bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the Interval to Diagnosis in Pediatric Bone Sarcoma
Authors: Kha Stephanie T. , Sharma Jigyasa , Kenney Deborah , Daldrup-Link Heike , Steffner Robert 
Published: August 2023

Objectives
The timely diagnosis of primary bone malignancies in pediatric patients is critical to clinical outcomes. The purpose of this study is to investigate the initial presentation of pediatric bone sarcoma patients to an academic health care system and assess the current interval to diagnosis.

Methods
We conducted a retrospective review of pediatric patients (aged 1–18) with biopsy-proven diagnosis of osteosarcoma or Ewing sarcoma presenting between 2004 and 2020. All living patients had 1 year or more of follow-up. Primary outcomes were interval to diagnosis, clinical features on initial presentation, percent of patients with negative radiographic workup at initial presentation, and number of health care encounters before diagnosis.

Results
Seventy-one patients (osteosarcoma, 51; Ewing sarcoma, 20) were included. Average age at presentation was 13.1 ± 3.3 years (range, 4.4–18.3). Average symptom duration was 5.4 ± 13.9 months (range, 0.1–84). Clinical features at initial presentation included limb/back pain (91.5% of patients), activity modification/pain medication use (78.9%), palpable mass (40.8%), night pain (35.2%), limp (25.4%), limb disuse (18.3%), and recent fever history (2.8%). Fourteen of 71 patients (19.7%) had negative radiographs at initial presentation. Average number of health care encounters before diagnosis was 1.9 ± 0.6 (range, 1.0–4.0), with most in the outpatient pediatrician clinics (81.2%) and emergency department (18.3%). Average time to diagnosis from initial presentation was 19.5 ± 65 days (range, 0–493); the 14 patients with initial negative radiographs had a statistically significant prolonged interval to diagnosis of 54 ± 134 days (range, 0–493; P = 0.018).

Conclusions
We found pediatric patients with primary bone sarcoma present with an average interval to diagnosis of 20 days. Twenty percent of patients had a significantly prolonged interval to diagnosis of 54 days. Clinical features suggest night pain is not a sensitive indicator. In patients of appropriate age with persistent unilateral pain in suspicious locations, early advanced imaging with magnetic resonance imaging should be considered.
Operational Considerations for Using Deer-Targeted 4-Poster Tick Control Devices in a Tick-borne Disease Endemic Community
Authors: Hornbostel Victoria L. , Meek James I. , Hansen AmberJean P. , Niesobecki Sara A. , Nawrocki Courtney C. , Hinckley Alison F. , Connally Neeta P. 
Published: August 2023

Context:
In the northeastern United States, recommendations to prevent diseases spread by black-legged ticks (Ixodes scapularis) and lone star ticks (Amblyomma americanum) often rely on individuals to use personal protection or yard-based strategies. The 4-Poster deer treatment stations (4-Posters) suppress tick populations by treating deer hosts with acaricide, potentially offering a community-wide approach for reducing tick-borne diseases in endemic areas. The 4-Poster deployment logistics in mainland community settings are not well documented but are needed for future public health tick control efforts.

Program:
As part of a public health research effort to design a population-based 4-Poster effectiveness study aimed at reducing tick-borne disease incidence, TickNET researchers partnered with the Town of Ridgefield (Connecticut) to understand the feasibility and operational logistics of deploying 4-Posters on public land within a residential community to inform future public health interventions by municipalities or vector control agencies.

Implementation:
We deployed three 4-Posters on a municipal property from July to December 2020 and used motion-activated cameras to record wildlife activity nearby. We documented per-device operational details, costs, materials consumed, and animal activity.

Evaluation:
Operation of 4-Posters was feasible, and device challenges were easily remedied. Deer visitation and heavy nontarget animal use were documented at all devices. Unexpectedly, monthly corn consumption was not correlated with monthly deer-view days. The monthly cost per device was US $1279 or US $305 per hectare with an average 21 minutes of weekly service time.

Discussion:
Use of 4-Posters by communities, public health agencies, or vector control programs may be a practicable addition to tick management programs in tick-borne disease endemic areas in the Northeast. Such programs should carefully consider local and state regulations, follow manufacturer and pesticide label guidelines, and include wildlife monitoring. High labor costs incurred in this project could be mitigated by training vector control agency or municipality staff to service 4-Posters.
The Impact of Neighborhood and Socioeconomic Disparities on Distal Radius Fracture Follow-Up Adherence
Authors: Moura Steven P. , McLaughlin Matthew T. , Gowda Madhu , Shaffrey Ellen C. , Edalatpour Armin , Chu Daniel Y. , Michelotti Brett F. 
Published: August 2023

Background:
The aims of this retrospective cohort study were (1) to assess whether the Area Deprivation Index (ADI), a novel neighborhood-level socioeconomic disparities metric, is associated with follow-up nonadherence, and (2) to determine the individual-level socioeconomic factors associated with follow-up nonadherence after treatment of distal radius fractures (DRFs).

Methods:
The authors included all patients who underwent nonoperative or operative management of DRFs at an academic level I trauma center between 2019 and 2021. A manual chart review was performed to collect data on ADI, sociodemographic factors, injury characteristics, conservative and surgical interventions, and health care utilization.

Results:
There was a significant weak negative Spearman-ranked correlation between ADI state deciles and clinic attendance rates (r

s
[220] = −0.144 [95% CI, −0.274 to −0.009]; P = 0.032). Socioeconomic factors associated with significant differences in clinic attendance rates were having a spouse or partner (protective) (P = 0.007), Medicaid insurance (P = 0.013), male sex (P = 0.023), and current smoking (P = 0.026). Factors associated with differences in no-show rates were having a spouse or partner (odds ratio [OR], 0.326 [95% CI, 0.123 to 0.867]; P = 0.025), Medicaid insurance (OR, 7.78 [95% CI, 2.15 to 28.2]; P = 0.002), male sex (OR, 4.09 [95% CI, 1.72 to 9.74]; P = 0.001), and cigarette use (OR, 5.07 [95% CI, 1.65 to 15.6]; P = 0.005).

Conclusions:
ADI has a weak, negative correlation with clinic attendance rates after DRF treatment. Significant disparities in clinic follow-up adherence exist between patients on the basis of marital status, insurance, sex, and cigarette use.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
A Patient Who Developed Lagophthalmos Following Rhinoplasty
Authors: Ural Alper , Gümüş Koray 
Published: August 2023

Abstract:
Lagophthalmos, impairment of closing upper eyelids, can result from various reasons. However, lagophthalmus after a rhinoplasty is both unusual and frustrating. We report a patient experiencing lagophthalmos following rhinoplasty and its management.
Characteristics of Cerebellar Cognitive Affective Syndrome (CCAS) in patients with acute cerebellar stroke and its impact on outcome
Authors: Shinya Tokuaki , Kota Yamauchi , Tanaka Shota , Goto Kei , Arakawa Shuji 
Published: August 2023

AbstractBackgroundRecently, cerebellar cognitive affective syndrome-scale (CCAS-S) was developed to assess CCAS—a syndrome in which cognitive impairment is caused by cerebellar lesions. Literature regarding CCAS in patients with stroke is scarce, and its impact on outcomes is unclear. This study aimed to evaluate CCAS in patients with acute cerebellar stroke and examine its relationship with the outcomes.MethodsPatients who experienced acute cerebellar stroke for the first time and were hospitalized in Steel Memorial Yawata Hospital within 7 days of stroke onset between April 2021 and April 2023 were included in this observational study. CCAS-S, Mini-Mental State Examination (MMSE), and Scale for the Assessment and Rating of Ataxia (SARA) scores were measured 1 week after stroke onset, and Functional Independence measure (FIM)/Barthel Index (BI) at discharge, physical function, activities of daily life (ADL), length of hospital stay, and outcome (discharge destination) were evaluated. The Mann–Whitney U test was used to compare CCAS-S scores and variables.ResultsThirteen consecutive patients with acute cerebellar stroke (9 women) and age-and sex-matched healthy controls (7 women) were included. The MMSE score was within the normal range in all patients; however, patients with stroke had a lower total CCAS-S score (median 72, interquartile range [IQR] 66–80) and a higher number of failed tests (median 4, IQR 3–5) than those of healthy controls. Significant deficits were observed in semantic fluency (p=0.008), category switching (p=0001), and similarity (p=009). Possible, probable, and definite CCAS were diagnosed in 2, 1, and 10 patients, respectively. Patients discharged home showed better SARA and FIM/BI scores but similar CCAS-S scores compared to those discharged to rehabilitation hospitals.ConclusionCCAS along with impaired executive and language functions is frequently observed in patients with acute cerebellar stroke; however, impaired motor function, and not CCAS, influences the outcome.
Effectiveness of Switching CGRP monoclonal antibodies in non-responder patients in the UAE: A retrospective study
Authors: Suliman Reem , Santos Vanessa , Qaissi Ibrahim Al , Aldaher Batool , Fardan Ahmed Al , Barrawy Hajir Al , Bader Yazan , Supena Jonna Lyn , Alejandro Kathrina , Alsaadi Taoufik 
Published: August 2023

AbstractCalcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) have shown promising effectiveness in migraine management compared to other preventative treatment options. Currently there are several studies related to the efficacy and tolerability of CGRP mAbs in the management of mgraine. However, many questions remain unanswered when it comes to switching between antibody classes as a treatment option in patients with migraine headaches. The present study seeks to explore and assess the treatment response to CGRP mAb in patients who have previously failed other CGRP mAbs.This was a retrospective, real-world, exploratory study. The participants included within the study were adult (≥18 years) patients diagnosed with migraine. Patients who were treated with two or more GCRP mAbs were retrospectively analyzed. Data was collected from one site, 53 patients with migraine headache switched between three CGRP mAb types (Eptinezumab, Erenumab, and Glacanezumb) due to lack of efficacy of the original prescribed CGRP mAb. Efficacy of switching between types of CGRP mAb’s was evaluated through documented MMD’s in patient diaries and clinical records. Non-parametric analysis was used to compare efficacy of the first six months of each prescribed medication. The analysis of efficacy demonstrated that some improvements were seen in both class switch cohorts (CGRP/R to CGRP/L and CGRP/L to CGRP/R). However, the most noticeable improvement in efficacy of the prescription switch was found in patients who switched between different medications of the CGRP/L class. Both chronic migraine and episodic migraine patients showed improved MMD’s, however chronic migraine patients demonstrated higher responsiveness of efficacy following this lateral switching, The safety of switching between CGRP classes was well observed as any adverse events presented pre-class switch did not lead to the discontinuation of treatment following the later switch. The findings of this study suggest that switching between different classes of CGRP mAbs is a potentially safe and clinically viable practice that may have some applications for those experiencing side effects on their current CGRP mAb or have suboptimal response. This is especially true for patients initiating treatment on ligand targeted CGRP mAb who experience side effects or lack of meaningful efficacy, as the ligand-ligand cohort seems to demonstrate the best outcome. Larger cohort studies and longer follow ups are needed to validate our findings.
Assessment of Right Ventricular Endocardial Fibroelastosis in Fetuses with Critical Pulmonary Stenosis and Pulmonary Atresia with Intact Ventricular Septum
Authors: Wang Yue , Luo Gang , Sun Yi , Chen Taotao , Pan Silin 
Published: August 2023

AbstractBackgroundSystematic assessment of right ventricular (RV) endocardial fibroelastosis (EFE) in the fetus with critical pulmonary stenosis and pulmonary atresia with intact ventricular septum (CPS/PA-IVS) has not been reported. The implications of RV EFE for circulatory outcomes with or without fetal cardiac intervention (FCI) have also not been demonstrated.MethodsThe fetal echocardiographic data from July 2018 to January 2021 in a single-center institution were collected. Three reviewers independently graded EFE according to the presence and extent of endocardial echogenicity. The associations among EFE severity, anatomic variables, and postnatal outcomes were analyzed.Results81 cases with RV EFE were identified. By consensus, EFE severity was assessed as grade 1 (“mild”; n=66, 81.48%), grade 2 (“moderate”; n=11, 13.58%), and grade 3 (“severe”; n=4, 4.94%). RV sphericity values were greater in grade 2 and 3 EFE groups compared to the grade 1 EFE group, implying more severe noncompliance and worse diastolic function. 10/81(12.35%) fetuses underwent FCI. At the latest available follow-up, 59/81 (72.84%) patients had achieved biventricular circulation. Furthermore, 9/59 (15.25%)—four with grade 1 EFE, three with grade 2, and two with grade 3—had undergone FCI, whereas the other 50/59 (84.75%)—who all had grade 1 EFE—had not.ConclusionsFor the first time in CPS/PA-IVS, RV EFE was graded and the potential of FCI to improve the prognosis of non-mild RV EFE patients was revealed. Non-mild RV EFE was suggested to be a putative indicator of FCI.Graphic Abstract
SARS-CoV-2 Pandemic Non-Pharmacologic Interventions Temporally Associated with Reduced Pediatric Infections Due toMycoplasma pneumoniaeand Co-Infecting Respiratory Viruses in Arkansas
Authors: Boyanton Bobby L. , Frenner Rachel A. , Ingold Ashton , Ambroggio Lilliam , Kennedy Joshua L. 
Published: August 2023

AbstractIntroductionNon-pharmacologic interventions (NPIs), such as universal masking, implemented during the SARS-CoV-2 pandemic have reduced respiratory infections among children. This study focuses on evaluating the impact of NPIs onMycoplasma pneumoniaeinfections in children, analyzing data from two hospitals in Arkansas, and examining age-related differences and coinfections with other viruses.MethodsThe study was approved by the Institutional Review Board and included patients aged ≤18 years with upper respiratory tract symptoms. Data from the FilmArray® Respiratory Panel (FARP) were collected and divided into pre-NPI and NPI periods for analysis. Total test positivity rate and interval change in the positivity rate were evaluated. Statistical differences were determined by Chi-square (χ2-independence) analysis.ResultsA total of 68,949 tests were performed with a statistical increase in testing during the NPI period. The overall test positivity rate forM. pneumoniaedecreased by 74% (0.86% to 0.03%) during the NPI period, and the preschool age group had the highest number of positive tests in the pre- and NPI periods (Pre-NPI: n=40, NPI: n=12 positive tests, p=<0.001). The reduction inM. pneumoniaeinfections was consistent across age groups. Coinfections with other respiratory viruses, particularly human rhinovirus/enterovirus, were observed at much lower levels.ConclusionsNPIs effectively reducedM. pneumoniaein pediatric patients in Arkansas, and coinfections with specific viruses still occurred, albeit at lower levels during the SARS-CoV-2 pandemic. As NPIs are relaxed and the pandemic ends, we expectM. pneumoniaeinfections to return to pre-pandemic levels within the next 1-2 years.
Genetic Elucidation of Ultrasonography Fetal Anomalies in Children with Autism Spectrum Disorder
Authors: Regev Ohad , Shil Apurba , Bronshtein Tal , Hadar Amnon , Meiri Gal , Zigdon Dikla , Michaelovski Analya , Dinstein Ilan , Hershkovitz Reli , Menashe Idan 
Published: August 2023

AbstractRecent evidence suggests that certain fetal anomalies detected upon prenatal ultrasound screenings may be associated with autism spectrum disorder (ASD). In this cross-sectional study, we aimed to identify genetic variants associated with fetal ultrasound anomalies (UFAs) in children with ASD. The study included all children with ASD who are registered in the database of the Azrieli National Center of Autism and Neurodevelopment and for whom both prenatal ultrasound and whole exome sequencing (WES) data were available. We applied our in-house integrative bioinformatics pipeline,AutScore, to these WES data to prioritize gene-disrupting variants (GDVs) probably contributing to ASD susceptibily. Univariate statistics and multivariable regression were used to assess the associations between UFAs and GDVs identified in these children. The study sample comprised 126 children, of whom 43 (34.1%) had at least one UFA detected in the prenatal ultrasound scan. A total of 87 candidate ASD genetic variants were detected in 60 children, with 24 (40%) children carrying multiple variants. There was a weak, but significant, correlation between the number of mutations and the number of abnormalities detected in the same children (r = 0.21,P= 0.016). Children with UFAs were more likely to have loss-of-function (LoF) mutations (aOR=2.55, 95%CI: 1.13–5.80). This association was particularly noticeable when children with structural anomalies or children with UFAs in their head and brain scans were compared to children without UFAs (any mutation: aOR=8.28, 95%CI: 2.29–30.01; LoF: aOR=5.72, 95%CI: 2.08–15.71 and any mutation: aOR=6.39, 95%CI: 1.34–30.47; LoF: aOR=4.50, 95%CI: 1.32–15.35, respectively). GDVs associated with UFAs were enriched in genes highly expressed across all tissues (aOR=2.76, 95%CI: 1.14–6.68). The results provide valuable insights into the potential genetic basis of prenatal organogenesis abnormalities associated with ASD and shed light on the complex interplay between genetic factors and fetal development.
Age-related dysmodulation of systemic immune-inflammatory indices is associated with aggressive colorectal cancer in West Africa
Authors: Okoye Jude Ogechukwu , Chiemeka Michael Emeka , Menkiti Felix Emeka , Iheakwoaba Eric Chukwudi , Agbakoba Nneka 
Published: August 2023

AbstractIntroductionDespite the high mortality rate among colorectal cancer (CRC) patients in Africa, patients still bear the huge cost-related burden of cancer management. To reduce this burden, there is a current search for affordable markers for disease assessment and treatment monitoring. Contributing to this effort, this study evaluated systemic immune-inflammatory indices (SIII) among CRC patients.MethodsThis study included 89 patients with CRC diagnosed from Jan. 2016 to Dec. 2022. The patients were sub-grouped based on age and chemotherapy response. The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), platelets-neutrophils-to-lymphocytes ratio (PNLR), and neutrophils-to-lymphocytes platelets ratio (NLPR) were assessed and analyzed accordingly. Significance was set at p< 0.05.ResultsThe median age of the patients was 58.0 years. Metastatic and stage III/IV CRCs were prevalent among patients older than 50 years compared with patients aged 50 years or less. Among patients aged > 50 years, the pre-treatment (pre-T) to post-treatment (post-T) total white blood cell count (TWBC), neutrophils, monocytes, and NLPR significantly increased whereas the post-T lymphocyte count and LMR significantly declined (p< 0.05). Post-T TWBC count and LMR of patients aged > 50 years were 1.5 times higher and 2.4 times lower, respectively compared with the post-T values of patients who were 50 years old or less (p< 0.05). The post-T PNLR/NLPR and LMR were 2.7/2.3 times higher and 4 times lower among chemotherapy-naïve patients compared with the post-T values of chemotherapy-experienced patients, respectively (p< 0.05). The post-T NLR, PLR, and PNLR among chemoresistance. patients were 2.4, 2.3, and 1.5 higher than the post-T values of chemosensitive patients at p= 0.027, 0.015, and 0.022, respectively.ConclusionThis study revealed a higher frequency of CRC and mortality risk among patients older than 50 years. It suggests that SIII could be used as a prognostic tool for CRC.
Identification of new angio-architectural features of at-risk cranial dural arteriovenous fistulas using machine learning approaches
Authors: Frank Katharina , Shalchian-Tehran Paiman , Manu Mihai , Cinibulak Zafer , Poggenborg Jörg , Nakamura Makoto 
Published: August 2023

BackgroundCranial dural arteriovenous fistulas (dAVF’s) are rare complex vascular malformations that have a bleeding risk with potential lethal consequences. Despite this, the vascular architectural features associated with the rupture risk are not always clearly defined.MethodsWe retrospectively analyzed cranial arteriovenous fistulas in terms of their anatomical and angio-architectural features as evaluated on conventional subtraction angiography: Location of the fistula, fistula architecture, venous ectasia, reflux in cortical draining veins, presence of pial feeders, outflow stenosis, presence of a major sinus thrombosis, flow-associated arterial aneurysms as well as presenting symptoms. Patterns in the data were identified after multiple components analysis followed by automatic k-means clustering and their predictive power was confirmed using a neural network and a random forest classifier.ResultsNew relevant features predictive of hemorrhage (venous outflow stenosis and fistula architecture) were identified using distinct but surprisingly converging modeling paradigms. Both the neural network and the random forest classifier achieved a relatively high performance metric, with area under the receiver operating characteristic curve (ROC AUC)) of 0.875 [95% CI, 0.75-1.0]. The relevance of these findings was verified by performing a multiple correspondence analysis followed by k-means clustering in the angiographic feature vector space. There was good agreement between the ground truth (hemorrhage) and the cluster labels (adjusted Rand score 0.273, purity index 0.82).ConclusionMachine learning approaches confirmed the importance of previously described features (reflux in a cortical vein and venous ectasia) but also uncovered novel relevant characters (outflow stenosis and fistula architecture) for the hemorrhage risk of dAVF’s.
WITHDRAWN: Period2-mediated downregulation of ERK/MAPK phosphorylation in nasopharyngeal carcinoma
Authors: Zhang Zhijuan , Ma Zheng , Kang Jing , Yang Jing , Xu Qianru , Niu Xinran , Luo Xiaoya , Wang Jingyuan , Li Hailiang , Hou Li 
Published: August 2023

Withdrawal statementThe authors have withdrawn their manuscript owing to because authors want to do further study about period2-mediated downregulation of ERK/MAPK phosphorylation in nasopharyngeal carcinoma. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.