bluuebunny/crossref_metadata_2025_split huggingface dataset:
A report on five cases of cholesterol granulomas in the thymus
Authors: Matsuda Ryosuke , Ose Naoko , Nagata Hideki , Morii Eiichi , Shintani Yasushi 
Published: August 2024

Abstract
Background
Cholesterol granuloma (CG) is a benign entity characterized by the presence of cholesterol crystals and foreign body giant cells. This condition can be attributed to cholesterol crystals that are deposited in the tissues and react with foreign body giant cells, resulting in granuloma formation. Lesions commonly develop in the otolaryngeal region, such as the middle ear. However, crystals rarely form in the thymus, accounting for 1% of all mediastinal tumors. Herein, we present five cases of mediastinal CG.

Case presentation
The patients were aged 49–61 (mean, 55.4) years. Among them, three were men and two women. One patient had fever, and four patients were asymptomatic. The patients’ lesions were detected during follow-up of other diseases or medical examinations showing the presence of abnormal chest shadows. The patients did not have a history of trauma or surgery. All lesions were located within the thymus gland. Three patients presented with multifocal lesions and two with a single lesion. Four patients had contrast effect on computed tomography scan. Four patients had abnormal fluorodeoxyglucose accumulation (mean maximum standardized uptake value, 4.67) on positron emission tomography-computed tomography. Four patients underwent complete surgical resection. The size of the resected lesions ranged from 1.8 to 5.1 (mean, 3.24) cm. Histologically, all patients presented with small nodules with cholesterol clefts and foreign body giant cells and histiocyte infiltration within the thymic tissue. The postoperative course was excellent. None of the patients who underwent complete resection presented with recurrence. Moreover, the patient who underwent partial resection did not have lesion enlargement.

Conclusions
CG in the thymus is clinically challenging to differentiate from malignant lesions, and histologic diagnosis via surgical resection is required.
Menopausal Hormone Therapy and Ovarian and Endometrial Cancers: Long-Term Follow-Up of the Women's Health Initiative Randomized Trials
Authors: Chlebowski Rowan T. , Aragaki Aaron K. , Pan Kathy , Haque Reina , Rohan Thomas E. , Song Mihae , Wactawski-Wende Jean , Lane Dorothy S. , Harris Holly R. , Strickler Howard , Kauntiz Andrew M. , Runowicz Carolyn D. 
Published: August 2024

PURPOSE
Menopausal hormone therapy's influence on ovarian and endometrial cancers remains unsettled. Therefore, we assessed the long-term influence of conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) and CEE-alone on ovarian and endometrial cancer incidence and mortality in the Women's Health Initiative randomized, placebo-controlled clinical trials.

MATERIALS AND METHODS
Postmenopausal women, age 50-79 years, were entered on two randomized clinical trials evaluating different menopausal hormone therapy regimens. In 16,608 women with a uterus, 8,506 were randomly assigned to once daily 0.625 mg of CEE plus 2.5 mg once daily of MPA and 8,102 placebo. In 10,739 women with previous hysterectomy, 5,310 were randomly assigned to once daily 0.625 mg of CEE-alone and 5,429 placebo. Intervention was stopped for cause before planned 8.5-year intervention after 5.6 years (CEE plus MPA) and after 7.2 years (CEE-alone). Outcomes include incidence and mortality from ovarian and endometrial cancers and deaths after these cancers.

RESULTS

After 20-year follow-up, CEE-alone, versus placebo, significantly increased ovarian cancer incidence (35 cases [0.041%]
v
17 [0.020%]; hazard ratio [HR], 2.04 [95% CI, 1.14 to 3.65];
P
= .014) and ovarian cancer mortality (
P
= .006). By contrast, CEE plus MPA, versus placebo, did not increase ovarian cancer incidence (75 cases [0.051%]
v
63 [0.045%]; HR, 1.14 [95% CI, 0.82 to 1.59];
P
= .44) or ovarian cancer mortality but did significantly lower endometrial cancer incidence (106 cases [0.073%]
v
140 [0.10%]; HR, 0.72 [95% CI, 0.56 to 0.92];
P
= .01).

CONCLUSION
In randomized clinical trials, CEE-alone increased ovarian cancer incidence and ovarian cancer mortality, while CEE plus MPA did not. By contrast, CEE plus MPA significantly reduced endometrial cancer incidence.
Under-Representation and Under-Reporting of Minoritized Racial and Ethnic Groups in Clinical Trials on Immune Checkpoint Inhibitors
Authors: Chua Alfredo V. , Delmerico Jennifer , Sheng Haiyang , Huang Xin-Wei , Liang Emily , Yan Li , Gandhi Shipra , Puzanov Igor , Jain Prantesh , Sakoda Lori C. , Morrow Gary R. , Ambrosone Christine B. , Kamen Charles , Yao Song 
Published: August 2024

PURPOSE Minoritized racial/ethnic groups are historically under-represented in cancer clinical trials, which may be exacerbated in recent trials on immune checkpoint inhibitors (ICIs). We examined the representation and reporting of the racial/ethnic composition of participants in clinical trials on ICIs. METHODS We examined English full-text trials on ICIs published from 2007 to 2022. Information on trial characteristics and racial/ethnic composition of participants was extracted from published papers or ClinicalTrials.gov. Differences in participation by publication year, ICI agent, and cancer site were analyzed. Enrollment-incidence ratio (EIR) was calculated to compare the proportion of minoritized racial/ethnic group patients in US-based trials against age-adjusted cancer incidence data available for the US population. An EIR > 1 signified over-representation, whereas an EIR <1 signified under-representation. RESULTS Of the 471 trials examined, racial composition was unreported in 146 (31%), whereas Hispanic/Latinx ethnicity was unreported in 278 (59%). Only 30 (6%) trials reported race/ethnicity-specific results. In US-only trials (n = 174), White patients were over-represented (EIR, 1.20 [95% CI, 1.17 to 1.22]), whereas Hispanic/Latinx patients were the most under-represented (EIR, 0.35 [95% CI, 0.24 to 0.48]), followed by Black/African American patients (EIR, 0.66 [95% CI, 0.54 to 0.79]). Subgroup analyses consistently indicated over-representation of White patients across publication years (EIR, 1.19-1.24), ICI classes (EIR, 1.16-1.23), and cancer sites (EIR, 1.11-1.31), whereas Hispanic/Latinx patients were consistently under-represented. An upward trend of trial representation and reporting was observed for all minoritized racial/ethnic groups over time (trend P values ≤.05). CONCLUSION Disparities in the representation and reporting of minoritized racial/ethnic groups persist in recent trials on ICIs, necessitating collaborative efforts for improved diversity and equitable cancer treatment access.
GIP Receptor Antagonism Eliminates Paradoxical Growth Hormone Secretion in Some Patients With Acromegaly
Authors: Jensen Mette H , Gasbjerg Lærke S , Skov-Jeppesen Kirsa , Jacobsen Jens C B , Poulsen Steen S , Zhou Cuiqi , Jakubauskaite Ruta , Poulsen Frantz R , Bonde Christian , Albarazi Mahmoud , Halle Bo , Christiansen Charlotte B , Sanni Samra J , Byberg Sarah , Hoe Bjørn , Holst Jens J , Dela Flemming , Rasmussen Aase K , Knop Filip K , Arlien-Søborg Mai C , Melmed Shlomo , Jørgensen Jens Otto L , Andersen Marianne S , Hartmann Bolette , Klose Marianne C , Feldt-Rasmussen Ulla , Sparre-Ulrich Alexander H , Rosenkilde Mette M 
Published: August 2024

Abstract

Context
About 30% of patients with active acromegaly experience paradoxically increased growth hormone (GH) secretion during the diagnostic oral glucose tolerance test (OGTT). Endogenous glucose-dependent insulinotropic polypeptide (GIP) is implicated in this paradoxical secretion.

Objective
We used the GIP receptor (GIPR) antagonist GIP(3-30)NH2 to test the hypothesis that GIP mediates this paradoxical response when GIPR is abundantly expressed in somatotropinomas.

Methods
A total of 25 treatment-naive patients with acromegaly were enrolled. Each patient underwent one OGTT during simultaneous placebo infusion and one OGTT during a GIP(3-30)NH2 infusion. Blood samples were drawn at baseline and regularly after infusions to measure GH. We assessed pituitary adenoma size by magnetic resonance imaging and GIPR expression by immunohistochemistry on resected somatotropinomas. For mechanistic confirmation, we applied in vitro and ex vivo approaches. The main outcome measure was the effect of GIP(3-30)NH2 on paradoxical GH secretion during OGTT as a measure of GIP involvement.

Results
In 4 of 7 patients with paradoxical GH secretion, GIP(3-30)NH2 infusion completely abolished the paradoxical response (P = .0003). Somatotrophs were available from 3 of 4 of these patients, all showing abundant GIPR expression. Adenoma size did not differ between patients with and without paradoxical GH secretion.

Conclusion
Of 25 patients with acromegaly, 7 had paradoxical GH secretion during OGTT, and pharmaceutical GIPR blockade abolished this secretion in 4. Corresponding somatotroph adenomas abundantly expressed GIPR, suggesting a therapeutic target in this subpopulation of patients. In vitro and ex vivo analyses confirmed the role of GIP and the effects of the antagonist.
18F-DOPA PET/MRI With Carbidopa for the Diagnosis of Hyperinsulinemic Hypoglycemia in an Adolescent Patient
Authors: Anka Carine , Ponisio Maria Rosana , Dillon Patrick A , Schmitt Chelsea , Fraum Tyler J , Arbeláez Ana María 
Published: August 2024

Abstract
Hyperinsulinism due to focal or diffuse pancreatic lesions causing recurrent episodes of hypoglycemia is rare in mid-childhood. There is no consensus on the gold-standard imaging method to diagnose focal insulin-producing lesions beyond infancy. A 14-year-old boy with a complex medical history and refractory epilepsy, presented with blood glucose (BG) of 52 mg/dL (2.9 mmol/L) (normal reference range: 70-100 mg/dL [3.9-5.6 mmol/L]) and increased seizure frequency. He failed a fast within 4 hours, with BG of 48 mg/dL (2.7 mmol/L) and insulin level of 4.6 µIU/mL (24.6 pmol/L) (diagnostic at the time of hypoglycemia &gt;1.25 μU/mL [8.7 pmol/L]). Conventional imaging studies showed no pancreatic lesion. Fluorine-18-L-dihydroxyphenylalanine positron emission tomography/magnetic resonance imaging (18F-DOPA-PET/MRI) scan premedicated with carbidopa demonstrated intense focal 18F-DOPA uptake in the distal pancreatic tail. He underwent distal pancreatectomy. Histopathology showed focal pancreatic islet cell hyperplasia, with more than 90% of the neuroendocrine islet cells being positive for chromogranin and synaptophysin, with no loss of p57 staining. Genetic studies were negative for mutations in ABCC8, KCNJ11, GCK, or GLUD1 genes, multiple endocrine neoplasia (MEN) type 1, and Beckwith-Wiedemann syndrome. BG normalized after surgery. Seizure frequency improved. This case highlights the utility of 18F-DOPA PET/MRI imaging in diagnosing focal hyperinsulinism beyond infancy.
Intraoperative Intracranial Pressure Changes in Children With Craniosynostosis Undergoing Endoscopic-Assisted Strip Craniectomy
Authors: Makoshi Ziyad , Hayek Gabriel , Aquino Vincent , Arias Alondra , Guido Julia , Radenovich Violeta , Jimenez David , Yates David 
Published: August 2024

BACKGROUND AND OBJECTIVES:
Craniosynostosis can lead to progressive cranial and skull base deformities and can be associated with increased intracranial pressure (ICP), ophthalmological manifestations, behavioral changes, and developmental delay. Most published data on the incidence of elevated ICP include older children undergoing open surgical correction. Endoscopic-assisted release of fused sutures with postoperative helmet therapy is an established method for managing craniosynostosis presenting at an early age; however, the immediate effect of this approach on ICP in a young cohort has not been previously reported.

METHODS:
Prospective data on 52 children undergoing endoscopic-assisted release of stenosed cranial sutures were included. Individuals were excluded if they underwent open correction or had previous cranial surgery. Individuals underwent a standardized endoscopic approach for each suture type. ICP was measured using an intraparenchymal sensor both before creation of the neosuture and after complete release of the stenosed suture. An ICP reading of >10 mm Hg was considered elevated.

RESULTS:
The mean age was 5.3 months, range 1 to 32 months, and 94% was younger than 12 months. The mean opening pressure was 12.7 mm Hg, and the mean closing pressure was 2.9 mm Hg. Opening ICP ≥10 mm Hg was present in 58%, ≥15 mm Hg was present in 31%, and ≥20 mm Hg was present in 23%. No patient had an ICP above 10 mm Hg at closing. The mean percentage change in ICP among all craniosynostosis cases was a 64% decrease. Optic disk swelling was identified in 28 children preoperatively and improved in 22 children at follow-up.

CONCLUSION:
Elevated ICP may occur in infants with craniosynostosis at higher rates than previously reported. Endoscopic-assisted craniectomy has an immediate effect on lowering ICP and improving postoperative ophthalmological findings.
Selected occupational burdens of masseur’s job – research report
Authors: Lewandowski Andrzej , Siedlaczek Marcin , Piekorz Zuzanna , Zukow Walery 
Published: August 2024

Introduction: Aim of the work is to analyze the burdensomeness of masseurs professional activities. Material and methods: Five massage standards were selected. The subjectively perceived level of physical and mental effort during massage was determined. The PWC170 test was used to measure physical fitness, and the intensity of physical exercise associated with the massage was determined. Statistics: Student's t-test and Fisher's test were used. Results: Women and men were characterized by medium/high levels of physical capacity (men: 3.70±0.82 l/min, women 2.21±0.34 l/min). Men's loads during massage was low (HR=87.49±1.748, which corresponded to 44.21±1.04% HRmax, VO2max=19.03±1.48, VO2=0.69±0.14 and 2.69±0.83 MET). The women performed work with moderate heart rate (HR=84.8±6.88, which corresponds to 44.18±3.67% HRmax, VO2max=18.99±5.24, VO2=0.43±0.162 and 2.16±0.86 MET). Respondents assessed their work as hard. The results suggest that massage and physical therapists had similar levels of fitness, but women differed significantly. Conclusions: Massage therapists of both sexes have similar opportunities to perform their profession. Difficulty in performing is caused the external working conditions and therapist strength.
Drainage Water Management: A Review of Nutrient Load Reductions and Cost Effectiveness
Authors: Frankenberger Jane , McMillan Sara K. W. , Williams M. R. , Mazer Katy , Ross Jared , Sohngen Brent 
Published: August 2024

Highlights

Reductions of nitrogen due to drainage water management were synthesized from 290 plot-years.

Nitrate reduction was 13.3 kg N/ha/yr (46%) based on a mixed effects modeling analysis.

Dissolved reactive phosphorus and total phosphorus load reductions were 0.04 kg/ha (34%) and 0.06 kg/ha (36%).

Cost of nitrogen reduction was $1 to $11 per kg N removed, with a net benefit if yield increased by 3%.

Abstract.
Drainage water management (DWM) is the practice of seasonally adjusting the drainage outlet elevation with a control structure and is implemented to decrease nutrient loss in drained agricultural landscapes. In this study, we review the effect of DWM on annual nitrogen (N) and phosphorus (P) loads compared to free drainage and examine its cost-effectiveness using data from around the world published between 1979 and 2022. Studies included in the review were limited to row-crop agriculture without irrigation, with controlled drainage and free drainage compared during the same year. A total of 290 plot-years for N were compiled and analyzed using a mixed effects linear model to assess differences in flow, load, and concentrations and account for within and among site variability. Few studies examined dissolved reactive P (n=7) or total P (n=3); thus, only DRP results from these studies were statistically evaluated using Kruskal-Wallis tests. Analysis of N data showed that DWM reduced N loss on average by 13.3 kg/ha/yr (95% confidence interval: 9.4-17.3 kg/ha/yr), which corresponds to a 46% load removal efficiency (95% confidence interval: 37.4%-54.5%). Drainage water management decreased annual DRP and TP load compared to free drainage by an average of 0.04 kg/ha/yr (mean=34%; range=-35% to 80%) and 0.06 kg/ha/yr (mean=36%; range=7% to 72%), respectively. Economic analysis showed that the cost of N reduction would range from $1 to $11 per kg N removed assuming no yield benefit, while a 3% yield increase would lead to a likely net economic benefit to the producer. Findings indicate that DWM can be an effective practice for decreasing nutrient loading from drained landscapes, however, losses through unmeasured flow paths such as seepage and surface runoff may lead to overestimating the effectiveness of DWM. Additionally, complex interactions among soil organic matter, soil nutrient levels, and water table depths need to be accounted for to ensure both N and P removal is achieved. Recommendations for monitoring discharge and nutrient loads in future DWM studies are provided to better understand the processes influencing nutrient load reductions and/or increases and further quantify the effectiveness of DWM implementation in drained landscapes. Keywords: Agricultural conservation practices, Controlled drainage, Nitrogen, Phosphorus, Subsurface drainage, Water quality.
Positioning spherical nanoantennas with picometer precision
Authors: Ma Haixiang , Feng Fu , Qiao Jie , Gan Jiaan , Yuan Xiaocong 
Published: August 2024

Accurate positioning of nanoantennas is critical for their efficient excitation and integration. However, since nanoantennas are subwavelength nanoparticles, normally smaller than the diffraction limit, measuring their positions presents a significant challenge. This is particularly true for locating the nanoantenna along the z-direction, for which no suitable method currently exists. Here, we have theoretically developed and experimentally validated a novel light field capable of measuring the 3D positions of nanoantennas accurately. This field’s polarization chirality transitions from right-handed to left-handed along a predefined 3D direction at a subwavelength scale. For a spherical single-element nanoantenna, the polarization components of the scattering field change significantly as the nanoantenna moves, due to the rapid polarization transformation in the excitation light field. By analyzing the polarization components of the scattering field, we can achieve positional accuracy of the nanoantenna along the specified direction close to 20 pm. This work improves the accuracy of transversely distinguishing nanoantennas from 100 pm in conventional methods to 20 pm. Moreover, the positioning of the nanoantenna along three dimensions is all available as polarization transitions can be predefined along arbitrary 3D direction, which is significant for precision measurement and nanoscale optics.
Changes in reasons for visits to primary care after the start of the COVID-19 pandemic: An international comparative study by the International Consortium of Primary Care Big Data Researchers (INTRePID)
Authors: Tu Karen , Lapadula María C. , Apajee Jemisha , Bonilla Angela Ortigoza , Baste Valborg , Cuba-Fuentes María S. , de Lusignan Simon , Flottorp Signe , Gaona Gabriela , Goh Lay Hoon , Hallinan Christine M. , Kristiansson Robert S. , Laughlin Adrian , Li Zhuo , Ling Zheng J. , Manski-Nankervis Jo-Anne , Ng Amy P. P. , Scattini Luciano F. , Silva-Valencia Javier , Pace Wilson D. , Wensaas Knut-Arne , Wong William C. W. , Zingoni Paula L. , Westfall John M. ,   on behalf of INTRePID
Published: August 2024

Background
The COVID-19 pandemic has reshaped healthcare delivery worldwide.

Objective
To explore potential changes in the reasons for visits and modality of care in primary care settings through the International Consortium of Primary Care Big Data Researchers (INTRePID).

Methods
We conducted a cross-sectional, retrospective study from 2018–2021. We examined visit volume, modality, and reasons for visits to primary care in Argentina, Australia, Canada, China, Peru, Norway, Singapore, Sweden, and the USA. The analysis involved a comparison between the pre-pandemic and pandemic periods.

Results
There were more than 215 million visits from over 38 million patients during the study period in INTRePID primary care settings. Most INTRePID countries experienced a decline in monthly visit rates during the first year of the pandemic, with rate ratios (RR) and 95% confidence intervals (CI) ranging from RR:0.57 (95%CI:0.49–0.66) to RR:0.90 (95%CI:0.83–0.98), except for in Canada (RR:0.99, 95%CI:0.94–1.05) and Norway (RR:1.00, 95%CI:0.92–1.10), where rates remained stable and in Australia where rates increased (RR:1.19, 95%CI:1.11–1.28). Argentina, China, and Singapore had limited or no adoption of virtual care, whereas the remaining INTRePID countries varied in the extent of virtual care utilization. In Peru, virtual visits accounted for 7.34% (95%CI:7.33%-7.35%) of all interactions in the initial year of the pandemic, dipping to 5.22% (95%CI:5.21%-5.23%) in the subsequent year. However, in Canada 75.30% (95%CI:75.20%-75.40%) of the visits in the first year were virtual, decreasing to 62.77% (95%CI:62.66%-62.88%) in the second year. Diabetes, hypertension and/or hyperlipidemia and general health exams were in the top 10 reasons for visits in 2019 for all countries. Anxiety, depression and/or other mental health related reasons were among the top 10 reasons for virtual visits in all countries that had virtual care.

Conclusions
The pandemic resulted in changes in reasons for visits to primary care, with virtual care mitigating visit volume disruptions in many countries.
A Brief Model Evaluated Outcomes After Liver Transplantation Based on the Matching of Donor Graft and Recipient
Authors: Li Yuancheng , Liu Xingchao , Zhang Chengcheng , Tao Ran , Pan Bi , Liu Wei , Jiang Di , Hu Feng , Xu Zeliang , Tan Dehong , Ou Yanjiao , Li Xun , You Yuemei , Zhang Leida 
Published: August 2024

INTRODUCTION:
A precise model for predicting outcomes is needed to guide perioperative management. With the development of the liver transplantation (LT) discipline, previous models may become inappropriate or noncomprehensive. Thus, we aimed to develop a novel model integrating variables from donors and recipients for quick assessment of transplant outcomes.

METHODS:
The risk model was based on Cox regression in a randomly selected derivation cohort and verified in a validation cohort. Perioperative data and overall survival were compared between stratifications grouped by X-tile. Receiver-operating characteristic curve and decision curve analysis were used to compare the models. Violin and raincloud plots were generated to present post-LT complications distributed in different stratifications.

RESULTS:
Overall, 528 patients receiving LT from 2 centers were included with 2/3 in the derivation cohort and 1/3 in the validation cohort. Cox regression analysis showed that cold ischemia time (CIT) (P = 0.012) and Model for End-Stage Liver Disease (MELD) (P = 0.007) score were predictors of survival. After comparison with the logarithmic models, the primitive algorithms of CIT and MELD were defined as the CIT-MELD Index (CMI). CMI was stratified by X-tile (grade 1 ≤1.06, 1.06 < grade 2 ≤ 1.87, grade 3 >1.87). In both cohorts, CMI performed better in calculating transplant outcomes than the balance of risk score, including perioperative incidents and prevalence of complications.

DISCUSSION:
The model integrating variables from graft donors and recipients made the prediction more accurate and available. CMI provided new insight into outcome evaluation and risk factor management of LT.