bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rare presentation of hydatid cyst disease at the thigh: a case report from Syria
Authors: Ahmad Aya , Janoud Omran , Balouli Maram , Alnasan Abdullah , Ahmad Basel , Ahmad Mohamad 
Published: April 2024

Introduction and importance:
Hydatid cyst disease is a zoonotic disease caused by Echinococcus granulosus and is recognized as a significant health issue in many countries, particularly Mediterranean countries. Hydatid cysts in the musculoskeletal system are rare, with only a few reported cases. These usually occur as secondary cysts resulting from the hematogenous dissemination from primary sites.

Case presentation:
This paper reports a case of a 77-year-old man with a mass in his thigh that had been increasing dramatically in size for 4 months with no signs of local inflammation, fever, or any other symptoms. Findings from an MRI were consistent with a large abscess, so a true-cut biopsy was taken before referral. A pathological study after surgery revealed the lesion was a hydatid cyst, and a previously performed biopsy caused a rupture of the cyst.

Clinical discussion:
Misdiagnosing hydatid cysts, especially in non-usual areas, may lead to an unwelcome biopsy and consequences.

Conclusion:
This case report highlights the importance of considering hydatid cysts when encountering any enlarging mass, regardless of its location or rate of growth.
The silent threat: investigating the incidence and clinical characteristics of pre-eclampsia and eclampsia in women from tertiary care hospitals of the Democratic Republic of Congo
Authors: Nyakio Olivier , Cakwira Hugues , Masimango Gaston , Kena Louison , Narayan Gaurang , Naaz Farheen , Mugenyi Nathan , Cyubahiro Vérité K. , Amani Toussaint , Balagizi Fabien , Suvvari Tarun Kumar , Oduoye Malik Olatunde , Akilimali Aymar 
Published: April 2024

Background:
Pre-eclampsia and eclampsia are medical conditions that can cause severe complications, such as maternal and foetal morbidity and mortality. This study aimed to assess the incidence and characteristics of pre-eclampsia and eclampsia.

Methods:
From July 2021 to July 2022, the authors conducted a retrospective, cross-sectional, descriptive study in the Department of Obstetrics and Gynaecology of a tertiary care hospital in the Democratic Republic of the Congo (DR Congo). Out of 1236 total deliveries, 40 patients aged 18–35 years with pre-eclampsia and/or eclampsia with complete data in medical records were studied.

Results:
In the studied group, 3.23% of women (40 cases) experienced pre-eclampsia or eclampsia, with the majority (75%, 30 cases) occurring before childbirth. Among these, 62.5% (25 cases) were first-time mothers. The main complications observed in the mothers included HELLP syndrome and placental abruption, whereas their newborns frequently exhibited delayed in-utero growth. Caesarean delivery was the prevalent birthing method, and the treatments most often used for effective management were magnesium sulfate and nicardipine.

Conclusion:
The research highlights the common occurrence of eclampsia among patients in the DRC and stresses the critical need for prompt detection of hypertensive complications during pregnancy, aiming to reduce negative health impacts on both mothers and their children.
Pyoderma Gangrenosum of the Genitalia, Anus, and Perineum: Two Case Reports and a Review of Published Cases
Authors: Choe Sharon I. , Shettig Abigale , Kody Shannon , Vague Morgan , Hoff Ashley , Rios-Duarte Jorge A. , Ortega-Loayza Alex G. 
Published: April 2024

Abstract
Pyoderma gangrenosum is an inflammatory skin disease that presents with rapidly progressive ulcers with violaceous, undermined borders. Despite most commonly affecting the lower extremities, pyoderma gangrenosum can rarely present in the genital, anal, and perineal regions. We describe 2 cases and report a review of published cases.
Hippocampus diffusivity abnormalities in classical trigeminal neuralgia
Authors: Hanycz Shaun Andrew , Noorani Alborz , Hung Peter Shih-Ping , Walker Matthew R. , Zhang Ashley B. , Latypov Timur H. , Hodaie Mojgan 
Published: April 2024

Abstract

Introduction:
Patients with chronic pain frequently report cognitive symptoms that affect memory and attention, which are functions attributed to the hippocampus. Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder characterized by paroxysmal attacks of unilateral orofacial pain. Given the stereotypical nature of TN pain and lack of negative symptoms including sensory loss, TN provides a unique model to investigate the hippocampal implications of chronic pain. Recent evidence demonstrated that TN is associated with macrostructural hippocampal abnormalities indicated by reduced subfield volumes; however, there is a paucity in our understanding of hippocampal microstructural abnormalities associated with TN.

Objectives:
To explore diffusivity metrics within the hippocampus, along with its functional and structural subfields, in patients with TN.

Methods:
To examine hippocampal microstructure, we utilized diffusion tensor imaging in 31 patients with TN and 21 controls. T1-weighted magnetic resonance images were segmented into hippocampal subfields and registered into diffusion-weighted imaging space. Fractional anisotropy (FA) and mean diffusivity were extracted for hippocampal subfields and longitudinal axis segmentations.

Results:
Patients with TN demonstrated reduced FA in bilateral whole hippocampi and hippocampal body and contralateral subregions CA2/3 and CA4, indicating microstructural hippocampal abnormalities. Notably, patients with TN showed significant correlation between age and hippocampal FA, while controls did not exhibit this correlation. These effects were driven chiefly by female patients with TN.

Conclusion:
This study demonstrates that TN is associated with microstructural hippocampal abnormalities, which may precede and potentially be temporally linked to volumetric hippocampal alterations demonstrated previously. These findings provide further evidence for the role of the hippocampus in chronic pain and suggest the potential for targeted interventions to mitigate cognitive symptoms in patients with chronic pain.
Perceived Stress, Blood Biomarkers, and Cognitive Functioning in Older Adults
Authors: Desai Pankaja , Ng Ted K.S. , Krueger Kristin R. , Wilson Robert S. , Evans Denis A. , Rajan Kumar B. 
Published: April 2024

ABSTRACT

Introduction
There is a substantial gap in knowledge regarding how perceived stress may influence the relationship between serum-measured biomarkers for Alzheimer’s disease and cognitive decline.

Methods
This study consists of 1118 older adult participants from the Chicago Health and Aging Project (CHAP) (60% Black participants and 63% female participants). Linear mixed effects regression models were conducted to examine the role of perceived stress in the association between three blood biomarkers: total tau (t-tau), glial fibrillary acid protein (GFAP), and neurofilament light chain (NfL) on global cognitive decline. Stratified analysis by stress level was also conducted to evaluate the associations between each blood biomarker and baseline cognitive function and decline. All models adjusted for age, race, sex, education, time, and their interactions with time.

Results
The interaction of stress, NfL concentration, and time was statistically significant on global cognition (β = −0.064 [SE = 0.028], p = .023) and on episodic memory (β = −0.097 [SE = 0.036], p = .007).

Conclusions
Greater stress level worsens the association between high NfL concentration and cognitive decline. Stress management interventions may be helpful to reduce the rate of cognitive decline in individuals with high concentrations of NfL.
Transcranial Direct Current Stimulation Combined With Aerobic Exercise for the Treatment of Chronic Nonspecific Low Back Pain
Authors: Sánchez Marina Castel , Prieto Rafael , Maffezzoli Gioel Luca , Frumento Lorenzo , Aguilera José Francisco Torneno , Pérez José Luis Alonso , Reina Maria Dolores Sosa 
Published: April 2024

Objective:
The purpose of the study is to determine the effectiveness of transcranial direct current stimulation (tDCS) combined with aerobic exercise in the short, medium, and long term.

Methods:
Two-arms triple-blind randomized controlled trial. Thirty-eight subjects with a diagnosis of nonspecific chronic low back pain. Experimental group will receive real-tDCS and aerobic exercise and control group will be treated with sham tDCS and aerobic exercise. Pain intensity, pressure pain, disability, kinesiophobia, quality of life, catastrophism, heart rate variability, and critical flicker fusion frequency will be measured before and after each session and at 3- and 6-month follow-up.

Discussion and Conclusion:
This study introduces the novel measurement of heart rate variability and cortical arousal to explore their potential in understanding the effects of tDCS on pain modulation.

Trial Registration:
ClinicalTrials.gov ID NCT05830851. Date of registration: April 14, 2023.
Ventricle-specific myocardial protein and metabolite characterisation in healthy humans, with differential regulation in end-stage cardiomyopathies
Authors: Hunter Benjamin , Li Mengbo , Parker Benjamin L. , Koay Yen Chin , Harney Dylan J. , Pearson Evangeline , Cao Jacob , Chen Gavin T. , Guneratne Oneka , Smyth Gordon K. , Larance Mark , O’Sullivan John F. , Lal Sean 
Published: April 2024

AbstractBackgroundThe left and right ventricles of the human heart are functionally and developmentally distinct such that genetic or acquired insults can cause dysfunction in one or both ventricles resulting in heart failure. The left ventricle is most clinically relevant in research as its dysfunction is the most dominant cause of heart failure whereby right ventricular involvement can exacerbate the condition. However, the molecular composition of the left ventricular adult human myocardium relative to the right ventricle in health and in heart failure has yet to be thoroughly explored.MethodsWe performed unbiased quantitative mass spectrometry analyses on the myocardium of pre-mortem cryopreserved non-diseased human hearts to compare the proteome (n = 27) and metabolome (n = 25) between the normal left and right ventricles. We then characterised the proteome and metabolome of the left and right ventricles within end-stage dilated cardiomyopathy (n = 14 and 13) and ischaemic cardiomyopathy (n = 19-17), respectively. All analyses featured a mix of paired and unpaired samples. Intra-condition comparative analyses were performed to identify differences of molecular abundance between the ventricles, and intra-ventricular analyses were performed between sexes of non-diseased hearts. Novel and innovative techniques were used to merge datasets, increasing the sample size and statistical power. KEGG and Gene Ontology databases were used to perform enrichment analyses and inform metabolic trends.ResultsConstituents of gluconeogenesis, glycolysis, lipogenesis, lipolysis, fatty acid catabolism, the citrate cycle and oxidative phosphorylation were down-regulated in the non-diseased left ventricle, while glycogenesis, pyruvate and ketone metabolism were up-regulated. Inter-ventricular significance of these metabolic pathways was then found to be diminished within end-stage dilated cardiomyopathy and ischaemic cardiomyopathy, while heart failure-associated pathways were increased in the left ventricle relative to the right within ischaemic cardiomyopathy, such as fluid sheer-stress, increased glutamine to glutamate ratio, and down-regulation of contractile proteins, indicating a left ventricular pathological bias.ConclusionsThe inter-ventricular molecular analyses within this study aides to fill a critical gap in our understanding of the metabolic differences between the human left and right ventricular myocardium and may be used to inform future therapeutic targets for heart failure processes in one or both the ventricles.
Long-term outcomes of radiofrequency catheter ablation for patients with persistent atrial fibrillation lasting ≥ 3 years
Authors: Zhong Zikan , An Jie , Shen Jiaqi , Zhang Qitong , Wu Xiaoyu , Gao Longzhe , Wei Yong , Chen Songwen , Lu Xiaofeng , Xu Juan , Ding Yu , Cheng Cheng , Cai Lidong , Xu Min , Liu Shaowen , Zhou Genqing 
Published: April 2024

AbstractBackgroundRadiofrequency catheter ablation (RFCA) for long-standing persistent atrial fibrillation (LSP-AF) remains challenging, especially in patients with very long atrial fibrillation (AF) duration.ObjectiveTo evaluate the long-term outcomes of RFCA in patients with LSP-AF lasting ≥ 3 years, and to identify predictors for AF recurrence.MethodsThis retrospective study included 151 patients with LSP-AF undergoing first-time RFCA. Procedure was performed with wide antral pulmonary vein isolation (PVI) based individualized ablation strategy, guided by ablation index (AI). Patients were followed up for ≥ 18 months, and recurrence predictors were determined.ResultsEnrolled patients (mean persistent AF duration: 7.6 ± 5.2 years) had a mean age of 65.3 ± 9.2 years and the median left atrial diameter (LAD) was 45.0 (42.0-49.0) mm. PVI was achieved in all, followed by modified left posterior wall isolation (PWI) in 147 patients. Additional ablation after PWI was performed in 88 patients. During the 18-month follow-up, the overall success rate was 74.2%. Multivariate analysis identified AF duration (HR 1.078; 95% CI 1.020-1.139; P = 0.007), LAD (HR 1.069; 95% CI 1.010-1.132; P = 0.022), and pre-procedure CRP (HR 1.063; 95% CI 1.010-1.117; P = 0.018) as independent predictors of AF recurrence. Among patients with PVI and PWI, those without empirical additional ablation (EAA) had a lower but not statistically significant recurrence rate (18.6%) than those with EAA (31.8%, P = 0.076).ConclusionAmong LSP-AF patients, the long-term efficacy of AI-guided RFCA is acceptable, especially in selected patients. However, EAA after PVI and PWI may be unhelpful.
A Smaller Right Ventricle Results in Poorer Exercise Performance in Adolescents After Surgical Repair of Tetralogy of Fallot
Authors: Mhanna Christiane , Kourpas Katerina , Tsuda Takeshi 
Published: April 2024

AbstractBackgroundChronic pulmonary valve insufficiency frequently results in right ventricular (RV) dilatation and dysfunction in surgically repaired tetralogy of Fallot (rTOF). Correlations between peak exercise performance and progression of RV remodeling in rTOF remain elusive.MethodsPatients with rTOF were reviewed with cardiopulmonary exercise testing (CPET) and cardiac magnetic resonance (CMR). Peak and submaximal CPET parameters were obtained. Both RV and left ventricular (LV) volume were measured in end-systole (RVESV and LVESV, respectively) and end-diastole (LVEDV and RVEDV, respectively). Stroke volume (SV), ejection fraction (EF), and pulmonary regurgitant fraction (RF) were calculated.ResultsThirty-seven patients (17 ± 5 years; 22 females; 5 with pulmonary atresia and 2 with absent pulmonary valve) were studied. Pulmonary RF was 28.3 ± 13.4%. Indexed RVEDV was 132 ± 33 mL/m2. Ejection fraction of RV and LV was 50.3 ± 7.8% and 59.1 ± 6.1%, respectively. Peak oxygen consumption (pVO2) was 71 ± 16% of predicted maximum value. A strong positive correlation was noted between CMR data including RVEDV, RVSV and LVSV, and pVO2. Higher RVEDV was correlated with higher RVSV and LVSV and higher pVO2, whereas lower RVEDV was associated with lower RVSV and LVSV and lower pVO2.ConclusionIn rTOF, smaller RV resulted in reduced SV of both ventricles and significantly lower pVO2, whereas larger RV provided higher SV and higher pVO2 regardless of RVEF or RF. Smaller RV in rTOF may represent a unique pathological entity responsible for reduced exercise performance, which requires special consideration when determining further surgical interventions.Clinical PerspectiveWhat is New?We characterized a novel clinical entity after surgical repair of tetralogy of Fallot (TOF) with a relatively small right ventricle (RV) and decreased exercise performance. It is likely due to limited RV stroke volume adjustment in response to peak exercise affecting left ventricular (LV) stroke volume. Although the pathogenesis of this smaller RV remains undetermined, our results shed light on the diverse clinical phenotypes after surgical repair of TOF.What are the Clinical Implications?Pulmonary valve replacement (PVR) is a treatment option for progressive RV dilatation and/or symptoms of exercise intolerance related to persistent pulmonary valve insufficiency in repaired TOF. Our data demonstrated that poor exercise performance was more frequently associated with a smaller RV size rather than dilated RV. Indication for PVR in repaired TOF needs to be carefully assessed in symptomatic patients with non-enlarged RV.
X-ray Crystallographic and Hydrogen Deuterium Exchange Studies Confirm Alternate Kinetic Models for Homolog Insulin Monomers
Authors: Ayan Esra , Türk Miray , Tatlı Özge , Bostan Sevginur , Telek Elek , Dingiloğlu Baran , Dogan Büşra Züleyha , Alp Muhammed Ikbal , Katı Ahmet , Dinler-Doğanay Gizem , DeMirci Hasan 
Published: April 2024

AbstractDespite the crucial role of various insulin analogs in achieving satisfactory glycemic control, a comprehensive understanding of their in-solution dynamic mechanisms still holds the potential to further optimize rapid insulin analogs, thus significantly improving the well-being of individuals with Type 1 Diabetes. Here, we employed hydrogen-deuterium exchange mass spectrometry to decipher the molecular dynamics of newly modified and functional insulin analog. A comparative analysis of H/D dynamics demonstrated that the modified insulin exchanges deuterium atoms faster and more extensively than the intact insulin aspart. Additionally, we present new insights derived from our 2.5 Å resolution X-ray crystal structure of modified hexamer insulin analog at ambient temperature. Furthermore, we obtained a distinctive side-chain conformation of the Asn3 residue on the B chain (AsnB3) by operating a comparative analysis with a previously available cryogenic rapid-acting insulin structure (PDB_ID: 4GBN). The experimental conclusions have demonstrated compatibility with modified insulin’s distinct cellular activity, comparably to aspart. Additionally, the hybrid structural approach combined with computational analysis employed in this study provides novel insight into the structural dynamics of newly modified and functional insulin vs insulin aspart monomeric entities. It allows further molecular understanding of intermolecular interrelations driving dissociation kinetics and, therefore, a fast action mechanism.
Sub-type specific connectivity between CA3 pyramidal neurons may underlie their sequential activation during sharp waves
Authors: Sammons Rosanna P. , Masserini Stefano , Moreno-Velasquez Laura , Metodieva Verjinia D. , Cano Gaspar , Sannio Andrea , Orlando Marta , Maier Nikolaus , Kempter Richard , Schmitz Dietmar 
Published: April 2024

AbstractThe CA3 region of the hippocampus is the major site of sharp wave initiation, a form a network activity involved in learning and memory. Highly recurrent connectivity within its excitatory network is thought to underlie processes involved in memory formation. Recent work has indicated that distinct subpopulations of pyramidal neurons within this region may contribute differently to network activity, including sharp waves, in CA3. Exactly how these contributions may arise is not yet known. Here, we disentangle the local connectivity between two distinct CA3 cell types: thorny and athorny pyramidal cells. We find an asymmetry in the connectivity between these two populations, with athorny cells receiving strong input from both athorny and thorny cells. Conversely, the thorny cell population receives very little input from the athorny population. Computational modelling suggests that this connectivity scheme may determine the sequential activation of these cell types during large network events such as sharp waves.
Prenatal carrier screening for spinal muscular atrophy among Thai pregnant women
Authors: Tangshewinsirikul Chayada , Panburana Panyu , Prakobpanich Maneerat , Chareonsirisuthigul Takol , Dejsuphong Donniphat , Tim-aroon Thipwimol , Khongkhatithum Chaiyos , Sura Thanyachai , Tunteeratum Atchara , Wattanasirichaigoon Duangrurdee 
Published: April 2024

ABSTRACTObjectivesTo investigate the acceptance rate for spinal muscular atrophy (SMA) carrier screening among Thai pregnant women, their attitudes toward the prenatal screening, carrier rate, and the frequencies ofSMN2copy numbers.Materials and methodsSingleton pregnant women who aged ≥18 years, with a gestational age of ≤14 weeks at their first visit, were invited to participate the study. All participants completed the questionnaire: Section I - demographic data. Then, they received a pre-test group counseling, followed by an offer of SMA carrier testing at no cost and completion of the questionnaire: Section II - awareness and attitudes toward the screening and Section III – reasons for their choosing ‘to have’ or ‘not to have’ the screening done. Only those having the test done and undergoing post-test counseling were asked to complete the questionnaire: Section IV – attitudes toward the screening process.ResultsWe found a high acceptance rate for carrier screening at 91.4% (181/198 participants), a carrier rate of 2.2% (1 in 45), and high frequency of ≤2 copies ofSMN2(98.3%). The preexisting knowledge about SMA was low (30.8%). The majority of participants became realized about the severity of SMA and its burden to the families (94.4%) and agreed to have fetal diagnosis if they were found to be a couple-at-risk (92.4%). Most participants (98%) suggested that SMA carrier screening should be offered to all pregnant women and that the cost of testing should be covered by the government and/or by their health coverage schemes (95.5%).ConclusionThe high acceptance rate and positive attitude toward prenatal SMA carrier was demonstrated among Thai pregnant women. Data from the present study highlight urgent needs for endorsement from professional society and public health policy in advancing the SMA carrier screening program in Thailand.