bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colorectal cancer metastases in thyroid: case report and literature review
Authors: Hussain Syed Mohammad Asim , Cole Suzanne , Hussain Iram 
Published: April 2023

Abstract
Background
The thyroid gland is an uncommon site for metastatic deposits from non-thyroid malignancies, occurring in only 1.4 - 3% of surgical specimens where malignancy is suspected. It is even rarer for the source of thyroid metastases to be of colorectal origin. In most cases reported, colorectal metastases in the thyroid occurs many years later after the primary colorectal cancer has been diagnosed and treated. In this unique case, a primary sigmoid carcinoma metastasised to the thyroid gland and presented synchronously as a thyroid nodule.

Case presentation
We describe a case of a 64-year-old Caucasian woman who presented with clinical features of metastatic cancer of unknown origin. Her medical history included underlying hyperthyroidism. She had a large pelvic mass adjacent to the sigmoid colon, a left lower lobe lung mass and a suspicious nodule in the left thyroid lobe. A fine-needle aspiration biopsy of the thyroid nodule was performed, which remarkably showed malignant cells originating from primary colorectal cancer on immunohistochemical staining. The patient was managed with palliative chemotherapy given the poor prognosis due to disseminated colorectal malignancy.

Conclusions
Colorectal adenocarcinoma metastases can rarely present as a metastatic thyroid nodule. Fine-needle aspiration should be performed in suspicious thyroid nodules and may be the least invasive way of identifying a metastatic colorectal or other non-thyroidal malignancy in patients presenting with an unknown primary. The pathologist should be vigilant to this possibility and specific immunohistochemical markers should be used to ensure accurate diagnosis.
In thyroid metastases, the prognosis is ultimately determined by the primary tumour but thyroidectomy still has a role in alleviating compressive symptoms and can potentially improve survival in selected cases.
A rare immunological disease, caspase 8 deficiency: case report and literature review
Authors: Bazgir Narges , Tahvildari Azin , Chavoshzade Zahra , Jamee Mahnaz , Golchehre Zahra , Karimi Abdollah , Dara Naghi , Fallahi Mazdak , Keramatipour Mohammad , Karamzade Arezou , Sharafian Samin 
Published: April 2023

Abstract
Background
Caspase-8 is a molecule in the FAS pathway that initiates apoptosis. One of the rarest autoimmune lymphoproliferative syndromes is caspase-8 deficiency. Immunodeficiency, splenomegaly, and lymphadenopathy are the common symptoms of this condition.

Case Presentation
A two-year-old boy entered this study with a fever of unknown origin (FUO) and dysentery. Moreover, he suffered from failure to thrive and was allergic to the cow's milk protein. His fever and dysentery did not respond to antibiotic therapy. The colonoscopy revealed diffuse ulcerations regions in the sigmoid along with skipped areas, mimicking Crohn's disease aphthous lesions. He represented very early-onset inflammatory bowel disease (IBD) and was diagnosed with the caspase-8 deficiency.

Conclusion
There can be diarrhea or dysentery as the first or main symptoms of inborn errors of immunity (IEIs). The cause of diarrhea and dysentery in this case was early-onset IBD. One of the symptoms of IEIs such as caspase-8 deficiency is early-onset of IBD. Patients with early-onset had normal T cell count and low or normal immunoglobulin levels with insufficient immune response.
National survey on clinical and genetic characteristics of patients with hereditary angioedema in Latvia
Authors: Kanepa Adine , Nartisa Inga , Rots Dmitrijs , Gailite Linda , Farkas Henriette , Kurjane Natalja 
Published: April 2023

Abstract
Background
Hereditary angioedema (HAE) is a rare and life-threatening inborn error of immunity. HAE is mostly caused by pathogenic variations in the serine protease inhibitor gene 1 (SERPING1), leading to deficient or dysfunctional C1-inhibitor (C1-INH), overproduction of bradykinin, and development of recurrent subcutaneous and/or submucosal oedema. The prevalence of HAE is 1 in 50,000 − 100000 people worldwide. We aimed to describe the clinical features and genetic spectrum of hereditary angioedema with C1-INH deficiency (C1-INH-HAE) in Latvia.

Methods
All patients from Latvia diagnosed with HAE (types I/II) from 2006 to March 2022 were included in the study. Laboratory tests and clinical data were analysed, and genetic tests with Sanger sequencing and whole genome sequencing were performed.

Results
The study identified 10 C1-INH-HAE patients (nine females, one male) from eight families. The point prevalence of HAE in Latvia is 0.53 per 100 000 inhabitants. Of all patients, seven (70%) had HAE type I and three (30%) had HAE type II. The median age of patients was 54 years and the median age at onset of symptoms was 15 years. A significant delay (median 20.5 years) until diagnosis was observed, and 60% of patients had a positive family history of angioedema. All HAE patients have been hospitalised a median two times during their lifetime. Skin (100%), abdominal (80%), and airway (80%) oedema were the most frequent symptoms. Triggering factors (60%) and prodromal symptoms (90%) were referred. Attacks were severe in 50% of patients, moderate in 10%, and mild in 40%. Pathogenic variations of SERPING1 were identified in eight patients (six families), confirming the diagnosis molecularly. In two patients (two families), no pathogenic variations in the genes were found even after whole genome sequencing.

Conclusions
Current data shows a significant delay and clear underdiagnosis of HAE in Latvia. Higher awareness and better information and communication between doctors would improve the diagnosis and management of HAE; as would screening of family members, patients with recurrent angioedema unresponsive to antihistamines and glucocorticoids, and patients with recurrent episodes of severe, unexplained abdominal pain.
Growth performance, nutrient digestibility, intestinal morphology, cecal mucosal cytokines and serum antioxidant responses of broiler chickens to dietary enzymatically treated yeast and coccidia challenge
Authors: Alagbe Emmanuel Oluwabukunmi , Schulze Hagen , Adeola Olayiwola 
Published: April 2023

Abstract
Background
There is a growing search for natural feed additives to alleviate the deleterious effects of coccidia infection in poultry production. This study aimed to investigate the effect of enzymatically treated yeast (ETY) on the growth performance, nutrient digestibility, intestinal morphology, antioxidative status, and cecal mucosa cytokines of coccidia-challenged broiler chickens.

Methods
From d 1 to 14 post hatching, 480 broiler chickens were allocated to 3 corn-soybean meal-based experimental diets with increasing concentrations of ETY (0, 1, or 2 g/kg). The experiment was designed as a randomized complete block design with body weight (BW) used as a blocking factor. On d 14 post hatching, the birds were re-randomized within each of the 3 experimental diets. Each of the 3 diet groups was split into a challenge or no-challenge group. This resulted in a 3 × 2 factorial arrangement of treatments. The coccidia challenge was administered on d 15 by an oral gavage.

Results
Dietary ETY improved (P < 0.05) the G:F of birds on d 21 regardless of the challenge state and linearly increased (P < 0.01) the apparent ileal digestibility of dry matter (DM), nitrogen, and gross energy (GE). The coccidia challenge decreased (P < 0.05) BW gain and feed intake of broiler chickens and reduced (P < 0.01) the total tract retention of DM, GE, and nitrogen. The coccidia challenge increased (P < 0.01) the mRNA gene expression of TNFα, IL-1β, IL-10, and IL-6 in the cecal mucosa. There was a tendency (P = 0.08) for ETY to linearly reduce IL-1β expression. Additionally, ETY supplementation increased (P < 0.05) the gene expression of OCLN. Serum catalase increased (P < 0.05) with dietary ETY in broiler chickens on d 21. Dietary ETY linearly increased (P < 0.05) the ileal villus height to crypt depth ratio, and ileal goblet cell density in broiler chickens. The ileal and excreta oocyst counts decreased (P < 0.01) with increasing supplementation of dietary ETY in coccidia-challenged broiler chickens on d 21.

Conclusions
Dietary ETY enhanced nutrient utilization and augmented intestinal development in broiler chickens. However, dietary ETY did not completely attenuate the adverse effects of a coccidia challenge in broiler chickens.
Thrombectomized autologous portal Y-graft inflow construction can be an option in living-donor liver transplantation: a case report
Authors: Akaoka Munetoshi , Haruki Koichiro , Furukawa Kenei , Onda Shinji , Ishizaki Shunta , Tsunematsu Masashi , Shirai Yoshihiro , Okui Norimitsu , Tanji Yoshiaki , Ikegami Toru 
Published: April 2023

Abstract
Background
In living-donor liver transplantation (LDLT), portal Y-graft interposition using the recipient’s portal vein (PV) bifurcation has been used for right lobe grafts with double PV orifices. We herein report the use of thrombectomized autologous portal Y-graft interposition for a recipient with preoperative portal vein thrombosis (PVT) in a right lobe LDLT with double PV orifices.

Case presentation
The recipient was a 54-year-old male with end-stage liver disease due to alcoholic liver cirrhosis. There was PV thrombus in the recipient’s PV. The living liver donor was his 53-year-old spouse, and a right lobe graft was planned for the transplantation. Since the donor's liver had a type III PV anomaly, autologous portal Y-graft interposition after thrombectomy was planned for PV reconstruction in the LDLT. The portal Y-graft was resected from the recipient and a thrombus extending from the main PV to the right PV branch was removed on the back table. The portal Y-graft was anastomosed to the anterior and posterior portal branches of the right lobe graft. Followed by venous reconstruction, the Y-graft was anastomosed to the recipient’s main PV. The operation time was 545 min and the intraoperative blood loss was 1355 ml. The recipient was discharged on postoperative day 13 without any complications. The recipient remains well with the patency of the portal Y-graft one year after the liver transplantation.

Conclusion
We herein report the successful use of autologous portal Y-graft interposition after thrombectomy on the back table for a recipient with PVT in a right lobe LDLT.
Evaluation of techniques to improve a deep learning algorithm for the automatic detection of intracranial haemorrhage on CT head imaging
Authors: Yeo Melissa , Tahayori Bahman , Kok Hong Kuan , Maingard Julian , Kutaiba Numan , Russell Jeremy , Thijs Vincent , Jhamb Ashu , Chandra Ronil V. , Brooks Mark , Barras Christen D. , Asadi Hamed 
Published: April 2023

Abstract
Background
Deep learning (DL) algorithms are playing an increasing role in automatic medical image analysis.

Purpose
To evaluate the performance of a DL model for the automatic detection of intracranial haemorrhage and its subtypes on non-contrast CT (NCCT) head studies and to compare the effects of various preprocessing and model design implementations.

Methods
The DL algorithm was trained and externally validated on open-source, multi-centre retrospective data containing radiologist-annotated NCCT head studies. The training dataset was sourced from four research institutions across Canada, the USA and Brazil. The test dataset was sourced from a research centre in India. A convolutional neural network (CNN) was used, with its performance compared against similar models with additional implementations: (1) a recurrent neural network (RNN) attached to the CNN, (2) preprocessed CT image-windowed inputs and (3) preprocessed CT image-concatenated inputs. The area under the receiver operating characteristic curve (AUC-ROC) and microaveraged precision (mAP) score were used to evaluate and compare model performances.

Results
The training and test datasets contained 21,744 and 491 NCCT head studies, respectively, with 8,882 (40.8%) and 205 (41.8%) positive for intracranial haemorrhage. Implementation of preprocessing techniques and the CNN-RNN framework increased mAP from 0.77 to 0.93 and increased AUC-ROC [95% confidence intervals] from 0.854 [0.816–0.889] to 0.966 [0.951–0.980] (p-value = 3.91 × 10−12).

Conclusions
The deep learning model accurately detected intracranial haemorrhage and improved in performance following specific implementation techniques, demonstrating clinical potential as a decision support tool and an automated system to improve radiologist workflow efficiency.

Key points
• The deep learning model detected intracranial haemorrhages on computed tomography with high accuracy.
• Image preprocessing, such as windowing, plays a large role in improving deep learning model performance.
• Implementations which enable an analysis of interslice dependencies can improve deep learning model performance.
• Visual saliency maps can facilitate explainable artificial intelligence systems.
• Deep learning within a triage system may expedite earlier intracranial haemorrhage detection.
A multicenter evaluation of a deep learning software (LungQuant) for lung parenchyma characterization in COVID-19 pneumonia
Authors: Scapicchio Camilla , Chincarini Andrea , Ballante Elena , Berta Luca , Bicci Eleonora , Bortolotto Chandra , Brero Francesca , Cabini Raffaella Fiamma , Cristofalo Giuseppe , Fanni Salvatore Claudio , Fantacci Maria Evelina , Figini Silvia , Galia Massimo , Gemma Pietro , Grassedonio Emanuele , Lascialfari Alessandro , Lenardi Cristina , Lionetti Alice , Lizzi Francesca , Marrale Maurizio , Midiri Massimo , Nardi Cosimo , Oliva Piernicola , Perillo Noemi , Postuma Ian , Preda Lorenzo , Rastrelli Vieri , Rizzetto Francesco , Spina Nicola , Talamonti Cinzia , Torresin Alberto , Vanzulli Angelo , Volpi Federica , Neri Emanuele , Retico Alessandra 
Published: April 2023

Abstract
Background
The role of computed tomography (CT) in the diagnosis and characterization of coronavirus disease 2019 (COVID-19) pneumonia has been widely recognized. We evaluated the performance of a software for quantitative analysis of chest CT, the LungQuant system, by comparing its results with independent visual evaluations by a group of 14 clinical experts. The aim of this work is to evaluate the ability of the automated tool to extract quantitative information from lung CT, relevant for the design of a diagnosis support model.

Methods
LungQuant segments both the lungs and lesions associated with COVID-19 pneumonia (ground-glass opacities and consolidations) and computes derived quantities corresponding to qualitative characteristics used to clinically assess COVID-19 lesions. The comparison was carried out on 120 publicly available CT scans of patients affected by COVID-19 pneumonia. Scans were scored for four qualitative metrics: percentage of lung involvement, type of lesion, and two disease distribution scores. We evaluated the agreement between the LungQuant output and the visual assessments through receiver operating characteristics area under the curve (AUC) analysis and by fitting a nonlinear regression model.

Results
Despite the rather large heterogeneity in the qualitative labels assigned by the clinical experts for each metric, we found good agreement on the metrics compared to the LungQuant output. The AUC values obtained for the four qualitative metrics were 0.98, 0.85, 0.90, and 0.81.

Conclusions
Visual clinical evaluation could be complemented and supported by computer-aided quantification, whose values match the average evaluation of several independent clinical experts.

Key points

We conducted a multicenter evaluation of the deep learning-based LungQuant automated software.

We translated qualitative assessments into quantifiable metrics to characterize coronavirus disease 2019 (COVID-19) pneumonia lesions.

Comparing the software output to the clinical evaluations, results were satisfactory despite heterogeneity of the clinical evaluations.

An automatic quantification tool may contribute to improve the clinical workflow of COVID-19 pneumonia.
First report of using Trichoderma longibrachiatum as a biocontrol agent against Macrophomina pseudophaseolina causing charcoal rot disease of lentil in Algeria
Authors: Kouadri Mohamed El Amine , Bekkar Ahmed Amine , Zaim Souad 
Published: April 2023

Abstract
Background
Lentil (Lens culinaris Medik.) is one of the major pulse crops in the world. The present study aimed to evaluate the effect of Trichoderma isolates to control the charcoal rot disease caused by Macrophomina pseudophaseolina recently reported on lentil plants.

Results
In this study, antagonistic effects of seven isolates of Trichoderma spp. isolated from the rhizosphere of lentil were evaluated in vitro against Macrophomina pseudophaseolina M1. All isolates of Trichoderma significantly reduced the mycelial growth of M1 in vitro. Maximum reduction of the pathogen growth was observed at T10 (72.53%), followed by T5 (63.7%) and T6 (62.88%), while T2 caused the minimum reduction (37.33%). Likewise, Trichoderma isolates significantly reduced the size and number microsclerotia. M1 produced the minimum number of microsclerotia in the presence of T10, followed by T1 causing reduction of 68.56 and 53.37% over control, respectively. The maximum reduction of microsclerotia’s size was observed in the presence of T10 (54.92%), followed by T1 (49.84) and T8 (48.68%). Results also revealed that production of volatile metabolite, components and inhibition of the test pathogen by volatile metabolites varied among different antagonistic Trichoderma. T1 produced the most volatile compounds, followed by T2 and T3 and T10 causing mycelial growth inhibition of 41.66, 33.88, 30.55 and 30.37%, respectively. The efficacy of the antagonistic biocontrol agents on charcoal rot was evaluated in vivo. Seed treatment with T10 significantly protected lentil seedlings from M. pseudophaseolina as compared to untreated plants and also improved their growth. T10 isolate was identified based on molecular tools, using internal transcribed spaces and Translation elongation factor of ribosomal DNA. The results identified T10 as Trichoderma longibrachiatum with accession number MW818102 and OK500004 deposited in NCBI GenBank database.

Conclusion
The study revealed the first report of using Trichoderma longibrachiatum as a promising biological agent against M. pseudophaseolina causing charcoal rot disease of lentil.
Egyptian evidence-based consensus on clinical practice recommendations for the management of Kawasaki disease
Authors: El Miedany Yasser , Salah Samia , Lotfy Hala M. , Abu-Zaid Mohammed Hassan , Mohamed Sally S. , Maher Sheren Esam , El Gaafary Maha , Abdulhady Hala , Farag Yomna , Eissa Mervat , Radwan Ahmed , Medhat Basma M. , El Mikkawy Dalia M. E. , Hassan Waleed A. , Mosa Doaa Mosad , El Deriny Ghada , Mortada Mohamed , Osman Naglaa S. , Fouad Nermeen Ahmed , Amer Youmna Ahmed , Nasef Samah Ismail , Abushady Hend , Galal Salwa , El-Latif Eiman Abd , Maria Dina , Shabana Ahmed H. , Tabra Samar AbdAlhamed 
Published: April 2023

Abstract
Background
Kawasaki disease (KD) is an acute, self-limited febrile disease of unidentified cause that mostly affects children less than 5 years of age. This work aimed to provide an appropriate Egyptian evidence-based consensus on clinical practice recommendations for the management of Kawasaki disease. The main objective of this study, which employed the Delphi method, was to reach a consensus among experts on a treat-to-target management approach for KD.

Results
The expert panel was confined to an online survey (n=26), and all the expert completed the three rounds. At the conclusion of round 3, a total of 17 recommendation items were gathered, which were divided into two sections. The range of respondents (ranks 7–9) who agreed with the recommendations was 92.3 to 100%. All 17 clinical standards identified by the scientific committee were written in the same way. There have been algorithms proposed for managing various KD conditions.

Conclusion
The developed evidence-based consensus recommendations for the diagnosis and management of KD represent an up-to-date document that focuses on clinical management questions which are generally posed to health care professionals involved in the management of KD. This guideline was developed considering experience with and availability of treatment and diagnostic options in Egypt.
Association Between Circulating Levels of C1q/TNF-Related Protein-9 and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis
Authors: Song Rui , Hu Weiting , Cheng Rui , Zhao Yibo , Qin Weiwei , Li Xing , Zhu Yikun , Gan Lu , Liu Jing 
Published: April 2023

Abstract

Context
According to growing research, C1q/TNF-Related Protein-9 (CTRP9) appears to be linked to type 2 diabetes mellitus (T2DM). But the literature on circulating levels of CTRP9 in patients with T2DM has been contradictory.

Objective
This is a systematic review and meta-analysis to reassess the circulating level of CTRP9 in patients with T2DM, with and without complications.

Methods
Relevant studies published until October 31, 2021, were identified from the PubMed, Embase, Web of Science, Cochrane Library, WanFang, CNKI, VIP, and CBM databases. Participants with age ≥18 years with clinically diagnosed T2DM were included. Sex and diabetes complications were not restricted. The data were extracted by 2 reviewers independently using a standard data collection form.

Results
Analysis demonstrated significantly lower circulating levels of CTRP9 in patients with T2DM than in patients without diabetes (standardized mean difference [SMD] = −1.36; 95% CI −1.78 to −0.93; P &lt; .001), I2 = 97.5%, P &lt; .001). Furthermore, the circulating level of CTRP9 in patients with T2DM-related complications was lower than that in patients with T2DM without complications, regardless of macrovascular complications or microvascular complications (SMD = −1.062; 95% CI −1.466 to −0.658; P &lt; .001, I2 = 91.3%, P &lt; .001). Subgroup analyses revealed that factors such as body mass index, T2DM duration, and fasting blood glucose were the sources of heterogeneity (P = .047, P = .034, and P = .07, respectively).

Conclusion
The present systematic review and meta-analysis found CTRP9 levels were lower in T2DM patients with or without complications. However, since this was a meta-analysis of most observational studies, these findings still need to be verified by further studies with a large sample size.
The Association of Accelerated Early Growth, Timing of Puberty, and Metabolic Consequences in Children
Authors: Jee Youn Hee , Jumani Sanjay , Mericq Veronica 
Published: April 2023

Abstract
Accelerated early growth and early timing of puberty or pubertal variant have been noticed as risk factors for metabolic syndrome, more frequently observed in children born small for gestational age (SGA) or children with premature adrenarche (PA). Children with SGA, especially if they make an accelerated catch-up growth in early life, carry a higher risk for long-term metabolic consequences, such as type 2 diabetes, insulin resistance, and cardiovascular diseases. Furthermore, multiple studies support that these children, either born SGA or with a history of PA, may have earlier pubertal timing, which is also associated with various metabolic risks. This review aims to summarize the recent studies investigating the association between early infantile growth, the timing of puberty, and metabolic risks to expand our knowledge and gain more insight into the underlying pathophysiology.