bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case of multiple intracerebral hemorrhage due to early-onset cerebral amyloid angiopathy with Alzheimer`s disease neuropathological change three decades after childhood neurosurgery
Authors: Funakoshi Takumi , Yamada Minoru , Ikeda Kazuna , Yokokawa Kazuki , Saito Tarou , Suzuki Syuuichiro , Iwahara Naotoshi , Kimura Yusuke , Akiyama Yukinori , Mikuni Nobuhiro , Hisahara Shin 
Published: August 2024

Abstract

Background
Cerebral amyloid angiopathy (CAA) is a disease in which Amyloid β (Aβ) is deposited in blood vessels and meninges in the brain. CAA typically occurs in the elderly but is also known to occur in younger patients with a history of childhood head trauma or dura graft following neurosurgical procedures. In some cases, pathological examination of brain biopsies has identified not only Aβ but also phosphorylated tau (p-tau) deposits. This is a pathological feature characteristic of Alzheimer`s disease (AD). There are few reports of cases in which AD has already developed based on cognitive decline symptoms and the presence of p-tau in cerebrospinal fluid (CSF). This is the first case of amyloid angiopathy after graft surgery in which the patient already had mild cognitive decline and pathological findings showed not only amyloid β accumulation but also abnormal tau accumulation.
Case presentation
The patient is a 39-year-old female who underwent neurosurgery for an arachnoid cyst in the right temporal lobe at the age of 2 years. The patient probably underwent dural transplantation, although this is unclear because no operative record remains. Severe headache, dizziness and right leg weakness developed abruptly. Neurological finding showed aprosexia and cognitive impairment of 21/30 on MMSE. The Aβ42/40 ratio had decreased in CSF. Brain MRI showed multiple cerebral hemorrhages. 123I -iodoamphetamine single-photon emission computed tomography (IMP-SPECT) showed hypoperfusion dominantly in the bilateral temporal lobe and posterior cingulate gyrus. Considering of CAA, brain biopsy was performed. Pathological examination showed severe CAA in many leptomeningeal and cortical vessels. Neurofibrillary tangles, neuropil threads and tau-positive neurites around plaques were also present.
Conclusion
We reported early-onset CAA after neurosurgery in childhood. In addition to pathological findings characteristic of AD, cognitive impairment was also observed, suggesting that the patient may have developed AD. In pathological finding, p-tau deposition was observed in neurons. These finding suggested the possibility of progression to AD in this patient. We believe that this is an extremely rare case of early-onset CAA with cognitive decline, abnormalities of Aβ and tau in cerebrospinal fluid, AD pathology including deposition of p-tau in neurons, and characteristic findings on IMP-SPECT.
Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013–2022)
Authors: Han Mei , Hua Miaomiao , Xie Hui , Li Jia , Wang Yijun , Shen Han , Cao Xiaoli 
Published: August 2024

Abstract

Objective
This study aimed to analyze the antimicrobial resistance profiles, the clinical characteristics and risk factors of bacteremia caused by Enterobacter cloacae complex (ECC) strains.
Methods
Clinical information of patients diagnosed with bacteremia caused by ECC from 2013 to 2022 were collected retrospectively. The clinical data of these patients were then analyzed in subgroups based on multidrug resistance (MDR), nosocomial acquired, polymicrobial bacteremia and mortality.
Results
The ECC strains showed the highest resistant rates to ceftriaxone (39.9%), followed by ceftazidime (36.7%) and aztreonam (31.2%). The proportion of MDR ECC was 30.9% (58/188). The analysis revealed that initial empirical antibiotic therapy was a robust and independent risk factor (OR = 3.193, 95%CI 1.203–8.479, P < 0.020), whereas, appropriately empirical therapy significantly reduced the risk (OR = 0.279, 95%CI 0.130–0.598, P < 0.001) of MDR-ECC bacteremia. In addition, ICU admission was identified as independent risk factors in patients with polymicrobial bacteremia (P = 0.009). Moreover, diagnostic procedure (endoscopy) (P = 0.009) and blood transfusion (P = 0.003) were independent risk factors for mortality.
Conclusion
Carbapenems and amikacin as the most effective treatments for ECC bacteremia. Initial empirical antibiotic therapy was an independent risk factor, and appropriate empirical therapy was a protective factor for patients with MDR ECC bacteremia. ICU admission was an independent risk factor for polymicrobial bacteremia. Both endoscopy and blood transfusion are associated with mortality of ECC Bacteremia. Control of MDR ECC bacteremia requires a cooperative and comprehensive approach, including strategies for identification of resistant organisms, risk factor detection and implementation strategies of infection-control and prevention.
Expanding clinical spectrum of PAICS deficiency: Comprehensive analysis of two sibling cases
Authors: Zikanova Marie , Weng Wen-Chin , Skopova Vaclava , Barešová Veronika , Liu Yao-Lin , Hsueh Hsueh-Wen , Chien Yin-Hsiu , Hwu Wuh-Liang , Souckova Olga , Hnizda Ales , Kmoch Stanislav , Lee Ni-Chung 
Published: August 2024

Abstract

De novo synthesis of purines (DNPS) is a biochemical pathway that provides the purine bases for synthesis of essential biomolecules such as nucleic acids, energy transfer molecules, signaling molecules and various cofactors. Inborn errors of DNPS enzymes present with a wide spectrum of neurodevelopmental and neuromuscular abnormalities and accumulation of characteristic metabolic intermediates of the DNPS in body fluids and tissues. In this study, we present the second case of PAICS deficiency due to bi-allelic variants of PAICS gene encoding for a missense p.Ser179Pro and truncated p.Arg403Ter forms of the PAICS proteins. Two affected individuals were born at term after an uncomplicated pregnancy and delivery and presented later in life with progressive cerebral atrophy, epileptic encephalopathy, psychomotor retardation, and retinopathy. Plasma and urinary concentrations of dephosphorylated substrates of PAICS, AIr and CAIr were elevated, though, in skin fibroblasts they remained undetectable. Both variants affect structural domains in SAICARs catalytic site and the oligomerization interface. In silico modelling predicted negative effects on PAICS oligomerization, enzyme stability and enzymatic activity. Consistent with these findings, affected skin fibroblast were devoid of PAICS protein and enzyme activity. This was accompanied by alterations in contents of other DNPS proteins, which had co-localized in granular structures that are characteristic of purinosome formation. Our observation expands the clinical spectrum of PAICS deficiency from recurrent abortions and fatal neonatal form to later onset neurodevelopmental disorders. The rarity of this condition may be based on poor clinical recognition and limited access to specialized laboratory tests diagnostic for PAICS deficiency.
Effects of temperature experienced across life stages on morphology and flight behavior of painted lady butterflies (Vanessa cardui)
Authors: Mesler Sarah P. , Mabry Karen E. 
Published: August 2024

Abstract

Background: With ongoing anthropogenic climate change, there is increasing interest in how organisms are affected by higher temperatures, including how animals respond behaviorally to increasing temperatures. Movement behavior is especially relevant here, as the ability of a species to shift its range is implicitly dependent upon movement capacity and motivation. Temperature may influence movement behavior of ectotherms both directly, through an increase in body temperature, and indirectly, through temperature-dependent effects on physiological and morphological traits that can influence movement.
Methods: Here, we investigate the influence of ambient temperature during two life stages, larval and adult, on body size and movement behavior of the painted lady butterfly (Vanessa cardui). We reared painted ladies to emergence at either a “low” (24 °C) or “high” (28 °C) temperature. At eclosion, we assessed flight behavior in an arena test, with half of the adults emerging from each rearing treatment tested at either the “low” or “high” temperature. We had a total of four treatment groups: the control (reared and tested at 24 °C), a consistently high temperature (reared and tested at 28 °C), and two treatments in which butterflies experienced flight tests at a temperature either higher or lower than the one at which they were reared. We measured adult body size, including wingspan, and determined flight speed, distance, and duration from video recordings.
Results: Adult butterflies that experienced the higher temperature during development were larger. We documented an interaction effect of rearing x testing temperature on flight behavior: unexpectedly, the fastest butterflies were those who experienced a change in temperature, whether an increase or decrease, between rearing and testing.
Conclusions: Individuals that experienced matching thermal environments flew more slowly, but for more time and covering more distance. Overall, the influence of body size per se on flight was minimal. We conclude that the potential role of “matching” thermal environments across life stages has been underinvestigated with regard to how organisms may respond to warming conditions.
Adapting Health Revenue Cycle Management Best Practices among Public or Private Healthcare providers in Saudi Arabia: A Pilot Study
Authors: Yafi Ola Al , Albabtain Monirah A. , Arafat Amr , Jassas Abdullatif Bin 
Published: August 2024

Abstract

The literature lacks evidence of scoring systems in health revenue cycle management (HRCM) assessment in Saudi Arabia. We established a gap analysis scoring system to classify healthcare providers' HRCM readiness. This pilot study aimed to assess the rate of adapting health revenue cycle management best practices among public or private healthcare providers in Saudi Arabia. This pilot study included ten healthcare providers in Saudi Arabia. The providers were assessed during the period from August 2022 to May 2023. HRCM components were assessed are contract management, pre-service, time-of-service, and post-service. Contract management and pre-service assessment found that all of the healthcare providers had missed some or most of sub-major functions. For Time-of-service, all healthcare providers required comprehensive gap analysis, and establishment of policies and procedures. Post-service was assessed in seven healthcare providers while absent in three. All healthcare providers required training and activation of reporting protocol and KPIs. Overall assessment revealed that one HCP had a low classification, seven had a moderate classification, and two had a high classification. All healthcare providers have a part that can be enhanced by training, comprehensive gap analysis, policies and procedures, ongoing monitoring, patient satisfaction research and developing health information systems.
The changes of serum uric acid and total cholesterol are associated with the severity of Crohn's disease：A cross-sectional study
Authors: Ni Jinchun , Tang Yunna , Hu Yiqun , Liu Lupeng , Lin Yumei , Ouyang Hui , Xie Chenxi 
Published: August 2024

Abstract

Background: More serological indicators with convenient and sensitive characteristics are needed in clinical practice to help determine the severity of Crohn's disease (CD).
Methods: One hundred and forty-one CD patients and ten health volunteers were included in this retrospective study. The serum urid acid (SUA) and indicators related to lipid metabolism were detected within one week before endoscopic and CT enterography (CTE) examinations. Patients were divided into groups according to CDAI（Crohn's disease activity index）scores.
Results: Patients were divided into two groups, and no patients with severe CD were included in the study. SUA values were increased in CD patients when compared to that of control group(p=0.033). The values of TC, apo A1, HDL-C and LDL-C were decreased in CD patients(p<0.05). The TC and LDL-C values were decreased in moderate CD group when compared to that of mild/remission group (p<0.01). Lower SUA and TC were independent risk factors for serious disease (for SUA, OR=2.319, 95%CI 1.067-5.041, p=0.034, for TC, OR=5.231, 95% CI 2.180-12.552, p<0.001). Both SUA and TC were correlated to CDAI scores negatively(p<0.05), and TC was also correlated to CRP negatively (r=-0.250, p=0.003). The sensitivity of TC and SUA was fine in distinguishing patients with moderate CD.
Conclusions: For CD patients, SUA and TC levels were associated with clinical activity. Detection of the two serum indicators may be conducive to screening serious disease.
HMGB-1 as a predictor of massive transfusion protocol activation in major trauma: a prospective observational study
Authors: Frelich Michal , Bebej Marek , Pavlíček Jan , Burša Filip , Vodička Vojtěch , Švagera Zdeněk , Kondé Adéla , Jor Ondřej , Sklienka Peter 
Published: August 2024

Abstract

Background
Massive bleeding causes approximately 50% of deaths in patients with major trauma. Most patients die within 6 hours of injury, which is preventable in at least 10% of cases. For these patients, early activation of the massive transfusion protocol (MTP) is a critical survival factor. With severe trauma, high-mobility group box 1 (HMGB-1, i.e., amphoterin) is released into the blood, and its levels correlate with the development of a systemic inflammatory response, traumatic coagulopathy, and fibrinolysis. Previous work has shown that higher levels of HMGB-1 are associated with a higher use of red blood cell transfusions. We conducted a single-center, prospective, observational study to assess the value of admission HMGB-1 levels in predicting activation of MTP in the emergency department.
Methods
From July 11, 2019, to April 23, 2022, a total of 104 consecutive adult patients with severe trauma (injury severity score > 16) were enrolled. A blood sample was taken at admission, and HMGB-1 was measured. MTP activation in the emergency department was recorded in the study documentation. The total amount of blood products and fibrinogen administered to patients within 6 hours of admission was monitored.
Results
Among those patients with massive bleeding requiring MTP activation, we found significantly higher levels of HMGB-1 compared to patients without MTP activation (median [interquartile range]: 84.3 µg/L [34.2–145.9] vs. 21.1 µg/L [15.7–30.4]; p < 0.001). HMGB-1 level showed good performance in predicting MTP activation, with an area under the curve of 0.84 (95% CI 0.75–0.93) and a cut-off value of 30.55 µg/L. HMGB-1 levels correlated significantly with the number of red blood cell units (rs [95% CI] 0.46 [0.28–0.61]; p < 0.001), units of fresh frozen plasma (rs 0.46 [0.27–0.61]; p < 0.001), platelets (rs 0.48 [0.30–0.62]; p < 0.001), and fibrinogen (rs 0.48 [0.32–0.62]; p < 0.001) administered in the first 6 hours after hospital admission.
Conclusions
Admission HMGB-1 levels reliably predict MTP activation in the emergency department and correlate with the amount of blood products and fibrinogen administered during the first 6 hours of hemorrhagic shock resuscitation.
Trial registration
NCT03986736 Registration date: June 4, 2019
Pharmacokinetics-pharmacodynamics of first line antitubercular drugs: A comparative study in tuberculosis patients with and without concomitant diabetes mellitus
Authors: Mondal Sourav , Roy Vandana , Meshram Girish Gulab , Khanna Ashwani , Velpandian Thirumurthy , Garg Sandeep 
Published: August 2024

Abstract

Purpose
To observe the variability in the plasma concentrations and pharmacokinetic-pharmacodynamic (PK-PD) profile of first-line antitubercular drugs in pulmonary tuberculosis (TB) patients with and without diabetes mellitus (DM).
Methods
Newly diagnosed pulmonary TB patients aged 18–60 with or without DM were included in the study. Group I (n = 20) included patients with TB, whereas Group II (n = 20) contained patients with TB and DM. After 2 weeks of therapy, plasma concentrations and other PK-PD parameters were determined. The improvement in clinical features, X-ray findings, sputum conversion and adverse drug reactions (ADRs) were measured after 2 months of ATT.
Results
Isoniazid displayed non-significantly higher plasma concentrations in diabetic patients, along with a significantly (P < 0.05) longer elimination half-life (t1/2). Rifampicin plasma concentration at 4, 8, and 12 h were significantly (P < 0.05) lower and it displayed significantly (P < 0.05) lower area under curves (AUC0 − 12 and AUC0−∞), shorter t1/2, higher clearance (Cl) and a lower AUC0−∞/MIC ratio in diabetic patients. Pyrazinamide and ethambutol showed non-significantly higher plasma concentrations, AUC0 − 12, AUC0−∞, and t1/2 in diabetic patients. The improvement in clinical features, X-ray findings, sputum conversion, and ADRs were comparable in both the groups.
Conclusions
The presence of DM in TB patients affects the PK-PD parameters of isoniazid, rifampicin, pyrazinamide and ethambutol variably in the Indian population. Studies in a larger number of patients are required to further elucidate the role of DM on the PK-PD profile of first-line antitubercular drugs and treatment outcomes in TB patients with concomitant DM.
Trial registration number
CTRI/2021/08/035578 dated 11/08/2021.
Understanding the multidimensional structure of poverty in Argentine households
Authors: Pizarro Adrián Maximiliano Moneta 
Published: August 2024

Abstract

A question of great interest for the design of multidimensional poverty measures is whether they should include a monetary poverty indicator. One of the most common arguments for keeping income poverty separate from non-monetary poverty is that they reflect different dimensions of the phenomenon. This paper explores the multidimensional structure of poverty in Argentina and investigate whether monetary poverty should be considered as another indicator of multidimensional poverty using generalized structural equation modeling (GSEM) methods. Using categorical data from a household survey, a generalized confirmatory factor analysis model (GCFA) and a GSEM with a second order factor are analyzed. The GCFA model postulates the traditional assumption that monetary poverty is just another dimension of poverty, while the GSEM supports the hypothesis that monetary poverty is a cause of non-monetary poverty. The results show that the data fit well in both cases, but that it is more plausible to consider that the non-monetary factors are indicators of a higher order dimension and that this non-monetary poverty, as a whole, is explained by monetary poverty. Finally, the implications of these results for the design of multidimensional poverty indicators in Argentina are discussed.
JEL Classification: C38, I32
Automated detection of Kaposi sarcoma-associated herpesvirus infected cells in immunohistochemical images of skin biopsies
Authors: Hussain Iftak , Boza Juan , Lukande Robert , Ayanga Racheal , Semeere Aggrey , Cesarman Ethel , Martin Jeffrey , Maurer Toby , Erickson David 
Published: August 2024

Abstract

Immunohistochemical (IHC) staining for the antigen of Kaposi sarcoma-associated herpesvirus (KSHV), latency-associated nuclear antigen (LANA), is helpful in diagnosing Kaposi sarcoma (KS). A challenge, however, lies in distinguishing anti-LANA-positive cells from morphologically similar brown counterparts. In this work, we demonstrate a framework for automated localization and quantification of LANA positivity in whole slide images (WSI) of skin biopsies, leveraging weakly supervised multiple instance learning (MIL) while reducing false positive predictions by introducing a novel morphology-based slide aggregation method. Our framework generates interpretable heatmaps, offering insights into precise anti-LANA-positive cell localization within WSIs and a quantitative value for the percentage of positive tiles, which may assist with histological subtyping. We trained and tested our framework with an anti-LANA-stained KS pathology dataset prepared by pathologists in the United States from skin biopsies of KS-suspected patients investigated in Uganda. We achieved an area under the receiver operating characteristic curve (AUC) of 0.99 with a sensitivity and specificity of 98.15% and 96.00% in predicting anti-LANA-positive WSIs in a test dataset. We believe that the framework can provide promise for automated detection of LANA in skin biopsies, which may be especially impactful in resource-limited areas that lack trained pathologists.
Decreased Expression of hsa-miR-142-3p and hsa-miR-155-5p in Patients with Common Variable Immunodeficiency and Involvement of Their Target Genes and Biological Pathways
Authors: Ranjbarnejad Tayebeh , Gholaminejad Alieh , Sherkat Roya , Salehi Mansoor , Sharifi Mohammadreza 
Published: August 2024

Abstract

Background
Common variable immunodeficiency (CVID) is a heterogeneous disorder, and its pathogenesis is often unknown. Monogenic mutations have not been identified in the majority of CVID patients and the pathogenesis process is often unknown. Epigenetic modifications may be involved in unresolved patients. MiR-142 and miR-155 were identified as immune system modulators and are dysregulated in autoimmune and inflammatory diseases.
Methods
We assessed hsa-miR-142-3p and hsa-miR-155-5p expression in CVID patients and identified experimentally validated targets of these miRNAs. We constructed a protein‒protein interaction (PPI) network from the common targets of two miRNAs and determined the hub genes. The expression of the hub genes was investigated in the GEO datasets. Gene Ontology (GO) and pathway enrichment analysis were performed for the target genes.
Results
hsa-miR-142-3p and hsa-miR-155-5p expression was significantly reduced in CVID patients. Evaluation of the PPI network revealed several hub genes in which pathogenic mutations have been reported in PIDs/CVID, and other hub genes directly contribute to immune responses and the pathophysiology of PIDs. Expression analysis of the hub genes revealed that some of them were significantly dysregulated in CVID patients. Pathway enrichment analysis indicated the involvement of the FoxO-mediated signaling pathway, TGF-β receptor complex, and VEGFR2-mediated vascular permeability.
Conclusion
Considering the dysregulation of hsa-miR-142-3p and hsa-miR-155-5p in CVID and the known role of their target genes in the immune system, their involvement in the pathogenesis of CVID can be suggested.
The Prevalence and Factors Affecting Lower Urinary Tract Symptoms in Young Female University Students
Authors: ŞEN Mehmet Ali , AK Eda YAKIT , AYDIN Abdulkadir 
Published: August 2024

Abstract

Aim
The objective of this study was to assess the prevalence and risk factors associated with Lower Urinary Tract Symptoms (LUTS) among female university students.
Method
This cross-sectional survey study included 397 female university students aged 18 years and older. Participants completed self-administered questionnaires that assessed sociodemographic and lower urinary tract symptoms (LUTS) characteristics, as well as the Bristol Female Lower Urinary Tract Symptoms Scale (BFLUTS).
Results
The study found that the mean age of the students was 20.89 ± 4.02 years. Among the female students, 37% (n:147) did not experience urinary incontinence (UI), while 25.4% (n:101) experienced stress UI. The BFLUTS total score was low, with a mean of 9.63 ± 6.49. Risk factors associated with LUTS in female university students include smoking, presence of chronic disease and chronic constipation, cleaning from front to back after toileting, frequent urinary tract infections, poor toilet hygiene, enuresis as a child, and maternal history of urinary incontinence.
Conclusion
It has been determined that female university students experience a considerable level of lower urinary tract symptoms (LUTS). To prevent the development of negative symptoms in the future, it is important to identify the associated risk factors and increase knowledge and awareness of the problem.