bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case report of giant malignant schwannoma of the sciatic nerve associated with neurofibromatosis-1: A CARE-compliant article
Authors: Gokkus Kemal , Saylik Murat , Birtay Tayfun , Sahin Mehmet Sukru 
Published: December 2023

Rationale:
Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous syndrome that causes multiple central and peripheral nerve sheath tumors. People with NF1 have a 10% chance of developing malignant peripheral nerve sheath tumors (MPNSTs). Here we report a unique instance of a malignant schwannoma that has remained free of metastasis since its initial removal a decade ago. The malign schwannoma has been infrequently documented in the literature, and remarkably, no instances of such an extensive postoperative time without metastases have ever been described.

Patient concerns:
A 46-year-old male patient with NF had multiple neurofibromas in different parts of his body, underwent surgery about 10 years ago (2013), and was diagnosed histopathologically as MPNST.

Diagnoses:
He was admitted to our institution with a recurrent mass in the posterior third of the proximal thigh and severe pain radiating to the left lower extremity, which presented as sciatic pain (2021). A magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography examination revealed that the tumor was likely malignant.

Interventions:
Surgical excision was performed.

Outcome:
A 10-year follow-up revealed no metastases or neurologic impairment.

Lessons:
When articles about benign schwannomas are placed in a separate category, little is written about NF-1-related malignant schwannomas of the sciatic nerve. MPNSTs are high-grade, aggressive sarcomas with a high risk of local recurrence (40%–65%) and metastasis to other body parts. Therefore, among the various benign peripheral nerve sheath tumors in NF-1 patients, the diagnosis of MPNST is crucial.
Orthopedic surgeons should be aware that neurofibromas in NF-1 have a significant risk of developing MPNSTs. This study reports the successful treatment of a giant malignant sciatic nerve schwannoma with a long follow-up period without metastasis.
A case report of autoimmune glial fibrillary acidic protein astrocytopathy presenting as an isolated spinal cord lesion
Authors: Liu Qing , Ma Hongmei , Yang Dan , Bian Tingting , Ji Jinyuan , Duan Huijie , Yan Heli , Wang Xiangbo 
Published: December 2023

Introduction:
Autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) is a group of neurological syndromes involving the meninges, brain, spinal cord, and optic nerves and is characterized by sensitivity to steroid therapy. Due to the diverse clinical presentation and lack of uniform diagnostic criteria, GFAP-A can easily be overlooked or diagnosed as another disease. It is even rarer when presenting as an isolated spinal cord lesion.

Case Report:
We report the case of a 70-year-old man with initial symptoms of numbness and weakness in both lower limbs, followed by difficulty in urination and defecation, and progression of numbness upward to the hands. Magnetic resonance imaging (MRI) showed a lesion in the spinal cord from cervical level 2 to thoracic 7 in a T2-weighted image. T1-weighted image showed a punctate, lamellar strengthening lesion with significant spinal strengthening. GFAP immunoglobulin G (IgG) was detected in the cerebrospinal fluid and blood. After treatment with intravenous gamma globulin (IVIG), the patient symptoms improved and spinal cord enhancement was reduced.

Conclusion:
Long segment cases with punctate and patchy enhancement of the spinal cord are difficult to distinguish from CLAPPERS, so GFAP-A antibody detection is very important. This atypical case also increases neurologists’ understanding of GFAP-A.
The incidence and predisposing factors for irritable bowel syndrome following COVID-19: a systematic review and meta-analysis
Authors: Wang Yi-nuo , Zhou Li-ying , Huang Yu-Hong , Jiang Min , Dai Cong 
Published: December 2023

Background:
Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder. Several studies have analyzed the long-term GI symptoms and IBS following coronavirus disease 2019 (COVID-19). The purpose of this study is to evaluate the incidence and predisposing factors for IBS following COVID-19 by a systematic review and meta-analysis.

Methods:
Electronic databases were searched to identify relevant studies. Primary outcomes were the pooled incidence rate of IBS following COVID-19 and the pooled relative risk (RR) for IBS in the COVID-19 group compared to the non-COVID-19 group. Secondary outcomes were the pooled RR and the standardized mean difference (SMD) for predisposing factors in the IBS group compared to the non-IBS group. Heterogeneity was evaluated using Cochran’s Q test and I
2 statistics.

Results:
Ten studies were included in this study. The pooled incidence rate of IBS in COVID-19 patients was 12%. The pooled incidence rate of IBS-D, IBS-C and IBS-M was 5%, 2% and 1%. The pooled incidence rate of IBS in 6 and 12 months was 10% and 3%. The pooled RR for IBS in COVID-19 patients was 1.23 [95% confidence interval (CI) = 0.50–3.01] compared to non-COVID-19 patients. The pooled RR or SMD for mild, moderate, and severe disease activity, procalcitonin (PCT), depression or anxiety in IBS patients following COVID-19 was 0.94 (95% CI = 0.74–1.21), 1.19 (95% CI = 0.65–2.21), 1.30 (95% CI = 0.63–2.66), 6.73 (95% CI = 6.08–7.38) and 3.21 (95% CI = 1.79–5.75).

Conclusion:
The incidence of IBS following COVID-19 was 12%. But it was not higher than the general population. We also found some predisposing factors for IBS including depression or anxiety, PCT.
Extracorporeal Cardiopulmonary Resuscitation for Amniotic Fluid Embolism
Authors: Sundin Courtney Stanley , Gomez Laura , Chapman Brian 
Published: December 2023

Abstract
Amniotic fluid embolism (AFE) is a rare, sudden, and catastrophic complication of pregnancy that can result in cardiopulmonary arrest, potentially leading to death. The pathophysiology of an AFE includes an inflammatory and coagulopathic response due to fetal materials entering maternal circulation with the hallmark triad of symptoms: acute respiratory distress, cardiovascular collapse, and coagulopathy. Management of AFE should include high-quality cardiopulmonary resuscitation, immediate delivery of the fetus if applicable, early intubation to provide adequate oxygenation and ventilation, fluid volume resuscitation, and ongoing evaluation of coagulopathy. Priorities include thromoboelastography interpretation if available, control of hemorrhage and coagulopathy with blood component therapy, and cardiovascular support through inotropes and vasopressor administration. More recent approaches include implementing the A-OK (atropine, ondansetron, and ketorolac) protocol for suspected AFE protocol, extracorporeal cardiopulmonary resuscitation (ECPR), and extracorporeal membrane oxygenation (ECMO) therapies to increase survival and decrease complications. Venoarterial ECMO is the highest form of life support that provides support in patients with pulmonary and cardiac failure. ECPR is the application of Venoarterial ECMO during cardiopulmonary resuscitation in cases where the cause of arrest is believed to be reversible. Early implementation of ECPR during the acute phase of AFE can provide support for end-organ perfusion in place of the weakened and recovering heart while optimizing oxygenation, making venoarterial ECMO an ideal adjunctive therapy. Because of the rarity of AFE, many obstetrical teams may have limited prior experience in managing these catastrophic cases; however, with ongoing education and simulation, teams can be better prepared in the recognition and management of these life-threatening events.
NIPBL::NACC1 Fusion Hepatic Carcinoma
Authors: Hissong Erika , Al Assaad Majd , Bal Munita , Reed Katelyn A. , Fornelli Adele , Levine Max F. , Gundem Gunes , Semaan Alissa , Orr Christine E. , Sakhadeo Uma , Manohar Jyothi , Sigouros Michael , Wilkes David , Sboner Andrea , Montgomery Elizabeth A. , Graham Rondell P. , Medina-Martínez Juan S. , Robine Nicolas , Fang Jiayun M. , Choi Eun-Young K. , Westerhoff Maria , Delgado-de la Mora Jesús , Caudell Patricia , Yantiss Rhonda K. , Papaemmanuil Elli , Elemento Olivier , Sigel Carlie , Jessurun José , Mosquera Juan Miguel 
Published: December 2023

Several reports describing a rare primary liver tumor with histologic features reminiscent of follicular thyroid neoplasms have been published under a variety of descriptive terms including thyroid-like, solid tubulocystic, and cholangioblastic cholangiocarcinoma. Although these tumors are considered to represent histologic variants, they lack classic features of cholangiocarcinoma and have unique characteristics, namely immunoreactivity for inhibin and NIPBL::NACC1 fusions. The purpose of this study is to present clinicopathologic and molecular data for a large series of these tumors to better understand their pathogenesis. We identified 11 hepatic tumors with these features. Immunohistochemical and NACC1 and NIPBL fluorescence in situ hybridization assays were performed on all cases. Four cases had available material for whole-genome sequencing (WGS) analysis. Most patients were adult women (mean age: 42 y) who presented with abdominal pain and large hepatic masses (mean size: 14 cm). Ten patients had no known liver disease. Of the patients with follow-up information, 3/9 (33%) pursued aggressive behavior. All tumors were composed of bland cuboidal cells with follicular and solid/trabecular growth patterns in various combinations, were immunoreactive for inhibin, showed albumin mRNA by in situ hybridization, and harbored the NIPBL::NACC1 fusion by fluorescence in situ hybridization. WGS corroborated the presence of the fusion in all 4 tested cases, high tumor mutational burden in 2 cases, and over 30 structural variants per case in 3 sequenced tumors. The cases lacked mutations typical of conventional intrahepatic cholangiocarcinoma. In this report, we describe the largest series of primary inhibin–positive hepatic neoplasms harboring a NIPBL::NACC1 fusion and the first WGS analysis of these tumors. We propose to name this neoplasm NIPBL:NACC1 fusion hepatic carcinoma.
Combination of Intranasal Dexmedetomidine and Midazolam for Sedation in Pediatric Magnetic Resonance Imaging
Authors: Palmese Salvatore , Bilancio Giancarlo , Caterino Vittorio , De Anseris Anna Giulia , Perciato Stanislao , Siglioccolo Antonio , Gammaldi Renato 
Published: December 2023

Background
Intranasal dexmedetomidine associated with midazolam has been used for pediatric magnetic resonance imaging studies because immobility is a fundamental requirement for correct execution. Many studies have shown dexmedetomidine to be a good option for non-operating room sedation. However, identifying the optimal dose remains a key challenge, especially for pediatric patients.

Methods
All medical records of 139 pediatric patients who underwent sedation for magnetic resonance imaging studies between September 2021 and November 2022 at the University Hospital of Salerno, Italy, were retrospectively reviewed about success rate and adverse events. Our protocol required dosing 30 minutes before the procedure. Patients weighing up to 40 kg received intranasal dexmedetomidine (3 μg/kg) with intranasal midazolam (0.2 mg/kg). Those weighing more than 40 kg received intranasal dexmedetomidine (2 μg/kg) with midazolam orally (0.3 mg/kg; maximum dose, 15 mg).

Results
A total of 139 pediatric patients, with age range between 2 months and 16 years, median (95% confidence interval) of 3 (3–5) years, and weight range between 4 and 70 kg, median (95% confidence interval) of 19 (15–24) kg, were reviewed.
The procedure was satisfactorily completed in 93.5% (130 patients) (P < 0.01). Only 9 (6.5%) patients completed the procedure with general anesthesia; there are hot adverse events.

Conclusions
Our experience with association of intranasal dexmedetomidine and midazolam has a high success rate, with high effectiveness and safety.
Clinical and Pathological Validation of CT-Based Regional Harmonization Methods of Amyloid PET
Authors: Kim Soo-Jong , Jang Hyemin , Yoo Heejin , Na Duk L. , Ham Hongki , Kim Hee Jin , Kim Jun Pyo , Farrar Gill , Moon Seung Hwan , Seo Sang Won 
Published: December 2023

Purpose
The CT-based regional direct comparison Centiloid (dcCL) method was developed to harmonize and quantify regional β-amyloid (Aβ) burden. In the present study, we aimed to investigate correlations between the CT-based regional dcCL scales and Aβ pathological burdens and to validate the clinical utility using thresholds derived from pathological assessment.

Patients and Methods
We included a pathological cohort of 63 cases and a clinical cohort of 4062 participants, and obtained modified Consortium to Establish a Registry for Alzheimer’s Disease criteria (mCERAD) scores by assessment of neuritic plaque burdens in multiple areas of each cortical region. PET and CT images were processed using the CT-based regional dcCL method to calculate scales in 6 distinct regions.

Results
The CT-based regional dcCL scales were correlated with neuritic plaque burdens represented by mCERAD scores, globally and regionally (r = 0.56~0.76). In addition, striatum dcCL scales reflected Aβ involvement in the striatum (P < 0.001). The regional dcCL scales could predict significant Aβ deposition in specific brain regions with high accuracy: area under the receiver operating characteristic curve of 0.81–0.97 with an mCERAD cutoff of 1.5 and area under the receiver operating characteristic curve of 0.88–0.93 with an mCERAD cutoff of 0.5. When applying the dcCL thresholds of 1.5 mCERAD scores, the G(−)R(+) group showed lower performances in memory and global cognitive functions and had less hippocampal volume compared with the G(−)R(−) group (P < 0.001). However, when applying the dcCL thresholds of 0.5 mCERAD scores, there were no differences in the global cognitive functions between the 2 groups.

Conclusions
The thresholds of regional dcCL scales derived from pathological assessments might provide clinicians with a better understanding of biomarker-guided diagnosis and distinguishable clinical phenotypes, which are particularly useful when harmonizing different PET ligands with only PET/CT.
Clinical Implications of Adding SPECT/CT to Radioiodine Whole-Body Scan in Patients With Differentiated Thyroid Cancer
Authors: Chong Ari , Seo Youngduk , Bang Ji-In , Park Sohyun , Kim Keunyoung , Hong Chae Moon , Choi Miyoung , Oh So Won , Lee Sang-Woo 
Published: December 2023

Purpose
This study aimed to determine the usefulness of adding SPECT/CT to radioiodine whole-body scans (WBSs) for the treatment of differentiated thyroid cancer (DTC).

Patients and Methods
A systematic review and meta-analysis were performed following the PRISMA guidelines (PROSPERO registration: CRD42022341732) to compare the feasibility of conclusive readings and the frequency of changes in treatment plans in patients with DTC undergoing WBS + SPECT/CT versus WBS. MEDLINE, EMBASE, and Cochrane databases were searched to identify relevant articles concerning thyroid cancer, radioactive iodine, and SPECT/CT or SPECT, published before August 16, 2023. Studies not comparing WBS + SPECT/CT with WBS, those lacking target outcomes, and those not involving human subjects were excluded. The risk of bias was assessed using the RoBANS 2.0 (Risk of Bias Assessment Tool for Nonrandomized Studies) tool. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system was used to evaluate the quality of evidence and strength of recommendations.

Results
A total of 30 studies (prospective n = 9, retrospective n = 21) were included in the meta-analyses. Adding SPECT/CT to WBS was shown to increase conclusive readings for cervical lesions, extracervical lesions, and all regions. Lesion-based analyses showed improvements of 14%, 20%, and 18%, respectively, whereas scan-based analyses showed improvements of 27%, 9%, and 34%. The addition of SPECT/CT to WBS led to changes in 30% of treatment plans after diagnostic scans and 9% of treatment plans after posttherapeutic scans. The quality of evidence and strength of recommendations were low.

Conclusions
Compelling evidence demonstrates that the addition of SPECT/CT to WBS improves lesion localization, diagnostic performance, and therapy plan for patients with DTC.
Cure Probabilities After Resection of Pancreatic Ductal Adenocarcinoma: A Multi-Institutional Analysis of 2554 Patients
Authors: Crippa Stefano , Malleo Giuseppe , Langella Serena , Ricci Claudio , Casciani Fabio , Belfiori Giulio , Galati Sara , Ingaldi Carlo , Lionetto Gabriella , Ferrero Alessandro , Casadei Riccardo , Ercolani Giorgio , Salvia Roberto , Falconi Massimo , Cucchetti Alessandro 
Published: December 2023

Objective:
To assess the probability of being cured of pancreatic ductal adenocarcinoma (PDAC) by pancreatic surgery.

Background:
Statistical cure implies that a patient treated for a specific disease will have the same life expectancy as if he/she never had that disease.

Methods:
Patients who underwent pancreatic resection for PDAC between 2010 and 2021 were retrospectively identified using a multi-institutional database. A nonmixture statistical cure model was applied to compare disease-free survival to the survival expected for a matched general population.

Results:
Among 2554 patients, either in the setting of upfront (n=1691) or neoadjuvant strategy (n=863), the cure model showed that the probability that surgery would offer the same life expectancy (and tumor-free) as the matched general population was 20.4% (95% CI: 18.3, 22.5). Cure likelihood reached the 95% of certainty (time to cure) after 5.3 years (95% CI: 4.7, 6.0). A preoperative model was developed based on tumor stage at diagnosis (P=0.001), radiologic size (P=0.001), response to chemotherapy (P=0.007), American Society of Anesthesiology class (P=0.001), and preoperative Ca19-9 (P=0.001). A postoperative model with the addition of surgery type (P=0.015), pathologic size (P=0.001), tumor grading (P=0.001), resection margin (P=0.001), positive lymph node ratio (P=0.001), and the receipt of adjuvant therapy (P=0.001) was also developed.

Conclusions:
Patients operated for PDAC can achieve a life expectancy similar to that of the general population, and the likelihood of cure increases with the passage of recurrence-free time. An online calculator was developed and available at https://aicep.website/?cff-form=15.
Risk Factors for Surgical-Site Infections After Liver Transplant: Does Perioperative Antibiotic Regimen Matter?
Authors: Rolak Stacey C. , Yetmar Zachary A. , Lahr Brian D. , Beam Elena , Razi Samrah , Watt Kymberly , Yang Liu , Aqel Bashar A. , Mahmood Maryam 
Published: December 2023

Background.
Surgical-site infections (SSIs) are common in liver transplant recipients. The optimal SSI antimicrobial prophylaxis agent and duration are not established. We aimed to explore risk factors for SSIs after transplant, with a particular interest in the impact of perioperative antibiotic regimen on the development of SSIs.

Methods.
Retrospective study of adults undergoing liver transplant across 3 transplant programs between January 1, 2020, and June 01, 2021.

Results.
Of 557 patients included in the study, 32 (5.7%) were infected or colonized with a multidrug-resistant organism (MDRO) within 1 y before liver transplant. Narrow-spectrum SSI prophylaxis with ceftriaxone or cefazolin alone was administered in 488 of 577 patients (87.6%); the remaining 69 patients (12.4%) received broad-spectrum prophylaxis with vancomycin and aztreonam (n = 40), piperacillin–tazobactam (n = 11), carbapenems (n = 8), ceftriaxone and another antibiotic (n = 7), and others. Patients with pretransplant MDRO were more likely to receive broad-spectrum coverage than those without pretransplant MDROs (28.1% versus 11.4%, P = 0.005). SSIs were identified in 40 patients (7.2%); 25 (62.5%) were organ–space infections, 3 (7.5%) were deep incisional infections, and 12 (30.0%) were superficial incisional infections. The median time from liver transplant to SSIs was 14 d (interquartile range, 10–20.2). MDROs were identified in 12 SSIs (30%). Multivariable analysis revealed no significant association between antimicrobial spectrum and risk of SSIs (P = 0.5), whereas surgical leak (P<0.001) and reoperation (P = 0.017) were independently associated with increased risk of SSIs. SSIs were not significantly associated with composite risk of death or liver allograft failure.

Conclusions.
The spectrum of antimicrobial prophylaxis did not impact the development of SSIs in liver transplant recipients.
Ab initio
study of defect interactions between the negatively charged nitrogen vacancy centre and the carbon self-interstitial in diamond
Authors: Kirkpatrick Andrew R. , Chen Guangzhao , Witkowska Helen , Brixey James , Green Ben L. , Booth Martin J. , Salter Patrick S. , Smith Jason M. 
Published: December 2023

Fabrication techniques for nitrogen-vacancy centres in diamond require the creation of Frenkel defects (vacancy-interstitial pairs) the components of which can interact with formed NV centres affecting their photophysical properties. Here we use Density Functional Theory simulations of inter-defect electronic and strain interactions to explore how the NV centre and carbon self-interstitial interact in different configurations. We find that hybridization occurs between the NV centre e-orbitals and the carbon self-interstitial when an interstitial is present on the vacancy side of the NV centre. We propose that this phenomenon may explain the fluorescence blinking of NV centres observed during annealing.
This article is part of the Theo Murphy meeting issue ‘Diamond for quantum applications’.
Distinct gradients of cortical architecture capture visual representations and behavior across the lifespan
Authors: Chen Xiayu , Liu Xingyu , Hoyos Patricia Maria , Daniel Hertz Edan , Yao Jewelia K. , Zhen Zonglei , Gomez Jesse 
Published: December 2023

AbstractThe microstructure of cells within human cerebral cortex varies across the cortical ribbon, where changes in cytoarchitecture and myeloarchitecture are thought to endow each region of cortex with its unique function. While fine-scale relative to a cell, these changes at population level impact architectural properties of cortex measurable in vivo by noninvasive MRI, such as the thickness and myelin content of cortex. This raises the question of whether or not we can use these in vivo architectural measures to understand cortical organization, function, and development more broadly. Using human visual cortex as a test bed, we demonstrated two architectural gradients, one in which cytoarchitecture and myeloarchitecture converge and another in which they diverge. These two gradients underlie the structural and functional topography of visual cortex, even predicting the presence of new visual field maps. Moreover, the two gradients show distinct visual behavior relevance and lifespan trajectory. These findings provide a more general framework for understanding human cortex, showing that architectural gradients are a measurable fingerprint of functional organization and ontogenetic routines in the human brain.