bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rectal squamous cell carcinoma treated with neoadjuvant fluorouracil, oxaliplatin, cetuximab, and radiation: A case report of pathological complete response
Authors: Fujise Yuta , Hazama Shoichi , Fujii Toshiyuki , Inoue Motoshige , Takahashi Shotaro , Yoshida Kazuya , Ikeda Akihiko , Hashiyada Hiroshi , Nakamoto Kembu , Yamashita Aogu , Hino Keisuke , Okita Kiwamu 
Published: June 2024

Rationale:
Treatment strategies for rectal squamous cell carcinoma (rSCC) are yet to be established, given its rarity. Although squamous cell carcinoma has been reported to be highly sensitive to cetuximab and radiation, there is no report of combination therapy of cetuximab and radiation for rSCC. In this study, we firstly reported a case of rSCC in which a complete response was achieved with the original chemoradiotherapy comprising oxaliplatin, S-1, cetuximab, and simultaneous radiation.

Patient concerns:
A 46-year-old women presented to our hospital with lower abdominal pain and fatigue.

Diagnoses:
Based on tumor marker analyses, histological examination of biopsy specimens, and comprehensive imaging, the patient was diagnosed with rSCC.

Interventions:
Neoadjuvant chemoradiotherapy (50.4 Gy) was administered in 28 fractions, along with concurrent chemotherapy comprising SOX (S-1: 80 mg/m2, days 1–5 and 8–12, oxaliplatin: 85 mg/m2, day 1) and cetuximab (400 mg/m2, day 1, 250 mg/m2, after day 8).

Outcomes:
Five weeks after chemoradiation, the patient underwent laparoscopic partial intersphincteric resection, achieving a complete pathological response.

Lessons:
This case firstly highlights the usefulness of SOX plus cetuximab combined with radiation in the treatment of locally advanced rSCC. However, a large-scale study is required to establish safe and effective treatment regimens.
The presentation of two rare idiopathic diseases in one patient: spontaneous idiopathic pneumoperitoneum and idiopathic gastroparesis: a case report
Authors: González-Acosta Isabela , Maldonado-García Edwin L. , López-Jasso Federico 
Published: June 2024

Introduction:
Idiopathic gastroparesis (GP) is a syndrome characterized by delayed gastric emptying in the absence of a mechanical obstruction and the presence of cardinal symptoms, spontaneous idiopathic pneumoperitoneum is the presence of free air in the abdomen with the exclusion of a perforated viscera on endoscopy; both diseases have a low prevalence in which no detectable primary etiology can be identified. The authors present the case of a 44-year-old female with both diseases occurring simultaneously.

Presentation of case:
A 44-year-old female without relevant prior medical history, presented to the emergency room with intense abdominal pain in all four quadrants, on superficial and deep palpation. Imaging studies were conducted revealing the presence of a distended stomach filled with contrast and free air in the abdomen. An endoscopy was conducted looking for an obstruction of the gastric content and a laparotomy for the presence of a perforation on the viscera; both were ruled out.

Clinical discussion:
Although surgical intervention is not necessary on a patient presenting either with GP or spontaneous idiopathic pneumoperitoneum, given the clinical presentation and image studies of this patient with the finding of free air in the abdomen, a distended stomach filled with contrast and severe abdominal pain, it was decided to perform a laparotomy looking for a possible source and avoid complications of a possible blockage and/or perforation in the gastrointestinal tract.

Conclusion:
First-time cases pose a challenge for physicians at the moment of deciding on the best treatment option for the patient, especially with low-frequency pathologies.
Unanticipated discovery: incidental encounter with fasciola hepatica during ERCP – a case report
Authors: Sharma Pasanda , Sapkota Prakash , Gurung Ram Bahadur , Shrestha Nikesh Mani , Shrestha Sajan , Humagain Sankalpa , Tamang Ashish 
Published: June 2024

Introduction and Importance:
Fasciola hepatica (FH) is a rare parasitic infection in humans. Its incidental detection during endoscopic retrograde cholangiopancreatography (ERCP) is exceptionally uncommon. This case underscores the importance of considering parasitic infections, even in low-endemicity regions, and the potential implications of dietary and environmental factors in disease transmission.

Case Presentation:
The authors present a case of a 31-year-old female from Dhading, Nepal, who underwent ERCP for suspected biliary stone. The patient had been experiencing recurring, nonradiating, burning epigastric pain for 5 to 7 years, which had recently intensified. Previous evaluations, including abdominal ultrasonography, CT, and MRI, revealed a dilation within the common bile duct and an obstruction in the biliary system.

Clinical Discussion:
During ERCP, cholangiography revealed mildly dilated extra and intrahepatic bile ducts with irregular filling defects in the common hepatic duct. Sphincterotomy was performed, followed by the extraction of multiple FH worms. A 7 Fr 7 cm double pigtail plastic stent was placed with a good flow of bile. However, the patient experienced anaphylaxis during the procedure, necessitating swift and tailored administration of appropriate medications to ensure effective management and stabilization. The patient was closely monitored in the ICU postprocedure.

Conclusion:
After careful monitoring and treatment, the patient fully recovered. The unexpected discovery of FH during ERCP is extremely rare. Early recognition and appropriate management of such incidental findings are crucial to ensuring optimal patient outcomes.
Unusual extrahepatic metastatic site of hepatocellular carcinoma with post-therapy disseminating metastases presenting as a primary soft tissue sarcoma: case report
Authors: Liu Kuang-Ting , Chang Yueh-Ching , Lin Yu-Chieh , Chang Junn-Liang 
Published: June 2024

Introduction and importance:
Hepatocellular carcinoma (HCC) is a highly malignant primary hepatic tumor. However, extrahepatic metastatic sites of HCC with post-therapy dissemination of metastases mimicking primary soft tissue sarcomas with rib metastases are extremely rare.

Case presentation:
The authors report a unique case of hepatitis B virus (HBV)-positive HCC with bilateral lung involvement and widespread right-flank soft tissue and rib metastases. The pathological diagnosis after surgical resection confirmed extrahepatic HCC metastasis. Subsequently, adjuvant-targeted and immune-checkpoint inhibitor therapies were still initiated.

Clinical discussion:
Extrahepatic HCC metastasis, which initially presents at distant sites, is uncommon. HCC commonly metastasizes to the lungs, bones, lymph nodes, kidneys, adrenal glands, and peritoneum/omentum. HCC with aggressive post-scheduled adjuvant therapy to the lungs and hypochondriac soft tissue with rib metastasis is very rare and has a poor prognosis.

Conclusion:
Although most patients with HCC have disseminated extrahepatic metastases, primary HCC should still be treated. Thus, a review of the history and imaging, histopathology, and immunohistochemical findings is crucial for the definite and differential diagnosis of this tumor.
Esophageal chemical burns as a risk factor for esophageal malignancies: in-silico analyses – experimental research
Authors: Khosravani Hengameh , Ataee Disfani Reza , Farhadi Bahar , Tohidian Mobina , Garrosi Lida , Shirvani Proushat , Zabihi Mohammad Reza , Akhoondian Mohammad , Norouzkhani Narges , Farzan Ramyar 
Published: June 2024

Introduction:
Esophageal chemical burns often occur through accidental or intentional oral consumption of chemical agents and lead to severe complications such as esophageal stricture, acute perforation, and even death. Esophageal squamous cell carcinoma is a squamous epithelium tumor that lines the normal esophagus. Additionally, adenocarcinomas are tumors located at the interface between the distal esophagus and the proximal gastric and divided into esophageal adenocarcinoma and gastric-cardia adenocarcinoma. Various conditions, such as chemical burns, are considered risk factors in the disease’s pathogenesis. In the in-silico study, the authors aim to present the relationship between chemical burns and esophageal cancer by analyzing bioinformatics genetic data.

Methods:
The proper gene set was extracted using the ‘GEO’ database. The string web tool was utilized to form the gene-interaction network. Gephi and Cytoscape software were applied to achieve network analysis.

Results:
According to in-silico data, 26 genes, including NCAPH, DLGAP5, CCNB1, KIF11, KIAA0101, CDCA5, BIRC5, NUF2, BUB1B, RRM2, TTK, CDC20, NUSAP1, CCNB2, CCNA2, MELK, TPX2, PRC1, KIF4A, CENPF, TOP2A, CDK1, ASPM, CEP55, BUB1, KIF20A were extracted that can be regarded as the most critical shared genes between chemical burns and esophageal cancer.

Conclusion:
In sum, esophageal chemical burns can be related to the occurrence of esophageal cancer. Moreover, esophageal chemical burn is an external factor that upregulates present genes and can be regarded as a worsening prognosis or risk factor for esophageal cancer.
Development of a Single-Visit Protocol for the Management of Pregnancy of Unknown Location Following In Vitro Fertilization: A Retrospective Study
Authors: Dooley W. M. , de Braud L. V. , Wong M. , Platts S. , Ross J. A. , Jurkovic D. 
Published: June 2024

(Abstracted from Hum Reprod 2024;39(3):509–515)
Pregnancy of unknown location (PUL) refers to a positive pregnancy test that cannot be visualized on transvaginal ultrasound. No medical intervention should be initiated without a clear diagnosis in PUL, despite the term “pregnancy of unknown location” often being used synonymously with suspected ectopic pregnancy.
Trends in HIV testing and HIV stage at diagnosis among people newly diagnosed with HIV
Authors: King Jonathan M. , Dobbins Timothy , Keen Phillip , Cornelisse Vincent J. , Stoové Mark , Nigro Steven J. , Asselin Jason , Higgins Nasra , Mao Limin , Aung Htein Linn , Petoumenos Kathy , McGregor Skye 
Published: June 2024

Objective:
To identify groups more likely to be referred for HIV testing because of symptomatic presentation rather than as part of asymptomatic screening.

Design:
A retrospective analysis of Australian National HIV Registry (NHR) surveillance data including sociodemographic and clinical data, as well as reasons for HIV test.

Methods:
Using notification records from 2017 to 2022, we summarised reasons for testing leading to an HIV diagnosis. Reasons for testing were combined with clinical status at diagnosis to derive HIV testing categories: testing while symptomatic; asymptomatic HIV screening; seroconversion; and other test reason. We stratified these categories by stage of HIV at diagnosis with late-stage HIV defined as a CD4+ cell count <350 cells/μl at time of diagnosis.

Results:
Among 4134 HIV notifications with at least one reason for testing recorded, STI screening was the predominant reason for test referral (38%), followed by HIV indicative symptoms (31%), and risk behaviour (13%). By testing category, people aged 50 years or older (24%), people with HIV attributed to heterosexual sex (21%), people born in sub-Saharan Africa (19%), and women (17%) had lower levels of asymptomatic screening. More late-stage HIV diagnoses resulted from testing while symptomatic (58%) compared with asymptomatic screening (25%).

Conclusions:
Older people and heterosexuals may not access HIV focused healthcare where HIV screening is routinely offered. Instead, HIV testing opportunities may arise in other settings. By normalising HIV testing and offering low-cost HIV screening in a range of settings, it may be possible to facilitate earlier HIV diagnoses, better health outcomes, and reduced onward transmission.
A Mixed Methods Evaluation of Pharmacists' Readiness to Provide Long-Acting Injectable HIV Pre-exposure Prophylaxis in California
Authors: Beltran Raiza M. , Hunter Lauren A. , Packel Laura J. , De Martini Loriann , Holloway Ian W. , Dong Betty J. , Lam Jerika , McCoy Sandra I. , Ochoa Ayako Miyashita 
Published: June 2024

Background:
Pre-exposure prophylaxis (PrEP) uptake remains low among people who could benefit, some of whom may prefer alternatives to oral PrEP, such as long-acting injectable pre-exposure prophylaxis (LAI-PrEP). We evaluated the potential for LAI-PrEP provision in pharmacies through a mixed methods study of pharmacists in California, where Senate Bill 159 enables pharmacists to independently provide oral PrEP.

Methods:
In 2022–2023, we conducted an online cross-sectional survey of California pharmacists and pharmacy students (n = 919) and in-depth interviews with pharmacists (n = 30), both of which included modules assessing attitudes about PrEP provision. Using log-binomial regression, we estimated prevalence ratios (PRs) comparing survey participants' willingness to provide LAI-PrEP by pharmacy- and individual-level characteristics. Qualitative interview data were analyzed using Rapid Qualitative Analysis to identify factors that may affect pharmacists' provision of LAI-PrEP.

Results:
Half of the survey participants (53%) indicated that they would be willing to administer LAI-PrEP using gluteal injection in their pharmacy. Willingness was higher among participants who worked in pharmacies that provided vaccinations or other injections (56% vs. 46%; PR: 1.2; 95% confidence interval: 1.0–1.4) and/or oral PrEP under Senate Bill 159 (65% vs. 51%; PR: 1.3; 95% confidence interval: 1.1–1.5) than among participants whose pharmacies did not. Interviewed participants reported barriers to LAI-PrEP provision, including the need for increased training and staffing, a private room for gluteal injections, better medication access, and payment for services.

Conclusion:
Pharmacies offer a promising setting for increased LAI-PrEP access. However, pharmacists may require additional training, resources, and policy changes to make implementation feasible.
Immune Activation Is Associated With Neurocognitive Performance in Ugandan Adolescents Living With HIV
Authors: Dirajlal-Fargo Sahera , Sattar Abdus , Strah Monika , Karungi Christine , Gumikiriza-Onoria Joy Louise , Santoro Anthony F. , Kirsch Courtney , Nanteza Angel , Ferraris Christopher M. , Tsapalas Daphne , Asiedu Nana , Funderburg Nicholas , Musiime Victor , McComsey Grace A. , Robbins Reuben N. 
Published: June 2024

Abstract:
We examined relationships between neurocognition and immune activation in Ugandan adolescents with perinatally acquired HIV (PHIV). Eighty-nine adolescents in Kampala, Uganda (32 virally suppressed [<400 copies/mL] PHIV and 57 sociodemographically matched HIV-negative controls), completed a tablet-based neurocognitive test battery. Control-derived z-scores for 12 individual tests and a global/overall z-score were calculated. We measured plasma (soluble CD14 and CD163), monocyte (proportions of monocyte subsets), and T-cell (expression of CD38 and HLA-DR on CD4+ and CD8+) activation and gut markers. Spearman rank correlations and median regressions examined associations between test performance and immune activation. The median [IQR] age was 15 [13–16] years, and 40% were girls. The median time on antiretroviral therapy was 10 years [7–11] for PHIV; 87% had viral load <50 copies/mL. Compared with controls, global z-scores were lower among PHIV (P = 0.05) and significantly worse on tests of executive functioning and delayed recall (P's ≤ 0.05). Overall, monocyte activation significantly correlated with worse test performance on global z-score (r = 0.21, P = 0.04), attention, processing speed, and motor speed (r = 0.2–0.3, P ≤ 0.01). T-cell activation was significantly correlated with worse performance on tests of learning, executive functioning, and working memory (r = 0.2–0.4, P ≤ 0.04). In PHIV, after adjusting for age, sex, and antiretroviral therapy duration, activated CD4 T cells remained associated with worse memory (β-0.3, 95% CI: −0.55 to −0.07, P = 0.01). PHIV with virologic suppression on antiretroviral therapy shows evidence of worse neurocognitive test performance compared with controls. Monocyte and T-cell activation is correlated with worse neurocognition in Ugandan youth with and without HIV, which has not been previously investigated in this setting.
Less Is More
Authors: Magnotti Louis J. , Bhogadi Sai Krishna , Anand Tanya , Stewart Collin , Colosimo Christina , Spencer Audrey L. , Nelson Adam , Joseph Bellal 
Published: June 2024

Objective:
This study aims to examine the relationship between procedural volume and annual trauma volume (ATV) of ACS Level I trauma centers (TC).

Background:
Although ATV is a hard criterion for TC verification, importance of procedural interventions as a potential quality indicator is understudied.

Methods:
Patients managed at ACS level I TCs were identified from ACS-TQIP 2017–2021. TCs were identified using facility keys and stratified into quartiles based on ATV into low, low-medium, medium-high, and high volume. TCs were also stratified into tertiles [low (LV), medium (MV), high (HV)] based on procedural volume by assessing annual number of laparotomies, thoracotomies, craniotomies/craniectomies, angioembolizations, vascular repairs, and long bone fixations performed at each center. The Cohen κ statistic was used to assess concordance between ATV and procedural volume.

Results:
A total of 182 Level I TCs were identified: 76 low, 47 low-medium, 35 high-medium, and 24 high volume. Long bone fixation, laparotomy, and craniotomy/craniectomy were the most performed procedures with a median of 65, 59, and 46 cases/center/year, respectively. Overall, 31% of HV laparotomy centers, 31% of HV thoracotomy centers, 22% of HV craniotomy/craniectomy centers, 22% of HV vascular repair centers, 32% of HV long bone fixation centers, and 33% of HV angioembolization centers contributed to the overall number of low-medium and low-volume TCs. The Cohen κ statistic demonstrated poor concordance between ATV and procedural volumes for all procedures (overall procedural volume—κ=0.378, laparotomy—κ=0.270, thoracotomy—κ=0.202, craniotomy/craniectomy—κ=0.394, vascular repair—κ=0.298, long bone fixation—κ=0.277, angioembolization—κ=0.286).

Conclusions:
ATV does not reflect the procedural interventions performed. Combination of procedural and ATV may provide a more accurate picture of the clinical experience at any given TC.

Level of Evidence:
Level III.
Repeated COVID-19 Vaccination Drives Memory T- and B-cell Responses in Kidney Transplant Recipients: Results From a Multicenter Randomized Controlled Trial
Authors: Malahe S. Reshwan K. , den Hartog Yvette , Rietdijk Wim J. R. , van Baarle Debbie , de Kuiper Ronella , Reijerkerk Derek , Ras Alicia M. , Geers Daryl , Diavatopoulos Dimitri A. , Messchendorp A. Lianne , van der Molen Renate G. , Imhof Céline , Frölke Sophie C. , Bemelman Frederike J. , Gansevoort Ron T. , Hilbrands Luuk B. , Sanders Jan-Stephan F. , GeurtsvanKessel Corine H. , Kho Marcia M. L. , de Vries Rory D. , Reinders Marlies E. J. , Baan Carla C. ,   On behalf of RECOVAC Consortium
Published: June 2024

Background.
Insight into cellular immune responses to COVID-19 vaccinations is crucial for optimizing booster programs in kidney transplant recipients (KTRs).

Methods.
In an immunologic substudy of a multicenter randomized controlled trial (NCT05030974) investigating different repeated vaccination strategies in KTR who showed poor serological responses after 2 or 3 doses of an messenger RNA (mRNA)-based vaccine, we compared SARS-CoV-2-specific interleukin-21 memory T-cell and B-cell responses by enzyme-linked immunosorbent spot (ELISpot) assays and serum IgG antibody levels. Patients were randomized to receive: a single dose of mRNA-1273 (100 μg, n = 25), a double dose of mRNA-1273 (2 × 100 μg, n = 25), or a single dose of adenovirus type 26 encoding the SARS-CoV-2 spike glycoprotein (Ad26.COV2.S) (n = 25). In parallel, we also examined responses in 50 KTR receiving 100 μg mRNA-1273, randomized to continue (n = 25) or discontinue (n = 25) mycophenolate mofetil/mycophenolic acid. As a reference, the data were compared with KTR who received 2 primary mRNA-1273 vaccinations.

Results.
Repeated vaccination increased the seroconversion rate from 21% to 66% in all patients, which was strongly associated with enhanced levels of SARS-CoV-2-specific interleukin-21 memory T cells (odd ratio, 3.84 [1.89-7.78]; P < 0.001) and B cells (odd ratio, 35.93 [6.94-186.04]; P < 0.001). There were no significant differences observed in these responses among various vaccination strategies. In contrast to KTR vaccinated with 2 primary vaccinations, the number of antigen-specific memory B cells demonstrated potential for classifying seroconversion after repeated vaccination (area under the curve, 0.64; 95% confidence interval, 0.37-0.90; P = 0.26 and area under the curve, 0.95; confidence interval, 0.87-0.97; P < 0.0001, respectively).

Conclusions.
Our study emphasizes the importance of virus-specific memory T- and B-cell responses for comprehensive understanding of COVID-19 vaccine efficacy among KTR.
Normative Data and Quantile Regression Analysis of the Sural-to-Radial Nerve Amplitude Ratio
Authors: Pourhamidi Kaveh 
Published: June 2024

Purpose:
The aim of this study was to establish normative data for the sural-to-radial nerve amplitude ratio (SRAR) and develop a quantile regression model for individualized cutoff values.

Methods:
A cohort of 68 healthy individuals (36 female participants) aged 20 to 59 years was recruited. Sensory nerve conduction studies were conducted to measure sural and radial sensory nerve action potential amplitudes. Quantile regression analysis was used to determine the fifth percentile of SRAR after adjusting for age, sex, and other demographic variables.

Results:
This study found significant differences in body height and weight between the sexes, with radial sensory nerve action potential being higher in female participants. The sural-to-radial nerve amplitude ratio was negatively correlated with age (r = −0.3, p = 0.007) and showed significant sex differences. The final regression equation, SRAR = 0.519 − 0.006 × age + 0.046 × sex (1 = male, 0 = female), was developed for the fifth percentile cutoff, accounting for age and sex.

Conclusions:
This study establishes normative SRAR data and introduces a novel quantile regression approach to determine individualized cutoff values. Age and sex are critical factors for SRAR variation, necessitating tailored diagnostic criteria for neuropathy assessment. This model enhances diagnostic accuracy and potentially reduces misdiagnosis in clinical settings. Further research is recommended to validate the clinical applicability of SRAR across different types of neuropathies.