In clinical practice, we noticed that this instruction may be inconvenient for patients. Therefore, we aimed to evaluate patient experiences and preferences concerning the recommended fasting administration of LT4.

Methods
Patients using LT4 were invited to complete a questionnaire. Regression analyses were performed to identify patient characteristics associated with taking LT4 close to or together with food and/or interfering drugs, feeling burdened with postponing breakfast, and preferring nonfasting LT4 ingestion.

Results
Of 463 invited patients, 410 completed the questionnaire (88.6%). Of these, 76.8% was female and median age was 57 years (interquartile range: 43-67). Nearly all patients (97.3%) reported to have received instruction on fasting LT4 ingestion, but only 30% adhered to this. Nonfasting LT4 intake was associated with use of co-medication (odds ratio [OR], 2.82; 95% CI, 1.77-4.47), treatment duration &gt;1 year (OR, 1.76; 95% CI, 1.02-3.04), and male sex (OR, 1.67; 95% CI, 1.03-2.70). Approximately half of the patients reported being burdened with postponing breakfast and the majority (60.5%) expressed their preference for nonfasting LT4 ingestion. Interestingly, 25% omitted breakfast and 13.4% forgot their medication because of the fasting requirement. Furthermore, the majority (68.2%) of patients that used interfering drugs stated not to be instructed to separate these drugs from LT4.

Conclusion
This study highlights the burden associated with fasting LT4 ingestion, leading to nonadherence, irregular LT4 intake, and omitting breakfast. Given the clear preferences towards nonfasting LT4 ingestion, further research into alternative nonfasting administration methods is warranted.
Acquired Partial Lipodystrophy: Clinical Management in a Pregnant Patient
Authors: Romanisio Martina , Bighetti Leonardo , Daffara Tommaso , Mollero Edoardo Luigi Maria , Pelosini Caterina , Antoniotti Valentina , Ciamparini Carola , Aimaretti Gianluca , Caputo Marina , Prodam Flavia 
Published: October 2024

Abstract

Background
Pregnancy represents an additional challenge to the complex clinical picture of lipodystrophy disorders, and the management of such conditions with related comorbidities has been underreported. This work aims to outline the risk associated with a pregnancy event for women dealing with acquired partial lipodystrophy and the need for diverse but specialized care.

Case
We report on the successful pregnancy outcome of a 28-year-old woman with an acquired partial form of lipodystrophy related to an allogenic bone marrow transplant that occurred at pediatric age. Although metabolic control was challenging, glucose levels progressively improved during the pregnancy, and triglycerides increased less than expected. The periodic monitoring of leptin levels showed a progressive increase with a peak in the third trimester (41.53 ng/mL), followed by a fast decline the day after giving birth, with a lower basal level than the prepregnancy period. However, preterm delivery occurred associated with cardiac complications in the mother.

Results
A total of 12 studies were retrieved concerning women aged 14 to 38 years with various lipodystrophy phenotypes. Diabetes and hypertriglyceridemia were the most common comorbidities. Most women had successful pregnancies despite gestational complications (including miscarriages), preterm and emergency deliveries, and newborns undergoing partum or postpartum transient or chronic complications.

Conclusion
Lipodystrophy disorders expose both mothers and children to very high risk. Intensive monitoring and care of all potential clinical complications should be planned and carried out by a multidisciplinary team before, during, and after the pregnancy. Leptin secretion during pregnancy should be investigated more deeply in these patients.
Assessing Neurosurgery Training: Accreditation Council for Graduate Medical Education Case Minimums Versus Surgical Autonomy
Authors: Venkatraman Vishal , Kelly-Hedrick Margot , Suarez Alexander D. , Dharmapurikar Rajeev , Lad Shivanand P. , Haglund Michael M. 
Published: October 2024

BACKGROUND AND OBJECTIVES:
The Accreditation Council for Graduate Medical Education (ACGME) requires neurosurgery residents to reach a set number of cases in specified procedure types (case minimums) before graduation and mandates completion of Milestones. We used the Surgical Autonomy Program, a validated method of autonomy-based resident evaluation, to determine the number of cases it took for residents to become competent and compared these with the ACGME case minimums.

METHODS:
We collected data from neurosurgery residents at Duke University on 7 procedures (tumor craniotomy, trauma craniotomy, ventriculoperitoneal shunt, anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCF), discectomy/laminectomy, and posterior thoracolumbar spinal fusion [PSF]). We defined competency as being graded at the highest autonomy level in the Surgical Autonomy Program by attending neurosurgeons for the first and second time and determined the case volume on the ACGME case log when these were achieved. These results were analyzed with summary statistics.

RESULTS:
The median case volume among residents (N = 4-8) for the first and second competency rating (and ACGME minimum) for each procedure type was found to be: tumor: 44.5 and 64.5 (min. 60), trauma: 21 and 30 (min. 60), ventriculoperitoneal shunt: 11.3 and 13 (min. 20), ACDF: 30 and 32.5 (min. 20), PCF: 24 and 40 (min. 30), discectomy/laminectomy: 28 and 36 (min. 30), and PSF: 51 and 54 (min. 30).

CONCLUSION:
We found variation in the case numbers to reach competency and that for some procedures (tumor, ACDF, PCF, discectomy/laminectomy, and PSF), most residents required more cases than the ACGME case minimums to achieve competency. The ACGME case minimums may not accurately reflect the number of cases required for neurosurgical residents to reach competency. To promote trainee-centered education, individualized, competency-based evaluation systems may be better determining readiness for graduation, including a system that builds off the established ACGME Milestones.
Early-life cisplatin exposure induces neuroinflammation and chemotherapy-induced neuropathic pain
Authors: Da Vitoria Lobo Marlene , Hardowar Lydia , Valentine Tameille , Tomblin Lucy , Guest Charlotte , Sharma Dhyana , Dickins Benjamin , Paul-Clark Mark , Hulse Richard Philip 
Published: October 2024

ABSTRACT
Chemotherapy-induced neuropathic pain (CINP) is a common adverse health-related comorbidity that manifests later in life in patients with paediatric cancer. Current analgesia is ineffective, aligning closely with our lack of understanding of CINP. The aim of this study was to investigate how cisplatin induces nerve growth factor (NGF)-mediated neuroinflammation and nociceptor sensitisation. In a rat model of cisplatin-induced survivorship pain, cisplatin induced a neuroinflammatory environment in the dorsal root ganglia (DRG), demonstrated by NGF-positive macrophages infiltrating into the DRG. Cisplatin-treated CD11b- and F4/80-positive macrophages expressed more NGF compared to those treated with vehicle control. Mouse primary DRG sensory neuronal cultures demonstrated enhanced NGF-dependent TRPV1-mediated nociceptor activity after cisplatin treatment. Increased nociceptor activity was also observed when cultured mouse DRG neurons were treated with conditioned medium from cisplatin-activated macrophages. Elevated nociceptor activity was inhibited in a dose-dependent manner by an NGF-neutralising antibody. Intraperitoneal administration of the NGF-neutralising antibody reduced cisplatin-induced mechanical hypersensitivity and aberrant nociceptor intraepidermal nerve fibre density. These findings identify that a monocyte- or macrophage-driven NGF–TrkA pathway is a novel analgesic target for adult survivors of childhood cancer.
EFX: A Simpler Approach and an (Almost) Optimal Guarantee via Rainbow Cycle Number
Authors: Akrami Hannaneh , Alon Noga , Chaudhury Bhaskar Ray , Garg Jugal , Mehlhorn Kurt , Mehta Ruta 
Published: October 2024

A Simpler Approach to the EFX Problem Envy-freeness up to any item (EFX) has emerged as a compelling fairness notion in discrete fair division. However, its existence remains one of the biggest open problems in the field. In a breakthrough, Chaudhury et al. (2020) establish the existence of EFX allocations for three agents with additive valuations through intricate case analysis. The paper “EFX: A Simpler Approach and an (Almost) Optimal Guarantee via Rainbow Cycle Number” by Akrami, Alon, Chaudhury, Garg, Mehlhorn, and Mehta offers a simpler approach for improving the EFX guarantee. They demonstrate the existence of EFX allocations for three agents when at least one has additive valuations (whereas the other two have general monotone valuations). Additionally, they nearly resolve a conjecture regarding the rainbow cycle number, leading to an (almost) tight bound for the existence of approximate EFX allocations with few unallocated items achievable through this approach.
Little disease but lots of bites: social, urbanistic, and entomological risk factors of human exposure to Aedes aegypti in South Texas, U.S.
Authors: Scavo Nicole A. , Juarez Jose G. , Chaves Luis Fernando , Fernández-Santos Nadia A. , Carbajal Ester , Perkin Joshuah , Londono-Renteria Berlin , Hamer Gabriel L. 
Published: October 2024

Background
Aedes aegypti presence, human-vector contact rates, and Aedes-borne virus transmission are highly variable through time and space. The Lower Rio Grande Valley (LRGV), Texas, is one of the few regions in the U.S. where local transmission of Aedes-borne viruses occurs, presenting an opportunity to evaluate social, urbanistic, entomological, and mobility-based factors that modulate human exposure to Ae. aegypti.

Methodology & Principal findings
Mosquitoes were collected using BG-Sentinel 2 traps during November 2021 as part of an intervention trial, with knowledge, attitudes, and practices (KAP) and housing quality surveys to gather environmental and demographic data. Human blood samples were taken from individuals and a Bitemark Assay (ELISA) was conducted to quantify human antibodies to the Ae. aegypti Nterm-34kDa salivary peptide as a measure of human exposure to bites. In total, 64 houses were surveyed with 142 blood samples collected. More than 80% of participants had knowledge of mosquito-borne diseases and believed mosquitoes to be a health risk in their community. Our best fit generalized linear mixed effects model found four fixed effects contributed significantly to explaining the variation in exposure to Ae. aegypti bites: higher annual household income, younger age, larger lot area, and higher female Ae. aegypti abundance per trap night averaged over 5 weeks prior to human blood sampling.

Conclusions
Most surveyed residents recognized mosquitoes and the threat they pose to individual and public health. Urbanistic (i.e., lot size), social (i.e., income within a low-income community and age), and entomological (i.e., adult female Ae. aegypti abundance) factors modulate the risk of human exposure to Ae. aegypti bites. The use of serological biomarker assays, such as the Bitemark Assay, are valuable tools for surveillance and risk assessment of mosquito-borne disease, especially in areas like the LRGV where the transmission of target pathogens is low or intermittent.