bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncommon ileal perforation due to intestinal tuberculosis: A case report and literature review
Authors: Ju Jianhua , Liu Jingyu , Dong Wei , Zhong Yuxu , Chu Haibo 
Published: January 2025

Rationale:
Tuberculosis (TB) is a chronic granulomatous infectious disorder, caused by Mycobacterium tuberculosis. Extrapulmonary TB, which accounts for 20% of cases, includes intestinal TB in 10%. Gastrointestinal TB leads to intestinal perforation in 4% to 7.6% of cases, with a mortality rate of 30%.

Patient concerns:
We conducted a retrospective analysis of a patient with ileal perforation due to intestinal TB. A male in his early 20s (initial weight, 35 kg) presented with a 2-day history of abdominal pain, exhibiting tenderness, rebound tenderness, and muscular guarding upon physical examination. Computed tomography (CT) imaging revealed a significant amount of free gas and fluid in the abdominal cavity. Subsequently, the patient underwent ileal repair and ileostomy.

Diagnoses:
Histopathological examination confirmed multifocal amorphous pink caseating necrotic material and Langhans giant cells in the mesenteric lymph nodes. A polymerase chain reaction (PCR) assay confirmed infection with M tuberculosis.

Interventions:
On the 20th postoperative day, enteral nutrition was initiated concomitantly with antitubercular therapy (ATT). After 1 month, enteral nutrition and oral diet were alternated for 2 months, then changed to oral diet alone, and the patient was discharged to continue ATT. Five months later, the patient’s weight increased by 20 kg, and he began exercising outdoors. The patient underwent a successful ostomy reversal.

Outcomes:
At the 12-month follow-up, his body weight had increased to 65 kg, PCR testing was negative for M tuberculosis, and antituberculosis drugs were discontinued.

Lessons:
This case highlights the successful management of ileal perforation due to intestinal TB with peritonitis, without complications such as fistulas. Diagnosis of small bowel perforations due to intestinal TB remains challenging even for experienced clinicians, and surgical approaches are controversial. We emphasized the significance of diagnostics of such cases and often requiring a multidisciplinary approach involving various medical teams.
Report on the clinical outcomes of using postural drainage with intervertebral space as the main focus for managing thoracolumbar tuberculosis: Eight case reports
Authors: Xing Hao , Li Jianhua , Chang Zhengqi 
Published: January 2025

Rationale:
Conservative treatment has shown limited effectiveness in managing thoracolumbar tuberculosis (TB) that extends to the intervertebral space, as antibiotics are unable to penetrate avascular intervertebral discs, while conventional surgery is known for its extensive trauma and slow healing process.

Patient concerns:
Infection of the thoracic and lumbar vertebrae with tuberculosis can lead to difficulties in treatment due to involvement of the intervertebral space.

Diagnosis:
The diagnosis of TB was confirmed through clinical manifestations, impact studies, and T-spot experiments.

Interventions:
A retrospective analysis was conducted on the clinical data of 8 patients with thoracolumbar spinal TB who underwent postural drainage focusing on the intervertebral space as a treatment from June 2012 to August 2019. The average duration of treatment was 7.75 ± 10.19 months. Among the patients, there were 2 cases of thoracolumbar and 6 cases of lumbar spine involvement, with 6 cases affecting a single segment and 2 cases involving 2 segments. The total number of affected vertebrae included 4 thoracic, 12 lumbar, and 2 sacral vertebrae. All patients received standardized quadruple antituberculosis treatment (HRZE scheme). Specific postural drainage paths and catheter placement locations were determined based on clinical imaging results, and percutaneous catheter placement was performed with the assistance of foraminoscopy. Erythrocyte sedimentation rate, C-reactive protein, Visual Analogue Scale score, American Spinal Cord Injury Association score, and Oswestry function index were statistically analyzed before, after postural drainage, and at the final follow-up.

Outcomes:
The average operation time was 44.38 ± 10.50 minutes, with a blood loss of 6.88 ± 2.59 mL. The average catheter drainage time was 13.25 ± 4.95 days, and the follow-up period ranged from 36 to 122 months. The average total drainage volume was 281.25 ± 167.69 mL. Significant improvements were observed in erythrocyte sedimentation rate, C-reactive protein, Visual Analogue Scale score, American Spinal Cord Injury Association score, and Oswestry functional index at 7 days after postural drainage and at the last follow-up compared to before postural drainage (P < .05). At the last follow-up, there were 8 cases with no recurrence reported among the patients.

Lessons:
The utilization of positional drainage in the intervertebral space, coupled with chemotherapy, has demonstrated encouraging clinical results and may be deemed appropriate for treatment.
Diagnosis of pulmonary adenoid cystic carcinoma using multimodal ultrasound imaging technology: A case report
Authors: Shi Hong , Qiu Wei , Yang Ping , Zhang Yaping , Huang Tingyu , Mei Jinyuan , Yin Xinrui , Yang Yanhui 
Published: January 2025

Rationale:
Pulmonary adenoid cystic carcinoma (PACC) is an exceedingly uncommon malignant tumor originating from salivary glands.

Patient concerns:
We present a case of primary PACC with multiple lung metastases in a 48-year-old male patient.

Diagnosis:
Diagnosis involved grayscale ultrasound, shear wave elastography, contrast-enhanced ultrasound, and ultrasound-guided percutaneous lung biopsy, all conducted in a one-stop manner, and confirmed by pathological examination.

Interventions:
Treatment was recommended after the diagnosis was confirmed, but was not accepted.

Outcomes:
With telephone follow-up, the patient survived.

Lessons:
PACC is an exceedingly uncommon malignant tumor originating from salivary glands. Compared to other cases, this case highlights the potential of multimodal ultrasound imaging for diagnosing lung tumors.
Exploring potential treatment opportunities in a head and neck tumor patient with AdCC: A novel germline ERCC2 mutation case report
Authors: Liu Yuanhao , Han Tiantian , Guo Didi , Chen Dongsheng , Li Yunqian 
Published: January 2025

Rationale:
Adenoid cystic carcinoma (AdCC) is an invasive head and neck malignancy characterized by unpredictable growth, extensive perineural invasion, a high rates of metastasis, and poor survival rates. Genetic alterations, including MYB-NFIB and MYBL1-NFIB fusions, and mutations within the Notch signaling and DNA damage repair pathways, have been identified.

Patient concerns:
A 58-year-old female presented with a space-occupying lesion of the anterior cranial fossa floor during a physical examination and sought further consultation in July 2022.
In our case, a 58-year-old woman was incidentally found to have an anterior cranial fossa lesion during a routine physical examination, which was subsequently confirmed as AdCC following postoperative immunohistochemistry.

Diagnoses:
Based on these imaging and histopathological findings, a diagnosis of AdCC was established. Integrating the genetic test results, the case was diagnosed as MYB or MYBL1 fusion-negative AdCC. This case report highlights a rare molecular signature of ERCC2 and BRCA2 inactivation in AdCC, in the absence of MYB or MYBL1 fusions.

Interventions:
The patient underwent postoperative radiotherapy (RT) to the primary site approximately 2.5 months postsurgery. The concurrent presence of germline ERCC2 and somatic BRCA2 mutations offers novel insights into potential treatment strategies for this rare malignancy.

Outcomes:
To date, no recurrence has been observed during follow-up.

Lessons:
We found a novel germline ERCC2 mutation and somatic BRCA2 mutation in a patient with AdCC. Our findings expand the molecular landscape of rare MYB or MYBL1 fusion-negative AdCC patients and provide a potential therapeutic strategy for this rare head and neck tumor.
Rare “ileum–ileum–colon type” adult intussusception caused by Meckel’s diverticulum inversion: A case report
Authors: Mao Yi-Hu , Huang Li-Bin , Jia Qi , Li Shu-Jun , Zeng Qian , Yang Jian , Yang Cai-Jun , Pu Qi , Liu Xue-Ping 
Published: January 2025

Rationale:
Ileum–ileum–colon intussusception constitutes a small proportion of the classification of intussusception. Both adult intussusception and Meckel’s diverticulum are rare clinical entities, with few reports documenting Meckel’s diverticulum inversion leading to ileum–ileum–colon intussusception in adults.

Patient concerns:
A 33-year-old Chinese male presented with intermittent abdominal pain persisting for 1 month, that had intensified over the preceding day.

Diagnoses:
Abdominal computed tomography revealed intussusception, suspected to be secondary to a small intestinal lipoma.

Interventions:
Emergency laparotomy was performed, during which the ileum, located approximately 70 cm from the ileocecal region, was found to be invaginated into the terminal ileum and subsequently into the ascending colon, reaching the hepatic flexure. An inverted Meckel’s diverticulum was at the forefront of the intussusception. Surgical resection of the diverticulum, terminal ileum, and cecum was performed, followed by an end-to-side anastomosis of the ileum and colon.

Outcomes:
The patient was discharged on postoperative day 7 without complications. During a 1-month follow-up, the patient reported no discomfort and exhibited normal bowel movements.

Lessons:
Adult intussusception of the “ileum–ileum–colon type” resulting from inverted Meckel’s diverticulum is exceedingly rare and poses challenges for preoperative diagnosis. Prompt surgical intervention can lead to favorable outcomes in patients. During surgery, the initial step should involve attempting reduction of the intussusception while ensuring that the intestine is preserved as much as possible to maintain intestinal function.
A giant spinal schwannoma at the C1-C2 level: A case report
Authors: Wu Xiaodong , Li Dazhi , Zhang Lu , Li Yanming 
Published: January 2025

Rationale:
Giant spinal schwannomas located at the C1-C2 level pose significant surgical challenges because of their proximity to the brainstem, cervical spinal cord, and vertebral arteries. This case provides insight into the surgical management of giant spinal schwannomas at the C1-C2 level.

Patient Concerns:
A 40-year-old female presented with a 2-year history of progressive limb numbness, weakness, and gait instability. She reported a sensation of stepping on cotton and tightness in the chest and abdomen with worsening symptoms over time.

Diagnoses:
Physical examination revealed limited cervical spine movement, increased muscle tone in the limbs, and Hoffmann and Babinski signs. Imaging, including CT, CTA and MRI, identified a large schwannoma at the C1-C2 level, with compression of the spinal cord and proximity to the vertebral artery.

Interventions:
The patient underwent surgical excision of the tumor using full laminectomy approach under intravenous anesthesia.

Outcomes:
The surgery was successfully completed, and the patient’s neurological symptoms, including numbness and weakness, were significantly relieved.

Conclusion:
Strict enucleation within the capsule can effectively protect the vertebral artery and nearby nerves. When functional nerve roots or the spinal cord are involved, leaving the residual capsule may be safer than risking permanent deficits.
Promoting Physical Activity in People With Parkinson’s Disease Through a Smartphone App: A Pilot Study
Authors: Schootemeijer Sabine , de Vries Nienke M. , Darweesh Sirwan K.L. , Ascherio Alberto , Schwarzschild Michael A. , Macklin Eric A. , Bloem Bastiaan R. 
Published: January 2025

Background and Purpose:
Physical activity has beneficial symptomatic effects for people with Parkinson’s disease (PD), but increasing—and sustaining—a physically active lifestyle remains challenging. We investigated the feasibility (ability to increase step counts) and usability of a behavioral intervention using a motivational smartphone application to remotely increase physical activity in PD.

Methods:
We performed a 4-week, double-blind pilot trial. Thirty people with PD who were able to walk independently and did not take more than 7000 steps at baseline were randomized to minimal, moderate, or large increases in step counts. Step counts were continuously collected with the participants’ own smartphones. Usability was assessed with a translated version of the System Usability Scale. We reported the distribution of clinical characteristics in our participants.

Results:
Step counts per day increased over 4 weeks in a dose-dependent pattern (mean ± standard deviation: minimal = 1064 ± 1030, moderate = 1689 ± 2060, large = 2745 ± 3817). The usability of the STEPWISE app (System Usability Scale) was perceived as excellent (mean ± standard deviation: 86.6 ± 12.7).

Discussion and Conclusions:
Our findings support the notion that a titrated increase in daily step count is feasible over 4 weeks. This motivates and supports further development of a smartphone application to increase physical activity in people with manifest PD. If effective, this behavioral intervention could provide an accessible option for people with PD worldwide.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content available at: http://links.lww.com/JNPT/A516).
Lessons Learned from a Quality Improvement Initiative to Increase COVID-19 Vaccination in Hospitalized Children
Authors: Young Daniel G. , Rogers Cortney S. , Mayefsky Isaac , Neufeld Thomas , Niesen Angela , Reich Patrick J. , Kao Carol M. , Srinivasan Mythili 
Published: January 2025

Introduction:
Pediatric coronavirus disease 2019 (COVID-19) vaccination rates in the United States remain lower compared with adults. We aimed to (1) implement a quality improvement initiative to increase COVID-19 vaccination 2-fold in hospitalized patients 12–21 years of age from 4.7% during the baseline period (August 10, 2021–November 1, 2021) to 9.4% during the intervention phase (November 2, 2021—March 31, 2023) and (2) assess the importance of existing interventions and obtain feedback for future interventions to increase COVID-19 vaccination via a provider survey.

Methods:
We conducted the quality improvement initiative in the inpatient units of a freestanding children’s hospital. Interventions included provider education, electronic medical record best practice alerts, monthly competition, parental counseling to increase vaccine acceptance, and ensuring vaccine availability. The primary outcome measure was the percentage of hospitalized patients 12–21 years of age who received COVID-19 vaccine. Providers addressing COVID-19 vaccination with patients, as documented by COVID-19-specific problem lists, were a process measure. Length of stay was a balancing measure.

Results:
Although COVID-19 vaccination increased 1.6-fold during the initial 5 months of interventions, the interrupted time series analysis did not show a significant impact of our interventions on vaccination. Documentation of COVID-19 vaccine-specific problem lists increased 1.9-fold during most of the intervention period. There was no significant (P = 0.61) difference in length of stay between children in the baseline and intervention groups.

Conclusions:
Despite our best efforts, we could not increase the number of COVID-19 vaccinations in our patients. Lessons learned suggest that creating a nurse-driven COVID-19 vaccine screening/ordering protocol and integrating COVID-19/influenza vaccination annually during influenza season can potentially increase vaccination rates, but further research is required.
Keep Moving: Sustainability of an Early Mobility Protocol in an Academic Pediatric ICU
Authors: Domann Jenna E. , Davies Lindsay E. , Zivick Elizabeth E. , Johnson Laken , Keller Everette P. , Walz Alice A. 
Published: January 2025

Introduction:
Mobilization protocols are safe and feasible for critically ill pediatric patients in the intensive care unit (ICU), but barriers exist to sustainability. This study described a focused early mobility protocol, sustained over 5 years, which is on time for therapy consults and patient mobilization at a single institution.

Methods:
A formal ICU mobility protocol was implemented as part of a unit-wide ICU liberation bundle. As part of the ongoing program assessment, over a specific 3-month timeframe annually from 2017 to 2023, the number of physical and occupational therapy (PT/OT) consults, mobilization rate, and time to PT/OT consult were analyzed. In addition, in 2023, we assessed specific barriers to early PT/OT consultation.

Results:
Annually, for each study timeframe, there was a sustained decrease in time to therapy consult from a mean of 3.8 days for PT and 7 days for OT in 2017 to 1.9 and 1.6 days, respectively, in 2023. Similarly, the mobilization rate increased from 20.3 sessions per 100 patient days in 2017 to 48.2 in 2023. There was a trend toward missed or delayed therapy consults at times of higher ICU census. No adverse events were associated with mobilization.

Conclusions:
An ICU early mobility protocol leads to a sustained decrease in the time to therapy consultation, an increase in the number of therapy consults, and an increase in the mobilization rate. Future interventions should focus on mitigating barriers to timely consultation, specifically at times of higher ICU census.
Assessing Gaps in Integrated HIV and STI Testing Among New York State-Funded Providers by Pre-Exposure Prophylaxis Status: Implications for Status-Neutral Programming
Authors: Tesoriero James M. , Boos Elizabeth M. , Adamashvili Natalia , Massaroni Ronald , Maglaperidze Tatia , O’Grady Thomas J. 
Published: January 2025

Background:
In the United States, up to 75% of primary care patients go untested for HIV each year, and nearly two-thirds of adults report never having been tested for HIV. Integrated HIV and STI testing, combining these tests into a single visit, is recommended as a status neutral approach to prevention.

Setting:
Over 200 New York State Department of Health-funded primary care clinics, hospitals, health centers and community-based organizations funded to conduct integrated screening.

Methods:
We analyzed weekly testing data from December 2022 to January 2024 to prospectively evaluate whether integrated HIV and STI testing events and results occurred within 30 days of each other. We also assessed group differences in integrated testing by sex at birth, gender, race/ethnicity, risk, organization type, and pre-exposure prophylaxis (PrEP) status using Pearson’s Chi-square tests and calculated prevalence ratios using log binomial models stratified be PrEP usage. Analyses were restricted to individuals with an HIV-negative status.

Results:
Integrated testing was completed for 69% for individuals on PrEP and 39% for those not taking PrEP, with significant differences observed across all client-specific categories at p < 0.001. Except for age group, variations in integrated screening levels by client characteristics were similar by PrEP status. Individuals who identified as female at birth, as non-Hispanic Black, without an elevated risk, and those tested in non-hospital settings were significantly less likely to experience integrated screening. HIV-test reactivity was 0.04% among integrated testers and 0.15% for HIV-only testers. STI-test reactivity was 4.9% among integrated testers and 7.8% for STI-only testers.

Conclusions:
A significant gap was identified in integrated testing among providers specifically funded to perform it, resulting in missed opportunities for identification of HIV and other sexually transmitted infections. Integrating HIV and STI testing at a systems level will require significant changes to the perceived individual- and provider-level risks and benefits associated with testing.
Optimizing inpatient diabetes management with the diabetes dashboard
Authors: Wang Wenyong , Puri Gaurav , Sly Benjamin , Samadbeik Mahnaz , Ng Soong , Newton Jenna , Sullivan Clair 
Published: January 2025

ABSTRACT
Inpatient diabetes management presents a complex challenge that is distinct from outpatient management. This is due to acute changes in physiology, medication regimens, and eating patterns associated with hospitalization, alongside the condition's prevalent and variable nature. The conventional systems for managing glycemic control in hospital have been found lacking, with gaps in data integration, decision support, and timely intervention. Queensland Health's development and adoption of the Glucose Management View and the Glucose Assessment for Inpatients (GAIN) dashboard represents a significant leap forward. The TIDieR checklist and guide have been used to report the implementation of these two interventions. The Glucose Management View, available within an individual's electronic medical record, provides an overview of demographics, relevant medication details, pathology data, and blood glucose levels. This cohesive and intuitive interface enhances individual patient trend visibility and facilitates diabetes medication prescribing. GAIN consolidates all diabetes-related patient data within the hospital into a single interface, enabling clinicians to monitor glycemic status across the whole cohort in near real-time, promoting a proactive approach to diabetes management. The future of inpatient diabetes care looks toward the incorporation of machine learning and artificial intelligence (AI) to predict adverse events and streamline care further. However, significant gaps remain in the deployment of these technologies, indicating a need for more comprehensive development and testing of all phases of the AI lifecycle, before integration into clinical practice.

Spanish abstract:

http://links.lww.com/IJEBH/A308
Frontal eye field neurons predict “anti-Bayesian” but not Bayesian judgments of visual stability across saccades
Authors: Subramanian Divya , Pearson John , Sommer Marc A. 
Published: January 2025

AbstractBayesian models, in which priors are used to optimally compensate for sensory uncertainty, have had wide-ranging success in explaining behavior across sensorimotor contexts. We recently reported, however, that humans and monkeys use a combination of Bayesian and non-Bayesian strategies when making categorical judgments of visual stability across saccades. While they used priors to compensate for internal,movement-driven sensory uncertainty, consistent with Bayesian predictions, they decreased their use of priors when faced with external,visual imageuncertainty—an “anti-Bayesian” adjustment consistent with the use of a simple classifier. Here, we tested for neural correlates of these Bayesian and classifier-based strategies in the frontal eye field (FEF), a prefrontal region shown to be important for the perception of visual stability across saccades. We recorded from single FEF neurons while two rhesus macaques performed the internal (motor) and external (image) noise tasks in each session, interleaved trial by trial. FEF activity correlated with and predicted the anti-Bayesian, but not the Bayesian, behavior. These results suggest that the two computational strategies for visual stability are implemented by distinct neural circuits and provide a first step toward an integrated understanding of the computational and neural mechanisms underlying visual perception across saccades.