bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lichen Sclerosus in Cancer Patients
Authors: Geisler Amaris N. , Jain Shivani , Long Roche Kara , Goldfrank Deborah J. , Markova Alina , Lacouture Mario E. , Noor Sarah J. 
Published: February 2025

Objective
To characterize the association between cancer therapies and the development of lichen sclerosus (LS) in a case series of patients.

Methods
A retrospective chart review was performed to screen for patients who were diagnosed with LS while undergoing cancer therapy at Memorial Sloan Kettering Cancer Center between 2003 and 2019. Patients were excluded if they had been diagnosed with LS prior to starting cancer therapy. Clinical and treatment characteristics were analyzed.

Results
The final study sample included 29 female patients who developed LS in the setting of systemic cancer therapy. Median time to LS onset after cancer therapy initiation was 420 days. Primary tumor types included breast (10, 34.5%), gynecologic (8, 27.6%), gastrointestinal (5, 17.2%), cutaneous (2, 6.9%), lung (2, 6.9%), and hematologic (2, 6.9%). Cancer therapy regimens included hormonal therapy (10, 34.5%), chemoradiation (7, 24.1%), cytotoxic chemotherapy (7, 24.1%), PD-1/PD-L1 inhibitors (3, 10.3%), local radiation (1, 3.4%), and allogeneic stem cell transplant (1, 3.4%). Across all patients, the mean number of treatments for LS was 2.8. Twenty-three (79.3%) patients received the first-line therapy of ultrapotent topical steroids, but 16 (69.6%) required additional topical and systemic treatment. Limitations include retrospective design and referral bias.

Conclusions
Breast cancer was the most common primary tumor among patients in this study. The most common cancer therapy regimen was hormonal therapy. Most patients required an escalation in therapy to manage their LS. For patients undergoing cancer treatment, concomitant LS management can present unique challenges due to the biological mechanism of some anticancer therapies and the pathophysiology of LS. There is limited data to guide treatment of LS for this population. Some of the patients included in this analysis had progression of LS and recurrence of cancer while undergoing management of both conditions, necessitating close follow-up.
Dome osteotomy for cubitus varus correction in a 26-year-old male with left elbow gunstock deformation: a case report
Authors: Ahmad Muhammad Husnain , Ashraf Mirza Zaid , Ali Masab , Babar Ilsa , Javeriya Sana , Chaudhary Kanchan , Saeed Humza 
Published: February 2025

Background:
Cubitus varus deformity is a common complication of untreated elbow fractures in children but is rare and challenging to treat in adults. This study presents the first documented case of correcting cubitus varus deformity in an adult.

Case presentation:
A 26-year-old male laborer presented with a deformed left elbow and impaired limb function due to a childhood fall. Clinical examination revealed a 30-degree cubitus varus deformity (Grade IV), confirmed by x-rays of the limb showing malunion with increased Baumann’s and metaphyseal-diaphyseal angle. The surgical intervention involved a dome osteotomy using a triceps-splitting approach under general anesthesia. The deformity was corrected by manipulating the distal fragment in the coronal and sagittal planes and fixing it with a dynamic compression plate and interfragment screw. Postoperative care included immobilization in a long arm cast and progressive rehabilitation.

Clinical discussion:
This case demonstrates the effectiveness of dome osteotomy in correcting adult cubitus varus deformity. The technique provides precise correction by targeting the center of rotation of angulation, ensuring superior bone contact and stability. It also minimizes periosteal dissection, reducing the risk of thermal necrosis and preserving bone length. As compared to other osteotomy techniques, dome osteotomy allows for correction in multiple planes and achieves better functional and cosmetic outcomes, despite being technically demanding.

Conclusion:
Dome osteotomy is an effective surgical option for correcting cubitus varus deformity in adults, providing excellent functional and aesthetic results. This case highlights the importance of precise preoperative planning and meticulous surgical execution for optimal outcomes in patients with complex deformities.
Diagnostic value of lymphocyte-to-monocyte ratio in Crohn’s disease: a cross-sectional study
Authors: Karwan Anwar Hassan ALJAF , Hama Salih Ahmed , Mohammed Mohammed Omer , Rahim Hawbash M. 
Published: February 2025

Background:
Investigating non-invasive laboratory biomarkers for detecting and classifying Crohn’s disease (CD) activity remains challenging. Here, we aimed to evaluate the diagnostic efficacy of immunological biomarkers in identifying disease activity in newly diagnosed CD patients.

Methods:
This cross-sectional study was performed from October 2022 to July 2023 and included 20 healthy participants and 46 confirmed newly diagnosed CD patients in a Teaching Hospital for Gastroenterology and Hepatology, Sulaimani, Iraq. The patients were categorized according to the disease activity assessed according to the Harvey-Bradshaw Index and divided into remission and active CD.

Results:
A statistically higher serum C-reactive protein and erythrocyte sedimentation rate was found among the remission CD group (p = 0.005 and p = 0.0002, respectively) and active CD group (p<0.0001 and p<0.0001, respectively) compared to the healthy controls. Moreover, the mean C-reactive protein and erythrocyte sedimentation rate levels among active CD were also considerably higher than those of remission CD (P = 0.018 and 0.005, respectively). The lymphocyte-to-monocyte ratio was significantly lower in patients with active disease (3.01 ± 1.36) than in remission patients (6.77 ± 2.17) (cutoff<4.42, area under receiver operating characteristic curve = 0.807, 95% CI, 77.35-98.73%, 93% sensitivity, and 78% specificity). Although the neutrophil-to-lymphocyte ratio was significantly elevated in active patients (3.64 ± 2.004) compared to healthy controls (1.91 ± 0.48; p = 0.0001), it is not usable for disease activity or severity as the area under the receiver operating characteristic curve was 0.68 (95% CI, 52.22%-85.08%, sensitivity = 79%, specificity = 62%).

Conclusion:
Lymphocyte-to-monocyte ratio can be an affordable, easily accessible test that shows promise for determining disease activity in newly diagnosed CD patients.
“Biceps femoris calcific tendinitis as a rare cause of lateral knee pain; a case report”
Authors: Karki Shivaji , Pokhrel Sushil , Khadka Karuna 
Published: February 2025

Introduction:
Calcific tendinitis is a common cause of periarticular pain, though it rarely affects the distal biceps femoris tendon, leading to lateral knee pain. This case report highlights a rare instance of biceps femoris calcific tendinitis and its successful conservative management.

Case presentation:
A 40-year-old female presented with a one-week history of sharp lateral knee pain, which worsened with movement but persisted at rest. There was no history of trauma or systemic illness. On examination, tenderness was localized to the lateral knee, specifically over the fibular head and biceps femoris tendon. Blood tests were unremarkable. Radiographs and ultrasound revealed multifocal calcifications at the fibular head. Although MRI was recommended, it was not feasible in this resource-limited setting. The patient was initially treated conservatively with NSAIDs and physiotherapy but did not respond. She subsequently underwent ultrasound-guided barbotage and corticosteroid injection, resulting in complete resolution of symptoms within one week.

Discussion:
Calcific tendinitis is caused by the deposition of calcium hydroxyapatite crystals in periarticular tendons, leading to inflammation and pain. Biceps femoris calcific tendinitis is rare, and diagnosis can be made using cost-effective imaging modalities such as radiography and ultrasound. Conservative management, including NSAIDs, physiotherapy, and ultrasound-guided barbotage, is the preferred first-line treatment. In this case, the combination of barbotage and physiotherapy led to complete symptom relief.

Conclusion:
Biceps femoris calcific tendinitis, though rare, should be considered in cases of lateral knee pain. Early diagnosis and conservative treatment can result in rapid symptom relief.
Acute spontaneous hemorrhagic cholecystitis with systemic lupus erythematosus and antiphospholipid antibody syndrome: a case report and literature review
Authors: Abdul–Hafez Hamza A , Abudeyak Yazan , Ali Abd-Alkarim , Barakat Mohammed A. , Abdallah Yazan N. , Alawneh Mahmoud 
Published: February 2025

Introduction and importance:
Hemorrhagic cholecystitis (HC) is a rare and serious complication of acute cholecystitis, characterized by intraluminal or extraluminal bleeding within the gallbladder. While commonly associated to gallstones, HC may also arise from coagulopathies, anticoagulant therapy, and autoimmune conditions such as systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). However, HC in patients with SLE or APS is rarely reported in the literature.

Case presentation:
A 59-year-old female with a history of SLE and APS, on corticosteroids, hydroxychloroquine, methotrexate, and warfarin, presented with acute right upper quadrant pain, vomiting, hematemesis, and melena. Clinical examination revealed right upper quadrant tenderness and positive Murphy’s sign. Imaging studies, including ultrasound and computed tomography, confirmed a distended gallbladder with intraluminal hyperdense content and surrounding inflammation. An urgent open cholecystectomy was performed, revealing clotted blood within the gallbladder. The patient recovered uneventfully and was discharged in stable condition.

Clinical discussion:
HC is an uncommon but critical condition that requires prompt recognition and intervention. In this case, the coexistence of autoimmune diseases and anticoagulant therapy likely predisposed the patient to HC. Imaging played an essential role in diagnosis, and open cholecystectomy provided definitive management.

Conclusion:
HC should be considered in patients with SLE, APS, or coagulopathies presenting with acute abdominal symptoms. Early recognition and multidisciplinary management are essential to prevent life-threatening outcomes.
Reducing Unnecessary Penicillin Allergy Labels in the Pediatric Surgical Population
Authors: Hefel Ann M. , Wang Laura A. , Bauer Maureen , Tong Suhong , Tan Gee Mei 
Published: February 2025

Background:
Up to 10% of children report having a penicillin allergy; however many of these are misdiagnoses or the allergy resolves over time. Having an unnecessary penicillin allergy label increases risk of adverse clinical outcomes and increased health care costs.

Local Problem:
At our local pediatric surgical center, the percentage of patients with a penicillin allergy label was 7%.

Methods:
A pre/postimplementation design was used.

Interventions:
Pediatric surgical patients with a penicillin allergy label were identified and risk-stratified to undergo a single-dose oral provocation test (OPT) to amoxicillin.

Results:
Forty-two patients underwent an OPT. The percentage of patients with a penicillin allergy label decreased to 6.4% after 6 months (P = .045). Median wait time for an allergy evaluation decreased from 102 to 42 days (P < .0001).

Conclusions:
This quality improvement project decreased penicillin allergy labeling rates in pediatric surgical patients, improved access to penicillin allergy evaluation, and had no adverse outcomes.
Impact of Personalized Nursing Care on Bowel Preparation for Colonoscopy
Authors: Lu Lijuan , Huang Hua 
Published: February 2025

Background:
Effective bowel preparation is critical for successful colonoscopy, yet inadequate preparation frequently impairs outcomes.

Purpose:
This study evaluated personalized nursing care (PNC) against standard care in improving bowel preparation quality for colonoscopy.

Methods:
A prospective, 2-phase, single-center trial was conducted from July 2023 to July 2024. In phase 1, patients received standard care; in phase 2, personalized preparations were used.

Results:
Among 1057 patients, PNC significantly improved bowel preparation quality (P < .001). Adequate preparation was achieved by 79% of the PNC group vs 64.3% of the control group. Adherence to bowel preparation was higher in the PNC group (84.0% vs 70.4%, P < .001), as were polyp detection rates (38.2% vs 28.1%, P = .003). Patient satisfaction increased with PNC interventions.

Conclusion:
PNC enhances colonoscopy preparation, boosting clinical effectiveness and patient satisfaction and advocating for its integration into routine protocols.
Personalized Auditory Rhythmic Cues to Optimize Gait in Older Adults and People With Parkinson Disease
Authors: Harrison Elinor C. , Tueth Lauren E. , Haussler Allison M. , Rawson Kerri S. , Earhart Gammon M. 
Published: February 2025

Background and Purpose:
Gait dysfunction in people with Parkinson disease (PwPD) is common and debilitating. Internal cues (ie, mental singing) may provide a useful alternative to external cueing (ie, listening to music) to improve walking for PwPD. In this study, we individually tailored cues to each participant by allowing them to choose their own cue song and by selecting the cue rate that elicited the longest strides.

Methods:
Fifty-six participants (28 controls and 28 PwPD) performed walking trials in a single-session, cross-sectional study. Initially, uncued trials were compared with cued conditions in which participants walked to music or while they mentally sang at 4 randomized cue rates (90%, 100%, 110%, and 120% of uncued walking cadence). Participants chose their songs from a curated catalog. Cues were optimized according to longest stride lengths as measured by APDM wearable sensors. Repeated measures Analysis of Variance assessed differences between gait characteristics (velocity, cadence, and stride length) and gait variabilities (coefficients of variations) across conditions and groups.

Results:
Both cue types improved velocity, cadence, and stride length as compared to uncued walking. Internal cues were most beneficial to gait variability. The majority of participants exhibited the longest strides and fastest velocities at the highest cue rate of 120%, though a cue rate of 110% was most beneficial to gait variability.

Discussion and Conclusions:
This study shows how internal and external cues personalized by song choice and cue rate may be tailored to individuals. The information gained may help tailor cues to optimize gait performance for older adults and PwPD.

Video Abstract available
for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A518).
Drug resistance testing at regimen failure in individuals diagnosed with HIV-1 between 2010 and 2018 in Israel
Authors: Wagner Tali , Levy Itzchak , Wieder-Finesod Anat , Wax Marina , Gozlan Yael , Elbirt Daniel , Kedem Eynat , Olshtain-Pops Karen , Elinav Hila , Chowers Michal , Istomin Valery , Smolyakov Rozalia , Matus Natasha , Girshengorn Shirley , Marom Rotem , Turner Dan , Mor Orna 
Published: February 2025

Objective:
Assess virological failures, analyze the results of resistance testing (RET), and investigate factors associated with acquired drug resistance mutations (aDRM).

Design:
A retrospective longitudinal cohort study.

Methods:
Virological failures (viral load >50 copies/ml) from a cohort of 1130 individuals, diagnosed with HIV-1 in 2010–2018 and followed up until 2020, were included. Demographic, clinical, and virological data were collected. A piecewise exponential additive mixed model was employed to estimate the association of various factors with aDRM.

Results:
Only 82 individuals had virological failure, 20/82 had multiple virological failures. The majority of virological failures (77%) were men, 48% were Israeli-born,79% were diagnosed in 2010–2014. Only 18% initiated with second-generation integrase-inhibitor (INI) based regimens. Although no baseline differences were identified between those with single and multiple virological failures, the latter had lower CD4+ levels before first virological failure. NRTI M184IV and INI N155H were identified in more than 10% of the cases. In those with additional failures, INI N155H was more prominent in cases with subtype B compared to those with non-B subtypes (P = 0.039). Diagnoses with CD4+ cell count less than 200 cells/μl and AIDS [hazard ratio = 3.46, 95% confidence interval (95% CI): 1.51–7.92, P = 0.003], second-generation INI at the first virological failure (HR = 0.32, 95% CI: 0.11–0.91, P = 0.033), and RET at baseline (hazard ratio = 0.34, 95% CI: 0.13–0.86, P = 0.022) had a significant and persistent relative effect on aDRM.

Conclusion:
The risk for aDRM is reduced in those who are treated with second-generation INI-based regimens. Diagnosis with low CD4+ cell counts and AIDS is associated with detection of aDRM.
Discrepancies in Temporal Artery Biopsy Positivity Rate Among White and Black Patients Suspected of Having Giant Cell Arteritis
Authors: Vachhani Raj , Li Peng , Tavakoli Mehdi , Kline Lanning , Gaffo Angelo 
Published: February 2025

Objective
Our hypothesis is that biopsy-positive giant cell arteritis (GCA) is infrequent among Black patients. To evaluate this, we compared the temporal artery biopsy (TAB) positivity rates among White and Black patients.

Methods
This is a case-control study review from all patients who underwent TAB at our institution from 2012 until 2021. The main study outcome was the TAB positivity rate. The main independent variable was race/ethnicity. Clinical and demographic features of patients undergoing TAB were compared between those with positive and negative biopsies with t tests, Wilcoxon rank sum test, χ2 test, or Fisher exact test where appropriate. A multiple logistic regression with Firth correction was performed with factors found to be significant in bivariate analysis to evaluate for independent associations with a positive biopsy.

Results
Three hundred eighty-five patients who underwent TAB for suspected GCA were included (290 White, 95 Black). Mean sedimentation rate was higher in Black patients, but otherwise, both groups had similar demographic and clinical characteristics. Positivity rate of TAB in White patients was 20.3% and 8.4% in Black patients. White race was associated with higher likelihood of TAB positivity compared with Black race (odds ratio, 3.47). Patients with positive TAB were more likely to have jaw claudication, constitutional symptoms, and higher inflammatory markers. Other factors significant in the logistic regression model included age, and inversely with decreased visual acuity.

Conclusions
Our study results support the hypothesis that there is a discrepancy in the frequency of biopsy-confirmed GCA in patients referred for TAB, with Black patients having lower rates than their White counterparts.
Genome Report: First whole genome assembly ofPython regius(ball python), a model of extreme physiological and metabolic plasticity
Authors: Hunt Dakota R. , Allen Holly , Martin Thomas G. , Feghali Sophia N. , Chuong Edward B. , Leinwand Leslie A. 
Published: February 2025

AbstractThe study of nontraditional model organisms, particularly those exhibiting extreme phenotypes, offers unique insights into adaptive mechanisms of stress response and survival. Snakes, with their remarkable physiological, metabolic, and morphological adaptations, serve as powerful models for investigating these processes. Pythons are a unique model organism that have been studied for their extreme metabolic and physiological plasticity. To date, the Burmese python (Python bivittatus) is the only member of thePythonidaefamily to have been sequenced. The low contiguity of this genome and rising challenges in obtaining Burmese pythons for study prompted us to sequence, assemble, and annotate the genome of the closely related ball python (Python regius). Using a hybrid sequencing approach, we generated a 1.45 Gb genome assembly with a contig N50 greater than 18 Mb and a BUSCO score of 98%, representing the highest quality genome to date for a member of thePythonidaefamily. This assembly provides a valuable resource for studying snake-specific traits and evolutionary biology. Furthermore, it enables exploration of the molecular mechanisms underlying the remarkable cardiac and muscular adaptations in pythons, such as their ability to rapidly remodel organs following feeding and resist muscular atrophy during prolonged fasting. These insights have potential applications in human health, particularly in the development of therapies targeting cardiac hypertrophy and muscular atrophy.
Estimating recombination using only the allele frequency spectrum
Authors: Hahn Matthew W. , Mishra Sarthak R. 
Published: February 2025

AbstractStandard methods for estimating the population recombination parameter,ρ, are dependent on sampling individual genotypes and calculating various types of disequilibria. However, recent machine learning (ML) approaches to estimating recombination have used pooled sequencing data, which does not sample individual genotypes and cannot be used to calculate disequilibria beyond the length of a single sequence read. Motivated by these results, this study examines the “black box” of such ML methods to understand what signals are being used to infer recombination rates. We find that it is indeed possible to estimate recombination solely using the allele frequency spectrum, and we provide a genealogical interpretation of these results. We further show that even a simplified representation of the allele frequency spectrum can be used to estimate recombination. We demonstrate the accuracy of such inferences using both simulations and data from humans. These results offer a new way to understand the effects of recombination on patterns of sequence data, as well as providing an example of how the internal workings of ML methods can give insight into biological processes.Article SummaryMachine learning methods are becoming more common, offering powerful approaches to study the natural world. We investigated a popular machine learning method to see how it worked, discovering that it was exploiting data (the allele frequency spectrum) to estimate genetic recombination rates that had not been considered before. Our study demonstrates that this approach is indeed quite powerful, opening up new avenues of research. The work also demonstrates that looking inside machine learning models can sometimes teach us novel things about nature.