bluuebunny/crossref_metadata_2025_split huggingface dataset:
The three-dimensional weakly supervised deep learning algorithm for traumatic splenic injury detection and sequential localization: an experimental study
Authors: Cheng Chi-Tung , Lin Hou-Shian , Hsu Chih-Po , Chen Huan-Wu , Huang Jen-Fu , Fu Chih-Yuan , Hsieh Chi-Hsun , Yeh Chun-Nan , Chung I-Fang , Liao Chien-Hung 
Published: March 2023

Background:
Splenic injury is the most common solid visceral injury in blunt abdominal trauma, and high-resolution abdominal computed tomography (CT) can adequately detect the injury. However, these lethal injuries sometimes have been overlooked in current practice. Deep learning (DL) algorithms have proven their capabilities in detecting abnormal findings in medical images. The aim of this study is to develop a three-dimensional, weakly supervised DL algorithm for detecting splenic injury on abdominal CT using a sequential localization and classification approach.

Material and methods:
The dataset was collected in a tertiary trauma center on 600 patients who underwent abdominal CT between 2008 and 2018, half of whom had splenic injuries. The images were split into development and test datasets at a 4 : 1 ratio. A two-step DL algorithm, including localization and classification models, was constructed to identify the splenic injury. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Grad-CAM (Gradient-weighted Class Activation Mapping) heatmaps from the test set were visually assessed. To validate the algorithm, we also collected images from another hospital to serve as external validation data.

Results:
A total of 480 patients, 50% of whom had spleen injuries, were included in the development dataset, and the rest were included in the test dataset. All patients underwent contrast-enhanced abdominal CT in the emergency room. The automatic two-step EfficientNet model detected splenic injury with an AUROC of 0.901 (95% CI: 0.836–0.953). At the maximum Youden index, the accuracy, sensitivity, specificity, PPV, and NPV were 0.88, 0.81, 0.92, 0.91, and 0.83, respectively. The heatmap identified 96.3% of splenic injury sites in true positive cases. The algorithm achieved a sensitivity of 0.92 for detecting trauma in the external validation cohort, with an acceptable accuracy of 0.80.

Conclusions:
The DL model can identify splenic injury on CT, and further application in trauma scenarios is possible.
A case study of myopericarditis due to immune checkpoint inhibitor therapy: Proposed surveillance and management
Authors: Kuhnly Nicole M. , Coviello Jessica Shank 
Published: March 2023

ABSTRACT
Immune checkpoint inhibitor (ICI) therapy is a treatment modality used in many types of cancer. Immune-related adverse events are relatively common. Cardiovascular adverse events are uncommon, but carry a high mortality rate of 25–50%. They require cessation of therapy. There is currently no universal screening before initiation of ICI therapy to identify patients with cardiovascular risk. There is also no ongoing screening to identify myocarditis and treatment is driven by symptoms. This article provides a case study of a patient who developed myopericarditis and the patient's clinical course. Furthermore, it proposes surveillance for patients before and during ICI therapy to swiftly identify potential cases of myocarditis. There is currently no universal baseline screening for cardiovascular risk in patients planned for ICI therapy. A proposed baseline cardiac evaluation, as well as scheduled surveillance therapy, is outlined in this article. With further education and training, immune-related cardiac adverse events may be more promptly detected, leading to better patient outcomes.
A case of chronic eosinophilic pneumonia associated with rheumatoid arthritis in glucocorticoid-free remission with JAK inhibitor: A case report
Authors: Yamane Takashi , Hashiramoto Akira 
Published: March 2023

Rationale:
Chronic eosinophilic pneumonia (CEP) presents eosinophil infiltrations in the lung due to allergic reactions. Most CEP patients continue to take glucocorticoids, and their prolonged use induces various side effects. In this case report, based on the efficacy of baricitinib in patients with rheumatoid arthritis (RA) and CEP, we aimed to show that the administration of Janus kinase (JAK) inhibitors, when RA is complicated by an allergic disease, can stabilize the disease state and help avoid the adverse effects of long-term systemic glucocorticoid administration.

Patients concerns:
A 56-year-old woman developed RA at the age of 19 years. Treatment of the arthritis was initiated, but the joint destruction had progressed. At the age of 42, she developed eosinophilic pneumonia, which was relieved by glucocorticoid therapy. Since then, maintenance therapy has been continued with the diagnosis of CEP. She was treated with concomitant tacrolimus for persistent arthritis, and the prednisolone (PSL) dose was reduced to 3 mg/day after 10 years. However, around this time, an increase in peripheral blood eosinophil counts and respiratory symptoms was observed.

Diagnosis:
The peripheral blood eosinophil count was 4000/µL and computed tomography revealed multiple ground-glass opacities in the peripheral lung fields. As interstitial pneumonia due to infection or other causes was ruled out, CEP relapse was diagnosed.

Interventions:
Pneumonia rapidly recovered when the PSL dose was increased to 15 mg/day, and asymptomatic eosinophilic infiltrates reappeared in the lung field along with a relapse of arthritis when the PSL dose was reduced to 5 mg/day. Concomitant use of methotrexate and baricitinib has been introduced to suppress allergic reactions to pneumonia.

Outcomes:
After starting combination therapy with baricitinib and methotrexate, both arthritis and eosinophilia improved, and glucocorticoid-free remission was achieved.

Lessons:
Recently, inhibition of IL-5 signaling via JAK2 has been reported to be effective in bronchial asthma and atopic dermatitis. Although complications of RA and CEP are not common, the actions of baricitinib are useful not only in arthritis but also in allergic diseases. The efficacy of some JAK inhibitors should be actively tested in patients with RA and these complications.
A case report of T cell/histiocyte-rich large B cell lymphoma misdiagnosed as lymphomatoid papulosis
Authors: Kim Taekwoon , Kim Jisung , Park Joonsoo 
Published: March 2023

Rationale:
T cell/histiocyte-rich large B cell lymphoma (THRLBCL) is an uncommon B cell lymphoma characterized by < 10% large neoplastic B cells in a background of abundant T cells and frequent histiocytes. If a skin lesion is the first clinical sign of lymphoma, the diagnosis might be difficult and misdiagnosed.

Patient concerns:
A 60-year-old woman presented with multiple erythematous umbilicated nodules on her left upper back for 3 months.

Diagnoses:
Through punch biopsy of the back lesion and additional excisional right inguinal lymph node biopsy, the patient was diagnosed with cutaneous metastasis of THRLBCL.

Interventions:
The patient was referred to the Hemato-oncology Department for chemotherapy.

Outcomes:
R-CHOP chemotherapy is currently in progress, and some skin lesions show improvement.

Lessons:
Skin lesions might be the first clinical sign of THRLBCL and when THRLBCL is suspected, careful further evaluation is essential for accurate diagnosis and treatment.
An obvious antinomy, superior sagittal sinus thrombosis in a patient with immune thrombocytopenia: Case report and a review of literatures
Authors: Wang Yuhui , Zhang Ge , Ding Jinggang 
Published: March 2023

Rationale:Immune thrombocytopenia (ITP) is an autoimmune disease with an increased risk of bleeding. However, in recent years, it has been reported that patients with this hemorrhagic disease have the risk of thrombosis and embolism.Patient concerns and diagnosis:The patient, in this case, was a young female who was diagnosed with ITP. When the platelet count was low, she had skin, mucosa, internal organs, and intracranial hemorrhage. In the process of ITP and hemostatic treatment, superior sagittal sinus thrombosis occurred when she was still bleeding.Interventions:She was given treatments for reducing intracranial pressure and controlling epilepsy.Outcomes:And then the embolectomy operation failed. It was suggested in this case that ITP patients with severe thrombocytopenia and bleeding tendency also have a risk of having thrombotic disease. We reviewed literatures regarding the mechanism of the simultaneous occurrence of 2 antinomy diseases and cerebral venous thrombosis.Lessons:There are many factors for ITP patients to have thrombosis involving ITP itself, its treatment and the patients’ constitution, medical history, and former medication. ITP is not only a hemorrhagic disease but also a thrombotic disease. Clinicians should be alert to the risk of thrombotic diseases in ITP treatment. Therefore thrombus monitoring and screening should be carried out, and early prevention or appropriate anticoagulant treatment should be selected, especially for patients with high risk.
Novel mutation in the SETD1A gene in a newborn patient associating with congenital airway and heart defeats: A case report
Authors: Jin Long , Mo Wendi , Yan Yu , Wang Ying 
Published: March 2023

Rationale:
Congenital malformations are commonly associated with genetic disorders in infants and children.

Patient concerns:
A 13-day-old male infant was admitted to our hospital presenting with aggravated dyspnea and characteristic facial and body features. Examinations during hospitalization found congenital bronchomalacia and heart defects including atrial septal defect, patent ductus arteriosus, and pulmonary hypertension, congenital laryngeal stridor, and tracheal stenosis.

Diagnosis:
Considering complicated clinical manifestations, the Trio Whole Exon Sequencing test was run to screen for any hereditary diseases and found a heterozygous pathogenic mutation in SET domain containing 1A (SETD1A) gene (c.2096T > A; p. Leu699Ter, 1099), which was a de novo mutation.

Intervention:
The patient was given amoxicillin clavulanate potassium for antibiotic, fibro bronchoscope lavage and other symptomatic support therapy, and referred to the department of Cardiac Surgery for arterial catheter ligation.

Outcomes:
The patient was discharged after postoperative recovery without shunt. In the following 2 years, he was admitted to hospital multiple times during to infectious pneumonia.

Lessons:
SETD1A gene mutation is commonly associated with neuropsychiatric disorders. This is the first reported case with a novel mutation of SETD1A gene along with new associated phenotypes. Our results broaden the genotypic and phenotypes spectrum of SETD1A gene mutation in infant patients.
Leadership Elements in Veterans Affairs All Employee Survey
Authors: Perla Lisa Y. , Barry Erin S. , Grunberg Neil E. 
Published: March 2023

Purpose/Objectives:
Veterans Affairs (VA) case managers assist and advocate for veterans navigating VA and civilian health care systems. However, government reports indicate repeated dissatisfaction with veteran care coordination. Several case management publications suggest that VA case managers lead, as well as manage, but do not indicate exactly what this means. Few published articles address leadership, specifically, among VA case managers.
The VA All Employee Survey (AES) is an annual survey of VA employees, including case managers, to gather information about their attitudes toward workplace characteristics, relationships, and leadership. The present study utilized a conceptual Leader–Follower Framework (LF2) to assess questions on the annual VA AES to determine which leadership elements are addressed, which leadership elements are not addressed, and whether there are any leadership elements that do not fit within the LF2.

Primary Practice Setting:
Case managers work in a variety of clinical settings including more than1,400 facilities throughout the United States. VA case managers advocate for safe, effective, and equitable patient care according to their scope of practice.

Findings/Conclusions:
All eight leadership elements from the LF2—Character, Competence, Context, Communication, Personal, Interpersonal, Team, and Organizational—were represented among the AES questions, and no leadership elements outside of the framework were identified. However, the leadership elements were unevenly represented within the AES questions, with communication and personal elements occurring frequently whereas context and team were underrepresented.

Implications for Case Management Practice:
These results indicate the LF2 can be used to evaluate the responses of VA employees, including those providing case management, and to address questions of interest related to leadership and may be considered in the development of future case management surveys.
Prediction of Malignant Thyroid Nodules Using 18F-FDG PET/CT–Based Radiomics Features in Thyroid Incidentalomas
Authors: Ko Woo Seog , Kim Seong-Jang 
Published: March 2023

Objective
The purpose of the current study was to evaluate the diagnostic performances of 18F-FDG PET/CT–based radiomics features for prediction of malignant thyroid nodules (TNs) in thyroid incidentaloma (TI).

Methods
PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through December 31, 2022, were searched for studies evaluating diagnostic performance of 18F-FDG PET/CT–based radiomics features for prediction of malignant TNs in TI. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LRs; positive and negative LRs), and estimated pooled area under the curve.

Results
Across 5 studies (518 patients), the pooled sensitivity of 18F-FDG PET/CT was 0.77 (95% confidence interval [CI], 0.67–0.84), and a pooled specificity was 0.67. Likelihood ratio syntheses gave an overall positive LR of 2.3 (95% CI, 1.5–3.6) and negative LR of 0.35 (95% CI, 0.26–0.47). The pooled diagnostic odds ratio was 7 (95% CI, 4–12). The pooled area under the curve of fixed effects was 0.763 (95% CI, 0.736–0.791), and that of random effects was 0.763 (95% CI, 0.721–0.805).

Conclusion

18F-FDG PET/CT–based radiomics features showed a good diagnostic performance for prediction of malignant TNs in TI.
Roseobacter insulae sp. nov. and Loktanella gaetbuli sp. nov., isolated from tidal flats in the Yellow Sea in Korea
Authors: Lee Eun Bee , Park Sooyeon , Kim Wonyong , Yoon Jung-Hoon 
Published: March 2023

Two bacterial strains (designated as YSTF-M11T and TSTF-M6T) were isolated from tidal flat sediments of the Yellow Sea, Republic of Korea, and taxonomically characterized. A neighbour-joining phylogenetic tree based on 16S rRNA gene sequences showed that strain YSTF-M11T clusters with the type strains of

Roseobacter

species and strain TSTF-M6T clusters with the type strains of

Loktanella salsilacus

,

Loktanella fryxellensis

and

Loktanella atrilutea

. Strains YSTF-M11T and TSTF-M6T exhibited 16S rRNA gene sequence similarity values of 97.5–98.9 % and 94.1–97.2 % to the type strains of four

Roseobacter

species and to the type strains of four

Loktanella

species, respectively. An UBCG tree based on genomic sequences and a tree based on AAI showed that strains YSTF-M11T and TSTF-M6T form a cluster with the type strains of

Roseobacter

species and with the type strains of

L. salsilacus

,

L. fryxellensis

and

L. atrilutea

, respectively. The ANI and dDDH values between genomic sequences of strain YSTF-M11T and the type strains of four

Roseobacter

species and between those of strain TSTF-M6T and the type strains of the three

Loktanella

species were in ranges of 74.0–75.9 and 18.2–19.7 % and 74.7–75.5 and 18.8–19.3 %, respectively. The DNA G+C contents of strains YSTF-M11T and TSTF-M6T were 60.3 and 61.9 % based on their genomic sequences. Both strains contained Q-10 as the predominant ubiquinone and C18 : 1
ω7c as the major fatty acid. Strains YSTF-M11T and TSTF-M6T were separated from recognized

Roseobacter

species and

L. salsilacus

,

L. fryxellensis

and

L. atrilutea

, respectively, by their phenotypic properties together with the phylogenetic and genetic distinctiveness. Based on data presented in this study, strains YSTF-M11T (=KACC 21642T =NBRC 115155T) and TSTF-M6T (=KACC 21643T =NBRC 115154T) are considered to represent novel species of the genera

Roseobacter

and

Loktanella

, respectively, for which the names Roseobacter insulae sp. nov. and Loktanella gaetbuli sp. nov. are proposed.
Factors Shaping Network Emergence: A Cross-Country Comparison of Quality of Care Networks in Bangladesh, Ethiopia, Malawi, and Uganda
Authors: Shawar Yusra Ribhi , Djellouli Nehla , Akter Kohenour , Payne Will , Kinney Mary , Mwaba Kasonde , Seruwagi Gloria , English Mike , Marchant Tanya ,   The QCN Evaluation Group, Shiffman Jeremy , Colbourn Tim 
Published: March 2023

AbstractThe Quality Care Network (QCN) was conceptualized by the World Health Organisation (WHO) and other global partners to facilitate learning on and improve quality of care for maternal and newborn health within and across low and middle-income countries. However, there was significant variance in the speed and extent in which QCN formed in the involved countries. This paper investigates the factors that shaped QCN’s differential emergence in Bangladesh, Ethiopia, Malawi, and Uganda. Drawing on network scholarship, we conducted a replicated case study of the four country cases and triangulated several sources of data, including a document review, observations of national-level and district level meetings, and key informant interviews in each country and at the global level. Thematic coding was performed in NVivo 12. We find that QCN emerged most quickly and robustly in Bangladesh, followed by Ethiopia, then Uganda, and slowest and with least institutionalization in Malawi. Factors connected to the policy environment and network features explained variance in network emergence. With respect to the policy environment, pre-existing resources and initiatives dedicated to maternal and newborn health (MNH) and quality improvement, strong data and health system capacity, and national commitment to advancing on synergistic goals were crucial drivers to QCN’s emergence. With respect to the features of the network itself, the embedding of QCN leadership in powerful agencies with pre-existing coordination structures and trusting relationships with key stakeholders, inclusive network membership, and effective individual national and local leadership were also crucial in explaining QCN’s speed and quality of emergence across countries. Studying QCN emergence provides critical insights as to why some well- intentioned top-down global health networks don’t materialize in some country contexts and have relatively quick uptake in others, and has implications for a network’s perceived legitimacy and ultimate effectiveness in producing stated objectives.
Natural antibodies as “eat-me” signals for phagocytosis of necrotic cell debris at sites of tissue injury
Authors: Mattos Matheus Silvério , Vandendriessche Sofie , Schuermans Sara , Feyaerts Lars , Hövelmeyer Nadine , Waisman Ari , Marques Pedro Elias 
Published: March 2023

SummaryNatural antibodies (NAbs) are circulating polyreactive immunoglobulins that bind endogenous and exogenous antigens. Here, we investigated the role of NAbs in driving the clearance of necrotic cell debris from injury sites. Using mouse models of liver injury, we observed that IgM and IgG NAbs opsonize necrotic debrisin vivoby recognizing common self-molecules such as histones, actin, phosphoinositides and cardiolipin, but not phosphatidylserine. Importantly, mice lacking NAbs presented impaired recovery from liver injury, which was correlated to sustained presence of necrotic debris in the tissue, prolonged inflammation and reduced hepatocellular proliferation. Mechanistically, necrotic debris phagocytosis was dependent on NAbsin vitroandin vivo, and restitution with total immunoglobulins rescued the defective recovery from liver injury in immunodeficient mice. In summary, we showed that NAbs opsonize necrotic cell debris and act as “eat-me” signals for engulfment through FcγRs and CD11b, driving the recovery from tissue injury.HighlightsNatural antibodies opsonize exposed self-antigens upon necrotic cell death.The phagocytosis of necrotic cell debris requires natural antibodies, FcγRs and CD11b.Natural antibodies drive cellular proliferation and tissue regeneration after liver injury.Treatment with natural antibodies improves the recovery from liver injury in both immunodeficient and immunocompetent mice.Graphical abstract
An atlas and database of neuropeptide gene expression in the adult zebrafish forebrain
Authors: Hiraki-Kajiyama Towako , Miyasaka Nobuhiko , Ando Reiko , Wakisaka Noriko , Itoga Hiroya , Onami Shuichi , Yoshihara Yoshihiro 
Published: March 2023

AbstractZebrafish is a useful model organism in neuroscience; however, its gene expression atlas in the adult brain is not well developed. In the present study, we examined the expression of 38 neuropeptides, and glutamatergic neuron marker gene mix (slc17a6a, slc17a6b, slc17a7a,andslc17a7b) in the adult zebrafish brain usingin situhybridization. The results are summarized as an expression atlas in 19 coronal planes of the forebrain. Furthermore, the scan data of all sections were made publicly available as a database. Based on these data, we performed detailed neuroanatomical analyses of the hypothalamus. By scrutinizing and comparing the expression patterns of neuropeptides, we found that several regions described as one nucleus in the reference zebrafish brain atlas contain two or more subregions with significantly different neuropeptide/neurotransmitter expression profiles, and we proposed them as novel subnuclei. Subsequently, the expression data obtained in this study were compared with those in mice, and a cluster analysis was performed to examine the similarities. As a result, several nuclei in zebrafish and mice were clustered in close vicinity: zebrafish ventral part of the anterior part of the parvocellular preoptic nucleus (PPav)/magnocellular preoptic nucleus (PM) and mouse paraventricular hypothalamic nucleus (Pa), zebrafish posterior part of the parvocellular preoptic nucleus (PPp) and mouse medial preoptic area (MPA), zebrafish dorsal part of the ventral zone of periventricular hypothalamus (Hvd)/anterior tuberal nucleus (ATN) and mouse ventromedial hypothalamic nucleus (VMN). The present expression atlas, database, and anatomical findings will contribute to future neuroscientific research using zebrafish.Key pointsThe expression of 38 neuropeptides and GABAergic/glutamatergic neuronal marker genes in adult zebrafish forebrain was examined and compiled as an atlas.All scanned brain section data were published as a database.Based on the expression data obtained, multiple subnuclei in the zebrafish hypothalamus were proposed, and comparisons with the mouse hypothalamus were conducted.