bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unilateral adrenalectomy as a treatment option in a patient with recurrent Cushing’s disease
Authors: Gosmanov Aidar R , Green Maria , Gerges Antoni Kafrouni , Ziganshina Anna P , Roy Mary P 
Published: August 2023

Abstract
In recurrent Cushing’s disease (CD), therapeutic management options may pose challenges related to risk-benefit profile of available pharmacological agents or bilateral adrenalectomy. Here, we describe a patient with recurrent CD who in context of progressive worsening of diabetes control and new diagnosis of coronary artery disease was offered a unilateral adrenalectomy (UA) to help alleviate the metabolic burden of hypercortisolemia. Within 6 months following UA she was able to stop her blood pressure medications; her anti-diabetes medications were significantly titrated down and she experienced significant weight loss. Currently, 18 months after the UA, the patient has not experienced new clinical events, her weight is stable and diabetes control is consistently optimal, and she remains off anti-hypertensive medications. This report adds to currently scarce body of literature that patients with difficult to manage CD can be considered as candidates for UA to potentially alleviate the metabolic burden of hypercortisolemia.
Food allergy masquerading as persistent proteinuria in post-infectious glomerulonephritis: a case report
Authors: Mohkam Masoumeh , Jamee Mahnaz , Mortazavi Nafiseh , Mirzaee Mahbubeh , Mansouri Mahboubeh 
Published: August 2023

Abstract
Background: Post-infectious glomerulonephritis (PIGN) is one of the most common causes of pediatric acute glomerulonephritis. Immune system dysregulation manifesting as food allergy may predispose PIGN patients to nephrotic-range proteinuria.
Case Presentation: The patient was a 3-year-old male that presented with edema, gross hematuria and reduced urine output following a mild fever, rhinorrhea and lethargy. Due to the persistence of proteinuria and hematuria, he underwent a kidney biopsy. The patient was diagnosed with atypical PIGN and was placed on oral prednisolone. During treatment, a relationship between the consumption of dairy products and the degree of proteinuria was noted. The clinical manifestations and urinalysis indices improved upon steroid discontinuation and initiation of a hypoallergic diet.
Conclusion: The association between the degree of proteinuria and consumption of dairy products in this PIGN patient led to the identification of food allergy as an underlying factor for nephrotic-range proteinuria.
Antipsychotic Medication and Risk of Metabolic Disorders in People With Schizophrenia: A Longitudinal Study Using the UK Clinical Practice Research Datalink
Authors: Eyles Emily , Margelyte Ruta , Edwards Hannah B , Moran Paul A , Kessler David S , Davies Simon J C , Bolea-Alamañac Blanca , Redaniel Maria Theresa , Sullivan Sarah A 
Published: August 2023

Abstract

Background and Hypothesis
Antipsychotics are first-line drug treatments for schizophrenia. When antipsychotic monotherapy is ineffective, combining two antipsychotic drugs is common although treatment guidelines warn of possible increases in side effects. Risks of metabolic side effects with antipsychotic polypharmacy have not been fully investigated. This study examined associations between antipsychotic polypharmacy and risk of developing diabetes, hypertension, or hyperlipidemia in adults with schizophrenia, and impact of co-prescription of first- and second-generation antipsychotics.

Study Design
A population-based prospective cohort study was conducted in the United Kingdom using linked primary care, secondary care, mental health, and social deprivation datasets. Cox proportional hazards models with stabilizing weights were used to estimate risk of metabolic disorders among adults with schizophrenia, comparing patients on antipsychotic monotherapy vs polypharmacy, adjusting for demographic and clinical characteristics, and antipsychotic dose.

Study Results
Median follow-up time across the three cohorts was approximately 14 months. 6.6% developed hypertension in the cohort assembled for this outcome, with polypharmacy conferring an increased risk compared to monotherapy, (adjusted Hazard Ratio = 3.16; P = .021). Patients exposed to exclusive first-generation antipsychotic polypharmacy had greater risk of hypertension compared to those exposed to combined first- and second-generation polypharmacy (adjusted HR 0.29, P = .039). No associations between polypharmacy and risk of diabetes or hyperlipidemia were found.

Conclusions
Antipsychotic polypharmacy, particularly polypharmacy solely comprised of first-generation antipsychotics, increased the risk of hypertension. Future research employing larger samples, follow-up longer than the current median of 14 months, and more complex methodologies may further elucidate the association reported in this study.
Narratives of Rehabilitation in a South African Prison
Authors: Symkovych Anton 
Published: August 2023

Abstract
How individuals incarcerated in the Global South engage with the official rehabilitative model remains largely under-documented. Through analysis of the narratives of men and women living in a large, medium-security correctional complex in Gauteng, South Africa, I argue that the grandiloquent official discourse of rehabilitation constitutes an important resource for those incarcerated. Highlighting the importance of local context in debates about carceral rehabilitation, I demonstrate that not only prisoners’ personal circumstances, but also the wider socio-economic context of enduring colonial legacies of structural inequalities shape their interactions with the penal regime. By foregrounding what those subjected to penal power make of their incarceration, I argue that the official rehabilitative discourse helps many to make sense of their predicament, actualise their lives, and sustain hope. I highlight how individual narrative strategies are channeled by and mapped on the official discourse of rehabilitation, free will, and personal responsibility, attesting to the success of the disciplinary project of the post-apartheid prison. I demonstrate how prisoners incorporate engagement with the rehabilitative model into a moral order of carceral cohabitation. I suggest that narrative work in the prison constitutes a nexus of individual needs and private aspirations and structural regimes of inequality, poverty, deprivation, and neglect.
Genomic diversity, evolutionary history, and species limits of the endemic Ethiopian laminate-toothed rats (genus Otomys, Rodentia: Muridae)
Authors: Mizerovská Daniela , Martynov Aleksey A , Mikula Ondřej , Bryjová Anna , Meheretu Yonas , Lavrenchenko Leonid A , Bryja Josef 
Published: August 2023

Abstract
The Ethiopian Highlands represent one of the most important centres of endemism on Earth. Six endemic species of laminate-toothed rats have been reported from Ethiopia in a previous study based mostly on morphological analyses. Largely missing genetic data for some of the species, insufficient sampling across Ethiopia, and presence of a pseudogene on cytochrome b created knowledge gaps in basic taxonomy, distribution, and phylogenetic position of the Ethiopian taxa. Here we perform an integrative taxonomic revision of the group by using the largest available sets of genomic and morphological data. We first reconstructed the mitochondrial phylogeny of the whole genus, delimited major clades, and evidenced two independent colonization events of Otomys to Ethiopia. By using genome-scale SNPs, we delimited putative Ethiopian species and analysed their phylogenetic relationships. In genetically characterized specimens we assessed morphological variation of skulls. We confirmed the presence of six previously reported species and significantly extended the known distributional range for some of them. Furthermore, we discovered a genetically and morphologically distinct lineage in northern Ethiopia, probably representing a new species. The speciation processes are similar to other Afromontane Ethiopian endemic rodent clades, with prevailing allopatric diversification combined with reticulate processes.
The risk of pulmonary NTM infections and water-quality constituents among persons with cystic fibrosis in the United States, 2010–2019
Authors: Lipner Ettie M. , French Joshua P. , Mercaldo Rachel A. , Nelson Stephen , Zelazny Adrian M. , Marshall Julia E. , Strong Michael , Falkinham Joseph O. , Prevots D. Rebecca 
Published: August 2023

Rationale:
The prevalence of nontuberculous mycobacterial (NTM) pulmonary disease varies geographically in the United States. Previous studies indicate that the presence of certain water-quality constituents in source water increases NTM infection risk.

Objective:
To identify water-quality constituents that influence the risk of NTM pulmonary infection in persons with cystic fibrosis in the United States.

Methods:
We conducted a population-based case-control study using NTM incidence data collected from the Cystic Fibrosis Foundation Patient Registry during 2010–2019. We linked patient zip code to the county and associated patient county of residence with surface water data extracted from the Water Quality Portal. We used logistic regression models to estimate the odds of NTM infection as a function of water-quality constituents. We modeled two outcomes: pulmonary infection due to Mycobacterium avium complex (MAC) and Mycobacterium abscessus species.

Results:
We identified 484 MAC cases, 222 M. abscessus cases and 2816 NTM-negative cystic fibrosis controls resident in 11 states. In multivariable models, we found that for every 1-standardized unit increase in the log concentration of sulfate and vanadium in surface water at the county level, the odds of infection increased by 39% and 21%, respectively, among persons with cystic fibrosis with MAC compared with cystic fibrosis-NTM-negative controls. When modeling M. abscessus as the dependent variable, every 1-standardized unit increase in the log concentration of molybdenum increased the odds of infection by 36%.

Conclusions:
These findings suggest that naturally occurring and anthropogenic water-quality constituents may influence the NTM abundance in water sources that supply municipal water systems, thereby increasing MAC and M. abscessus infection risk.
Pre-participation Withdrawal and Noncompletion of Cardiac Rehabilitation in Peripheral Artery Disease
Authors: Nguyen Cindy H. , Marzolini Susan 
Published: August 2023

Purpose:
Despite the mortality benefit of cardiac rehabilitation (CR) participation, as well as its cost-effectiveness for people with peripheral artery disease (PAD), there are limited data on adherence and completion of CR in those with and without concomitant coronary artery disease (CAD). The objective of this study was to compare CR pre-participation withdrawal and noncompletion between patients with PAD and concomitant PAD and CAD (PAD/CAD) versus matched and unmatched patients with CAD (uCAD).

Methods:
Consecutively referred patients between 2006-2017 with PAD (n = 271) and PAD/CAD (n = 610) were matched to CAD by age, sex, diabetes, smoking status, and referral year. The uCAD (n = 14 487) group was included for comparison. Reasons for withdrawal were ascertained by interview.

Results:
There were no significant differences in pre-participation withdrawal between PAD and matched CAD (46 vs 43%, P = .49), nor in noncompletion (22 vs 18%, P = .28). Results were similar for PAD/CAD and matched CAD (withdrawal: 36 vs 34%, P = .37) and (noncompletion: 25 vs 23%, P = .46). A smaller proportion of patients with uCAD withdrew (28%) than patients with PAD (P < .001) and PAD/CAD (P < .001), with no difference in noncompletion (P > .40, both). There were no differences between PAD and PAD/CAD and their matched counterparts for medical and nonmedical reasons for withdrawal and noncompletion (P ≥ .25, all).

Conclusion:
Pre-participation withdrawal rates were similar between patients with PAD, PAD/CAD, and their matched cohorts but greater than patients with uCAD. Once patients started CR, there were similar completion rates among all groups. Reports that patients with PAD are less likely to start CR may be related to their complex medical profile rather than PAD alone. Strategies to improve participation among patients with PAD should focus on the immediate post-referral period.
Preoperative and Intraoperative Risk Factors for Surgical Site Infection in Pediatric Cardiac Surgery
Authors: Takahashi Yoshihiro , Ueno Kentaro , Nakae Koji , Kawamura Junpei , Matsuba Tomoyuki , Okamoto Yasuhiro 
Published: August 2023

Background:
Surgical site infection (SSI) is a major complication of pediatric cardiac surgery. If the risk of developing SSI can be predicted based on the patient’s preoperative background, appropriate preoperative management to prevent the development of SSI can be achieved.

Methods:
We retrospectively studied cases for patients younger than 7 years of age among surgeries performed through a median sternotomy at Kagoshima University Hospital from April 2011 to March 2021. SSI was diagnosed according to the Centers for Disease Control and Prevention guidelines and classified into 3 types: superficial incisional SSI (SiSSI), deep incisional SSI (DiSSI) and mediastinitis.

Results:
Of the 765 consecutive pediatric cardiac surgeries, 597 were included in the analysis based on the exclusion criteria. Of these, 17 (2.8%) developed SSI (3 SiSSI cases, 2 DiSSI cases and 12 mediastinitis cases), with Staphylococcus aureus as the major pathogen. Univariate analysis revealed that low preoperative serum protein (P = 0.049) and low serum albumin levels (P = 0.023) were risk factors for the development of SSI. No findings suggested impaired hepatic synthesis, inflammatory disease or protein loss from the kidney or intestinal tract. We concluded that malnutrition caused low serum protein and albumin levels.

Conclusions:
Low preoperative serum protein and albumin levels are risk factors for SSI development of SSI. Nutritional status should be regularly assessed in children scheduled for cardiac surgery, and interventions, such as nutritional guidance, should be considered if malnutrition is suspected.
Cochlear Implant Upper Stimulation Levels: eSRT vs. Loudness Scaling
Authors: Holder Jourdan T. , Henry Melissa R. , MacDonald Andrina E. , Gifford René H. 
Published: August 2023

Objective
To assess the difference in speech recognition and sound quality between programming upper stimulation levels using behavioral measures (loudness scaling) and electrically evoked stapedial reflex thresholds (eSRTs).

Study Design
Double-blinded acute comparison study.

Setting
Cochlear implant (CI) program at a tertiary medical center.

Patients
Eighteen adult (mean age = 60 years) CI users and 20 ears.

Main Outcome Measures
Speech recognition scores and sound quality ratings.

Results
Mean word and sentence in noise recognition scores were 8 and 9 percentage points higher, respectively, for the eSRT-based map. The sound quality rating was 1.4 points higher for the eSRT-based map. Sixteen out of 20 participants preferred the eSRT-based map.

Conclusions
Study results show significantly higher speech recognition and more favorable sound quality using an eSRT-based map compared with a loudness-scaling map using a double-blinded testing approach. Additionally, results may be understated as 18 of 20 ears had eSRTs measured before study enrollment. Results underscore the importance of incorporating eSRTs into standard clinical practice to promote best outcomes for CI recipients.
Factors Determining Testicular Torsion and Consequent Orchiectomy in Pediatric Patients Presenting With Scrotal Pain
Authors: Yen Chen-Wei , Chang Yi-Jung , Ming Yung-Ching , Gau Chun-Chun , Wu Chang-Teng , Lee Jung 
Published: August 2023

Objective
Factors associated with testicular torsion (TT) and consequent orchiectomy in patients presenting to pediatric emergency departments (PEDs) with scrotal pain (SP) are not well described. We report the factors predicting TT and consequent orchiectomy in children with SP.

Methods
The data on patients (aged ≤18 years) who presented with SP to PEDs at 4 branches of the Chang Gung Hospital through 10 years were analyzed.

Results
In all, 256 pediatric patients presented with SP. Their mean age was 11.60 ± 4.61 years and 72.7% (n = 186) were aged 10 to 18 years. The pain was left-sided in 54.7% (n = 140) and the interval between SP onset and PED arrival was 22.45 ± 31.27 hours. Overall, 84 (32.8%) patients needed surgery and 72 (28.1%) had TT. Of the patients with TT, 28 (38.9%) patients needed an orchiectomy. After analysis, TT and consequent orchiectomy were associated with a longer interval between SP onset and PED arrival, absent of testicular ultrasonic blood flow, interval between SP onset and surgery of more than 24 hours, and a high degree of TT. None of them experienced recurrent SP symptoms or TT again.

Conclusions
The rate of TT in patients presenting to PEDs with an SP was 28.1%, and 38.9% of the patients with TT needed an orchiectomy. Early diagnosis and intervention helped to prevent subsequent orchiectomy in pediatric patients with TT.
Deep Learning Image Reconstruction Algorithm for CCTA: Image Quality Assessment and Clinical Application
Authors: Catapano Federica , Lisi Costanza , Savini Giovanni , Olivieri Marzia , Figliozzi Stefano , Caracciolo Alessandra , Monti Lorenzo , Francone Marco 
Published: August 2023

Objective
The increasing number of coronary computed tomography angiography (CCTA) requests raised concerns about dose exposure. New dose reduction strategies based on artificial intelligence have been proposed to overcome limitations of iterative reconstruction (IR) algorithms. Our prospective study sought to explore the added value of deep-learning image reconstruction (DLIR) in comparison with a hybrid IR algorithm (adaptive statistical iterative reconstruction-veo [ASiR-V]) in CCTA, even in clinical challenging scenarios, as obesity, heavily calcified vessels and coronary stents.

Methods
We prospectively included 103 consecutive patients who underwent CCTA. Data sets were reconstructed with ASiR-V and DLIR. For each reconstruction signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was calculated, and qualitative assessment was made with a four-point Likert scale by two independent and blinded radiologists with different expertise.

Results
Both SNR and CNR were significantly higher in DLIR (SNR-DLIR median value [interquartile range] of 13.89 [11.06–16.35] and SNR-ASiR-V 25.42 [22.46–32.22], P < 0.001; CNR-DLIR 16.84 [9.83–27.08] vs CNR-ASiR-V 10.09 [5.69–13.5], P < 0.001).
Median qualitative score was 4 for DLIR images versus 3 for ASiR-V (P < 0.001), with a good interreader reliability [intraclass correlation coefficient(2,1)e intraclass correlation coefficient(3,1) 0.60 for DLIR and 0.62 and 0.73 for ASiR-V].
In the obese and in the “calcifications and stents” groups, DLIR showed significantly higher values of SNR (24.23 vs 11.11, P < 0.001 and 24.55 vs 14.09, P < 0.001, respectively) and CNR (16.08 vs 8.04, P = 0.008 and 17.31 vs 10.14, P = 0.003) and image quality.

Conclusions
Deep-learning image reconstruction in CCTA allows better SNR, CNR, and qualitative assessment than ASiR-V, with an added value in the most challenging clinical scenarios.
Fast Quantitative Magnetic Resonance Imaging Evaluation of Hydrocephalus Using 3-Dimensional Fluid-Attenuated Inversion Recovery: Initial Experience
Authors: Goo Hyun Woo , Park Sang Hyub 
Published: August 2023

Objective
This study aimed to demonstrate the initial experience of using fast quantitative magnetic resonance imaging (MRI) to evaluate hydrocephalus.

Methods
A total of 109 brain MRI volumetry examinations (acquisition time, 7 minutes 30 seconds) were performed in 72 patients with hydrocephalus. From the measured ventricular system and brain volumes, ventricle-brain volume percentage was calculated to standardize hydrocephalus severity (processing time, <5 minutes). The obtained values were categorized into no, mild, and severe based on the fronto-occipital horn ratio (FOHR) and the ventricle-brain volume percentages reported in the literature. The measured volumes and percentages were compared between patients with mild hydrocephalus and those with severe hydrocephalus. The diagnostic performance of brain hydrocephalus MRI volumetry was evaluated using receiver operating characteristic curve analysis.

Results
Ventricular volumes and ventricle-brain volume percentages were significantly higher in in patients with severe hydrocephalus than in those with mild hydrocephalus (FOHR-based severity: 352.6 ± 165.6 cm3 vs 149.1 ± 78.5 cm3, P < 0.001, and 26.8% [20.8%–33.1%] vs 12.1% ± 6.0%, P < 0.001; percentage-based severity: 359.5 ± 143.3 cm3 vs 137.0 ± 62.9 cm3, P < 0.001, and 26.8% [21.8%–33.1%] vs 11.3% ± 4.2%, P < 0.001, respectively), whereas brain volumes were significantly lower in patients with severe hydrocephalus than in those with mild hydrocephalus (FOHR-based severity: 878.1 ± 363.5 cm3 vs 1130.1 cm3 [912.1–1244.2 cm3], P = 0.006; percentage-based severity: 896.2 ± 324.6 cm3 vs 1142.3 cm3 [944.2–1246.6 cm3], P = 0.005, respectively). The ventricle-brain volume percentage was a good diagnostic parameter for evaluating the degree of hydrocephalus (area under the curve, 0.855; 95% confidence interval, 0.719–0.990; P < 0.001).

Conclusions
Brain MRI volumetry can be used to evaluate hydrocephalus severity and may provide guide interpretation because of its rapid acquisition and postprocessing times.
Assessment of Outer Retina and Choroid Using Swept Source Optical Coherence Tomography and Angiography in Patients With Multiple Sclerosis
Authors: Gao Yuzhu , Liu Yilin , Zhang Yifan , Lang Yanlin , Xu Hanyue , Tao Yunhan , Li Yating , Mou Kefan , Zhang Yiteng , Man Shulei , Chen Qing , Zhou Hongyu , Zhang Ming 
Published: August 2023

Background:
For patients with multiple sclerosis (MS), both structure and microvasculature alterations in the inner retina have been investigated in several studies. However, little is known about the alterations in the outer retina and choroid. Hence, this study aimed to assess the outer retinal and choroidal changes in patients with MS with no history of optic neuritis (ON).

Methods:
Patients with MS and healthy control participants were enrolled in this cross-sectional study. Quantitative analyses were performed using swept source optical coherence tomography and swept source optical coherence tomography angiography images to assess outer retina thickness (ORT) and choroid thickness (CT), vessel density (VD) of choriocapillaris, and choroidal vascularity index (CVI), which were then compared between the groups.

Results:
A total of 37 participants with MS (72 eyes) and 74 healthy control participants (148 eyes) were included in this study. Compared with healthy controls, patients with MS with no history of ON showed reduced VD of the choriocapillaris and CVI. There was no significant difference in ORT and CT between 2 groups. Meanwhile, in patients with MS, no correlation between OCTA parameters and expanded disability status scale score were found in this study.

Conclusions:
Our study indicates that patients with MS with no history of optical neuritis have reduced choriocapillaris vessel density and decreased choroidal vascularity index without detectable alteration in outer retina thickness and choroid thickness. The findings complement the outer retinal and choroidal component of MS, providing deeper insight into the pathophysiology of MS.