bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of radial artery cannulation in treatment of cardiac arrest: A case report
Authors: Jin Li , Ji Hanzhen , Xu Jianru 
Published: August 2024

Rationale:
Timely treatment and recovery of cardiac arrest in out-of-hospital settings present significant challenges. This report describes a novel method of integrating advanced monitoring techniques such as radial artery cannulation in the treatment of an 85-year-old male patient who suffered an out-of-hospital cardiac arrest (OHCA).

Patient concerns:
The patient, an 85-year-old man, experienced sudden cardiac arrest at home around 4:10 pm on November 22, 2023, characterized by immediate loss of consciousness and absence of pulse, and no response when called by name, necessitating urgent medical intervention.

Diagnoses:
The patient was diagnosed with OHCA by the emergency doctor, which was further confirmed by the absence of spontaneous circulation and respiratory failure.

Interventions:
The patient was treated with manual cardiopulmonary resuscitation (CPR), ventilator-assisted ventilation, internal jugular venous catheterization, medical treatment, mechanical CPR, and supplemented by radial artery cannulation for invasive blood pressure monitoring. This technique was pivotal for real-time hemodynamic assessment.

Outcomes:
The invasive monitoring facilitated the early detection of the return of spontaneous circulation, allowing for the timely cessation of mechanical CPR. Subsequent treatment in the intensive care unit was optimized based on continuous arterial pressure readings, enhancing the stabilization of the patient’s condition.

Lessons:
This case underscores the significant role of radial artery cannulation for invasive blood pressure monitoring in improving clinical outcomes for patients experiencing OHCA. Integrating radial artery cannulation with other advanced monitoring techniques aids in the early detection of the return of spontaneous circulation and optimizes subsequent intensive care treatment.
Use of sodium oxybate for the treatment of alcohol withdrawal syndrome in patients with acute alcohol-associated hepatitis: A 4-patient case report
Authors: Caputo Fabio , Casabianca Alberto , Brazzale Camilla , Lungaro Lisa , Costanzini Anna , Caio Giacomo , De Giorgio Roberto , Testino Gianni , Piscaglia Fabio , Caraceni Paolo 
Published: August 2024

Introduction:
During the treatment of alcohol use disorder, alcohol withdrawal syndrome (AWS) can occur. Benzodiazepines remain the “gold standard” for the pharmacological treatment of AWS. However, other drugs have been approved in some European Countries for the treatment of AWS: namely, clomethiazole in Spain and Germany and sodium oxybate in Italy and Austria. Acute alcohol-associated hepatitis (AAH) is a distinct clinical syndrome characterized by the recent onset of jaundice with or without other signs of liver decompensation in patients with ongoing alcohol consumption.

Rationale:
We report 4 paradigmatic clinical cases to analyze the efficacy, safety, and tolerability of the very short half-life (30–45 minutes) sodium oxybate (SO) in the management of AWS with moderate to severe AAH. Compared to SO, “as needed” short-acting benzodiazepines, currently prescribed to treat AWS in patients with AAH, have a much longer half-life (5–25 hours) which increases the risk of drug accumulation. The very short half-life of SO provides a fixed dose approach allowing for a more effective control of AWS than “as needed” therapy throughout the 24 hours.

Patient concerns:
Patients reported anxiety, agitation, diffuse abdominal pain, loss of appetite, and nausea with elevation in serum bilirubin and 2 of them had abdomen distension due to ascites.

Diagnosis:
Patients were affected by moderate or severe AWS and moderate or severe AAH on alcohol-related liver cirrhosis.

Interventions:
In order to suppress AWS, all patients were treated with oral sodium oxybate at a dose of 25 mg/kg/day, progressively increased to 50 to 100 mg/kg/day, divided into 3 to 5 administrations.

Outcomes:
SO was efficient, safe and tolerable in suppressing AWS even in patients with severe AAH. All treated patients showed a rapid improvement of all symptom (via the Clinical Institute of Withdrawal Assessment for Alcohol Scale) and liver test scores (Model for End-Stage Liver Disease).

Conclusion:
Because of its short half-life, SO can be considered a safe and effective pharmacological option for the AWS in patients with moderate to severe AAH even in comparison to short-acting benzodiazepines, thus avoiding the risk of accumulation. Notably, SO guarantees a fixed approach to cover the possible onset of AWS throughout the 24 hours.
Thoracoscopic wedge resection of the upper lobe of the left lung achieved by a new approach of laryngeal mask general anesthesia with preservation of spontaneous breathing: A case report
Authors: Xie Mengran , Meng Yu , Pei Huanshuang 
Published: August 2024

Introduction:
General laryngeal mask anesthesia with the preservation of spontaneous breathing has accelerated the advancement of the enhanced recovery after surgery concept in thoracoscopic surgery. However, the need for increased doses of anesthetic drugs to reduce laryngeal mask airway (LMA) stimulation poses challenges due to the increased risk of hypotension, respiratory depression, susceptibility to hypoxemia, and carbon dioxide retention, particularly in the lateral position.

Patient concerns:
During the perioperative period, reducing the dose of anesthetic drugs while simultaneously improving LMA tolerance and preventing circulatory and respiratory depression poses a challenge.

Diagnoses:
The patient was diagnosed with a nodule in the upper lobe of the left lung.

Interventions:
In this case, we chose remimazolam sedation, which mildly inhibits circulatory respiration, and used mucosal surface anesthesia in the pharynx. This approach improved the patient’s tolerance to LMA, reduced the dose of anesthetic drugs, and facilitated the successful thoracoscopic wedge resection of the upper lobe of the left lung with preservation of spontaneous respiration.

Outcomes:
During 2 weeks follow-up, the patient recovered satisfactorily and did not report any discomfort.

Conclusion:
We used pharyngeal mucosal surface anesthesia and thoracic paravertebral nerve block in combination with remimazolam sedation to provide precise analgesia, moderate sedation, and successful LMA general anesthesia with preservation of spontaneous respiration in patients undergoing thoracoscopic pulmonary wedge resection.
Cervical vertigo due to rotational fixation of atlantoaxial joint combined with benign paroxysmal positional vertigo: A case report and literature review
Authors: Sun Yahui , Wu Xingquan , Lou Huijuan , Jiang Jinglei , Li Zhongxu , Xu Jing , Sun Yiping , Cong Deyu 
Published: August 2024

Introduction:
Vertigo is the most common clinical complaint, misdiagnosed patients are not rare, so it is very important to exclude and identify vertigo. For vertigo caused by multiple causes, including cervical vertigo with atlantoaxial rotation fixation combined with benign paroxysmal positional vertigo (BPPV), tuina can correct joint misalignment. The reduction technique will return the fallen otolith to the correct position. The use of massage and reduction can improve clinical symptoms and improve quality of life and may be a simple, safe, and effective treatment strategy for this disease.

Patient concerns:
We report on a patient with both cervical vertigo due to atlantoaxial rotational fixation and BPPV, including his imaging examination, clinical manifestations, and treatment methods.

Diagnosis:
Cervical vertigo (atlantoaxial rotatory fixation) and BPPV.

Intervention:
Tuina combined with atlantoaxial directional inverted reduction technique and reduction manipulation.

Outcomes:
The patient’s vertigo symptoms improved significantly, nystagmus disappeared, cervical occipital pain, nausea, head distension, and other symptoms disappeared, and cervical motion rotation reached 60°.

Conclusion:
This study proved the effectiveness of massage combined with a reduction in the treatment of cervical vertigo and BPPV, as well as the importance of vertigo diagnosis and differential diagnosis, and provided a new treatment idea for the future diagnosis and treatment of vertigo caused by a variety of causes.
Splenic abscess secondary to COVID-19 acute infection: A case report and literature review
Authors: Wang Wei , Zhai Wen-Hui , Zhang Ying , Tao Li , Li Yun , Jiang Tong-xue , Zhang Jin-ping 
Published: August 2024

Rationale:
Splenic abscess is relatively rare in clinical practice as an invasive disease. However, during the continuous prevalence of coronavirus disease 2019 (COVID-19), the incidence rate of splenic abscess showed an upward trend. However, because the etiology of splenic abscess is not specific, it is easy to be covered by the respiratory symptoms of COVID-19, resulting in omission or delay in diagnosis. If splenic abscesses cannot be treated in a timely manner, the mortality rate can reach 100%. Therefore, it is important to fully understand the correlation between COVID-19 and the development of splenic abscesses.

Patient concerns:
A female patient, 71 years of age, was admitted to our hospital because of cough and sputum for 1 week and fever for 2 days. According to the positive results of novel coronavirus nucleic acid and chest computed tomography, novel coronavirus pneumonia was diagnosed. On the 4th day after treatment, abdominal distension and vomiting were observed. Abdominal ultrasound indicated splenomegaly and mixed echo masses in the spleen and abdominal computed tomography indicated 2 new round low-density lesions were found in the spleen.

Diagnoses:
The patient was diagnosed with secondary splenic abscess after COVID-19 infection.

Interventions:
The patient and her family members refused to undergo ultrasound-guided splenic puncture drainage and splenectomy. In terms of treatment, she was given meropenem combined with vancomycin to continue anti-infection treatment.

Outcomes:
The patient’s body temperature and infection indicators gradually increased, and the scope of splenic abscess continued to expand. The infection worsened and progressed to septic shock. The patient abandoned rescue drugs and invasive treatment, and died on the 9th day after admission.

Lessons:
This case introduces the clinical characteristics of secondary splenic abscess caused by COVID-19 from the aspects of etiology, disease course, clinical manifestations, auxiliary examinations, and treatment methods. The focus is on improving the understanding of clinical doctors about secondary splenic abscesses caused by COVID-19, providing reference for early diagnosis and timely treatment.
Suicide by Ethyl Methacrylate Ingestion
Authors: Prahlow Samuel P. , Wilson Taylor , Gruszecki Amy C. 
Published: August 2024

Abstract
This case report characterizes a unique way in which suicide was accomplished through ingestion of chemicals typically used to create acrylic fingernails that resulted in death. Ethyl methacrylate and acrylic powder are commonly combined to form acrylic nails in nail salons. The process of applying acrylic nails utilizes each substance by mixing both before it typically solidifies within seconds of combining the two compounds. Ingestion of these compounds has not been previously described within the medical literature. The decedent was a nail technician at a local salon. He was found unresponsive in his yard which led to a 911 call. At the scene, a mostly empty 16-oz bottle of ethyl methacrylate, a chemical used at the salon where he worked, was found. At autopsy, the decedent's body had a strong chemical odor consistent with odors present at nail salons. Significant gastrointestinal tract damage was seen including discoloration within the esophagus, and the stomach contained a molded, hardened nail compound. The cause of death was ruled as complications of nail acrylic powder and liquid ethyl methacrylate ingestion. This case shows the unusual findings seen at autopsy from a decedent who committed suicide by ingestion of ethyl methacrylate with acrylic powder.
A False-Negative 123I-MIBG SPECT/CT With True-Positive 68Ga-DOTATATE PET/CT in a Patient With Neuroblastoma Following 177Lu-DOTATATE Therapy
Authors: Li Siqi , Xu Yanfeng , Lu Xia , Wang Wei , Yang Jigang 
Published: August 2024

Abstract
A 10-year-old girl with high-risk neuroblastoma underwent 123I-MIBG SPECT/CT and 68Ga-DOTATE PET/CT, which both showed multiple bone metastases. However, following 177Lu-DOTATATE therapy, only 68Ga-DOTATATE PET/CT identified residual lesions with negative 123I-MIBG SPECT/CT results. The case emphasized the complementary role of 68Ga-DOTATATE PET/CT and 123I-MIBG SPECT/CT after 177Lu-DOTATATE therapy.
SANE Knowledge of HIV nPEP
Authors: Simms-Roberson Priscilla M. , Broda Piotr 
Published: August 2024

Background:
Discussing the risk of exposure to human immunodeficiency virus (HIV) and assessing the need for HIV nonoccupational postexposure prophylaxis (nPEP) are essential components of providing care to victims of sexual assault. Current literature on the topic of HIV nPEP for victims of sexual assault surrounds risk of exposure, patient adherence, access and barriers, current practices, and standardized order sets. A significant gap in the literature concerning sexual assault nurse examiner (SANE) knowledge of HIV infection and HIV nPEP evidence-based practice guidelines was identified. The purpose of this research was to assess SANE knowledge surrounding HIV infection and evidence-based practice recommendations for HIV nPEP use in victims of sexual assault.

Methods:
A 20-item knowledge survey was created using QuestionPro. The aim of the survey was to measure SANE knowledge of HIV transmission, pathophysiology, nPEP medications, and evidence-based practice guidelines for victims of sexual assault. In addition to the 20 knowledge items, 15 demographic questions were included. The study design was cross-sectional, descriptive, and comparative. A total of 411 participants completed the survey.

Results:
Data analysis revealed knowledge deficits for topics such as risk of HIV transmission, nPEP indications, laboratory testing, drug regimens, nPEP timing, mechanism of action, medication contraindications, and adherence issues. The overall mean score for the knowledge survey among all participants was 13.36 out of 20 (66.8%).

Conclusion:
A knowledge deficit among SANEs surrounding HIV infection and HIV nPEP evidence-based practice guidelines for patients who experienced sexual assault was identified. The study highlights the need for additional education for specialized nurses who are providing care to victims of sexual assault.
A Deep Learning Approach for Accurate Discrimination Between Optic Disc Drusen and Papilledema on Fundus Photographs
Authors: Sathianvichitr Kanchalika , Najjar Raymond P. , Zhiqun Tang , Fraser J. Alexander , Yau Christine W. L. , Girard Michael J. A. , Costello Fiona , Lin Mung Y. , Lagrèze Wolf A. , Vignal-Clermont Catherine , Fraser Clare L. , Hamann Steffen , Newman Nancy J. , Biousse Valérie , Milea Dan ,   for the BONSAI Group
Published: August 2024

Background:
Optic disc drusen (ODD) represent an important differential diagnosis of papilledema caused by intracranial hypertension, but their distinction may be difficult in clinical practice. The aim of this study was to train, validate, and test a dedicated deep learning system (DLS) for binary classification of ODD vs papilledema (including various subgroups within each category), on conventional mydriatic digital ocular fundus photographs collected in a large international multiethnic population.

Methods:
This retrospective study included 4,508 color fundus images in 2,180 patients from 30 neuro-ophthalmology centers (19 countries) participating in the Brain and Optic Nerve Study with Artificial Intelligence (BONSAI) Group. For training and internal validation, we used 857 ODD images and 3,230 papilledema images, in 1,959 patients. External testing was performed on an independent data set (221 patients), including 207 images with ODD (96 visible and 111 buried), provided by 3 centers of the Optic Disc Drusen Studies Consortium, and 214 images of papilledema (92 mild-to-moderate and 122 severe) from a previously validated study.

Results:
The DLS could accurately distinguish between all ODD and papilledema (all severities included): area under the receiver operating characteristic curve (AUC) 0.97 (95% confidence interval [CI], 0.96–0.98), accuracy 90.5% (95% CI, 88.0%–92.9%), sensitivity 86.0% (95% CI, 82.1%–90.1%), and specificity 94.9% (95% CI, 92.3%–97.6%). The performance of the DLS remained high for discrimination of buried ODD from mild-to-moderate papilledema: AUC 0.93 (95% CI, 0.90–0.96), accuracy 84.2% (95% CI, 80.2%–88.6%), sensitivity 78.4% (95% CI, 72.2%–84.7%), and specificity 91.3% (95% CI, 87.0%–96.4%).

Conclusions:
A dedicated DLS can accurately distinguish between ODD and papilledema caused by intracranial hypertension, even when considering buried ODD vs mild-to-moderate papilledema.
SDoH-Aware Approach to Prostate Cancer Screening: Addressing Overdiagnosis of Prostate Cancer using PSA
Authors: Lewis Ashley , Khandwala Yash Samir , Hernandez-Boussard Tina , Brooks James D 
Published: August 2024

This study investigates the potential of multimodal data for prostate cancer (PCa) risk prediction using the All of Us (AoU) research program dataset. By integrating polygenic risk scores (PRSs) with diverse clinical, survey, and genomic data, we developed a model that identifies established PCa risk factors, such as age and family history, and a novel factor: recent healthcare visits are linked to reduced risk. The model’s performance, notably the false positive rate, is improved compared to traditional methods, despite the lack of Prostate-Specific Antigen (PSA) data. The findings demonstrate that incorporating comprehensive multimodal data from AoU can enhance PCa risk prediction and provide a robust framework for future clinical applications.Code Availablehttps://github.com/ashlew23/pc_multimodal
Genetic association and machine learning improves discovery and prediction of type 1 diabetes
Authors: McGrail Carolyn , Sears Timothy J. , Kudtarkar Parul , Carter Hannah , Gaulton Kyle 
Published: August 2024

AbstractType 1 diabetes (T1D) has a large genetic component, and expanded genetic studies of T1D can lead to novel biological and therapeutic discovery and improved risk prediction. In this study, we performed genetic association and fine-mapping analyses in 817,718 European ancestry samples genome-wide and 29,746 samples at the MHC locus, which identified 165 independent risk signals for T1D of which 19 were novel. We used risk variants to train a machine learning model (named T1GRS) to predict T1D, which highly differentiated T1D from non-disease and type 2 diabetes (T2D) in Europeans as well as African Americans at or beyond the level of current standards. We identified extensive non-linear interactions between risk loci in T1GRS, for example between HLA-DQB1*57 andINS,coding and non-coding HLA alleles, andDEXI, INSand other beta cell loci, that provided mechanistic insight and improved risk prediction. T1D individuals formed distinct clusters based on genetic features from T1GRS which had significant differences in age of onset, HbA1c, and renal disease severity. Finally, we provided T1GRS in formats to enhance accessibility of risk prediction to any user and computing environment. Overall, the improved genetic discovery and prediction of T1D will have wide clinical, therapeutic, and research applications.
Differences in bioprosthetic valve failure after aortic valve replacement in patients with immune mediated inflammatory diseases
Authors: Sefton Christopher , Leaphart Davis , Klein Benjamin , Santini Garrett , Patel Aditi , Husni M. Elaine , Vargo Patrick R. , Roselli Eric E. , Svensson Lars , Krishnaswamy Amar , Kapadia Samir , Menon Venu , Khot Umesh , Wassif Heba 
Published: August 2024

ABSTRACTIntroductionImmune-mediated inflammatory disease (IMID) is a subset of autoimmune diseases including systemic lupus erythematosus, rheumatoid arthritis, and psoriasis that is emerging as a risk factor for many cardiovascular diseases including valvular disease.ObjectivesTo determine whether IMID is associated with frequent and early development of bioprosthetic valve failure (BVF) after surgical aortic valve replacement (SAVR) and transcatheter valve replacement (TAVR).MethodsSerial echocardiograms for patients who underwent SAVR and TAVR at Cleveland Clinic between 2000 and 2022 were assessed for time to development of BVF after procedure. ICD10 codes were used to stratify to those with and without IMID. Kaplan-Meier curve and cox proportional hazard regression analysis were used to assess for differences in development of BVF after TAVR and SAVR.Results351 TAVR patients (52 IMID and 299 controls) and 1961 SAVR patients (300 IMID and 1661 controls) were included. BVF after TAVR occurred in 12 (23.1%) IMID and 21 (7.0%) control patients, respectively, yielding an adjusted hazard ratio of 4.02 (1.81 - 8.92). Time to 50% of patients developing BVF was earlier among IMID, occurring at 6.6 years IMID and not reached in controls (p < 0.001). There were no significant differences in prevalence and time to development of BVF in IMID vs controls after SAVR.ConclusionAfter TAVR, BVF occurred earlier and more frequently in patients with IMID than controls. This risk should be included during shared decision making among IMID patients considered for TAVR, and may warrant more frequent monitoring post procedure. These differences in BVF were not seen after SAVR.
Synergistic combination therapy with ONC201 or ONC206, Enzalutamide and Darolutamide in preclinical studies of castration-resistant prostate cancer
Authors: Wu Laura , Pinho-Schwermann Maximilian , Zhou Lanlan , Zhang Leiqing , Huntington Kelsey E. , Malpass Ryan , Seyhan Attila A. , Carneiro Benedito A. , El-Deiry Wafik S. 
Published: August 2024

AbstractAndrogen receptor (AR) signaling plays a primary role in prostate cancer progression. Non-steroidal anti- androgens (NSAA) including enzalutamide, and apalutamide have been used to treat patients with advanced disease. However, patients with metastatic castration-resistant prostate cancer (mCPRC) develop resistance, resulting in limited overall survival benefit. Darolutamide is a novel next-generation androgen receptor- signaling inhibitor that is FDA approved for non-metastatic castration resistant prostate cancer (nmCRPC). Imipridone ONC201/TIC10 is first-in-class small molecule that activates the integrated stress response (ISR) and upregulates TNF-related apoptosis-inducing ligand (TRAIL). Our study investigates ISR and AR signaling in anti-tumor efficacy with ONC201 and enzalutamide or darolutamide against mCRPC cells. mCRPC cell lines 22RV1, LNCaP, DU145 and PC3 were treated with ONC201, darolutamide, and enzalutamide as single agents or in combinations. Combinations of ONC201 and darolutamide or enzalutamide demonstrated synergistic effects in mCRPC cells. Combinations of ONC201 and darolutamide or enzalutamide reduced PSA levels in LNCaP cells and induced of ATF4 in both LNCaP and 22RV1 cell lines. Darolutamide synergized with ONC201 regardless of AR status or castration sensitivityin vitro.Flow cytometric analysis showed increased intra-tumoral NK cells in mice treated with ONC201 and combination of ONC201 and darolutamide. Trends of increased TRAIL activation within NK cells were also observed in treatment groups. ONC201 and darolutamide demonstrated anti-tumor effectsin vivoin the 22RV1 CRPC model. Our results prompt further translational and clinical studies with imipridones ONC201 or ONC201 in combination with enzalutamide or darolutamide for treatment of castrate resistant advanced or metastatic prostate cancer.