bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laparoscopic Diagnosis and Treatment of an Isolated Cervical Diverticulum
Authors: Nezhat Farr , Demirel Esra , Mesbah Michael , Hill Kaitlyn 
Published: April 2023

BACKGROUND:
Congenital müllerian anomalies are found in 8.0% of women with infertility and up to 5.5% of women in a general population. Cervical diverticulum is a type of cervical malformation that can be congenital or acquired, with only select cases documented in the literature. Cervical diverticulum can be asymptomatic or present with abnormal uterine bleeding, pelvic pain, or infertility. Previously described management options are largely limited to observation or exploratory laparotomy.

CASE:
A 35-year-old woman, gravida 2 para 2, presented with persistent menorrhagia, pelvic pain, and abdominal bloating and was found to have an 8-cm right adnexal mass on pelvic ultrasonography. Magnetic resonance imaging showed a hemorrhagic cervical mass communicating with the uterine cavity. The mass was resected laparoscopically, and pathology revealed fibromuscular tissue with endocervical epithelium consistent with a cervical diverticulum.

CONCLUSION:
Isolated cervical diverticula are rare but should be considered in the differential diagnosis of adnexal masses. Laparoscopic surgery is a safe, minimally invasive approach for evaluation and repair of cervical diverticula.
Role of HNF4alpha-cMyc interaction in liver regeneration and recovery after acetaminophen-induced acute liver injury
Authors: Kotulkar Manasi , Paine-Cabrera Diego , Abernathy Sarah , Robarts Dakota R. , Parkes Wendena S. , Lin-Rahardja Kristi , Numata September , Lebofsky Margitta , Jaeschke Hartmut , Apte Udayan 
Published: April 2023

Background and Aims:
Overdose of acetaminophen (APAP) is the major cause of acute liver failure in the western world. We report a novel signaling interaction between hepatocyte nuclear factor 4 alpha (HNF4α) cMyc and nuclear factor erythroid 2–related factor 2 (Nrf2) during liver injury and regeneration after APAP overdose.

Approach and Results:
APAP-induced liver injury and regeneration were studied in male C57BL/6J (WT) mice, hepatocyte-specific HNF4α knockout mice (HNF4α-KO), and HNF4α-cMyc double knockout mice (DKO). C57BL/6J mice treated with 300 mg/kg maintained nuclear HNF4α expression and exhibited liver regeneration, resulting in recovery. However, treatment with 600-mg/kg APAP, where liver regeneration was inhibited and recovery was delayed, showed a rapid decline in HNF4α expression. HNF4α-KO mice developed significantly higher liver injury due to delayed glutathione recovery after APAP overdose. HNF4α-KO mice also exhibited significant induction of cMyc, and the deletion of cMyc in HNF4α-KO mice (DKO mice) reduced the APAP-induced liver injury. The DKO mice had significantly faster glutathione replenishment due to rapid induction in Gclc and Gclm genes. Coimmunoprecipitation and ChIP analyses revealed that HNF4α interacts with Nrf2 and affects its DNA binding. Furthermore, DKO mice showed significantly faster initiation of cell proliferation resulting in rapid liver regeneration and recovery.

Conclusions:
These data show that HNF4α interacts with Nrf2 and promotes glutathione replenishment aiding in recovery from APAP-induced liver injury, a process inhibited by cMyc. These studies indicate that maintaining the HNF4α function is critical for regeneration and recovery after APAP overdose.
Compounded 0.01% Atropine—What's in the Bottle?
Authors: Richdale Kathryn , Skidmore Kelsea V. , Tomiyama Erin S. , Bullimore Mark A. 
Published: April 2023

Objective:To describe the labeling, packaging practices, and characteristics of compounded 0.01% ophthalmic atropine.Methods:A convenience sample of parents of children who had previously been prescribed low-concentration atropine for myopia management were randomized to obtain 0.01% atropine ophthalmic solution from one of nine compounding pharmacies. The products were analyzed for various important quality attributes. The main outcomes were labeling practices, concentration of atropine and degradant product tropic acid, pH, osmolarity, viscosity, and excipients in 0.01% atropine samples obtained from nine US compounding pharmacies.Results:Twenty-four samples from nine pharmacies were analyzed. The median bottle size was 10 mL (range 3.5–15 mL), and eight of nine pharmacies used clear plastic bottles. Storage recommendations varied and were evenly split between refrigeration (33%), room temperature (33%), and cool, dark, dry location (33%). Beyond use dates ranged from 7 to 175 days (median, 91 days). Median pH of samples was 7.1 (range, 5.5–7.8). Median measured concentration relative to the prescribed concentration was 93.3% (70.4%–104.1%). One quarter of samples were under the 90% minimum target concentration of 0.01%.Conclusions:An inconsistent and wide variety of formulation and labeling practices exist for compounding 0.01% atropine prescribed to slow pediatric myopia progression.
Two cases of intraventricular hemorrhage treated by prone position drainage combined with intraventricular infusion of urokinase
Authors: Li Jiarou , Wang Hongliang 
Published: April 2023

ABSTRACT
Intracerebral hemorrhage (ICH) is a common neurosurgical emergency in high mortality. In recent years, stereotactic aspiration and subsequent fibrinolysis has been considered less invasive and more effective compared with the conventional surgical removal of ICH. On this basis, we improved the treatment method and combined it with the mature prone position therapy in ICU. We present two unique cases of intraventricular hemorrhage treated by prone position, radiographic evidence proves its availability and feasibility. Prone positin can liquefy hematoma better, make its density more uniform thus easy to drain. In similar cases of intraventricular hemorrhage, we hypothesize that prone position may offer a greater result of drainage, and should be strongly recommended for treatment.
Comparative Evaluation of the ABC Score to Other Risk Stratification Scales in Managing High-risk Patients Presenting With Acute Upper Gastrointestinal Bleeding
Authors: Kherad Omar , Restellini Sophie , Almadi Majid , Martel Myriam , Barkun Alan N. 
Published: April 2023

Objective:
The ABC risk score identifies patients at high risk of mortality in acute lower and upper gastrointestinal bleeding (UGIB). We aimed to externally validate the ABC score while comparing it to other prognostication scales when assessing UGIB patients at high risk of negative outcomes before endoscopy.

Methods:
UGIB patients from a national Canadian registry (REASON) were studied, with mortality prediction as a primary outcome. Secondary endpoints included prognostication of rebleeding, intensive care unit (ICU) admission, ICU and hospitalization lengths of stay (LOS), and a previously proposed composite outcome measure. Univariable and areas under the receiver operating characteristic curve analyses compared discriminatory abilities of the ABC score to the AIMS65, Glasgow Blatchford Scale (GBS), and clinical Rockall score.

Results:
The REASON registry included 2020 patients [89.4% nonvariceal; mean age (±SD): 66.3±16.4 y; 38.4% female]. Overall mortality, rebleeding, ICU admission, transfusion and composite score rates were 9.9%, 11.4%, 21.1%, 69.0%, and 67.3%, respectively. ICU and hospitalization LOS were 5.4±9.3 and 9.1±11.5 days, respectively. The ABC score displayed superior 30-day mortality prediction [0.78 (0.73; 0.83)] compared with GBS [0.69 (0.63; 0.75)] or clinical Rockall [0.64 (0.58; 0.70)] but not AIMS65 [0.73 (0.67; 0.79)]. Although most scales significantly prognosticated secondary outcomes in the univariable analysis except for ICU LOS, discriminatory abilities on areas under the receiver operating characteristic curve analyses were poor.

Conclusions:
ABC and AIMS65 display similar good prediction of mortality. Clinical usefulness in prognosticating secondary outcomes was modest for all scales, limiting their adoptions when informing early management of high-risk UGIB patients.
Acute limb ischemia due to diclofenac sodium iatrogenic intra-arterial injection: a case report
Authors: Banana Youssef , Bashir Husam , Boukabous Sara , Rezziki Abdellah , Benzirar Adnane , El Mahi Omar 
Published: April 2023

Introduction:
Diclofenac sodium is a nonsteroidal anti-inflammatory, the injection of which by the intra-arterial route can lead to serious vascular complications, including limb ischemia.

Case presentation:
We report the case of accidental intra-arterial injection of diclofenac sodium in the brachial artery leading to acute limb ischemia.

Clinical discussion:
Iatrogenic intra-arterial injection is rarely reported in the literature; however, it is toxic and can lead to limb amputation. Only two cases of intra-arterial injection of diclofenac have been reported in the literature. The proposed pathophysiological mechanism is vasospasm, intravascular thrombosis, and chemical endoarteritis. The most common anatomical location in accidental intra-arterial injection is the antecubital fossa, where branches of the ulnar and brachial arteries are more superficial.

Conclusion:
The injection of medication must be as careful as possible, since the intra-arterial injection can affect the functional prognosis of the organ.
Incidental finding of Poland syndrome in a case of phimosis: a rare case report from Nepal
Authors: Niraula Zenish , Ghimire Pradip , Pokhrel Sanish , Ale Magar Sugam , Bajracharya Jasmine , Thapa Bineet 
Published: April 2023

Introduction:
Poland syndrome is a rare congenital syndrome that mostly includes the absence of unilateral pectoralis major muscle and digit anomalies like symbrachydactyly. It can also present with other varied manifestations like the absence of ribs, bilateral absence of pectoralis major muscle, urogenital anomalies, dextrocardia, etc.

Case Presentation:
We herein present a case of a 6-year-old boy with Poland syndrome as an incidental finding, the second one reported from Nepal, 11 years after the first report. The syndrome was diagnosed after the patient came to the hospital for treatment of phimosis. On examination, the sternocostal head of the right pectoralis major muscle was absent with a palpable clavicular head with symbrachydactyly of the ipsilateral side.

Discussion:
Poland syndrome is mostly diagnosed clinically. Its differential diagnosis includes other chest wall anomalies, nipple anomalies, isolated thoracic lipoatrophy, and isolated hand/upper limb anomalies without pectoralis major muscle involvement. Computed tomography and MRI scans can help delineate the exact chest wall abnormality. It also helps to find other manifestations of the syndrome and for the treatment plans.

Conclusion:
Poland syndrome is a rare syndrome that has the propensity to be missed in clinical settings. Treatment, mainly sought for cosmetic reasons, includes breast augmentation procedures or myocutaneous flap coverage.
Pancreatic cancer presenting with acute pancreatitis complicated by Wernicke’s encephalopathy and a colonic fistula: a case report
Authors: Ibnawadh Abdulrahman K. , Alashgar Hamad I. , Peedikayil Musthafa , Amin Tarek 
Published: April 2023

Introduction and Importance:
This account details the case of a 39-year-old male patient who presented with acute necrotizing hemorrhagic pancreatitis. The comorbid conditions of Wernicke’s encephalopathy, and a pancreatic–colonic fistula developed during his care. This case is unique in that it illustrates the effects of these complications individually and through their interaction. Given that there are no firm guidelines regarding the nature and timing of interventions for a pancreatic–colonic fistula diagnosis, this case may provide helpful information.

Case Presentation:
As previously noted, this is the case of a 39-year-old male patient with a BMI of 46 kg/m2 who presented with acute necrotizing hemorrhagic pancreatitis. Complications developed as noted above. Multiple diagnostic imaging methods were utilized but failed to detect the presence of metastatic pancreatic adenocarcinoma. After a course of antimicrobial and nutritional therapy, we attempted surgical intervention for the pancreatic–colonic fistula and pancreatic abscess debridement. Unfortunately, during that procedure, we observed extensive carcinomatosis, at which point we did a gastrojejunostomy. Subsequently, the patient’s condition did not permit chemoradiotherapy. After completion, we transferred the patient to palliative care, where he died.

Clinical Discussion:
This case was complex due to the previously recounted results of the underlying condition, pancreatic adenocarcinoma, and the complications of Wernicke’s encephalopathy and pancreatic–colonic fistula. The presence of risk factors in patients increases the need to perform appropriate diagnostic tests. Even with tests and multiple imaging modalities, these particular events remain challenging to diagnose, given the nature of the development and presentation of the disease condition. It was only after the surgical intervention that the carcinoma became evident. Early screening and imaging could improve detection rates and prevent disease progression.

Conclusion:
In this case report of acute hemorrhagic necrotizing pancreatitis and its complications, we discuss the factors making this disease process particularly difficult to diagnose, detect, and manage. Even though the complications detailed herein are rare, in this case, the significance is the need to evaluate all patients with acute pancreatitis and acute confusion for Wernicke’s encephalopathy, which is preventable. In addition, suggestive findings on computed tomography signal the need for further investigation of the colonic fistula. Finally, at this time, there are no clear guidelines for the surgical management of these complications. We hope that this case report will contribute to their development.
Direct posterior approach to posterior cruciate ligament bony avulsion fractures: a case series introducing a new surgical technique
Authors: Talebian Parham , Aref Daneshi S. , Soleimani Mohammad 
Published: April 2023

Background:
Posterior cruciate ligament bony avulsion is one of the well-known knee injuries, which includes about 3–20% of knee ligament injuries. Failure to properly treat this injury causes instability in the knee. Although various surgical approaches have been introduced for this injury, there is controversy regarding selecting the suitable method under certain conditions.

Method:
In this study, as well as introducing our new surgical technique, we reported the treatment results of our patients who underwent surgery between April 2021 and June 2022. In this approach, in a short time with about 5 cm incisions, we can directly access the fracture site and directly fix the fracture with minimal tissue damage.

Result:
Results of this study showed that the operating time was about 24.2 min on average. And in the 6-month follow-up results of our patients, no complications were reported, while the results stipulate a complete recovery of knee pain, range of motion, and stability in examinations.

Conclusion:
Apparently, the direct posterior approach to posterior cruciate ligament bony avulsion fractures is a safe method with minimal complications and suitable treatment results for patients.
Restoration of the Lost Human Beta Defensin (hBD-1) in Cancer as a Strategy to Improve the Efficacy of Chemotherapy
Authors: Pandurangi Raghu S. , Sekar Thillai V. , Paulmurugan Ramasamy 
Published: April 2023

AbstractBoth innate and adaptive immunity are the important components of the human defense system against various diseases including cancer. Human Beta Defensin (hBD-1) is one such immunomodulatory peptide which is lost at high frequencies in malignant cancers, while high levels of expression are maintained in benign regions making it a potential biomarker for the onset and metastasis of the disease. Loss of putative function of hBD-1 as a tumor suppressor gene combined with the defects in apoptosis pathways (CD95, ASK1) make tumor cells insensitive to chemotherapy and render it ineffective.Triple negative breast cancer (TNBC) is an aggressive form of breast cancer for which no targeted therapy works due to lack of biomarkers (ER, PR and HER2 negative). That makes chemotherapy as a first line of treatment despite high side effects. TNBC is known for avoiding immunosurveillance and desensitizing themselves to intervention by dysregulating cell death pathways (CD95 & ASK1) and developing resistance to chemotherapy A priori Activation of Apoptosis Pathways of Tumor often referred to as AAAPT is a novel targeted tumor sensitizing technology which sensitizes low responsive and resistant tumor cells to evoke a better response from the current treatments for TNBC. Here, we show that hBD-1 is shown to target tumor specific biomarker Trx, activates dual cell death pathways CD95 and ASK1 (apoptosis stimulating kinase) to sensitize TNBC cells to chemotherapy drug Doxorubicin. As far as we know, this is the first-time injection of hBD-1 in TNBC mouse model to prove the restoration of hBD-1 back to the basal level can sensitize cancer cells which resulted in significant reduction of tumor volume in TNBC mouse model‘ in vivo. Sensitizing the low or non-responsive tumor cells by AAAPT and making chemotherapy work at lower doses may lead to the significant reduction of dose related side effects and may expand the therapeutic index of the current treatments.
Differential effects of prolonged aerobic and resistance exercise on cognitive functioning in sedentary young adults
Authors: Riganello Francesco , Pearce Alexandra , Lyons Kathleen M. , Owen Adrian M. , Soddu Andrea , Stojanoski Bobby 
Published: April 2023

AbstractObjectivesInconsistencies in the literature make it difficult to outline the relationship between exercise and cognition in young adults. Our aim is to better understand the relationship between prolonged aerobic and resistance exercise and cognitive abilities in sedentary young adults, and how this relationship is mediated by changes in cardiovascular fitness.MethodsTwenty-three volunteers were recruited and assigned to two groups to complete one hour of continuous daily workout sessions of aerobic (SPIN) and anaerobic (SCSW) exercises over a 30 day period. Each subject was provided with a Polar-10 wearable to record the heart rate (HR) activity during the workout sessions. The workout sessions were completed during five consecutive days over four consecutive weeks. Each week, HR data were collected from the last workout session. Volunteers also completed a neurocognitive test battery (Cambridge Brain Sciences, CBS) each exercise session, including an additional baseline measure before exercise regime began.ResultsWe found that memory, reasoning and verbal abilities improved throughout the aerobic, but not the resistance exercise program. We found a positive correlation between heart rate index (HRI) and memory and reasoning test scores. We also found a negative correlation between reasoning ability and HRM (heart rate mean), and heart rate skewness (SKW). The results of a regression model to predict memory and reasoning abiltiies revealed that memory was best predicted by HRI and HRM, while the reasoning ability was best predicted by only HRI.ConclusionRegular aerobic exercises improved specific cognitive performance and it was possible to predict the performance by employing the HR parameters HRI and HRM.
NanoMOFs with Encapsulated Photosensitizer: Accumulation inChlamydia trachomatisInclusions and Antimicrobial Effects
Authors: Qi Xiaoli , Grafskaia Ekaterina , Yu Zhihao , Shen Ningfei , Fedina Elena , Masyutin Alexander , Erokhina Maria , Lepoitevin Mathilde , Lazarev Vassili , Zigangirova Nailya , Serre Christian , Durymanov Mikhail 
Published: April 2023

ABSTRACTMetal-organic framework nanoparticles (nanoMOFs) are a promising class of hybrid nanomaterials for biomedical applications. Some of them, including biodegradable porous iron carboxylates are proposed for encapsulation and delivery of antibiotics. Due to the high drug loading capacity and fast internalization kinetics nanoMOFs are more beneficial for the treatment of intracellular bacterial infections compared to free antibacterial drugs, which poorly accumulate inside the cells because of the inability to cross membrane barriers or have low intracellular retention. However, nanoparticle internalization does not ensure their accumulation in the cell compartment that shelters a pathogen. This study shows the availability of MIL-100(Fe) MOF nanoparticles to co-localize withChlamydia trachomatis, an obligate intracellular bacterium, in the infected RAW264.7 macrophages. Furthermore, nanoMOFs loaded with photosensitizer methylene blue (MB) exhibit complete photodynamic inactivation ofChlamydia trachomatisgrowth. Simultaneous infection and treatment of RAW264.7 cells with empty nanoMOFs resulted in a 3-fold decrease in bacterial load that indicates an intrinsic anti-chlamydial effect of this iron-containing nanomaterial. Thus, our findings suggest the use of iron-based nanoMOFs as a promising drug delivery platform, which contributes to antibacterial effect, for the treatment of chlamydial infections.
Increased atherosclerotic plaque and anti-oxidized low density lipoprotein in anti-Ro60 SLE autoantibody subset
Authors: Kurien Biji T. , Fesmire James , Nath Swapan K. , Scofield R. Hal 
Published: April 2023

AbstractObjectivePremature atherosclerosis is associated with systemic lupus erythematosus (SLE). We previously showed an association of anti-Ro60/La/Ro52 to anti-oxidized LDL in SLE. Here, we hypothesized that atherosclerotic plaque will be associated with anti-oxidized LDL (anti-oxLDL)/anti-lipoprotein lipase (ALPL) in a specific SLE autoantibody sub-set (anti-Ro60 positive, anti-RNP positive or extractable nuclear antigen antibody negative).MethodsWe carried out a case-control study (one time-point testing) of plaque, ALPL, anti-oxLDL, anti-low density lipoprotein (ALDL) or anti-LDL in 114 SLE and 117 age/sex matched controls. Total cholesterol, LDL, HDL, triglycerides, and HDL-Trig were also measured. Students t test was used for statistical analysisResultsInterestingly, plaque was highest in SLE subset with anti-Ro60 (23/114). Plaque and anti-oxLDL were statistically significantly elevated in the anti-Ro60 SLE subset (1.3 +/-1.66, p<0.01; 0.26 +/-0.16, p<0.002 respectively) compared to controls (0.54 +/-1.26; 0.165 +/-0.13 respectively), but not anti-LPL/anti-LDL. Plaque was significantly elevated (0.9 +/-1.71; p< 0.05) in the SLE subset without anti-ENA (63/114) compared to controls. Other antibodies in this subset were not statistically different compared to other SLE subsets or controls. Only anti-oxLDL was significantly elevated (0.29 +/-0.27; p<0.005) in SLE subset with anti-RNP (14/114) compared to controls, while none were elevated in anti-SmRNP subset (6/114). We did not find significant differences in lipids between various SLE subsets.ConclusionPlaque segregates in anti-Ro and ENA negative groups either with or without anti-oxLDL. It will be clinically important if cardiovascular events are augmented in SLE anti-Ro subset having elevated anti-oxidized LDL antibodies.Key pointsPlaque and anti-oxLDL significantly elevated in anti-Ro60 SLE subsetOnly plaque significantly elevated in SLE subset without antibodies against extractable nuclear antigensIt will be clinically important to see if augmented cardiovascular events occur in SLE anti-Ro subset having elevated anti-oxidized LDL antibodies.