bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phyllodes tumor of the distal end of ureter: A report of an extremely rare case
Authors: Xu LiXia , Song PengTao , Pin JinLiang 
Published: October 2024

Abstract

Background
The phyllodes tumor (PT) is a biphasic fibroepithelial lesion which most commonly found in breast tissue, whereas they are uncommon in ureter tissue. Only one case has been documented thus far. There are some similarities in histology and clinical characteristics between this type of tumor and PT of the female breast: the lesions can be surgically removed, but some recur locally and invade directly into the breast. This case of primary phyllodes tumor of the ureter is useful for pathologists and clinicians.
Clinical and laboratorial characterization of a cohort of patients with hereditary platelet disorders
Authors: Grassi Letícia Dalla Vecchia , Okazaki Erica , Rothschild Cynthia , Villaça Paula , Orsi Fernanda Andrade , Stefanello Bianca 
Published: October 2024

Abstract

Introduction: Inherited platelet disorders (IPDs) are rare conditions characterized by altered platelet function (IPFDs) and/or reduced platelet counts (IPNDs). Diagnosing IPDs is challenging which may results in delays, misdiagnosis and unappropriated treatment. In low and middle-income countries data on these disorders are scarce. Here, we describe a cohort of IPD patients at a reference center in Brazil. Methods: A descriptive analysis was conducted on patients with suspected or diagnosed IPDs at the Thrombosis and Hemostasis outpatient clinic of the Hospital das Clinicas, University of São Paulo, Brazil. From 857 patients identified between 1998 and 2023, 60 met the eligibility criteria for suspected or confirmed IPDs. Patients with acquired causes of platelet dysfunction were excluded. Results: The cohort comprised 60 patients, 65% with IPFDs and 35%, IPNDs. Women were 75%, with a median age of 48 years. IPDs were suspected based on clinical history, family history, and laboratory tests. In the IPND group, 62% had a family history of thrombocytopenia. In the IPFD group, family history was positive in 51% of cases. Previous misdiagnosis included ITP (immune thrombocytopenia) and von Willebrand disease. The bleeding phenotype, assessed using the ISTH BAT (Bleeding Assessment Tool) score, showed a median score of 6, with IPNDs scoring lower than IPFDs. Conclusions: Identifying IPDs is essential for proper treatment and follow-up. This study emphasizes the need for careful assessment of the familial history, bleeding risk, platelet count, morphology and function in diagnosing IPDs, particularly in low resource settings without access to advanced genetic testing.
Genetic analysis of a pedigree with hereditary coagulation factor XII deficiency
Authors: Fang Weiwei , Chen Bile , Zou Anqin , Xu Fei , Qin Langyi , Yang Lihong , Wang Mingshan , Zhou Xingxing 
Published: October 2024

Abstract

Objective: Analyze the clinical phenotype and gene mutations of a family with hereditary FXII deficiency, and preliminarily explore its molecular pathogenic mechanism.
Methods: The routine coagulation indicators and related coagulation factors were measured.. Thromboelastography and thrombin generation tests simulated coagulation and anticoagulation states in vitro and in vivo. PCR direct sequencing was utilized to analyze all exons and flanking sequences of the F12 gene in the proband, confirming suspected mutations through reverse sequencing, and identifying corresponding mutation sites in family members. Using ClustalX-2.1-win to analyze the conservation of the variant, and employing online software to predict the pathogenicity of mutations.
Results: The proband exhibited significantly prolonged APTT (169.1 seconds) and a pronounced decrease in FXII:C to 1.0%. Thromboelastography testing indicated a diminished function of the endogenous coagulation system, while thrombin generation testing revealed a normal ability for thrombin production in the proband. Gene sequencing revealed that the proband harbored a deletion mutation c.303_304delCA in exon 5 and a substitution mutation c.800+1G>A in intron 8. All three bioinformatics software indicated that the mutations were pathogenic and could lead to the production of a terminator, potentially altering the structure and function of the protein.
Conclusion: The deletion mutation c.303_304delCA and substitution mutation c.800+1G>A are associated with a decreased in FXII levels in this family, with the c.800+1G>A mutation being the first reported mutation worldwide.
In-depth Exploration of Cutaneous Anthrax: Clinical and Pathological Manifestations of a Case Report
Authors: Du Yongjun , Ma Jizhou , Liu Guozhen , Chai Zhi , Han Hang , Chen Tairen , Yang Lan , Jing Li , Xu Fangjing , Fan Yucheng 
Published: October 2024

Abstract

Anthrax is an acute infectious disease caused by Bacillus anthracis, which can infect various animals and humans. Cutaneous anthrax primarily presents as infiltrative, edematous erythema, surface vesicles, hemorrhagic vesicles, and necrotic eschar; some patients may also experience systemic symptoms such as fever and leukocytosis. With economic development and improvements in public health conditions, naturally occurring cases of cutaneous anthrax have significantly decreased, leading to limited reports on the pathological manifestations of this disease. This article reports a case of a patient with cutaneous anthrax diagnosed and treated in our hospital, aiming to explore the laboratory examinations, imaging, pathological features, and clinical treatment methods of the disease. The goal is to enhance understanding of anthrax and increase vigilance in clinical practice to avoid misdiagnosis and missed diagnosis.
Effects of the Japanese traditional medicine Goreisan on adverse events affecting mucosal edema in patients with subarachnoid hemorrhage treated with clazosentan
Authors: Akamatsu Yosuke , Chida Kohei , Miyoshi Kenya , Kojima Daigo , Yoshida Koji , Misaki Toshinari , Koji Takahiro , Fujiwara Shunrou , Kubo Yoshitaka , Kashimura Hiroshi , Ogasawara Kuniaki 
Published: October 2024

Abstract

Despite successful management of pulmonary complication with fluid restriction protocol in aneurysmal subarachnoid hemorrhage (aSAH) patients treated with clazosentan, management of symptoms related to mucosal edema, such as diarrhea, stuffy nose, and difficulty in breathing, remains challenging. Hence, we investigated the effect of Goreisan shown to be effective in the treatment of symptoms related with mucosal edema in aSAH patients treated with clazosentan. Patients with aSAH who received clazosentan for vasospasm after aneurysm obliteration were prospectively enrolled in the study. Fluid balance parameters and the incidence of vasospasm, pulmonary edema, mucosal edema-related symptom (such as diarrhea and swelling of the nasal mucosa) were compared between these patients treated with Goreisan (Group G) and without Goreisan (Group NG). As results, Groups NG and G comprised 29 and 40 consecutive patients, respectively. No significant differences in fluid intake, urine volume, frequency of furosemide injection, incidence of vasospasm, pulmonary edema, or discontinuation of clazosentan treatment between the two groups were found over the treatment course, although refractory hyponatremia occurred less frequently in Group G than in Group NG (0% and 10.3%, p = 0.039, respectively). The incidence of diarrhea and the relative mucosal thickness was also significantly lower in Group G than in Group NG (7.3% and 21.9%; p = 0.0004, 113.8% vs. 175.4%; p = 0.001). Clazosentan treatment combined with diuretics and Goreisan was effective in managing diarrhea and swelling of the nasal mucosa. Our treatment protocol may be reasonably applied to patients with aSAH who are treated with clazosentan.
Reduced taurine synthesis underlies morphine-promoted lung metastasis of triple-negative breast cancer
Authors: Chen Shih-Hong , Shih Chien-Hung , Ke Ting-Ling , Hsiung Chia-Ni , Chen Kuo-Chin , Huang Zi-Xuan , Chuang Tsung-Hsien , Chen Li-Kuei , Chen Linyi 
Published: October 2024

Abstract

Background
The mechanisms underlying the progression and metastasis of triple-negative breast cancer (TNBC) in the context of extended morphine exposure remain poorly understood. Morphine consumption has been a pressing issue in many countries. While the physiological impact of extended morphine use is multifaceted, cancer patients with a history of prolonged morphine usage often result in poor prognosis.
Methods
In this study, we investigated the impact of extended morphine treatment on the transcriptional profiles of TNBC. To this end, mice were administered morphine intraperitoneally for 14 days followed by the implantation of EO771 cells, which are triple negative breast cancer cells, into their mammary fat pad. After primary tumors were removed on 38th day, a subset of mice were continuously giving saline or morphine until the 68th day. Tumor size, organ metastasis, and tumor RNA expression were analyzed.
Results
Our findings showed that prolonged exposure to morphine led to an increase in lung metastasis in the mouse model of triple-negative breast cancer. We conducted RNA sequencing analysis on tumors to compare their transcriptional profiles with or without metastasis. Through pathway analysis, we specifically examined the novel impact of morphine on the downregulation of taurine/hypotaurine biosynthesis. Given that morphine, droperidol (a dopamine receptor antagonist), and naloxone (an opioid receptor antagonist) might act through either opioid receptors or dopamine receptors, we further demonstrated that taurine mitigated EO771 cell invasion induced by morphine, but not by droperidol or naloxone treatment. Additionally, morphine treatment markedly decreased the expression of GAD1, one of the enzymes essential for taurine biosynthesis, whereas droperidol and naloxone did not.
Conclusion
The findings of morphine-induced reduction in GAD1 level and the inhibition of invasion by taurine treatment suggest that taurine could serve as a potential supplement for triple-negative breast cancer patients who require morphine as part of their treatment regimen or due to their circumstances.
A Human-Centred Approach to Designing a Social Media-Based Digital Health Intervention to Foster HIV Awareness and Peer Learning Among Adolescents and Young People in a Resource-Limited Setting: A Protocol Paper
Authors: MACHARIA Paul , MUGO Cyrus , SEREMBE James , WANJIHIA Violet , BUKUSI David , IKAMARI Lawrence , NDUATI Ruth , NGARUIYA Christine 
Published: October 2024

Abstract

Background: Despite progress in HIV awareness among adolescents, gaps persist in knowledge, treatment adherence, and mental health support. While current social media apps show promise for information dissemination, privacy and confidentiality concerns remain a barrier. In 2020, WHO, UNICEF, UNFPA, and UNESCO published an inter-agency framework to guide the development of youth-centered digital health interventions (DHIs). This participatory approach, designed to incorporate adolescent aspirations and expectations, is crucial for DHI efficacy. This study explores the potential of applying the DHI inter-agency framework to co-design an adolescent-led web-based social media forum, potentially addressing adolescents’ information gaps while maintaining privacy and confidentiality.
Objective: we aimed to co-design an interactive and engaging social media app that fosters interaction and awareness among adolescents and young people on HIV, intimate partner violence, substance use, mental health, sexual health, and nutrition. The study would investigate the potential of a web-based social media forum to empower adolescent-led interaction and engagement.
Methodology: This proof-of-concept (PoC) study would employ a Design Science (DS) research design, guided by a Human-Centered Design (HCD) a multi-phased approach in the development of interventions. In phases 1 and 2 of the HCD process, focus group discussions (FGDs) would utilize an FGD guide to identify the health information needs of participants. In phase 3, a prospective cohort study at the co-design stage, would evaluate the usability and user experience of the developed web-based social media app.
Utility:The app aims to promote awareness and interaction around HIV, mental health, sexual health, nutrition, and intimate partner violence. The study would evaluate the effectiveness of this web-based platform in fostering adolescent-led engagement and communication on these topics.
Active Surveillance Follow-Up for Prostate Cancer: From Guidelines to Real-World Clinical Practice
Authors: Chiarelli Giuseppe , Stephens Alex , Finati Marco , Cirulli Giuseppe Ottone , Tinsley Shane , Wang Yuzhi , Kolanukuduru Kaushik , Sood Akshay , Carrieri Giuseppe , Briganti Alberto , Montorsi Francesco , Lughezzani Giovanni , Buffi Nicolò , Rogers Craig , Abdollah Firas 
Published: October 2024

Abstract

Purpose
To assess active surveillance (AS) adherence for prostate cancer (PCa) in a “real-world” clinical practice.
Materials and Methods
We utilized our institutional database which was built by interrogating electronic medical records for all men who got diagnosed with PCa from 1995 to 2022. Our cohort included all patients aged < 76 years, with PCa Gleason Grade (GG) 1 or 2, ≤ cT2c, PSA ≤ 20 ng/ml at diagnosis, enrolled on AS, and with at least one biopsy after diagnosis. Patients were separated into two groups based on the monitoring intensity.Patients with at least 1 PSA/year and at least 1 biopsy every 4 years were categorized as adherent to guidelines. Univariable and Multivariable logistic regression analyses were used to examine the impact of covariates on non-adherence to guidelines. Competing risks cumulative incidence was used to depict PCSM.
Results
A total of 546 men met the inclusion criteria. Overall, 63 (11%) patients were adherent to guidelines (Group 1), while 483 (89%) were not (Group 2). Median PSAs/year and median biopsies/year were 2.3 (2.0-2.7) and 0.4 (0.3-0.6) for Group 1, and 1.2 (0.7-1.8) and 0.2 (0.1-0.2) for Group 2, respectively (both p<0.0001). At multivariable analysis, Black men had a 2.20-fold higher risk of being in Group 2 than White men (p<0.05). Patients with cT2 (OR:0.24, CI:0.11-0.52) and those with CCI ³2(OR:0.40, CCI:0.19-0.82) were less likely to be in Group 2, when compared to cT1 stage and CCI=0, respectively (both p< 0.05). At 10 years, the cumulative incidence estimate of prostate cancer-specific mortality (PCSM) for the entire cohort was 2.1%.
Conclusion
We found substantial deviations from AS monitoring guidelines, particularly in biopsy frequency, which did not seem to compromise PCSM in patients with stable PSA. Notably, our findings suggest that strict adherence to guidelines, especially in patients with cT2 at diagnosis, remains crucial.
Amyotrophic Lateral Sclerosis developing in a patient with Chronic lymphocytic leukaemia and drug related a sarcoid-like reaction; teasing apart multiple diagnoses
Authors: Freiha Joumana , Grand Effie , Marshall Ben , Arunchalam Ramamurthy , Pinto Ashwin , Osman Chinar 
Published: October 2024

Abstract

Background
Sarcoid-like reaction is an autoinflammatory disease that can affect lymph nodes and organs but does not meet the diagnostic criteria for systemic sarcoidosis. Anti-CD20 auto-antibodies have been reported to be responsible for such reactions. There are several reported associations between Chronic lymphocytic leukaemia (CLL) , Amyotrophic lateral sclerosis (ALS) and Sarcoid-like reactions. We report a case of ALS developing in a patient with CLL and drug related sarcoid-like reaction.
Case presentation
A 60-year-old male presented with lower limb rash, left leg weakness followed by bulbar symptoms which progressed over 12-months. Workup demonstrated a CSF pleocytosis and inguinal lymphadenopathy. Skin and inguinal lymph node biopsies showed non-necrotising granulomata. Electromyography met diagnostic criteria for ALS. He was treated for presumed neurosarcoidosis presenting with ALS. Despite treatment, the clinical course progressed like a classical ALS.
Conclusion
ALS may occur on a background of pre-existing chronic haematological disorders. Additionally, there is an occasional association of ALS and sarcoidosis. More interestingly, Rituximab can induce a sarcoid-like reaction.
A phase II study of personalized ultrafractionated stereotactic adaptive radiotherapy for palliative head and neck cancer treatment (PULS-Pal): a single-arm clinical trial protocol
Authors: Courtney P. Travis , Santoso Milisuryani , Savjani Ricky R. , Reddy Vishruth , Chai-Ho Wanxing , Velez Maria A. Velez , Wong Deborah , Palodichuk Christy , Basehart T. Vincent , O’Connell Dylan , Cao Minsong , Telesca Donatello , Chin Robert K. 
Published: October 2024

Abstract

Background: Many patients with head and neck cancer will not be candidates for standard of care definitive treatments though often require palliative treatments given the frequent symptoms associated with head and neck cancer. While existing palliative radiotherapy regimens can provide adequate symptom control, they have limitations particularly with respect to local control which is becoming more important as advances in systemic therapy are improving survival. Personalized ultrafractionated stereotactic adaptive radiotherapy (PULSAR) is a novel radiotherapy regimen which leverages advances in radiotherapy treatment technology and extended interfraction intervals to enable adaptive radiotherapy and possible synergy with the immune system. Additionally, HyperArc© (Varian Medical Systems, Inc.) radiotherapy planning software allows for safe dose-escalation to head and neck tumors.
Methods: This single-arm phase II study will prospectively evaluate PULSAR with HyperArc software for palliative treatment of head and neck cancer. Patients with de novo or recurrent, localized or metastatic, head and neck cancer who are ineligible for or decline standard of care definitive treatments are eligible for enrollment. Forty-three patients will receive an 11 Gray fraction of radiation every two weeks for a total of five fractions and dose of 55 Gy. Adaptive radiotherapy planning is permitted. A safety and feasibility evaluation will be performed after enrollment of the first fifteen patients whereby the trial will continue if less than five patients experience a CTCAEv5.0 grade 3 or higher toxicity definitely attributable to PULSAR during or within thirty days after its completion. The primary endpoint is one-year local head and neck tumor control. Secondary endpoints include safety, disease progression-free and overall survival, symptomatic impact, frequency of re-simulation and/or adaptive planning, and radiation dosimetry of PULSAR. Additionally, enrolled patients are permitted to receive immunotherapy during PULSAR, which may allow for the analysis of the safety and efficacy of this combination.
Discussion: The PULS-Pal trial is the first prospective study of PULSAR with HyperArc software for head and neck cancer. We hypothesize that this radiotherapy regimen will lead to improved local tumor control compared with historical controls in patients undergoing palliative radiotherapy for head and neck cancer.
Trial Registration: Clinicaltrials.gov identifier: NCT06572423. Date of registration: August 28th, 2024. https://clinicaltrials.gov/study/NCT06572423.
Unexpected Hypereosinophilia after Sinopharm Vaccination: A Case Report
Authors: Dalfardi Behnam , Rad Niloofar Khoshnam , Alizade Tayebe Mohammad , Edalatifard Maryam , Asadi Sanaz , Rahimi Besharat 
Published: October 2024

Abstract

COVID-19 vaccines have been associated with various adverse events, though their safety profile is generally favorable.
We present a case of a 66-year-old male who developed hypereosinophilia (Absolute eosinophil count: 4063 cells/µL) and lymphadenopathy following the third dose of the Sinopharm COVID-19 vaccine. Despite extensive investigations, an underlying cause for these findings was not identified. While a causal relationship cannot be definitively established, the temporal association between the vaccine and symptom onset is intriguing. This case highlights the importance of continued surveillance for rare adverse events following vaccination and emphasizes the need for further research to understand the potential mechanisms linking COVID-19 vaccines to eosinophilic disorders.
The status of insecticide resistance of Anopheles coluzzii on the islands of São Tomé and Príncipe, after 20 years of malaria vector control
Authors: Correa Maria , Lopes Janete , Sousa Carla A. , Rocha Gustavo , Oriango Robin , Cardetas Andreia , Viegas Joao , Cornel Anthony J. , Lanzaro Gregory C. , Pinto João 
Published: October 2024

Abstract

Background
Insecticide based malaria vector control has been implemented on the islands of São Tomé and Príncipe (STP) for more than 20 years. During this period malaria incidence was significantly reduced to pre-elimination levels. While cases remained low through 2015, there has been a steady increase in cases since that time, challenging the country’s commitment of achieving malaria elimination by 2025. To better understand the reasons for increasing malaria cases, we characterized levels and underlying mechanisms of insecticide resistance in local Anopheles coluzzii populations.
Methods
Mosquito larval collections were performed in the rainy and dry seasons, between 2022 and 2024, in two localities in São Tomé and one in Príncipe. Susceptibility to permethrin, α-cypermethrin, pirimiphos-methyl and DDT was assessed using WHO bioassays and protocols. Intensity of resistance and reversal by PBO pre-exposure were determined for pyrethroid insecticides. The kdr locus was genotyped by PCR assays in subsamples of the mosquitoes tested.
Results
Anopheles coluzzii populations were fully susceptible to pirimiphos-methyl but high levels of resistance to pyrethroids and DDT were detected, particularly in São Tomé rainy season collections. Increasing the pyrethroid and DDT dosages to 5\(\:\times\:\) and 10\(\:\times\:\) did not restore full susceptibility in all populations. Pre-exposure to PBO resulted in partial reversal of the resistance phenotype suggesting the presence of cytochrome P450 oxidase-mediated metabolic resistance. The L1014F knockdown resistance mutation was present in An. coluzzii on both islands but at much higher frequency in São Tomé where it was associated with the resistant phenotype.
Conclusions
Future vector control interventions should consider the use of non-pyrethroid insecticides or combination with synergists to overcome the high levels of pyrethroid resistance. Alternative control methods not dependent on the use of insecticides should be additionally implemented to achieve malaria elimination in STP.
A Load Forecasting Model for Smart Grid Based on RF-BiLSTM and Federated Learning
Authors: Li Wenhui , Jiang Huilin , Zhang Lei 
Published: October 2024

Abstract

Accurate load forecasting is essential for improving the efficiency and reliability of smart grids. Traditional forecasting models face challenges in integrating high-dimensional data and protecting privacy. To address these issues, a novel load forecasting model is presented in this paper. The proposed approach combines a random forest (RF) and a bi-directional long short-term memory (BiLSTM) network based on a federated learning framework. To effectively process high-dimensional heterogeneous data in smart grids, the proposed model exploits the feature extraction capability of radio frequency. In addition, the sequential data processing capability of BiLSTM provides a means of processing time-varying load data in smart grids. The federated learning method protects user privacy and achieves the goal of global model training adopting distributed data. Experimental results demonstrate that the proposed model is superior to traditional models in accuracy and efficiency.