bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brain injury biomarkers and applications in neurological diseases
Authors: Zhang Han , Wang Jing , Qu Yang , Yang Yi , Guo Zhen-Ni 
Published: June 2024

Abstract
Neurological diseases are a major health concern, and brain injury is a typical pathological process in various neurological disorders. Different biomarkers in the blood or the cerebrospinal fluid are associated with specific physiological and pathological processes. They are vital in identifying, diagnosing, and treating brain injuries. In this review, we described biomarkers for neuronal cell body injury (neuron-specific enolase, ubiquitin C-terminal hydrolase-L1, αII-spectrin), axonal injury (neurofilament proteins, tau), astrocyte injury (S100β, glial fibrillary acidic protein), demyelination (myelin basic protein), autoantibodies, and other emerging biomarkers (extracellular vesicles, microRNAs). We aimed to summarize the applications of these biomarkers and their related interests and limits in the diagnosis and prognosis for neurological diseases, including traumatic brain injury, status epilepticus, stroke, Alzheimer’s disease, and infection. In addition, a reasonable outlook for brain injury biomarkers as ideal detection tools for neurological diseases is presented.
Pediatric Terrien Marginal Degeneration
Authors: Eskenazi-Betech Ruth , Fabregas-Sanchez-Woodworth Daniela , Ramirez-Miranda Arturo , Navas Alejandro , González José M. , Mangwani-Mordani Simran , Graue-Hernández Enrique O. 
Published: June 2024

Purpose:
To describe 2 cases of Terrien marginal degeneration (TMD) in young children.

Methods:
A total of 2 pediatric patients aged 5 and 10 years with unremarkable familial history underwent routine ophthalmological examination because of the presence of superior corneal opacities with no other associated symptoms. The younger patient showed lipid deposition adjacent to the superior limbus and peripheral thinning with vessels coursing across the left eye. The visual acuity was 20/20 in both eyes. The older patient had similar clinical features. The visual acuity improved from 20/25 and 20/60 in the right and left eye, respectively, to 20/20 with subjective refraction in both eyes. The left eye revealed a superior crescent-shaped corneal opacity and superotemporal peripheral thinning associated with lipid deposition and superficial vascularization. Serological markers for autoimmune diseases were negative. The patients were diagnosed with TMD.

Results:
Corneal tomography (Pentacam, Oculus, Wetzlar, Germany) revealed steepening of the superior cornea of the affected eye in both patients. Anterior segment optical coherence tomography of the younger patient confirmed marked furrow indentation and peripheral thinning. The older patient showed peripheral stromal thinning on Scheimpflug imaging. These findings supported the diagnosis of TMD.

Conclusions:
Ophthalmologists should acknowledge that TMD can present with or without ocular inflammation, especially at a young age. Given the variable progression rate of TMD, ongoing and thorough monitoring is crucial for effective management and prognosis in affected patients.
Pedunculated Neoplasm of the Vulva
Authors: Zeng Ziyuan , Xiong Xia , Liu Zongjunlin , Lei Qirong , He Yuanmin 
Published: June 2024

Abstract:
Extramammary Paget disease (EMPD) is a rare cutaneous malignancy, typically presenting as eczema-like lesions in areas rich in apocrine glands such as the perineum. Here, we report a case of EMPD presenting as a prominent pedunculated neoplasm in a 65-year-old woman. Despite initial misdiagnosis and treatment, biopsy confirmed EMPD infiltration. Following surgical excision, the patient developed brain metastases, indicating a poor prognosis. EMPD's pathogenesis remains unclear, but distinguishing primary from secondary forms is crucial for prognosis and treatment. Our case underscores the importance of recognizing atypical EMPD presentations for timely intervention and improved outcomes.
A Rare Case of Adenocarcinoma With Micropapillary Structure and Apocrine Differentiation Arising in a Sebaceous Tumor
Authors: Shojiguchi Naoko , Arai Eiichi , Kamimura Anna , Yasuda Masanori 
Published: June 2024

Abstract:
A 77-year-old Japanese man presented to our hospital with subcutaneous tumors of the right upper arm and axilla. A biopsy revealed a cutaneous adnexal tumor, showing apocrine differentiation, and axillary lymph node metastasis. After chemoradiotherapy to shrink the tumors, both lesions were resected. A resected specimen of the arm tumor showed a variegated histology: (1) a classic sebaceoma with an organoid pattern and sebocytes; (2) a sebaceous tumor with cellular atypia; (3) a papillotubular tumor showing a biphasic pattern of pale eosinophilic cells with apocrine differentiation and basaloid cells; and (4) an invasive adenocarcinoma with a micropapillary structure, reminiscent of an invasive micropapillary carcinoma of the breast. The axillary tumor was regressed. To our knowledge, this is the first reported case of an adnexal tumor of the skin with an invasive micropapillary structure arising in a sebaceous tumor.
Cellular Schwannoma Mimicking a Nodular Melanoma on the Sole of the Foot, an Avoidable Diagnostic Pitfall
Authors: Ruz Portero Begoña , García de Sola Llamas Carmen , Pérez Pérez Manuel , Sánchez Bernal María Luisa , Moreno Ramírez David , Ríos Martín Juan José 
Published: June 2024

Abstract:
We report a rare case of cellular schwannoma (CS) manifesting as an ulcerated nodular lesion, mimicking spindle cell melanoma on the sole of the foot. CS, a benign variant of schwannoma, typically occurs in deep soft tissues but can rarely present cutaneously. The diagnosis of CS heavily relies on histopathological examination and immunohistochemical staining for specific markers such as SOX10 and S100. In this case, initial clinical suspicion of nodular melanoma was confirmed on biopsy, which revealed a spindle cell neoplasm positive for SOX10 and negative for melanocytic markers. Misdiagnosis of nodular melanoma was averted through complete excision. CS diagnosis demands careful consideration due to its resemblance to other spindle cell neoplasms, especially melanoma. Meticulous histopathological evaluation and immunostaining are important to differentiate CS from similar lesions, ensuring accurate diagnosis and appropriate management. This report contributes valuable insights into the diagnostic challenges and management of CS, particularly in unusual cutaneous presentations.
Usefulness of a virtual reality educational program for reducing preoperative anxiety in children
Authors: Carbó Adriana , Tresandí Daniel , Tril Cristina , Fernández-Rodríguez Diego , Carrero Enrique 
Published: June 2024

BACKGROUND
Preoperative anxiety (PA) is common in children and has detrimental effects on surgical outcome. Strategies based on virtual reality (VR) have recently been introduced to address this problem.

OBJECTIVE
This study evaluated the usefulness of a virtual reality educational program (VREP) for reducing preoperative anxiety in elective low-complexity paediatric surgery.

DESIGN
Randomised clinical trial.

SETTING
Single tertiary centre in Barcelona, Spain. Between January 2019 and June 2022.

PATIENTS
Children aged 3–13 years of age, American Society of Anesthesiologists (ASA) I–II, scheduled for elective low-complexity surgery were enrolled in the study.

INTERVENTION
Children were randomised into a control group (received oral/written information about the anaesthetic-surgical process, and patients and their parents remained in a playroom waiting for the surgery) or VREP (viewed a VR-based educational video on the surgical process, 7–10 days prior to surgery) using the MATLAB application.

MAIN OUTCOME MEASURE
PA using the modified Yale Preoperative Anxiety Scale (mYPAS) during separation from parents.

RESULTS
In total, 241 children aged 3–12 years of age were studied (120 patients with VREP and 121 controls). Randomisation eliminated the differences between the groups, except for a greater male presence in the VREP group (83.3% vs. 71.1%; P = 0.023). The mYPAS yielded was lower in the VREP group (29.2% vs. 83.5%; P < 0.001). Sex did not influence VREP-mediated decrease in PA (P < 0.001). In turn, VREP patients were more cooperative (Induction Compliance Checklist [ICC] score 0 points vs. 2 points; P < 0.001) during anaesthesia induction, presented less delirium (Pediatric Anesthesia Emergence Delirium [PAED] score 1 point vs. 3 points; P = 0.001) on leaving the recovery room, and experienced less pain upon arrival in the hospital ward (Wong-Baker Faces Pain Rating Scale: 0-points vs. 1 point; P < 0.001).

CONCLUSIONS
The VREP-based prevention strategy reduced preoperative anxiety in children undergoing elective low-complexity surgery.

TRIAL REGISTRATION
NCT03578393.
Development and Validation of a High-Performance Liquid Chromatography With Ultraviolet Detection Method to Facilitate Therapeutic Monitoring of Teicoplanin Using Dried Blood Spots
Authors: Ramadan Ola , Opitz Patrick , Hempel Georg 
Published: June 2024

Background:
In neonatal and pediatric intensive care units, Gram-positive infections are a significant cause of morbidity and mortality. The increase in infections caused by methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococci have led to the increased use of glycopeptides, which treat invasive infections caused by Gram-positive organisms, particularly those resistant to beta-lactam antibiotics. Teicoplanin has bacteriostatic activity against Gram-positive bacteria, but its pharmacokinetics in children is highly variable, with most children failing to reach target levels at the recommended dose. This study aimed to develop a cost-effective method for determining concentrations using dried blood spot (DBS).

Methods:
A method to determine the concentrations of teicoplanin in 20 µL blood or plasma using the Whatman 903 Protein Saver filter was evaluated. High-performance liquid chromatography with ultraviolet detection high-performance liquid chromatography with ultraviolet/vis was used, with internal standard ketoconazole. In addition, a method to quantify teicoplanin using 50 µL of liquid plasma was established to compare the results with the values obtained by DBS and dried plasma methods.

Results:
The method was successfully developed and validated for 20 µL DBS. Furthermore, 50 µL of plasma was used to quantify teicoplanin with a lower limit of quantification of 10 mg/L. Precision and accuracy ranged from 2.3% to 10.7% and 95%–114.2%, respectively. A consistent factor (1.15) was used to calculate teicoplanin plasma concentrations from whole blood, indicating the reliability of the DBS method for therapeutic drug monitoring of teicoplanin.

Conclusions:
A simple, reliable, and cost-effective method using high-performance liquid chromatography with ultraviolet/vis was established to determine pediatric teicoplanin concentrations in both small plasma sample volumes and whole blood using DBS, and an accurate correlation factor for estimating teicoplanin plasma concentrations from DBS was identified. This method is suitable for the use in pediatrics.
Simultaneous Reconstruction of the Bilateral Maxillae and Nasal Hard Structure Using a Vascularized and Nonvascularized Fibula
Authors: Tsuge Itaru , Yamanaka Hiroki , Katsube Motoki , Sakamoto Michiharu , Morimoto Naoki 
Published: June 2024

Summary:
Midfacial reconstruction for extensive defects of the hard nasal structures and bilateral maxillae is challenging. Postoperative radiotherapy causes skin contracture, making secondary reconstruction extremely difficult. A 57-year-old man underwent resection of the nasal bone, nasal cartilage, and hard palate for cancer of the nasal cavity. Postoperative radiotherapy (70 Gy) resulted in bilateral osteoradionecrosis. Severe depression deformity of the midface causes a disorder in closing the mouth, resulting in difficulty in conversation and oral intake. We performed simultaneous reconstruction of the bilateral maxillary and nasal hard structures using double free flaps (fibular osteocutaneous and anterolateral thigh flaps). A 16-cm right fibular osteocutaneous flap was elevated, and an 8-cm proximal bone was resected to obtain the length of the peroneal vessels. The distal 8 cm was cut into three pieces while maintaining the blood flow. The removed nonvascularized fibula was processed into two pieces of cortex: nasal bridge and columella. All areas of the skin island were de-epithelialized to bilaterally fill the maxillary sinuses. Next, the ipsilateral anterolateral thigh flap was elevated with the central 6-cm part for closure of the palate and the proximal area to fill the nasal cavity. The distal area consisted of a fascial flap to cover the reconstructed nasal structure. The chimeric double flap allowed for oral intake, conversation, and nasomaxillary prominence. Computed tomography performed 8 months postoperatively showed maintained bony structures. We used the extra fibula as a nonvascularized cortex piece to prevent infection and exposure, which enabled simultaneous reconstruction of the bilateral maxillae and hard nasal structure.
Aramchol improves hepatic fibrosis in metabolic dysfunction–associated steatohepatitis: Results of multimodality assessment using both conventional and digital pathology
Authors: Ratziu Vlad , Yilmaz Yusuf , Lazas Don , Friedman Scott L. , Lackner Caroline , Behling Cynthia , Cummings Oscar W. , Chen Li , Petitjean Mathieu , Gilgun-Sherki Yossi , Gorfine Tali , Kadosh Shaul , Eyal Eli , Sanyal Arun J. 
Published: June 2024

Background and Aims:
Antifibrotic trials rely on conventional pathology despite recognized limitations. We compared single-fiber digital image analysis with conventional pathology to quantify the antifibrotic effect of Aramchol, a stearoyl-CoA desaturase 1 inhibitor in development for metabolic dysfunction–associated steatohepatitis.

Approach and Results:
Fifty-one patients with metabolic dysfunction–associated steatohepatitis enrolled in the open-label part of the ARMOR trial received Aramchol 300 mg BID and had paired pre-post treatment liver biopsies scored by consensus among 3 hepatopathologists, and separately assessed by a digital image analysis platform (PharmaNest) that generates a continuous phenotypic Fibrosis Composite Severity (Ph-FCS) score. Fibrosis improvement was defined as: ≥1 NASH Clinical Research Network (NASH-CRN) stage reduction; “improved” by ranked pair assessment; reduction in Ph-FCS (“any” for ≥0.3 absolute reduction and “substantial” for ≥25% relative reduction). Fibrosis improved in 31% of patients (NASH-CRN), 51% (ranked pair assessment), 74.5% (any Ph-FCS reduction), and 41% (substantial Ph-FCS reduction). Most patients with stable fibrosis by NASH-CRN or ranked pair assessment had a Ph-FCS reduction (a third with substantial reduction). Fibrosis improvement increased with treatment duration: 25% for <48 weeks versus 39% for ≥48 weeks by NASH-CRN; 43% versus 61% by ranked pair assessment, mean Ph-FCS reduction −0.54 (SD: 1.22) versus −1.72 (SD: 1.02); Ph-FCS reduction (any in 54% vs. 100%, substantial in 21% vs. 65%). The antifibrotic effect of Aramchol was corroborated by reductions in liver stiffness, Pro-C3, and enhanced liver fibrosis. Changes in Ph-FCS were positively correlated with changes in liver stiffness.

Conclusions:
Continuous fibrosis scores generated in antifibrotic trials by digital image analysis quantify antifibrotic effects with greater sensitivity and a larger dynamic range than conventional pathology.
Research Letter: Concussion-Related General Startle Suppression in Adolescent Athletes
Authors: Oldham Jessie R. , DeFalco Angelica , Willwerth Sarah , Nagle Shannon , Whittaker Freya , Mannix Rebekah , Meehan William P. , Bradford Daniel E. 
Published: June 2024

Objectives:
We investigated the acoustic startle reflex in recently concussed adolescent athletes compared to healthy controls and those with concussion history (>1 year prior) but no current symptoms. We hypothesized that individuals with recent concussion would have a suppressed startle response compared to healthy controls.

Methods:
We conducted a cross-sectional study on 49 adolescent athletes with a recent concussion (n = 20; age: 14.6 ± 1.6 years; 60% female), a concussion history > 1 year prior (n = 16; age: 14.8 ± 2.0 years; 44% female), and healthy controls (n = 13; age: 13.3 ± 2.8 years; 54% female). We measured the eyeblink of the general startle reflex via electromyography activity of the orbicularis oculi muscle using electrodes placed under the right eye. Measurement sessions included twelve 103 decibel acoustic startle probes ~50 milliseconds in duration delivered ~15-25 seconds apart. The primary dependent variable was mean startle magnitude (µV), and group was the primary independent variable. We used a one-way analysis of variance followed by a Tukey post hoc test to compare mean startle magnitude between groups.

Results:
Mean startle magnitude significantly differed (F = 5.49, P = .007) among the groups. Mean startle magnitude was significantly suppressed for the concussion (P = .01) and concussion history groups (P = .02) compared to healthy controls. There was no significant difference between the recent concussion and concussion history groups (P = 1.00).

Conclusion:
Our results provide novel evidence for startle suppression in adolescent athletes following concussion. The concussion history group had an attenuated startle response beyond resolution of their recovery, suggesting there may be lingering physiological dysfunction.
Declining Incidence of Kawasaki Disease During the COVID-19 Pandemic: A Time Series Analysis
Authors: Lin Yi-Hsuan , Lin Ching-Heng , Lin Ming-Chih 
Published: June 2024

Background:
In 2020, Taiwan experienced a dramatic disruption of daily life due to measures aimed at limiting the spread of coronavirus disease 2019 (COVID-19), although domestic COVID-19 cases were extremely rare. This provided a chance to investigate the change of incidence and possible triggers of Kawasaki disease (KD) without the interference of multisystem inflammatory syndrome in children.

Methods:
This population-based study used Taiwan’s National Health Insurance Research Database. To detect the change in KD incidence in children less than 6 years old during the period of social distancing policy in 2020, the autoregressive integrated moving average model was used based on seasonal variation and the increasing trend of KD incidence over the past 10 years. The trends in population mobility and common infectious diseases were also analyzed to observe their effects on KD incidence.

Results:
The predicted monthly incidence [95% confidence interval (CI)] of KD in April, May and June 2020 were 5.26 (3.58–6.94), 5.45 (3.70–7.20) and 5.41 (3.61–7.21) per 100,000 person-months. The actual observed incidences were 2.41, 2.67 and 2.60 per 100,000 person-months, respectively, representing a 51.2%, 51.0% and 51.9% reduction in incident rates in the 3-month period of stringent COVID-19 mitigation measures. The trend was not proportionate to the profound decline of common infectious cases.

Conclusions:
KD incidence decreased by approximately 50% during the period of stringent COVID-19 mitigation measures in 2020 in Taiwan. Human-to-human contact may be a potential KD trigger, but there are likely other contributing factors aside from infection.
Projected Public Health Impact of a Universal Rotavirus Vaccination Program in France
Authors: Oluwaseun Sharomi , Cagnan Lauren , Xausa Ilaria , Nachbar Robert B. , Levy Bachelot Laurie , Chen Yao-Hsuan , Carias Cristina 
Published: June 2024

Objective:
In June 2022, French health authorities issued a universal recommendation for routine administration and reimbursement of rotavirus vaccines in infants. Given this recent recommendation by French health authorities, we sought to understand the public health impact of a universal rotavirus vaccination strategy compared with no vaccination.

Materials and Methods:
A deterministic, age-structured, nonlinear dynamic transmission model, accounting for herd immunity, was developed. We considered 3 vaccination coverage scenarios: high (95%), medium (75%) and low (55%). Model parameter values were based on published modeling and epidemiological literature. Model outcomes included rotavirus gastroenteritis (RVGE) cases and healthcare resource utilization due to RVGE (hospitalizations, general practitioner or emergency department visits), as well as the number needed to vaccinate to prevent 1 RVGE case (mild or severe) and 1 RVGE-related hospitalization. Model calibration and analyses were conducted using Mathematica 11.3.

Results:
Over 5 years following implementation, RVGE cases for children under 5 years are estimated to be reduced by 84% under a high vaccination coverage scenario, by 72% under a medium vaccination coverage scenario and by 47% under a low vaccination coverage scenario. Across all scenarios, the number needed to vaccinate to avert 1 RVGE case and hospitalization varied between 1.86–2.04 and 24.15–27.44, respectively.

Conclusions:
Rotavirus vaccination with high vaccination coverage in France is expected to substantially reduce the number of RVGE cases and associated healthcare resource utilization.
Reduced Functioning After Hospitalization for COVID-19 Infection
Authors: Smith James M. , Smith Ellen M.T. , Zafron Michelle L. , Bohannon Richard W. , Miller Kenneth , Thiele Alecia , Zeleznik Hallie , Ohtake Patricia J. 
Published: June 2024

Background and Purpose:
COVID-19 infection is associated with persistent physical problems, and approximately 2% of the >100 million people in the United States with COVID-19 infection have required hospitalization. The purpose of this review is to identify problems with activity and participation persisting during the first 6 months after hospitalization for COVID-19.

Methods:
A comprehensive search of 5 bibliographic databases was performed for cohort studies examining activity limitations and participation restrictions assessed within 6 months of hospitalization in adults hospitalized with COVID-19 infection. Two reviewers screened titles, abstracts, and full text to determine eligibility. Study methodological quality was assessed using the SIGN Methodology Checklist 3. Study methods, design, and participant outcomes were extracted. Results were summarized in narrative synthesis, and meta-analysis was conducted for 6-minute walk test.

Results:
Titles (n = 2670) were screened, and 26 acceptable to high-quality studies satisfied all eligibility criteria. Within the first 6 months following hospitalization for COVID-19 people experienced activity limitations and participation restrictions, including 16% reduction in 6-minute walk test distance (compared to age and gender-matched norms) and 59% return to employment rate.

Discussion and Conclusion:
The first 6 months following hospitalization for COVID-19 infection are associated with significant reductions in exercise capacity and return to work. Problems associated with post-intensive care syndrome cannot be ruled out as contributing to these findings. Recognition of these problems is essential and should inform hospital discharge planning and rehabilitation services.