bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of low dose efavirenz regimen in Indian adults with HIV-1 infection: Insights from a phase 4 interventional randomised trial
Authors: Dravid Ameet N. , Pilawan Anant S. , Anuradha S. , Morkar Dnyanesh N. , Ramapuram John T. , Madhukarrao Kulkarni Milind , Naik K. Sunil , Bhrusundi Milind , Raveendra K.R. , Nageswaramma Siddabathuni , Kulkarni Vinay 
Published: November 2023

Background:
A randomized interventional phase 4 study in the Indian population confirmed the non-inferiority of the combination tenofovir/lamivudine/efavirenz (TLE)-400 to TLE600. The current manuscript describes in detail the safety profile and patient-reported safety outcomes obtained from the phase 4 study.

Methods:
This investigation was part of a phase 4 non-inferiority study with a blinded assessment, conducted across 17 sites in India. The duration of the study was 24 weeks. Safety endpoints assessed included all the adverse events (AEs) related to the study treatment (TLE400 and TLE600). The depression anxiety stress 21-item scale questionnaire and efavirenz-related symptom questionnaire were also used to measure depression, anxiety, stress, and patient experience.

Results:
A total of 68 patients (52.3%) reported 261 AEs and 87 patients (64.9%) reported 379 AEs related to study treatment in TLE400 group and TLE600 group respectively, P = .037. The reported AEs associated with central nervous system disorders were lower in the TLE400 group with 41 patients (31.5%) to 61 patients (45.5%) in the TLE600 group. The change from mean baseline value for depression anxiety stress 21-item scale at week 28 in TLE400 group and TLE600 group was −5.1 and −6.2 respectively. Similarly, the mean change from baseline score of efavirenz-related symptoms at week 28 in TLE400 group and TLE600 group were −5.1 and −4.1 respectively.

Conclusion:
The low dose efavirenz (400 mg) in combination with tenofovir and lamivudine had a better safety and tolerability profile than the standard dose of efavirenz (600 mg) in combination with tenofovir and lamivudine. Thus, low dose efavirenz should be preferred over the standard dose.
Intentional replantation and dental autotransplantation of mandibular posterior teeth: Two case reports
Authors: Wang Yao , Hofmann Maria , Ruf Sabine , Zhang Jian , Huang Qiuju 
Published: November 2023

Background:
Intentional replantation and dental autotransplantation are 2 similar techniques both involving atraumatic tooth extraction, visualization of the root, and replantation. They are considered as the last resort for unsalvageable teeth. The author aims to describe 2 mandibular posterior teeth with serious periapical lesions which are resolved by intentional replantation and dental autotransplantation, respectively.

Case summary:
In case 1, a 45-year-old male patient received root canal treatment because of a cracked mandible right first molar with periapical lesions. An endodontic file was separated in the apical third of the mesiolingual root canal. After conventional canal filling of the other root canals, the molar was atraumatically extracted. The separated instrument was removed, the mesiolingual root received a retrograde filling and the molar was replanted. At the 3-month follow up, the patient was asymptomatic and the X-ray picture showed no detectable root resorption and ankylosis. In case 2, a 29-year-old woman reported discomfort during occlusal loading after a root canal treatment and a coronal restoration of the mandibular right first molar. Radiographs showed a low-density shadow in the mesial apical and in the root furcation area of the mandibular first molar so the patient was diagnosed as chronic periapical periodontitis. After the removal of the affected tooth, the extraction socket was thoroughly debrided and irrigated. The intact mandibular right third molar with similar dimensions was extracted by minimally invasive procedure and transplanted. The donor tooth was fixed by a fiber-splint for 1 month and a root canal treatment was performed 2 weeks after surgery. After 1 year, clinical and radiographical examination revealed functional and periodontal healing.

Conclusions:
These 2 reports present the successful management of intentional replantation and dental autotransplantation. Both procedures are recommended after nonsurgical endodontic treatment, especially when apical microsurgery is not an option, for example because of difficult accessibility or patient preference.
Prediction of leg-length discrepancy in pediatric femoral shaft fracture using bone SPECT/CT: A case report
Authors: Wang Sung Il , Jeong Hwan-Jeong , Lim Seok Tae , Han Yeon-Hee 
Published: November 2023

Rationale:
Children’s bones are in the process of growing in both length and width. Therefore, evaluating whether fractures affect the growth plate or not is very crucial. However, even in cases of lower limb fractures where the growth plate remains unaffected, overgrowth or shortening of the affected limb are encountered.

Patient concerns:
An 11-year-old boy was admitted to the emergency department after a passenger car accident.

Diagnoses:
A comminuted fracture of the right femoral shaft was diagnosed by X-ray image.

Interventions:
Closed reduction and internal fixation were performed using intramedullary titanium elastic nails. Six months after the operation, bone union was achieved and the nails were removed.

Outcomes:
Nine months after nail removal, the right leg was unexpectedly noticed 5 mm shorter than the left one. On the initial and follow-up bone single-photon emission computed tomography/computed tomography images with a 9-month interval, radioactivity of growth plate in the right proximal femur was much lower than that of the left femur, suggesting a further increasing of leg-length discrepancy (LLD) in the future. As we expected, LLD had progressively increased up to 20 mm. Epiphysiodesis was finally decided for the left distal femur. Twenty-two months after the length equalization operation, LLD decreased to 5 mm.

Lessons:
This case emphasizes that quantitative analysis of growth plate activity using bone single-photon emission computed tomography/computed tomography could predict LLD and help us decide when and which limb should be operated on for pediatric patients with lower limb fractures.
Comparison of UPDRS III score between young and late onset Parkinson disease after deep brain stimulation: A meta-analysis
Authors: Lee Jae Meen , Pak Kyoungjune 
Published: November 2023

Purpose:
Parkinson disease (PD) is a common age-related neurodegenerative disease. Subthalamic nucleus deep brain stimulation (DBS) is a safe and effective surgical treatment for medically resistant advanced PD. However, the relationship between the age at PD onset and the efficacy of subthalamic nucleus DBS surgery remains unclear. Thus, we conducted a meta-analysis to compare motor symptom improvements after DBS for the treatment of young-onset and late-onset PD.

Methods:
We systematically searched the Medline and Embase databases (from inception to March 2023) for English publications. All published studies comparing the outcomes (Unified Parkinson’s Disease Rating Scale part III [UPDRS III] scores) of DBS between the young-onset Parkinson disease (YOPD) and late-onset Parkinson disease (LOPD) groups were identified. The effect size was defined as the standardized mean difference (Hedge g) with 95% confidence intervals. The standardized mean difference was calculated by dividing the difference in UPDRS III scores between old and young patients by the pooled and weighted standard deviations. The meta-analysis was performed using R Statistical Software version 4.2.2 (The R Foundation for Statistical Computing).

Results:
Six studies were eligible for inclusion. The standardized mean difference of UPDRS III score between young and old patients ranged from −0.54 to 1.43 with a pooled difference of 0.0932 (95% confidence intervals: − 0.4666 to 0.6530, I
2 = 86.77%). Subgroup analyses were performed with a cutoff age of 65 years and did not show a significant difference in UPDRS III scores between patients with YOPD and LOPD (0.1877, −0.6663 to 1.0417).

Conclusions:
The efficacy of DBS in patients with YOPD and LOPD showed similar improvements in the UPDRS score; hence, DBS should be considered, if necessary, regardless of the onset age of PD.
Duodenal ulcer bleeding from a branch of the middle colic artery: A case report
Authors: Shishido Yutaka , Mitsuoka Eisei , Tanigawa Yuma , Ooki Hodaka , Shio Seiji , Monzawa Shuichi , Ishii Masayuki , Fujimoto Koji 
Published: November 2023

Rationale:
Duodenal ulcer bleeding is a potentially life-threatening condition commonly caused by the erosion of the duodenal arteries.

Patient concerns:
A 55-year-old male was referred to our hospital with abdominal pain for the past 3 days. Contrast-enhanced computed tomography of the abdomen revealed wall thickening in the descending part of the duodenum and a cystic lesion (27 × 19 mm) contiguous with the duodenum, with an accumulation of fluid. An esophagogastroduodenoscopy showed the significantly stenotic duodenum, which prevented passage of the endoscope and evaluation of the main lesion. Based on these findings, duodenal ulcer perforation and concomitant abscess formation were suspected. Two days after admission, he had massive hematochezia with bloody drainage from the nasogastric tube.

Diagnoses:
Emergency angiography revealed duodenal ulcer bleeding from the gastroduodenal artery and the branch artery of the inferior pancreaticoduodenal artery and middle colic artery (MCA).

Interventions:
The patient was treated with transcatheter arterial embolization (TAE) of the gastroduodenal artery, the branch vessel of the inferior pancreaticoduodenal artery, and the main trunk of the MCA.

Outcomes:
Hemostasis was achieved with TAE. The patient recovered uneventfully and undergone a gastro-jejunal bypass surgery for the duodenal stenosis 2 weeks after TAE. He was discharged without any abnormal complaints on postoperative day 12.

Lessons:
We have experienced a rare case of duodenal ulcer bleeding from a branch of the MCA. In patients with refractory upper gastrointestinal bleeding, careful evaluation of bleeding sites is recommended considering unexpected culprit vessels.
Thematic maps with scatter and 4-quadrant plots in R to identity dominant entities on schizophrenia in psychiatry since 2017: Bibliometric analysis
Authors: Jang Fong-Lin , Chien Tsair-Wei , Chou Willy 
Published: November 2023

Background:
Schizophrenia affects more than 21 million people worldwide. There have been a number of articles published in the literature regarding schizophrenia. It is unclear which authors contributed the most to the field of schizophrenia. This study examines which article entities (affiliated countries, institutes, journals, and authors) earn the most research achievements (RAs) and whether keywords in articles are associated with the number of article citations.

Methods:
As of August 25, 2022, 20,606 abstracts published on schizophrenia in psychiatry since 2017 were retrieved from the WoS core collection (WoSCC). RAs were measured using the category, JIF, authorship, and L-index (CJAL) score. The follower-leading cluster algorithm (FLCA) was used to examine clusters of keywords associated with core concepts of research. There were 7 types of visualizations used to report the study results, including Sankey diagrams, choropleth maps, scatter charts, radar plots, and cluster plots. A hypothesis was examined that the mean number of citations for keywords could predict the number of citations for 100 top-cited articles(T100SCHZ).

Results:
The results indicate that the US (18861), Kings College London (U.S. (2572), Psychiatry (14603), and Kolanu Nithin (Australia) (9.88) had the highest CJAL scores in countries, institutes, departments, and authors, respectively. The journal of Schizophrenia Res had higher citations (19,017), counts (1681), and mean citations (11.31) in journals. There was a significant correlation between article citations and weighted keywords (F = 1471.74; P < .001).

Conclusion:
Seven visualizations were presented to report the study results, particularly with thematic maps using scatter and 4-quadrant plots produced in R programming language. We recommend that more future bibliographical studies utilize CAJL scores and thematic maps to report their findings, not restrict themselves solely to schizophrenia in psychiatry as done in this study.
Preimplantation genetic testing and prenatal diagnosis in a family with pseudovaginal perineoscrotal hypospadias: A case report
Authors: Chen Jiayao , Zhang Zhiping , Shi Wenjing , Yan Qin , Bi Xingyu , Zhu Pengfei , Zhang Dongdong , Wu Xueqing 
Published: November 2023

Rationale:
Pseudovaginal perineoscrotal hypospadias (PPSH) is a rare autosomal recessive disorder of sex development caused by biallelic mutations in SRD5A2. PPSH is characterized by a vaginal-like blind ending perineal opening, penoscrotal hypospadias, and impaired masculinization.

Patient concerns:
We reported preimplantation genetic testing and prenatal diagnosis in a family with PPSH.

Diagnosis:
Whole-exome sequencing of the family identified 2 SRD5A2 pathogenic variants (c.578A>G and c.607G>A). Haplotype analysis showed that the variants were inherited from the previous generation of this family.

Interventions:
During subsequent in vitro fertilization, preimplantation genetic testing was performed on 9 embryos. One unaffected embryo was transferred, resulting in a singleton pregnancy.

Outcomes:
The prenatal diagnosis at 20 weeks’ gestation confirmed the fetus was unaffected. A healthy female infant weighing 3100 g and measuring 50 cm was delivered vaginally at 39+5 weeks of gestation.

Lessons subsections:
This case highlights the use of preimplantation genetic testing and prenatal diagnosis to prevent the transmission of PPSH in families at risk. Our approach provides an effective strategy for identification and management of families with autosomal recessive disorders like PPSH.
Anesthetic management for surgery in a nemaline myopathy patient with difficult airway: A CARE-compliant case report
Authors: Jung Hoon , Kim Hyunjee , Lee See Woo 
Published: November 2023

Rationale:
Nemaline myopathy (NM) is a congenital disease characterized by nonprogressive or slowly progressing muscle weakness and may increase the risk of anesthesia in case of respiratory muscle or cardiac involvement. Care should be taken to prevent respiratory failure after surgery.

Patient concerns:
A 35-year-old man with NM, who had difficult airway, restrictive ventilatory pattern, and pulmonary hypertension, required general anesthesia for surgery because of limited mouth opening.

Diagnoses:
The patient was diagnosed with NM (ACTA1 mutation) and coronoid hyperplasia.

Interventions:
Awake fiberoptic nasal intubation was performed following preparations for analgesia. General anesthesia was maintained using inhalational anesthetics and opioids without using neuromuscular blocking agents.

Outcomes:
General anesthesia remained well maintained during surgery, with no movement or spontaneous breathing of the patient and he recovered from anesthesia uneventfully without complications.

Lessons:
This report highlights the safe performance of anesthesia induction and recovery in a case where anesthesia management is necessary for surgery in a patient of NM at a high risk of anesthesia-related complications.
Lumbosacral Paravertebral Tophaceous Gout on an Adolescent Mimicking Malignant Neoplasm in 18F-FDG PET/CT
Authors: Jiao Benzheng , Liu Shanshan , Zhuang Yuying , Zhao Shuangyan , Zhao Hongguang 
Published: November 2023

Abstract
Contrast-enhanced MRI was performed on a 17-year-old adolescent boy with chronic lumbar and lower-limb pain, which had worsened over the past 3 days. It revealed a suspicious malignant mass adjacent to right appendage of L5–S1 vertebrae, with mixed signals and heterogeneous and obvious enhancement. 18F-FDG PET/CT was subsequently performed for staging. It showed an FDG-avid mass with mixed density in right psoas major muscle, involving adjacent appendage of L5–S1 vertebrae. Histopathological examination confirmed the mass to be gouty tophus, characterized by nodular homogeneous pink amorphous deposits around the cartilage tissue, surrounded by histiocytes and multinucleated giant cells.
68Ga-PSMA Uptake in Solar Elastosis
Authors: Calderon Tobar Merve Nida , Önner Hasan , Yavuz Cahit 
Published: November 2023

Abstract

68Ga–prostate specific membrane antigen (PSMA) PET/CT scan for staging revealed increased 68Ga-PSMA uptake in solar elastosis in a patient with prostate cancer. Solar elastosis is a degenerative condition of elastic tissue in the dermis caused by prolonged sun exposure. A few studies have demonstrated 68Ga-PSMA uptake in cutaneous lesions. This case illustrates another instance of a benign cutaneous lesion accompanied by increased 68Ga-PSMA uptake.
Osteonecrosis of the Femoral Head as a Potential Pitfall in 18F-PSMA-1007 PET
Authors: Bailly Matthieu , Ibrahim Nada , Champeaux-Orange Elise , Metrard Gilles 
Published: November 2023

Abstract
PSMA-targeted PET agents are mainly involved for prostate cancer; however, unspecific bone uptakes can be challenging for the clinician. We report the case of a 71-year-old man with history of recurrent prostate cancer initially treated by surgery and radiation therapy. 18F-PSMA 1007 PET/CT was performed. Beside hyperfixing lymph nodes, focal uptake was found in right femoral head with shell subchondral hypofixation and no morphologic correlate on CT. MRI found bilateral osteonecrosis of the femoral head. This case emphasizes that osteonecrosis of the femoral head can mimic a metastasis uptake, even with normal CT, without however the fixation being constant.
Regional White Matter Hyperintensities Relate to Specific Cognitive Abilities in Older Adults Without Dementia
Authors: Membreno Rachel , Thomas Kelsey R. , Calcetas Amanda T. , Edwards Lauren , Bordyug Maria , Showell Maya , Stanfill Morgan , Brenner Einat K. , Walker Kayla S. , Rotblatt Lindsay J. , Brickman Adam M. , Edmonds Emily C. , Bangen Katherine J. ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: November 2023

Introduction:
White matter hyperintensities (WMHs) are magnetic resonance imaging markers of small vessel cerebrovascular disease that are associated with cognitive decline and clinical Alzheimer disease. Previous studies have often focused on global or total WMH; less is known about associations of regional WMHs and cognitive abilities among older adults without dementia.

Methods:
A total of 610 older adults with normal cognition (n=302) or mild cognitive impairment (n=308) from the Alzheimer’s Disease Neuroimaging Initiative underwent neuropsychological testing and magnetic resonance imaging. Linear regression models examined associations between regional WMH volumes and cognition, adjusting for age, sex, education, apolipoprotein E ε4 allele frequency, and pulse pressure.

Results:
Among all participants, greater regional WMH volume in all lobes was associated with poorer performance on memory and speed/executive functioning. Among participants with normal cognition, greater temporal and occipital WMH volumes were associated with poorer memory, whereas no regional WMH volumes were associated with speed/executive function.

Discussion:
Results show that greater regional WMH volume relates to poorer cognitive functioning—even among those with normal cognition. Together with results from previous studies, our findings raise the possibility that WMH may be a useful therapeutic target and/or important effect modifier in treatment or prevention dementia trials.
Seizure forecasting by tracking cortical response to electrical stimulation
Authors: Laiou Petroula , Kraljevic Zeljko , Valentin Antonio , Jewell Sharon , Viana Pedro F. , Mehra Chirag , Dobson Richard J.B. , Schulze-Bonhage Andreas , Dümpelmann Matthias , Denison Timothy J. , Winston Joel S. , Richardson Mark P. 
Published: November 2023

AbstractBackgroundSeizure unpredictability is a significant burden in the lives of people with epilepsy. Previously published approaches to seizure forecasting analysed intracranial electroencephalographic recordings (iEEG) and showed that seizures can be forecast above chance levels. Although passive observation of the brain might provide some insights, repeated active perturbation of the cortex and measuring the cortical response may provide more direct information about time-varying cortical excitability.ObjectiveThe aim of this study is to investigate whether seizures can be forecast by stimulating the cortex via intracranial electrodes and measuring cortical response from the iEEG.MethodsWe studied a cohort of eight patients with treatment-resistant epilepsy who were admitted to King’s College Hospital for presurgical evaluation with iEEG. During their stay, they underwent prolonged single pulse electrical stimulation for approximately one day. Stimuli were delivered every 5 minutes to a constant pair of electrodes and all patients experienced at least one clinical seizure during the period of stimulation. We extracted quantitative features from the iEEG post-stimulus response and developed a logistic regression algorithm to estimate the seizure likelihood at each stimulus. To evaluate the algorithm’s performance, we used improvement over chance (IoC), sensitivity, time spent in warning and Brier Skill score. We also compared performance with seizure prediction based on passive observation of iEEG.ResultsIn seven out of eight patients, seizures could be forecast using the post-stimulus response above chance levels (average IoC: 0.74). In comparison, the seizure forecasting performance based on passive (unstimulated) iEEG was less good (average IoC: 0.54).ConclusionsThese results suggest that cortical response to electrical stimulation may aid in the development of seizure forecasting algorithms as well as in the design of novel implantable devices that deliver electrical stimulation to control seizures.
Reduced Achilles tendon stiffness in aging persists at matched activations and associates with higher metabolic cost of walking
Authors: Franz Jason R. , Krupenevich Rebecca L. , Gray Aubrey J. , Batsis John A. , Sawicki Gregory S. 
Published: November 2023

AbstractThe mechanisms responsible for increased walking metabolic cost among older adults are poorly understood. We recently proposed a theoretical premise by which age-related reductions in Achilles tendon stiffness (kAT) can disrupt the neuromechanics of calf muscle behavior and contribute to faster rates of oxygen consumption during walking. The purpose of this study was to objectively evaluate this premise. We quantified kATat a range of matched activations prescribed using electromyographic biofeedback and walking metabolic cost in a group of 15 younger (age: 23±4 yrs) and 15 older adults (age: 72±5 yrs). Older adults averaged 44% less kATthan younger adults at matched triceps surae activations (p=0.046). This effect appeared to arise not only from altered tendon length-tension relations with age, but also from differences in the operating region of those length-tension relations between younger and older adults. Older adults also walked with a 17% higher net metabolic power than younger adults (p=0.017). In addition, we discovered empirical evidence that lesser kATexacts a metabolic penalty and was positively correlated with higher net metabolic power during walking (r=-0.365, p=0.048). These results pave the way for interventions focused on restoring ankle muscle-tendon unit structural stiffness to improve walking energetics in aging.