bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unmasking the invisible enemy: A case report of metagenomics-guided diagnosis and treatment of neonatal septic meningitis caused by Corynebacterium aurimucosum in a preterm infant with neonatal lupus erythematosus
Authors: Xia Qing , Gu Meiqun , Xu Yu , Sang Haoke , Lin Wenhua , Wang Yajun , Liu Kai 
Published: February 2024

Rationale:Neonatal septic meningitis is a serious condition that can be caused by various pathogens, includingCorynebacterium aurimucosum, a rare and opportunistic bacterium. We reports a case of infectious meningitis in a premature infant with neonatal lupus erythematosus caused byC aurimucosum. The purpose of this study is to explore the occurrence of meningitis caused byC aurimucosumin preterm infants with neonatal lupus erythematosus. We found that early diagnosis and treatment are crucial for this type of meningitis, especially for infants with impaired immunity or mothers receiving immunosuppressive therapy. This bacterium is rare in clinical practice, but it needs to be taken seriously.Patient concerns:The infant was born to a mother with systemic lupus erythematosus who had a history of long-term immunosuppressive therapy. The infant presented with preterm birth, purplish-red skin, fever, and widespread scarlet dermatitis. He also had positive anti-Ro/SSA and anti-La/SSB antibodies.Diagnosis:The infant was diagnosed with neonatal lupus erythematosus based on clinical and serological features. A lumbar puncture revealed septic meningitis with high levels of total nucleated cells, protein, and Pan’s test in the CSF. The macrogenic examination identifiedC aurimucosumas the causative agent. The culture of the mother’s vaginal secretion also revealed the same bacterium.Interventions:The infant was treated with anti-infective therapy with ceftriaxone, ampicillin, vancomycin, and meropenem. He also received prednisone and gammaglobulin infusion for neonatal lupus erythematosus.Outcomes:The infant’s temperature returned to normal, and his general condition and responsiveness improved. The CSF cytology and biochemistry normalized, and the culture was negative. The cranial MRI examination showed no abnormalities. The red rash disappeared, and the follow-ups after discharge revealed no complications.Lessons:This case highlights the importance of early diagnosis and treatment of neonatal septic meningitis caused byC aurimucosum, especially in infants with immunocompromised conditions or maternal history of immunosuppressive therapy.C aurimucosumshould not be overlooked as a potential pathogen in neonatal septic meningitis.
Recurrent hematuria involving urinary system with Klippel-Trenaunay syndrome: A case report
Authors: Lin Feng , Yang Kewei , Xu Jiadong , Wang Gang , Yang Lixia , Huang Jinrong , Li Dan 
Published: February 2024

Rationale:
Klippel-Trenaunay syndrome (KTS) is a rare congenital venous malformation, it had been found to be caused by mutations of the phosphatidylinositol 4, 5-diphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene. Currently KTS is defined as a triad of skin wine pigmented spots, varicose veins and malformations of the lower extremities, and hypertrophy of bone and soft tissue, involving urinary system up to 6% to 30%. When the urinary system is involved, KTS is often presented as painless massive gross hematuria.

Patient concerns:
This article describes a woman who was hospitalized with painless massive gross hematuria. Physical examination revealed significant hypertrophy of the right lower limb with varicose veins, port-wine stains in the skin, and right perineal hemangiomatous changes with swelling. The patient was admitted to hospital 4 times for repeated hematuria and infection.

Diagnoses:
By physical examination, CT urography, ureteroscopy and cystoscopy, the patient was diagnosed to have Klippel-Trenaunay syndrome, involving the urinary system.

Interventions:
The patient hematuria improved after multiple indwelling D-J tubes and anti-inflammatory treatment.

Outcomes:
The final symptoms of hematuria improved significantly, follow-up so far has not recurred.

Lessons:
This case presents the possibility of painless gross hematuria with KTS. Most of patients can be improved by conservative treatment. Cystoscopic laser therapy is the preferred treatment for poor bleeding control. Cystectomy and nephrectomy should be considered when life-threatening.
Rodenticide poisoning leading to cerebral hemorrhage: A case report
Authors: He Qian-kun , Wu Yuan-hua , Lu Xiao-ying , Liu Ming-wei 
Published: February 2024

Rationale:
Anticoagulant rodenticides (ARs) are a substantial fraction of murine types. AR poisoning causes bleeding from the skin, mucous membranes, and multiple organs. However, reports of AR-induced cerebral hemorrhage are scarce.

Patient concerns:
A 40-year-old male presented with dizziness, headache, and limb weakness for 5 days and with coagulopathy. Two days prior to the onset of these symptoms, the patient was exposed to dead mice.

Diagnoses:
Rodenticide intoxication-induced cerebral hemorrhage.

Interventions:
Vitamin K1 infusion, administration of dehydrating agents to reduce intracranial pressure, and correction of acid-base and electrolyte imbalances.

Outcomes:
After 9 days of treatment, the patient’s symptoms were relieved, and reexamination revealed that coagulation parameters returned to normal levels. The patient was eventually discharged for observation with oral vitamin K1.

Conclusions:
Rodenticide poisoning can lead to intracerebral hemorrhage, and treatment with vitamin K1 infusion is effective.

Lesson:
Rodenticide poisoning-induced cerebral hemorrhage is rarely reported. Because its symptoms are nonspecific, it is easy to miss the diagnosis or misdiagnose. When patients present with direct and indirect symptoms such as dizziness, headache, and limb weakness, rodenticide poisoning should be considered. Coagulation function and head computed tomography or magnetic resonance imaging examination should be performed at the earliest to confirm the diagnosis and provide timely treatment.
Williams-Beuren syndrome in pediatric T-cell acute lymphoblastic leukemia: A rare case report and review of literature
Authors: Yang Rong , Ai Yuan , Bai Ting , Lu Xiao-Xi , He Guoqian 
Published: February 2024

Background:
Williams-Beuren syndrome (WBS) is a rare genetic disorder caused by hemizygous microdeletion of contiguous genes on chromosome 7q11.23. Although the phenotype features extensive heterogeneity in severity and performance, WBS is not considered to be a predisposing factor for cancer development. Currently, hematologic cancers, mainly Burkitt lymphoma, are rarely reported in patients with WBS. Here in, we report a unique case of T-cell acute lymphoblastic leukemia in a male child with WBS.

Methods:
This retrospective study analyzed the clinical data of this case receiving chemotherapy were analyzed. This is a retrospective study.

Results:
The patient, who exhibited a typical WBS phenotype and presented with hemorrhagic spots. Chromosomal genome-wide chip analysis (CMA) revealed abnormalities on chromosomes 7 and 9. The fusion gene STIL-TAL1 and mutations in BCL11B, NOTCH1, and USP7 have also been found and all been associated with the occurrence of T-cell leukemia. The patient responded well to the chemotherapy.

Conclusion:
To the best of our knowledge, this is the first reported case of WBS in T-cell acute lymphoblastic leukemia. We want to emphasize that the occurrence of leukemia in this patient might be related to the loss of 7q11.23 and microdeletion of 9p21.3 (including 3 TSGs), but the relationship between WBS and malignancy remains unclear. Further studies are required to clarify the relationship between WBS and malignancy.
Finite element study on three osteotomy methods for treating thoracolumbar osteoporotic fracture vertebral collapse complicated with neurological dysfunction
Authors: Long Zhisheng , Zhou Jingyu , Xiong Long , Chen Gang , Wen Jiabin 
Published: February 2024

Background:
Surgical methods for patients with osteoporotic fracture vertebral collapse complicated with neurological dysfunction are still a topic of debate. We designed an improved osteotomy for the treatment of osteoporotic compression fracture patients with neurological dysfunction. Compared with traditional osteotomy methods such as pedicle subtraction osteotomy (PSO) and bone-disc-bone osteotomy (BDBO), the osteotomy range is reduced. Therefore, we use a finite element method to analyze the biomechanical conditions of these three osteotomy methods and provide a mechanical theoretical basis for the surgical treatment of these three osteotomy methods.

Methods:
Based on the CT scan of a patient with L1 osteoporotic fracture vertebral collapse and neurological dysfunction, the finite element model was constructed by importing Mimics software, and three different osteotomy models were established. The forces and displacements of internal fixation device, T1-L5 whole segment, T10 vertebral body, and T10/11 intervertebral disc were recorded under different working conditions.

Results:
The displacement levels of internal fixation device, T1-L5 spine, T10 vertebral body, and T10/11 intervertebral disc in the modified osteotomy group were between BDBO group and PSO group. The stress in BDBO group was concentrated in titanium mesh and its maximum stress was much higher than that in PSO group and modified osteotomy group. The mechanical distribution of T10/11 intervertebral disc showed that the maximum stress distribution of the three osteotomy methods was similar.

Conclusion:
The relatively simple modified osteotomy has certain advantages in stress and displacement. In contrast, the stability of BDBO group was poor, especially in the lumbar intervertebral disc and lumbar body. For this type of osteotomy patients, it is recommended to avoid postoperative flexion so as not to increase the load.
Stubborn hypoxemia after mild to moderate sedation and analgesia: A case report
Authors: Zou Jiayun , Wang Huazhen , Nan Yongshan , Jin Xianglan 
Published: February 2024

Introduction:
Atelectasis typically denotes the partial or complete collapse of lung segments, lobes, or lobules in individuals, leading to a compromised respiratory function. The prevalence of perioperative atelectasis may be significantly underestimated, particularly among patients subjected to general anesthesia.

Patient concerns:
This article conducts a retrospective analysis of a case involving refractory hypoxemia in a patient with a liver tumor who was admitted to Yanbian University Affiliated Hospital (Yanbian Hospital) after undergoing mild-to-moderate sedation and analgesia outside the operating room.

Diagnosis:
Based on the results of CT examination and present history, the patient was diagnosed with intraoperative atelectasis.

Intervention:
After the surgery, the patient was transferred to the recovery ward, where nasal oxygen therapy and nebulized inhalation treatment were administered. Vital signs were closely monitored at the bedside, gradually returning to the preoperative baseline.

Outcome:
Postoperatively, the patient developed atelectasis, with the percentage of lung opacity shown in the image decreasing from 9.2% of the total thoracic cage area to 8.4%.

Conclusion:
During non-intubated intravenous anesthesia, patients with compromised pulmonary conditions are more susceptible to refractory hypoxemia. Therefore, a personalized approach should be adopted regarding oxygen concentration and the dosage and type of medication. Additionally, preparations for appropriate airway management measures are essential to safeguard patient safety in the event of respiratory issues.
The impact of a trial of labor after cesarean versus elective repeat cesarean delivery: A meta-analysis
Authors: Chen Xiao , Mi Mei-yan 
Published: February 2024

Background:
The increasing global incidence of cesarean section has prompted efforts to reduce cesarean delivery rates. A trial of labor after cesarean (TOLAC) has emerged as an alternative to elective repeat cesarean delivery (ERCD) for women with a prior cesarean delivery. However, the available evidence on the comparative outcomes of these 2 options remains inconsistent, primarily due to varying advantages and risks associated with each. Our meta-analysis aims to compare the maternal-neonatal results in TOLAC and ERCD in women with prior cesarean deliveries.

Methods:
A comprehensive search was performed in PubMed, Embase, Cochrane library databases up to September,2022 to identity studies evaluating perinatal outcomes in women who underwent TOLAC compared to ERCD following a previous cesarean delivery. The included studies were subjected to meta-analysis using RevMan 5.3 software to assess the overall findings.

Results:
A total of 13 articles were included in this meta-analysis. Statistically significant differences were identified in the rate of uterine rupture (OR = 2.01,95%CI = 1.48–2.74, P < .00001) and APGAR score < 7 at 5 minutes (OR = 2.17,95%CI = 1.69–2.77, P < .00001) between the TOLAC and ERCD groups. However, no significant differences were observed in the rates of hysterectomy, maternal blood transfusion, postpartum infection, postpartum hemorrhage and neonatal intensive care unit (P ≥ .05) admission between the 2 groups.

Conclusions:
Our analysis revealed that TOLAC is associated with a higher risk of uterine rupture and lower incidence APGAR score < 7 at 5 minutes compared to ERCD. It is vital to consider predictive factors when determining the appropriate mode of delivery in order to ensure optimal pregnancy outcomes. Efforts should be made to identify the underlying causes of adverse outcomes and implement safety precautions to select suitable participants and create safe environments for TOLAC.
The effect and safety of obeticholic acid for patients with nonalcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
Authors: Zhao Jie , Li Baozhen , Zhang Kai , Zhu Zhiyong 
Published: February 2024

Background and aims:
Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NASH) is one of the primary causes of chronic liver disease worldwide. Obeticholic acid (OCA), a potent farnesoid X nuclear receptor activator, has shown promise for treating NASH-related fibrosis due to its anti-fibrotic effects. This study aimed to examine the efficacy of OCA for patients with NASH as well as to investigate its impact on dyslipidemia.

Method:
A search of databases including PubMed, Embase, and Cochrane Library from January 1, 2010, to November 1, 2022, was conducted to identify systematic reviews of randomized controlled trials involving NASH patients. Inclusion criteria comprised randomized controlled trials that specifically addressed NASH as diagnosed through magnetic resonance imaging, computed tomography, or histology. The results were then categorized, with consideration given to both biochemical and histological outcomes.

Result:
Five NASH studies were ultimately selected for further analysis. In terms of biochemical indicators, patients receiving OCA treatment showed improvements in alanine transaminase (mean difference: −19.48, 95% confidence interval [CI]: −24.39 to 14.58; P < .05) and aspartate aminotransferase (mean difference: −9.22, 95% CI: −12.70 to 5.74; P < .05). As for histological improvement, OCA treatment reduced fibrosis (odds ratio [OR]: 1.95, 95% CI: 1.47–2.59; P = .001) and steatosis (OR: 1.95, 95% CI: 1.47–2.59; P = .001). No significant differences were observed regarding adverse events (1.44, 95% CI: 0.57–3.62; P > .001). Regarding dyslipidemia, mean differences between total cholesterol and low-density lipoprotein were found to be high (0.33, 95% CI: 0.01–0.64, P < .05; 0.39, 95% CI: 0.04–0.73, P < .05). In the case of pruritus, OCA achieved a high OR (3.22, 95% CI: 2.22–4.74) compared with placebo.

Conclusion:
OCA also reduced several liver test markers compared to placebo, including the biochemical indicators alanine transaminase, aspartate aminotransferase, alkaline phosphatase, and γ-glutamyl transpeptidase, and improved hepatocellular ballooning, fibrosis, steatosis, and lobular inflammation. Although the incidence of adverse events did not significantly differ between OCA and placebo groups among NASH patients, OCA treatment was found to elevate total cholesterol and low-density lipoprotein levels, and the reported severity of pruritus increased with higher doses of OCA.
High-flow nasal cannula oxygen versus noninvasive ventilation for the management of acute cardiogenic pulmonary edema: a randomized controlled pilot study
Authors: Marjanovic Nicolas , Piton Melyne , Lamarre Jennifer , Alleyrat Camille , Couvreur Raphael , Guenezan Jérémy , Mimoz Olivier , Frat Jean-Pierre 
Published: February 2024

BackgroundWhether high-flow nasal oxygen can improve clinical signs of acute respiratory failure in acute heart failure (AHF) is uncertain.ObjectiveTo compare the effect of high-flow oxygen with noninvasive ventilation (NIV) on respiratory rate in patients admitted to an emergency department (ED) for AHF-related acute respiratory failure.Design, settings and participantsMulticenter, randomized pilot study in three French EDs. Adult patients with acute respiratory failure due to suspected AHF were included. Key exclusion criteria were urgent need for intubation, Glasgow Coma Scale <13 points or hemodynamic instability.InterventionPatients were randomly assigned to receive high-flow oxygen (minimum 50 l/min) or noninvasive bilevel positive pressure ventilation.Outcomes measureThe primary outcome was change in respiratory rate within the first hour of treatment and was analyzed with a linear mixed model. Secondary outcomes included changes in pulse oximetry, heart rate, blood pressure, blood gas samples, comfort, treatment failure and mortality.Main resultsAmong the 145 eligible patients in the three participating centers, 60 patients were included in the analysis [median age 86 (interquartile range (IQR), 90; 92) years]. There was a median respiratory rate of 30.5 (IQR, 28; 33) and 29.5 (IQR, 27; 35) breaths/min in the high-flow oxygen and NIV groups respectively, with a median change of −10 (IQR, −12; −8) with high-flow nasal oxygen and −7 (IQR, −11; −5) breaths/min with NIV [estimated difference −2.6 breaths/min (95% confidence interval (CI), −0.5–5.7),P = 0.052] at 60 min. There was a median SpO2of 95 (IQR, 92; 97) and 96 (IQR, 93; 97) in the high-flow oxygen and NIV groups respectively, with a median change at 60 min of 2 (IQR, 0; 5) with high-flow nasal oxygen and 2 (IQR, −1; 5) % with NIV [estimated difference 0.8% (95% CI, −1.1–2.8),P = 0.60]. PaO2, PaCO2and pH did not differ at 1 h between groups, nor did treatment failure, intubation and mortality rates.ConclusionIn this pilot study, we did not observe a statistically significant difference in changes in respiratory rate among patients with acute respiratory failure due to AHF and managed with high-flow oxygen or NIV. However, the point estimate and its large confidence interval may suggest a benefit of high-flow oxygen.Trial registrationNCT04971213 (https://clinicaltrials.gov).
Risk Reduction of Concussion in Athletes: Do Neck Size or Neck Strength Make a Difference?
Authors: Silverman Sean , Vidt Meghan E. , Hong Justin S. , Grafton Lori M. 
Published: February 2024

Abstract
Medical provider’s ability to detect, diagnose, and treat sport-related concussion (SRC) has greatly improved in recent years. Though more is known about the biomechanical forces involved in concussion, it is still uncertain whether there are preventative measures athletes can take to prevent a SRC from occurring. The objective of this review was to determine if either neck size or neck strength is related to a decreased risk of sustaining a SRC. A literature review was conducted on Google Scholar and Ovid MEDLINE for pertinent articles. Findings indicate that isometric neck strength, but not neck size, has been shown to be a predictor for SRC prevention. Formal neck strengthening programs are feasible and lead to decreased SRC risk. Additionally, there may be greater opportunity to increase neck strength in amateur athletes compared to professional. In conclusion, cervical strengthening programs have been shown to be feasible and beneficial for athletes to decrease their risk of sustaining a SRC, though the optimal duration, intensity, and frequency has yet to be determined.
Molecular mechanisms underlying the modulation of T-cell proliferation and cytotoxicity by immobilized CCL21 and ICAM1
Authors: Yado Sofi , Dassa Bareket , Zoabi Rawan , Reich-Zeliger Shlomit , Friedman Nir , Geiger Benjamin 
Published: February 2024

AbstractBackgroundAdoptive cancer immunotherapy, using engineered T-cells, expressing chimeric antigen receptor (CARs) or autologous tumor infiltrating lymphocytes (TILs) became, in recent years, a major therapeutic approach for diverse types of cancer. However, despite the transformative potential of adoptive cancer immunotherapy, this field still faces a major challenge manifested by the complex interplay between the proliferation rate and cytotoxic capacity of effector CD8+T cells.MethodsWe performed integrated analysis of specific differentiation markers via flow cytometry, together with gene expression profiling to explore the molecular mechanisms through which a “synthetic immune niche” (SIN), composed of immobilized CCL21 and ICAM1, modulates the interplay between the proliferation and cytotoxic potency of effector CD8+T cells.ResultsOn day 3, the transcriptomic effect induced by the SIN was largely similar for both DC/OVA and anti CD3/CD28-activated cells. Cell proliferation increased and the cells exhibited high killing capacity. On day 4 and on, the proliferation/cytotoxicity phenotypes were radically “activation-specific”; The DC/OVA-activated cells lost their cytotoxic activity, which, in turn, was rescued by the SIN treatment. Upon longer incubation, the cytotoxic activity further declined, and on day7, could not be rescued by the SIN. SIN stimulation following activation with antiCD3/CD28 beads resulted in a highly proliferative phenotype with low cytotoxicity, yet the cells regained killing activity on day 7. Potential molecular regulations of the SIN effects were identified, based on transcriptomic and multispectral imaging profiling.ConclusionsThese data indicate that cell proliferation and cytotoxicity are negatively correlated, and the interplay between them is differentially regulated by the mode of initial activation. The SIN stimulation greatly enhanced the cell expansion, following both activation modes, while maintaining high cytotoxic potency, suggesting that it could reinforce adoptive cancer immunotherapy.
A reference genome for the Chinese Lizardtail Herb (Saururus chinensis)
Authors: Tang Chengyi 
Published: February 2024

AbstractSeveral months earlier, other researchers had achieved the inaugural publication of the Chinese Lizardtail Herb (Saururus chinensis) genome dataset. However, the quality of that genome dataset is not deeply satisfactory, especially in terms of genome continuity (Contig N50 length ≈ 1.429 Mb) and gene-set completeness (BUSCO evaluation ≈ 91.32%). In this study, we present an improved chromosome-level genome ofS. chinensis, characterized by heightened genome continuity (Contig N50 length ≈ 4.180 Mb) and a more complete gene-set (BUSCO evaluation ≈ 95.91%). Our investigation reveal that the extantS. chinensis genome preserves abundant vestiges of a paleo-tetraploidization event that are discernible both at the macroscopic chromosome level and within microscopic gene families, such as the PEL (pseudo-etiolation in light) family. Moreover, we elucidate that this paleo-tetraploidization event is associated with an expansion of the PEL family, potentially initiating a process conducive to its neofunctionalization and/or subfunctionalization.