bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embolization of left anterior descending artery due to pledget after a redo surgery
Authors: Kanemura Takeyuki , Nakahara Yoshinori , Fukushima Toshiya , Kawamoto Shuhei , Morooka Kazuki , Shimozawa Motoharu 
Published: April 2024

Abstract
A 53-year-old man underwent aortic root replacement for acute aortic dissection. Following this procedure, the patient developed a pseudoaneurysm at the aortic root, necessitating reoperation. The subsequent surgery was performed routinely, allowing the patient to be weaned from mechanical ventilation on the same day. Postoperative electrocardiography revealed ST-segment elevation, suggesting myocardial ischaemia. Coronary angiography identified 90% stenosis in the left anterior descending artery, and computed tomography revealed a high-density mass. These findings suggested an embolus from a previous surgery. A snare catheter was successfully employed to extract the embolic material, which was identified as a pledget used for aortic valve replacement in the initial operation. This case underscores the potential for complications associated with pledgets used in valve surgeries, illustrating the risk of embolization when the valve is subsequently removed.
An uninvited guest, Ascaris in the bile duct causing cholangitis successfully treated with surgery
Authors: Ramos Darwin R , Robalino Antonio S , Mogrovejo Daniel L , Suárez Doménica A , Proaño Aitana E Ross , Parrales Diana E , Molina Gabriel A 
Published: April 2024

Abstract
Parasitic infections continue to be a burden for developing countries—the lack of hygiene measures and clean water results in dangerous scenarios that can lead to challenging problems. Most Ascaris lumbricoides infections are usually mild; nonetheless, in rare cases in endemic regions, they can migrate to the bile duct and cause severe complications requiring surgery. We present the case of a 43-year-old woman who had severe cholangitis due to A. lumbricoides. The worm migrated from the bowel and obstructed the bile duct; after surgery, the patient fully recovered.
Traumatic appendicitis with mass formation, a rare case report
Authors: Shawasha Bassam Adel , Awaysa Asala M , Smerat Mohammad I , Fakhouri Sulaiman Naji Fares 
Published: April 2024

Abstract
This case report delves into an atypical presentation of postblunt abdominal trauma in an adult male, characterized by acute appendicitis complicated by the formation of an appendicular inflammatory mass. The patient’s clinical evolution, diagnostic intricacies, and the multidisciplinary approach employed for successful management. By documenting this rare complication, our report contributes to expanding knowledge base on unusual consequences of abdominal trauma, aiming to enhance awareness and facilitate informed decision-making in clinical practice.
A huge benign gastric schwannomas presented with upper and lower gastrointestinal bleeding: a case report and literature review
Authors: AlAli Mohammed N , AlDayel Aya K , Alshammari Afraj T , Essa Mohamed S , AlAmodi Maha , Alrashed Muath , Amer Sadiq M , Meaigel Mohammed A , AlTahan Talal M , Ahmad Khalid S 
Published: April 2024

Abstract
Gastric schwannomas (GS) are rare mesenchymal tumors from Schwann cells in the gastrointestinal (GI) tract, representing 2–6% of such tumors. We report a 52-year-old woman who experienced abdominal pain, hematemesis, and melena, initially suspected of having a GI stromal tumor through ultrasound and computed tomography abdomen. Despite no active bleeding found during an upper endoscopy, she underwent a successful open subtotal gastrectomy, with histopathology confirming GS. The diagnosis of GS, which may mimic other GI conditions, relies heavily on imaging and histopathological analysis due to its nonspecific symptomatology, including the potential for both upper and lower GI bleeding. This case underscores the diagnostic challenges of GS and highlights surgical resection as the preferred treatment, generally leading to a favorable prognosis.
BET inhibition induces GDH1-dependent glutamine metabolic remodeling and vulnerability in liver cancer
Authors: Mi Wen , You Jianwei , Li Liucheng , Zhu Lingzhi , Xia Xinyi , Yang Li , Li Fei , Xu Yi , Bi Junfeng , Liu Pingyu , Chen Li , Li Fuming 
Published: April 2024

Abstract
Bromodomain and extra-terminal domain (BET) proteins, which function partly through MYC proto-oncogene (MYC), are critical epigenetic readers and emerging therapeutic targets in cancer. Whether and how BET inhibition simultaneously induces metabolic remodeling in cancer cells remains unclear. Here we find that even transient BET inhibition by JQ-1 and other pan-BET inhibitors (pan-BETis) blunts liver cancer cell proliferation and tumor growth. BET inhibition decreases glycolytic gene expression but enhances mitochondrial glucose and glutamine oxidative metabolism revealed by metabolomics and isotope labeling analysis. Specifically, BET inhibition downregulates miR-30a to upregulate glutamate dehydrogenase 1 (GDH1) independent of MYC, which produces α-ketoglutarate for mitochondrial oxidative phosphorylation (OXPHOS). Targeting GDH1 or OXPHOS is synthetic lethal to BET inhibition, and combined BET and OXPHOS inhibition therapeutically prevents liver tumor growth in vitro and in vivo. Together, we uncover an important epigenetic-metabolic crosstalk whereby BET inhibition induces MYC-independent and GDH1-dependent glutamine metabolic remodeling that can be exploited for innovative combination therapy of liver cancer.
Impact of Gram-Negative Bacilli Resistance Rates on Risk of Death in Septic Shock and Pneumonia
Authors: Hixon Alison M , Micek Scott , Fraser Victoria J , Kollef Marin , Guillamet M Cristina Vazquez 
Published: April 2024

Abstract

Background
Sepsis is a major cause of morbidity and mortality worldwide. When selecting empiric antibiotics for sepsis, clinicians are encouraged to use local resistance rates, but their impact on individual outcomes is unknown. Improved methods to predict outcomes are needed to optimize treatment selection and improve antibiotic stewardship.

Methods
We expanded on a previously developed theoretical model to estimate the excess risk of death in gram-negative bacilli (GNB) sepsis due to discordant antibiotics using 3 factors: the prevalence of GNB in sepsis, the rate of antibiotic resistance in GNB, and the mortality difference between discordant and concordant antibiotic treatments. We focused on ceftriaxone, cefepime, and meropenem as the anti-GNB treatment backbone in sepsis, pneumonia, and urinary tract infections. We analyzed both publicly available data and data from a large urban hospital.

Results
Publicly available data were weighted toward culture-positive cases. Excess risk of death with discordant antibiotics was highest in septic shock and pneumonia. In septic shock, excess risk of death was 4.53% (95% confidence interval [CI], 4.04%–5.01%), 0.6% (95% CI, .55%–.66%), and 0.19% (95% CI, .16%–.21%) when considering resistance to ceftriaxone, cefepime, and meropenem, respectively. Results were similar in pneumonia. Local data, which included culture-negative cases, showed an excess risk of death in septic shock of 0.75% (95% CI, .57%–.93%) for treatment with discordant antibiotics in ceftriaxone-resistant infections and 0.18% (95% CI, .16%–.21%) for cefepime-resistant infections.

Conclusions
Estimating the excess risk of death for specific sepsis phenotypes in the context of local resistance rates, rather than relying on population resistance data, may be more informative in deciding empiric antibiotics in GNB infections.
Right ventricular papillary muscle crossing the moderator band mimicked infective endocarditis: the utility of multimodal imaging
Authors: Kamiyama Masaki , Higaki Akinori , Miyabe Ryo , Higashi Haruhiko , Inoue Katsuji , Yamaguchi Osamu 
Published: April 2024

Abstract
Right-sided infective endocarditis (RSIE) generally carries a positive prognosis; however, it can result in complications such as heart failure, underscoring the importance of prompt diagnosis. While echocardiography serves as the standard diagnostic tool, it may occasionally face challenges in distinguishing between normal structures and vegetations. In this report, we present the case of a 60-year-old man diagnosed with pyogenic vertebral osteomyelitis, alongside suspected coexisting RSIE. During both transthoracic and transesophageal echocardiography, a rod-like mobile structure was observed adjacent to the right ventricular moderator band. However, confirming its nature as an infective vegetation proved challenging. Despite the inconclusive diagnosis of IE by echocardiography, the positron emission tomography/computed tomography (PET/CT) scan and cardiac magnetic resonance imaging (MRI) played a pivotal role in distinguishing between normal structures and vegetations. Since IE could develop life-threatening events, the role of multimodal imaging is of paramount importance. This case serves as a compelling example of the diagnostic value through the integration of PET/CT and MRI in ruling out IE.
Non-Stokesian dynamics of magnetic helical nanoswimmers under confinement
Authors: Fazeli Alireza , Thakore Vaibhav , Ala-Nissila Tapio , Karttunen Mikko 
Published: April 2024

Abstract
Electromagnetically propelled helical nanoswimmers offer great potential for nanorobotic applications. Here, the effect of confinement on their propulsion is characterized using lattice-Boltzmann simulations. Two principal mechanisms give rise to their forward motion under confinement: (i) pure swimming and (ii) the thrust created by the differential pressure due to confinement. Under strong confinement, they face greater rotational drag but display a faster propulsion for fixed driving frequency in agreement with experimental findings. This is due to the increased differential pressure created by the boundary walls when they are sufficiently close to each other and the particle. We have proposed two analytical relations (i) for predicting the swimming speed of an unconfined particle as a function of its angular speed and geometrical properties, and (ii) an empirical expression to accurately predict the propulsion speed of a confined swimmer as a function of the degree of confinement and its unconfined swimming speed. At low driving frequencies and degrees of confinement, the systems retain the expected linear behavior consistent with the predictions of the Stokes equation. However, as the driving frequency and/or the degree of confinement increase, their impact on propulsion leads to increasing deviations from the Stokesian regime and emergence of nonlinear behavior.
Medical Malpractice Cases Involving Medical Students
Authors: Pollock Jordan R. , Shappell Eric , Sandefur Benjamin J. , Moore M. Lane , Lindor Rachel A. 
Published: April 2024

Abstract

Purpose
This study uses a large national legal database to analyze characteristics of malpractice claims involving U.S. medical students.

Method
The Westlaw database was searched in September 2023 for malpractice cases involving medical students from January 1, 1900, through September 1, 2023. Each case was independently reviewed by 2 authors, abstracting each variable. Categorical data were summarized as frequency of occurrence (i.e., number and percentage), and continuous data were summarized with means, medians, and ranges. All authors independently reviewed the dataset to identify potential themes and codes.

Results
There were 65 cases that met the inclusion criteria. Reported patient outcomes were death (19, 29%), pain (25, 38%), and disability (36, 55%). The most common specialties involved were emergency medicine (16, 25%), general surgery (14, 22%), and obstetrics and gynecology (13, 20%). The most common primary alleged errors attributed to students related to medical decision-making (30, 46%), procedural complication (24, 37%), and poor communication (11, 17%). Among 23 (35%) cases reporting year of training, 1 (4%) included a second-year student, 13 (57%) included third-year students, and 9 (39%) included fourth-year students. Of the 65 lawsuits, 28 (43%) resulted in a settlement or verdict against the medical student. The total amount paid in these cases was $78,192,612, with a mean (median) of $3,007,408 ($1,050,000) per case. Of these 28 cases, 14 (50%) cited minimal or no physician supervision.

Conclusions
Medical malpractice claims involving medical students are rare but commonly relate to medical decision-making, procedural complication, and poor communication, with a lack of supervision being frequently cited. These results can be used to guide students and supervising physicians on how to avoid scenarios that may increase vulnerability to medical malpractice lawsuits.
MRI Dixon Fat-Corrected Look-Locker T1 Mapping for Quantification of Liver Fibrosis and Inflammation—A Comparison With the Non–Fat-Corrected Shortened Modified Look-Locker Inversion Recovery Technique
Authors: Klaus Jeremias Bendicht , Goerke Ute , Klarhöfer Markus , Keerthivasan Mahesh Bharath , Jung Bernd , Berzigotti Annalisa , Ebner Lukas , Roos Justus , Christe Andreas , Obmann Verena Carola , Huber Adrian Thomas 
Published: April 2024

Objectives
This study evaluates the impact of liver steatosis on the discriminative ability for liver fibrosis and inflammation using a novel Dixon water-only fat-corrected Look-Locker T1 mapping sequence, compared with a standard shortened Modified Look-Locker Inversion Recovery (shMOLLI) sequence, with the aim of overcoming the limitation of steatosis-related confounding in liver T1 mapping.

Materials and Methods
3 T magnetic resonance imaging of the liver including the 2 T1 mapping sequences and proton density fat fraction (PDFF) was prospectively performed in 24 healthy volunteers and 38 patients with histologically proven liver fibrosis evaluated within 90 days of liver biopsy. Paired Mann-Whitney test compared sequences between participants with and without significant liver steatosis (PDFF cutoff 10%), and unpaired Kruskal-Wallis test compared healthy volunteers to patients with early (F0–2) and advanced (F3–4) liver fibrosis, as well as low (A0–1) and marked (A2–3) inflammatory activity. Univariate and multivariate logistic regression models assessed the impact of liver steatosis on both sequences.

Results
Dixon_W T1 was higher than shMOLLI T1 in participants without steatosis (median 896 ms vs 890 ms, P = 0.04), but lower in participants with liver steatosis (median 891 ms vs 973 ms, P < 0.001). Both methods accurately differentiated between volunteers and patients with early and advanced fibrosis (Dixon_W 849 ms, 910 ms, 947 ms, P = 0.011; shMOLLI 836 ms, 918 ms, 978 ms, P < 0.001), and those with mild and marked inflammation (Dixon_W 849 ms, 896 ms, 941 ms, P < 0.01; shMOLLI 836 ms, 885 ms, 978 ms, P < 0.001). Univariate logistic regression showed slightly lower performance of the Dixon_W sequence in differentiating fibrosis (0.69 vs 0.73, P < 0.01), compensated by adding liver PDFF in the multivariate model (0.77 vs 0.75, P < 0.01).

Conclusions
Dixon water-only fat-corrected Look-Locker T1 mapping accurately identifies liver fibrosis and inflammation, with less dependency on liver steatosis than the widely adopted shMOLLI T1 mapping technique, which may improve its predictive value for these conditions.
Sex differences in vaccine induced immunity and protection againstMycobacterium tuberculosis
Authors: Parvathy Gishnu Harikumar , Bhandiwad Dhananjay , Eggers Lars , von Borstel Linda , Behrends Jochen , Hein Martina , Hertz David , Marschner Jaqueline , Orinska Zane , Kaufmann Stefan H E , Flores-Valdez Mario Alberto , Lotter Hanna , Schneider Bianca E 
Published: April 2024

AbstractTuberculosis (TB) is a disease that has evolved with humankind for millennia, causing approximately 1.3 million deaths worldwide per annum. Although increased male affliction for TB and other infections were long known from an epidemiological perspective, our mechanistic understanding of the underlying immunological divergences is relatively recent. As such, there is insufficient knowledge regarding the sexually dimorphic immune response to TB vaccines, where no accepted correlates of protection are yet available. In this context, our goal was to explore how individual sex influences the protective effects of TB vaccines. For this purpose, we vaccinated female and male C57BL/6 mice with Bacille Calmette-Guérin (BCG) and two recombinant derivatives, VPM1002 and BCGΔBCG1419c, to analyse their protective efficacy against challenge withMycobacterium tuberculosisHN878. We found poor efficacy of BCG in males and the ability of next generation vaccine candidates to improve protection specifically in males. To determine the underlying mechanisms for the differences in survival upon vaccination between females and males, as well as, among different vaccine candidates, we analysed the distribution and persistence of the vaccine strains, in addition to vaccine-induced immune responses at various time points in draining lymph nodes and spleen. We identified sex specific differences in CD8 T cell proliferation in response to mycobacterial antigensex vivo, 90 days post-vaccination, that associates with vaccine mediated protection against HN878. By integrating our multi-parametric datasets into principal component analysis, followed by extraction of high-variance features, we have uncovered an additional significant association of early CD4 T cell responses with late CD8 T cell responses as well as with survival post HN878 infection. In addition, we have also identified specific clusters of responding CD8 T cells in spleen post-vaccination, that are globally deficient in males as compared to females, irrespective of the BCG strain administered.
The German Multicenter Registry for ME/CFS (MECFS-R)
Authors: Hieber Hannah , Pricoco Rafael , Gerrer Katrin , Heindrich Cornelia , Wiehler Katharina , Mihatsch Lorenz L. , Hägele Matthias , Schindler Daniela , Donath Quirin , Christa Catharina , Grabe Annika , Kircher Alissa , Leone Ariane , Müller Yvonne , Zietemann Hannah , Freitag Helma , Sotzny Franziska , Warlitz Cordula , Stojanov Silvia , Hattesohl Daniel B. R. , Hausruckinger Anna , Mittelstrass Kirstin , Scheibenbogen Carmen , Behrends Uta 
Published: April 2024

ABSTRACTMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multi-systemic disease characterized by a complex, incompletely understood etiology. To facilitate future clinical and translational research, a multicenter German ME/CFS registry was established to collect comprehensive, longitudinal, clinical, epidemiological, and laboratory data from adults, adolescents, and children in a web-based multilayer-secured database.Here, we present the research protocol and first results of a pilot cohort of 174 ME/CFS patients diagnosed at two specialized tertiary fatigue centers, including 130 (74.7%) adults (mean age 38.4; SD 12.6) and 43 (25.3%) pediatric patients (mean age 15.5; SD 4.2). A viral trigger was identified in 160/174 (92.0%) cases, with SARS-CoV-2 in almost half of them. Patients exhibited severe functional and social impairment, as reflected by a median Bell Score of 30.0 (IQR 30.0 to 40.0) and a poor health-related quality of life assessed with the Short form-36 health survey, resulting in a mean score of 40.4 (SD 20.6) for physical function and 59.1 (SD 18.8) for mental health.The MECFS-R provides important clinical information on ME/CFS to research and healthcare institutions and, together with a multicenter ME/CFS biobank, will pave the way for research projects addressing the pathogenesis, diagnostic markers, and treatment options.Trial registration:ClinicalTrials.govNCT05778006.
Why are social media users susceptible to health misinformation? A perspective from complexity theory
Authors: Mo Zuying , Guo Yiming , Pan Daqing 
Published: April 2024

PurposeHealth misinformation on social media threatens public health. A critical question that sheds light on the propagation of health misinformation across social media platforms revolves around identifying the specific types of social media users susceptible to this issue. This study provides an initial insight into this matter by examining the underlying psychological mechanism that renders users susceptible to health misinformation.Design/methodology/approachIn this study, we developed an integrated model of susceptibility to health misinformation, drawing on the motivation-opportunity-ability theory and the elaboration likelihood model. We collected the data from a sample of 342 social media users in China. Furthermore, the fuzzy-set qualitative comparative analysis was adopted to examine the proposed model and uncover the causal recipes associated with susceptibility to health misinformation.FindingsThe results indicated that there are three configural types of users that are susceptible to health misinformation: the health-consciousness core-driven type, the popularity-driven core type and the dual-driven type characterized by both high health consciousness and information popularity. Among these, high health-consciousness and the reliance on information popularity-based pathways emerge as pivotal factors influencing susceptibility to health misinformation.Originality/valueThis study contributes to the social media literature by identifying various psychological traits that lead to social media users’ susceptibility to health misinformation. Additionally, the study provides comprehensive guidance on how to mitigate the spread of health misinformation.
Motivations of internal workplace coaches: what attracts them to the role? A mixed-methods study
Authors: Robson Mark , Boak George 
Published: April 2024

Purpose
Internal workplace coaches are employees who, in addition to their main job, volunteer to provide coaching to work colleagues who are not their direct reports. The purpose of this paper is to explore what motivates these individuals to volunteer to be an internal workplace coach and to continue carrying out the role.

Design/methodology/approach
To explore the experiences of internal coaches, a questionnaire was devised and issued; it attracted 484 responses – the largest survey response to date from this population. Following analysis of the questionnaire data, semi-structured interviews were carried out with 20 internal coaches from private, public and not-for-profit UK organisations. The responses were analysed in relation to motivation theory, principally self-determination theory.

Findings
Individuals were motivated to volunteer for the role, and to continue to practise as coaches, in the most part to satisfy intrinsic needs for competence, relatedness and autonomy. The research presents rich information about how coaches perceived these needs were satisfied by coaching. In general, there were only moderate or poor levels of support and recognition for individual coaches within their organisation, indicating limited extrinsic motivation.

Practical implications
The practical implications are that organisations can draw on the findings from this study to motivate individuals to volunteer to be internal coaches and to continue to act in that role.

Originality/value
Many organisations use internal coaches, but there is very little research into what motivates these volunteers.