bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proteus syndrome: clinical and radiological findings through a new case report
Authors: Hager Barakizou , Azza Khelifi , Maryem Ferjani , Tahar Gargah 
Published: April 2024

Abstract
Background
Proteus syndrome (PS) is a complex and uncommon disorder with as its main feature a patchy or mosaic postnatal overgrowth. A high clinical and radiological variability characterizes it.

Case presentation
We report the case of a 2-year-old boy presenting with lipomas and diagnosed as PS in front of general criteria (sporadic occurrence, progressive course, and mosaic distribution of lesions) and specific criteria (linear epidermal nevus in the chest and asymmetric and overgrowth in the upper limbs) of Biesecker. The course of the disease was marked by a huge overgrowth of arms despite several surgeries. By the age of 10 years, a painful swelling of the right forearm revealed a venous thrombosis on a venous malformation.

Conclusions
This case report highlights the variability of clinical findings in PS. It also emphasizes the contribution of routine imaging tools for the diagnosis and the follow-up of this rare disease.
Patient and Caregiver Perceptions of an Interface Design to Communicate Artificial Intelligence–Based Prognosis for Patients With Advanced Solid Tumors
Authors: Sloss Elizabeth A. , McPherson Jordan P. , Beck Anna C. , Guo Jia-Wen , Scheese Carolyn H. , Flake Naomi R. , Chalkidis George , Staes Catherine J. 
Published: April 2024

PURPOSE Use of artificial intelligence (AI) in cancer care is increasing. What remains unclear is how best to design patient-facing systems that communicate AI output. With oncologist input, we designed an interface that presents patient-specific, machine learning–based 6-month survival prognosis information designed to aid oncology providers in preparing for and discussing prognosis with patients with advanced solid tumors and their caregivers. The primary purpose of this study was to assess patient and caregiver perceptions and identify enhancements of the interface for communicating 6-month survival and other prognosis information when making treatment decisions concerning anticancer and supportive therapy. METHODS This qualitative study included interviews and focus groups conducted between November and December 2022. Purposive sampling was used to recruit former patients with cancer and/or former caregivers of patients with cancer who had participated in cancer treatment decisions from Utah or elsewhere in the United States. Categories and themes related to perceptions of the interface were identified. RESULTS We received feedback from 20 participants during eight individual interviews and two focus groups, including four cancer survivors, 13 caregivers, and three representing both. Overall, most participants expressed positive perceptions about the tool and identified its value for supporting decision making, feeling less alone, and supporting communication among oncologists, patients, and their caregivers. Participants identified areas for improvement and implementation considerations, particularly that oncologists should share the tool and guide discussions about prognosis with patients who want to receive the information. CONCLUSION This study revealed important patient and caregiver perceptions of and enhancements for the proposed interface. Originally designed with input from oncology providers, patient and caregiver participants identified additional interface design recommendations and implementation considerations to support communication about prognosis.
A Large Benign Adrenocortical Adenoma Cosecreting Testosterone and Cortisol
Authors: Dillon Martha , Shteyman Sara , Rabiehashemi Samaneh , Madhavan Parvathy , Luthra Pooja 
Published: April 2024

Abstract
Most adrenal incidentalomas are benign neoplasms of the adrenal cortex. While the majority are nonfunctional, many secrete cortisol. Androgen- or estrogen-secreting adenomas are rare. A 44-year-old female, with history of hypertension and prediabetes, presented with worsening acne, hirsutism, secondary amenorrhea for 2 years, and a 40-pound weight gain. Laboratory evaluation showed high 24-hour urine free cortisol, suppressed adrenocorticotropic hormone (ACTH) level, indicative of ACTH independent Cushing syndrome, and elevated testosterone and androstenedione. Abdominal computed tomography (CT) revealed a 6.3 × 5.2 × 5.6 cm left adrenal mass. Patient underwent left open adrenalectomy. Pathology revealed benign adrenocortical adenoma. Postoperatively there was a significant improvement in her blood pressure and blood sugar levels, resumption of menses, and complete resolution of hyperandrogenism and hypercortisolism. We describe a patient with an adrenal adenoma cosecreting cortisol and androgen, leading to Cushing syndrome and significant virilization. Adrenal masses secreting androgens are less common and concerning for adrenocortical carcinoma (ACC). Patients with adrenal masses cosecreting multiple hormones should undergo workup expediently since ACC confers poor outcomes.
Persistent Gynecomastia due to Short-term Low-dose Finasteride for Androgenetic Alopecia
Authors: Farkas Hal Steven , Jee Youn Hee , Szymczuk Vivian , Leschek Ellen Werber 
Published: April 2024

Abstract
We report a case of persistent gynecomastia in a healthy 20-year-old man after 1 month of low-dose finasteride. Finasteride was discontinued after 2 months, and gynecomastia was unchanged 5 months after drug withdrawal. The gynecomastia regressed but did not resolve after 6 months of treatment with raloxifene, a selective estrogen receptor modulator. One year later, bilateral mammoplasty was performed to remove the remaining breast tissue. Finasteride, a 5-alpha-reductase inhibitor, is widely used for the treatment of androgenetic alopecia. Gynecomastia is an expected side effect of this therapy given its mechanism of action. However, only 8 cases of gynecomastia have been reported with low-dose (1 mg daily) finasteride treatment since its approval for androgenetic alopecia in 1997. This raises the concern that gynecomastia resulting from low-dose finasteride is significantly underreported, causing inadequately informed patients. Further, because of the risk of gynecomastia, it is important for prescribing physicians to counsel patients regarding this complication and to consider early intervention when finasteride-induced gynecomastia first arises to prevent fibrosis and thus irreversible gynecomastia.
HIERARCHICAL CLUSTERIZATION AND DEEP LEARNING MODEL RANDOM FOREST OF BANKS’ STABILITY UNDER RISK CONDITIONS
Authors: Lomakin Nikolay I. , Kuzmina Tatyana I. , Maramygin Maxim S. , Dergacheva Svetlana N. , Tsebekova Yulia T. , Vimalarathne Kanchana , Lomakin Ivan N. 
Published: April 2024

Certain theoretical aspects of the stability of Russian banks under risk conditions have been studied. The relevance is due to the fact that in conditions of market uncertainty and risk, approaches to ensure the stability of banks using artificial intelligence are increasingly being used. The goal is to identify patterns between the characteristics of Assets and ROA (Return on Assets), an indicator of return on assets, and obtain a forecast value of Sberbank’s net profit. The result of the study was hierarchical clustering, as well as the generated Deep Learning model Random Forest, which calculated the predicted value of the Sberbank’s net profit. The novelty lies in the fact that the work puts forward and proves the hypothesis that using the Random Forest Deep learning model, a forecast of the net profit of commercial banks can be obtained, which predetermines the stability and dynamics of their development. The conclusions from the study boil down to the fact that a Deep Learning model Random Forest was developed to forecast the amount of net profit, which for Sberbank for 2023 amounted to 38,631 billion rubles, which coincided with its actual value. The area of application of the results obtained is commercial banks.
On Customer (Dis-)Honesty in Unobservable Queues: The Role of Lying Aversion
Authors: Estrada Rodriguez Arturo , Ibrahim Rouba , Zhan Dongyuan 
Published: April 2024

Queues where people misreport their private information to access service faster are everywhere. Motivated by the prevalence of such behavior in practice, we construct a queueing-game-theoretic model where customers make strategic claims to reduce their waiting time and where the manager decides on the static scheduling policy based on those claims to minimize the expected delay cost in the system. We develop a lying-aversion model where customers incur both delay and lying costs. We run controlled experiments to validate our modeling assumptions regarding customer misreporting behavior. In particular, we find that people do incur lying costs, and we find that their misreporting behavior does not depend on changes in waiting times but rather, on the scheduling parameters. Based on the validated lying-aversion model, we study the equilibrium that arises in our game. We find that under certain conditions, the optimal policy is to use an honor policy where service priority is given according to customer claims. We also find that it may be optimal to incentivize more honesty by means of an upgrading policy where some customers who claim to not deserve priority are upgraded to the priority queue. We find that the upgrading policy deviates from the celebrated cµ rule. This paper was accepted by Elena Katok, operations management. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.04036 .
Sharpen Your Sword for Litigation: Incumbent Strategic Reaction to the Threat of Entry
Authors: Conti Annamaria , Ortega Leonardo , Sung Elie 
Published: April 2024

While patents have been shown to play a role as barriers to entry, they also reveal information about incumbent strategies and risk being invalidated. We examine the trade-off incumbents face between using their patents ex ante as entry deterrents or ex post once competitors have revealed their moves. Leveraging the unique characteristics of the pharmaceutical sector, in which it is possible to observe exactly when a competitor entry threat materializes, and exploiting exogenous variation in that timing, we show that incumbents intentionally fragment and delay the full disclosure of their intellectual property rights through continuation patents. They disproportionately reveal continuation patents after a competitor entry threat becomes concrete, tailoring their response to the threat they have received and successfully delaying competitor entry through litigation. The detected incumbents’ reaction is stronger when their attacked drugs are valuable and when the patents listed at the Food and Drug Administration approval of a drug are relatively narrow in scope. This paper was accepted by Alfonso Gambardella, business strategy. Funding: A. Conti acknowledges funding from E4S. E. Sung acknowledges funding from the HEC Foundation [Grant 9B82F1905+] and the U.S. National Science Foundation [Grant 1759991]. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2023.00900 .
Equilibrium Portfolio Selection for Smooth Ambiguity Preferences
Authors: Guan Guohui , Liang Zongxia , Xia Jianming 
Published: April 2024

This paper investigates the equilibrium portfolio selection for smooth ambiguity preferences in a continuous-time market. The investor is uncertain about the risky asset’s drift term and updates the subjective belief according to the Bayesian rule. A verification theorem is established, and an equilibrium strategy can be decomposed into a myopic demand and two hedging demands. When the prior is Gaussian, we provide an equilibrium solution in closed form. Moreover, a puzzle in the numerical results is interpreted via an alternative representation of the smooth ambiguity preferences. Funding: This work was supported by the National Key R&D Program of China [Grant 2020YFA0712700], the National Natural Science Foundation of China [Grants 11871036, 11901574, 12071146, 12271290, and 12371477], and the MOE Project of Key Research Institute of Humanities and Social Sciences [Grant 22JJD910003].
Establishment and evaluation of a prognostic model for patients with unresectable gastric cancer liver metastases
Authors: Chang Zheng-Yao , Gao Wen-Xing , Zhang Yue , Zhao Wen , Wu Di , Chen Lin 
Published: April 2024

BACKGROUND
Liver metastases (LM) is the primary factor contributing to unfavorable outcomes in patients diagnosed with gastric cancer (GC). The objective of this study is to analyze significant prognostic risk factors for patients with GCLM and develop a reliable nomogram model that can accurately predict individualized prognosis, thereby enhancing the ability to evaluate patient outcomes.
AIM
To analyze prognostic risk factors for GCLM and develop a reliable nomogram model to accurately predict individualized prognosis, thereby enhancing patient outcome assessment.
METHODS
Retrospective analysis was conducted on clinical data pertaining to GCLM (type III), admitted to the Department of General Surgery across multiple centers of the Chinese PLA General Hospital from January 2010 to January 2018. The dataset was divided into a development cohort and validation cohort in a ratio of 2:1. In the development cohort, we utilized univariate and multivariate Cox regression analyses to identify independent risk factors associated with overall survival in GCLM patients. Subsequently, we established a prediction model based on these findings and evaluated its performance using receiver operator characteristic curve analysis, calibration curves, and clinical decision curves. A nomogram was created to visually represent the prediction model, which was then externally validated using the validation cohort.
RESULTS
A total of 372 patients were included in this study, comprising 248 individuals in the development cohort and 124 individuals in the validation cohort. Based on Cox analysis results, our final prediction model incorporated five independent risk factors including albumin levels, primary tumor size, presence of extrahepatic metastases, surgical treatment status, and chemotherapy administration. The 1-, 3-, and 5-years Area Under the Curve values in the development cohort are 0.753, 0.859, and 0.909, respectively; whereas in the validation cohort, they are observed to be 0.772, 0.848, and 0.923. Furthermore, the calibration curves demonstrated excellent consistency between observed values and actual values. Finally, the decision curve analysis curve indicated substantial net clinical benefit.
CONCLUSION
Our study identified significant prognostic risk factors for GCLM and developed a reliable nomogram model, demonstrating promising predictive accuracy and potential clinical benefit in evaluating patient outcomes.
Yiwei Xiaoyu granules for treatment of chronic atrophic gastritis with deficiency syndrome of the spleen and stomach
Authors: Chen Wan-Qun , Fan Qing-Feng , He Yuan-Jun , Li Fei , Wu Xin , Li Yan-Ping , Yang Xiao-Jun 
Published: April 2024

BACKGROUND
The Correa sequence, initiated by Helicobacter pylori (H. pylori ), commonly progresses to gastric cancer through the stage of chronic atrophic gastritis (CAG). Although eradication of H. pylori only reduces the risk of gastric cancer, it does not eliminate the risk for neoplastic progression. Yiwei Xiaoyu granules (YWXY) are a commonly used composite preparation in Chinese clinics. However, the pursuit of excellence in clinical trials and the establishment of standardized animal experiments are still needed to contribute to full understanding and application of traditional Chinese medicine in the treatment of CAG.
AIM
To demonstrate the effectiveness of YWXY in patients with CAG and spleen-stomach deficiency syndrome (DSSS), by alleviating histological scores, improving response rates for pathological lesions, and achieving clinical efficacy in relieving DSSS symptoms.
METHODS
We designed a double-blind, randomized, controlled trial. The study enrolled seventy-two H. pylori -negative patients (mean age, 52.3 years; 38 men) who were randomly allocated to either the treatment group or control group in a 1:1 ratio, and treated with 15 g YWXY or 0.36 g Weifuchun (WFC) tablet combined with the respective dummy for 24 wk. The pre-randomization phase resulted in the exclusion of 72 patients: 50 participants did not meet the inclusion criteria, 12 participants declined to participate, and 10 participants were excluded for various other reasons. Seven visits were conducted during the study, and histopathological examination with target endoscopic biopsy of narrow-band imaging was requested before the first and seventh visits. We also evaluated endoscopic performance scores, total symptom scores, serum pepsinogen and gastrin-17.
RESULTS
Six patients did not complete the trial procedures. Treatment with YWXY improved the Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stage, compared with WFC (P < 0.05). YWXY provided better relief from symptoms of DSSS and better improvement in serum gastric function, compared with WFC (P < 0.05).
CONCLUSION
YWXY compared with WFC significantly reduced the risk of mild or moderate atrophic disease, according to OLGIM stage, significantly relieved symptoms of DSSS, and improved serum gastric function.
Airway management of a patient with linear immunoglobulin A bullous dermatosis: A case report
Authors: Nin Olga C , Hutnik Robert , Chheda Neil N , Hutchinson David 
Published: April 2024

BACKGROUND
There is limited literature on managing the airway of patients with linear immunoglobulin A (IgA) bullous dermatosis, a rare mucocutaneous disorder that leads to the development of friable bullae. Careful clinical decision making is necessary when there is a risk of bleeding into the airway, and a multidisciplinary team approach may lead to decreased patient morbidity during these high-risk scenarios, especially when confronted with an unusual cause for bleeding.
CASE SUMMARY
A 45-year-old African American female presented to our ambulatory surgical center for right corneal transplantation due to corneal perforation after blunt trauma in the setting of cicatricial conjunctivitis and diffuse corneal neovascularization from linear IgA bullous dermatosis. The diagnosis of IgA dermatosis was recent, and the patient had been lost to follow-up. The severity of the disease and extent of airway involvement was unknown at the time of the surgery. Significant airway bleeding was noticed upon intubation and the otorhinolaryngology team had to be called to the operating room. The patient required transfer to the intensive care unit where a multidisciplinary team was involved in her case. The patient was extubated on postoperative day 4.
CONCLUSION
A multidisciplinary approach to treating this disease is the best course of action before a surgical procedure. In our case, key communication between the surgery, anesthesia, and dermatology teams led to the quick and safe treatment of our patient’s disease. Ambulatory surgery should not be considered for these cases unless they are in full remission and there is no mucous membrane involvement.
Atypical presentation of a posterior fossa tumour: A case report
Authors: Narotam Alisha , Archary Mikara , Naidoo Poobalan , Naidoo Yeshkhir , Naidu Vanesha 
Published: April 2024

BACKGROUND
We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory distress. This is of interest as the patient had no other symptomatology, especially given the size of the mass, which would typically cause a pressure effect leading to neurological and auditory symptoms.
CASE SUMMARY
This case report described a 48-year-old male who was married with two children and employed as a car guard. He had a medical history of asthma for the past 10 years controlled with an as-needed beta 2 agonist metered dose inhaler. He initially presented to our facility with severe respiratory distress. He reported a 1-wk history of shortness of breath and wheezing that was not relieved by his bronchodilator. He had no constitutional symptoms or impairment of hearing. On clinical examination, the patient’s chest was “silent.” Our initial assessment was status asthmaticus with type 2 respiratory failure, based on the history of asthma, a “silent chest,” and the arterial blood gas results.
CONCLUSION
A posterior fossa meningioma of such a large size and with extensive infiltration rarely presents with an isolated unilateral vocal cord palsy. The patient’s chief presenting feature was severe respiratory distress, which combined with his background medical history of asthma, was misleading. Clinicians should thus consider meningioma as a differential diagnosis for a unilateral vocal cord palsy even without audiology involvement.
Hand and Wrist trauma: Antimicrobials and Infection Audit of Clinical Practice (HAWAII ACP) protocol
Authors: Shafi Shiraz Q. , Yoshimura Ryo , Harrison Conrad J. , Wade Ryckie G. , Shaw Abigail V. , Totty Joshua P. , Rodrigues Jeremy N. , Gardiner Matthew D. , Wormald Justin C. R. 
Published: April 2024

AimsHand trauma, consisting of injuries to both the hand and the wrist, are a common injury seen worldwide. The global age-standardized incidence of hand trauma exceeds 179 per 100,000. Hand trauma may require surgical management and therefore result in significant costs to both healthcare systems and society. Surgical site infections (SSIs) are common following all surgical interventions, and within hand surgery the risk of SSI is at least 5%. SSI following hand trauma surgery results in significant costs to healthcare systems with estimations of over £450 per patient. The World Health Organization (WHO) have produced international guidelines to help prevent SSIs. However, it is unclear what variability exists in the adherence to these guidelines within hand trauma. The aim is to assess compliance to the WHO global guidelines in prevention of SSI in hand trauma.MethodsThis will be an international, multicentre audit comparing antimicrobial practices in hand trauma to the standards outlined by WHO. Through the Reconstructive Surgery Trials Network (RSTN), hand surgeons across the globe will be invited to participate in the study. Consultant surgeons/associate specialists managing hand trauma and members of the multidisciplinary team will be identified at participating sites. Teams will be asked to collect data prospectively on a minimum of 20 consecutive patients. The audit will run for eight months. Data collected will include injury details, initial management, hand trauma team management, operation details, postoperative care, and antimicrobial techniques used throughout. Adherence to WHO global guidelines for SSI will be summarized using descriptive statistics across each criteria.DiscussionThe Hand and Wrist trauma: Antimicrobials and Infection Audit of Clinical Practice (HAWAII ACP) will provide an understanding of the current antimicrobial practice in hand trauma surgery. This will then provide a basis to guide further research in the field. The findings of this study will be disseminated via conference presentations and a peer-reviewed publication.Cite this article: Bone Jt Open 2024;5(4):361–366.