bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impending HCC diagnosis in patients with cirrhosis after HCV cure features a natural killer cell signature
Authors: Engelskircher Sophie Anna , Chen Po-Chun , Strunz Benedikt , Oltmanns Carlos , Ristic Tijana , Owusu Sekyere Solomon , Kraft Anke R.M. , Cornberg Markus , Wirth Thomas , Heinrich Bernd , Björkström Niklas K. , Wedemeyer Heiner , Woller Norman 
Published: February 2024

Background and Aims:
The risk of developing HCC in chronically infected patients with AQ2 HCV with liver cirrhosis is significantly elevated. This risk remains high even after a sustained virological response with direct-acting antivirals. To date, disease-associated signatures of NK cells indicating HCC development are unclear.

Approach and Results:
This study investigated NK cell signatures and functions in 8 cohorts covering the time span of HCC development, diagnosis, and onset. In-depth analysis of NK cell profiles from patients with cirrhosis who developed HCC (HCV-HCC) after sustained virological response compared with those who remained tumor-free (HCV-noHCC) revealed increasingly dissimilar NK cell signatures over time. We identified expression patterns with persistently high frequencies of TIM-3 and CD38 on NK cells that were largely absent in healthy controls and were associated with a high probability of HCC development. Functional assays revealed that the NK cells had potent cytotoxic features. In contrast to HCV-HCC, the signature of HCV-noHCC converged with the signature found in healthy controls over time. Regarding tissue distribution, single-cell sequencing showed high frequencies of these cells in liver tissue and the invasive margin but markedly lower frequencies in tumors

Conclusions:
We show that HCV-related HCC development has profound effects on the imprint of NK cells. Persistent co-expression of TIM-3hi and CD38+ on NK cells is an early indicator for HCV-related HCC development. We propose that the profiling of NK cells may be a rapid and valuable tool to assess the risk of HCC development in a timely manner in patients with cirrhosis after HCV cure.
Dose Measurements at Provision Proton Therapy Center
Authors: Burahmah Naser , Heilbronn Lawrence 
Published: February 2024

Abstract
Proton therapy is an advanced method for treating cancerous tumors, and its adoption has expanded significantly in recent years. The production of high-energy protons, however, may result in the creation of secondary neutrons and gamma rays. Hence, ensuring radiation safety at proton therapy centers is crucial, with shielding playing a vital role. This study aimed to evaluate the efficacy of the shielding implemented at the Provision Proton Therapy center in Knoxville, TN, USA. For this purpose, we measured and compared gamma ray radiation levels within the treatment room and the facility’s roof. These measurements were conducted using a NaI(Tl) scintillator detector. The PHITS Monte Carlo code was used to deconvolute the incident spectrum using detector response functions. Findings reveal that the facility’s shielding effectively protects the general public from gamma ray radiation, with the effective dose within the treatment room being minimal and dose on the roof was comparable to background radiation levels. However, it is important to note that this study did not address the issue of secondary neutron radiation field, which is an important aspect of dose and radiation safety in proton therapy centers.
A Review of the Resuspension of Radioactively Contaminated Particles by Vehicle and Pedestrian Traffic—Current Theory, Practice, Gaps, and Needs
Authors: Kaminski Michael D. , Daiyega Nico , Magnuson Matthew 
Published: February 2024

Abstract
The resuspension of radioactively contaminated particles in a built environment, such as from urban surfaces like foliage, building exteriors, and roadways, is described empirically by current plume and dosimetry models used for hazard assessment and long-term risk purposes. When applying these models to radiological contamination emergencies affecting urban areas, the accuracy of the results for recent contamination deposition is impacted in two main ways. First, the data supporting the underlying resuspension equations was acquired for open, quiescent conditions with no vehicle traffic or human activities, so it is not necessarily representative of the urban environment. Second, mechanical disturbance by winds in urban canyons and during emergency operations caused by vehicle traffic and human activities are not directly considered by the equations. Accordingly, plume and dosimetry models allow the user to input certain compensating values, but the models do not necessarily supply users instructions on what values to use. This manuscript reviews the available literature to comprehensively and consistently pool data for resuspension due to mechanically induced resuspension applicable to urban contamination. Because there are few studies that directly measured radioactive resuspension due to vehicles and pedestrians, this review novelly draws on a range of other studies involving non-radioactive particles, ranging from outdoor air pollution emissions to indoor allergen transport. The results lead to tabulated, recommended values for specific conditions in the emergency phase to help users of plume and dosimetry models maintain the conservativeness needed to properly capture the potential radiation dose posed by mechanically induced resuspension. These values are of benefit to model users until better data are available. The results also suggest the types of data that may result in improved plume and dose modeling.
Evaluation of the German Version of the Keratoconus Outcomes Research Questionnaire
Authors: Pomberger Leon , Tasch Lisa , Lundström Mats , Waser Klemens , Khalil Haidar , Kronschläger Martin , Hirnschall Nino , Bolz Matthias 
Published: February 2024

Purpose:
To translate, validate, and evaluate the psychometric properties of the German version of Keratoconus Outcomes Research Questionnaire (KORQ).

Methods:
This prospective study included 3 phases. In phase 1, the KORQ was translated in a standardized way; in phase 2, Rasch validation was performed; in phase 3, the validated questionnaire was evaluated in a separate patient cohort. All patients answered the German KORQ. Scheimpflug imaging (Pentacam) and optical coherence tomography scans (MS-39) were conducted. Corneal imaging measurements were correlated with patient-reported outcome measures.

Results:
After standardized translation, 100 patients self-administered the German KORQ. Rasch analysis was conducted for psychometric testing of the KORQ. Based on the results of the Rasch analysis, the original German version of the KORQ was modified and any items showing a misfit were excluded. This resulted in a new shortened version of the KORQ, which was evaluated in 30 patients. The revised German KORQ met the criteria of Rasch analysis and showed excellent internal consistency reliability and convergent validity. The correlation between the KORQ score and various clinical measurements was examined using Spearman correlation. A significant moderate correlation was observed between the D (r = 0.237; P = 0.006) and Kmax (r = 0.162; P = 0.065) values of Pentacam. Inverse correlations were observed for thinnest pachymetry measured with MS-39 (r = −0.167; P = 0.058) and best corrected visual acuity (r = −0.210; P = 0.016).

Conclusions:
The shortened German KORQ met the assumptions of the Rasch model and displayed satisfactory psychometric properties. The German KORQ could be adopted as a powerful patient-reported outcome measures tool for German-speaking patients with keratoconus in the future.
Pulmonary Complications of Cytomegalovirus Infection in Neonates and Infants: A Systematic Review of Case Reports and Pooled Analysis
Authors: Ong Leong Tung , Fan Si Wei David 
Published: February 2024

Background:
Cytomegalovirus (CMV) causes intrauterine infections in 0.67% of neonates, with 12.7% displaying symptoms at birth. CMV can lead to severe multiorgan involvement, and mortality in symptomatic cases is around 30%. Pulmonary complications are rare in infants with CMV. This review assesses pulmonary complications and outcomes in infants with CMV infection.

Methods:
A systematic literature search was conducted using PubMed, SCOPUS and Ovid SP to retrieve case reports on pulmonary complications in infants with congenital or perinatal CMV infection. Descriptive analysis and pooled analysis were conducted for the case reports.

Results:
A total of 28 articles with 38 patients were included in this systematic review. The reported pulmonary complications in the case reports were CMV pneumonitis (34.2%), persistent pulmonary hypertension of the newborn (18.4%), emphysema and chronic lung disease (15.8%), diaphragmatic dysfunction (13.2%), lung cysts and calcifications (10.5%), Pneumocystis jirovecii infection (7.9%), pulmonary hypoplasia (5.3%) and bronchial atresia (2.6%). Seven (18.4%) of 38 patients passed away because of the pulmonary complications of CMV infection. Congenital transmission (P = 0.0108), maternal CMV (P = 0.0396) and presence of neonatal comorbidities (P = 0.0398) were independent risk factors for mortality.

Conclusions:
This systematic review demonstrated infrequent occurrence of severe pulmonary involvement in CMV infection but should be considered in infants with persistent or severe respiratory symptoms.
Vaccine Associated Measles Complicated by Suspected Measles Inclusion Body Encephalitis in a Pediatric Leukemia Patient and Stem Cell Transplant Recipient: A Focus on Clinical Evolution and Management
Authors: Kushner Lauren E. , Kamens Jennifer , Bertaina Alice , Shyr David , Gans Hayley A. 
Published: February 2024

Background:
Immunocompromised individuals are at increased risk for severe disease and complications from viral infections, highlighting the importance of vaccination. However, in extremely rare situations, vaccine associated viral infections can be associated with disseminated disease and complications in immunocompromised hosts.

Case:
Herein, we present a case of a 1-year-old child diagnosed with acute myeloid leukemia less than 2 weeks after receiving live viral vaccines who developed acute vaccine-strain measles virus disease, later complicated by central nervous system involvement following hematopoietic stem cell transplantation. A brain biopsy specimen was positive for vaccine-strain measles virus detected by reverse transcriptase polymerase chain reaction.

Management and Outcome:
She was treated with intravenous ribavirin, inosine pranobex, intrathecal interferon-alpha and donor lymphocyte infusion following measles-mumps-rubella vaccine boost. Despite these measures, the patient suffered neurologic decline and dysautonomia, expiring after compassionate extubation. Management and ideal risk mitigation strategies are discussed within the context of existing literature for this rare complication.
Quantitative sensory testing, psychological factors, and quality of life as predictors of current and future pain in patients with knee osteoarthritis
Authors: Hertel Emma , Arendt-Nielsen Lars , Olesen Anne Estrup , Andersen Michael Skipper , Petersen Kristian Kjær-Staal 
Published: February 2024

Abstract
Substantial interindividual variability characterizes osteoarthritis (OA) pain. Previous findings identify quantitative sensory testing (QST), psychological factors, and health-related quality of life as contributors to OA pain and predictors of treatment outcomes. This exploratory study aimed to explain baseline OA pain intensity and predict OA pain after administration of a nonsteroidal anti-inflammatory drug in combination with paracetamol for 3 weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score was used to estimate OA pain presentation. One hundred one patients were assessed at baseline and follow-up using QST (pressure pain thresholds and temporal summation of pain [TSP]), symptoms of depression and anxiety, pain catastrophizing scales (PCSs), and health-related quality of life. Linear regression with backward selection identified that PCS significantly explained 34.2% of the variability in baseline KOOS pain, with nonsignificant contributions from TSP. Pain catastrophizing score and TSP predicted 29.3% of follow-up KOOS pain, with nonsignificant contributions from symptoms of anxiety. When assessed separately, PCS was the strongest predictor (32.2% of baseline and 24.1% of follow-up pain), but QST, symptoms of anxiety and depression, PCS, and quality of life also explained some variability in baseline and follow-up knee OA pain. Further analyses revealed that only TSP and PCS were not mediated by any other included variables, highlighting their role as unique contributors to OA pain presentation. This study emphasizes the importance of embracing a multimodal approach to OA pain and highlights PCS and TSP as major contributors to the baseline OA pain experience and the OA pain experience after OA treatment.
Immune-related signature identifies IL1R2 as an immunological and prognostic biomarker in pancreatic cancer
Authors: Wang Chengcheng , Chen Yuan , Yin Xinpeng , Xu Ruiyuan , Ruze Rexiati , Song Jianlu , Hu Chenglin , Zhao Yupei 
Published: February 2024

Objective:
Pancreatic cancer is one of the most aggressive malignancies, a robust prognostic signature and novel biomarkers are urgently needed for accurate stratification of the patients and optimization of clinical decision-making.

Methods:
A list of bioinformatic analysis were applied in public dataset to construct an immune-related signature. Furthermore, the most pivotal gene in the signature was identified. The potential mechanism of the core gene function was revealed through GSEA, CIBERSORT, ESTIMATE, immunophenoscore (IPS) algorithm, single-cell analysis, and functional experiment.

Results:
An immune-related prognostic signature and associated nomogram were constructed and validated. Among the genes constituting the signature, interleukin 1 receptor type II (IL1R2) was identified as the gene occupying the most paramount position in the risk signature. Meanwhile, knockdown of IL1R2 significantly inhibited the proliferation, invasion, and migration ability of pancreatic cancer cells. Additionally, high IL1R2 expression was associated with reduced CD8+ T cell infiltration in pancreatic cancer microenvironment, which may be due to high programmed cell death-ligand-1 (PD-L1) expression in cancer cells. Finally, the IPS algorithm proved that patients with high IL1R2 expression possessed a higher tumor mutation burden and a higher probability of benefiting from immunotherapy.

Conclusion:
In conclusion, our study constructed an efficient immune-related prognostic signature and identified the key role of IL1R2 in the development of pancreatic cancer, as well as its potential to serve as a biomarker for immunotherapy efficacy prediction for pancreatic cancer.
Evaluation of a Radiological Tool for Semiautomatic Scalar Translocation Detection After Cochlear Implantation
Authors: Arends Sebastiaan R.S. , Briaire Jeroen J. , Geiger Stephan , Nauwelaers Tim , Frijns Johan H.M. 
Published: February 2024

Objective
To evaluate the clinical applicability of a semiautomatic radiological tool for scalar translocation detection.

Study Design
Retrospective study.

Setting
Tertiary care academic center.

Patients
We included 104 patients implanted with 116 HiFocus Mid-Scala electrode arrays between January 2013 and September 2016.

Intervention
Cochlear implantation.

Main Outcome Measures
The tool's scalar position assessments were compared with manual ones by calculating intraclass coefficient (ICC) for individual contacts and sensitivity and specificity for translocation detection of the whole array. In addition, ICC was calculated for diameters A and B, ratio A/B, and angular insertion depth (AID).

Results
Nine-one percent of cases could be processed, which took 5 to 10 minutes per case. Comparison of manual and semiautomatic scalar position showed for individual contacts an ICC of 0.89 and for the whole array a sensitivity of 97% and a specificity of 96%. ICCs for A, B, and A/B were 0.82, 0.74, and 0.39 respectively. For AID, ICC of each of the 16 contacts was 0.95 or higher.

Conclusions
The semiautomatic radiological tool could analyze most cases and showed good to excellent agreement with manual assessments for translocation detection, diameter A, diameter B, and AID. The variability between semiautomatic and manual measurements is comparable to interobserver variability, indicating that clinical implementation of the tool is feasible.
Treatment of primary vaginal malignant melanoma and review of previous literature: A case report
Authors: Bai Suning , Wu Qi , Song Liyun , Wu Wenfei 
Published: February 2024

Introduction:
Primary vaginal malignant melanoma is a rare gynecological malignant tumor with high malignancy and poor prognosis. Because of its insidious incidence, it is generally diagnosed in the late stage, and the 5-year survival rate is only 5% to 25%. Due to the rarity of this disease and the limited number of related cases reported in the literature, there is currently no unified standard for its diagnosis and treatment. Therefore, the treatment of this disease has always been a difficult problem in clinical practice.

Patient concerns:
A 56-year-old woman was admitted to our hospital with discomfort in the lower abdomen.

Diagnosis:
The final diagnosis of this patient was vaginal malignant melanoma (T4N1M0).

Interventions:
The patient underwent extensive hysterectomy, bilateral adnexectomy, pelvic lymph node resection, and total vaginectomy. Following the surgery, the patient received adjuvant chemotherapy.

Outcomes:
The patient was followed up regularly. No recurrence or metastasis has been reported to date.

Conclusion:
The treatment of primary vaginal malignant melanoma is still dominated by surgery, while radiotherapy and chemotherapy are controversial. Immunotherapy and targeted therapy highlight certain advantages in advanced patients, which still need to be verified by large sample studies, We provide a case of postoperative adjuvant chemotherapy for vaginal malignant melanoma. So far, no signs of disease recurrence have been found. As the price of chemotherapy drugs decreases, it is economically convenient and acceptable for most patients, but its effectiveness needs to be observed in large-scale clinical trials.
Acute endocarditis complicated by left ventricular pseudoaneurysm with acute bloody pericardial effusion: A case report
Authors: Shimada Akie , Yamamoto Taira , Dohi Shizuyuki , Yokoyama Yasutaka , Endo Daisuke , Tabata Minoru 
Published: February 2024

Rationale:
Delay in seeking medical attention for high fever and inadequate diagnosis can lead to rapid progression of inflammation and spread to surrounding tissues and organs. Staphylococcus aureus is a common cause of systemic infections, and infectious endocarditis can swiftly become severe; therefore, careful management is required.

Patient concerns:
A 54-year-old woman was admitted to our hospital with high fever and progressive loss of consciousness. Meningitis was suspected, and antibiotic treatment was initiated. Blood culture revealed methicillin-sensitive Staphylococcus aureus. Subsequently, the patient developed hypotension, bradycardia, and cardiac arrest and underwent emergency cardiopulmonary resuscitation.

Diagnoses:
Transesophageal echocardiography performed during the procedure revealed significant vegetation at the posterior leaflet of the mitral valve, an abscess at the valve annulus, and a pseudoaneurysm of the left ventricular posterior wall.

Interventions:
The patient underwent emergency small incision pericardiotomy drainage, and her blood pressure and heart rate stabilized. After pericardial drainage, acute renal failure, fulminant hepatitis, and disruption of coagulation function were observed, and she was treated with plasma exchange therapy and intravenous immunoglobulin. Resection of the huge vegetation, debridement, patch closure of the ventricular perforation, and mitral valve replacement were performed.

Outcomes:
Surgical findings showed massive vegetation in the posterior leaflet of the mitral valve, an annular abscess in the posterior leaflet of the mitral valve connected to the left ventricular posterior wall, and a pseudoaneurysm. Postoperatively, her pseudoaneurysm resolved and her cardiac function stabilized, while circulatory failure due to bacteremia progressed, and she gradually developed acidosis and unstable blood pressure. Plasma exchange and continuous hemodiafiltration were continued; however, she died of progressive multiorgan failure.

Lesson:

Staphylococcus aureus bacteremia can cause fatal complications. Even when symptoms of meningitis are suspected, it is essential to examine the patient for endocarditis. Delayed diagnosis can lead to fatal endocarditis-related complications.
Surgical treatment of male breast cancer metastasis to thoracic spine: A case report
Authors: Ko Jong-Hyun , Kim Jong-Hong , Ham Dong-Hun 
Published: February 2024

Purpose:
We present a rare clinical case of a metastatic spinal tumor in the 7th thoracic spine from male breast cancer (MBC).

Method:
A 62-year-old man was referred as an outpatient, complaining of continuous pain in the back and right flank that began 2 weeks earlier. The patient had no neurologic signs or symptoms but had a medical history of left breast modified radical mastectomy because of MBC. Computed tomography and magnetic resonance imaging showed metastasis in the T7 vertebra and no other metastasis on positron emission tomography/computed tomography or bone scan. Separation surgery was performed with posterior corpectomy of T7 (en bloc excision), followed by stabilization with an expandable titanium cage and pedicle screws. The pathological examination of the excised T7 vertebra confirmed metastatic carcinoma with neuroendocrine differentiation from the breast. Adjuvant chemo-radiotherapy was performed after surgery.

Results:
The patient had no symptoms at the 21-month follow-up. Radiologic studies showed no evidence of recurrent or metastatic lesions.

Conclusion:
MBC is extremely rare, with fewer cases of spinal metastases. Among these, patients who undergo separation surgery are even rarer. This case shows that radical surgery can be an option for MBC with spine metastasis if indicated.