bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case report: Intraabdominal infection of Mycobacterium syngnathidarum in an immunocompetent patient confirmed by whole-genome sequencing
Authors: Ge Hu , Liang Xiongwei , Lu Qiuran , He Aixiang , Zhong Peiwen , Liu Jun , Yu Yan , Song Honglian 
Published: October 2023

BackgroundThe taxonomic group of non-tuberculous mycobacteria (NTM) encompasses more than 190 species and subspecies, some of which can cause pulmonary and extrapulmonary diseases across various age groups in humans. However, different subspecies exhibit differential drug sensitivities, and traditional detection techniques struggle to accurately classify NTM. Therefore, clinicians need more effective detection methods to identify NTM subtypes, thus providing personalized medication for patients.Case presentationWe present the case of a 47-year-old female patient diagnosed with an intraabdominal infection caused by Mycobacterium syngnathidarum. Despite computed tomography of the chest suggesting potential tuberculosis, tuberculosis infection was ruled out due to negative TB-DNA results for ascites fluid and sputum and limited improvement of lung lesions after treatment. Additionally, acid-fast staining and Lowenstein–Jensen culture results revealed the presence of mycobacterium in ascites fluid. Subsequent whole-genome sequencing (WGS) confirmed the DNA sequences of Mycobacterium syngnathidarum in colonies isolated from the ascites fluid, which was further corroborated by polymerase chain reaction and Sanger sequencing. Ultimately, the patient achieved a complete recovery following the treatment regimen targeting Mycobacterium syngnathidarum, which involved clarithromycin, ethambutol hydrochloride, pyrazinamide, rifampicin, and isoniazid.ConclusionThis is the first reported case of Mycobacterium syngnathidarum infection in humans. Mycobacterium syngnathidarum was detected by WGS in this case, suggesting that WGS may serve as a high-resolution assay for the diagnosis of different subtypes of mycobacterium infection.
Higher critical closing pressure is independently associated with enlarged basal ganglia perivascular spaces
Authors: Zhong Jiayi , Lin Wanrong , Chen Junru , Gao Qingchun 
Published: October 2023

ObjectiveThis study aimed to explore the association between cerebral hemodynamic parameters focused on the critical closing pressure (CCP) and enlarged perivascular spaces (EPVS).MethodsCerebral blood velocity in the middle cerebral artery (MCAv) and non-invasive continuous blood pressure (NIBP) were measured using a transcranial Doppler (TCD) and Finometer, followed by the calculation of cerebral hemodynamic parameters including CCP, resistance area product (RAP), pulsatility index (PI), and pulse pressure (PP). EPVS were graded separately in the basal ganglia (BG) and centrum semiovale (CSO), using a visual semiquantitative ordinal scale. Patients with EPVS &gt;10 were classified into the severe BG-EPVS group and severe CSO-EPVS group, and the remainder into the mild BG-EPVS group and the mild CSO-EPVS group. Spearman’s correlation and binary logistic regression analysis were performed to analyze the relationship between hemodynamic parameters and BG-EPVS and CSO-EPVS, respectively.ResultsOverall, 107 patients were enrolled. The severe BG-EPVS group had higher CCP, mean arterial blood pressure (MABP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) than that in the mild BG-EPVS group (p &lt; 0.05). There was no statistical difference in hemodynamic parameters between the severe CSO-EPVS group and the mild CSO-EPVS group. Spearman’s correlation analysis showed that CCP was positively associated with BG-EPVS (rho = 0.331, p &lt; 0.001) and CSO-EPVS (rho = 0.154, p = 0.044). The binary logistic regression analysis showed that CCP was independently associated with severe BG-EPVS (p &lt; 0.05) and not with CSO-EPVS (p &gt; 0.05) after adjusting for confounders.ConclusionCCP representing cerebrovascular tension was independently associated with BG-EPVS.
The influence of delirium on mortality and length of ICU stay and analysis of risk factors for delirium after liver transplantation
Authors: Ma Ying , Li Cuiying , Peng Weiting , Wan Qiquan 
Published: October 2023

ObjectiveTo analyze the incidence, timing, risk factors and prognosis of delirium after liver transplantation (LT).MethodsThe clinical data of 321 patients undergoing LT in the Third Xiangya Hospital of Central South University from January 2018 to December 2022 were collected to investigate the incidence, onset, and risk factors for post-LT delirium and the impact of delirium on LT recipients’ prognosis by statistical analysis.ResultsThe incidence of post-LT delirium was 19.3% (62/321), and the median interval between LT and onset of delirium was 20.1 h. Univariate analysis showed that pre-LT variables (Model for End Stage Liver Disease (MELD) score, hospital stay, hepatic encephalopathy, infection, white blood cell (WBC) count, lymphocyte count, abnormal potassium, lactulose use), intraoperative variables (red blood cell transfusion, remimazolam use, dexmedetomidine use) and post-LT variables (hypernatraemia, acute rejection, reoperation, basiliximab use, tacrolimus concentration) were associated with post-LT delirium. Multivariate logistic regression analysis revealed that MELD score at LT ≥22 [OR = 3.400, 95% CI:1.468–7.876, p = 0.004], pre-LT hepatic encephalopathy [OR = 3.224, 95% CI:1.664–6.244, p = 0.001], infection within 2 months prior to LT [OR = 2.238, 95% CI:1.151–4.351, p = 0.018], acute rejection [OR = 2.974, 95% CI:1.322–6.690, p = 0.008], and reoperation [OR = 11.919, 95% CI:2.938–48.350, p = 0.001] were independent risk factors for post-LT delirium. Post-LT delirium was reduced in LT recipients exposing to intraoperative remimazolam [OR = 0.287, 95% CI: 0.113–0.733, p = 0.009] or ≥ 25 μg of intraoperative dexmedetomidine [OR = 0.441, 95% CI 0.225–0.867, p = 0.018]. As for clinical outcomes, patients with delirium had a higher percentage of staying at the (ICU) ≥7 d after LT than those without delirium [OR = 2.559, 95% CI 1.418–4.617, p = 0.002].ConclusionThe incidence of delirium was high and the onset of delirium was early after LT. Risk factors for post-LT delirium included high MELD score at LT, pre-LT hepatic encephalopathy and infections, acute rejection and reoperation. Intraoperative use of remimazolam or dexmedetomidine reduced post-LT delirium. Delirium had a negative impact on the length of ICU stay.
Brain network mechanism of acupuncture for chronic spontaneous urticaria: a functional magnetic resonance imaging study protocol
Authors: Huang Xianhao , Xie Jing , Yang Yang , Dai Xuechun , Lu Lingyun , Li Ning , Li Ying , Wang Song , Zhang Leixiao 
Published: October 2023

IntroductionChronic spontaneous urticaria (CSU) is a common skin condition that can significantly impact patients’ quality of life. Although studies have demonstrated the efficacy of acupuncture in treating CSU, the underlying mechanisms remain unclear. Dysfunction within the brain’s default mode network (DMN) represents a fundamental characteristic of central pathological changes associated with CSU. Therefore, it is hypothesized that improving brain network dysfunction could serve as a key mechanism through which acupuncture exerts its therapeutic effects. This study aims to provide evidence supporting this hypothesis.Methods and analysisThis study, a parallel, randomized, sham-controlled functional neuroimaging investigation will be conducted in China. We aim to enroll 50 patients with CSU and 25 healthy controls, distributing them evenly between the acupuncture and sham acupuncture groups in a 1:1 ratio. The total observation period will span 6 weeks, including 2 weeks designated for the baseline phase and 4 weeks allocated for the clinical treatment phase. Prior to treatment, all participants will undergo magnetic resonance scanning, clinical index detection, and microbiota collection. Following treatment, the patients with CSU will be retested for these indicators. Using resting-state functional connectivity (rsFC) analysis, dynamic Functional Connection (dFC) analysis, and brain microstate extraction technology combined with correlation analysis of microbiota and clinical indicators, the regulatory mechanism of acupuncture on the brain network of CSU will be evaluated from multiple dimensions.Ethics and disseminationThis trial was approved by the Biomedical Ethics Review Committee of the West China Hospital, Sichuan University (No. 2022-1255). Each participant will provide written informed consent to publish any potentially identifiable images or data.Clinical trial registrationhttps://www.chictr.org.cn/, identifier: ChiCTR2200064563.
Improvement of vertigo symptoms after 2 months of Vertigoheel treatment: a case series in patients with bilateral vestibulopathy and functional dizziness
Authors: Ganeva Dilyana , Tiemann Rolf , Duller Stephan , Strupp Michael 
Published: October 2023

BackgroundDizziness is a common leading symptom in bilateral vestibulopathy (BVP) and functional dizziness (FD), with significant negative effects on functional ability and quality of life. Vertigoheel is a widely used non-prescription drug for the treatment of vertigo. In order to generate systematic data for Vertigoheel in BVP and FD, we conducted a non-interventional study assessing vertigo symptoms.MethodsThis study was conducted as an open-label, prospective, monocentric, non-interventional case series (ClinicalTrials.gov identifier NCT05897853). Patients with BVP and FD received Vertigoheel according to market approval for an observational period of 2 months. Change from baseline after 2 months was assessed for the following endpoints: Dizziness Handicap Inventory (DHI) as the primary endpoint, quality of life (QoL) by EQ-5D-5L, and body sway by static posturography. Patients with FD were additionally assessed for depression and anxiety by PHQ-9 and GAD-7 questionnaires. Patients with BVP were assessed for vestibular function by video head impulse testing and caloric testing. Adverse events and other safety-related observations were evaluated.ResultsOf 41 patients with FD and 13 with BVP, two with FD and none with BVP dropped out before the follow-up visit. Both patient groups showed significantly improved disability caused by dizziness after 2 months: In BVP, the DHI decreased on average by 13.2 points from 45.4 to 32.2 (p &lt; 0.001). In FD, the DHI decreased on average by 12.0 points from 46.5 to 34.5 (p &lt; 0.001). In patients with FD, significant improvements were also observed for the secondary endpoints QoL, anxiety, and depression. No significant change was observed for posturography readouts. In patients with BVP, there were no statistically significant improvements for the secondary endpoints QoL, posturography, or vestibular function within the observation period. The study found no evidence of a safety risk.ConclusionThe study provides evidence for Vertigoheel’s clinical safety and limited evidence – because of the non-interventional design – for its effectiveness in BVP and FD that are considered disease entities with high medical need for new treatment options. The results may serve as the basis for randomized placebo-controlled trials.
Acute positional vertigo in the emergency department—peripheral vs. central positional nystagmus
Authors: Koohi Nehzat , Male Amanda J. , Kaski Diego 
Published: October 2023

IntroductionBenign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. However, positional vertigo can also be due to diseases affecting the central vestibular pathways, such as vestibular migraine. Accurate and timely diagnosis enables effective triage and management.ObjectivesTo evaluate diagnoses made by emergency clinicians compared to acute vertigo specialists, in patients presenting to an emergency department (ED) with positional vertigo.MethodsFollowing routine ED care, patients with a primary complaint of dizziness, vertigo, light-headedness or unsteadiness, underwent detailed neuro-otological assessment by acute vertigo specialists. Demographics and final diagnoses were recorded and analyzed.ResultsOf 71 consented patients (21−91 years; mean 56 years, ±16.7 years, 40 females), ED identified 13 with a peripheral cause of positional vertigo (mean 48.85 years, ±16.19, 8 females). Central positional nystagmus was not noted in any of the patients with positional vertigo seen by the ED clinicians. Acute vertigo specialists diagnosed nine patients with BPPV (age range 50-88 years, mean 66 years, ±12.22, 5 females), and six with central positional nystagmus (age range 23−59 years, mean 41.67 years, ±15.78, 6 females).ConclusionPositional vertigo should be assessed with positional maneuvers such as Dix-Hallpike and Roll tests in the ED to identify peripheral and central nystagmus features. Central causes are more common in younger females, with the presence of vomiting, and/or a background of motion sensitivity.
EEG-based biomarkers for optimizing deep brain stimulation contact configuration in Parkinson’s disease
Authors: Peeters Jana , Van Bogaert Tine , Boogers Alexandra , Dembek Till Anselm , Gransier Robin , Wouters Jan , Vandenberghe Wim , De Vloo Philippe , Nuttin Bart , Mc Laughlin Myles 
Published: October 2023

ObjectiveSubthalamic deep brain stimulation (STN-DBS) is a neurosurgical therapy to treat Parkinson’s disease (PD). Optimal therapeutic outcomes are not achieved in all patients due to increased DBS technological complexity; programming time constraints; and delayed clinical response of some symptoms. To streamline the programming process, biomarkers could be used to accurately predict the most effective stimulation configuration. Therefore, we investigated if DBS-evoked potentials (EPs) combined with imaging to perform prediction analyses could predict the best contact configuration.MethodsIn 10 patients, EPs were recorded in response to stimulation at 10 Hz for 50 s on each DBS-contact. In two patients, we recorded from both hemispheres, resulting in recordings from a total of 12 hemispheres. A monopolar review was performed by stimulating on each contact and measuring the therapeutic window. CT and MRI data were collected. Prediction models were created to assess how well the EPs and imaging could predict the best contact configuration.ResultsEPs at 3 ms and at 10 ms were recorded. The prediction models showed that EPs can be combined with imaging data to predict the best contact configuration and hence, significantly outperformed random contact selection during a monopolar review.ConclusionEPs can predict the best contact configuration. Ultimately, these prediction tools could be implemented into daily practice to ease the DBS programming of PD patients.
Type 2 cytokines sensitize human sensory neurons to itch-associated stimuli
Authors: Mack Madison R. , Miron Yannick , Chen Fanny , Miller Paul E. , Zhang Annie , Korotzer Andrew , Richman Daniel , Bryce Paul J. 
Published: October 2023

IntroductionChronic itch is a central symptom of atopic dermatitis. Cutaneous afferent neurons express receptors interleukins (IL)-4, IL-13, and IL-33, which are type 2 cytokines that are elevated in atopic dermatitis. These neuronal cytokine receptors were found to be required in several murine models of itch. Prior exposure of neurons to either IL-4 or IL-33 increased their response to subsequent chemical pruritogens in mice but has not been previously examined in humans. The objective of the present study was to determine if type 2 cytokine stimulation sensitizes sensory neurons to future itch stimuli in a fully human ex vivo system.MethodsWe measured calcium flux from human dorsal root ganglia cultures from cadaveric donors in response to pruritogens following transient exposure to type 2 cytokines. We also measured their effect on neuronal calcium flux and changes in gene expression by RNA sequencing.ResultsType 2 cytokines (IL-4, IL-13, and IL-33) were capable of sensitizing human dorsal root ganglia neurons to both histaminergic and nonhistaminergic itch stimuli. Sensitization was observed after only 2 h of pruritogen incubation. We observed rapid neuronal calcium flux in a small subset of neurons directly in response to IL-4 and to IL-13, which was dependent on the presence of extracellular calcium. IL-4 and IL-13 induced a common signature of upregulated genes after 24 h of exposure that was unique from IL-33 and non-type 2 inflammatory stimuli.DiscussionThis study provides evidence of peripheral neuron sensitization by type 2 cytokines as well as broad transcriptomic effects in human sensory ganglia. These studies identify both unique and overlapping roles of these cytokines in sensory neurons.
Long-term impact of post COVID-19 pandemic quarantine on eating habits changes among adult residents of Riyadh, Saudi Arabia
Authors: Al-Tannir Mohamad , AlFayyad Isamme , Altannir Mona , Alosaimi Arwa , Alonazi Afrah , Alqarni Afnan 
Published: October 2023

BackgroundCOVID-19 outbreak and quarantine measures clearly had an impact on the population’s eating habits-related behavior.ObjectiveThis study aimed to explore the long-term impact of the COVID-19 pandemic and physical quarantine on eating habits after quarantine among Riyadh city residents, Saudi Arabia.MethodsA cross-sectional study was conducted through an online survey between December 2022 and April 2023 on a convenient sample of Saudi adults in Riyadh, Saudi Arabia. A valid questionnaire was used to measure study outcomes. A comparison between dietary habits before and after COVID-19 was performed to identify the changes in dietary habits.Results1,451 Saudi adults residing in Riyadh completed the online survey. The majority (88.6%) of the respondents reported changes in dietary habits after COVID-19. About 50% had 1–3 dietary habits changes and slightly more than one-third had 4–7 dietary habits change. About 33.8% of the participants reported stable weight during the COVID-19 pandemic. However, 40.9% reported weight gain, and 20.7% reported weight loss. The participants reported several unhealthy dietary changes most commonly eating fast food (33%), eating junk food/fast food due to boredom/distress/disappointment (29.8%), and high sugar such as sweet porridge, pastry, sweets, and chocolate (28.5%). On the other side, the participants showed healthy dietary habits such as having a balanced healthy ingredients diet (34.4%), an increase in the consumption of fruits and vegetables, and a decrease in the intake of junk foods (28.9%). Males were more likely to exhibit unhealthy dietary habits than females (Odd Ratio:1.43, p = 0.038, CI: 1.02–2.02). Increasing age was associated with a reduction in the likelihood of exhibiting unhealthy dietary habits (OR: 0.98, p = 0.011, CI: 0.96–0.99). Moreover, participants who reported stable weight or weight loss during COVID-19 were 0.29 (p = 0.043, 0.09–0.96) and 0.34 (p = 0.020, 0.07–0.79), respectively, less likely to have unhealthy dietary habits.ConclusionAlthough healthy dietary habits have been reported in this study, such as consumption of fruits and vegetables, COVID-19 confinement has also led to negative dietary behaviors reflected by high consumption of fast/junk food and sugar intake resulting in weight gain, a potential adverse impact on the population wellbeing.
Healthcare access dimensions and uterine cancer survival: a national cancer database study
Authors: Anastasio Mary Katherine , Gupta Anjali , Akinyemiju Tomi F. , Previs Rebecca A. 
Published: October 2023

ObjectiveDisparities exist throughout diagnosis, treatment, and survival for Black patients with uterine cancer. There is limited data on how several healthcare access (HCA) dimensions contribute to these disparities in patients with advanced stage uterine cancer.MethodsUsing the National Cancer Database (NCDB), we identified patients aged 40-89 years with Stage III-IV uterine cancer between 2004-2015 who received chemotherapy and/or radiotherapy. Race/ethnicity were classified as non-Hispanic (NH)-Black, Hispanic, and NH-White. Variables defined in the NCDB were used to assess HCA affordability, availability, and accessibility. Kaplan-Meier estimates, log-rank test, and multivariable Cox proportional hazards models were used to analyze overall survival.ResultsOf 43,134 patients, 78.8% of the cohort identified as NH-White, 15.3% NH-Black, and 5.9% Hispanic. NH-Black patients were the most likely to have type II (75.6% vs. 53.9% and 55.4%) and stage IV (40.8% vs. 30.7% and 32.3%) disease compared to NH-White and Hispanic patients. NH-Black patients were more likely than NH-White and Hispanic patients to have government funded insurance (58.6% vs. 50.3% and 50.4%), live in low-income areas (46.4% vs. 14.2% and 29.9%), and receive only chemotherapy (53.5% vs. 43.1% and 46.2%). Having private insurance and receiving treatment at an academic facility were positive predictors of survival. NH-Black patients had worse survival than NH-White patients after adjusting for clinical characteristics and healthcare access dimensions (HR 1.29; 95% CI 1.24, 1.34).ConclusionWhile HCA affordability and availability predicted survival in patients with advanced stage uterine cancer, additional factors contribute to racial disparities. Compared to NH-White patients, NH-Black patients had more aggressive disease, received only chemotherapy rather than combined therapy, and had worse survival regardless of cancer subtype. Additional dimensions of healthcare access must be explored to remedy uterine cancer disparities.
Use of allogeneic platelet-rich plasma for the treatment of autoimmune ocular surface disorders: case series
Authors: Mancini Maura , Postorino Elisa Imelde , Gargiulo Ludovica , Aragona Pasquale 
Published: October 2023

PurposeTo assess the effectiveness of topical allogeneic platelet-rich plasma (PRP) eye drops for the treatment of symptoms and clinical signs in patients with severe dry eye disease as a secondary condition caused by Sjögren’s syndrome (SS).DesignCase series and literature review.MethodsSix eyes from three consecutive patients with severe dry eye from SS were evaluated. The eyes were treated with allogeneic topical PRP eye drops, with one drop applied six times daily for 3 months. A post-treatment follow-up evaluation was conducted 3 months after treatment suspension. We evaluated subjective symptoms, visual acuity, tear breakup time, the results of Schirmer’s I test, fluorescein corneal and conjunctival staining, and corneal sensitivity.ResultsThe symptoms and visual acuity improved significantly in all patients. There was a significant improvement in corneal sensitivity and a decrease or disappearance of fluorescein corneal staining.ConclusionThe treatment with allogenic PRP eye drops of patients with SS-related severe dry eye disease has proven to be very effective, with an improvement in symptoms and main clinical signs.