bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nucleophilic cleavage of C–F bonds by Brønsted base for rapid synthesis of fluorophosphate materials
Authors: Fu Qingfeng , Chang Zihao , Gao Peng , Zhou Wang , Dong Hongliang , Huang Peifeng , Hu Aiping , Fan Changling , Xiao Peitao , Chen Yufang , Liu Jilei 
Published: January 2025

ABSTRACT
Fluorochemicals are a rapidly expanding class of materials used in a variety of fields including pharmaceuticals, metallurgy, agrochemicals, refrigerants, and in particular, alkali metal ion batteries. However, achieving one-step synthesis of pure fluorophosphate compounds in a well-controlled manner remains a formidable challenge due to the volatilization of fluorine during the heat treatment process. One feasible method is to cleave the C–F bond in polytetrafluoroethylene (PTFE) during synthesis to create a fluorine-rich atmosphere and strongly reducing environment. However, the inert nature of the C–F bond in PTFE presents a significant obstacle, as it is the strongest single bond in organic compounds. To address this predicament, we propose a fluorine-compensating strategy that involves cleavage of the C–F bonds by nucleophilic SN2-type reactions of Brønsted base (ammonia) enabling fluorine compensation. The decomposed products (NH2· and C·) also result in the formation of micropores (via NH3 escape) and in-situ carbon coating (via C· polymerization). The resultant cathode delivers a superior potassium storage capability including high rate performance and capacity retention. This contribution not only overcomes the obstacles associated with the inert C–F bond in fluororesin, but also represents a significant step forward in the development of fluorine-containing compounds.
Defining Fulminant Clostridioides difficile Infections: Assessing the Utility of Hypotension as a Diagnostic Criterion
Authors: Chua Hubert C , Eubank Taryn A , Lee Allen , Rao Krishna , Jo Jinhee , Garey Kevin W , Gonzales-Luna Anne J 
Published: January 2025

Abstract

Background
Fulminant Clostridioides difficile infection (FCDI) is associated with a 30%–40% mortality rate. Guideline definitions for FCDI severity classification include ileus, megacolon, shock, or hypotension. However, no hypotension definition is provided, making application of the definition challenging. The objective of this study was to assess optimal hypotension definitions for FCDI severity criteria.

Methods
This was a multicenter cohort study involving 1172 hospitalized patients diagnosed with C difficile infection (CDI) from 2015 to 2022 (Houston cohort). Patients were assessed for a composite endpoint of colectomy or mortality within 30 days of diagnosis. The ability of the CDI severity criteria to predict the composite endpoint was assessed using 2 definitions of hypotension (systolic blood pressure [SBP] ≤90 mm Hg and mean arterial pressure [MAP] ≤65 mm Hg) through multivariable regression models. A separate CDI cohort of 494 hospitalized patients validated the results (Midwest cohort).

Results
The composite endpoint was similar in the Houston cohort (98 patients [8.4%]) and the Midwest cohort (26 patients [5.3%]). Using either a MAP ≤65 mm Hg or SPB ≤90 mm Hg as criteria for hypotension was the best-performing model in both the development and validation cohorts. Removal of hypotension was the worst-performing model in both cohorts.

Conclusions
Inclusion of hypotension, defined as SBP ≤90 mm Hg or MAP ≤65 mm Hg, was an important component of FCDI severity criteria, significantly improving the predictive ability to identify FCDI patients at risk for poor outcomes.
From Chart Biopsy to Liquid Biopsy: Evaluating the Diagnostic Yield and Clinical Impact of Plasma Microbial Cell-Free DNA Next-Generation Sequencing in the Management of Fever of Unknown Origin
Authors: Ranganath Nischal , Bisono Garcia Bismarck , Vaillant James , Katragadda Silpita , Kerkelis Melissa , Abu Saleh Omar , Fida Madiha 
Published: January 2025

Abstract

Background
The underlying cause of fever of unknown origin (FUO) remains unidentified in up to 51% of cases despite systematic evaluation. Microbial cell-free DNA next-generation sequencing (mcfDNA-NGS) offers an agnostic, noninvasive approach to pathogen identification, but the utility and clinical impact of this assay in FUO remain unknown.

Methods
This retrospective cohort study evaluated adult patients referred for FUO evaluation at a tertiary medical center between November 2019 and November 2023. Patients underwent both standard microbiologic testing (ST) and mcfDNA-NGS. Diagnostic impact was assessed in 4 domains: new diagnoses, earlier time to diagnosis, avoidance of invasive procedures, and non-hypothesis-driven diagnoses. Logistic regression was used to identify predictors of positive mcfDNA-NGS testing.

Results
Among 176 patients, mcfDNA-NGS was positive in 44.3%, with 49% of these cases considered clinically significant. Infectious cause of FUO was identified in 39% of patients, noninfectious in 35%, and unknown in 26%. mcfDNA-NGS contributed to a positive diagnostic impact in 30% of cases, mainly by earlier diagnosis (16%) and potential for avoidance of invasive procedures (10%). Positive mcfDNA-NGS was significantly associated with higher Charlson comorbidity index score (odds ratio [OR], 1.22; P &lt; .001) and white blood cell (WBC) count ≤4.5 × 109 cells/L (OR, 8.61; P &lt; .001). Conversely, FUO without localization was associated with a decreased likelihood of positive mcfNDA testing (OR, 0.18; P &lt; .001).

Conclusions
mcfDNA-NGS effectively complements ST in diagnosing FUO, providing earlier detection and minimizing invasive testing. Clinical predictors such as high comorbidity and low WBC count may guide the optimal use of mcfDNA-NGS in FUO. Prospective evaluation of optimal timing and use of mcfDNA-NGS and cost-benefit analysis in FUO is needed.
Clinical Epidemiology of Dengue and COVID-19 Co-infection Among the Residents in Dhaka, Bangladesh, 2021–2023: A Cross-sectional Study
Authors: Sharif Nadim , Opu Rubayet Rayhan , Khan Afsana , Saha Tama , Masud Abdullah Ibna , Naim Jannatin , Martinez Zaily Leticia Velázquez , García Carlos Osorio , Alsuwat Meshari A , Alzahrani Fuad M , Alzahrani Khalid J , De la Torre Díez Isabel , Dey Shuvra Kanti 
Published: January 2025

Abstract

Background
Co-infection of dengue and COVID-19 has increased the health burden worldwide. We found a significant knowledge gap in epidemiology and risk factors of co-infection in Bangladesh.

Methods
This study included 2458 participants from Dhaka city from 1 December 2021 to November 30 2023. We performed the Kruskal-Wallis test and χ2 test. Multivariable logistic regression was also performed.

Results
Co-infection of dengue and COVID-19 was found among 31% of the participants. Coprevalence of dengue and COVID-19 was found in higher frequency in Jatrabari (14%) and Motijhil (11%). Severe (65%, P = .001) and very severe (78%, P = .005) symptoms were prevalent among the participants aged &gt;50 years. Long-term illness was prevalent among the participants with co-infection (35%; 95% confidence interval [CI], 33–36) and COVID-19 (28%; 95% CI, 26–30). Co-infected participants had a higher frequency of heart damage (31.6%, P = .005), brain fog (22%, P = .03), and kidney damage (49.3%, P = .001). Fever (100%) was the most prevalent symptom followed by weakness (89.6%), chills (82.4%), fatigue (81.4%), headache (80.6%), feeling thirsty (76.3%), myalgia (75%), pressure in the chest (69.1%), and shortness of breath (68.3%), respectively. Area of residence (odds ratio [OR], 2.26; 95% CI, 1.96–2.49, P = .01), number of family members (OR, 1.45; 95% CI ,1.08–1.87; P &lt;.001), and population density (OR, 2.43; 95% CI, 2.15–3.01; P = .001) were associated with higher odds of co-infection. We found that coinfected participants had a 4 times higher risk of developing severe health conditions (OR, 4.22; 95% CI, 4.11–4.67; P = .02).

Conclusions
This is one of the early epidemiologic studies of co-infection of dengue and COVID-19 in Bangladesh.
Topographical and Refractive Outcomes After Corneal Cross-linking in Novice Scleral Lens Users
Authors: Aisien Faith , Di Meglio Laura , Bower Kraig , Crum Amanda 
Published: January 2025

Objective:
To determine if scleral fittings that occur before corneal cross-linking (CXL) are still successful after the procedure.

Methods:
This prospective study included seven patients with keratoconus or post–laser-assisted in situ keratomileusis (LASIK) corneal ectasia who were fitted with scleral lenses then underwent CXL. Four patients (six eyes) had keratoconus and three patients (five eyes) had post-LASIK ectasia. Topographic and refractive parameters, as well as uncorrected visual acuity, best spectacle-corrected visual acuity, and scleral lens–corrected visual acuity were collected preoperatively and compared with values 1 and 3 months postoperatively.

Results:
Ten eyes had no significant change in refractive parameters from baseline to 3 months (P>0.05). Nine eyes had no significant change in Km (mean keratometry), K2 (steep keratometry), Kmax (maximal corneal curvature), or pachymetry from baseline to 3 months (P>0.05). On average, there was no significant difference regarding scleral lens or topographic measurements preoperatively versus postoperatively (P>0.05).

Conclusion:
On average, no significant differences were observed between preoperative and postoperative corneal measurements or refractive correction. These findings suggest that scleral fittings could be introduced before CXL to expedite the process of lens prescription and future acquisition. Safe scleral lens use with a lens fit before surgery could resume 1 month postoperatively.
Lacrimal Sac CLL: A Review of Clinical Features, Investigations, and Management
Authors: Reigler Oliver , Ben Ishai Meydan , Oliphant Huw 
Published: January 2025

Purpose:
This study reviews all reported cases of lacrimal gland chronic lymphocytic leukemia (CLL) to identify patterns in clinical presentation, diagnosis, and management to aid in early recognition and treatment of this uncommon occurrence.

Methods:
A comprehensive search of medical literature databases was performed to identify studies reporting lacrimal sac involvement in CLL from 1970 to 2024. Data were extracted regarding demographics, symptoms, diagnostic methods, treatment, and outcomes.

Results:
Thirty-three cases of CLL lacrimal sac infiltration were identified. The median age was 71, with a slight female predominance of 54.5%. The most common symptoms were epiphora (63.6%) and pseudo-dacryocystitis or symptoms of dacryocystitis (48.5%). A significant proportion of patients (87.9%) had a known history of CLL at presentation. Chemotherapy combined with surgery was the most frequent treatment, 48.4%, with a positive response in 93.3% of patients. Local recurrence occurred in 10.3% of cases, predominantly in those treated with chemotherapy and surgery, or surgery alone.

Conclusions:
Lacrimal sac CLL, though rare, should be considered in patients with nasolacrimal duct obstruction, especially those with a prior CLL diagnosis. Early diagnosis can be aided by imaging and histopathological evaluation, and treatment typically results in favorable outcomes with low recurrence rates. Tailoring treatment based on individual patient factors is essential for optimal management.
The Epidemiology and Treatment Outcomes of Facial Nerve Palsy Using a Population-Based Method
Authors: Hwang Christopher J. , Alshami Sarah , Hodge David O. , Bradley Elizabeth A. 
Published: January 2025

Purpose:
To update the epidemiological patterns of facial nerve palsy (FNP) in Olmsted County, MN.

Methods:
A retrospective chart review using the Rochester Epidemiology Project database was conducted. Patients aged ≥18 years receiving a diagnosis of FNP within the Rochester Epidemiology Project database from the years 2000 to 2010 were included in the study. Data collected included age, gender, cause of FNP, degree of paralysis, medical and/or surgical management, and outcomes. Overall incidence rates were determined using gender-specific population figures for Olmsted County. Incidence trends were compared with previous Rochester Epidemiology Project studies.

Results:
The most common cause for FNP was Bell palsy (70.3% of cases). The overall incidence rate for Bell palsy in Olmsted County from 2000 to 2010 was 39.9 (95% CI, 36.1–43.7) per 100,000 person-years. This is an absolute increase of 14.9 per 100,000 person-years and a 60% relative increase in Bell palsy compared with a previous study performed at Mayo Clinic using the Rochester Epidemiology Project database population data from 1968 to 1982. Patients were infrequently evaluated by an ophthalmologist (8.4% of cases), and surgical intervention to address ophthalmic sequelae was rare (1.7% of cases).

Conclusions:
The incidence of Bell palsy has increased dramatically over previous studies, which has occurred in the setting of declining herpes simplex virus type 1 seropositivity trends and increasing herpes zoster incidence in the United States. Few patients with FNP are referred to ophthalmologists, which may represent a gap in care for both acute and long-term ophthalmic sequelae.
Toxic Anterior Segment Syndrome: A 2012-2022 Update on the Most Common Causes
Authors: Yao Melissa , Mudalegundi Shwetha , Eid Kevin , Bundogji Nour , Kelkar Neil , Werner Liliana , Mamalis Nick 
Published: January 2025

Purpose:
To identify trends in the reporting of toxic anterior segment syndrome (TASS) to the American Society of Cataract and Refractive Surgery (ASCRS) TASS Force from 2012-2022.

Setting:
John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.

Design:
Cross-sectional study.

Methods:
TASS questionnaires on instrument cleaning and sterilization, and extraocular and intraocular products used during cataract surgery were available on the American Society of Cataract and Refractive Surgery website. A retrospective analysis of questionnaires submitted by surgical centers reporting cases of TASS was performed between January 1, 2012, and December 31, 2022, to identify commonly held practices that could cause TASS.

Results:
Data from 77 questionnaires were analyzed. The reporting centers performed 56,319 cataract surgeries and reported 539 cases of TASS from January 1, 2012, to December 31, 2022. Common practices associated with the TASS outbreaks in the surveys included re-use of single-use cannulas, phacoemulsification, and irrigation/aspiration tips (69%), use of enzymatic cleaners (40%), inadequate flushing of phacoemulsification and irrigation/aspiration handpieces (27%), reuse of phacoemulsification tubing (22%), use of preservative-containing intracameral anesthetic (18%), and addition of antibiotics to balanced salt solution (17%).

Conclusions:
The surveys identified commonly held practices associated with TASS while showcasing trends over the past 10 years. Understanding these findings and the safe alternatives will allow surgical center personnel to change their practices as needed to prevent this complication.
Insufficient pretransplant induction therapy is associated with diffuse intrahepatic cholangiopathy in ABO-incompatible living donor liver transplantation for acute liver failure
Authors: Hu Chih-Yao , Chen Cheng-Yen , Tsai Hsin-Lin , Le Hao-Jan , Tsou Yi-Fan , Kuo Fang-Cheng , Tsai Pei-Chin , Chung Meng-Hsuan , Chou Shu-Cheng , Wang Shen-Chih , Hsia Cheng-Yuan , Loong Che-Chuan , Liu Chin-Su , Lin Niang-Cheng 
Published: January 2025

Background:
ABO-incompatible liver transplantation (ABOi LT) can now be successfully performed with standard pretransplant induction therapy. For patients with chronic end-stage liver disease (ESLD), ABOi LT can achieve long-term outcomes comparable to those of blood type-compatible (ABOc) LT. Outcomes of patients with acute liver failure (ALF) who undergo urgent transplantation surgery with a limited induction period should be further investigated.

Methods:
Between 2004 and 2023, adult patients who underwent living donor liver transplantation (LDLT) at Taipei Veterans General Hospital were enrolled. Based on the chronicity of liver disease and the transplant type, patients were divided into 4 groups for outcome analysis: ALF patients who received ABOi LDLT, ALF patients who received ABOc LDLT, ESLD patients who received ABOi LDLT, and ESLD patients who received ABOc LDLT.

Results:
Four instances of diffuse intrahepatic cholangiopathy (DIC) occurred in the ABOi LDLT group (n=3, 27.3% in group 1 and n=1, 2.6% in group 3, p=0.03). In ABOi LDLT patients, rituximab was administered closer to LT in group 1 (5 [3~6] days before LDLT) than that in group 3 (15 [14~22] days before LDLT) (p<0.01). Univariate analysis revealed that ALF, small graft-to-recipient weight ratio (GRWR), low rituximab dose (<210 mg/m 2) and postoperative rebound of isoagglutinin immunoglobulin M (IgM) antibody titers were factors contributing to an increased risk of DIC. Allograft loss eventually occurred in 3 of the 4 patients with DIC. Overall, ABOi LDLT showed inferior long-term outcomes for ALF (5-year patient survival: 62.3%/73.6%/74.1%/76.7% in groups 1/2/3/4, respectively, p=0.25).

Conclusion:
ABOi LDLT achieved outcomes comparable to those of ABOc LDLT among ESLD patients but not among ALF patients. DIC results in a high risk of allograft loss; however, the combination of potent immunosuppressive agents and early recognition of antibody rebound and the initiation of salvage treatment may improve long-term outcomes among these patients.
Type II Lepra Reaction With Idiopathic Intracranial Hypertension: A Case Report With Challenges in Diagnosis and Management
Authors: Zhu Rui-Xuan , Jiang Yu-Meng , Zhan Yi , Xiao Rong , Yuan Shu-Juan , Zhang Gui-Ying , Chen Huan 
Published: January 2025

Introduction:
Leprosy-related type II lepra reaction (T2LR) is a rare immune-mediated complication that typically treated with glucocorticoids and thalidomide. Idiopathic intracranial hypertension (IIH) is marked by increased intracranial pressure leading to symptoms like headache and vision loss. Here we report a rare case of concomitant T2LR and IIH. Here, we reported a woman with leprosy T2LR with idiopathic intracranial hypertension

Case presentation:
A 35-year-old woman with leprosy who developed T2LR received regular glucocorticoid and thalidomide treatment for 2 years. She subsequently experienced progressive vision loss, which was initially misdiagnosed as optic neuritis. After high-dose glucocorticoid treatment, her condition worsened. The patient was later found to have elevated intracranial pressure and was ultimately diagnosed with idiopathic intracranial hypertension. She was treated with cerebrospinal fluid diversion, which relieved her symptoms. Although the exact cause of her vision loss and intracranial hypertension was unclear, it was speculated to be related to T2LR. The patient was mildly obese and had received high-dose corticosteroids, both of which are known risk factors for intracranial hypertension. T2LR is associated with increased proinflammatory cytokine levels, which can enhance choroid plexus permeability, potentially leading to intracranial hypertension.

Discussion:
IIH and T2LR are both rare conditions, and evidence suggests that inflammatory mediators in T2LR may increase choroid plexus permeability, raising intracranial pressure. In this case, mild obesity, female sex, and prolonged corticosteroid therapy for T2LR likely increase the risk for IIH. Long-term glucocorticoid use is associated with IIH, as it may increase intracranial pressure through local cortisol activation in the choroid plexus. The patient’s misdiagnosis of optic neuritis, due to a lack of typical IIH symptoms, delayed appropriate treatment and led to vision loss. This case emphasizes the importance of considering IIH in patients on chronic corticosteroids presenting with unusual vision changes.

Conclusion:
While this case may represent an extreme instance, it highlights a broader issue: prolonged steroid use can increase intracranial pressure to varying degrees, and not all patients with elevated intracranial pressure experience headaches. Clinicians should be aware of this possibility in patients undergoing long-term steroid treatment and conduct thorough evaluations to detect such complications.
Exertional Compartment Syndrome Strategies for Evaluation and Management
Authors: Strauss Michael , Wilson Katherine , Xian Sammy , Chan Adam 
Published: January 2025

Objective:
The exertional compartment syndrome (ECS) is often a delayed diagnosis. Compartment pressure measurements (CPM) confirm the diagnosis. Herein we present our algorithm for the evaluation and management (E&M) of ECS. It avoids multiple CPM and shows the importance of the history and examination for E&M of the ECS.

Design:
A literature review showed that limb abnormalities are hardly ever mentioned. Subsequently we show how the history, examination (for recognizing abnormalities), and CPM integrate with our algorithm for E&M of the ECS.

Setting:
Our algorithm evolved for a 32-year interval and approximately 150 ECS evaluations.

Patients:
Our E&M method was used for the above complement of patients.

Interventions:
The symptomatic muscle compartment(s) and the severity of pain during the inciting activity are ascertained. The examination detects abnormalities and tautness of muscle compartments. This information integrated into our ECS algorithm establishes which compartments need CPM.

Main Outcome Measures:
Pain severity is quantified on a 0- to 10-point scale. This information is integrated with history, examination findings, and CPMs to guide E&M for a range of ECS presentations.

Results:
Abnormalities detected on the examination often explain why ECS occurs. This information is valued by the patient, minimizes CPM, and offers sound advice for E&M.

Conclusions:
Our article heightens awareness of the ECS diagnosis for all levels of care providers. It objectifies pain severity, shows the importance of the examination, and minimizes ECM in giving advice to the referral sources.
Cutaneous Intertriginous Langerhans Cell Histiocytosis in Adults: A Case Report and Systematic Review
Authors: Mansfield Patricia K. , Tinker Daniel , Smith Emily , Burkemper Nicole M. , Smith Kristin , Guo Aibing Mary 
Published: January 2025

Objective
Authors characterized all published adult cases of cutaneous, intertriginous Langerhans cell histiocytosis (LCH) to bring this clinical presentation to the attention of clinicians. We emphasize the morphology, histopathology, immunohistochemical profiles, and genetic mutations associated with these cases.

Materials and Methods
A systematic review of the National Center for Biotechnology Information's PubMed was conducted, utilizing the following specific key words to identify all adult LCH patients with cutaneous intertriginous involvement: “Intertriginous Langerhans,” “Vulvar Langerhans,” “Genital Langerhans,” “Perineal Langerhans,” “Perianal Langerhans,” “Intergluteal Langerhans,” “Inguinal Langerhans,” “Axillary Langerhans,” and “Inframammary Langerhans.” Reports were subjected to strict inclusion criteria: case reports, case series, or meta-analyses documenting case(s) of biopsy-proven LCH with cutaneous, intertriginous involvement in adult patients (>18 years of age at the time of diagnosis).

Results
This systematic review identified 1 original and 121 published cases of biopsy-proven, cutaneous, intertriginous LCH in adult patients. Morphology commonly included eroded, ulcerated papules and plaques, and rare presentations demonstrated potential mimickers (hidradenitis suppurativa, deep fungal mycosis, condyloma accuminata).

Conclusions
This systematic review encompasses the largest compilation of adult cutaneous intertriginous LCH cases in the medical literature to our knowledge to date. This study identifies an important clinical presentation of this rare, commonly pediatric diagnosis; highlights trends among these cases and important clinical mimickers; and serves as a reminder to clinicians to maintain suspicion for LCH in adult populations, particularly in the setting of intertriginous cutaneous involvement.