bluuebunny/crossref_metadata_2025_split huggingface dataset:
Milky Way globular clusters on cosmological timescales
Authors: Ishchenko Maryna , Sobolenko Margaryta , Kuvatova Dana , Panamarev Taras , Berczik Peter 
Published: April 2023

Aims. We estimate the dynamical evolution of the interaction of globular clusters’ with the Galactic centre that dynamically changed in the past.
Methods. We simulated the orbits of 147 globular clusters over a 10 Gyr lookback time using the parallel N-body code ‘φ-GPU’. For each globular cluster, we generated 1000 sets of initial data with random proper motions and radial velocities based on the observed values. To distinguish globular clusters interacting with the Galactic centre, we used the criterion of a relative distance of less than 100 pc. We used four external potentials from the IllustrisTNG-100 database, which were selected for their similarity to the present-day Milky Way, to simulate the structure of the Galaxy at different times.
Results. We obtained approximately three to four globular cluster interactions per billion years at distances of less than 50 pc and approximately five to six interactions per billion years at distances of less than 80 pc among the studied 147 globular clusters that had close passages near the Galactic centre. We selected ten of them for detailed study and found almost 100% probability of an interaction with the Galactic centre for six of them.
Conclusions. According to our results, the maximum interaction frequency of globular clusters with the Galactic centre in the Milky Way is likely to be a few dozens of passages per billion years within a central zone of 100 pc. This low frequency may not be sufficient to fully explain the relatively high mass (of order 107 M⊙) of the nuclear star cluster in the Milky Way if we consider only the periodic capture of stars from globular clusters during close encounters. Therefore, we must also consider the possibility that some early globular clusters were completely tidally disrupted during interactions with the forming nuclear star cluster and the Galactic centre.
Adult Philadelphia-Positive Acute Lymphoblastic Leukemia: A Single-Institution Experience in Limited-Resource Setting
Authors: Antapura Rudresha Haleshappa , Vaibhav Amale Baburao , Dasappa Lokanatha , Jacob Linu Abraham , Sureshbabu Mallekavu Channappa , Lokesh Kadabur Nagendrappa , Rajeev Lakkavalli Krishnappa , Saldanha Smitha C. , Venkatesh Tirumala 
Published: April 2023

Background Adult Philadelphia-positive (Ph + ) acute lymphoblastic leukemia (ALL) is a distinct entity with poor prognosis. Treatment with tyrosine kinase inhibitors improved responses but still with poor outcomes. We evaluated treatment outcomes in these patients treated in limited-resource settings in the absence of availability of allogeneic stem cell transplantation (ASCT).
Materials and Methods We studied case record files of the adult patients diagnosed with Ph+ ALL.
Results A total of 18 patients were evaluated retrospectively. The median age of presentation was 28 years. Male-to-female ratio was 1:1. Patients presented with fever and fatigue. Six patients (33.33%) presented with cervical lymphadenopathy. Clinical splenomegaly was present in 16 (88.88%) patients on palpation, whereas on ultrasonographic evaluation, all 18 patients had splenomegaly. The median size of the spleen was 15 cm. Hepatomegaly was seen in 5 (27%) patients. All 18 patients had anemia at the time of presentation. Leukocytosis was seen in 17 (94.44%) patients, whereas 1 (5.56%) patient presented with low total leukocyte count. The median platelet count at the time of presentation was 30,000/mm.3 On peripheral smear, median number of blast cells was 55%, and on bone marrow aspiration samples, median blast percentage seen was 70%. Conventional cytogenetics was done in all the patients on bone marrow aspiration samples. Ten patients (55.55%) had t(9;22) – Ph chromosome. One patient (5.56%) on cytogenetics showed double Ph chromosome. The median value of breakpoint cluster region-ABL1 transcript in IS% was 13%. Seventeen (94.44%) received ALL protocol (BFM95) along with tyrosine kinase inhibitor (imatinib). One (5.56%) patient refused aggressive cytotoxic chemotherapy. No patient underwent ASCT. The median duration of follow-up was 7.5 months, ranging from 3 to 16 months. Median overall survival (OS) was 7.5 months and 2-year OS was 33.33%.
Conclusion Poor prognosis of this disease, especially in the absence of ASCT, remains a major challenge in the treatment.
Experience with Generic Pegylated L-asparaginase in Children with Acute Lymphoblastic Leukemia from a Tertiary Care Oncology Center in South India
Authors: Jayaraman Dhaarani , Sneha Latha M. , Jeyarani Gracelin , Somayajula Alekhya , Kothandam Balaji Thiruvengadam , Scott Julius Xavier , Gadekar A 
Published: April 2023

Background Acute lymphoblastic leukemia (ALL) is a common type of leukemia in children. The innovator pegylated L-asparaginase has several advantages over native L-asparaginase; however, its use in India is limited due to availability and cost. Therefore, a generic pegylated L-asparaginase can be considered as an alternative to the innovator molecule.
Methods A retrospective study was conducted to assess the outcome (minimal residual disease [MRD]) and toxicity of a generic pegylated L-asparaginase (Hamsyl) at the end of induction therapy.
Results Eighty-eight (80.7%) and 21 (19.3%) patients had received generic pegylated L-asparaginase and conventional asparaginase, respectively, as a part of their treatment protocol. Nearly 82% of patients had B-type ALL. Eight-one percent of children had a white blood cell count of fewer than 50,000/mm3. At the end of induction, 80.7% (88) of children were minimal residual disease (MRD)-negative, and at the end of augmented consolidation therapy, 20.2% were MRD-negative. Ten percent of patients exhibited allergic reactions. Two children had pancreatitis, and one child had central venous thrombosis.
Conclusion The generic pegylated L-asparaginase (Hamsyl) was effective and safe for use in pediatric ALL.
Doxorubicin Dose Deintensification in Pediatric Osteosarcoma, Is Less Better?
Authors: Halalsheh Hadeel , Abu-Hijlih Ramiz , Ismael Taleb , Shehadeh Ahmad , Salaymeh K. J. , Boheisi Mohammad , Sultan Iyad 
Published: April 2023

Introduction We implemented new clinical practice guidelines (CPG) for patients with osteosarcoma starting in January 2009. These guidelines were based on standard European and American Osteosarcoma Study regimen, which includes six cycles of doxorubicin with a cumulative dose of 450 mg/m2. Aiming to reduce cardiac toxicity at our center, we opted to reduce the cumulative dose of doxorubicin to 375 mg/m2.
Materials and Methods This is a retrospective cohort of osteosarcoma patients aged <18 years, treated at our center between 2009 and 2018. Patients were treated with unified CPG and were prospectively followed. Disease and treatment characteristics were depicted, and survival rates were calculated. When needed, comparison of survival of different groups were conducted using log-rank test.
Results After a median follow-up of 43.3 months (range, 2–153 months), 79 patients were diagnosed with osteosarcoma and treated with dose-reduced doxorubicin. Median age at diagnosis was 12.8 years. At diagnosis, 58 patients (73%) had localized disease. The 5-year event-free survival (EFS) for the whole group was 50 ± 5.9%, and overall survival (OS) was 64 ± 5.7%. For patients with extremity nonmetastatic tumors (N = 56), 5-year EFS and OS were 60 ± 6.9% and 70 ± 6.8%, respectively, and for this group of patients, response to chemotherapy was associated with better EFS (p = 0.0048) and OS (p = 0.013). Only two patients suffered transient cardiac dysfunction, which was resolved after treatment.
Conclusion Our findings suggest that deintensification of doxorubicin may provide adequate control for pediatric osteosarcoma. In the absence of large randomized clinical trials addressing this issue, developing countries with less resources to treat patients with heart failure may consider using the lower dose.
Society of Chest Imaging and Interventions Consensus Guidelines for the Interventional Radiology Management of Hemoptysis
Authors: Singhal Rajat , K.B Santhosh Babu , Naranje Priyanka , Kazimi Junaid , Garg Pawan K. , Chandra Daksh , Popat Bhavesh A. , Shetty Nitin S. , Gorsi Ujjwal , Vimala Leena Robinson , Khera Pushpinder S. , Irodi Aparna , Kulkarni Suyash , Keshava Shyamkumar N. , Bhalla Ashu S. 
Published: April 2023

AbstractThe recommendations from the Society of Chest Imaging and Interventions expert group comprehensively cover all the aspects of management of hemoptysis, highlighting the role of diagnostic and interventional radiology. The diversity existing in etiopathology, imaging findings, and management of hemoptysis has been addressed. The management algorithm recommends the options for effective treatment while minimizing the chances of recurrence, based on the best evidence available and opinion from the experts.
Paratesticular Osteosarcoma—A Rare Tumor with Distinctive Imaging Findings
Authors: Nithiyanandham Lesin Kumar , Vaikundaraja Indhuja Muthiah , Sundersingh Shirley , Lalit Sneha , Menon Arun Ramdas , Raj Elluswami Hemanth , Raja Anand 
Published: April 2023

AbstractExtraosseous osteosarcoma (EOO) is a rare mesenchymal malignancy representing 4% of all osteosarcomas and 1% of soft tissue sarcomas. The testes, its supporting structures, that is, paratestes, and the spermatic cord are among the rarest sites for EOO, with only 11 published English language reports to date. We report our experience with a 73-year-old male presenting with left hemiscrotal swelling, noted to have extensive amorphous intratumoral calcification on imaging. He underwent left high inguinal orchidectomy with en bloc hemiscrotectomy, with a final pathologic diagnosis of primary paratesticular osteosarcoma. Our literature review corroborates this distinctive, hitherto overlooked imaging feature.
Reassures Me There Are People Around Who Care about Me: Analyzing Meanings of Support for People with Epilepsy
Authors: Walker Christine , Peterson Chris L. 
Published: April 2023

AbstractAims The study aimed to examine the nature and outcomes of social support for the well-being and quality of life (QoL) of adults with epilepsy.Methods The Australian Epilepsy Longitudinal Survey's 5th Wave included the Medical Outcomes Study Modified Social Support Survey on four dimensions of social support and the QOLIE-31. Both numerical data and open-ended responses were analyzed quantitatively and qualitatively. A mixed method was used where quantitative analysis used t-tests, analysis of variance and block recursive regression, and qualitative analysis identified themes.Results Three-hundred thirty-two people with epilepsy (PWE) participated. The quantitative component showed that for emotional/informational support being older and living alone were key factors. These as well as household income were important in tangible support. For affectionate support living alone and household income were factors, but only income was a factor for positive social interaction. In addition, only positive social interaction predicted increased QoL. In the qualitative component of the study both positive and negative supports were identified for the emotional/informational supports. Many reported the benefits of having information, although some reported failure to have their needs taken seriously by health professionals or epilepsy associations. Inability to drive was an important feature of negative tangible support as was finding some assistive services unaffordable. Reports of positive social interaction identified being accepted as a person with epilepsy that is the primary concern. Peer support plays a role here.Discussion The findings of factors affecting the four dimensions of support in this study have supported a number of studies. This includes the effects of positive social interaction on QoL. The qualitative analysis supports these results, but it also contributes to deeper understanding of support in the lives of PWE.Conclusion Social support is a particularly important issue for PWE. The results of this study demonstrate the complexities and benefits of obtaining the appropriate forms of support. This survey took place before the coronavirus disease 2019 pandemic and it may well be that this phenomenon affects PWE's support needs.
An Atypical Presentation of Hepatocellular Carcinoma with Multisite Metastasis following a Curative Liver Transplant
Authors: Gidley Patrick , Patel Anand , Barkan Guliz A. , Jawahar Anugayathri 
Published: April 2023

AbstractHepatocellular carcinoma (HCC) is the most common primary liver malignancy, and liver transplantation is usually curative. HCC recurrences are rare after curative treatment options, although they are prevalent depending on various risk factors. We present a 71-year-old female patient with an unusual pattern of disease progression following a curative liver transplant with a metastatic presentation in the absence of alpha-fetoprotein elevation after 3 years of disease-free clinical presentation. We present this case to emphasize the importance of intermittent cross-sectional imaging in addition to ultrasound screening in HCC surveillance.
Historical Perspectives on the Neurologic Manifestations of Viral Pandemics
Authors: Holroyd Kathryn B. , Berkowitz Aaron L. 
Published: April 2023

AbstractNeurologic symptoms have been reported in over 30% of hospitalized patients with coronavirus disease 2019 (COVID-19), but the pathogenesis of these symptoms remains under investigation. Here, we place the neurologic complications of COVID-19 within the context of three historical viral pandemics that have been associated with neurologic diseases: (1) the 1918 influenza pandemic, subsequent spread of encephalitis lethargica, and lessons for the study of COVID-19-related neuroinflammation; (2) the controversial link between the 1976 influenza vaccination campaign and Guillain–Barré Syndrome and its implications for the post- and parainfectious complications of COVID-19 and COVID-19 vaccination; and (3) potential applications of scientific techniques developed in the wake of the human immunodeficiency virus pandemic to the study of postacute sequelae of COVID-19.
Relationship of the Presence of the Inferior Right Hepatic Vein with the Right Hepatic Vein Diameter and CT Liver Volumetry
Authors: Gündoğdu Elif 
Published: April 2023

Abstract
Background Right hepatic venous anatomy, right lobe volume, and percentage of remnant liver are issues to be considered in preoperative planning especially transplantation.
Objectives The aim of this study was to investigate the relationship of the presence of the inferior right hepatic vein (IRHV) with the right hepatic vein (RHV) diameter, right lobe volume, and percentage of remnant liver.
Materials and Methods In this cross-sectional study, the computed tomography (CT) images of 90 patients who underwent triphasic CT for being living liver donation were evaluated retrospectively. The number and diameter of IRHVs and the diameter of main RHV were recorded. For the liver volume analysis, a deep learning-based automatic liver segmentation (Hepatic VCAR) program was used. A virtual hepatectomy plane was drawn, where the right and left liver volumes were found and the percentage of the left lobe to the total liver volume was calculated. Pearson's correlation analysis was used for correlation analysis and Student's t-test was used to compare parameters.
Results A total of 74 IRHVs were detected in 53 (58.88%) of 90 patients. There were no differences in the percentage of remnant left lobe volume, right lobe volume, and RHV diameter between the IRHV (+) and (−) groups. The RHV diameter had a weak negative correlation with the IRHV diameter, and a weak positive correlation with the right lobe volume.
Conclusions The percentage of remnant left lobe volume, right lobe volume, and RHV diameter did not differ in liver donors with and without an IRHV. The RHV diameter had a weak negative correlation with the IRHV diameter and a weak positive correlation with the right lobe volume.
Postpartum Opioid Prescribing in Patients with Opioid Use Prior to Birth
Authors: Peahl Alex F. , Keer Emma , Hallway Alexander , Kenney Brooke , Waljee Jennifer F. , Townsel Courtney 
Published: April 2023

Objective This study aimed to describe opioid prescribing patterns for pregnant patients with a history of or active opioid use to inform postpartum pain management strategies.
Study Design We conducted a retrospective cohort analysis of all patients with a history of opioid use disorder (OUD) or chronic pain seen at a single outpatient clinic specializing in opioid use and OUD in pregnancy from January 2019 to August 2021. Patient characteristics, delivery outcomes, and opioid prescribing information were collected through electronic health record fields. We used descriptive statistics to characterize differences in receipt of an opioid prescription, prescription size, and receipt of a prescription refill across three patient groups: patients with OUD on medication, patients with OUD maintaining abstinence, and patients with chronic pain using opioids. In the study period, the institutional average rate of opioid prescribing after cesarean and vaginal birth were 80.0 and 2.8%, respectively.
Results Of the 69 patients included in this study, 46 (66.7%) had a history of OUD on medication, 14 (20.3%) had a history of OUD maintaining abstinence, and 9 (13.0%) had a history of chronic pain. Receipt of an opioid prescription after childbirth was more common after cesarean birth (12/23, 52.2%) than vaginal birth (3/46, 6.5%). Refills were common in patients who received an opioid proscription (cesarean: 5/12, 41.7%; vaginal: 1/3, 33.3%).
Conclusion Compared with institutional averages, postpartum opioid prescribing rates for people with a history of OUD or chronic pain were 50 to 60% lower for cesarean birth and three times higher for vaginal birth. Future work is needed to balance opioid stewardship and harm reduction with adequate pain control in these high-risk populations.
Key Points
The Subtilisin-Like Protease Furin Regulates Hemin-Dependent Ectodomain Shedding of Glycoprotein VI
Authors: Fink Annalena , Rohlfing Anne-Katrin , Dicenta Valerie , Schaale David , Kremser Marcel , Laspa Zoi , Sigle Manuel , Fu Xiaoqing , Pelzer Andreas , Fischer Melina , Münzer Patrick , Castor Tatsiana , Müller Karin Anne Lydia , Borst Oliver , Lämmerhofer Michael , Gawaz Meinrad Paul 
Published: April 2023

Introduction Hemolysis results in release of free hemoglobin and hemin liberation from erythrocytes. Hemin has been described to induce platelet activation and to trigger thrombosis.
Methods We evaluated the effect of hemin on platelet function and surface expression of the platelet collagen receptor glycoprotein VI (GPVI). Isolated platelets were stimulated with increasing concentrations of hemin.
Results We found that hemin strongly enhanced platelet activation, aggregation, and aggregate formation on immobilized collagen under flow. In contrast, we found that surface expression of GPVI was significantly reduced upon hemin stimulation with high hemin concentrations indicating that hemin-induced loss of surface GPVI does not hinder platelet aggregation. Loss of hemin-induced surface expression of GPVI was caused by shedding of the ectodomain of GPVI as verified by immunoblotting and is independent of the GPVI or CLEC-2 mediated ITAM (immunoreceptor-tyrosine-based-activation-motif) signaling pathway as inhibitor studies revealed. Hemin-induced GPVI shedding was independent of metalloproteinases such as ADAM10 or ADAM17, which were previously described to regulate GPVI degradation. Similarly, concentration-dependent shedding of CD62P was also induced by hemin. Unexpectedly, we found that the subtilisin-like proprotein convertase furin controls hemin-dependent GPVI shedding as shown by inhibitor studies using the specific furin inhibitors SSM3 and Hexa-D-arginine. In the presence of SSM3 and Hexa-D-arginine, hemin-associated GPVI degradation was substantially reduced. Further, SSM3 inhibited hemin-induced but not CRP-XL-induced platelet aggregation and thrombus formation, indicating that furin controls specifically hemin-associated platelet functions.
Conclusion In summary, we describe a novel mechanism of hemin-dependent GPVI shedding and platelet function mediated by furin.
Intravenous Thrombolysis or Medical Management for Minor Strokes
Authors: Tu Wen-Jun , Xu Yicheng , Liu Yakun , Li Jilai , Du Jichen , Zhao Jizong 
Published: April 2023

Objective To evaluate the outcomes of acute ischemic stroke patients with minor deficits treated with either intravenous thrombolysis (IVT) or routine medical management (MM).Methods The study included patients with acute ischemic stroke and National Institutes of Health Stroke Scale (NIHSS) scores of 5 or less who were treated with IVT within 4.5 hours from symptom onset and were classified as the IVT group. The MM group consisted of an equal number of patients with minor strokes, matched for sex, age, and severity, who did not receive thrombolysis. Data on patient information were collected for both groups.Results A total of 26,236 patients were included in this study (13,208 in IVT and 13,208 in MM). Of these patients, 67.9% were men, and the mean age was 67.1 years (standard deviation: 10.9). At 3 months, the IVT group had a higher rate of stroke-independent outcome (Rankin Scale score of 0–2) compared with the MM group (IVT vs. MM: 91.6 vs. 88.6%, absolute difference: 2.5%, 95% confidence interval [CI]: 1.6–3.4%, p = 0.008; adjusted hazard ratio [HR]: 1.2, 95% CI: 1.1–1.4, p = 0.003). Furthermore, there was no significant difference in 3-month mortality rates between the IVT and MM groups (IVT vs. MM: 2.1 vs. 2.5%, absolute difference: −0.6%, 95% CI: −1.1 to 0.3%, p = 0.11; adjusted HR: 0.9, 95% CI: 0.8–1.2, p = 0.09).Conclusion Compared with MM, IVT does not reduce mortality in minor ischemic stroke but improves functional outcomes in minor stroke with an NIHSS score of 3 to 5.
Adventitial Vasa Vasorum Neovascularization in Femoral Artery of Type 2 Diabetic Patients with Macroangiopathy Is Associated with Macrophages and Lymphocytes as well as the Occurrence of Cardiovascular Events
Authors: Chen Dong , Zhao Zixi , Liu Peng , Liu Xinbang , Wang Xin , Ren Qiuyue , Chang Bai 
Published: April 2023

Objectives This study was conducted to assess the relationship between adventitial vasa vasorum neovascularization (VVn) in femoral artery of type 2 diabetic patients with macroangiopathy and the recruitment of macrophages and lymphocytes, and to relate the density of VVn to the occurrence of cardiovascular events.
Materials Femoral artery samples were obtained from amputation cases. A total of 55 type 2 diabetic patients with macroangiopathy, 15 autopsy cases with type 2 diabetes without atherosclerosis.
Methods Hematoxylin and eosin (H&E) staining to observe the histopathological features; Victoria blue staining to analyze the histological features; immunohistochemistry (CD34, CD68, CD20, and CD3) to determine the VVn density and the expression of macrophages, B lymphocytes, and T lymphocytes.
Results Type 2 diabetic patients with macroangiopathy showed a higher mean adventitial VVn density in femoral artery (48.40 ± 9.39 no./mm2) than patients with type 2 diabetes without atherosclerosis (19.75 ± 6.28 no./mm2) (p < 0.01). In addition, the VVn density was positively associated with the expression of CD68 macrophages (r = 0.62, p < 0.01) and CD20 B lymphocytes (r = 0.59, p < 0.01). Type 2 diabetic patients with high VVn density showed more adverse cardiovascular events (27/35 vs. 8/20 events, p = 0.006). In multivariable analysis adjusted for main risk factors for cardiovascular disease, VVn was still independently associated with adverse cardiovascular events (p = 0.01).
Conclusion VVn density in type 2 diabetic patients with macroangiopathy is positively correlated with the adventitial immune-inflammatory cell numbers and the development of atherosclerotic lesions. Furthermore, VVn density is associated with adverse cardiovascular events.