bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term treatment with cholestyramine increases long-acting anticoagulant rodenticide clearance from rabbits without affecting plasma vitamin K1 levels or blood coagulation
Authors: Muchiri Ruth N , Rocha Jackie , Tandon Ankit , Chen Yongmei Luo , Alemani Rebecca , Ahmad Intakhar , McDonald Zachary , Lindeblad Matthew , Rubinstein Israel , van Breemen Richard B , Feinstein Douglas L 
Published: April 2024

Abstract
Administration of high-dose vitamin K1 (VK1) overcomes coagulopathy and bleeding elicited by acute poisoning with long-acting anticoagulant rodenticides (LAARs). However, long-term (months) treatment is required due to long LAAR biological half-lives that may lead to poor compliance and recurrent coagulopathy. The half-lives of LAARs are extended by slow metabolism, and similar to warfarin, are thought to undergo enterohepatic recirculation. We now show that treatment with the bile acid sequestrant cholestyramine (CSA) administered concomitantly with VK1 decreases plasma LAAR levels and increases LAAR fecal excretion. Daily CSA treatment for 14 days did not reduce plasma VK1 levels, or increase prothrombin time. Collectively, these data show that CSA accelerates LAAR clearance from rabbits without adverse effects on VK1 anticoagulation, and could provide an additional therapeutic option for treatment of LAAR poisoning.
Seasonal patterns of nonstructural carbohydrate storage and mobilization in two tree species with distinct life-history traits
Authors: Lu Long-Long , Liu Hao , Wang Jing , Zhao Kun-Peng , Miao Yuan , Li Hai-Chang , Hao Guang-You , Han Shi-Jie 
Published: April 2024

Abstract
Nonstructural carbohydrates (NSC) are essential for tree growth and adaptation, yet our understanding of the seasonal storage and mobilization dynamics of whole-tree NSC is still limited, especially when tree functional types are involved. Here, Quercus acutissima Carruth. and Pinus massoniana Lamb, with distinct life-history traits (i.e. a deciduous broadleaf species vs an evergreen coniferous species), were studied to assess the size and seasonal fluctuations of organ and whole-tree NSC pools with a focus on comparing differences in carbon resource mobilization patterns between the two species. We sampled the organs (leaf, branch, stem and root) of the target trees repeatedly over four seasons of the year. Then, NSC concentrations in each organ were paired with biomass estimates from the allometric model to generate whole-tree NSC pools. The seasonal dynamics of the whole-tree NSC of Q. acutissima and P. massoniana reached the peak in autumn and summer, respectively. The starch pools of the two species were supplemented in the growing season while the soluble sugar pools were the largest in the dormant season. Seasonal dynamics of organ-level NSC concentrations and pools were affected by organ type and tree species, with above-ground organs generally increasing during the growing season and P. massoniana roots decreasing during the growing season. In addition, the whole-tree NSC pools of P. massoniana were larger but Q. acutissima showed larger seasonal fluctuations, indicating that larger storage was not associated with more pronounced seasonal fluctuations. We also found that the branch and root were the most dynamic organs of Q. acutissima and P. massoniana, respectively, and were the major suppliers of NSC to support tree growth activities. These results provide fundamental insights into the dynamics and mobilization patterns of NSC at the whole-tree level, and have important implications for investigating environmental adaptions of different tree functional types.
Dual Joystick Technique for Reduction of Torsional Profile in Pediatric Supracondylar Humerus Fracture With Delayed Presentation
Authors: Kaganur Raghavendra , Jaisankar Pragadeeshwaran , Sarkar Bhaskar , Paul Nirvin , Azam Md Quamar 
Published: April 2024

Background:
Reduction of some modified Gartland type III and IV supracondylar humerus fractures can pose difficulties, especially if they present late to the hospital. Various techniques of reduction have been tried for reducing the supracondylar humerus fracture for sagittal and coronal plane correction. This retrospective study assesses the dual joystick technique’s possible effectiveness in achieving an anatomical reduction of the supracondylar humerus fracture.

Methods:
Patients with modified Gartland’s type III and IV supracondylar humerus fractures who underwent closed reduction and percutaneous pinning using the dual joystick technique at our trauma center between January 2020 and January 2022 were the subject of a retrospective review. Forty-six patients treated by the above technique who met the inclusion criteria were analyzed at the end of the final follow-up.

Results:
The mean age of the children was 7.9+/− 2.25 years, with a male predominance at 32:14. The Right upper limb was more involved compared to the left side. The mean injury to hospital presentation was 2.67+/− 1.28 days, and the mean surgical duration was 24.57+/− 13.76 minutes. The average pin spread ratio at the fracture site was 35.17+/− 3.04%. Baumann angle at the final follow-up was 74.83+/− 2.56 degrees. The mean lateral rotation percentage was 2.8+/− 1.3%. 39 patients had excellent cosmetic outcomes, and 42 had excellent functional outcomes, whereas 7 and 4 patients had good cosmetic and functional outcomes, respectively, according to Flynn criteria.

Conclusions:
In modified Gartland type III and IV fractures with late presentation where reduction is challenging, this technique is shown to be convenient and easily reproducible and helps accomplish near anatomical reduction with reduced lateral rotation percentage and results in excellent to good outcomes.
Challenging Case: New-Onset Hallucinations and Developmental Regression in a Child with Autism Spectrum Disorder
Authors: Sharma Aanchal , Pappas Demetra , Gonzalez-Heydrich Joseph , Sullivan Nancy R. , Nyp Sarah S. 
Published: April 2024

CASE:
Nick is a 5-year-old boy who began displaying self-stimulating behaviors and decreased social interactions shortly before turning 3 years. At the age of 3.5 years, he was diagnosed with autism spectrum disorder by a local developmental-behavioral pediatrician. His parents recall that the physician described Nick to be “high functioning” and encouraged them to expect that he would attend college and live independently as an adult. Upon receiving the diagnosis, intervention was initiated using an applied behavioral analysis (ABA) approach. With this intervention, he demonstrated initial gains in the use of complex language and improved social interactions.
Concerns regarding suspected psychosis emerged just before starting kindergarten when Nick began experiencing ego-dystonic visual and auditory hallucinations. Initially, Nick verbally responded to the hallucinations and vividly described what he was experiencing. Shortly after the onset of these hallucinations, Nick experienced a significant decrease in the frequency and complexity of his expressive language and became more withdrawn. Over time, his hallucinations intensified, and his parents became increasingly fearful for his safety. Various antipsychotic and mood-stabilizing medications, steroids, and immunotherapy have been trialed with limited improvement of his symptoms.
An extensive medical evaluation yielded the following:
1. Magnetic resonance imaging of the brain: dilated perivascular spaces.
2. Urine organic acids: ketosis and increased lactic acid.
3. Antinuclear antibody: minimally positive.
4. Vitamin B12: elevated.
All other studies, including lumbar puncture, electroencephalogram (awake and asleep), genetic studies (chromosomal microarray, fragile X testing, and whole exome sequencing), metabolic studies, inflammatory markers, and thyroid panel, were negative/normal.
Nick is enrolled in a special education classroom within a school that utilizes an ABA-based approach for all students. As part of his educational programming, he receives 25 hours of ABA in a 1:1 setting, 2 hours of speech therapy, 3 hours of occupational therapy, 1 hour of physical therapy, and 30 minutes of music therapy weekly. Current concerns include significant head-banging and thrashing before falling asleep, hyperactivity, unsafe behaviors (e.g., banging on windows, climbing high to reach desired items), aggression toward caregivers, limited ability to complete self-care tasks (e.g., personal hygiene, toileting), significant decline in expressive language, and continued response to internal stimuli.
Nick's parents now present to a multidisciplinary center seeking guidance regarding additional therapies/interventions to assist in management of his current developmental and behavioral challenges as well as information regarding his expected developmental trajectory as he reaches adulthood.
Lymphovascular Invasion in Cutaneous Squamous Cell Carcinoma
Authors: Ryan Michael P. , Winsett Frank T. , Armenta Andrew M. , Goodwin Brandon P. , Wagner Richard F. 
Published: April 2024

BACKGROUND
Although there is a large body of literature regarding risk stratification and outcomes for perineural invasion (PNI) in cutaneous squamous cell carcinoma (cSCC), there is a relative paucity of studies exploring the role of lymphovascular invasion (LVI) in cSCC and a lack of clear evidence-based guidelines for how to manage patients with these tumors.

OBJECTIVE
This article is intended to review the available literature regarding LVI in cSCC and formulate evidence-based recommendations for clinical management.

METHODS AND MATERIALS
A literature review was conducted using PubMed to find relevant articles relating to outcomes and management of primary cSCC with LVI.

RESULTS
The available literature suggests that LVI is a major risk factor for poor outcomes and increased morbidity and mortality in cSCC.

CONCLUSION
Lymphovascular invasion is a very high-risk feature that should place these tumors in the highest-risk category, and management of these tumors should be similar to that of squamous cell carcinoma with PNI.
The application of artificial intelligence in EUS
Authors: Zhang Deyu , Wu Chang , Yang Zhenghui , Yin Hua , Liu Yue , Li Wanshun , Huang Haojie , Jin Zhendong 
Published: April 2024

Abstract
Artificial intelligence (AI) is an epoch-making technology, among which the 2 most advanced parts are machine learning and deep learning algorithms that have been further developed by machine learning, and it has been partially applied to assist EUS diagnosis. AI-assisted EUS diagnosis has been reported to have great value in the diagnosis of pancreatic tumors and chronic pancreatitis, gastrointestinal stromal tumors, esophageal early cancer, biliary tract, and liver lesions. The application of AI in EUS diagnosis still has some urgent problems to be solved. First, the development of sensitive AI diagnostic tools requires a large amount of high-quality training data. Second, there is overfitting and bias in the current AI algorithms, leading to poor diagnostic reliability. Third, the value of AI still needs to be determined in prospective studies. Fourth, the ethical risks of AI need to be considered and avoided.
Treatment and follow-up of melanoma in situ in a geriatric patient that is a nonsurgical candidate
Authors: Zimmerman Brittany 
Published: April 2024

Background: The standard of care for melanoma in situ is a wide excision with at least 0.5 cm margins. These melanomas can be large in size, and some elderly patients are not good surgical candidates so alternative treatment options have been explored. Topical imiquimod is currently approved by the Federal Drug Administration for the treatment of actinic keratosis, external anogenital warts, and superficial basal cell carcinoma. In some patients, treatment with topical imiquimod for malignant melanoma in situ has been shown to be successful. Case report: A 97-year-old male patient presented to a dermatology office with a 4.5×4.0 cm malignant melanoma in situ. The patient was given treatment options of excision and radiation therapy but refused due to his advanced age and desire to avoid extensive surgery. The patient agreed to topical treatment with imiquimod cream 5 times weekly for 5 months. A post-treatment repeat biopsy showed no evidence of residual malignant melanoma in situ. Continued post-treatment follow-up at 3-month internals with pigmented lesion assay(s) and repeat biopsies showed no evidence of recurrence at 1 year. Conclusions: In geriatric patients with a large-sized melanoma in situ that are not good surgical candidates, treatment with topical imiquimod should be considered. Long-term follow-up with pigmented lesion assay(s) should be considered in these patients to help avoid biopsy fatigue, wound management, and complications from comorbidities.
Real-world insights for the evolving intervention strategy for non-mild acute pancreatitis: 35-year experience in a Chinese Tertiary Center
Authors: Yan Xiaxiao , Zhou Jingya , Cao Jian , Xu Qiang , Han Xianlin , Wang Duan , Zhang Shengyu , Wu Dong 
Published: April 2024

Background:
With the accumulation of experience and evidence, guidelines for invasive intervention for acute pancreatitis (AP) have continuously evolved, followed in Peking Union Medical College Hospital (PUMCH). We aimed to review AP case series to help understand the impact of guideline evolution on the management and prognosis of AP in real-world practice.

Methods:
This was a single-center study of AP patients who had received invasive interventions from 1988 to 2022. Patient demographics, baseline severity, imaging findings, and the indication, timing, and specific modalities of invasive interventions were collected. The composite primary endpoint was death during hospitalization or major complications after intervention. Other endpoints included pancreatic fistula, incision infection, number of interventions, length of intensive care stay, length of hospitalization, and total medical cost.

Results:
A total of 195 patients were included. The most common indication for invasive intervention was suspected infection, followed by persistent symptoms. The step-up and delayed strategies reduced the incidence of major complications or death. Over 35 years, the number of patients requiring surgery has gradually declined, and more patients need only minimally invasive procedures for remission. The incidence of the primary outcome decreased as well as the duration of hospitalization.

Conclusions:
The management of AP patients at PUMCH in the last 35 years has undergone therapeutic guideline changes that support the efficacy and safety of the deferred step-up strategy in real-world practice.
A molecular journey on the pathogenesis of primary hyperoxaluria
Authors: Cellini Barbara 
Published: April 2024

Purpose of review
Primary hyperoxalurias (PHs) are rare disorders caused by the deficit of liver enzymes involved in glyoxylate metabolism. Their main hallmark is the increased excretion of oxalate leading to the deposition of calcium oxalate stones in the urinary tract. This review describes the molecular aspects of PHs and their relevance for the clinical management of patients.

Recent findings
Recently, the study of PHs pathogenesis has received great attention. The development of novel in vitro and in vivo models has allowed to elucidate how inherited mutations lead to enzyme deficit, as well as to confirm the pathogenicity of newly-identified mutations. In addition, a better knowledge of the metabolic consequences in disorders of liver glyoxylate detoxification has been crucial to identify the key players in liver oxalate production, thus leading to the identification and validation of new drug targets.

Summary
The research on PHs at basic, translational and clinical level has improved our knowledge on the critical factors that modulate disease severity and the response to the available treatments, leading to the development of new drugs, either in preclinical stage or, very recently, approved for patient treatment.
Advances in preclinical assessment of therapeutic targets for bladder cancer precision medicine
Authors: Nössing Christoph , Herek Paula , Shariat Shahrokh F. , Berger Walter , Englinger Bernhard 
Published: April 2024

Purpose of review
Bladder cancer incidence is on the rise, and until recently, there has been little to no change in treatment regimens over the last 40 years. Hence, it is imperative to work on strategies and approaches to untangle the complexity of intra- and inter-tumour heterogeneity of bladder cancer with the aim of improving patient-specific care and treatment outcomes. The focus of this review is therefore to highlight novel targets, advances, and therapy approaches for bladder cancer patients.

Recent findings
The success of combining an antibody-drug conjugate (ADC) with immunotherapy has been recently hailed as a game changer in treating bladder cancer patients. Hence, interest in other ADCs as a treatment option is also rife. Furthermore, strategies to overcome chemoresistance to standard therapy have been described recently. In addition, other studies showed that targeting genomic alterations (e.g. mutations in FGFR3, DNA damage repair genes and loss of the Y chromosome) could also be helpful as prognostic and treatment stratification biomarkers. The use of single-cell RNA sequencing approaches has allowed better characterisation of the tumour microenvironment and subsequent identification of novel targets. Functional precision medicine could be another avenue to improve and guide personalized treatment options.

Summary
Several novel preclinical targets and treatment options have been described recently. The validation of these advances will lead to the development and implementation of robust personalized treatment regimens for bladder cancer patients.
Chest Compression Depth Targets in Critically Ill Infants and Children Measured With a Laser Distance Meter: Single-Center Retrospective Study From Japan, 2019–2022*
Authors: Ikeyama Takanari , Hozumi Takunori , Kikuyama Kazuki , Niles Dana , Nadkarni Vinay , Ito Komei 
Published: April 2024

OBJECTIVES:
Current resuscitation guidelines recommend target chest compression depth (CCd) of approximately 4cm for infants and 5cm for children. Previous reports based on chest CT suggest these recommended CCd targets might be too deep for younger children. Our aim was to examine measurements of anterior-posterior chest diameter (APd) with a laser distance meter and calculate CCd targets in critically ill infants and children.

DESIGN:
A retrospective descriptive study.

SETTING:
Single-center PICU, using data from May 2019 to May 2022.

PATIENTS:
All critically ill children admitted to PICU and under 8 years old were eligible to be included in the retrospective cohort.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The chest APd measurements using a laser distance meter are part of our usual practice on the PICU. Target CCd and the over-compression threshold CCd for each age group was calculated as 1/3 and 1/2 of APd, respectively. In 555 patients, the median (interquartile range) of the calculated target CCd for each age group was: 2.7 cm (2.5–2.9 cm), 2.9 cm (2.7–3.2 cm), 3.2 cm (3–3.5 cm), 3.4 cm (3.2–3.6 cm), 3.4 cm (3.2–3.6 cm), 3.6 cm (3.4–3.8 cm), 3.6 cm (3.4–4 cm), and 4 cm (3.5–4.2 cm), for 0, 2, 3–5, 6–8, 9–11, 12–17, 18–23, 24 to less than 60, and 60 to less than 96 months, respectively. Using guideline-recommended absolute CCd targets, 4 cm for infants and 5 cm for children, 49% of infants between 0 and 2 months, and 45.5% of children between 12 and 17 months would be over-compressed during cardiopulmonary resuscitation.

CONCLUSIONS:
In our cohort, the 1/3 CCd targets calculated from APd measured by laser meter were shallower than the guideline-recommended CCd. Further studies including evaluating hemodynamics during cardiopulmonary resuscitation with these shallower CCd targets are needed.
Design and Modification of COVID-19 Case Investigation and Contact Tracing Interview Scripts Used by Health Departments Throughout the COVID-19 Pandemic
Authors: Orfield Cara , Loosier Penny S. , Wagner Sarah , Sabin E. Rain , Fiscus Michelle , Matulewicz Holly , Vohra Divya , Staatz Colleen , Taylor Melanie M. , Caruso Elise C. , DeLuca Nickolas , Moonan Patrick K. , Oeltmann John E. , Thorpe Phoebe 
Published: April 2024

Objectives:
We sought to (1) document how health departments (HDs) developed COVID-19 case investigation and contact tracing (CI/CT) interview scripts and the topics covered, and (2) understand how and why HDs modified those scripts.

Design:
Qualitative analysis of CI/CT interview scripts and in-depth key informant interviews with public health officials in 14 HDs. Collected scripts represent 3 distinct points (initial, the majority of which were time stamped May 2020; interim, spanning from September 2020 to August 2021; and current, as of April 2022).

Setting:
Fourteen state, local, and tribal health jurisdictions and Centers for Disease Control and Prevention (CDC).

Participants:
Thirty-six public health officials involved in leading CI/CT from 14 state, local, and tribal health jurisdictions (6 states, 3 cities, 4 counties, and 1 tribal area).

Main Outcome Measure:
Interview script elements included in CI/CT interview scripts over time.

Results:
Many COVID-19 CI/CT scripts were developed by modifying questions from scripts used for other communicable diseases. Early in the pandemic, scripts included guidance on isolation/quarantine and discussed symptoms of COVID-19. As the pandemic evolved, the length of scripts increased substantially, with significant additions on contact elicitation, vaccinations, isolation/quarantine recommendations, and testing. Drivers of script changes included changes in our understanding of how the virus spreads, risk factors and symptoms, new treatments, new variants, vaccine development, and adjustments to CDC's official isolation and quarantine guidance.

Conclusions:
Our findings offer suggestions about components to include in future CI/CT efforts, including educating members of the public about the disease and its symptoms, offering mitigation guidance, and providing sufficient support and resources to help people act on that guidance. Assessing the correlation between script length and number of completed interviews or other quality and performance measures could be an area for future study.