bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast metastasis in high-grade endometrial stromal sarcoma (HG-ESS) with BCOR rearrangement: a case report of a novel metastatic site
Authors: Fong Ashlyn , Offman Saul 
Published: March 2023

Abstract
Background
The ZC3H7B-BCOR fusion gene has recently been described in tumours with kinship to so-called high grade endometrial stromal sarcoma (HG-ESS). This subset of tumour behaves similarly to YWHAE-NUTM2A/B HG-ESS, however, they are both morphologically and immunophenotypically distinct neoplasms. The identified rearrangements in the BCOR gene have been accepted as both the driver and requisite feature in creating a novel sub-entity within the category of HG-ESS.
Preliminary investigations into BCOR HG-ESS have shown similar outcomes to YWHAE-NUTM2A/B HG-ESS, with patients typically presenting with high stage disease. Clinical recurrences and metastases to lymph nodes, sacrum/bone, pelvis/peritoneum, lung, bowel and skin have been identified. In this report, we describe a case of BCOR HG-ESS, that is deeply myoinvasive and widely metastatic. Metastatic deposits include a mass in the breast discovered on self-examination; a metastatic site that has yet to be reported in the literature.

Case presentation
A 59-year-old female underwent biopsy for post-menopausal bleeding, yielding a diagnosis of “low-grade spindle cell neoplasm with myxoid stroma and endometrial glands”, favouring endometrial stromal sarcoma (ESS). She was then referred for total hysterectomy and bilateral salpingo-oophorectomy. The resected uterine neoplasm was both intracavitary and deeply myoinvasive with morphology consistent with that of the biopsy specimen. Characteristic immunohistochemistry (IHC) was noted, and fluorescence in situ hybridization confirmed BCOR rearrangement, supporting a diagnosis of BCOR HG-ESS. A few months postoperatively, the patient underwent needle core biopsy of the breast which revealed metastatic HG-ESS.

Conclusions
This case highlights some of the diagnostic challenges posed by uterine mesenchymal neoplasms, and exemplifies the emerging histomorphologic, immunohistochemical, molecular and clinicopathologic features of the recently described HG-ESS with ZC3H7B-BCOR fusion. It adds to the body of evidence supporting the inclusion of BCOR HG-ESS as a sub-entity of HG-ESS within the endometrial stromal and related tumours subcategory of uterine mesenchymal tumors, as well as the poor prognosis and high metastatic potential of this tumor.
Machine learning identification of thresholds to discriminate osteoarthritis and rheumatoid arthritis synovial inflammation
Authors: Mehta Bella , Goodman Susan , DiCarlo Edward , Jannat-Khah Deanna , Gibbons J. Alex B. , Otero Miguel , Donlin Laura , Pannellini Tania , Robinson William H. , Sculco Peter , Figgie Mark , Rodriguez Jose , Kirschmann Jessica M. , Thompson James , Slater David , Frezza Damon , Xu Zhenxing , Wang Fei , Orange Dana E. 
Published: March 2023

Abstract
Background
We sought to identify features that distinguish osteoarthritis (OA) and rheumatoid arthritis (RA) hematoxylin and eosin (H&E)-stained synovial tissue samples.

Methods
We compared fourteen pathologist-scored histology features and computer vision-quantified cell density (147 OA and 60 RA patients) in H&E-stained synovial tissue samples from total knee replacement (TKR) explants. A random forest model was trained using disease state (OA vs RA) as a classifier and histology features and/or computer vision-quantified cell density as inputs.

Results
Synovium from OA patients had increased mast cells and fibrosis (p < 0.001), while synovium from RA patients exhibited increased lymphocytic inflammation, lining hyperplasia, neutrophils, detritus, plasma cells, binucleate plasma cells, sub-lining giant cells, fibrin (all p < 0.001), Russell bodies (p = 0.019), and synovial lining giant cells (p = 0.003). Fourteen pathologist-scored features allowed for discrimination between OA and RA, producing a micro-averaged area under the receiver operating curve (micro-AUC) of 0.85±0.06. This discriminatory ability was comparable to that of computer vision cell density alone (micro-AUC = 0.87±0.04). Combining the pathologist scores with the cell density metric improved the discriminatory power of the model (micro-AUC = 0.92±0.06). The optimal cell density threshold to distinguish OA from RA synovium was 3400 cells/mm2, which yielded a sensitivity of 0.82 and specificity of 0.82.

Conclusions
H&E-stained images of TKR explant synovium can be correctly classified as OA or RA in 82% of samples. Cell density greater than 3400 cells/mm2 and the presence of mast cells and fibrosis are the most important features for making this distinction.
DNA methylation as a potential mediator of the association between indoor air pollution and neurodevelopmental delay in a South African birth cohort
Authors: Feil Dakotah , Abrishamcar Sarina , Christensen Grace M. , Vanker Aneesa , Koen Nastassja , Kilanowski Anna , Hoffman Nadia , Wedderburn Catherine J. , Donald Kirsten A. , Kobor Michael S. , Zar Heather J. , Stein Dan J. , Hüls Anke 
Published: March 2023

Abstract
Background
Exposure to indoor air pollution during pregnancy has been linked to neurodevelopmental delay in toddlers. Epigenetic modification, particularly DNA methylation (DNAm), may explain this link. In this study, we employed three high-dimensional mediation analysis methods (HIMA, DACT, and gHMA) followed by causal mediation analysis to identify differentially methylated CpG sites and genes that mediate the association between indoor air pollution and neurodevelopmental delay. Analyses were performed using data from 142 mother to child pairs from a South African birth cohort, the Drakenstein Child Health Study. DNAm from cord blood was measured using the Infinium MethylationEPIC and HumanMethylation450 arrays. Neurodevelopment was assessed at age 2 years using the Bayley Scores of Infant and Toddler Development, 3rd edition across four domains (cognitive development, general adaptive behavior, language, and motor function). Particulate matter with an aerodynamic diameter of 10 μm or less (PM10) was measured inside participants’ homes during the second trimester of pregnancy.

Results
A total of 29 CpG sites and 4 genes (GOPC, RP11-74K11.1, DYRK1A, RNMT) were identified as significant mediators of the association between PM10 and cognitive neurodevelopment. The estimated proportion mediated (95%-confidence interval) ranged from 0.29 [0.01, 0.86] for cg00694520 to 0.54 [0.11, 1.56] for cg05023582.

Conclusions
Our findings suggest that DNAm may mediate the association between prenatal PM10 exposure and cognitive neurodevelopment. DYRK1A and several genes that our CpG sites mapped to, including CNKSR1, IPO13, IFNGR1, LONP2, and CDH1, are associated with biological pathways implicated in cognitive neurodevelopment and three of our identified CpG sites (cg23560546 [DAPL1], cg22572779 [C6orf218], cg15000966 [NT5C]) have been previously associated with fetal brain development. These findings are novel and add to the limited literature investigating the relationship between indoor air pollution, DNAm, and neurodevelopment, particularly in low- and middle-income country settings and non-white populations.
Unique considerations for the medical care of restrictive eating disorders in children and young adolescents
Authors: Tanner Anna B. 
Published: March 2023

Abstract
Background
The medical complications of eating disorders are often approached through an age-neutral lens. However, children and young adolescents may have unique medical complications related to the energy needs and timing of growth and development. Providers caring for patients in this vulnerable age range should understand how to identify, approach, and manage these potential age-related complications.

Review
Evidence continues to accumulate that increasingly younger patients are being diagnosed with eating disorders. These children and young adolescents have significant risk for unique and potentially irreversible medical complications. Without early identification and treatment, restrictive eating disorders may negatively impact linear growth, bone development and brain maturation in children and young adolescents. Additionally, due to the energy needs of growth and development, unique considerations exist for the use of acute medical stabilization and the identification of patients at risk for refeeding syndrome with initial nutritional rehabilitation. This review presents an approach to the evaluation and management of children and young adolescents with eating disorders.

Conclusion
Children and young adolescents with restrictive eating disorders may have unique medical complications related to the energy needs and timing of linear growth and pubertal development. Significant risk exists for irreversible medical complications of impaired growth, bone, and brain health. Increased awareness of the energy needs for growth and development may improve early recognition, appropriate intervention, and future outcomes for children and young adolescents with restrictive eating disorders.
A long-term survival case of histiocytic sarcoma by surgery alone in a Japanese elderly breast tumor patient
Authors: Higuchi Toru , Li Chih-Ping , Hirota Yuko , Hayashi Yuji , Arisawa Fumio , Manabe Ikuko , Sakurai Takashi , Adachi Akiko , Saito Tsuyoshi 
Published: March 2023

Abstract
Introduction
Histiocytic sarcoma (HS) is a rare hematologic malignancy. HS of the breast is extremely rare, and we present a case of an elderly patient with breast HS.

Case presentation
An 81-year-old woman with unremarkable past medical and family histories presented to our hospital with a palpable mass in her right upper breast. She had noticed a mass in her right breast 3 months before her first visit. Physical examination revealed a mass measuring approximately 30 mm in the right upper quadrant of the breast; there were no cervical or axillary lymphadenopathies. Mammography revealed a high-concentration mass with unclear margins in the upper and outer breast. Ultrasound and magnetic resonance imaging (MRI) revealed a 31 × 23-mm nodule with a relatively clear margin and necrotic sign on the T2-intensified image. A mastectomy was performed upon the patient’s request, and the surgical specimen revealed a 35-mm hemorrhagic mass. The lesion was estrogen receptor-, progesterone receptor-, and HER2/neu-negative. The Ki-67 labeling index was approximately 30%. The immunohistochemical panel showed immune reactivity for the histiocytic markers CD68, CD163, and CD206 and was immune-negative for B lineage, T lineage, Langerhans cells, and keratins. The diagnosis of HS was based on the morphological and immunophenotypic characteristics of the mass. The patient received no systemic therapy and survived for 50 months without recurrence.

Conclusions
Here, we report the case of an elderly patient with rare breast HS. Although the prognosis of HS seems poor, the breast HS was not as poor as expected, since it might have been discovered in the local region before it metastasized.
Knowledge, and practices on sexual and reproductive health among youth trainees attached to youth training centers in Sri Lanka
Authors: Mataraarachchi D. , Vithana P. V. S. C. , Lokubalasooriya A. , Jayasundara C. J. , Suranutha A. S. , Pathirana T. E. A. , De Silva C. 
Published: March 2023

Abstract
Background
Sexual and reproductive health is a major concern among adolescents and youth in Sri Lanka. The study was carried out to assess the knowledge, and practices of the youth trainees attached to youth training institutes in Sri Lanka.

Methodology
A descriptive, cross-sectional study was carried out among randomly selected 425 youth trainees attached to youth training centers in Sri Lanka using a pre-tested self-administered questionnaire. Statistical analysis was conducted using SPSS-21. Categorical variables were presented as numbers and percentages. A comparison of categorical variables was conducted using the Chi-Square test and Fisher’s exact test as applicable. The bivariate logistic regression model was used to determine the independent association of the selected demographic factors with youth trainees’ sexual and reproductive health knowledge.

Results
Study group consisted of 51.8% (n = 220) males and 48.2% (n = 205) females with a mean age of 18.6 years (SD = 1.8). Youth trainees’ knowledge of the physiology of the reproductive tract was not at a satisfactory level, where Only 49% (n = 211) knew that nocturnal emission is normal in young men. The trainee’s knowledge of contraception was also at a poor level. Only 47.5% (n = 202) had ever heard of condoms, and 13.2% (n = 56) knew about the emergency contraceptive pill. Nearly 8% (n = 33) of the youth had engaged in sexual intercourse at least once in their lifetime. Male gender (AOR = 2.3, p < 0.001), and age above 20 years (AOR = 1.9, P = 0.005) were positively associated with SRH knowledge.

Conclusions and recommendations
Knowledge and practices on sexual and reproductive health among youth trainees were sub-standard. The study recommends strengthening sexual and reproductive health education at youth training centers.
Post-mortem interval of buried homicides in Okuku, Nigeria
Authors: Onyejike Darlington Nnamdi , Fischer Victor Adolf , Esomonu Ugochukwu Godfrey , Onyejike Ifeoma Miracle 
Published: March 2023

Abstract
Background
Post-mortem interval estimation of carcasses buried in shallow graves is a grey area in Nigerian forensic investigations. Most of the investigations and court decisions on the time of death of concealed homicides are based on assumptions in Nigeria. Therefore, this study investigated the post-mortem interval of buried remains in Okuku, Cross River State of Nigeria using porcine models. This study also provided a model account of the pattern and timeline of decomposition of buried remains in Nigeria.

Results
Four stages of decomposition were identified within the study period which includes fresh, bloat, active decay, and advanced decay stages. Features of bloat stage of decomposition include bloating of the animals and release of putrid odour. The active decay stage was characterized by the absence of maggots, bone exposure, and greyish discolouration of the body. The advanced decay stage of decomposition is characterized by adipocere formation, fungi activities, and bone exposure.

Conclusions
Buried bodies do not completely skeletonize within 168 days in a typical Nigerian savannah region. Bloat stage started by the 7th day; the active decay stage started by the 14th day. The fresh stage of decay lasted up to 7 days; the bloat stage lasted for 14 days. The active decay stage lasted about 35 days, and the advanced decay stage started at about the 56th day and progressed until the end of the study.
Influence of benign prostatic hyperplasia patterns detected with MRI on the clinical outcome after prostatic artery embolization
Authors: Boschheidgen Matthias , Al-Monajjed Rouvier , Minko Peter , Jannusch Kai , Ullrich Tim , Radke Karl Ludger , Michalski Rene , Radtke Jan Philipp , Albers Peter , Antoch Gerald , Schimmöller Lars 
Published: March 2023

Abstract
Background
To investigate the influence of benign prostatic hyperplasia (BPH) patterns detected with MRI on clinical outcomes after prostatic artery embolization (PAE).

Materials & methods
This retrospective study included 71 consecutive patients with lower urinary tract symptoms (LUTS), who underwent magnetic resonance imaging (MRI) of the prostate followed by PAE at a single centre. MRI scans were evaluated and BPH patterns were determined according to Wasserman type and a modified BPH classification. Additionally, scans were evaluated regarding the presence of adenomatous-dominant benign prostatic hyperplasia (AdBPH). LUTS were assessed using the International Prostate Symptom Score (IPSS) and urinary flow rate (Qmax). Follow-up examination included MRI and clinical outcome.

Results
For clinical outcome at follow-up, IPSS showed median reduction of 54% (IQR 41—75%) and Qmax improved by 4.1 ml/s. We noted significant reduction in volume, intraprostatic protrusion, and prostatic urethral angle in our collective (p < 0.01). Median volume reduction was 25% (IQR 15%—34%). Bilateral embolization was a significant predictor for volume reduction at follow-up. Multiple linear regression analysis showed significant effect of high initial volume on reduction in IPSS after treatment (p < 0.01). Presence of AdBPH was significantly associated with both, volume loss and clinical improvement in terms of IPSS reduction (p < 0.01). Neither BPH pattern based on the Wassermann type nor modified BPH classification were significantly related with postinterventional IPSS and volume loss.

Conclusions
Men benefit from PAE regardless the macroscopic BPH MRI pattern. Preinterventional prostate volume and presence of AdBPH on MRI should be considered for outcome prognosis after PAE.
An ensemble deep learning based IDS for IoT using Lambda architecture
Authors: Alghamdi Rubayyi , Bellaiche Martine 
Published: March 2023

AbstractThe Internet of Things (IoT) has revolutionized our world today by providing greater levels of accessibility, connectivity and ease to our everyday lives. It enables massive amounts of data to be traversed across multiple heterogeneous devices that are all interconnected. This phenomenon makes IoT networks vulnerable to various network attacks and intrusions. Building an Intrusion Detection System (IDS) for IoT networks is challenging as they enable a massive amount of data to be aggregated, which is difficult to handle and analyze in real time mainly because of the heterogeneous nature of IoT devices. This inefficient, traditional IDS approach accentuates the need to develop advanced IDS techniques by employing Machine or Deep Learning. This paper presents a deep ensemble-based IDS using Lambda architecture by following a multi-pronged classification approach. Binary classification uses Long Short Term Memory (LSTM) to differentiate between malicious and benign traffic, while the multi-class classifier uses an ensemble of LSTM, Convolutional Neural Network and Artificial Neural Network classifiers to detect the type of attacks. The model training is performed in the batch layer, while real-time evaluation is carried out through model inferences in the speed layer of the Lambda architecture. The proposed approach gives high accuracy of over 99.93% and saves useful processing time due to the multi-pronged classification strategy and using the lambda architecture.
Wavelet image scattering based glaucoma detection
Authors: Agboola Hafeez Alani , Zaccheus Jesuloluwa Emmanuel 
Published: March 2023

AbstractBackgroundThe ever-growing need for cheap, simple, fast, and accurate healthcare solutions spurred a lot of research activities which are aimed at the reliable deployment of artificial intelligence in the medical fields. However, this has proved to be a daunting task especially when looking to make automated diagnoses using biomedical image data. Biomedical image data have complex patterns which human experts find very hard to comprehend. Against this backdrop, we applied a representation or feature learning algorithm: Invariant Scattering Convolution Network or Wavelet scattering Network to retinal fundus images and studied the the efficacy of the automatically extracted features therefrom for glaucoma diagnosis/detection. The influence of wavelet scattering network parameter settings as well as 2-D channel image type on the detection correctness is also examined. Our work is a distinct departure from the usual method where wavelet transform is applied to pre-processed retinal fundus images and handcrafted features are extracted from the decomposition results. Here, the RIM-ONE DL image dataset was fed into a wavelet scattering network developed in the Matlab environment to achieve a stage-wise decomposition process called wavelet scattering of the retinal fundus images thereby, automatically learning features from the images. These features were then used to build simple and computationally cheap classification algorithms.ResultsMaximum detection correctness of 98% was achieved on the held-out test set. Detection correctness is highly sensitive to scattering network parameter setting and 2-D channel image type.ConclusionA superficial comparison of the classification results obtained from our work and those obtained using a convolutional neural network underscores the potentiality of the proposed method for glaucoma detection.
A peek behind the curtain in the diagnosis and management of COVID‑19‑Associated Mucormycosis (CAM)
Authors: Osman Nermin A. , Anwar Mohammed Moustapha , Singh Bivek , Gupta Girish K. , Rabie Amgad M. 
Published: March 2023

AbstractCoronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) is responsible for a high mortality rate due to its unique and severe host-pathogen interactions. Critically ill or immunocompromised COVID-19 patients are more prone to suffer from aggressive mycoses. Probable victims include those with uncontrolled diabetes mellitus (DM), metabolic acidosis, prolonged neutropenia, increased ferritin levels, hypoxia, and prolonged hospitalization with/without mechanical ventilators and corticosteroids administration. The current review aims to outline the journey of patients with CAM as well as the advantages and disadvantages of the currently available diagnostic techniques. It also discussed the current status of treatment options and caveats in the management of mucormycosis. Multidisciplinary team, early diagnosis, controlling the predisposing condition(s), complete surgical debridement, effective antifungal therapies (e.g., amphotericin B, isavuconazole, and posaconazole), and implementing antifungal stewardship programs are imperative in CAM cases.