bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Impact of Preoperative MRI-Based Vertebral Bone Quality Scores on 5-Year Prognosis in Lumbar Spine Surgery
Authors: Taniwaki Hiroshi , Hoshino Masatoshi , Kinoshita Yuki , Matsumura Akira , Namikawa Takashi , Kato Minori , Takahashi Shinji , Nakamura Hiroaki 
Published: May 2024

Study Design.
Retrospective cohort study.

Objective.
To assess the utility of preoperative vertebral bone quality (VBQ) scores in predicting the 5-year clinical outcomes following lumbar spine surgery.

Summary of Background Data.
Osteoporosis poses a significant concern in older adults undergoing spinal surgery. The VBQ score, assessed through preoperative magnetic resonance imaging (MRI), is associated with subsequent osteoporotic fractures and postoperative complications. However, previous report on the impact of VBQ score on mid-term clinical outcomes after lumbar spine surgery remains lacking.

Methods.
A total of 189 patients who underwent lumbar surgery (≤3-disc levels) for lumbar spinal stenosis between 2010 and 2016 were enrolled. Patients were classified into high (>3.35), middle (2.75 to 3.35), and low (<2.73) VBQ score groups based on tertiles. Clinical scores, including Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and Short Form-36 (SF-36), were recorded preoperatively and 1, 2, and 5 years postoperatively.

Results.
Comparative analysis showed significant differences among the VBQ groups throughout the study period in low back pain (P=0.013), walking ability (P=0.005), social life function (P=0.010) of JOABPEQ, and physical component summary of the SF-36 (P=0.018) following lumbar spine surgery. A higher VBQ score was significantly correlated with worse 5-year postoperative outcomes for all domains except for lumbar function of the JOABPEQ using multiple linear regression analysis, adjusting for age, sex, BMI, hyperlipidemia, surgical procedures, and each preoperative score.

Conclusion.

A high preoperative VBQ score is a risk factor for poor 5-year clinical outcomes after lumbar spine surgery. Evaluation of the VBQ score through routine preoperative MRI facilitates osteoporotic screening in lumbar patients without radiation exposure and healthcare costs, while also demonstrating its potential as a prognostic indicator of postoperative clinical outcomes.

Level of Evidence.
3
Concomitant Central and Peripheral Nervous System Involvement Associated With Mycoplasma pneumoniae Infection in Pediatric Patients: Two Case Reports and Literature Review
Authors: Xue Yuan , Yu Zhiwei , Cheng Min , Li Xiujuan , Jiang Li , Han Wei 
Published: May 2024

Background:

Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen for community-acquired pneumonia and is also implicated in a broad array of extra-pulmonary manifestations. M. pneumoniae infection is rarely associated with concurrent central nervous system (CNS) and peripheral nervous system (PNS) involvement in children.

Methods:
We report 2 patients who presented with acute encephalitis and polyradiculitis due to M. pneumoniae infection and review the literature to discuss the pathogenesis and treatment of concomitant CNS and PNS involvement associated with M. pneumoniae infection.

Results:
We report two 6-year-old boys with M. pneumoniae antecedent infection who presented initially with impaired consciousness followed by limb weakness, limb pain and urinary retention, and responded well to immunotherapy.

Conclusions:
We described 2 patients who presented symptomatic combined CNS and PNS involvement with persistent urinary retention associated with M. pneumoniae infection. We found autoimmunity plays an important role and recommend that antibiotics and immunomodulators should be administered with concurrent CNS and PNS involvement associated with M. pneumoniae.
Where Birth Month, Sex and Age Matters: The Burden of Severe Respiratory Disease in Danish Children <5 Years, 2016–2022
Authors: Flach de Neergaard Ebba Emilie , Egeskov-Cavling Amanda Marie , Rytter Dorte , Johannesen Caroline Klint , Fischer Thea K. 
Published: May 2024

Background:
In light of the substantial impact that respiratory diseases in young children poses on healthcare systems globally, and in the wake of the recent COVID-19 pandemic, there is a growing urgency to obtain reliable estimates on the burden of respiratory disease.

Objectives:
The aim of this study is to quantify the overall burden of respiratory disease requiring hospitalizations and explore the trends in these admissions in Danish children <5 years, January 1, 2016–October 31, 2022.

Methods:
The number of hospitalizations attributed to respiratory infections in children <5 years, was extracted from the Danish National Patient Register, and stratified into subgroups based on age, gender and birth month, and presented on a month-to-month basis.

Results:
A total of 48,194 children under the age of 5, were hospitalized due to respiratory infections within the study period and the annual hospitalization incidence exhibited a noteworthy variation. Risk factors associated with the highest hospitalization incidence were young age, male gender and in children under 1-year-old, birth months falling in the period of November to January. Younger age and admission during the winter months were linked to longer hospital stays. The seasonal pattern of hospitalizations and the distribution of hospitalizations across various subgroups were greatly influenced by the COVID-19 pandemic.

Conclusion:
This study describes and quantifies the importance of factoring in specific child demographics and seasonal variations in hospitalizations when devising preventive healthcare strategies such as the use of monoclonal antibody therapy and vaccines.
Long-term comparison of image-guided thermal ablation vs. lobectomy for solitary papillary thyroid microcarcinoma: a multi-center retrospective cohort study
Authors: Yan Lin , Li WenHui , Zhu YaLin , Li Xinyang , Li Yingying , Li Yiming , Song Qing , Che Ying , Wang Hui , Luo Yukun 
Published: May 2024

Background:
Image-guided thermal ablation has been applied in patients with papillary thyroid microcarcinoma (PTMC) who refuse surgery or active surveillance. However, evidence to support ablation is limited by single-center designs and a lack of long-term data. The purpose of this study was to compare long-term outcomes between ablation and lobectomy for patients with solitary PTMC.

Materials and methods:
This multi-center retrospective study included 1021 consecutive patients with solitary PTMC who underwent ablation (n=444) or lobectomy (n=577) at the four university-affiliated hospitals. The primary outcomes were disease progression [lymph node metastasis (LNM), recurrent tumors, persistent tumors and distant metastasis] and disease-free survival (DFS). Secondary outcomes were complications, hospitalization, procedure time, estimated blood loss and cost. The two groups were compared using propensity score matching.

Results:
After matching, no significant differences were observed in disease progression (4.7% vs. 3.4%, P=0.307), LNM (1.6% vs. 1.6%, P=1.000), recurrent tumors (2.9% vs. 1.8%, P=0.269), persistent tumors(0.2% vs. 0%, P=0.317) and DFS (95.5% vs. 97.1%, P=0.246) between the ablation and lobectomy groups during the median follow-up of 96.5 months. The ablation group had significantly lower complication rates (0.7% vs. 5.2%, P<0.001), shorter post-treatment hospitalization {median [interquartile range (IQR)], 0 vs. 4.0 [3.0] days, P<0.001}, shorter procedure time [8.5 (2.8) vs. 90.0 (43.8) min, P<0.001], reduced estimated blood loss [0 vs. 20.0 (10.0) ml, P<0.001], and lower cost [$1873.2 (254.0) vs. $2292.9 (797.8), P<0.001] than the lobectomy group.

Conclusions:
This study revealed comparable disease progression and survival outcomes between ablation and lobectomy for solitary PTMC. Imaged-guided thermal ablation could be effective and safe alternatives to lobectomy for properly selected patients with PTMC.
Case Series
Authors: Phenegar Griffin C. , Kallan Jamie E. , Corliss Robert F. 
Published: May 2024

Abstract
Titanium dioxide is a versatile compound that is found in a variety of consumer products, medical hardware, and pharmaceuticals. Although oral and topical ingestion of this compound is common, intravenous introduction is much less common. We present three cases where significant titanium dioxide deposits were identified in liver and splenic tissue of three decedents, all of whom died of illicit drug overdose in the same geographic area and had fentanyl and its metabolites in blood on postmortem toxicologic testing. At autopsy, liver sections had a granular texture with fine white stippling grossly, and histologic examination of hepatic and splenic tissues showed scattered patches of black granular material with pink birefringence. Energy-dispersive x-ray spectroscopy performed on these tissues revealed the presences of clusters of titanium dioxide. Immunohistochemical staining of both the liver and spleen with CD68 confirmed the titanium dioxide clusters were within macrophages. Intravenous titanium dioxide nanoparticle elimination studies in rats suggest a time sensitive period for this elimination, with a transient period of pigment deposition between 1–58 days following injection. If a time-dependent link between titanium dioxide pigment deposition within tissues and intravenous drug use can be shown, this could be a valuable tool for Pathologists.
Bone Metastases
Authors: Cook Gary J. R. , Thorpe Matthew P. 
Published: May 2024

Abstract
Bone metastases occur frequently in common malignancies such as breast and prostate cancer. They are responsible for considerable morbidity and skeletal-related events. Fortunately, there are now several systemic, focal, and targeted therapies that can improve quality and length of life, including radionuclide therapies. It is therefore important that bone metastases can be detected as early as possible and that treatment can be accurately and sensitively monitored. Several bone-specific and tumor-specific single-photon emission computed tomography and positron emission tomography molecular imaging agents are available, for detection and monitoring response to systemic therapeutics, as well as theranostic agents to confirm target expression and predict response to radionuclide therapies.
PSMA-Targeted Radiopharmaceuticals for Prostate Cancer Diagnosis and Therapy
Authors: Oldan Jorge D. , Almaguel Frankis , Voter Andrew F. , Duran Alfonso , Gafita Andrei , Pomper Martin G. , Hope Thomas A. , Rowe Steven P. 
Published: May 2024

Abstract
Prostate cancer (PCa) is the most common noncutaneous malignancy in men. Until recent years, accurate imaging of men with newly diagnosed PCa, or recurrent or low-volume metastatic disease, was limited. Further, therapeutic options for men with advanced, metastatic, castration-resistant disease were increasingly limited as a result of increasing numbers of systemic therapies being combined in the upfront metastatic setting. The advent of urea-based, small-molecule inhibitors of prostate-specific membrane antigen (PSMA) has partially addressed those shortcomings in diagnosis and therapy of PCa. On the diagnostic side, there are multiple pivotal phase III trials with several different agents having demonstrated utility in the initial staging setting, with generally modest sensitivity but very high specificity for determining otherwise-occult pelvic nodal involvement. That latter statistic drives the utility of the scan by allowing imaging interpreters to read with very high sensitivity while maintaining a robust specificity. Other pivotal phase III trials have demonstrated high detection efficiency in patients with biochemical failure, with high positive predictive value at the lesion level, opening up possible new avenues of therapy such as metastasis-directed therapy. Beyond the diagnostic aspects of PSMA-targeted radiotracers, the same urea-based chemical scaffolds can be altered to deliver therapeutic isotopes to PCa cells that express PSMA. To date, one such agent, when combined with best standard-of-care therapy, has demonstrated an ability to improve overall survival, progression-free survival, and freedom from skeletal events relative to best standard-of-care therapy alone in men with metastatic, castration-resistant PCa who are post chemotherapy. Within the current milieu, there are a number of important future directions including the use of artificial intelligence to better leverage diagnostic findings, further medicinal chemistry refinements to the urea-based structure that may allow improved tumor targeting and decreased toxicities, and the incorporation of new radionuclides that may better balance efficacy with toxicities than those nuclides that are available.
Positron Emission Tomography Imaging of Tumor Proliferation and DNA Repair
Authors: Shields Anthony F. , Chen Delphine L. 
Published: May 2024

Abstract
Positron emission tomography (PET) is an established tool for molecular imaging of cancers, and its role in diagnosis, staging, and phenotyping continues to evolve and expand rapidly. PET imaging of increased glucose utilization with 18F-fluorodeoxyglucose is now entrenched in clinical oncology practice for improving prognostication and treatment response assessment. Additional critical processes for cancer cell survival can also be imaged by PET, helping to inform individualized treatment selections for patients by improving our understanding of cell survival mechanisms and identifying relevant active mechanisms in each patient. The critical importance of quantifying cell proliferation and DNA repair pathways for prognosis and treatment selection is highlighted by the nearly ubiquitous use of the Ki-67 index, an established histological quantitative measure of cell proliferation, and BRCA mutation testing for treatment selection. This review focuses on PET advances in imaging and quantifying cell proliferation and poly(ADP-ribose)polymerase expression that can be used to complement cancer phenotyping approaches that will identify the most effective treatments for each individual patient.
Implementation of the Versius Surgical System in Complex Abdominal Wall Repair: First Reported Case of an Robotic ETEP/TAR Procedure
Authors: Pinto Renato D. , Trauczynski Pedro , Lima Diego L. , Cavazzola Leandro T. 
Published: May 2024

Background:
Robotic ventral hernia repair has been increasing globally, with comparable outcomes to laparoscopic repair and lower rates of conversion to open surgery. Robotic surgery is increasing in popularity, and there is a number of new robotic systems entering the marketing. We report the first case of a Roboic eTEP using the Versius robotic system in a patient with an incisional hernia.

Methods:
Surgery was performed using the Versius system from CMR surgical which consists of bedside units for each instrument and a console. The patient presented with an incisional hernia measuring 9.5×5 cm in the left flank.

Results:
The patient was discharged on postoperative day (POD) 2 with a drain. There was no need for opioids. The drain was removed at POD 7. The patient presented at POD 10 with erythema and cellulitis in the area that previously had tape on it, and it was resolved with a short course of oral antibiotics.

Conclusion:
The eTEP technique for hernia surgery was safe and feasible using the Versius robotic system. Implementation is possible in experienced hands with minimal changes to the surgical techniques.
A Grading System for Assessing the Status of the Sphincter of Oddi During Intraoperative Choledochoscopy: A Surgeon’s Perspective
Authors: Chen Hai Chuan , Wang Zhe Jin , Song Hong Liang 
Published: May 2024

Background:
The aim of this study was to establish a simple and practical grading system for evaluating the status of the sphincter of Oddi (SO) during intraoperative choledochoscopy. This system helps identify relevant variables that influence the status of the SO and provides recommendations for preventing stone recurrence.

Methods:
Ninety-three patients were selected retrospectively from a total of 316 patients diagnosed with choledocholithiasis between July 2020 and June 2023. All patients underwent common bile duct (CBD) exploration surgery and intraoperative choledochoscopy. The status of the SO was assessed during choledochoscopy. According to the severity of the condition, the patients were categorized into 4 groups. Data from each group, grades 1, 2, 3, 4, was analyzed statistically.

Results:
The number of patients in grade 1 was significantly lower than that of the other 3 groups. Except for grade 1, patients in grade 4 exhibited significant differences compared with the other 2 groups in terms of the diameter of the CBD, size of stones, presence of pneumobilia, and history of endoscopic retrograde cholangiopancreatography (ERCP) (P<0.05). There were no significant differences between the groups in terms of sex, age, liver function, number of stones, history of gastrectomy, cholecystectomy, or CBD exploration.

Conclusions:
The grading system helps us classify different sphincter functions and better understand the formation of choledocholithiasis by subdividing the status of the SO. Endoscopic sphincterotomy (EST) treatment can easily result in the loss of SO function, which increases the risk of stone recurrence.
Successful Recovery of Cardiac Function Following 20 min of a No-touch Period in a Donation After Circulatory Death: A Case Report
Authors: Zanatta Paolo , Linassi Federico , Gasparetto Nicola , Polesello Luigi , Bussola Matteo , Nascimben Ennio , Minniti Giuseppe , Cernetti Carlo , Angelini Matteo , Feltrin Giuseppe , Romano Maurizio , Zanus Giacomo , Benazzi Francesco , Gerosa Gino 
Published: May 2024

Background.
Withdrawal of life-sustaining therapy (WLST) performed in the circulatory determination of death (DCD) donors leads to cardiac arrest, challenging the utilization of the myocardium for transplantation. The rapid initiation of normothermic regional perfusion or extracorporeal membrane oxygenation after death helps to optimize organs before implantation. However, additional strategies to mitigate the effects of stress response during WLST, hypoxic/ischemic injury, and reperfusion injury are required to allow myocardium recovery.

Methods.
To this aim, our team routinely used a preconditioning protocol for each DCD donation before and during the WLST and after normothermic regional perfusion/extracorporeal membrane oxygenation. The protocol includes pharmacological treatments combined to reduce oxidative stress (melatonin, N-acetylcysteine, and ascorbic acid), improve microcirculation (statins), and mitigate organ’s ischemic injury (steroids) and organ ischemia/reperfusion injury (remifentanil and sevoflurane when the heart is available for transplantation).

Results.
This report presents the first case of recovery of cardiac function, with the only support of normothermic regional reperfusion, following 20 min of a no-touch period and 41 min of functional warm ischemic time in a DCD donor after the preconditioning protocol.

Conclusions.
Our protocol seems to be effective in abolishing the stress response during WLST and, on the other hand, particularly organ protective (and heart protective), giving a chance to donate organs less impaired from ischemia/reperfusion injury.
Pharmacological Ascorbate Induces Transient Hypoxia Sensitizing Pancreatic Ductal Adenocarcinoma to a Hypoxia Activated Prodrug
Authors: Kishimoto Shun , Crooks Daniel R. , Yasunori Otowa , Kota Yamashita , Yamamoto Kazutoshi , Linehan W. Marston , Levine Mark , Krishna Murali C , Brender Jeffrey R 
Published: May 2024

AbstractHypoxic tumor microenvironments pose a significant challenge in cancer treatment. Hypoxia-activated prodrugs like evofosfamide aim to specifically target and eliminate these resistant cells. However, their effectiveness is often limited by reoxygenation after cell death. We hypothesized that ascorbate’s pro-oxidant properties could be harnessed to induce transient hypoxia, enhancing the efficacy of evofosfamide by overcoming reoxygenation.To test this hypothesis, we investigated the sensitivity of MIA Paca-2 and A549 cancer cells to ascorbate in vitro and in vivo. Ascorbate induced a cytotoxic effect at 5 mM that could be alleviated by endogenous administration of catalase, suggesting a role for hydrogen peroxide in its cytotoxic mechanism. In vitro, Seahorse experiments indicated generation of hydrogen peroxide consumes oxygen, which is offset at later time points by a reduction in oxygen consumption due to hydrogen peroxide’s cytotoxic effect.In vivo, photoacoustic imaging showed ascorbate treatment at sublethal levels triggered a complex, multi-phasic response in tumor oxygenation across both cell lines. Initially, ascorbate generated transient hypoxia within minutes through hydrogen peroxide production, via reactions that consume oxygen. This initial hypoxic phase peaked at around 150 seconds and then gradually subsided. However, at longer time scales (approximately 300 seconds) a vasodilation effect triggered by ascorbate resulted in increased blood flow and subsequent reoxygenation. Combining sublethal levels of ascorbate with evofosfamide significantly prolonged tumor doubling time in MIA Paca-2 and A549b xenografts compared to either treatment alone. This improvement, however, was only observed in a subpopulation of tumors, highlighting the complexity of the oxygenation response.
Genetic and environmental contributions to eigengene expression
Authors: Gillespie Nathan A , Bell Tyler R. , Hearn Gentry C , Hess Jonathan L. , Tsuang Ming T. , Lyons Michael J. , Franz Carol E. , Kremen William S. , Glatt Stephen J. 
Published: May 2024

AbstractMultivariate network-based analytic methods such as weighted gene co-expression network analysis are being increasingly applied to human and animal gene-expression data to estimate module eigengenes (MEs). MEs represent multivariate summaries of correlated gene-expression patterns and network connectivity across genes within a module. Although this approach has the potential to elucidate the mechanisms by which molecular genomic variations contribute to individual differences in complex traits, the genetic etiology of MEs has never been empirically established. It is unclear if and to what degree individual differences in blood derived MEs reflect random variation versus familial aggregation arising from heritable or shared environmental influences. We used biometrical genetic analyses to estimate the contribution of genetic and environmental influences on MEs derived from blood lymphocytes collected on a sample of N=661 older male twins from the Vietnam Era Twin Study of Aging (VETSA) whose mean age at assessment was 67.7 years (SD=2.6 years, range=62-74 years). Of the 26 detected MEs, 14 (56%) had statistically significant additive genetic variation with an average heritability of 44% (SD=0.08, range=35-64%). Despite the relatively small sample size, this demonstration of significant family aggregation including estimates of heritability in 14 of the 26 MEs suggests that blood-based MEs are reliable and merit further exploration in terms of their associations with complex traits and diseases.