bluuebunny/crossref_metadata_2025_split huggingface dataset:
The CXCR4 might be a potential biomarker for esophageal squamous cell carcinoma: A meta-analysis
Authors: Chen Pei , Zhang Yu-Ling , Zhang Xiao-Lei , Guo Ying , Tang Pei-Pei 
Published: April 2024

Objective:
To evaluate the relationship between CXCL12/CXCR4 and the progress, prognosis of esophageal squamous cell carcinoma (ESCC), providing evidence for potential early diagnosis, clinical treatment, prognosis evaluation, and therapeutic target of ESCC.

Methods:
Databases of PubMed, the Cochrane Library, Embase, and Web of Science were searched for the relationship between CXCL12/CXCR4 and clinicopathological characteristics and survival time of ESCC. Stata16.0 software was used to conduct meta-analysis.

Results:
A total of 10 studies involving 1216 cases of patients with ESCC were included in our study. The results indicated that high-level expression of CXCR4 was significantly correlated with tumor differentiation [OR = 0.69, 95% confidence interval (CI): (0.50, 0.97)], tumor infiltration [OR = 0.39, 95% CI: (0.25, 0.61)], lymph node metastasis [OR = 0.36, 95% CI: (0.21, 0.61)], clinical stage [OR = 0.33, 95% CI: (0.24, 0.45)] of ESCC. The expression of CXCR4 was also significantly correlated with OS [HR = 2.00, 95% CI: (1.63, 2.45)] and disease-free survival [HR = 1.76, 95% CI: (1.44, 2.15)] in patients of ESCC after surgical resection. No significant relationship was observed between the expression of CXCL12 and the clinicopathological characteristics of ESCC.

Conclusion:
CXCR4 might be a potential biomarker for the progress and prognosis evaluation, and therapeutic target for ESCC.
Efficacy of cementless porous tantalum tibial components versus cemented tibial components in primary total knee arthroplasty: A meta-analysis
Authors: Li Lei , Pan Chao , Zhang Xingyan , Liu Wei , Zhang Tingting , Liu Yufan , Li Jingyi , Ma Yuhang , Jia Chenfan , Liu Xinying , Shi Chunbao 
Published: April 2024

Background:
Total knee arthroplasty involves the use of cemented tibial components for fixation. In recent years, cementless porous tantalum tibial components have been increasingly utilized. The aim of this meta-analysis was to compare the efficacy of cementless porous tantalum tibial components with traditional cemented tibial components in terms of postoperative outcomes following total knee arthroplasty.

Methods:
Relevant literature was retrieved from Cochrane Library, PubMed, Embase, and Web of Science using the search terms “(trabecular metal OR Porous tantalum)” AND “knee” up to July 2023. The weighted mean difference with a 95% confidence interval was used as the effect size measure to evaluate the functional recovery of the knee joint, radiological analysis, complications, and implant revisions between cementless porous tantalum tibial components and traditional cemented tibial components after total knee arthroplasty. Review Manager 5.3 was utilized to conduct a comparative analysis of all included studies.

Results:
Nine studies with a total of 1117 patients were included in this meta-analysis, consisting of 447 patients in the porous tantalum group and 670 patients in the cemented group. Radiological analysis demonstrated that the porous tantalum group had better outcomes than the cemented group (P < .05). The combined results for the 5-year and 10-year follow-ups, range of motion, Western Ontario and McMaster University Osteoarthritis Index, complications, and implant revisions showed no significant differences between the porous tantalum and cemented groups.

Conclusion:
The results of the 5-year and 10-year follow-ups indicate that the use of cementless porous tantalum tibial components is comparable to traditional cemented tibial components, with no significant advantages observed. However, at the 5-year follow-up, the porous tantalum group demonstrated a good bone density in the proximal tibia. Future studies with a larger sample size, long-term clinical follow-up, and radiological results are needed to verify the differences between the 2 implants.
Fragment excision and triceps V-Y advanced reattachment using suture anchor for olecranon nonunion: A case report
Authors: Kim Tae-Yeong , Yang Jae-Shin , Hwang Jung-Taek 
Published: April 2024

Rationale:
The nonunion of olecranon fractures is uncommon in simple fractures, and it is challenging to treat surgically due to the disruption of the anatomy of the elbow joint. There is limited literature on surgical options, and several factors to determine the treatment, including the amount and quality of bone stock, age, and degree of articular damage.

Patient concerns:
A 58-year-old man presented at the clinic with neglected olecranon fracture for 1 year (case 1). A 74-year-old man (case 2) presented with consistent pain and limited of motion after surgery for olecranon fracture.

Diagnosis:
Both patients were diagnosed with olecranon nonunion.

Intervention:
Both patients received the excision of nonunited fragment and reattaching with V-Y advancement of triceps.

Outcomes:
Range of motion and Mayo elbow performance score were improved after surgery.

Lessons:
This technique is useful in patients who cannot undergo other surgical options due to insufficient bone quality and elbow function, and it can lead to satisfactory outcomes with an acceptable range of motion and pain relief.
Sirolimus combined with glucocorticoids in the treatment of Kasabach-Merritt phenomenon in a neonate: A case report
Authors: Cheng Jun , Zou Yun , Fu Ronghua , Jin Pingliang , Huang Mengyu , Wu Zhiping , Bai Hanxiang , Huang Xiangqun , Yuan Hua 
Published: April 2024

Rationale:
Kaposiform hemangioendothelioma is an aggressive vascular tumor that is often associated with life-threatening coagulopathies and Kasabach-Merritt phenomenon. Pathologic biopsies can provide a good basis for diagnosis and treatment. Therapy with srolimus combined with glucocorticoids may offer patients a favorable prognosis.

Patient concerns:
A large purplish-red mass on the knee of a child with extremely progressive thrombocytopenia and refractory coagulation abnormalities. Conventional doses of glucocorticoids alone failed to improve coagulation abnormalities and the child developed large cutaneous petechiae and scalp hematomas.

Diagnosis:
Kaposiform hemangioendothelioma combined with Kasabach-Merritt phenomenon.

Interventions:
The patient received prednisolone 2.0 mg/kg*d for 4 days. Blood products were transfused to ensure vital signs and to complete the pathologic biopsy. Sirolimus combined with prednisolone was given after clarifying the diagnosis of Kaposiform hemangioendothelioma.

Outcomes:
The tumor basically disappeared on examination and the ultrasound showed a subcutaneous hyperechoic mass with normal blood flow.

Lessons:
Sirolimus combined with glucocorticoids is effective in controlling Kasabach-Merritt phenomenon and pathologic biopsy is important for definitive diagnosis.
A case report of a patient with Turner syndrome who develops catatonia secondary to psychotic symptoms
Authors: Xia Yong , Sun Yuyong , Zhi Qianna , Cui Wenjing , Liu Xiaoyan 
Published: April 2024

Rationale:
Turner syndrome (TS) is a genetic disorder associated with partial or complete monosomy X abnormalities; some patients may have a higher risk of psychiatric symptoms. Catatonia is associated with a wide range of life-threatening complications with complex pathogenesis; However, It very rare for patients with TS to develop psychotic symptoms and eventually progress to catatonia. This case report describes the diagnostic and therapeutic course of catatonia-associated TS.

Patient concerns:
In this study, we report the case of a patient with TS who initially developed sudden hallucinations, delusions, and emotional instability, followed by catatonia.

Diagnoses:
The patient was diagnosed with: unspecified catatonia; TS.

Interventions:
Treatment included administering a combination of esazolam injections and olanzapine tablets, placing a gastric tube and urinary catheter, and providing nutritional support.

Outcomes:
After treatment, the patient’s hallucinations, delusions, and catatonia disappeared, with no residual sequelae, and social functioning returned to normal.

Lessons:
For patients with TS who present with psychotic symptoms and catatonia, a comprehensive evaluation is necessary, and treatment with antipsychotics and benzodiazepines is effective.
Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective cohort study in Iran
Authors: Hedayati Goudarzi Mohammad Taghi , Abrotan Saeed , Ziaie Naghmeh , Amin Kamyar , Saravi Mehrdad , Jalali Seyed farzad , Pourkia Roghayeh , Jafaripour Iraj , Moradi Amir , kargar-soleimanabad Saeed , Saffar Homina 
Published: April 2024

Background:
Coronary artery calcification (CAC) has been established as an independent risk factor for major adverse cardiovascular events. Nevertheless, the effect of CAC on in-hospital mortality and adverse clinical outcomes in patients with COVID-19 has yet to be determined.

Objective:
To investigate the association between CAC score and in-hospital mortality of COVID-19 patients

Method:
This retrospective cohort study was conducted across tertiary hospitals of University of Medical Sciences in Babol, a northern city in Iran, and enroled 551 confirmed COVID-19 patients with definitive clinical outcomes of death or discharge between March and October 2021. Demographic and clinical data, along with chest computed tomography (CT) findings and CAC score on admission, were systematically collected. The study utilized logistic regression analysis and Kaplan-Meier plots to explore the association between CAC score and in-hospital death and adverse clinical outcomes.

Results:
The mean age was 60.05±12.8. A significant difference regarding CAC score, age, history of hypertension, hyperlipidemia, cardiovascular diseases, and respiratory diseases among survivors and non-survivors was observed; however, gender was not found to be different. Furthermore, in multivariate analysis, CAC score greater than or equal to 400 [odds ratio (OR): 4.2, 95% CI: 1.70–10.33, P value: 0.002], hospitalization time (OR: 1.31, 95% CI: 1.13–1.53, P value < 0.001), length of ICU stay (OR: 2.02, 95% CI: 1.47–2.77, P value < 0.001), severe or critical COVID-19 severity in time of admission (95% CI: 1.79–18.29, P value: 0.003), and history of respiratory diseases (95% CI: 2.18–40, P value: 0.003) were found to be associated with higher odds of in-hospital mortality. Log-rank test also revealed a significant difference regarding the time of admission to death between patients with CAC score greater than or equal to 400 and those with CAC score less than 400 (P value < 0.001).

Conclusion:
Elevated CAC score is a crucial risk factor linked to in-hospital mortality and unfavourable clinical results in confirmed COVID-19 patients. This finding emphasizes the need for careful monitoring of individuals with high CAC scores.
Magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia: systematic review and meta-analysis
Authors: Tsehay Yeshimebet Tamir , Bogale Alemwork Dessalegn , Mulatu Sileshi , Netsere Henok Biresaw , Adal Ousman , Messelu Mengistu Abebe , Mamo Sosina Tamre , Demile Tiruye Azene , Abebe Gebremeskel Kibret , Mekonnen Gebrehiwot Berie , Belay Alamirew Enyew , Wondie Wubet Tazeb , Belayneh Asnake Gashaw 
Published: April 2024

Background:
Postoperative mortality is one of the six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. This study aimed to assess the magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia.

Methods:
This systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Ten studies were included in this Systematic review and meta-analysis. The risk of bias for each study was assessed using the Joanna Briggs Institute quality appraisal scale. Publication bias was checked using a funnel plot and Egger’s regression test. Heterogeneity across studies was assessed by I2 statistics. STATA version 17 software was used for analysis. A random effect model and the DerSimonian–Laird method of estimation was used to estimate the pooled magnitude of postoperative mortality. Odds ratios with 95% CIs were calculated to determine the associations of the identified factors with postoperative mortality.

Results:
The results revealed that the pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was 4.53% (95% CI :3.70–5.37). An American Society of Anesthesiologists score greater than or equal to III [adjusted odds ratio (AOR): 2.45, 95% CI: 2.02, 2.96], age older than or equal to 65 years (AOR: 3.03, 95% CI: 2.78, 3.31), and comorbidity (AOR: 3.28, 95% CI: 1.91, 5.63) were significantly associated with postoperative mortality.

Conclusion and recommendations:
The pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was high. The presence of comorbidities, age older than 65 years, and ASA physical status greater than III were significantly associated with postoperative mortality. Therefore, the Ministry of Health and other concerned bodies should consider quality improvement processes.
Fertility education on Instagram: advertisements vs. educational content analysis for posts in Bahasa (Indonesian language)
Authors: Harzif Achmad K , Kusuma Berli , Ummah Nafi’atul , Puspawardani Aisyah R , Nurbaeti Putri , Wiweko Budi 
Published: April 2024

Background:
As one of Indonesia’s major social media platforms, Instagram provides abundant information, including fertility topics. However, fertility information in Bahasa (Indonesian language) had never been mapped before. This study aims to determine the prevalence, authorship, and types of fertility-related information in Bahasa shared on Instagram using hashtag and content analysis. Additional outcomes included a comparison of post content stratified by author type (healthcare providers vs. non-healthcare providers).

Materials and methods:
Five hashtags comprising fertility terms in Bahasa (Indonesian language) were derived. Content analysis was performed on the top 100 posts for each hashtag to determine the authorship and content type. The contents posted by healthcare providers were analyzed and compared to those published by non-healthcare providers.

Results:
Our search yielded 3 883 000 posts for the five most popular hashtags. The three most popular hashtags were ‘promil’, ‘program hamil’ and ‘bayitabung’. Authorship of the top posts for each hashtag was predominantly by for-profit healthcare institutions (27.6%), followed by commercial alternative/herbal medicine (20.2%), patients (20%), physicians (11.8%), allied health professionals (3.2%), professional societies (0.8%), and others (16.4%). Of these posts, 35.4% were advertisements, 28% were related to patient experience, and 18% were educational. Healthcare provider groups were more likely to author educational posts than advertisements, while non-healthcare providers were more likely to post content for commercial purposes (P < 0.001).

Conclusion:
Fertility-related posts were dominated by for-profit healthcare institutions and alternative/herbal medicines for commercial purposes. The physician group authored more of the educational content. There is plenty of room for optimal utilization of social platforms as educational media.
Infantile tremor syndrome with global developmental delay and microcephaly in a 16-month-old male: a case report
Authors: Shah Ujjwal Kumar , Chaudhary Shipra , Ghimire Aasha , Shah Neha , Muskan Vitasta 
Published: April 2024

Introduction and importance:
Infantile tremor syndrome (ITS) affects children aged 6–18 months, and is characterized by tremors, pallor, developmental regression, skin pigmentation changes, and sparse hypopigmented hair. This case report highlights an ITS presentation in a 16-month-old exclusively breastfed male, emphasizing the significance of complementary feeding.

Case presentation:
The patient presented with abnormal body movements, loss of developmental milestones, hyperpigmented skin changes, hypopigmented scalp hairs, pallor, and microcephaly. Born to a vegetarian mother with inadequate prenatal care, the child’s exclusive breastfeeding till 16 months of age without complementary feeding led to severe developmental delay and moderate malnutrition. Diagnostic workup revealed vitamin B12 deficiency, anaemia, and neurologic abnormalities.

Clinical discussion:
ITS is associated with various manifestations, including pallor, hyperpigmentation, and tremors, commonly linked to vitamin B12 deficiency. In this case, developmental delays and malnutrition underscored the importance of early recognition. Despite neurological improvement with vitamin B12 supplementation, ITS’s long-term impact on cognitive functions necessitates vigilance and appropriate nutritional interventions.

Conclusion:
Early recognition of ITS is vital for the prevention of long-term neurodevelopmental sequelae. Injectable vitamin B12 supplementation and nutritional interventions have demonstrated significant developmental gains. Increased awareness among mothers about nutritional intake during pregnancy and lactation is crucial, especially among vegetarians.
Targeting Breast Cancer Using 177Lu-Labeled Trastuzumab and Trastuzumab Fragment
Authors: Rathore Yogesh , Lakhanpal Tamanna , Chakraborty Sudipta , Chakravarty Rubel , Mittal B.R. , Irrinki R.N. Santhosh , Laroiya Ishita , Kaur Komalpreet , Shukla Jaya 
Published: April 2024

Purpose
A monoclonal antibody, trastuzumab, is used for immunotherapy for HER2-expressing breast cancers. Large-sized antibodies demonstrate hepatobiliary clearance and slower pharmacokinetics. A trastuzumab fragment (Fab; 45 kDa) has been generated for theranostic use.

Patients and Methods
Fab was generated by papain digestion. Trastuzumab and Fab have been radiolabelled with 177Lu after being conjugated with a bifunctional chelating. The affinity and target specificity were studied in vitro. The first-in-human study was performed.

Results
The bifunctional chelating agent conjugation of 1–2 molecules with trastuzumab and Fab was detected at the molar ratio 1:10 in bicarbonate buffer (0.5 M, pH 8) at 37°–40°C. However, 2–3 molecules of bifunctional chelating agent were conjugated when DMSO in PBS (0.1 M, pH 7) was used as a conjugation buffer at a molar ratio of 1:10. The radiolabelling yield of DOTA-conjugated Fab and trastuzumab at pH 5, 45°C to 50°C, with incubation time 2.5–3 hours was 80% and 41.67%, respectively. However, with DOTAGA-conjugated trastuzumab and Fab, the maximum radiolabelling yield at pH 5.5, 37°C, and at 2.5–3 hours was 80.83% and 83%, respectively. The calculated Kd of DOTAGA Fab and trastuzumab with HER2-positive SKBR3 cells was 6.85 ± 0.24 × 10−8 M and 1.71 ± 0.10 × 10−8 M, respectively. DOTAGA-Fab and trastuzumab showed better radiolabelling yield at mild reaction conditions.

177Lu-DOTAGA-Fab demonstrated higher lesion uptake and lower liver retention as compared with 177Lu-DOTAGA-trastuzumab. However, 177Lu-DOTAGA-Fab as compared with 177Lu-DOTAGA-trastuzumab showed a relatively early washout (5 days) from the lesion.

Conclusions

177Lu-DOTAGA-Fab and trastuzumab are suitable for targeting the HER2 receptors.
Prediction of Permanent Enophthalmos Using 3-Dimensional Integral Model in Blowout Fractures
Authors: Kim Jun Hyun , Choi Yean Su , Shin Ho Seong 
Published: April 2024

Background:
The objective of this study is to validate the possibility of setting volumetric surgical indications by predicting permanent enophthalmos using a simplified formula.

Methods:
The volume difference of bilateral orbits in a CT scan was automatically measured, and permanent enophthalmos was predicted by substituting the volume difference into a formula made using the 3-dimensional (3D) integral model.

Results:
The predicted enophthalmos showed a strong positive correlation with the permanent enophthalmos of 52 blowout fracture patients. Analyzing CT of 768 pure blowout fracture patients, the mean predicted enophthalmos was 1.84 mm, and both the size of the fracture area and the degree of EOM herniation showed the absence of correlations.

Conclusions:
Through the digitized orbital volume analysis and formula using the 3D integral model, blowout fracture patients who require surgery in the early post-traumatic period can be identified with convenience and reproducibility.
The Prevalence of Difficult Airway and Associated Risk Factors in Pediatric Patients: A Cross-sessional Observational Study
Authors: Shen Chen , Shi Yun 
Published: April 2024

Background:
Difficult airway remains a great challenge in pediatric anesthesia practice. Previously published data show the prevalence of difficult airways in pediatric population varies in a wide range. However, there is a lack of studies in the Asian region.

Methods:
This cross-sectional single-center study was conducted in a tertiary pediatric hospital in China from October 2022 to October 2023. The patients who underwent elective surgery under general anesthesia with tracheal intubation were recruited consecutively. Data on patient characteristics, airway assessment, and airway management information were collected. Multivariable logistic regression analysis was performed to detect the independent variables of difficult airway in pediatric patients.

Results:
A total of 18,491 pediatric patients were included in this study. The overall incidence of difficult airways was 0.22%, 39% of whom were unanticipated. Very few previous airway management information was available in the patients presented with a known difficult airway. Patients with younger age, higher American Society of Anesthesiologists (ASA) physical status classification grade, and presented for craniofacial and thoracic surgery were associated with higher incidence of difficult airway. Further multivariable logistic regression analysis revealed that age ≤28 days (OR=50.48), age between 28days and 1 year (OR=6.053), craniofacial surgery (OR=1.81), and thoracic surgery (OR=0.2465) were independent risk factors of increased incidence of difficult airway.

Conclusions:
Our study showed the prevalence of difficult airways in pediatric surgical patients. Patient characteristics, age, and type of surgery were identified as the independent factors associated with increased occurrence of difficult airways. Unanticipated difficult airway was not unusual in our study population, even for the patients with previous surgical history.