bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ketorolac-induced anaphylaxis following oral administration: a case series
Authors: Yogi Tek N. , Bhusal Amrit , Kafle Rijan , Labh Sujal , Pokhrel Sagar 
Published: October 2023

Background:
Ketorolac is a commonly used non-steroidal anti-inflammatory drug for reducing pain and inflammation. Anaphylaxis is a medical emergency that occurs after exposure to an allergen, with a varied clinical presentation requiring prompt and appropriate measures to prevent or manage it. Although uncommon, ketorolac can cause anaphylaxis requiring immediate medical care. The authors present two cases of anaphylaxis in females induced after oral intake of ketorolac with successful outcomes.

Case presentations:
The cases involve two adult women who experienced an allergic reaction to ketorolac. The first woman, aged 36, and the second woman, aged 26, on her second postpartum day, both developed similar types of symptoms like periorbital swelling, itching, and difficulty breathing after taking oral ketorolac. The second woman had a history of allergic rashes. They received immediate treatment with epinephrine, oxygen therapy, intravenous fluids, and other medications. They showed a rapid improvement and were discharged after observation.

Clinical discussion:
Anaphylactic reactions to ketorolac, a commonly used pain management drug, have been reported. Symptoms include swelling, difficulty breathing, and hypotension. Treatment involves medications like epinephrine, hydrocortisone, and pheniramine. A detailed medical history, laboratory investigations, appropriate medication, oxygen therapy, and follow-up care are important in managing anaphylactic reactions, which can be life-threatening.

Conclusion:
Although rare, ketorolac can cause anaphylactic reactions in patients with or without a history of drug allergy. Immediate recognition and management are essential, along with a detailed medical history and follow-up care.
A potential protective role of congenital peritoneal encapsulation coexisting with metastatic colon cancer: a rare case report
Authors: Ahmad Youssef , Fahed Joud , Mousa Jebrail , Souleiman Fadi 
Published: October 2023

Introduction and importance:
Congenital peritoneal encapsulation (CPE) is a rare condition in which the small intestine is encased within a mesothelial-lined sac. The following case is an extremely rare description of the co-existence of both colon cancer and peritoneal encapsulation, highlighting the potential role of this co-existence in preventing the spread of metastases and tumor implantation.

Case-presentation:
A 60-year-old female was diagnosed with metastatic colon cancer. During the operation, a thin fibrous membrane was found covering the small intestine, which suggested CPE. The tumor was removed, and the additional membrane was totally excised. The patient is currently receiving chemotherapy for metastatic treatment and is in good health.

Clinical discussion:
CPE is a medical condition that results from abnormal peritoneal development, and it is often confused with other differential diagnoses resulting from inflammatory causes. It can occur at different ages and remains asymptomatic for the majority of cases. However, it can be a potential cause of bowel obstruction. An intraoperative diagnosis can easily differentiate the case. The co-existence with colon cancer has been described only once in the literature.

Conclusion:
Peritoneal encapsulation is a rare, mostly asymptomatic condition. However, it may play a protective role in preventing metastatic colon cancer from affecting the small intestine, thus potentially opening up new avenues for the treatment of cancer metastases.
CD8+ T-cell priming is quantitatively but not qualitatively impaired in people with HIV-1 on antiretroviral therapy
Authors: Cabral-Piccin Mariela P. , Briceño Olivia , Papagno Laura , Liouville Benjamin , White Eoghann , Perdomo-Celis Federico , Autaa Gaëlle , Volant Stevenn , Llewellyn-Lacey Sian , Fromentin Rémi , Chomont Nicolas , Price David A. , Sáez-Cirión Asier , Lambotte Olivier , Katlama Christine , Appay Victor 
Published: October 2023

Background:
The induction of de novo CD8+ T-cell responses is essential for protective antiviral immunity, but this process is often impaired in people with HIV-1 (PWH). We investigated the extent to which the immune competence of naive CD8+ T cells, a key determinant of priming efficacy, could be preserved or restored in PWH via long-term antiretroviral therapy (ART).

Methods:
We used flow cytometry, molecular analyses of gene transcription and telomere length, and a fully validated priming assay to characterize naive CD8+ T cells ex vivo and evaluate the induction of antigen-specific effector/memory CD8+ T cells in vitro, comparing age-matched healthy uninfected donors (HUDs), PWH on ART, and natural HIV-1 controllers (HICs).

Results:
We found that naive CD8+ T cells were numerically reduced and exhibited a trend toward shorter telomere lengths in PWH on ART compared with HUDs and HICs. These features associated with impaired priming efficacy. However, we also found that naive CD8+ T cells were fully equipped proliferatively and transcriptionally in PWH on ART, enabling the generation of antigen-specific effector/memory CD8+ T cells with functional and phenotypic attributes comparable to those primed from HUDs.

Conclusion:
Our data suggest that naive CD8+ T cells in PWH on ART are intrinsically capable of generating functionally and phenotypically intact effector/memory CD8+ T cells in response to antigen, despite evidence of senescence and an overall numerical reduction that compromises priming efficacy relative to HUDs and HICs.
Increased 68Ga-FAPI Uptake in Pulmonary Sclerosing Pneumocytoma
Authors: Li Hongyan , Li Chongjiao , Tian Yueli , Wen Bing , He Yong 
Published: October 2023

Abstract
Pulmonary sclerosing pneumocytoma is a rare benign neoplasm arising from the primitive respiratory epithelium. Here, we report 68Ga-FAPI PET/CT findings of pulmonary sclerosing pneumocytoma in a 55-year-old woman. The images showed a solitary pulmonary mass in the left lower lobe with intense 68Ga-FAPI uptake. Our case illustrates that the sclerosing pneumocytoma should be taken into consideration as one of the differential diagnoses in lung nodules/masses with intense 68Ga-FAPI uptake.
Association between Surgeon/anesthesiologist Sex Discordance and One-year Mortality Among Adults Undergoing Noncardiac Surgery
Authors: Etherington Cole , Boet Sylvain , Chen Innie , Duffy Melissa , Mamas Mamas A. , Eddeen Anan Bader , Bateman Brian T. , Sun Louise Y. 
Published: October 2023

Objective:
To investigate the association between surgeon-anesthesiologist sex discordance and patient mortality after noncardiac surgery.

Summary Background Data:
Evidence suggests different practice patterns exist amongst female and male physicians. However, the influence of physician sex on team-based practices in the operating room and subsequent patient outcomes remains unclear in the context of noncardiac surgery.

Methods:
We conducted a population-based, retrospective cohort study of adult Ontario residents who underwent index, inpatient noncardiac surgery between January 2007 and December 2017. Primary exposure was physician sex discordance (i.e., surgeon and anesthesiologist were of the opposite sex). The primary outcome was 1-year mortality. The association between physician sex discordance and patient outcomes was modeled using multivariable Cox proportional hazard regression with adjustment for relevant physician, patient, and hospital characteristics.

Results:
Of 541,209 patients, 158,084 (29.2%) were treated by sex-discordant physician teams. Physician sex discordance was associated with a lower rate of mortality at 1 year (5.2% vs. 5.7%; adjusted HR 0.95 [0.91-0.99]). Patients treated by teams composed of female surgeons and male anesthesiologists were more likely to be alive at 1 year than those treated by all-male physician teams (adjusted HR 0.90 [0.81-0.99]).

Conclusions:
Noncardiac surgery patients had a lower likelihood of 1-year mortality when treated by sex discordant surgeon-anesthesiologist teams. The likelihood of mortality was further reduced if the surgeon was female. Further research is needed to explore the underlying mechanisms of these observations and design strategies to diversify OR teams to optimize performance and patient outcomes.
Management of Pericardial Effusion in Patients with Solid Tumor
Authors: Choe Jennie K. , Byun Alexander J. , Robinson Eric , Drake Lauren , Tan Kay See , McAleer Eileen P. , Schaffer Wendy L. , Liu Jennifer E. , Chen Leon L. , Buchholz Tara , Yohannes-Tomicich Joanna , Yarmohammadi Hooman , Ziv Etay , Solomon Stephen B. , Huang James , Park Bernard J. , Jones David R. , Adusumilli Prasad S. 
Published: October 2023

Objective:
This study compared outcomes in patients with solid tumor treated for pericardial effusion with surgical drainage vs. interventional radiology (IR) percutaneous drainage and compared incidence of paradoxical hemodynamic instability (PHI) between cohorts.

Summary Background Data:
Patients with advanced-stage solid malignancies may develop large pericardial effusions requiring intervention. PHI is a fatal and underreported complication that occurs following pericardial effusion drainage.

Methods:
Clinical characteristics and outcomes were compared between patients with solid tumors who underwent surgical drainage or IR percutaneous drainage for pericardial effusion from 2010 to 2020.

Results:
Among 447 patients, 243 were treated with surgical drainage, of which 27 (11%) developed PHI, compared with 7 of 204 patients (3%) who were treated with IR percutaneous drainage (P=0.002); overall incidence of PHI decreased during the study period. Rates of reintervention (30-day: 1% vs. 4%; 90-day: 4% vs. 6%, P=0.7) and mortality (30-day: 21% vs. 17%, P=0.3; 90-day: 39% vs. 37%, P=0.7) were not different between patients treated with surgical drainage and IR percutaneous drainage. For both interventions, OS was shorter among patients with PHI than among patients without PHI (surgical drainage, median [95% confidence interval] OS, 0.89 mo [0.33–2.1] vs. 6.5 mo [5.0–8.9], P<0.001; IR percutaneous drainage, 3.7 mo [0.23–6.8] vs. 5.0 mo [4.0–8.1], P=0.044).

Conclusions:
With a coordinated multidisciplinary approach focusing on prompt clinical and echocardiographic evaluation, triage with bias toward IR percutaneous drainage than surgical drainage and post-intervention intensive care resulted in lower incidence of PHI and improved outcomes.
Anti-Ma2 Antibody-Mediated Paraneoplastic Cerebellar Degeneration and Myeloneuropathy Secondary to Lymphoma
Authors: Handzic Armin , Brossard-Barbosa Natalie , Mandell Daniel , Lou Si Kei , Margolin Edward 
Published: October 2023

Abstract:
A 61-year-old woman with a history of untreated low-grade B-cell lymphoma presented with blurry vision, unsteadiness, and worsening pain on touching skin of the upper trunk was enrolled. Blurry vision was attributed to oscillopsia from downbeat nystagmus, which later evolved into macrosaccadic oscillations. MRI brain and spine showed mild, longitudinally extensive T2 hyperintensity in the central gray matter of the spinal cord extending from the medulla to T11 level. Serum paraneoplastic panel was negative; however, she had very high titers of anti-Ma2 antibodies in cerebrospinal fluid. The diagnosis of paraneoplastic neurological syndrome was made. Empiric treatment with high dose of intravenous steroids followed by intravenous immunoglobulin infusions did not improve her symptoms. An extensive search for an underlying tumor commenced and was initially unrevealing. However, two-month follow-up positron emission tomography scan showed increased uptake in a right pulmonary nodule, which when biopsied confirmed diagnosis of extranodal marginal zone lymphoma. The final diagnosis was anti-Ma2 antibody-mediated paraneoplastic cerebellar degeneration and myeloneuropathy secondary to lymphoma.
A data-driven yield criterion for porous ductile single crystals containing spherical voids via physics-informed neural networks
Authors: Wu Liujun , Fu Jiaqi , Sui Haonan , Wang Xiaoying , Tao Bowen , Lv Pengyu , Chen Mohan , Yuan Zifeng , Duan Huiling 
Published: October 2023

Yield criteria for porous material have been widely used to model the decrease of yield strength caused by porosity during ductile failure which deserves long-term efforts in modelling to remedy the current drawbacks. To improve their accuracy, a method of building yield criteria for porous single crystals based on physics-informed neural networks (PINNs) has been developed, and the newly well-trained yield functions are capable of predicting the yield stress of porous single crystals with different porosity, stress states and crystal orientations. The reliability of the yield functions is guaranteed by the precise datasets generated by the crystal plasticity finite-element method. In particular, through embedding the associated flow rule into the training process, the PINN-based yield function not only achieves higher accuracy in comparison with the analytical methods (e.g. variational nonlinear homogenization or limit analysis) but also avoids the improper appearance of grooves that happens in feed-forward neural networks. The proposed framework enjoys an excellent portability as the yield functions can be rebuilt in the similar non-trivial procedure when new influencing factors must be introduced, which makes us believe in its potential to be extended.
Showing the limitations of available phenotypic assays to detect B. pseudomallei from clinical specimens in Nigeria
Authors: Orababa Oluwatosin Qawiyy , Adesida Solayide A. , Peters Rebecca F. , AbdulGanniyu Zainab , Olakojo Olawale , Abioye Adefunke 
Published: October 2023

Burkholderia is a genus comprising Gram-negative bacteria that are metabolically complex and versatile, thriving in frequently hostile settings. Burkholderia pseudomallei, the causative agent of melioidosis, is a prominent member of the genus and a clinical pathogen of tropical and sub-tropical regions. This pathogen is well known for its multidrug resistance nature and possible bioweapon potential. There is currently no report of the pathogen from clinical specimens in Nigeria, this might be due to misdiagnosis with phenotypic assays. This study aims to explore the accuracy in the use of phenotypic assays to accurately diagnose B. pseudomallei in Nigeria. Two hundred and seventeen (217) clinical samples and twenty-eight (28) Gram-negative clinical isolates were collected and analysed using Ashdown selective agar and monoclonal antibody-based latex agglutination. The species-level identification was achieved using the Analytical profile index (API) 20NE system. The susceptibility of the isolates to nine different antimicrobial agents was determined using the disk diffusion method. Sixty-seven (74) culture-positive isolates were obtained using Ashdown selective agar. Twenty-two isolates were believed to be B. pseudomallei through the monoclonal antibody-based latex agglutination test and API 20NE system subsequently identified 14 isolates as Burkholderia. The predominant Burkholderia species was B. cepacia with isolation rate of 30.8% (8/26). No isolate was distinctively identified as B. pseudomallei but five isolates were highly suspected to be B. pseudomallei with similarity indices ranging from 81.9 – 91.3%. Other bacterial species with definitive identity include Aeromonas sp., Sphingomonas sp. and Pseudomonas aeruginosa. The antibiotic susceptibility results revealed an overall resistance to amoxicillin-clavullanic acid (71.4%), cefepime (33.3%), trimethoprim-sulfamethoxazole (38.1%), piperacillin-tazobactam (33.3%), imipenem (66.7%), doxycycline (57.1%), and ceftazidime (66.7%). The highest intermediate resistance was observed for cefepime and piperacillin-tazobactam with a value 66.7% each while no intermediate-resistance for gentamicin, colistin and imipenem. Our findings, therefore, show that phenotypic assays alone are not enough in the diagnosis of melioidosis. Additionally, it provides a robust basis for supporting present and future decisions to expand diagnostic capability for melioidosis beyond phenotypic assays in low-resource settings.
Galbibacter pacificus sp. nov., isolated from surface seawater of the western Pacific Ocean and transfer of Joostella marina to the genus Galbibacter as Galbibacter orientalis nom. nov. and emended description of the genus Galbibacter
Authors: Wei Lin , Wang Jianning , Liu Xiupian , Lai Qiliang , Li Guizhen , Fu Xiaoteng , Li Guangyu , Shao Zongze , Dong Chunming 
Published: October 2023

Two Gram-stain-negative, non-motile, non-spore-forming, strictly aerobic and rod-shaped bacterial strains, CMA-7T and CAA-3, were isolated from surface seawater samples collected from the western Pacific Ocean. Phylogeny of 16S rRNA gene sequences indicated they were related to the genera

Galbibacter

and

Joostella

and shared 95.1, 90.9 and 90.8% sequence similarity with

G. mesophilus

Mok-17T,

J. marina

DSM 19592T and

G. marinus

ck-I2-15T, respectively. Phylogenomic analysis showed that the two strains, together with the members of the genera

Galbibacter

and

Joostella

, formed a monophyletic clade that could also be considered a monophyletic taxon. This distinctiveness was supported by amino acid identity and percentage of conserved proteins indices, phenotypic and chemotaxonomic characteristics and comparative genomics analysis. Digital DNA‒DNA hybridization values and average nucleotide identities between the two strains and their closest relatives were 18.0–20.8 % and 77.7–79.3 %, respectively. The principal fatty acids were iso-C15 : 0, iso-C17 : 0 3-OH, iso-C15 : 1 G, Summed Feature 3 (C16 : 1
ω7c/C16 : 1
ω6c or C16 : 1
ω6c/C16 : 1
ω7c), Summed Feature 9 (iso-C17 : 1
ω9c or C16 : 0 10-methyl), and C15 : 0 3-OH. The predominant respiratory quinone was MK-6. The polar lipids were phosphatidylethanolamine, aminolipid, aminophospholipid, phospholipid, phosphoglycolipid, glycolipid and unknown polar lipid. The genomic DNA G+C content of strains CMA-7T and CAA-3 was both 38.4 mol%. Genomic analysis indicated they have the potential to degrade cellulose and chitin. Based on the polyphasic evidence presented in this study, the two strains represent a novel species within the genus

Galbibacter

, for which the name Galbibacter pacificus sp. nov. is proposed. The type strain is CMA-7T (=MCCC M28999T = KCTC 92588T). Moreover, the transfer of

Joostella marina

to the genus

Galbibacter

as Galbibacter orientalis nom. nov. (type strain En5T = KCTC 12518T = DSM 19592T=CGMCC 1.6973T) is also proposed.
An Exploratory Study to Detect the Effects of the Combined Intake of Gamma-aminobutyric Acid (GABA) and L-theanine on Sleep by Wearable Device
Authors: Konno Hiroyuki , Murotani Rikuto , Kamada Yukikazu 
Published: October 2023

AbstractObjectivesSleep disorders are a global issue, and supplements for sleep and new devices for daily sleep status assessment are becoming widely available. Gamma-aminobutyric acid (GABA) and L-theanine are commonly used dietary supplements to improve sleep. This study examined whether the combined GABA (700 mg/day) and L-theanine (200 mg/day) intake improve sleep in adults with sleep problems and whether the Fitbit Charge 5 can detect sleep status changes the supplements induced.MethodsParticipants received the supplements for four weeks, and changes in sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and sleep-related data measured by the Fitbit Charge 5 were evaluated before and after the intake of the supplements.ResultsResults obtained from 19 participants indicated significant improvement in the total PSQI score (9.42 ± 1.80 to 6.26 ± 1.66 (mean ± standard deviation), p<0.001). Sleep score improvement was insignificant for the Fitbit data(N=17). However, sleep recovery scores improved significantly (p=0.042). In addition, heart rate during sleep decreased with a significant difference of 1.3 bpm decrease in the first week of intake (p = 0.045).ConclusionsThe simultaneous intake of GABA and L-theanine improved sleep in adults, and the Fitbit Charge 5 could detect improvements in objective information regarding sleep status.
Evaluating the comparability of osteoporosis treatments using propensity score and negative control outcome methods in UK and Denmark electronic health record databases
Authors: Rathod-Mistry Trishna , Tan Eng Hooi , Strauss Victoria Y , O’Kelly James , Giorgianni Francesco , Baxter Richard , Brunetti Vanessa C , Pedersen Alma Becic , Ehrenstein Vera , Prieto-Alhambra Daniel 
Published: October 2023

AbstractEvidence on the comparative effectiveness of osteoporosis treatments is heterogeneous. This may be attributed to different populations and clinical practice, but also to differing methodologies ensuring comparability of treatment groups before treatment effect estimation and the amount of residual confounding by indication. This study assessed the comparability of denosumab vs oral bisphosphonate (OBP) groups using propensity score (PS) methods and negative control outcome (NCO) analysis. A total of 280,288 women aged ≥50 years initiating denosumab or OBP in 2011-2018 were included from the UK Clinical Practice Research Datalink (CPRD) and the Danish National Registries (DNR). Balance of observed covariates was assessed using absolute standardised mean difference (ASMD) before and after PS weighting, matching, and stratification, with ASMD >0.1 indicating imbalance. Residual confounding was assessed using NCOs with ≥100 events. Hazard ratio (HR) and 95% confidence interval (CI) between treatment and NCO was estimated using Cox models. Presence of residual confounding was evaluated with two approaches: (1) >5% of NCOs with 95% CI excluding 1, (2) >5% of NCOs with an upper CI <0.75 or lower CI >1.3. The number of imbalanced covariates before adjustment (CPRD 22/87; DNR 18/83) decreased, with 2-11% imbalance remaining after weighting, matching or stratification. Using approach 1, residual confounding was present for all PS methods in both databases (≥8% of NCOs). Using approach 2, residual confounding was present in CPRD with PS matching (5.3%) and stratification (6.4%), but not with weighting (4.3%). Within DNR, no NCOs had HR estimates with upper or lower CI limits beyond the specified bounds indicating residual confounding for any PS method. Achievement of covariate balance and determination of residual bias were dependent upon several factors including the population under study, PS method, prevalence of NCO, and the threshold indicating residual confounding.