bluuebunny/crossref_metadata_2025_split huggingface dataset:
Boosting dark matter searches at muon colliders with machine learning: The mono-Higgs channel as a case study
Authors: Belfkir Mohamed , Jueid Adil , Nasri Salah 
Published: December 2023

Abstract
The search for dark matter (DM) candidates at high-energy colliders is one of the most promising avenues to understand the nature of this elusive component of the universe. Several searches at the Large Hadron Collider (LHC) have strongly constrained a wide range of simplified models. The combination of the bounds from the LHC with direct-detection experiments exclude the most minimal scalar-singlet DM model. To address this, lepton portal DM models are suitable candidates where DM is predominantly produced at lepton colliders since the DM candidate only interacts with the lepton sector through a mediator that carries a lepton number. In this work, we analyze the production of DM pairs in association with a Higgs boson decaying into two bottom quarks at future muon colliders in the framework of the minimal lepton portal DM model. It is found that the usual cut-based analysis methods fail to probe heavy DM masses for both the resolved (where the decay products of the Higgs boson can be resolved as two well-separated small-R jets) and the merged (where the Higgs boson is clustered as one large-R jet) regimes. We have then built a search strategy based on boosted-decision trees (BDTs). We have optimized the hyperparameters of the BDT model to both have a high signal-to-background ratio and to avoid overtraining effects. We have found very important enhancements of the signal significance with respect to the cut-based analysis by factors of 8–50 depending on the regime (resolved or merged) and the benchmark points. Using this BDT model on a 1D parameter space scan, we found that future muon colliders with $\sqrt{s}=3$ TeV and ${\cal L} = 1~{\rm ab}^{-1}$ can exclude DM masses up to 1 TeV at the 95% confidence level.
Selective Default Expectations
Authors: Accominotti Olivier , Albers Thilo N H , Oosterlinck Kim 
Published: December 2023

Abstract
This paper explores how selective default expectations affect the pricing of sovereign bonds in a historical laboratory: the German default of the 1930s. We analyze yield differentials between identical government bonds traded across various creditor countries before and after bond market segmentation. We show that, when secondary debt markets are segmented, a large selective default probability can be priced in bond yield spreads. Selective default risk accounted for one-third of the yield spread of German external bonds over the risk-free rate during the 1930s. Selective default expectations arose from differences in the creditor countries’ economic power over the debtor.
Physeal Migration During Knee-guided Growth With Tension Band Plates: Influence of Implant Position
Authors: Galán-Olleros María , Sánchez del Saz Jaime , Miranda-Gorozarri Carlos , Serrano Jose Ignacio , Egea-Gámez Rosa M. , Garríguez-Pérez Daniel , Alonso-Hernández Javier , Martínez-Caballero Ignacio 
Published: December 2023

Objective:
Physeal migration during guided growth with tension band plates (TBPs) has been poorly described. The positioning factors associated with this phenomenon and its clinical implications are unknown. Our aim is to determine the influence of implant position on the risk of physeal migration during knee-guided growth with TBP.

Methods:
Retrospective study of 491 patients who underwent temporary hemi or epiphysiodesis with TBP around the knee between 2007 and 2019. We identified 29 patients who presented physeal migration during follow-up. Demographic and clinical data were collected, and the following measures were obtained from the immediate postoperative radiographs: epiphyseal screw base–physis distance/epiphyseal screw tip–physis distance, interscrew angle, epiphyseal screw-physis angle(ES-PHa)/metaphyseal screw–physis angle, plate–physis angle, epiphyseal screw–plate angle/metaphyseal screw–plate angle, and epiphyseal screw–physis length ratio. Using follow-up radiographs, the type of physeal migration of the epiphyseal screw (touch, occupy, or traverse) and the status of the physis after implant removal (unaltered, physeal bar, and skeletal maturity) were also recorded. A descriptive analysis of the cases and a case-control comparison of imaging studies were performed.

Results:
The median patient age at intervention was 12.2 years (interquartile range: 11.3 to 14.1), and 76% were males. A statistically significant difference between cases and controls was obtained for epiphyseal screw base–physis distance (3.7 vs 6.3; P = 0.029), epiphyseal screw tip–physis distance (3.6 vs 7.85; P = 0.002), ES-PHa (–0.1 vs 7.45; P = 0.007), and plate–physis angle (85.45 vs 88.60; P = 0.012). In a categorical analysis, a significant difference was found for the ES-PHa categories (P = 0.002) and for the ES-PHa/metaphyseal screw–physis angle categorical pair (P = 0.018). In 16, 17, and 12 cases the physis was touched, occupied, or traversed, respectively, although we found no physeal alterations after plate removal.

Conclusions:
In our study, physeal migration of TBP is not an uncommon phenomenon, although no physeal abnormalities were detected. Convergent placement of the epiphyseal screw with the base or tip close to the physis should be avoided as this position is associated with a higher risk of physeal migration.

Level of Evidence
Level III—case-control study.
Predictors of Survival in Patients With Hepatocellular Cancer Receiving Atezolizumab and Bevacizumab
Authors: Ledenko Matthew , Mercado Lydia , Patel Tushar 
Published: December 2023

Objectives:
In randomized clinical trials in patients with hepatocellular cancer (HCC), combination therapy with atezolizumab and bevacizumab (Atezo-Bev) prolonged survival, and these treatments have become the standard first-line therapy for advanced HCC. However, clinical trials may not reflect real-life clinical practice due to treatment selection criteria. Thus, our aim was to understand predictors of HCC outcomes with these treatments in a real-world, multicenter setting.

Methods:
A retrospective review of all patients 18 years of age or older treated for advanced primary liver cancer between February 2020 and August 2022 was conducted to assess the relationship between overall survival and clinical and biochemical variables before or during treatment. Univariate and multivariate Cox regression survival analyses were performed to identify predictors of survival following treatment.

Results:
One hundred and eleven eligible patients with unresectable HCC received Atezo-Bev over a consecutive 30-month period. Cox regression identified several significant (P<0.05) predictors of survival, including pretreatment albumin (hazard ratios [HR]: 0.2; CI: 0.1-0.4), total bilirubin (HR: 1.3; CI: 1.2-1.5), and international normalized ratio (HR: 5.6; CI: 2.5-12.5). In multivariate analyses, these were significantly associated as predictors of mortality, and patients with pretreatment albumin <3.5 mg/dL had significantly lower survival than those ≥3.5 (153 vs. 522 d, P<0.0001).

Conclusions:
Pretreatment hypoalbuminemia, high bilirubin, and biochemical tests indicative of hepatic or renal dysfunction can independently predict short-term mortality in advanced HCC patients receiving Atezo-Bev.
Fractional CO2 Laser Combined With Autologous Nanofat Injection Versus Fractional CO2 Laser Combined With Platelet-Rich Plasma in the Treatment of Atrophic Acne Scars: A Split-Face Comparative Study With Optical Skin Imaging
Authors: Rageh Mahmoud A. , Tawfik Abeer Attia , Abdallah Noha , Ibrahim Shady Mahmoud Attia 
Published: December 2023

BACKGROUND
Atrophic acne scarring is a common problem. If left untreated, its implications can impair the quality of life. Various treatments, with differing degrees of success, are used to alleviate atrophic scars.

OBJECTIVE
To assess the efficacy of nanofat versus platelet-rich plasma (PRP) as an adjuvant therapy to fractional CO2 laser (FCL) for atrophic acne scars.

METHODS
This study included 35 patients with atrophic acne scars who received 3 sessions of FCL at 1-month intervals on both sides of the face, followed by intradermal PRP injection on the left side. A single session of nanofat was injected into the right side of the face 2 weeks before the laser sessions. The evaluation was conducted 3 months after the final treatment session.

RESULTS
After treatment, the right side of the face showed a significant reduction in Goodman scores and the indentation index of the Antera camera. The left side showed a significant difference in Goodman scores, yet the Antera camera showed a nonsignificant improvement. Nonetheless, the difference between the 2 sides was statistically insignificant.

CONCLUSION
Atrophic acne scars improved with both modalities. As a result, cotreatment with these techniques may synergistically affect atrophic acne scars in efficacy and safety.
Characterizing Gender and Leadership Trends Among Mohs Micrographic Surgery Fellowship Directors
Authors: Chen Caroline , Pulavarty Akshay , Lopez Adriana 
Published: December 2023

BACKGROUNDFellowship directors (FDs) play a key role in shaping Mohs micrographic surgery (MMS). Studies characterizing director trends are lacking and may provide a framework for improving gender diversity.OBJECTIVETo explore characteristics of FDs and trends in gender of both fellows and FDs over time.MATERIALS AND METHODSThe authors compiled a comprehensive list of FDs and fellows for all Accreditation Council for Graduate Medical Education–accredited Micrographic Surgery & Dermatologic Oncology programs from 1996 to 2023. Publicly available data from various internet sources from February 1, 2023 to May 30, 2023 were used to assess characteristics of MMS FDs.RESULTSThe percentage of female FDs increased from 6% to 25% from 1996 to 2023. Female directors were more likely to select female fellows than male directors (p= .0002) and had fewer years between fellowship completion and FD appointment (9.1 ± 4.7 years) compared with male directors (13.6 ± 8.8 years;p= .036). H-index, program type, and academic rank were similar between male and female directors.CONCLUSIONAlthough gender parity among MMS trainees has been achieved, discrepancies remain in the gender composition of FDs. Further studies are required to determine why women are underrepresented as FDs.
Pure and Mixed Variants of Desmoplastic Melanoma: A Single-Center, Retrospective, Clinicopathologic Review
Authors: Light Jeremy G. , Freeman Timothy , Russell Aaron J. , Council M. Laurin , Michalski Basia M. 
Published: December 2023

BACKGROUND
Desmoplastic melanoma (DM) is a rare melanoma variant. Prognostic indicators and survival vary widely and are further confounded by the histopathologic distinction between pure DM (pDM) and mixed DM (mDM) subtypes. The utility of current treatment guidelines is limited by the lack of evidence-based recommendations.

OBJECTIVE
To compare the clinicopathologic characteristics of pure and mixed subtypes of DMs.

METHODS
All cases of DM were identified from the Washington University in St Louis institutional pathology database between January 2000 and September 2022. Fifty-two cases were identified and subsequently categorized as pure (n = 26) or mixed (n = 26). Clinical and histopathologic data were collected and compared.

RESULTS
There were no differences in demographics or tumor location between pure and mixed subtypes. Patients with mDM were more likely to have mitoses present (p = .03). There were no differences in Breslow depth, tumor diameter, level of invasion, ulceration, and lymphovascular or perineural invasion. The utilization of sentinel lymph node biopsy (p = .17) and sentinel lymph node positivity (p = .67) were also similar.

CONCLUSION
Despite histopathologic distinction between pDM and mDM, these subtypes were found to have similar clinicopathologic characteristics, including similar rates of sentinel lymph node metastasis.
Determinants of clinical response to empirical antibiotic treatment in patients with cirrhosis and bacterial and fungal infections—Results from the ICA “Global Study” (EABCIR-Global Study)
Authors: Maiwall Rakhi , Piano Salvatore , Singh Virendra , Caraceni Paolo , Alessandria Carlo , Fernandez Javier , Soares Elza Cotrim , Kim Dong Joon , Kim Sung Eun , Marino Monica , Vorobioff Julio , Ribeiro Barea Rita de Cassia , Merli Manuela , Elkrief Laure , Vargas Victor , Krag Aleksander , Singh Shivaram Prasad , Lesmana Laurentius Adrianto , Toledo Claudio , Marciano Sebastian , Verhelst Xavier , Wong Florence , Intagliata Nicolas , Rabinowich Liane , Colombato Luis , Kim Sang Gyune , Gerbes Alexander , Durand Francois , Roblero Juan Pablo , Bhamidimarri Kalyan Ram , Maevskaya Marina , Fassio Eduardo , Kim Hyoung Su , Hwang Jae Seok , Gines Pere , Bruns Tony , Gadano Adrian , Angeli Paolo , Sarin Shiv Kumar ,   on behalf of the International Club of Ascites Global Study Group
Published: December 2023

Background:
The administration of an appropriate empirical antibiotic treatment is essential in cirrhosis and severe bacterial infections. We aimed to investigate the predictors of clinical response of empirical antibiotic treatment in a prospective cohort of patients with cirrhosis and bacterial and fungal infections included in the International Club of Ascites “Global Study.”

Methods:
Patients hospitalized with cirrhosis and bacterial/fungal infection were prospectively enrolled at 46 centers. Clinical response to antibiotic treatment was defined according to changes in markers of infection/inflammation, vital signs, improvement of organ failure, and results of cultures.

Results:
From October 2015 to September 2016, 1302 patients were included at 46 centers. A clinical response was achieved in only 61% of cases. Independent predictors of lack of clinical response to empirical treatment were C-reactive protein (OR = 1.16; 95% CI = 1.02–1.31), blood leukocyte count (OR = 1.39;95% CI = 1.09–1.77), serum albumin (OR = 0.70; 95% CI = 0.55–0.88), nosocomial infections (OR = 1.96; 95% CI = 1.20–2.38), pneumonia (OR = 1.75; 95% CI = 1.22–2.53), and ineffective treatment according to antibiotic susceptibility test (OR = 5.32; 95% CI = 3.47–8.57). Patients with a lack of clinical response to first-line antibiotic treatment had a significantly lower resolution rate of infections (55% vs. 96%; p < 0.001), a higher incidence of second infections (29% vs. 15%; p < 0.001), shock (35% vs. 7%; p < 0.001) and new organ failures (52% vs. 19 %; p < 0.001) than responders. Clinical response to empirical treatment was an independent predictor of 28-day survival ( subdistribution = 0.20; 95% CI = 0.14–0.27).

Conclusions:
Four out of 10 patients with cirrhosis do not respond to the first-line antibiotic therapy, leading to lower resolution of infections and higher mortality. Broader-spectrum antibiotics and strategies targeting systemic inflammation may improve prognosis in patients with a high degree of inflammation, low serum albumin levels, and severe liver impairment.
Meta-analysis for the relationship between circulating pregnancy-associated plasma protein A and placenta accreta spectrum
Authors: Li Yan , Meng Yizi , Chi Yang , Li Ping , He Jin 
Published: December 2023

Background:
Changes in circulating pregnancy-associated plasma protein A (PAPP-A) have been observed in women with a placenta accreta spectrum (PAS). However, no consensus has been reached according to the previous studies. Our study investigated the relationship between circulating PAPP-A and PAS risk through a systematic review and meta-analysis.

Methods:
Studies comparing the circulating level of PAPP-A between pregnant women with and without PAS were obtained by searching the Medline, Cochrane Library, Embase, CNKI, and Wanfang databases from the inception of the databases until February 12, 2023. Heterogeneity was considered in the pooling of results via a random-effects model.

Results:
Eight observational studies were obtained for the meta-analysis, which included 243 pregnant women with PAS and 1599 pregnant women without PAS. For all these women, the first-trimester circulating level of PAPP-A was measured by immunoassay and reported as multiples of the median (MoM) values. The pooled results showed that compared to those who did not develop PAS, women with PAS had significantly higher first-trimester serum level PAPP-A (mean difference: 0.43 MoM, 95% confidence interval [CI]: 0.30 to 0.56, P < .001; I2 = 32%). Furthermore, a high first-trimester serum PAPP-A level was related to a high PAS risk (odds ratio: 2.89, 95% CI: 2.13 to 3.92, P < .001; I2 = 0%). Sensitivity analysis which excluded one study at a time, also obtained similar results (p all < 0.05).

Conclusion:
Pregnant women with a high serum PAPP-A level in the first trimester may be at an increased risk for PAS.
Small bowel diaphragm disease with multiple cluster lesions in one segment of the small bowel mimicking an adhesion band: A case report
Authors: Jeong Youseok , Chung Jae Hun , Lim Dong Won , Lee Si Hak , Hwang Sun-Hwi , Shin Dong Hoon 
Published: December 2023

Rationale:
Small bowel diaphragm disease (SBDD) is a rare case, caused by long-term administration of nonsteroidal anti-inflammatory drugs (NSAIDs). The circumferential diaphragm in the lumen of small bowel causing mechanical obstruction is the characteristic finding.

Patient concerns:
A 74-year-old male was transferred to Pusan National University Yangsan Hospital (PNUYH) due to abdominal pain lasting for 2 months. He was treated in the local medical center (LMC) with Levin tube insertion and Nil Per Os (NPO) but showed no improvement.

Diagnosis:
According to abdomen-pelvis computed tomography (CT) result, small bowel obstruction due to the adhesion band was identified, showing dilatation of the small bowel with abrupt narrowing of the ileum.

Interventions:
Laparoscopic exploration was done but failed to find an adhesion band. An investigation of the whole small bowel was done with mini-laparotomy. At the transitional zone, the intraluminal air could not pass so the segmental resection of small bowel including the transitional zone and end-to-end anastomosis was done.

Outcomes:
After surgery, every laboratory finding recovered to the normal range in 4 days, but the patient’s ileus lasted for 8 days. The patient’s symptoms were relieved after defecation, he was discharged on postoperative day 10.

Lessons:
For patients who show mechanical obstruction without an operation history but with long-term administration of NSAIDs, the clinicians should suspect small bowel diaphragm disease.
Stroke risk of COPD patients and death risk of COPD patients following a stroke: A systematic review and meta-analysis
Authors: Ding Chaowei , Wang Runlu , Gong Xiaowei , Yuan Yadong 
Published: December 2023

Objective:
Chronic obstructive pulmonary disease (COPD) is closely related to the development and progression of cardiovascular disease. The purpose of this study is to clarify the answers to the following questions through systematic evaluation: the risk of stroke in COPD patients; the risk of stroke in acute exacerbations of COPD (AECOPD) patients; and the risk of death after stroke in COPD patients.

Methods:
Two reviewers independently searched EMbase, PubMed, and the Cochrane Library for relevant literature from the date of creation to February 17, 2023, for studies relating COPD to stroke patients. Of the 8039 publications retrieved, we identified 27 articles that met our selection criteria. Fixed-effects or random-effects models were used to calculate ORs and 95% confidence intervals for the combined risk.

Results:
combining studies on stroke risk in COPD patients by random-effects model suggested that COPD was an independent risk factor for stroke-associated pneumonia (OR 1.40, 95% CI: 1.24–1.59, I
2 = 98.4%, P = .000), with significant heterogeneity in the results, and subgroup analysis did not find a source of heterogeneity. In the combined 7 AECOPD studies, a significantly higher risk of stroke was found (OR 1.53, 95% CI: 1.44–1.63, I
2 = 49.2%, P = .066). In the combined 6 short- term prognostic studies, the relationship between COPD and risk of death was not highly significant (OR 1.12, 95% CI: 1.08–1.16, I
2 = 37.4%, P = .131). In 10 long-term observational prognosis studies, COPD was suggested to be associated with death after stroke by combining data using a random-effects model (OR 1.20, 95% CI: 1.13–1.27, I
2 = 56.8%, P = .014), and there was moderate heterogeneity in the combination, with subgroup analysis showing that stroke type may be a source of heterogeneity and the risk of death from ischemic stroke: OR 1.23, 95% CI: 1.17–1.29, I
2 = 45.0%, P = .191 and the risk of death from both types of stroke: OR 1.12, 95% CI: 1.07–1.18, I
2 =18.9%, P = .291.

Conclusion:
COPD is an independent risk factor for stroke. The risk of stroke is significantly increased, especially during AECOPD. In addition, the association between COPD and short-term death in stroke patients is insignificant, while it is more associated with fatal events in the long-term prognosis.
Novel mutation in RPGRIP1L gene causing Joubert syndrome: A case report
Authors: Duque-Cordoba Paola Andrea , Diaz-Ordoñez Lorena , Gutierrez-Medina Juan David , Pachajoa Harry 
Published: December 2023

Introduction:
Joubert syndrome is a rare disease of genetic origin with autosomal recessive inheritance and extreme genetic heterogeneity with more than 40 causative genes. Joubert syndrome 7 is caused by mutations in the RPGRIP1L gene.

Patient concerns:
Our report describes a pediatric patient with clinical features compatible with JS type 7 such as hypotonia, developmental delay and aplasia of the cerebellar vermis.

Diagnosis:
The clinical features and the MRI of the head and neck which showed alterations at the level of the posterior fossa, with absence of the vermis and horizontal disposition of the cerebellar peduncles, were compatible with Joubert syndrome. Whole exome sequencing detected the variants RPGRIP1L (NM_015272.2) c.697A > T (p. Lys233Ter) and RPGRIP1L (NM_015272.2) c.3545 del (p.Pro1182LeufsTer25).

Interventions:
Resection was performed to correct the polydactyly. At age 2 years umbilical hernia, adenoid surgery and ventilatory tubes surgery were performed. Renal biopsy confirmed interstitial fibrosis and focally accentuated mild tubular atrophy with focal tubular hypertrophy, compatible with the clinical suspicion of Joubert syndrome. Congenital hip dislocation surgery was performed. The patient underwent surgery for correction of concomitant divergent strabismus and continued with glasses for astigmatism and hyperopia.

Outcomes:
Sanger sequencing confirmed the patient´s results and the father was found to be a carrier of RPGRIP1L (NM_015272.2) c.697A > T (p. Lys233Ter) and the mother and maternal grandmother as carriers of RPGRIP1L (NM_015272.2) c.3545del (p.Pro1182LeufsTer25). RPGRIP1L:c.3545del novel variant is a deletion which changes the reading frame, altering the RPGR1_C terminal domain and giving rise to an incomplete protein whose functions will be altered.

Conclusion:
This is the first genetically confirmed case of JS in Colombia, the first carrier of biallelic RPGRIP1L gene mutations with hip dislocation and incomplete glottic closure and the first report of the novel c.3545del likely pathogenic variant causing JS.