bluuebunny/crossref_metadata_2025_split huggingface dataset:
Splenic filtration of red blood cells in physiology, malaria and sickle cell disease
Authors: Sissoko Abdoulaye , Othmene Yosra Ben , Buffet Pierre 
Published: September 2024

Purpose of review
The human spleen clears the blood from circulating microorganisms and red blood cells (RBCs) displaying alterations. This review analyzes how generic mechanisms by which the spleen senses RBC, such pitting, trapping and erythrophagocytosis, impact the pathogenesis of two major spleen-related diseases, malaria and sickle cell disease (SCD).

Recent findings
Scintigraphy, functional histology, comparison of circulating and splenic RBC, ex-vivo perfusion of human spleens and in-silico modeling enable relevant exploration of how the spleen retains and processes RBC in health and disease. Iterative cross-validations between medical observations, in-vitro experiments and in-silico modeling point to mechanical sensing of RBC as a central event in both conditions. Spleen congestion is a common pathogenic process explaining anemia and splenomegaly, the latter carrying a risk of severe complications such as acute splenic sequestration crisis and hypersplenism in SCD. Sickling of hemoglobin S-containing RBC may contribute to these complications without necessarily being the trigger.

Summary
Ongoing progress in the exploration and understanding of spleen-related complications in malaria and SCD open the way to optimized prognosis evaluation and therapeutic applications.
Individualized Pain Treatment in Chronic Pancreatitis (INPAIN)
Authors: Hagn-Meincke Rasmus , Dugic Ana , Agarwal Ankit , Phillips Anna Evans , Waage Anna , Yadav Dhiraj , Pillai Divya , Vivian Elaina , de-Madaria Enrique , Niazi Imran Khan , Easler Jeffrey , Frøkjær Jens Brøndum , McNabb-Baltar Julia , Asferg Louise Kuhlmann , Faghih Mahya , Montiel Maria Belen Garay , Cook Mathias , Unnisa Misbah , Tarnasky Paul , Hegyi Peter , Garg Pramod , Nedergaard Rasmus Bach , Edwards Robert , Talukdar Rupjyoti , Farheen Shagufta , Olesen Søren Schou , Jagannath Soumya , Schmidt Suzette , Singh Vikesh , Hajnády Zoltán , Drewes Asbjørn Mohr ,   on behalf of the International Pancreatic Pain Consortium
Published: September 2024

Objectives
Pain is the foremost complication of chronic pancreatitis (CP), affecting about 70% of patients. However, the pathophysiological understanding and management of CP-related pain are complex, likely as patients have diverse “pain phenotypes” responding differently to treatment. This study aims to develop a bedside test panel to identify distinct pain phenotypes, investigate the temporal evolution, and determine whether they can be used to predict treatment response.

Methods
The INPAIN study is an international, multicenter, observational, longitudinal cohort study consisted of 4 substudies. The studies will prospectively enroll 400 CP patients (50 without pain and 350 with pain) and 50 control subjects, conducting biannual observations for 4 years. The test panel is consisted of comprehensive subjective and objective assessment parameters. Statistical analysis strategies differ across the substudies. A model to predict treatment efficacy will be developed using various machine learning techniques, including an artificial intelligence approach, with internal cross-validation. Trajectories in pain parameters will be characterized by graphical analysis and mixed effect models.

Discussion
The INPAIN study aims to comprehensively understand pain in CP through a test panel developed for routine clinical use. This tool has the potential to personalize treatments, improve clinical practice, enhance patient care, improve quality of life, and minimize treatment side effects.
Unveiling post-COVID-19 Rasmussen’s encephalitis: a case report of rare neurological complication
Authors: Naisr Zaira , Ahmed Abdullah Munir , Arooj Hajira , Abdullah Lava , Naeem Zunaira , Hashmi Muhammad Usman 
Published: September 2024

Introduction and importance:
Rasmussen encephalitis (RE) is a rare autoimmune disorder that causes unilateral inflammation of the cerebral cortex and can lead to drug-resistant epilepsy and progressive neurological decline. Although the emergence of RE following COVID-19 has not been well documented, it emphasizes the need to understand the impact of COVID-19 on neurological health. This case emphasizes the importance of early recognition and intervention to prevent adverse outcomes related to post-COVID-19 neurological complications.

Case presentation:
A 30-year-old woman, recently diagnosed with COVID-19, experienced recurrent seizures that primarily affected the left side of her body. Despite medical management, signs of progressive weakness and altered consciousness were observed. Neurological examination, imaging, and electroencephalography confirmed a diagnosis of post-COVID-19 RE. Despite conservative management, the patient’s condition continued to deteriorate, ultimately resulting in fatal outcomes.

Clinical discussion:
The relationship between COVID-19 and autoimmune responses, which can lead to neurological complications, such as RE, is a matter of concern. Accurate diagnosis of RE depends on imaging and EEG studies; however, a definitive diagnosis often requires histopathological examination. The management of RE involves the use of anti-seizure medications and surgical interventions to control symptoms and improve outcomes. However, the unusual presentation of this case, along with challenges in diagnosis and treatment, underscores the need for increased awareness and extensive research on the neurological consequences of COVID-19.

Conclusion:
This case underscores the severe neurological consequences that can emerge after COVID-19, emphasizing the need for prompt identification and intervention. Additional research is essential to improve the comprehension and management of the neurological aftermath of COVID-19 with the ultimate goal of enhancing patient outcomes.
Male breast cancer: a 32-year retrospective analysis in radiation therapy referral center in northern Iran
Authors: Asgharian Mahboobeh , Moslemi Dariush , Nikbakht Hossein-Ali , Jahani Mohammad-Ali , Bijani Ali , Mehdizadeh Hakimeh 
Published: September 2024

Background:
Breast cancer commonly occurs in women, and male breast cancer makes up less than 1% of all cases of breast cancer. The limited prevalence of male breast cancer has led to decreased attention being paid to this condition, resulting in its diagnosis occurring at later ages and at more severe disease stages.

Objectives:
This study evaluates the demographic and clinicopathological characteristics of male patients diagnosed with breast cancer who visited the northern region of Iran from 1992 to 2023.

Methods:
This descriptive study reviewed data from 58 cases of male breast cancer between 1992 and 2023. The study aimed to examine and describe the information connected to these patients. The data were analyzed with SPSS.22 set at P value less than 0.05.

Results:
The mean age of the patients examined was 62.10±13.40 years, while their mean BMI was 27.08±4.95. The study found no statistically significant correlation between BMI with stage and kinds of recurrence, including metastasis and local recurrence (P>0.05). The right and left breast involvement rates were equal (48.28%) in 28 cases, and 2 cases (3.40%) had bilateral involvement. The bone was the predominant site of metastasis, accounting for 69.23% of cases. The analysis revealed no significant correlation between stage and metastasis (P=1.000) or local recurrence (P=0.543). Most metastasis and all the local recurrence were observed in stages 3 and 4.

Conclusion:
Male breast cancer mainly occurs in older age and is diagnosed in the advanced stages of the disease. Therefore, it is recommended to inform men and develop suitable screening programs, especially in high-risk families.
Longitudinal refractive errors over 36 months in Hispanic and Black children
Authors: Pang Yi , Li Qiong , Block Sandra S. , Wang Jingyun 
Published: September 2024

SIGNIFICANCE
This study brings awareness of racial/ethnic difference of refractive error characteristics in clinics.

PURPOSE
This study aimed to assess longitudinal change in refractive errors over a 36-month period in Hispanic and Black children.

METHODS
Children (2.4 to 15 years old) were studied. Cycloplegic refraction was measured annually. Spherical equivalent was calculated. Astigmatism was evaluated by magnitude of cylinder and power vector (J0 and J45). Absolute value of interocular spherical equivalent difference was used to calculate anisometropia. Mixed-linear model was used to analyze longitudinal annual change in spherical equivalent, cylinder, J0, and J45 over 36 months.

RESULTS
A total of 485 participants (310 Black, 175 Hispanic) met the criteria. At the baseline examination, prevalence of myopia, emmetropia, and hyperopia was 39% (n = 187), 31% (n = 150), and 30% (n = 148), respectively. Spherical equivalent of Black children was not significantly different from that in Hispanic children (0.10 ± 2.92 vs. −0.37 ± 2.05 D, p=0.06); however, the Hispanic children had a significantly higher cylinder compared with Black children (Hispanic: 1.46 ± 1.57 D vs. Black: 0.92 ± 1.07 D; p<0.001). Both J0 (p<0.001) and J45 (p=0.01) were significantly different between two groups; the Hispanic children had more with-the-rule astigmatism and oblique astigmatism than the Black children. Prevalence of anisometropia (≥1 D) was higher in Black children (14%) compared with Hispanic children (5%, p=0.006). Over 36 months, spherical equivalent significantly decreased an average of 0.69 D (0.23 D/y, p<0.001) for both groups; neither astigmatism nor anisometropia changed significantly (p>0.05).

CONCLUSIONS
Astigmatism in the Hispanic children was significantly higher than in Black children. However, the Black children had a higher prevalence and degree of anisometropia than the Hispanic children.
Exploring the Impact of Race on Addressing Intimate Partner Violence in the Emergency Department
Authors: Kasa Leena , Alexander Kristine , Obenschain Katherine , Joshi Priyanka , Murray Ashlee 
Published: September 2024

Objectives
Research highlights racial disparities among those experiencing intimate partner violence (IPV), yet little is known about disparities in addressing IPV in the emergency department (ED). This study was designed to examine variability in offering IPV universal education to adult caregivers across patient race within an urban pediatric ED and to explore provider attitudes regarding the role of race in this process.

Methods
We conducted a mixed-methods study using quantitative data on rates of offering adult caregivers IPV universal education and rates of missing documentation for when IPV universal education was not offered to adult caregivers from January 2016 to December 2020. Analyses compared both rates by patient race listed in the electronic health record. We also conducted semistructured interviews with ED providers, which were qualitatively analyzed for common themes.

Results
Caregivers of Black patients were both more likely to have received IPV universal education compared with caregivers of White patients (31.1% vs 27.3%, P < 0.05) and more likely to lack a documented reason for not offering than caregivers of White patients (70.4% vs 53.9%, P < 0.05). Our semistructured interviews with nurses, nurse practitioners, and physicians in the pediatric ED were able to ascertain specific racial biases that may influence these disparities.

Conclusions
Our study showed that racial disparities exist in both offering IPV universal education and documentation deferral in our pediatric ED. Combined analysis of our quantitative and qualitative data shows the importance of identifying biases that cause health disparities and increasing diversity among healthcare providers. The results of this study can be used to inform new methodologies for healthcare providers to address their personal biases and ensure that all caregivers visiting the ED are offered IPV support resources.
Ultrasound Imaging of Various Ingested Foreign Bodies in an Ex Vivo Intestinal Model
Authors: Wong Brandon M. , Wong Sterling R. , Nesiri Cem , Udayasankar Unni , Larson Michael C. 
Published: September 2024

Objective
Foreign body ingestion is an increasingly prevalent issue for children who are in the preverbal to early verbal stages of life. Foreign bodies lodged in the gastrointestinal tract can cause issues such as obstruction, perforation, and fistulae. Radiographic imaging can often locate most foreign bodies; however, radiolucent objects may be missed. Ultrasound is an alternative imaging modality that can be used to locate and track foreign objects as they pass through the bowel. The objective of this study was to characterize the sonographic appearance of various ingested foreign bodies of varying characteristics in an ex vivo gastrointestinal tract segment.

Methods
A GE Logiq 9 ultrasound machine with a linear transducer at a frequency of 15 MHz was used to examine various ingested foreign bodies placed in a segment of pig intestinal tract.

Results
Imaged objects varied in visual appearance from echogenicity, texture, size, and shape; acoustic shadows and reverberation artifacts cast were particularly distinguishing characteristics.

Conclusions
Ultrasound evaluation to assess foreign body ingestion in the pediatric population may provide a useful alternative or supportive imaging modality in confirming the location and real-time tracking of the ingested item. This may be especially useful for objects of varying radiodensities that cannot always be reliably seen in traditional radiographs.
“What Else Could It Be?” A Scoping Review of Questions for Patients to Ask Throughout the Diagnostic Process
Authors: Hill Mary A. , Coppinger Tess , Sedig Kimia , Gallagher William J. , Baker Kelley M. , Haskell Helen , Miller Kristen E. , Smith Kelly M. 
Published: September 2024

Background
Diagnostic errors are a global patient safety challenge. Over 75% of diagnostic errors in ambulatory care result from breakdowns in patient-clinician communication. Encouraging patients to speak up and ask questions has been recommended as one strategy to mitigate these failures.

Objectives
The goal of the scoping review was to identify, summarize, and thematically map questions patients are recommended to ask during ambulatory encounters along the diagnostic process. This is the first step in a larger study to co-design a patient-facing question prompt list for patients to use throughout the diagnostic process.

Methods
Medline and Google Scholar were searched to identify question lists in the peer-reviewed literature. Organizational websites and a search engine were searched to identify question lists in the gray literature. Articles and resources were screened for eligibility and data were abstracted. Interrater reliability (K = 0.875) was achieved.

Results
A total of 5509 questions from 235 resources met inclusion criteria. Most questions (n = 4243, 77.02%) were found in the gray literature. Question lists included an average of 23.44 questions. Questions were most commonly coded along the diagnostic process categories of treatment (2434 questions from 250 resources), communication of the diagnosis (1160 questions, 204 resources), and outcomes (766 questions, 172 resources).

Conclusions
Despite recommendations for patients to ask questions, most question prompt lists focus on later stages of the diagnostic process such as communication of the diagnosis, treatment, and outcomes. Further research is needed to identify and prioritize diagnostic-related questions from the patient perspective and to develop simple, usable guidance on question-asking to improve patient safety across the diagnostic continuum.
Inborn errors of immunity and invasive fungal infections: presentation and management
Authors: Paccoud Olivier , Warris Adilia , Puel Anne , Lanternier Fanny 
Published: September 2024

Purpose of review
We review the clinical presentations of invasive fungal infections in a selection of inborn errors of immunity. In addition, we review the particularities of their management, including antifungal therapy, prophylaxis, and immunomodulatory treatments.

Recent findings
Patients with chronic granulomatous disease and with signal transducer and activator of transcription 3 (STAT3) deficiency are particularly prone to aspergillosis. Mold-active antifungal prophylaxis should be prescribed to all patients with chronic granulomatous disease, and in patients with STAT3 deficiency and underlying parenchymal lung disease. Invasive fungal infections are rare in patients with STAT1 gain-of-function mutations, while the clinical phenotype of caspase-associated recruitment domain-containing protein 9 deficiency encompasses a wide range of superficial and invasive fungal infections. Most patients with inborn errors of immunity and invasive fungal infections require prolonged durations of antifungals. Hematopoietic stem cell transplantation should be considered early for patients with chronic granulomatous disease, but results have been more mixed for other inborn errors of immunity with active invasive fungal infections.

Summary
Inborn errors of immunity can confer increased susceptibility to a variety of invasive fungal infections, which can present with specific clinical and radiological features. Management of fungal infections in these patients is often challenging, and relies on a combination of antimicrobial prophylaxis, antifungal treatments, and immunomodulation.
Clinical Efficacy of Bionic Blepharoplasty Using the Flexible Suspension and Semiflexible Suspension Double-Insurance Methods
Authors: He Zhigang , Gu Xianbin , Chen Lisha , Liu Wenjing , Yi Yangyan , Yang Juanmin 
Published: September 2024

Objective:
To investigate the clinical effect of the double insurance method of flexible suspension and semiflexible suspension in bionic blepharoplasty.

Methods:
Between January 2020 and January 2022, a total of 115 patients (230 eyes) underwent double eyelid plastic surgery with flexible suspension and semiflexible suspension. Herein, we present a new type of double eyelid surgery that preserves the orbicular muscle of the anterior tarsus without removing the tissue. First, the loose fatty fascia layer between the anterior tarsus and the orbicularis oculi muscle was completely removed to a distance of 2 mm from the base of the eyelashes, leaving the compact pretarsal levator aponeurosis. Then, the anterior tarsus orbicularis oculi muscle and the upper levator aponeurosis were sutured and fixed (flexible suspension). Finally, the skin and the upper levator aponeurosis were sutured in the flexible suspension space (semiflexible suspension).

Results:
Six months after surgery, the patient’s double eyelid shape had recovered well, and the satisfaction rate reached 97.3%. Among the unsatisfied patients, 1 patient had a single-focused shallow eyelid line which was associated with postoperative hematoma, and 2 patients felt that the double eyelid line was narrow. All 3 patients achieved satisfactory results after reoperation.

Conclusions:
The bionic double eyelid method with flexible suspension and semiflexible suspension can restore the natural double eyelid anatomy very well by reconstructing the connection between the orbicularis oculi muscle or skin and the upper palpebral levator aponeurosis. After the operation, the incisions healed quickly and smoothly. The eyelid depression and fleshy feeling were not obvious when the eyes were closed. Consequently, the patient’s satisfaction was very high.
Divorce Among Surgeons and Other Physicians in the United States
Authors: Stearns Stephen A. , Farid Alexander R. , Jena Anupam B. 
Published: September 2024

Objective:
To compare divorce prevalence among surgeons with that of nonsurgeon physicians.

Summary Background Data:
The demanding nature of a career in surgery uniquely challenges the social well-being of a surgeon; however, its impact on marital health has not yet been well described.

Methods:
A cross-sectional study was conducted using publicly available US Census data from 2017 to 2021 to investigate the prevalence of divorce across different occupations. Survey respondents were divided into 2 groups, surgeons and nonsurgeon physicians, with the remaining Census participants as a control. All participants under the age of 18 were excluded to focus on the US adult population. The lifetime prevalence of divorce was measured across occupations, and multivariable logistic regression analyses were performed to identify factors that were independently associated with divorce. Secondarily, the occurrence of more than one marriage was used to supplement the understanding of marital health.

Results:
A total of 3171 surgeons and 51,660 nonsurgeon physicians were identified, with both groups similarly aged (51.6 and 50.2 y, respectively) and predominately male (82.9% and 61.9%, respectively). In unadjusted analysis, 21.3% (676/3,171) of surgeons had undergone a divorce compared with only 17.9% (9252/51,660) of nonsurgeon physicians, a 19% increase in risk of divorce [risk ratio (RR)=1.19; 95% CI, 1.11–1.28]. Both surgeons and nonsurgeon physicians were significantly less likely to report being divorced compared with the general population. The increased divorce prevalence among surgeons persisted in multivariable analysis that adjusted for age, age at the time of marriage, sex, race, income, hours worked per week, and the number of children in the household, with surgeons experiencing a 22% increased prevalence of divorce over nonsurgical physicians [adjusted divorce prevalence of 21.8% vs 18.7%, respectively; odds ratio (OR)=1.22; 95% CI, 1.09–1.35]. In subgroup analysis, the finding of higher divorce prevalence for surgeons over nonsurgeon physicians was concentrated among men (adjusted divorce prevalence: 22.6% of male surgeons vs 18.9% of male nonsurgeon physicians; adjusted OR 1.26, 95% CI, 1.11–1.42), White (adjusted divorce prevalence: 22.4% of white surgeons vs 19.1% of White nonsurgeons; adjusted OR 1.22, 95% CI, 1.09–1.38) and Asian surgeons (adjusted divorce prevalence: 12.0% of Asian surgeons vs 8.1% of Asian nonsurgeons; adjusted OR 1.55, 95% CI, 1.06–2.26), with the effect not present in other measured subgroups.

Conclusions:
Both surgeons and physicians have lower divorce prevalence than the general population. Surgeons exhibit higher prevalence of divorce compared with nonsurgeon physicians, with measured demographic and work characteristics insufficient to explain this difference.