bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early life stress modulates neonatal somatosensation and the transcriptional profile of immature sensory neurons
Authors: Harbour Kyle , Eid Fady , Serafin Elizabeth , Hayes Madailein , Baccei Mark L. 
Published: October 2024

Abstract
Early life stress (ELS) is associated with an increased risk of experiencing chronic pain during adulthood, but surprisingly little is known about the short-term influence of ELS on nociceptive processing in the immature nervous system and the concomitant effects on somatosensation in the neonate. Here, we investigate how ELS modulates pain in neonatal mice and the transcriptional and electrophysiological signatures of immature dorsal root ganglia (DRG). Shortly after the administration of a neonatal limiting bedding (NLB) paradigm from postnatal days (P)2 to P9, both male and female pups exhibited robust hypersensitivity in response to tactile, pressure, and noxious cold stimuli compared with a control group housed under standard conditions, with no change in their sensitivity to noxious heat. Bulk RNA-seq analysis of L3-L5 DRGs at P9 revealed significant alterations in the transcription of pain- and itch-related genes following ELS, highlighted by a marked downregulation in Sst, Nppb, Chrna6, Trpa1, and Il31ra. Nonetheless, ex vivo whole-cell patch-clamp recordings from putative A- and C-fiber sensory neurons in the neonatal DRG found no significant changes in their intrinsic membrane excitability following NLB. Overall, these findings suggest that ELS triggers hyperalgesia in neonates across multiple pain modalities that is accompanied by transcriptional plasticity within developing sensory neurons. A better understanding of the mechanisms governing the interactions between chronic stress and pain during the neonatal period could inform the future development of novel interventional strategies to relieve pain in infants and children who have experienced trauma.
Analysis of treatment benefits and prognostic factors for posttransplant HCC recurrence in a large Euro-American-Asian cohort
Authors: Li Zhihao , Chen Itsuko Chih-Yi , Centonze Leonardo , Magyar Christian T.J. , Choi Woo Jin , Shah Sachin , O’Kane Grainne M. , Vogel Arndt , De Carlis Luciano , Lerut Jan , Lai Quirino , Mehta Neil , Chen Chao-Long , Sapisochin Gonzalo 
Published: October 2024

Posttransplant HCC recurrence significantly impacts survival, yet its management is challenging due to limited evidence. With recent advancements in HCC treatment, updated data on managing recurrent diseases are needed. In this retrospective study across 6 centers (2000–2022), we employed Cox proportional-hazards regression and log-rank tests to assess survival differences. A prognostic score model was developed to categorize patient survival. The efficacy of tyrosine kinase inhibitors was evaluated through propensity score matching. In our study, 431 of 3349 (14%) patients with HCC who underwent transplantation developed recurrence within a median interval of 18 (IQR: 9–32) months. One hundred forty-seven (34%) underwent curative-intent treatments, 207 (48%) received palliative treatments, and 77 (18%) were given best-supportive care. Patients undergoing curative-intent treatments had better survival from the time of recurrence with a median survival of 45 (95% CI: 36–63) months and 1/3/5-year survival of 90%/56%/43% compared to those receiving noncurative treatments (median: 11 [95% CI: 10–13] mo, 1/3/5-y survival of 46%/10%/7%, log-rank p < 0.001). Patients with recurrence diagnosed in the era 2018–2022 showed improved survival over the previous era (HR 0.64 [95% CI: 0.47–0.86]). Multivariable analysis identified 5 prognostic factors: ineligibility for curative-intent treatment (HR: 3.5 [95% CI: 2.7–4.6]), recurrence within 1 year (HR: 1.7 [95% CI: 1.3–2.1]), poor tumor differentiation (HR: 1.5 [95% CI: 1.1–1.9]), RETREAT score ≥3 (HR: 1.4 [95% CI: 1.1–1.8]), and alpha-fetoprotein at recurrence ≥400 ng/mL (HR: 1.4 [95% CI: 1.1–1.9]). These factors contributed to a prognostic scoring system (0–9) that stratified patients into 3 prognosis groups. Both propensity score-matched analysis and multivariable regression indicated that lenvatinib was not statistically superior to sorafenib in terms of efficacy. Curative-intent treatments should be advocated for patients with posttransplant recurrence whenever possible. Prognostic factors linked to aggressive tumor biology significantly influence survival. Advancements in HCC management have improved survival outcomes over the past 5 years.
Evaluation of brain metabolism using F18-FDG PET/CT imaging in patients diagnosed with lung cancer
Authors: Şen Ahmet E. , Kaya Buğra , Bozcuk Hakan Ş. , Şahin Özlem , Uyar Mehmet , Artaç Mehmet , Erol Mustafa 
Published: October 2024

Objectives
Brain imaging of regional metabolic changes in cancer patients can provide insights into cancer biology. We aimed to detect regional metabolic changes in the brains of untreated lung cancer patients without brain metastases using 2-deoxy-2-[18F]fluoroglucose PET/computed tomography.

Methods
The study included 44 lung cancer patients and 17 non-cancer patients as controls. Standardized uptake value (SUV) mean values of 68 different brain regions were recorded, and their ratios to whole brain and brainstem SUVmean were calculated.

Results
Comparisons between the groups showed significant reductions in the frontal lobe, inferior temporal gyrus, and right cingulate and paracingulate gyrus ratios in the patient group. Conversely, the right nucleus caudatus and right pallidum ratios were elevated. Correlation analysis with total lesion glycolysis (TLG) revealed positive correlations in the basal ganglia, right insula, amygdala, and right hippocampus ratios. Negative correlations were observed in the left frontal lobe and some temporal and parietal regions.

Conclusions
While most brain regions showed reduced metabolism, potentially due to tumor-brain glucose competition, others were preserved or positively correlated with TLG, suggesting a link to poor prognosis. The reduced metabolism in the frontal lobe might be associated with depression and cognitive decline in cancer patients.
Spontaneous transomental hernia: a case report of a rare internal hernia with a challenging diagnosis
Authors: Ben Khalifa Mohamed , Ghannouchi Mossaab , Sarraj Achref , Aouadi Sabri , Maatouk Mohamed , Boudokhane Moez 
Published: October 2024

Introduction and Importance:
Transomental hernia (TOH) is an extremely rare clinical condition that represents 1–4% of all internal hernias. Spontaneous TOH occurs in patients with no history of surgery or previous abdominal trauma. It happens after protrusion of the abdominal viscera, commonly the small bowel loops through a defect on the great omentum.

Presentation of the case:
We present a case of occlusion due to TOH in a 66-year-old man who underwent a laparotomy, and operative exploration showed 10 cm of small bowel incarcerated through a defect in the right side of the greater omentum of 4 cm in diameter.

Discussion:
The diagnosis is usually delayed because symptoms are nonspecific. Postoperative morbidity and mortality are important because patients present most frequently with gangrenous bowel, making morbidity and mortality higher. Therefore, it constitutes a critical surgical emergency and must be quickly recognized and managed. Computed tomography (CT) scan plays a prominent role in diagnosis. Midline laparotomy is the main emergency approach for patients with unknown bowel obstruction. Some authors suggest a laparoscopic approach, but it requires a surgeon’s experience and propitious patient’s conditions.

Conclusion:
TOH is the rarest type of internal hernia with extremely difficult preoperative diagnosis due to nonspecific semiology. This type of hernia has the highest morbidity and mortality rates of all internal hernias. Thus, it must be suspected whenever there is bowel obstruction of unknown origin and quickly managed.
Pharmacological Dissociation in Hemicrania Continua With Persistent Visual Aura Evolved From Episodic Migraine
Authors: Grosberg Brian M. , Friedman Deborah I. , Robbins Matthew S. , Verhaak Allison M.S. 
Published: October 2024

Objective:
To report a case of hemicrania continua (HC) and persistent visual aura without infarction in a patient with previous episodic migraine with visual aura, whose persistent aura symptoms improved only after treatment with divalproex sodium.

Background:
Once regarded as highly specific for migraine, visual aura has been associated with trigeminal autonomic cephalalgias, including HC. In previous descriptions of HC and episodes of typical visual aura, the aura occurred exclusively with severe headache exacerbations and, like the pain, resolved with indomethacin.

Methods:
Case report and literature review.

Results:
A 54-year-old man with a history of episodic migraine with visual aura reported a gradual onset of HC with persistent visual aura of 15 months duration. General medical and neurological examinations were normal, including imaging studies. HC's headache responded to indomethacin, while the visual aura was recalcitrant, only improving with oral divalproex sodium treatment.

Conclusion:
As our patient experienced HC, which evolved from episodic migraine, we hypothesize that migraine and HC may share a common pathophysiology. However, the persistence of the visual aura, despite the abolition of pain and autonomic features with a therapeutic dose of indomethacin, and the subsequent successful treatment of the aura with divalproex sodium, suggest that aura and HC headache arise from distinct and dissociable mechanisms.
West Nile Virus Neuroinvasive Disease
Authors: Taga Arens , Filippatou Angeliki , Divakaruni Sai Sachin , Pardo Carlos , Green Kemar 
Published: October 2024

Background and Objective:
West Nile neuroinvasive disease (WNND) displays a wide range of clinical manifestations due to its involvement of various structures within the central nervous system and peripheral nervous system, often including prolonged unresponsiveness as the presenting symptom.

Methods and Results:
We describe 2 patients presenting with coma and bilateral thalamic lesions on brain magnetic resonance imaging, found to have WNND after extensive workup. These cases illustrate some of the challenges associated with evaluating coma in general and specifically in diagnosing WNND.

Conclusion:
The clinical diagnosis of WNND requires a high index of suspicion, particularly in immunocompromised and elderly patients. Brain and spine magnetic resonance imaging findings can help narrow down the differential diagnosis, although other diseases may manifest similarly. Serological studies on the cerebrospinal fluid are essential to confirm the diagnosis but have inherent limitations. Given these challenges, WNND should be considered in all patients living in endemic areas who present with unexplained altered mental status during the late summer and early fall seasons.
Concurrent Intracranial and Spinal Dural Metastases Demonstrated by 68Ga-DOTATATE PET/CT With Negative 123I-MIBG SPECT/CT in a Pediatric Neuroblastoma Patient
Authors: Qiao Haizhou , Li Siqi , Xu Yanfeng , Wang Wei , Yang Jigang 
Published: October 2024

Abstract
Contrast enhancement MRI of the brain and spine showed abnormal enhancement in intracranial and spinal dural lesions in a 6-year-old boy with high-risk neuroblastoma, suggesting the possibility of dural metastases. 123I-MIBG SPECT/CT did not show any abnormal MIBG accumulation in these lesions. However, 68Ga-DOTATATE PET/CT showed obvious DOTATATE uptake in these metastatic lesions. Surgical pathology confirmed the diagnosis of intracranial dural metastasis. Concurrent intracranial and spinal dural metastases from neuroblastoma demonstrated by 68Ga-DOTATATE PET/CT with negative 123I-MIBG SPECT/CT have not been reported previously.
Detection and Response Evaluation of Extramedullary and Medullary Blast Crisis in Chronic Myeloid Leukemia on 18F-FDG PET/CT
Authors: Behera Abhishek , Prabhu Meghana , Khanna Gaurav , Sawhney Shikhar , Mishra Pravas Chandra 
Published: October 2024

Abstract
FDG PET/CT imaging is usually not routinely undertaken in patients of chronic myeloid leukemia (CML). We present a case of CML on tyrosine kinase inhibitor treatment with disease control indicated by BCR-ABL1 quantitative reverse transcription–polymerase chain reaction, who underwent PET/CT for evaluation of recent onset vision deterioration with subretinal exudates on ophthalmological examination. PET CT detected FDG-avid sinonasal thickening and bilateral marrow lesions. These lesions on histopathological sampling, examination revealed extramedullary and intramedullary CML blast crisis. Patient was then treated with steroids and change of tyrosine kinase inhibitor for the CML blast crisis. FDG PET/CT done subsequently was able to demonstrate morphological and metabolic response in the lesions.
Positive 68Ga-FAPI-04 PET/MRI and Negative 18F-FDG PET/CT Imaging in Incidental Appendiceal Goblet Cell Adenocarcinoma
Authors: Sun Yu , Wang Haiyan , Chen Xing , Wang Weilun , Zhao Jun 
Published: October 2024

Abstract
A 70-year-old woman presented with left ovarian mass and thickened peritoneum. 18F-FDG PET/CT showed no significant FDG-avid in the whole body. 68Ga-FAPI-04 demonstrated abnormally high FAPI uptake in the ileocecal region, left ovarian lesion, and thickened peritoneum. The postoperative pathology confirmed the appendiceal goblet cell adenocarcinoma. This case highlights the superior and innovative diagnostic role of 68Ga-FAPI-04 in appendiceal goblet cell adenocarcinoma and its metastases.
Value of 68Ga-DOTATATE PET/CT in Follow-up of Renal Cell Carcinoma With Multiple Atypical Metastatic Sites
Authors: Filizoglu Nuh , Ozguven Salih , Ones Tunc , Turoglu Halil Turgut , Erdil Tanju Yusuf 
Published: October 2024

Abstract
The development of late metastatic recurrence after nephrectomy is a well-known characteristic of renal cell carcinoma (RCC). Correct diagnosis is often challenging due to the long time between primary tumor excision and the development of metastases. 68Ga-DOTATATE PET/CT has the potential to be employed in the follow-up of RCC, because RCC expresses somatostatin receptors. However, limited cases have been reported demonstrating 68Ga-DOTATATE uptake in the metastases of RCC. Herein, we describe a unique case of RCC with multiple atypical metastatic sites, emphasizing the usefulness of 68Ga-DOTATATE PET/CT in the evaluation and follow-up of patients with RCC.
Lateral Sacral Artery Perforator Flap as a New Option in Myelomeningocele Reconstruction
Authors: Bas Soysal , Goker Burcu 
Published: October 2024

Background
This study aims to present lateral sacral artery perforator (LSAP) flaps as a new option for myelomeningocele reconstruction and to discuss their advantages and disadvantages.

Methods
Eleven patients were included in the study, and reconstruction was performed with 22 LSAP flaps. Patients were evaluated in age, gender, birth weight, kyphosis status, defect localization and size, flap size, operation time, amount of bleeding, and postoperative complications.

Results
Sixteen flaps were raised from the first and 6 from the second LSA. The average time for soft tissue reconstruction was 57 minutes. The mean blood loss was 11.1 mL/kg. No cerebrospinal fluid leakage was detected in any patient. In 1 of the 22 flaps, venous congestion did not completely resolved and resulted in partial necrosis secondary to venous insufficiency. In 2 patients, minimal wound dehiscence was detected in the distal part of the flap. No wound infections, hematomas, donor site complications, or seromas were observed in any patient.

Conclusions
Considering that myelomeningoceles are often located in the lumbar region, we think that LSAP flaps will be a new option among other flaps. Additionally, if other flaps are used in the neonatal period, it may be a good alternative for pressure sore reconstruction in the kyphotic area.
Effectiveness of Colonoscopy in Reducing Incidence of Late-stage Colorectal Cancer Within an Opportunistic Screening Program
Authors: Casas Maria A. , Pereyra Lisandro , Angeramo Cristian A. , Monrabal Lezama Manuela , Schlottmann Francisco , Rotholtz Nicolás A. 
Published: October 2024

Background:
The effectiveness of colonoscopy in preventing colorectal cancer (CRC) within opportunistic screening programs has not been clearly established. The aim of this study was to analyze the effectiveness of colonoscopy within an opportunistic screening program using nested case-control study.

Methods:
Subjects who received a diagnosis of CRC (CG) between the ages of 50 and 90 years were included and matched by age and gender in a 1:5 ratio with patients without CRC diagnosis (COG) during the period 2015 to 2023. Using conditional regression analyses, we tested the association between screening colonoscopy and CRC. Subgroup analyses were then performed for CRC location, endoscopist specialty, and colonoscopy quality.

Results:
Of the 134 patients in CG, 19 (14.18%) had a colonoscopy in the preceding 5 years compared with 258 out of 670 (38.51%) in COG (AOR, 0.24; 95% CI: 0.14-0.41). Any colonoscopy was strongly associated with decreased odds for left-sided CRC (AOR, 0.09; 95% CI: 0.04-0.24) but not for right-sided CRC (AOR, 0.58; 95% CI: 0.29-1.17). Only complete colonoscopy (AOR, 0.41; 95% CI: 0.19-0.89) and colonoscopy with satisfactory bowel preparation (AOR, 0.38; 95% CI: 0.15-0.98) were associated with decreased odds for right-sided CRC. No significant differences in colonoscopy outcomes were found when stratifying by endoscopist specialty.

Conclusions:
In the setting of an opportunistic screening program, exposure to any colonoscopy significantly reduced left-sided CRC incidence; however, only high-quality colonoscopy was associated with a lower incidence of right-sided CRC. Therefore, every possible effort should be made to optimize the quality and cost-effectiveness of colonoscopy within an opportunistic screening program.
Is Intraoperative Muscle Motor Evoked Potential Variability due to Fluctuating Lower Motor Neuron Background Excitability?
Authors: Segura Martín J. , Talarico María E. , Piantoni Lucas , Noel Mariano A. , MacDonald David B. 
Published: October 2024

Purpose:
This pilot study tests the contribution of fluctuating lower motor neuron excitability to motor evoked potential (MEP) variability.

Methods:
In six pediatric patients with idiopathic scoliosis and normal neurologic examination, cascades of 30 intraoperative H-reflexes (HRs) and MEPs were evoked in the soleus muscle using constant-current stimulators and recorded through surface electrodes with a 20-second interstimulus interval. First, HRs were obtained with an intensity capable of evoking the maximum response. Subsequently, MEPs were obtained with double trains and an intensity of 700 to 900 mA. Coefficients of variation (CVs) of amplitude and area under the curve from HRs and MEPs were compared using a paired two-tailed Student t test. Coefficients of correlation between the mean CVs of HR and MEP parameters were also assessed.

Results:
Pooling the results from the six patients, the mean CV of amplitude from the MEP (24.6 ± 3) was significantly higher than that from the HR (3.5 ± 4.4) (P = 0.000091). The mean CV of the MEP area under the curve (21.8 ± 4.8) was also statistically significantly higher than that from the HR area under the curve (3.4 ± 4.5) (P = 0.00091). The coefficients of correlation of the mean CV of the HR amplitude and area under the curve compared with the corresponding values of the MEP were low (r = 0.29) and very low (r = 0.03), respectively.

Conclusions:
Our results suggest that fluctuations in lower motor neuron excitability may be less important than previously thought to explain the magnitude of MEP variability. The efficacy of corticospinal volleys to recruit a larger and more stable lower motor neuron population would be critical to obtain reproducible MEPs.
Chronobiological Spatial Clusters of Cortical Regions in the Human Brain
Authors: Arya Ravindra , Petito Gabrielle T. , Housekeeper Jeremy , Buroker Jason , Scholle Craig , Ervin Brian , Frink Clayton , Horn Paul S. , Liu Wei , Ruben Marc , Smith David F. , Skoch Jesse , Mangano Francesco T. , Greiner Hansel M. , Holland Katherine D. 
Published: October 2024

Purpose:
We demonstrate that different regions of the cerebral cortex have different diurnal rhythms of spontaneously occurring high-frequency oscillations (HFOs).

Methods:
High-frequency oscillations were assessed with standard-of-care stereotactic electroencephalography in patients with drug-resistant epilepsy. To ensure generalizability of our findings beyond patients with drug-resistant epilepsy, we excluded stereotactic electroencephalography electrode contacts lying within seizure-onset zones, epileptogenic lesions, having frequent epileptiform activity, and excessive artifact. For each patient, we evaluated twenty-four 5-minute stereotactic electroencephalography epochs, sampled hourly throughout the day, and obtained the HFO rate (number of HFOs/minute) in every stereotactic electroencephalography channel. We analyzed diurnal rhythms of the HFO rates with the cosinor model and clustered neuroanatomic parcels in a standard brain space based on similarity of their cosinor parameters. Finally, we compared overlap among resting-state networks, described in the neuroimaging literature, and chronobiological spatial clusters discovered by us.

Results:
We found five clusters that localized predominantly or exclusively to the left perisylvian, left perirolandic and left temporal, right perisylvian and right parietal, right frontal, and right insular-opercular cortices, respectively. These clusters were characterized by similarity of the HFO rates according to the time of the day. Also, these chronobiological spatial clusters preferentially overlapped with specific resting-state networks, particularly default mode network (clusters 1 and 3), frontoparietal network (cluster 1), visual network (cluster 1), and mesial temporal network (cluster 2).

Conclusions:
This is probably the first human study to report clusters of cortical regions with similar diurnal rhythms of electrographic activity. Overlap with resting-state networks attests to their functional significance and has implications for understanding cognitive functions and epilepsy-related mortality.
A Prototype Machine Learning Pipeline for Assessing and Tracking Keloid Scars
Authors: Abdolahnejad Mahla , Zandi Armita , Wong Jordan , Chan Hannah O. , Lin Victoria , Jeong Hyerin , Joshi Rakesh , Wong Joshua N. , Hong Colin 
Published: October 2024

AbstractDysregulated wound healing, marked by excessive collagen deposition, is the hallmark to keloid scar formation. Current methods for assessing keloids in clinical settings rely heavily on subjective measures, which are prone to interrater variability. This study introduces a machine learning (ML) pipeline prototype, designed to automate the detection, measurement, and colour analysis of keloid scars. Using a convolutional neural network (CNN), the pipeline segments keloid lesions from 2D images, applies fiducial markers for accurate size measurement, and utilizes K-Means clustering for colorimetry analysis. The CNN achieved a classification accuracy of 98% on a small test dataset. Segmentation was further refined using binary masks and contour-based detection.Colorimetry analysis revealed heterogeneity in pigmentation across keloid lesions, was varied by patient skin type, and tracked changes over time. The pipeline was validated on patients over a 5–6-month period, accurately detecting changes in keloid size and colour. While the algorithm was highly effective in most cases, challenges were noted in patients with nascent keloid or those with dark skin tones where the contrast between keloid and skin was insufficient for accurate segmentation. Additionally, early-stage keloid detection showed inconsistencies in defining lesion boundaries, particularly when keloids expanded rapidly. Despite these limitations, the ML pipeline presents a promising tool for objective keloid assessment, offering a practical, accessible, and accurate alternative to current clinical practices.