bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinal artery macroaneurysm complicated with subhyaloid hemorrhage: two case reports
Authors: Mahjoub Ahmed , Zaafrane Nesrine , Ben Youssef Chiraz , Sellem Ilhem , Guiga Ahmed , Jabri Ahmed , Ben Saidi Oussama , Feki Omar , Krifa Fethi , Mahjoub Hechemi 
Published: April 2023

The authors report two cases of retinal artery macroaneurysm (RAM) complicated with subhyaloid hemorrhage. There are multiple cases about RAM that have been published; however, none of them present all the different treatments with its benefits and its limitations. Our study highlights all aspects of treatment. RAM is an uncommon pathology that affects generally elderly women with systemic vascular pathologies. It is often unilateral, and the patients stay mostly asymptomatic. Most cases of RAM regress without any treatment. A case of a 54-year-old male, with a medical history of hypertension who presented with an acute and unilateral decreased visual acuity (VA). Initial VA was limited to counting fingers at 1 m in the right eye (RE). The anterior segment was normal in both eyes. A fundus examination in the RE showed a large subhyaloid hemorrhage associated to retinal hemorrhage. Fluorescein angiography in the RE did not reveal any sign of macroaneurysm due to blockage of fluorescein by the hemorrhage. In the left eye, there was a hyperfluorescent paramacular lesion. Optical coherence tomography showed the hyperreflectivity of the subhyaloid hemorrhage and the underlying retinal layers could not be seen. Neodymium-doped yttrium aluminum garnet laser hyaloidotomy was performed for this patient to release the trapped hemorrhage into the vitreous, 3 weeks after initial loss of vision with a good visual outcome after the treatment. An 80-year-old woman, with medical history of rheumatoid arthritis who presented with an acute loss of vision in the RE. VA in the RE was 20/200. She had a nuclear cataract in both eyes. A fundus examination showed a subyaloid hemorrhage. Fluorescein angiography in the RE revealed a hyperfluorescent structure emanating from the superotemporal arcade of the artery compatible with a macroaneurysm. The patient was treated with three intravitreal antivascular endothelial growth factor injections with poor visual outcomes. Vision loss occurs with RAM complications. They mainly involve hemorrhages and macular exudations and are usually associated with poor visual recovery. There is no established treatment for RAM and its complications. There are many options, but the optimal therapy is still unknown.
Adherence to guidelines in the follow-up of non-muscle-invasive bladder cancer among urology trainers and trainees in Jordan: a cross-sectional study
Authors: Al-Azab Rami , Al-Zubi Mohammad , Al Demour Saddam , Khaled Al-Jamal Suad , Nabeel Mahdawi Lobana , Saleh Al-Omari Salsabeel , Rasmi Banibakr Rania , Ali Alhallaq Luma , Abdelqader Yaseen Asa’d Yaseen , Omar Rjoub Wasan 
Published: April 2023

Objective:
To assess the clinical practice in the follow-up of non-muscle-invasive bladder cancer (NMIBC) among urology specialists (trainers) and residents (trainees) in Jordan.

Methods:
An electronic questionnaire containing, in addition to demographic data, four questions regarding the follow-up of NMIBC was sent by e-mail to 115 urologists (53 residents and 62 specialists) selected randomly by stratified random sampling from different clinical institutions, 105 of them were returned complete.

Results:
In all, 105 out of 115 (91%) questionnaires were returned complete. All of the candidates are male. For low-risk NMIBC follow-up, 46 of the specialists (79%) and 35 of the trainees (74%) decided to do a follow-up cystoscopy at 3 months after diagnosis, followed by a check cystoscopy 9 months later than yearly, while for high-risk patients, all of the specialists and 45 of the trainees (96%) decide to do a check cystoscopy every 3 months in the first 2 years after diagnosis. For upper tract follow-up in high-risk NMIBC, all of the urologists in the survey (specialists and trainees) routinely perform upper tract imaging in the form of a computed tomography scan with contrast in the first year after diagnosis. On the other hand, in the follow-up of the upper urinary tract in low-risk NMIBC, 16 of the trainees (34%) and 19 of the specialists (33%) still perform a yearly scan.

Conclusion:
Because of the high recurrence rate for NMIBC, this raises the importance of adherence to guidelines in the follow-up for these patients and, at the same time to avoid overdoing unnecessary cystoscopies or upper tract scans.
Tumour necrosis factor-alpha levels as predictor factor on clinical response of anthracycline-based neoadjuvant chemotherapy in locally advance breast cancer patients: experimental research
Authors: Adrian Kevin , Ghaib Husnul , Ali Iskandar 
Published: April 2023

Background:
The prevalence of locally advanced breast cancer is increasing yearly, so biomarkers are needed to assist in its management, one of which is tumour necrosis factor-alpha (TNF-α).

Objective:
Analysing TNF-α levels as a predictor factor on clinical response anthracycline-based neoadjuvant chemotherapy.

Methods:
This study design used observational analysis. The length of study was carried out in the period from May 2021 to June 2022. The study procedure included measuring participants' TNF-α levels the day before chemotherapy was carried out and clinical response. Participants received anthracycline-based neoadjuvant chemotherapy (cyclophosphamide of 500 mg/m2, doxorubicin of 50 mg/m2 and fluorouracil/5FU of 500 mg/m2) for 3 cycles. The study analysis used the Chi-square, logistic regression and Spearman’s test with P<0.05.

Results:
The average TNF-α levels was 137.2±311.8 pg/ml, ranging from 5.74 to 1.733 pg/ml. The results of the calculation of the cutoff value of TNF-α in the study were 18 635 pg/ml (area under curve =0.850; 95% CI =0.729–0.971). Based on cutoff 1, most participants with high TNF-α levels also had a negative response of 83.3% and those with low TNF-α levels also had a positive response of 75% (P<0.001). Meanwhile, at cutoff 2, similar conditions were also found, namely high TNF-α levels, negative response (84.2%) and low TNF-α levels, positive response (78.9%; P<0.001). The statical analysis showed a significant association of TNF-α levels on the clinical response of chemotherapy, which showed r=−0.606 and P<0.001.

Conclusion:
TNF-α levels predict clinical response for anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer patients.
Immune reconstitution inflammatory syndrome following disseminated TB with cerebral venous thrombosis in HIV-negative women during their postpartum period: a case report
Authors: Yadav Prashant , Bari Md Anwarul , Yadav Sushmita , Khan Amzad H. 
Published: April 2023

Introduction:
Immune reconstitution inflammatory syndrome (IRIS) is characterized by exuberant and dysregulated inflammatory responses to invading microorganisms. IRIS associated with tuberculosis (TB-IRIS) is widely known in HIV-positive patients after starting highly active antiretroviral therapy (HAART) therapy. However, IRIS has also been observed in solid organ transplant recipients, neutropenic patients, tumor necrosis factor antagonist recipients, and women during the postpartum period despite their HIV status.

Case Presentation:
We report an exceptional case of a 19-year-old HIV-negative lady who presented as IRIS following disseminated TB with cerebral venous thrombosis during her postpartum period. After 1 month of starting anti-TB therapy, we found a paradoxical worsening of her symptoms and further deterioration of radiological features showing extensive tubercular spondylodiscitis involving almost all the vertebral with extensive prevertebral and paravertebral soft tissue collections. Significant improvement was observed after 3 months of continuation of steroids along with an adequate dose of anti-TB therapy.

Discussion:
The possible mechanism that could explain this dysregulated and exuberant immune response in HIV-negative postpartum women would be rapidly changing immunologic repertoire, as the recovery of the immune system causes an abrupt shift of host immunity from an anti-inflammatory and immunosuppressive status toward a pathogenic proinflammatory state. Its diagnosis mostly depends on having a high degree of suspicion and ruling out alternative etiology.

Conclusion:
Therefore, clinicians should be aware of the paradoxical worsening of TB-related symptoms and/or radiological features at the primary site of infection or new location following an initial improvement in adequate anti-TB therapy despite HIV status.
Partial hydatidiform mole and coexistent live fetus with placenta previa: a case report
Authors: Santoso Dhanny P.J. , Anton Anton , Nugrahani Annisa D. , Pribadi Adhi , Kurniadi Andi 
Published: April 2023

Introduction and importance:
Partial molar pregnancy with a coexistent live fetus is very rare. This type of mole mostly ends in the early termination of pregnancy due to an abnormally developed fetus.

Case presentation:
Here, we report a case of a 24-year-old Indonesian woman with an ultrasonographic appearance of partial hydatidiform mole with initial placenta covering the internal uterine ostium in the late first trimester which then became marginal placenta previa in the third trimester. The woman decided to continue the pregnancy after considering the risks and benefits. The normal anatomy of the premature infant was vaginally delivered alive with a large and hydropic placenta.

Clinical discussion:
Proper diagnosis, management, and monitoring remain challenging as this case is still rarely reported. Although embryos from partial mole forms generally do not survive since the first trimester, our case reported the singleton pregnancy with the coexistent normal fetus and the partial mole characteristic of the placenta. Diploid karyotype, few and focal extent of hydatidiform tissue of placenta, low rate of molar degeneration, and the absence of fetal anemia hypothesized as the factors that influenced survival of the fetus. There were two maternal complications such as hyperthyroidism and frequent vaginal bleeding without subsequent anemia in this patient.

Conclusions:
A rare case of partial hydatidiform mole coexistent with a live fetus with placenta previa was reported in this study. There were also maternal complications. Thus, prompt and regular monitoring of maternal and fetal condition holds an important role.
A Sore Subject? An Examination of National Case–Based Chancroid Surveillance
Authors: Ogale Yasmin P. , Ridpath Alison D. , Torrone Elizabeth , Quilter Laura A. S. , Grey Jeremy A. 
Published: April 2023

Background
Chancroid has been a nationally notifiable condition in the United States since 1944, with cases reported to Centers Disease Control and Prevention through the National Notifiable Diseases Surveillance System. Although frequently reported during the 1940s, <20 cases have been reported annually since 2011. We assessed the performance and utility of national case-based chancroid surveillance.

Methods
We reviewed the literature to contextualize chancroid surveillance through National Notifiable Diseases Surveillance System. We then assessed 4 system attributes, including data quality, sensitivity, usefulness, and representativeness: we reviewed chancroid cases reported during 2011–2020, conducted interviews with (a) sexually transmitted disease programs reporting ≥1 case in 2019 or 2020 (n = 9) and (b) Centers Disease Control and Prevention subject matter experts (n = 10), and reviewed published communicable disease reporting laws.

Results
Chancroid diagnostic testing is limited, which affects the surveillance case definition. National case-based surveillance has poor data quality; of the 2019 and preliminary 2020 cases (n = 14), only 3 were verified by jurisdictions as chancroid cases. Sexually transmitted disease programs report the system has low sensitivity given limited clinician knowledge and resources; experts report the system is not useful in guiding national control efforts. Review of reporting laws revealed it is not representative, as chancroid is not a reportable condition nationwide.

Conclusions
Critical review of system attributes suggest that national case-based chancroid surveillance data have limited ability to help describe and monitor national trends, and chancroid's inclusion on the national notifiable list might need to be reconsidered. Alternative strategies might be needed to monitor national chancroid burden.
“The Cost in the Individual”
Authors: Lee Kenneth , Doan Quynh , Thompson Graham C. , Sandhu Ash , Bone Jeffrey N. , Ting Daniel K. 
Published: April 2023

Objectives
Emergency medicine (EM) confers a high risk of burnout that may be exacerbated by the COVID-19 pandemic. We aimed to determine the longitudinal prevalence of burnout in pediatric EM (PEM) physicians/fellows working in tertiary PEM departments across Canada and its fluctuation during the pandemic.

Methods
A national mixed-methods survey using a validated 2-question proxy for burnout was distributed monthly through 9 months. The primary outcome was the trajectory in probability of burnout, which was examined as both emotional exhaustion (EE) and depersonalization (DP), EE alone, and DP alone. Secondary outcomes investigated burnout and its association with demographic variables. Quantitative data were analyzed using logistic regression for primary outcomes and subanalyses for secondary outcomes. Conventional content analysis was used to analyze qualitative data and generate themes.

Results
From February to October 2021, 92 of 98 respondents completed at least 1 survey, 78% completed at least 3 consecutive surveys, and 48% completed at least 6 consecutive surveys. Predicted probability of EE was bimodal with peaks in May (25%) and October (22%) 2021. Rates of DP alone or having both EE and DP were approximately 1% and stable over the study period. Mid-career physicians were at lower risk of EE (odds ratio, 0.02; 95% confidence interval, 0–0.22) compared with early-career physicians. Underlying drivers of burnout were multifaceted.

Conclusions
Our study suggests that increased COVID-19 case burden was correlated with EE levels during the third and fourth waves of the pandemic. Emotional exhaustion was worsened by systemic factors, and interventions must target common themes of unsustainable workloads and overwhelming lack of control.
Analysis of age-related changes in lower facial fat compartments and of the course of blood vessels using computed tomography
Authors: Guo Yixuan , Wen Lihong , Wang Xianlong , Zou Huan , Liang Weiqiang , Wang Jinhuang , Zhu Xiongxiang 
Published: April 2023

Background:
According to the volume restoration theory, lower facial fat compartments tend to selectively atrophy or hypertrophy with age. The aim of this study was to demonstrate age-related changes in lower facial fat compartments using computed tomography (CT), with strict control of the body mass index (BMI) and underlying diseases.

Patients and methods:
This study included 60 adult women in three age-based categories. The thicknesses of the jowl, labiomandibular, and chin fat compartments were measured using CT images. The distribution and arrangement of facial blood vessels were further analyzed to provide evidence of the safety of rejuvenation strategies based on facial volumetric theory.

Results:
The inferior part of the superficial jowl fat compartment and deep jowl fat compartment thickened with age. The deep layer of the labiomandibular fat compartment thinned with age, and the superficial layer thickened with age. The deep and superficial layers of the chin compartments thickened with age. The facial vein passes through the lower mandibular border at the anterior edge of the masseter muscle and moves upward, perpendicular to the lower mandibular border. The high-risk area of the facial artery had an angle of approximately 45° to the lower mandibular border.

Conclusions:
This study suggests that with age, selective thickening or thinning occurs in different lower facial fat compartments. The mandible and masseter muscle were used as reference markers to analyze the courses of the facial artery and facial vein, which can help clinicians to reduce vascular injury.
Botulinum Toxins for the Treatment of Raynaud Phenomenon
Authors: Zhou Yannan , Yu Yue , Bi Siwei , Cen Ying 
Published: April 2023

Objective
Botulinum toxin (Btx) therapy has emerged as a potential treatment for patients with Raynaud phenomenon (RP) in recent years. This study aimed to investigate the efficacy and safety of Btx treatment for RP.

Methods
Databases of PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from their inception up to August 2022. Studies that reported Btx use for the treatment of RP were included. A meta-analysis was conducted for the Shortened version of the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) score and visual analog scale pain score using a random-effects model.

Results
Thirteen full-text studies were included. The pooled standard mean changes for the visual analog scale pain score and QuickDASH score were −3.82 (95% confidence interval, −6.62 to −1.02) and 0.83 (95% confidence interval, −1.47 to −0.19), respectively. The 2 most common complications were injection site pain and intrinsic hand weakness.

Conclusions
The effect of Btx treatment on RP is promising based on current evidence. Nevertheless, more studies and randomized clinical trials with larger sample sizes are needed to confirm the current results.
The Efficacy of Foot Massage for Pain Relief of Laparoscopic Cholecystectomy: A Meta-analysis Study
Authors: Cheng Yunlan , Zhou Xiaomin , Wang Guiying 
Published: April 2023

Background:
Foot massage may have some potential in improving pain relief in patients undergoing laparoscopic cholecystectomy, and this meta-analysis aims to explore the impact of foot massage on pain control after laparoscopic cholecystectomy.

Materials and Methods:
PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials assessing the effect of foot massage on pain control after laparoscopic cholecystectomy.

Results:
Five randomized controlled trials were included in the meta-analysis. Overall, compared with control intervention for laparoscopic cholecystectomy, foot massage was associated with significantly lower pain scores at 60 minutes [mean difference (MD)=−1.19; 95% CI=−2.01 to −0.38; P=0.004), pain scores at 90 minutes (MD=−1.41; 95% CI=−1.73 to −1.10; P<0.00001), pain scores at 120 to 150 minutes (MD=−2.20; 95% CI=−2.49 to −1.90; P<0.00001) and reduced need of additional analgesia (odd ratio=0.04; 95% CI=0.02-0.08; P<0.00001), but demonstrated no obvious effect on pain scores at 10 to 30 minutes (MD=−0.25; 95% CI=−0.79 to 0.29; P=0.37).

Conclusions:
Foot massage benefits to improve pain control after laparoscopic cholecystectomy.
Differential roles of CTP synthetases CTPS1 and CTPS2 in cell proliferation
Authors: Minet Norbert , Boschat Anne-Claire , Lane Rebecca , Laughton David , Beer Philip , Asnagli Hélène , Soudais Claire , Bourne Tim , Fischer Alain , Martin Emmanuel , Latour Sylvain 
Published: April 2023

ABSTRACTThe CTP nucleotide is a key precursor of nucleic acids metabolism essential for DNA replication. De novo CTP production relies on CTP synthetases 1 and 2 (CTPS1 and 2) that catalyze the conversion of UTP into CTP. CTP synthetase activity is high in proliferating cells including cancer cells, however, the respective roles of CTPS1 and CTPS2 in cell proliferation are not known. By inactivation of CTPS1 and/or CTPS2 and complementation experiments, we showed that both CTPS1 and CTPS2 are differentially required for cell proliferation. CTPS1 was more efficient in promoting proliferation than CTPS2, in association with a higher intrinsic enzymatic activity that was more resistant to inhibition by 3-Deaza-uridine, an UTP analog. The contribution of CTPS2 to cell proliferation was modest when CTPS1 was expressed, but essential in absence of CTPS1. Public databases analysis of more than 1,000 inactivated cancer cell lines for CTPS1 or CTPS2 confirmed that cell growth is highly dependent of CTPS1 but less of CTPS2. Therefore, our results demonstrate that CTPS1 is the main contributor to cell proliferation.
Attractant and repellent induce opposing changes in the chemoreceptor four-helix bundle ligand-binding domain
Authors: Guo Lu , Wang Yun-Hao , Cui Rui , Huang Zhou , Hong Yuan , Qian Jia-Wei , Ni Bin , Xu An-Ming , Jiang Cheng-Ying , Zhulin Igor B. , Liu Shuang-Jiang , Li De-Feng 
Published: April 2023

AbstractMotile bacteria navigate toward favorable conditions and away from unfavorable environments using chemotaxis. Mechanisms of sensing attractants are well understood, however molecular aspects of how bacteria sense repellents have not been established. Here, we identified malate as a repellent recognized by the MCP2021 chemoreceptor in a bacteriumComamonas testosteroniand showed that it binds to the same site as an attractant citrate. Binding determinants for a repellent and an attractant had only minor differences, and a single amino acid substitution in the binding site inverted the response to malate from a repellent to an attractant. We found that malate and citrate affect the oligomerization state of the ligand-binding domain in opposing way. We also observed opposing effects of repellent and attractant binding on the orientation of an alpha helix connecting the sensory domain to the transmembrane helix. We propose a model to illustrate how positive and negative signals are generated and transduced across the membrane and built chimera proteins to illustrate a universal nature of the transmembrane signaling by the repellent.
Novel non hot spot modification in Fks1 ofCandida aurisconfers echinocandin resistance
Authors: Kordalewska Milena , Cancino-Prado Geselle , de Almeida Júnior João Nobrega , Brandão Igor Brasil , de Souza Peral Renata Tigulini , Colombo Arnaldo L. , Perlin David S. 
Published: April 2023

ABSTRACTWe determined echinocandin susceptibility andFKS1genotypes of thirteen clinical isolates ofCandida aurisrecovered from four patients at a tertiary care center in Salvador, Brazil. Three isolates were categorized as echinocandin-resistant and harbored a novelFKS1mutation leading to an amino acid change W691L located downstream from hot-spot 1. When introduced to echinocandin-susceptibleC. aurisstrains by CRISPR/Cas9, Fks1 W691L induced elevated MIC values to all echinocandins (ANF 16-32x; CAS >64x; MCF >64x).