bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiorgan failure caused by pembrolizumab and axitinib in a woman affected by metastatic clear cell renal cell carcinoma: A case report and literature review
Authors: Di Marco Andrea , Artioli Grazia , Favaretto Adolfo , Cavasin Nicolò , Basso Umberto 
Published: March 2024

Rationale:
Treatment with a combination of immune checkpoint inhibitors (ICIs) (pembrolizumab or nivolumab) and oral Tyrosine Kinase Inhibitors (TKI) targeting angiogenesis (axitinib, cabozantinib or lenvatinib) has shown benefits in terms of efficacy and survival in metastatic renal cell carcinoma (mRCC), with a favorable toxicity profile. However, some rare and serious treatment-related adverse events can be difficult to manage.

Patient concerns:
Here we report the first case of an mRCC patient who, after only 2 administrations of pembrolizumab-axitinib, experienced severe multiorgan failure (MOF) with heart failure, oliguria and acute hepatitis requiring aggressive supportive treatment in intensive care unit.

Diagnoses:
A diagnosis of severe MOF induced by pembrolizumab plus axitinib was considered.

Interventions:
The patient was treated with dobutamine, levosimendan along with high-dose steroids under continuous cardiologic monitoring.

Outcomes:
After treatment, the patient had a full recovery and was discharged from the hospital.

Lessons:
We reviewed all the other cases of MOF reported during treatment with combined ICI-TKI in cancer patients in order to summarize incidence, clinical manifestations and management with a specific focus on the need for prompt recognition and aggressive management under multidisciplinary care.
ABCA3 mutation-induced congenital pulmonary surfactant deficiency: A case report
Authors: Lei Chunxia , Wan Chunhui , Liu Caixia 
Published: March 2024

Introduction:
Congenital surfactant deficiency, often caused by mutations in genes involved in surfactant biosynthesis such as ABCA3, presents a significant challenge in neonatal care due to its severe respiratory manifestations. This study aims to analyze the clinical data of a newborn male diagnosed with pulmonary surfactant metabolism dysfunction type 3 resulting from ABCA3 gene mutations to provide insights into the management of this condition.

Patient concerns:
A newly born male child aged 1 day and 3 hours was referred to our department due to poor crying and shortness of breath.

Diagnosis:
Primary diagnoses by the duty physicians were: neonatal pneumonia, neonatal respiratory failure, persistent neonatal pulmonary hypertension, birth asphyxia, myocardial damage, and arteriovenous catheterization. Genetic test revealed a compound heterozygous variant in the ABCA3 gene. One allele may be exon variant c.4561C>T, the second allele may be intron variant c.1896 + 2_1896 + 17del. The associated disease included pulmonary surfactant metabolism dysfunction type 3.

Interventions:
He was initially treated with an antiinfective therapeutic regimen.

Outcomes:
The family was informed of this condition and signed off, and the child died.

Conclusion:
Hereditary pulmonary surfactant deficiency is a rare and untreatable disease. The case highlights the challenges in managing congenital surfactant deficiencies and emphasizes the need for heightened awareness of this rare cause of infant respiratory failure.
Kikuchi-Fujimoto disease associated with a flare-up of a leukocytoclastic vasculitis: A rare case report and review of literature
Authors: Sandakly Nicolas , El Koubayati Georgio , Sarkis Jeannette , Naderi Samah , Sebaaly Delivrance , Haddad Fady 
Published: March 2024

Rationale:
Kikuchi-Fujimoto disease (KFD) also known as histiocytic necrotizing lymphadenopathy is an exceedingly rare cause of cervical lymphadenopathy, commonly accompanied by systemic symptoms such as fever, fatigue, night sweats, myalgia, skin rash.

Patient concerns:
In this paper, we report the case of a 22-year-old female patient who experienced a flare-up of leukocytoclastic vasculitis that was complicated by the appearance of a cervical lymph node with dysphagia, fever and nausea.

Diagnosis:
Infectious and autoimmune workup came back negative.

Interventions:
Excisional lymph node biopsy was done and the pathology results were consistent with histiocytic necrotizing lymphadenitis in keeping with Kikuchi-Fujimoto disease.

Outcomes:
Patient improved on intravenous corticosteroids and was discharged on per os prednisone. Six month follow-up shows complete resolution of her symptoms.

Lessons:
KFD should be ruled out in patients with autoimmune or inflammatory diseases who develop lymphadenopathies.
Gastritis cystica profunda in an unoperated stomach mimicking a pyloric submucosal tumor and causing anorexia: A case report and literature review
Authors: Shimizu Seito , Hara Hitoshi , Muto Yasuhide , Kido Tomoki , Miyata Ryohei 
Published: March 2024

Background:
Gastritis cystica profunda (GCP), commonly observed in remnant gastric anastomosis, is associated with developing gastric cancer.

Case:
This case report describes a patient with GCP in a previously unoperated stomach that mimicked a pyloric submucosal tumor and caused anorexia, which is rare in clinical practice.

Patient concerns:
A 72-year-old woman presented with loss of appetite and weight.

Diagnoses:
Gastroscopy detected a 20 mm diameter submucosal tumor near the pylorus. Computed tomography and magnetic resonance imaging identified a cystic lesion, unlike a usual submucosal tumor in the stomach. The diagnosis was difficult, even with endoscopic ultrasound-guided fine-needle aspiration.

Interventions:
Surgery was performed for diagnosis and treatment. The lesion was resected using a submucosal dissection technique after an incision of the gastric wall during open laparotomy. Histopathological examination confirmed the diagnosis of GCP and revealed no dysplasia or cancer.

Outcomes:
Anorexia resolved after the surgery. Residual or recurrent lesions were not detected during follow-up examinations performed 1 year after surgery.

Lessons:
GCP occurring in a previously unoperated stomach as a macroscopic lesion like a submucosal tumor causing some symptoms is rare. GCP is associated with a risk of developing cancer. Therefore, careful evaluation and management during treatment are required.
Contemporary management of patients with multiple rib fractures: What you need to know
Authors: Sarani Babak , Pieracci Fredric 
Published: March 2024

ABSTRACT
Ten percent of all injured patients and 55% of patients with blunt chest trauma experience rib fractures. The incidence of death due to rib fractures is related to the number of fractured ribs, severity of fractured ribs, and patient age and comorbid conditions. Death due to rib fracture is mostly caused by pneumonia because of inability to expectorate and take deep breaths. Over the last 25 to 30 years, there has been renewed interest in surgical stabilization of rib fractures (SSRF), known colloquially as “rib plating.” This review will present what you need to know in regard to triage decisions on whether to admit a patient to the hospital, the location to which they should be admitted, criteria and evidentiary support for SSRF, timing to SSRF, and operative technique. The review also addresses the cost-effectiveness of this operation and stresses nonoperative treatment modalities that should be implemented prior to operation.
Waitlist Outcomes for Exception and Non-exception Liver Transplant Candidates in the United States Following Implementation of the Median MELD at Transplant (MMaT)/250-mile Policy
Authors: Ishaque Tanveen , Beckett James , Gentry Sommer , Garonzik-Wang Jacqueline , Karhadkar Sunil , Lonze Bonnie E. , Halazun Karim J. , Segev Dorry , Massie Allan B. 
Published: March 2024

Background.
Since February 2020, exception points have been allocated equivalent to the median model for end-stage liver disease at transplant within 250 nautical miles of the transplant center (MMaT/250). We compared transplant rate and waitlist mortality for hepatocellular carcinoma (HCC) exception, non-HCC exception, and non-exception candidates to determine whether MMaT/250 advantages (or disadvantages) exception candidates.

Methods.
Using Scientific Registry of Transplant Recipients data, we identified 23 686 adult, first-time, active, deceased donor liver transplant (DDLT) candidates between February 4, 2020, and February 3, 2022. We compared DDLT rates using Cox regression, and waitlist mortality/dropout using competing risks regression in non-exception versus HCC versus non-HCC candidates.

Results.
Within 24 mo of study entry, 58.4% of non-exception candidates received DDLT, compared with 57.8% for HCC candidates and 70.5% for non-HCC candidates. After adjustment, HCC candidates had 27% lower DDLT rate (adjusted hazard ratio = 0.680.730.77) compared with non-exception candidates. However, waitlist mortality for HCC was comparable to non-exception candidates (adjusted subhazard ratio [asHR] = 0.931.031.15). Non-HCC candidates with pulmonary complications of cirrhosis or cholangiocarcinoma had substantially higher risk of waitlist mortality compared with non-exception candidates (asHR = 1.271.702.29 for pulmonary complications of cirrhosis, 1.352.043.07 for cholangiocarcinoma). The same was not true of non-HCC candidates with exceptions for other reasons (asHR = 0.540.881.44).

Conclusions.
Under MMaT/250, HCC, and non-exception candidates have comparable risks of dying before receiving liver transplant, despite lower transplant rates for HCC. However, non-HCC candidates with pulmonary complications of cirrhosis or cholangiocarcinoma have substantially higher risk of dying before receiving liver transplant; these candidates may merit increased allocation priority.
Tcf21 as a Founder Transcription Factor in Specifying Foxd1 Cells to the Juxtaglomerular Cell Lineage
Authors: Anjum Hina , Smith Jason P. , Martini Alexandre G , Yacu George S. , Medrano Silvia , Gomez R. Ariel , Sequeira-Lopez Maria Luisa S. , Quaggin Susan E. , Finer Gal 
Published: March 2024

ABSTRACTRenin is crucial for blood pressure regulation and electrolyte balance, and its expressing cells arise from Foxd1+ stromal progenitors. However, factors guiding these progenitors toward renin-secreting cell fate remain unclear. Tcf21, a basic helix-loop-helix (bHLH) transcription factor, is essential in kidney development. UtilizingFoxd1Cre/+;Tcf21f/fandRen1dCre/+;Tcf21f/fmouse models, we investigated the role of Tcf21 in the differentiation of Foxd1+ progenitor cells into juxtaglomerular (JG) cells. Immunostaining and in-situ hybridization demonstrated fewer renin-positive areas and altered renal arterial morphology, including the afferent arteriole, inFoxd1Cre/+;Tcf21f/fkidneys compared to controls, indicating Tcf21’s critical role in the emergence of renin-expressing cells. However, Tcf21 inactivation in renin-expressing cells (Ren1dCre/+;Tcf21f/f) did not recapitulate this phenotype, suggesting Tcf21 is dispensable once renin cell identity is established.Using an integrated analysis of single-cell RNA sequencing (scRNA-seq) and single-cell assay for transposase-accessible chromatin sequencing (scATAC-seq) on GFP+ cells (stromal lineage) from E12, E18, P5, and P30Foxd1Cre/+;Rosa26mTmGcontrol kidneys, we analyzed the temporal dynamics of Tcf21 expression in cells comprising the JG lineage (n=2,054). A pseudotime trajectory analysis revealed that Tcf21 expression is highest in metanephric mesenchyme and stromal cells at early developmental stages (E12), with a decline in expression as cells mature into renin-expressing JG cells. Motif enrichment analyses supported Tcf21’s significant involvement in early kidney development. These findings underscore the critical role of Tcf21 in Foxd1+ cell differentiation into JG cells during early stages of kidney development, offering insights into the molecular mechanisms governing JG cell differentiation and highlight Tcf21’s pivotal role in kidney development.NEW & NOTEWORTHYThis manuscript provides novel insights into the role of Tcf21 in the differentiation of Foxd1+ cells into JG cells. Utilizing integrated scRNA-seq and scATAC-seq, the study reveals that Tcf21 expression is crucial during early embryonic stages, with its peak at embryonic day 12. The findings demonstrate that inactivation of Tcf21 leads to fewer renin-positive areas and altered renal arterial morphology, underscoring the importance of Tcf21 in the specification of renin-expressing JG cells and kidney development.
Senolytic therapy preserves blood-brain barrier integrity and promotes microglia homeostasis in a tauopathy model
Authors: Yao Minmin , Wei Zhiliang , Nielsen Jonathan Scharff , Kakazu Aaron , Ouyang Yuxiao , Li Ruoxuan , Chu Tiffany , Scafidi Susanna , Lu Hanzhang , Aggarwal Manisha , Duan Wenzhen 
Published: March 2024

AbstractCellular senescence, characterized by expressing the cell cycle inhibitory proteins, is evident in driving age-related diseases. Senescent cells play a crucial role in the initiation and progression of tau-mediated pathology, suggesting that targeting cell senescence offers a therapeutic potential for treating tauopathy associated diseases. This study focuses on identifying non-invasive biomarkers and validating their responses to a well-characterized senolytic therapy combining dasatinib and quercetin (D+Q), in a widely used tauopathy mouse model, PS19. We employed human-translatable MRI measures, including water extraction with phase-contrast arterial spin tagging (WEPCAST) MRI, T2 relaxation under spin tagging (TRUST), longitudinally assessed brain physiology and high-resolution structural MRI evaluated the brain regional volumes in PS19 mice. Our data reveal increased BBB permeability, decreased oxygen extraction fraction, and brain atrophy in 9-month-old PS19 mice compared to their littermate controls. (D+Q) treatment effectively preserves BBB integrity, rescues cerebral oxygen hypometabolism, attenuates brain atrophy, and alleviates tau hyperphosphorylation in PS19 mice. Mechanistically, D+Q treatment induces a shift of microglia from a disease-associated to a homeostatic state, reducing a senescence-like microglial phenotype marked by increased p16/INK4a. D+Q-treated PS19 mice exhibit enhanced cue-associated cognitive performance in the tracing fear conditioning test compared to the vehicle-treated littermates, implying improved cognitive function by D+Q treatment. Our results pave the way for application of senolytic treatment as well as these noninvasive MRI biomarkers in clinical trials in tauopathy associated neurological disorders.
EEG biomarkers of α5-GABA positive allosteric modulators in rodents
Authors: Mazza Frank , Guet-McCreight Alexandre , Prevot Thomas D. , Valiante Taufik , Sibille Etienne , Hay Etay 
Published: March 2024

AbstractReduced cortical inhibition mediated by gamma-aminobutyric acid (GABA) is reported in depression, anxiety disorders, and aging. Novel positive allosteric modulator that specifically target α5-GABAAreceptor subunit (α5-PAM), ligand GL-II-73, shows anxiolytic, antidepressant, and pro-cognitive effects without the common side effects associated with non-specific modulation by benzodiazepines such as diazepam (DZP), thus suggesting novel therapeutic potential. However, it is unknown if α5-PAM has detectable signatures in clinically-relevant brain electroencephalography (EEG). We analyzed EEG in freely moving rats at baseline and following injections of α5-PAM and DZP. We showed that α5-PAM specifically decreased theta peak power whereas DZP shifted peak power from high to low theta, while increasing beta and gamma power. EEG decomposition showed that these effects were periodic and corresponded to changes in theta oscillation event duration. Our study thus shows that α5-PAM has robust and distinct EEG biomarkers in rodents, indicating that EEG could enable non-invasive monitoring of α5-PAM treatment efficacy.
Interca: an R library implementing “automatic” interpretation of results of multiple correspondence analysis (MCA)
Authors: Moschidis Stratos , Markos Angelos , Ioannidis Dimosthenis 
Published: March 2024

PurposeThe purpose of this paper is to develop a software-library in the R programming language that implements the concepts of the interpretive coordinate, interpretive axis and interpretive plane. This allows for the automatic and reliable interpretation of results from the multiple correspondence analysis (MCA) as previously proposed and published. Consequently, the users can seamlessly apply these concepts to their data, both via R commands and a corresponding graphical interface.Design/methodology/approachWithin the context of this study, and through extensive literature review, the advantages of developing software using the Shiny library were examined. This library allows for the development of full-stack applications for R users without the need for knowledge of the corresponding technologies required for the development of complex applications. Additionally, the structural components of a Shiny application were presented, leading ultimately to the proposed software application.FindingsSoftware utilizing the Shiny library enables nonexpert developers to rapidly develop specialized applications, either to present or to assist in the understanding of objects or concepts that are scientifically intriguing and complex. Specifically, with this proposed application, the users can promptly and effectively apply the scientific concepts addressed in this study to their data. Additionally, they can dynamically generate charts and reports that are readily available for download and sharing.Research limitations/implicationsThe proposed package is an implementation of the fundamental concepts of the exploratory MCA method. In the next step, discoveries from the geometric data analysis will be added as features to provide more comprehensive information to the users.Practical implicationsThe practical implications of this work include the dissemination of the method’s use to a broader audience. Additionally, the decision to implement it with open-source code will result in the integration of the package’s functions by other third-party user packages.Originality/valueThe proposed software introduces the initial implementation of concepts such as interpretive coordination, the interpretive axis and the interpretive plane. This package aims to broaden and simplify the application of these concepts to benefit stakeholders in scientific research. The software can be accessed for free in a code repository, the link to which is provided in the full text of the study.
Fuzzy causal model of enterprise flexibility dimensions using Fermatean Fuzzy DEMATEL: a case study of Indian pharmaceutical industry
Authors: Akhtar Mohammad , Asim Mohammad 
Published: March 2024

PurposeTo develop a fuzzy causal model of enterprise flexibility dimensions in a case study of Indian pharmaceutical industry.Design/methodology/approachThe eight dimensions of enterprise flexibility were identified based on literature review. Fermatean fuzzy decision-making trail and evaluation laboratory (FF-DEMATEL) technique is applied to develop the cause-and-effect interrelationship model among various enterprise flexibility dimensions.FindingsThe information technology flexibility, supply chain flexibility, technical flexibility and marketing flexibility are found to be causing/influencing other flexibilities and contributing to overall enterprise flexibilities. Therefore, more attention needs to be paid to develop and sustain them for competitive advantage.Research limitations/implicationsFermatean fuzzy sets offer more flexibility and more accurate handling complex uncertain group decision making. FF-DEMATEL is a more accurate method to develop inter-dependencies and causal model than ISM, TISM. Ratings from the limited number of decision experts (DEs) from few pharmaceutical firms were done. Future study should take bigger sample of firms and more number of DEs to generalize the findings.Practical implicationsThe model will help managers in pharmaceutical industry to prioritize the dimensions of enterprise flexibility to achieve agility, responsiveness, resilience and competitive advantage.Originality/valueTo the best knowledge of the authors, causal modeling enterprise flexibility dimensions using FF-DEMATEL has been studied for the first time in a developing economy context.
Drivers of corporate social responsibility initiatives among construction companies in Nigeria
Authors: Osuizugbo Innocent Chigozie , Oyeyipo Opeyemi Olanrewaju , Olojo Aduragbemi Deborah 
Published: March 2024

PurposeThis study investigates the drivers of CSR practices among construction companies in Lagos, Nigeria.Design/methodology/approachThis research adopted a questionnaire survey to achieve the aim. A purposefully chosen group of managing directors, directors, other senior construction experts or management personnel working for small, medium and large-sized construction enterprises in Nigeria were given questionnaires to complete. 196 questionnaires were issued, out of which 103 were properly completed and returned, with a return percentage of 61% which served as the basis for this study. Utilizing both descriptive and inferential statistics, the collected data were examined.FindingsThe results from the study revealed that “vision of the founder”, “creating public attention”, “competitive advantage” and “business strategy” were the top most four drivers of CSR initiatives among construction companies in Lagos, Nigeria. The results also showed that, there is a statistically significant degree of agreement between various categories of construction companies in Lagos, Nigeria regarding the drivers of CSR initiatives.Originality/valueThe study contributes more effectively to CSR studies by highlighting the drivers of CSR initiatives in construction companies. The finding would facilitate the adoption and implementation of CSR initiatives in construction organizations. The adoption of best CSR practices fosters strong relationship among construction companies, project stakeholders and communities.
The convergence of Education 4.0 and Industry 4.0: a Twin Peaks model
Authors: Ahmad Ehsan 
Published: March 2024

PurposeThis paper explores the convergence of Education 4.0 and Industry 4.0 and presents a Twin Peaks model for their seamless integration.Design/methodology/approachA high-level literature review is conducted to identify and discuss the important challenges and opportunities offered by both Education 4.0 and Industry 4.0. A novel Twin Peaks model is devised for the convergence of these domains and to cope with the challenges effectively.FindingsThe proposed Twin Peak model for the convergence of Education 4.0 and Industry 4.0 suggests that the development of these two domains is interdependent. It emphasizes ethical considerations, inclusivity and understanding the concerns of stakeholders from both education and industry. We have also explained how continuous incremental adaptation within the proposed Twin Peaks model might assist in addressing concerns of one sector with the opportunities of the other.Originality/valueFirst, Education 4.0 and Industry 4.0 are reviewed in terms of opportunities and challenges they present. Second, a novel Twin Peaks model for the convergence of Education 4.0 and Industry 4.0 is presented. The proposed discovers that the convergence is adaptive, iterative and must be ethically sound while considering the broader societal implications of the digital transformation. Third, this study also acts as a torch-bearer for the necessity for more research of this kind to guarantee that our educational ecosystem is adaptable and capable of producing the skills required for success in the era of IR4.0.