bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracranial progression of the epidermoid cyst to a white epidermoid cyst in a pediatric patient: a case report
Authors: Laverde-Reyes María Fernanda , Márquez Juan Camilo , Nasner Daniela , Granados-Sánchez Ana María , Castillo Luis Fernando 
Published: November 2023

Abstract
Background
Epidermoid cysts are rare benign lesions that originate from remnants of ectodermal epithelial tissue, particularly infrequent in the pediatric population. They exhibit characteristic imaging features, with occasional variations leading to the development of a “white” epidermoid cyst. This transformation results from the presence of protein and lipid material within the cyst, causing intrinsic hyperintensity in T1-weighted images, signal hypointensity in T2-weighted images, and a bright signal in diffusion-weighted imaging.

Case presentation
We describe the case of a 5-year-old Latina pediatric patient initially diagnosed with a typical epidermoid cyst. After 13 years of follow-up, this typical epidermoid cyst underwent a transformation, becoming a “white” epidermoid cyst.

Conclusions
Epidermoid cysts are rare intracranial lesions. The term “white epidermoid cyst” does not denote a variant; it represents a distinct transformation within an epidermoid cyst due to liquid and protein accumulation. This transformation should be considered in cases with specific imaging characteristics.
Acinetobacter baumannii: assessing susceptibility patterns, management practices, and mortality predictors in a tertiary teaching hospital in Lebanon
Authors: Itani Rania , Khojah Hani M. J. , Karout Samar , Rahme Deema , Hammoud Lara , Awad Reem , Abu-Farha Rana , Mukattash Tareq L. , Raychouni Hamza , El-Lakany Abdalla 
Published: November 2023

Abstract
Background
Acinetobacter baumannii is a major nosocomial pathogen capable of causing life-threatening infections. This bacterium is highly resistant to antibiotics and associated with high mortality rates. Therefore, this study aimed to evaluate A. baumannii's susceptibility patterns to antimicrobials, assess the appropriateness of the initiated antimicrobial therapy, determine the mortality rate, and identify predictors associated with mortality.

Methods
A retrospective observational study was conducted among patients infected with A. baumannii at a university hospital in Lebanon through the revision of medical records. Kaplan–Meier survival analysis and log-rank tests were used to analyze time-to-mortality. Binary logistic regression was performed to identify predictors of mortality.

Results
The records of 188 patients were screened, and 111 patients with A. baumannii infection were enrolled. Almost all isolates were resistant to carbapenem, and 43% of the isolates were extensively-drug resistant. Almost half of the patients received initial inappropriate antimicrobial therapy (n = 50, 45.1%). The 30-day mortality rate associated with A. baumannii infection was 71.2% (79/111). The time to mortality in patients who received inappropriate antimicrobial therapy (5.70 ± 1.07 days) was significantly shorter than in those who received appropriate antimicrobial therapy (12.43 ± 1.01 days, P < 0.01). Binary logistic regression revealed that inappropriate antimicrobial therapy (adjusted odds ratio [AOR] = 16.22, 95% CI 2.68–9.97, P = 0.002), mechanical ventilation (AOR = 14.72, 95% CI 3.27–6.61, P < 0.001), and thrombocytopenia (AOR = 8.82, 95% CI 1.12–9.75, P = 0.003) were more likely associated with mortality.

Conclusions
A. baumannii exhibits an alarming mortality rate among infected patients. Thrombocytopenia, mechanical ventilation, and inappropriate antibiotic administration are associated with mortality in patients infected with A. baumannii. The prompt initiation of appropriate antimicrobial therapy, infection control measures, and effective stewardship program are crucial to reduce the incidence of A. baumannii and improve the treatment outcomes.
Knee extension contracture with fixed anterior tibia subluxation treated with PCL release and quadricepsplasty: a case report
Authors: Kim Dong Woon , Mostowy Marcin , Pękala Przemyslaw A. , Bawor Michalina , Kennedy Nicholas I. , LaPrade Robert F. , Malinowski Konrad 
Published: November 2023

Abstract58‐year‐old male presented with knee extension contracture (25°) with iatrogenic fixed anterior tibial subluxation. Consecutive arthroscopic arthrolysis, manipulation under anesthesia, and quadriceps‐Z‐plasty during one surgery failed to restore flexion. Therefore, shortened posterior cruciate ligament was released, which eliminated subluxation and allowed 115° flexion. Despite physiotherapy, flexion progressively decreased to 70° postoperatively. Revision quadricepsplasty by transverse incisions restored 120° of flexion maintained at 31‐months follow‐up. International Knee Documentation Committee increased 4/87‐ > 50/87, Knee injury and Osteoarthritis Outcome 7/100‐ > 68/100 at follow‐up. Posterior cruciate ligament release and repeated quadricepsplasty could be a viable salvage option in severe extension contracture with fixed anterior tibial subluxation.
Femoral head translation in borderline and definite dysplastic hips during weight‐bearing: 2D/3D image registration analysis
Authors: Sakai Shinichiro , Kutsuna Tatsuhiko , Kono Kohei , Kinoshita Tomofumi , Mashima Naohiko , Takao Masaki 
Published: November 2023

AbstractPurposeThe aims of this study were to 1) assess femoral head translation during weight‐bearing in symptomatic developmental dysplasia of the hip (DDH) and 2) compare it between borderline DDH and definite DDH.MethodsThe study included four individuals with borderline DDH and nine with definite DDH, scheduled for periacetabular osteotomy. Anteroposterior X‐ray images of the hip joint were obtained in the standing position, and computed tomography images of the pelvis were obtained in the supine position. Femoral head translation from the supine to a standing position was measured using 2D/3D X‐ray image registration.ResultsFrom a supine to a standing position, the femoral head translated 0.3 mm laterally, 0.5 mm anteriorly, and 0.5 mm superiorly on average. The mean femoral head translation in 3D between the supine and standing positions was 1.5 mm. The 3D femoral head translation in the borderline DDH group was significantly greater than that in the definite DDH group. In the definite DDH group, there was a significant correlation between the center edge (CE) angle and 3D femoral head translation (ρ = ‐0.78, P = 0.012).ConclusionsSymptomatic DDH showed femoral head translation in the anterior, lateral, and superior directions during weight‐bearing. In definite DDH, the amount of femoral head translation was negatively correlated with the CE angle. The amount of 3D translation in patients with borderline DDH was larger than that in definite DDH. Dynamic joint instability during weight‐bearing was observed in borderline DDH as well as definite DDH. Treatment to enhance joint stability during weight‐bearing is important in both cases.
Comparison of the LBM snowdrift model output with the observation results
Authors: Tanji Seika , Inatsu Masaru , Harada Yusuke 
Published: November 2023

AbstractIn this work, snowdrift experiments which are equivalent to one drifting snow event are performed by the snowdrift model. The model consisted of the computational fluid dynamics part of the large-eddy simulation with the lattice Boltzmann method and the drifting snow part of the conventional advection algorithm for representative Lagrangian particles. The observed vertical wind profile of a 4 h drifting snow event in Teshikaga Town was used as the inflow boundary conditions in the model to compare the results of the snowdrift estimated by the model and the observed snowdrift distribution. Parallelization enabled us to simulate the snowdrift distribution in a realistic domain and on the time scale of a single drifting snow event. We demonstrated that the upgraded model could quantitatively reproduce the height and position of the observed snowdrift along the center of a three-dimensional fence.
Radiofrequency ablation induces tumor cell dissemination in a mouse model of hepatocellular carcinoma
Authors: Zhuang Bowen , Zhu Xi , Lin Jinhua , Zhang Fuli , Qiao Bin , Kang Jihui , Xie Xiaohua , Wei Xunbin , Xie Xiaoyan 
Published: November 2023

Abstract
Background
We tested the hypothesis that radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) promotes tumor cell release and explored a method for reducing these effects.

Methods
A green fluorescent protein-transfected orthotopic HCC model was established in 99 nude mice. In vivo flow cytometry was used to monitor circulating tumor cell (CTC) dynamics. Pulmonary fluorescence imaging and pathology were performed to investigate lung metastases. First, the kinetics of CTCs during the periablation period and the survival rate of CTCs released during RFA were investigated. Next, mice were allocated to controls, sham ablation, or RFA with/without hepatic vessel blocking (ligation of the portal triads) for evaluating the postablation CTC level, lung metastases, and survival over time. Moreover, the kinetics of CTCs, lung metastases, and mice survival were evaluated for RFA with/without ethanol injection. Pathological changes in tumors and surrounding parenchyma after ethanol injection were noted. Statistical analysis included t-test, ANOVA, and Kaplan-Meier survival curves.

Results
CTC counts were 12.3-fold increased during RFA, and 73.7% of RFA-induced CTCs were viable. Pre-RFA hepatic vessel blocking prevented the increase of peripheral CTCs, reduced the number of lung metastases, and prolonged survival (all p ≤ 0.05). Similarly, pre-RFA ethanol injection remarkably decreased CTC release during RFA and further decreased lung metastases with extended survival (all p ≤ 0.05). Histopathology revealed thrombus formation in blood vessels after ethanol injection, which may clog tumor cell dissemination during RFA.

Conclusion
RFA induces viable tumor cell dissemination, and pre-RFA ethanol injection may provide a prophylactic strategy to reduce this underestimated effect.

Relevance statement
RFA for HCC promotes viable tumor cell release during ablation, while ethanol injection can prevent RFA induced tumor cell release.

Key points
• RFA induced the release of viable tumor cells during the ablation procedure in an animal model.
• Hepatic vessel blocking can suppress tumor cells dissemination during RFA.
• Ethanol injection can prevent RFA-induced tumor cell release, presumably because of the formation of thrombosis.

Graphical Abstract
Identification of the cuproptosis-related ceRNA network and risk model in acute ischemic stroke by integrated bioinformatics analysis
Authors: Jia Fang , Zhang Bingchang , Li Chongfei , Yu Weijie , Li Zhangyu , Wang Zhanxiang 
Published: November 2023

Abstract
Background
Acute ischemic stroke (AIS) is one of the leading contributors to death and disability in adults. And cuproptosis is a novel type of cell death. Yet, its role in AIS is still unknown.

Methods
The mRNA, miRNA, and circRNA expression data were downloaded from the Gene Expression Omnibus database. We explored differentially expressed circRNAs (DEcircRNAs), microRNAs (DEmiRNAs), and cuproptosis-related genes (DECuRGs) after AIS. With the target prediction tools, we constructed a cuproptosis-related competitive endogenous RNA (ceRNA) network mediated by circRNAs in AIS. Afterward, functional enrichment analysis, cytoHubba plugin, protein–protein interaction, weighted gene co-expression network analysis, and unsupervised clustering analysis were performed to determine the critical genes and relevant pathways. Machine learning techniques were used to identify the optimal risk model. The CIBERSORT was applied to explore the immune-infiltrating characteristics in AIS samples. Finally, two independent datasets were employed to verify the predictive value of the risk model.

Results
Altogether, 26 DECuRGs were identified in this study. Enrichment analysis revealed that they participated in the reactive oxygen metabolism, inflammatory responses, and corresponding cuproptosis-related biological processes. Of the DECuRGs, MTF1 and UBE2D2 were included in the ceRNA network, comprising three circRNA-miRNA and two miRNA-mRNA interaction pairs. Hub gene analysis determined the hub regulatory axis in the process of cuproptosis, namely, MTF1-miR-765-circ_0040760/0068531. We finally constructed a 5-gene risk model (C10orf32, NUCB1, AX748267, MRPL28, and PPP1R15A) by multiple analyses, which was validated by two independent datasets (AUC = 0.958 and 0.668). Besides, significant differences in immune cell infiltration were observed between AIS patients and normal controls. The levels of neutrophils were correlated with most of the DECuRGs. The ceRNA axis identified in this study was also associated with the immune microenvironment of AIS patients.

Conclusion
The findings revealed that cuproptosis might be associated with AIS and that the key nodes, including the regulatory axes, might exert critical roles in the process of AIS. The risk model provided new insights into the early diagnosis and treatment of AIS.
Clinical features and therapeutic approaches of genital lichen sclerosus in children: results of an observational monocentric study
Authors: Caroppo Francesca , Mazzetto Roberto , Fortina Anna Belloni 
Published: November 2023

Abstract
Background
Lichen sclerosus is a chronic, progressive, inflammatory skin disease that presents unique challenges, particularly in the pediatric population, where limited data exist regarding its manifestation and optimal management. This retrospective observational monocentric study aims to provide insights into the clinical characteristics and therapeutic strategies employed, in a cohort of children and adolescents with genital lichen sclerosus.

Methods
A comprehensive analysis was conducted involving a cohort of 60 pediatric patients ranging from 1 to 15 years old, all diagnosed with lichen sclerosus. These cases were referred to the Pediatric Dermatology Regional Center of the University of Padua, Italy, between January 2018 and January 2022. Moreover, we propose a treatment protocol that showed beneficial outcomes in all of our patients. Specifically, the initial use of mid-potency topical corticosteroids has proven effective in addressing severe acute flares. Following this acute phase, transitioning to long-term treatment with topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, has demonstrated effectiveness in maintaining remission of the disease and also shown efficacy in treating mild cases. The therapeutic effectiveness was assessed by considering various clinical aspects, including erythema, paleness, skin erosions, and specific symptoms such as itching, burning, and pain.

Results
Erythema emerged as the predominant clinical sign, reported in 43 (78.3%) patients, followed by paleness, reported in 17 (28.3%) patients. Pruritus was observed in 25 girls (58.1% of females) and 2 boys (11.8% of males), while pain and burning sensations were predominantly reported in female children. Among females, we observed a higher prevalence of cutaneous comorbidities, such as atopic dermatitis, psoriasis, alopecia areata, and linear scleroderma, as opposed to autoimmune systemic diseases, that were more prevalent in males. Regarding therapeutic approaches, 21 (35.0%) patients applied topical corticosteroids, 28 (46,7%) applied topical tacrolimus and 21 (35,0%) applied topical pimecrolimus. All treated patients experienced notable benefits following the initiation of treatment proposed by our protocol.

Conclusions
This study provides further insights into the clinical presentation and management of lichen sclerosus in the pediatric population, shedding light on potential therapeutic pathways for optimizing patient outcomes in this specific demographic. The proposed protocol appears to be a promising strategy, especially when the onset of the disease occurs during childhood.
The role of magnetic resonance enterography and diffusion-weighted imaging in pediatric inflammatory bowel disease compared to endoscopic and clinical activity scores: pilot study
Authors: Saleh Gehad Ahmad , Razek Ahmed Abdel Khalek Abdel , Awad Sara Ibrahim , Shokeir Mohamad Abd El Rahaman , Megahed Ahmed 
Published: November 2023

Abstract
Background
Inflammatory bowel disease (IBD) is considered as significant cause of morbidity in children with a global rise in its pediatric onset recently. Our study aimed to assess the facility of magnetic resonance enterography (MRE) and diffusion-weighted imaging (DWI) to identify the activity of pediatric IBD in correlation with clinical and endoscopic activity scores. Twenty-four patients of IBD who underwent clinical examination, ileocolonoscopy and MRE and DWI within less than 14 days were prospectively included. For all Crohn’s cases (9/24), the simplified endoscopic activity score for Crohn’s disease (SES-CD) and magnetic resonance enterography global score (MEGS) were acquired, while for all UC (15/24) cases, MRE score and Mayo endoscopic score were calculated. Sensitivity and specificity of MRE for detection disease activity against clinical and endoscopic scores were compared. Pathological reference for disease activity was based on assessment for mucosal inflammatory changes on endoscopic biopsy in all cases.

Results
There was a perfect inter-observer agreement (kappa 0.81–1) regarding wall thickening and mural edema, with substantial agreement (kappa 0.61–0.8) for MRE severity score, mural diffusion restriction, mesenteric edema and vascular congestion, while mural enhancement and for number of active LNs revealed moderate agreement (kappa 0.41–0.6). There was a significant positive correlation between MEGS and SES-CD in Crohn’s cases as well as between Mayo endoscopic score and MRE severity in UC cases (r = 0.970, p > 0.001 and r = 0.544, p = 0.036, respectively). MRE compared to endoscopic findings and clinical activity scores revealed high accuracy (95.8%) with 87.5%, 80%, 96% and 94.1% for sensitivity, specificity, PPV and NPV, respectively.

Conclusion
MR enterography is a noninvasive reliable imaging modality of high accuracy for the diagnosis of pediatric IBD severity compared to endoscopic activity scores and pathological severity.
Vestibular-evoked myogenic potentials and video head impulse test in cochlear otosclerosis
Authors: Elmoazen Doaa Mohamed , Asal Samir Ibrahim , Ziton Shimaa Mohamed 
Published: November 2023

Abstract
Background
Otosclerosis is one of the most common causes of hearing loss in adults with clinical onset between 20 and 40 years of age. Vestibular symptoms may be the most agonizing and primary symptom in cases with otosclerosis, so the assessment of patients is important. The vestibular-evoked myogenic potentials test (VEMP) is used to assess the saccular and the utricular functions using cervical and ocular vestibular-evoked myogenic potentials (cVEMP and oVEMP), respectively. The video head impulse test (vHIT) which measure vestibulo-ocular reflex (VOR) to rapid impulsive head acceleration in the plane of each semicircular canal (SCC) has allowed quantitative monitoring of each canal function.

Methods
Twenty subjects with bilateral otosclerosis were studied, ranging in age from 30 to 55 years, divided into two groups. One group consisted of 10 adult patients with bilateral conductive otosclerosis. The second group consisted of 10 adult patients with bilateral mixed otosclerosis. All the patients underwent cVEMP and oVEMP, using a BC 500Hz tone burst stimulus and vHIT in three planes, left anterior right posterior (LARP), right anterior left posterior (RALP), and lateral SCCs.

Results
The findings indicate statistically significant differences in the peak-to-peak amplitudes of cVEMP and oVEMP in the two studied groups, and the mixed cases had lower amplitudes than conductive cases and a significant increase in p13 latencies. Also, there is a statistically significant difference in the lateral SCC gain between the two groups, as mixed cases had lower gain than conductive cases, but not for anterior or posterior SCCs, with no gain less than 0.8 in all three canals.

Conclusion
The findings suggested that the saccule is more liable to be affected by cochlear otosclerosis followed by the utricle. The three SCCs are mostly spared.
Clinical Factors Affecting Daily Dosage of Desmopressin Orally Disintegrating Tablets in Arginine Vasopressin Deficiency
Authors: Hoshino Yoshitomo , Inoue Kosuke , Ikeda Sara , Goshima Yukiko , Tatsushima Keita , Fukuhara Noriaki , Okada Mitsuo , Nishioka Hiroshi , Yamada Shozo , Takeuchi Yasuhiro , Takeshita Akira 
Published: November 2023

Abstract

Context
Desmopressin orally disintegrating tablets (ODTs) are widely used to treat arginine vasopressin deficiency (AVP-D). However, limited information is available on the dosage regimen; the dosage for each patient is selected based on their response to the initiation dose.

Objective
To investigate the relationships between clinical characteristics and the daily dose of ODTs and to identify factors that affect ODT dosages.

Methods
This retrospective study included 209 adult patients with AVP-D. Patients were administered ODTs sublingually and instructed to restrict eating and drinking for 30 minutes after taking ODTs using a patient leaflet. ODT dose titration was conducted during hospitalization with close monitoring of urine output, body weight, and serum sodium levels. Multivariable linear regression models were applied to identify clinical factors associated with the daily dose of ODTs at discharge. We also evaluated the dosage at 1 year in 134 patients who were followed up in our hospital.

Results
The median daily dose of ODTs at discharge was 90 µg (IQR 60-120 µg). Multivariable linear regression models identified sex, age, and estimated creatinine clearance (eCCr) as significant factors associated with the daily dose of ODTs, with eCCr having the strongest effect. After excluding patients recovering from AVP-D, 71% of those followed up at our hospital took the same daily dose at 1 year after discharge.

Conclusion
To achieve the safe and stable treatment of AVP-D, the daily dose of ODT needs to be selected based on a patient's sex, age, and eCCr under appropriate sublingual administration by patient education.