bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac metastasis mimicking STEMI—impact of point-of-care ultrasound on clinical decision-making: A case report
Authors: Le Anh Ngoc , Nguyen Anh Van , Nguyen Trang Ngoc , Kirkpatrick James N. , Nguyen Huyen Thi , Nguyen Hoai Thi Thu 
Published: March 2023

IntroductionThe manifestations of cardiac metastases are extremely variable depending on their location and extension.Case presentationA 62-year-old man was admitted to the cardiac emergency department presenting with chest pain, worsening shortness of breath and palpitations. He had a history of esophageal squamous cell carcinoma treated with chemoradiotherapy, and he was not diagnosed with cardiovascular disease before. The electrocardiogram showed significant ST-segment elevations in leads II, III, and aVF. Initially, the patient was diagnosed with ST-segment elevation myocardial infarction. A cardiac point-of-care ultrasound was performed immediately revealing two large heterogeneous masses in the left ventricular wall and the apex, which changed the diagnosis and the management strategy. There was no significant change in serial cardiac biomarkers in the setting of persistent STE. Thoracic computed tomography and cardiac magnetic resonance confirmed that the patient was suffering from cardiac and lung metastases.ConclusionECG findings of localized and prolonged STE without Q waves or changes in biomarkers may suggest myocardial tumor invasion, especially in the cancer setting. Cardiac point-of-care ultrasound is an effective, convenient, noninvasive imaging modality to guide real-time clinical decision-making.
The ankle in XLH: Reduced motion, power and quality of life
Authors: Akta Celine , Wenzel-Schwarz Florian , Stauffer Alexandra , Kranzl Andreas , Raimann Adalbert , Kocijan Roland , Ganger Rudolf , Mindler Gabriel T. 
Published: March 2023

BackgroundX-linked hypophosphatemia (OMIM 307800) is a rare bone disease caused by a phosphate-wasting condition with lifelong clinical consequences. Those affected suffer from bone pain, complex skeletal deformities, impaired mobility and a reduced quality of life. Early osteoarthritis and reduced range of motion of the lower limbs are known pathologies in XLH patients. However, XLH-specific data on the affected compartments such as the ankle joint through the evaluation of radiographic and gait analysis data is still lacking.Patients and methodsIn this cross-sectional study, patients with genetically verified XLH, age ≥ 16 - 50 years and a complete record of gait analysis and or radiographic analysis data were included. Clinical examination, radiological and gait analysis data were compared to norms using the dataset of our gait laboratory registry. Radiographic analysis included tibial deformity analysis and assessment of osteoarthritis and enthesopathies. Western Ontario and McMaster Universities Arthritis Index (WOMAC), SF36v2, American Orthopedic Foot and Ankle Society score (AOFAS) and the Foot and Ankle Outcome Score (FAOS) were used. Twentythree participants with 46 limbs were eligible for the study.ResultsA total of 23 patients (n=46 feet) met the inclusion criteria. Patients with XLH had significantly reduced gait quality, ankle power and plantar flexion (p &lt; 0.001) compared to a historic gait laboratory control group. Ankle valgus deformity was detected in 22 % and ankle varus deformity in 30 % of the patients. The subtalar joint (59.1%) as well as the anterior tibiotalar joint (31.1%) were the main localizations of moderate to severe joint space narrowing. Ankle power was decreased in moderate and severe subtalar joint space narrowing (p &lt; 0.05) compared to normal subtalar joint space narrowing. No lateral or medial ligament instability of the ankle joint was found in clinical examination. Tibial procurvatum deformity led to lower ankle power (p &lt; 0.05).ConclusionsThis study showed structural and functional changes of the ankle in patients with XLH. Subtalar ankle osteoarthritis, patient reported outcome scores and clinical ankle restriction resulted in lower gait quality and ankle power.
Effect of intravenous immunoglobulin therapy on the prognosis of patients with severe fever with thrombocytopenia syndrome and neurological complications
Authors: Liu Yun , Tong Hanwen , He Fei , Zhai Yu , Wu Chao , Wang Jun , Jiang Chenxiao 
Published: March 2023

BackgroundIntravenous immunoglobulin (IVIG) has been reported to exert a beneficial effect on severe fever with thrombocytopenia syndrome (SFTS) patients with neurological complications. However, in clinical practice, the standard regime is unclear and there is a lack of evidence from large-scale studies.MethodsA single-center retrospective study was conducted to determine the influence of IVIG dosage and duration on SFTS patients with neurological complications. The primary outcome was 28-day mortality, and laboratory parameters before and after IVIG treatment were measured. Survival curves were generated using the Kaplan–Meier method and analyzed with the log-rank test according to the median IVIG dosage and IVIG duration. Besides, multivariate Cox regression analysis was performed to examine the association between the independent factors and 28-day mortality in SFTS patients.ResultsOverall, 36 patients (58.06%) survived, while 26 (41.9%) patients died. The median age of the included patients was 70 (55–75) years, and 46.8% (29/62) were male. A significantly higher clinical presentation of dizziness and headache was observed in the survival group. The IVIG duration in the survival group was longer than in the death group (P &lt;0.05). Additionally, the IVIG dosage was higher in the survival group than in the death group, but there was not a statistically significant difference between the two groups (P = 0.066). The mediating effect of IVIG duration was verified through the relationship between IVIG dosage and prognosis using the Sobel test. Univariate analysis revealed that IVIG dosage (HR: 0.98; 95% CI: 0.97–1.00; P = 0.007) and IVIG duration (HR: 0.54; 95% CI: 0.41–0.72; P &lt;0.001) were significantly associated with risk of death. The multivariate analysis generated an adjusted HR value of 0.98 (95% CI: 0.96–1.00; P = 0.012) for IVIG dosage and 0.26 (95% CI: 0.09–0.78; P = 0.016) for dizziness and headache.ConclusionProlonged high-dose IVIG is beneficial to the 28-day prognosis in SFTS patients with neurological complications.
Response of harbor porpoises (Phocoena phocoena) to different types of acoustic harassment devices and subsequent piling during the construction of offshore wind farms
Authors: Voß Julika , Rose Armin , Kosarev Vladislav , Vílela Raúl , van Opzeeland Ilse Catharina , Diederichs Ansgar 
Published: March 2023

Before piling of offshore wind farm foundations, acoustic harassment devices (AHDs) are used to drive harbor porpoises out of the area where they could suffer injuries. Until 2017, a combination of pingers and seal scarer devices (usually SPL = 174-193 dB re 1 μPa (rms) @ 1m at 1 to 20 kHz depending on the device) was prescribed for mitigation purposes in Germany. However, seal scarers led to decreased porpoise detection rates in much larger distances than intended, when 750 m is usually rendered sufficient to avoid injuries. Therefore, devices specifically designed for mitigation purposes were developed and are prescribed since then. These acoustic porpoise deterrents (APDs; e.g. FaunaGuard Porpoise Module; SPL = 172 dB re 1 μPa (rms) @ 1m at 60 to 150 kHz) aim to keep the animals away from offshore construction sites but should not lead to large-scale disturbance as caused by a seal scarer. Although project-specific evaluations indicated that APDs are effective, a cross-project analysis and a comparison with data from previous piling procedures employing seal scarers were still pending. The present study aimed to fill this gap. Between March 2018 and April 2019, harbor porpoise detection rates were monitored acoustically in four offshore wind farm projects using CPODs before, during and after piling at different distances up to 10 km from piling. APD operation led to a significant decrease in detection rates in the vicinity of the device, indicating the displacement of the animals from a small-scale area. Depending on the wind farm, detection rates during APD operation decreased by 30 to 100% at 750 m distance compared to 6 hours before APD operation. Furthermore, reduced detection rates during APD operation were only observed up to about 2.5 km distance even when the APD was switched on for over 40 minutes. Given that the extent of disturbance to harbor porpoises is lower when using an acoustic porpoise deterrent compared to the seal scarer, we consider that preferential use of an acoustic porpoise deterrent is an improvement to mitigation strategies and an important step forward to a less harmful piling procedure.
Risk for multidrug-resistant tuberculosis in patients treated with anti-tumor necrosis factor agents
Authors: Park Jinkyeong , Hong Yoonki , Hong Ji Young 
Published: March 2023

BackgroundThere are few studies on medical conditions associated with the development of drug-resistant TB.ObjectiveWe investigated the risk factors for the occurrence of multidrug-resistant (MDR) tuberculosis (TB) in patients with pulmonary TB.Materials and methodsBased on claims data from the Health Insurance Review and Assessment service in South Korea, we retrospectively investigated patients aged 18 years or older with active pulmonary TB who were treated with anti-TB therapy between January 1, 2008, and February 28, 2021.ResultsAmong 248,176 patients with pulmonary TB who underwent anti-TB therapy, 2.0% were identified as having MDR-TB. MDR-TB showed male predominance compared to patients without MDR-TB, and patients with MDR-TB were younger. The risk for MDR-TB in patients treated with anti-TB therapy was 3.26 times higher in patients who received anti-tumor necrosis factor (TNF) agents before prescription of anti-TB medications than in those who had never been exposed to anti-TNF agents after adjusting for other TB risk factors (age, sex, inhaled corticosteroid, diabetes mellitus, liver disease, pneumoconiosis, and organ or blood recipients). The risk for MDR-TB was also increased in males and younger patients.ConclusionTreatment with an anti-TNF agent could be a driver of MDR-TB in patients with pulmonary TB.
Fibrosis score predicts mortality in patients with fibrotic hypersensitivity pneumonitis
Authors: Oh Ju Hyun , Kang Jieun , Song Jin Woo 
Published: March 2023

BackgroundVariable clinical courses make it challenging to predict mortality resulting from fibrotic hypersensitivity pneumonitis (HP). This study evaluated the usefulness of radiologic parameters for predicting mortality in patients with fibrotic HP.MethodsClinical data and high-resolution computed tomography (HRCT) images, which were scored for reticulation, honeycombing, ground glass opacity (GGO), consolidation, and mosaic attenuation (MA) by visual assessment, were retrospectively analyzed in a total of 101 patients with fibrotic HP (all biopsy-proven cases). Fibrosis score was defined as the sum of reticulation and honeycombing scores.ResultsThe mean age of the 101 patients was 58.9 years, and 60.4% were females. During the follow-up (median: 55.5 months; interquartile range: 37.7–89.0 months), the 1-, 3-and 5-year mortality rates were 3.9, 16.8, and 32.7%, respectively. The non-survivors were older and had significantly lower lung function and minimum oxygen saturation during the 6-min walk test than the survivors. The non-survivors had higher scores of reticulation, honeycombing, GGO, fibrosis, and MA on HRCT than survivors. In the multivariable Cox analysis, reticulation, GGO, and fibrosis scores were independent prognostic factors for mortality in patients with fibrotic HP, as well as age. Fibrosis score showed great performance for predicting the 5-year mortality (AUC = 0.752, p &lt; 0.001) and higher mortality was recorded for patients with high fibrosis score (≥12.0%) (the mean survival time: 58.3 vs. 146.7 months, p &lt; 0.01) than those without.ConclusionOur results suggest that radiologic fibrosis score may be a useful predictor of mortality in patients with fibrotic HP.
Genetically predicted green tea intake and the risk of arterial embolism and thrombosis
Authors: Jia Lingmei , Chen Yali , Liu Chang , Luan Yinyin , Jia Min 
Published: March 2023

BackgroundIn previous observational studies, green tea intake has been demonstrated to protect against arterial embolism and thrombosis. However, whether there is a causative connection between green tea intake and arterial embolism and thrombosis is currently unclear.MethodsA two-sample Mendelian randomization (MR) study has been designed to explore whether there is a causal association between green tea intake and arterial embolism and thrombosis by acquiring exposure and outcome data from previously published research. Data from the MRC-IEU (data on green tea intake, 64,949 participants) consortium and the FinnGen project (data on arterial embolism and thrombosis, 278 cases of arterial thrombosis and 92,349 control participants) has been utilized to determine the causal impact of green tea intake on arterial embolism and thrombosis.ResultsWe found that genetically predicted green tea intake was causally associated with a lower risk of arterial embolism and thrombosis (IVW odds ratio [OR] per SD decrease in green tea intake = 0.92 [95% confidence interval, 0.85–0.99]; p = 0.032). Moreover, the sensitivity analysis (both MR Egger regression and weighted median) yielded comparable estimates but with low precision. No directional pleiotropic effect between green tea intake and arterial embolism and thrombosis was observed in both funnel plots and MR-Egger intercepts.ConclusionsOur study provided causal evidence that genetically predicted green tea intake may be a protective factor against arterial embolism and thrombosis.
Numerical study of magneto-optical binding between two dipolar particles under illumination by two counter-propagating waves
Authors: Abraham-Ekeroth Ricardo Martín 
Published: March 2023

Introduction: The formation of a stable magneto plasmonic dimer with THz resonances is theoretically studied for the principal directions of the system. Unlike a recent report, our work provides a complete description of the full photonic coupling for arbitrary magnetic fields as, for instance, unbalanced particle spins.Methods: As an illustration, we consider two small, n-doped InSb nanoparticles under illumination by two counter-propagating plane waves.Results: Remarkably, when an external magnetic field exists, the symmetry in the system is broken, and a resonant radiation pressure for the dimer appears. Similarly, tunable inter-particle forces and spins are exerted on the non-reciprocal dimer. The system is also characterized when the magnetic field is absent. Moreover, we show how the mechanical observables truly characterize the dimer since their resonance dependency contains detailed information about the system.Discussion: Unlike far-field observables like absorption, mechanical magnitudes depend on the system's near-field. In addition, the nature of the particle spins is originally explained by the energy flow's behavior around the dimer. This work constitutes a generalization of any previous approach to optical binding between small nanoparticles. It paves the way for fully controlling optical matter and nano factory designs based on surface plasmon polaritons.
Design of a medical decision-supporting system for the identification of brain tumors using entropy-based thresholding and non-local texture features
Authors: Reddy K. Rasool , Batchu Raj Kumar , Polinati Srinivasu , Bavirisetti Durga Prasad 
Published: March 2023

IntroductionBrain tumors arise due to abnormal growth of cells at any brain location with uneven boundaries and shapes. Usually, they proliferate rapidly, and their size increases by approximately 1.4% a day, resulting in invisible illness and psychological and behavioral changes in the human body. It is one of the leading causes of the increase in the mortality rate of adults worldwide. Therefore, early prediction of brain tumors is crucial in saving a patient’s life. In addition, selecting a suitable imaging sequence also plays a significant role in treating brain tumors. Among available techniques, the magnetic resonance (MR) imaging modality is widely used due to its noninvasive nature and ability to represent the inherent details of brain tissue. Several computer-assisted diagnosis (CAD) approaches have recently been developed based on these observations. However, there is scope for improvement due to tumor characteristics and image noise variations. Hence, it is essential to establish a new paradigm.MethodsThis paper attempts to develop a new medical decision-support system for detecting and differentiating brain tumors from MR images. In the implemented approach, initially, we improve the contrast and brightness using the tuned single-scale retinex (TSSR) approach. Then, we extract the infected tumor region(s) using maximum entropy-based thresholding and morphological operations. Furthermore, we obtain the relevant texture features based on the non-local binary pattern (NLBP) feature descriptor. Finally, the extracted features are subjected to a support vector machine (SVM), K-nearest neighbors (KNN), random forest (RF), and GentleBoost (GB).ResultsThe presented CAD model achieved 99.75% classification accuracy with 5-fold cross-validation and a 91.88% dice similarity score, which is higher than the existing models.DiscussionsBy analyzing the experimental outcomes, we conclude that our method can be used as a supportive clinical tool for physicians during the diagnosis of brain tumors.
Diabetic rats with high levels of endogenous dopamine do not show retinal vascular pathology
Authors: Allen Rachael S. , Khayat Cara T. , Feola Andrew J. , Win Alice S. , Grubman Allison R. , Chesler Kyle C. , He Li , Dixon Jendayi A. , Kern Timothy S. , Iuvone P. Michael , Thule Peter M. , Pardue Machelle T. 
Published: March 2023

PurposeLimited research exists on the time course of long-term retinal and cerebral deficits in diabetic rodents. Previously, we examined short term (4–8 weeks) deficits in the Goto-Kakizaki (GK) rat model of Type II diabetes. Here, we investigated the long-term (1–8 months) temporal appearance of functional deficits (retinal, cognitive, and motor), retinal vascular pathology, and retinal dopamine levels in the GK rat.MethodsIn GK rats and Wistar controls, retinal neuronal function (electroretinogram), cognitive function (Y-maze), and motor function (rotarod) were measured at 1, 2, 4, 6, and 8 months of age. In addition, we evaluated retinal vascular function (functional hyperemia) and glucose and insulin tolerance. Retinas from rats euthanized at ≥8 months were assessed for vascular pathology. Dopamine and DOPAC levels were measured via HPLC in retinas from rats euthanized at 1, 2, 8, and 12 months.ResultsGoto-Kakizaki rats exhibited significant glucose intolerance beginning at 4 weeks and worsening over time (p &lt; 0.001). GK rats also showed significant delays in flicker and oscillatory potential implicit times (p &lt; 0.05 to p &lt; 0.001) beginning at 1 month. Cognitive deficits were observed beginning at 6 months (p &lt; 0.05), but no motor deficits. GK rats showed no deficits in functional hyperemia and no increase in acellular retinal capillaries. Dopamine levels were twice as high in GK vs. Wistar retinas at 1, 2, 8, and 12 months (p &lt; 0.001).ConclusionAs shown previously, retinal deficits were detectable prior to cognitive deficits in GK rats. While retinal neuronal function was compromised, retinal vascular pathology was not observed, even at 12+ months. High endogenous levels of dopamine in the GK rat may be acting as an anti-angiogenic and providing protection against vascular pathology.
Deep learning for real-time detection of breast cancer presenting pathological nipple discharge by ductoscopy
Authors: Xu Feng , Zhu Chuang , Wang Zhihao , Zhang Lei , Gao Haifeng , Ma Zhenhai , Gao Yue , Guo Yang , Li Xuewen , Luo Yunzhao , Li Mengxin , Shen Guangqian , Liu He , Li Yanshuang , Zhang Chao , Cui Jianxiu , Li Jie , Jiang Hongchuan , Liu Jun 
Published: March 2023

ObjectiveAs a common breast cancer-related complaint, pathological nipple discharge (PND) detected by ductoscopy is often missed diagnosed. Deep learning techniques have enabled great advances in clinical imaging but are rarely applied in breast cancer with PND. This study aimed to design and validate an Intelligent Ductoscopy for Breast Cancer Diagnostic System (IDBCS) for breast cancer diagnosis by analyzing real-time imaging data acquired by ductoscopy.Materials and methodsThe present multicenter, case-control trial was carried out in 6 hospitals in China. Images for consecutive patients, aged ≥18 years, with no previous ductoscopy, were obtained from the involved hospitals. All individuals with PND confirmed from breast lesions by ductoscopy were eligible. Images from Beijing Chao-Yang Hospital were randomly assigned (8:2) to the training (IDBCS development) and internal validation (performance evaluation of the IDBCS) datasets. Diagnostic performance was further assessed with internal and prospective validation datasets from Beijing Chao-Yang Hospital; further external validation was carried out with datasets from 5 primary care hospitals. Diagnostic accuracies, sensitivities, specificities, and positive and negative predictive values for IDBCS and endoscopists (expert, competent, or trainee) in the detection of malignant lesions were obtained by the Clopper-Pearson method.ResultsTotally 11305 ductoscopy images in 1072 patients were utilized for developing and testing the IDBCS. Area under the curves (AUCs) in breast cancer detection were 0·975 (95%CI 0·899-0·998) and 0·954 (95%CI 0·925-0·975) in the internal validation and prospective datasets, respectively, and ranged between 0·922 (95%CI 0·866-0·960) and 0·965 (95%CI 0·892-0·994) in the 5 external validation datasets. The IDBCS had superior diagnostic accuracy compared with expert (0.912 [95%CI 0.839-0.959] vs 0.726 [0.672-0.775]; p&lt;0.001), competent (0.699 [95%CI 0.645-0.750], p&lt;0.001), and trainee (0.703 [95%CI 0.648-0.753], p&lt;0.001) endoscopists.ConclusionsIDBCS outperforms clinical oncologists, achieving high accuracy in diagnosing breast cancer with PND. The novel system could help endoscopists improve their diagnostic efficacy in breast cancer diagnosis.