bluuebunny/crossref_metadata_2025_split huggingface dataset:
CT showed multiple pulmonary balloon lesions with intermediate balloon calcification in a case of nodular pulmonary amyloidosis: A case report
Authors: Yin Mingquan , Ouyang Lecong , Tan Jianlong , Liu Wei , Zhang Weidong 
Published: September 2023

Rationale:
Amyloidosis is a rare disease characterized by the misfolding of autologous proteins and extracellular deposition of fibrils, which can involve 1 or more vital organs in the body. Nodular pulmonary amyloidosis with extensive pulmonary cysts is even less common. This study discusses the diagnosis and treatment of a case of pulmonary nodular amyloidosis with extensive pulmonary cysts and calcification in the middle of the cysts on chest computed tomography, and reviews the related literature. We hope that this rare case will raise awareness of this disease among clinicians.

Patient concerns:
Multiple pulmonary nodules and cysts were found on computed tomography of the chest, and the patient was eager to further clarify the nature of the nodules and the next treatment plan.

Diagnoses:
Amyloidosis of pulmonary nodules.

Interventions and outcomes:
Since the patient’s primary lesion was outside the bronchial lumen near the hilum, we opted for endobronchial ultrasound-guided tunnel biopsy to obtain pathological specimens, and confirmed the diagnosis of nodular pulmonary amyloidosis. After a definite diagnosis, the patient was regularly followed without any specific treatment.

Lessons:
For patients with multiple pulmonary nodules combined with extensive pulmonary cysts, we also need to be alert to the possibility of pulmonary nodule amyloidosis. Secondly, when the main lesion is located outside the bronchial cavity near the hilum of the lung, the method of pathological tissue biopsy should also consider endobronchial ultrasound-guided tunnel biopsy.
Chylous aqueous humor caused by hyperlipidemia: A case report and literature review
Authors: Zhao Jing , Zou He , Xiao Jun 
Published: September 2023

Rationale:
Generally, there is no lipoprotein in aqueous humor, and chyle usually exists transiently in the body. Therefore, persistent chylous aqueous humor is rare.

Patient concerns:
We report a case of a 39-year-old man with persistent milky white appearance over the right eye.

Diagnoses:
The patient had a history of poorly controlled diabetes for the past 2 years and central retinal vein occlusion of the same eye for the past 2 weeks. The patient’s right eye had a uniform milky appearance in the anterior chamber, transparent cornea, and no keratic precipitate in the posterior cornea. Color Doppler ultrasound of the affected eye showed no obvious inflammation in the vitreous cavity. Laboratory tests revealed severe chylemia. The patient was finally diagnosed as chylous aqueous humor.

Interventions and outcomes:
After conventional hypolipidemia and hypoglycemia treatment and locally glucocorticoid treatment. The milky white changes in the anterior chamber improved considerably and finally disappeared.

Lessons:
Although the impact of hyperlipidemia on the cardiovascular system and digestive system is well known, its impact on the eyes is often overlooked. We report a rare case of unilateral chylous aqueous humor caused by hyperlipidemia. Through the analysis of this special case, we recommend that ophthalmologists should pay attention to the impact of blood lipid change on eyes.
Intervention study of tai chi training on the intestinal flora of college student basketball players
Authors: Kang Dongyang , Wang Xiaorong , Wang Jiahong 
Published: September 2023

Background:
In recent years, the interactions between host and host-associated gut flora have received increasingly widespread attention. Tai chi is a traditional Chinese exercise, which can significantly benefit adults with health condition. But the studies on the function of intestinal flora and its correlation with tai chi exercise, are limited. In addition, the influence of tai chi on intestinal flora has largely been understudied. In this study, we investigated the changes in intestinal microflora by 16S rRNA sequencing to clarify the specific mechanism of tai chi on the regulation of intestinal flora and seek to formulate a reasonable “exercise prescription.”

Methods:

Design: randomized controlled trial. Participants: thirty college basketball players randomly divided into control (n = 15) and test (n = 15) groups. Intervention: experimental group practiced 24-style simplified tai chi ≥ 6 times/week for 20 weeks. Outcomes: serum biochemical markers, blood pressure, and intestinal microbial composition measured post-intervention. Analysis: intent-to-treat analysis.

Results:

Primary outcomes: after tai chi intervention, the level of high-density lipoprotein cholesterol (1.22 mmol/L) and triglycerides (0.64 mmol/L) were significantly decreased. Secondary outcomes: aspartate transaminase, alanine aminotransferase, total cholesterol, and low-density lipoprotein remained unchanged. Microbiota: α-diversity index significantly increased, particularly with increased Blautia. Blood pressure: test group showed significantly lower diastolic blood pressure (83–95 mm Hg) compared to control.

Discussion:
Considering other markers, increased gut flora diversity during exercise may imply a healthier gut environment. Physical exercise promotes a decrease in the inflammatory process by reducing the levels of bacteria associated with pro-inflammation, such as Proteobacteria. Further research is required to understand the nuanced link between gut flora diversity and exercise intensity.

Conclusion:
24-style simplified tai chi enhances human intestinal flora diversity. Improvements observed in blood lipid profiles and blood pressure levels.
Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor: A case series study
Authors: Fang Yu , Wu Jun , Zhang Maolin , Yang Yang , Yao Lijun , Liu Lu , Luo Jun , Li Linjun , Zhang Cheng , Qin Zhiming 
Published: September 2023

Rationale:
Cases of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor have rarely been studied in detail. Diaphragmatic dysfunction in such cases can lead to potentially fatal respiratory and circulatory disturbances. Therefore, timely diagnosis and intervention are important. Conservative rehabilitation therapy is the first choice for respiratory dysfunction due to diaphragmatic dysfunction.

Patient concerns, Diagnoses and Interventions:
We present 3 patients with respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. The diagnostic methods and therapeutic procedures for diaphragmatic dysfunction for each patient are described in detail. This study highlights the role of ventilator support combined with physical therapy in the treatment of respiratory dysfunction in such cases. The diagnosis of diaphragmatic dysfunction as well as the risk assessment of phrenic nerve involvement are also discussed. The modalities of ventilator support, including modes and parameters, are listed.

Outcomes and Lessons:
This study provides experiences of diagnosis and treatment of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. Timely diagnosis of diaphragmatic dysfunction primarily relies on clinical manifestations and radiography. Conservative rehabilitation therapy can improve or restore diaphragmatic function in majority of patients, and avert or delay the need for surgical intervention. Preoperative assessment of the risk of phrenic nerve involvement is important in such cases.
Investigation of epigenetics insights of hypertension: A bibliometric analysis
Authors: Liu Nannan , Xia Lina 
Published: September 2023

Purpose:
Hypertension remains a major risk factor for myocardial infarction, heart failure, end-stage renal disease, and stroke. Multiple genes are involved in the process of hypertension with an additional dimension of interaction with the environment. This study conducted a bibliometric analysis of publications in the field of hypertension and epigenetics over the past 10 years to summarize the current status of the field and analyze the trends in the field.

Methods:
On February 5, 2023, we chose the web of science core collection database as the study data source. VOS viewer 1.6.18 and Cite Space 6.1.6 were used to examine publications of research on hypertension and epigenetics that were published between 2013 and 2022. We looked through the papers for journals, organizations, nations and regions, authors, and key terms.

Results:
This analysis covered a total of 1535 papers on studies into hypertension and epigenetics. There were 7279 authors, 83 nations, 1983 organizations, and 606 journals in all of the articles. In the USA, 540 publications were the most. The institution with the most publications was Harvard Medical School. The author with the most articles was Zhao Lubo.

Conclusion:
This study summarizes the global research trends in hypertension and epigenetics. Publications in this field have increased year by year in the last decade and the field of research on hypertension and epigenetics has good prospects for growth.
The feasibility of using the compound kushen injection to treat cervical cancer based on network pharmacology and transcriptomics
Authors: Zhang Yiting , Xu Linjing , Li Ling 
Published: September 2023

Background:
To investigate the molecular targets and mechanisms of compound kushen injection (CKI) in the prevention and treatment of cervical cancer based on network pharmacology and transcriptomics.

Methods:
In this study, we used network pharmacology methods to screen for effective compounds, integrated the results of network pharmacology and RNA-seq to comprehensively screen and predict target genes, analyze the biological functions and signaling pathways of target genes, and construct a PPI network to screen for hub genes. The results were further verified by biological experiments, molecular docking, RT-PCR, and western blot analysis.

Results:
The results showed that the hub genes CXCL2, anti-vascular endothelial growth factor, hexokinase 2 are therapeutic targets of CKI for the treatment of Cervical Cancer. These targets were significantly enriched in pathways mainly including pathways in cancer, cell cycle, MAPK signaling pathways, etc. In vitro cell experiments showed that CKI could effectively inhibit the proliferation of cancer cells, promote apoptosis, and induce cell cycle arrest. RT-PCR and western blot experiments showed that the expression of hub genes was significantly decreased. The compounds have good binding activity to hub genes.

Conclusion:
CKI, based on its active ingredients and through multiple targets and multiple pathways, can stop the growth of cervical cancer cells at a certain phase of the cell cycle and cause apoptosis, which proved CKI’s effect in treating cervical cancer.
Photon-Counting Versus Energy-Integrating Detector CT Angiography of the Lower Extremity in a Human Cadaveric Model With Continuous Extracorporeal Perfusion
Authors: Gruschwitz Philipp , Hartung Viktor , Kleefeldt Florian , Ergün Süleyman , Huflage Henner , Peter Dominik , Hendel Robin , Patzer Theresa Sophie , Pannenbecker Pauline , Kuhl Philipp Josef , Bley Thorsten Alexander , Petritsch Bernhard , Grunz Jan-Peter 
Published: September 2023

ObjectivesDetailed visualization of the arterial runoff is mandatory for the assessment of peripheral arterial occlusive disease. This study aims to compare the performance of a first-generation photon-counting detector computed tomography (PCD-CT) to a third-generation energy-integrating detector CT (EID-CT).Materials and MethodsComputed tomography angiographies of 8 upper leg arterial runoffs were performed on human cadaveric models with continuous extracorporeal perfusion. For both PCD-CT and EID-CT, radiation dose-equivalent 120 kVp acquisition protocols (low-/medium-/high-dose: CTDIVol= 3/5/10 mGy) were used. All scans were performed with standard collimation (PCD-CT: 144 × 0.4 mm; EID-CT: 96 × 0.6 mm), a pitch factor of 0.4, and a gantry rotation time of 1.0 second. Reformatting of data included the use of comparable vascular kernels (Bv 48/49), a slice thickness and increment of 1.0 mm, and a field of view of 150 × 150 mm. Eight radiologists evaluated image quality independently using a browser-based pairwise forced-choice comparison setup. Kendall concordance coefficient (W) was calculated to estimate interrater agreement. Signal-to-noise ratio and contrast-to-noise ratio (CNR) were compared based on 1-way analyses of variance and linear regression analysis.ResultsLow-dose PCD-CT achieved superior signal-to-noise ratio/CNR values compared with high-dose EID-CT (P< 0.001). Linear regression analysis suggested that an EID-CT scan with a CTDIVolof at least 15.5 mGy was required to match the CNR value of low-dose PCD-CT. Intraluminal contrast attenuation was higher in PCD-CT than EID-CT, irrespective of dose level (415.0 ± 31.9 HU vs 329.2 ± 29.4 HU;P< 0.001). Subjective image quality of low-dose PCD-CT was considered superior to high-dose EID-CT (P< 0.001). Interrater agreement was high (W= 0.989).ConclusionsUsing cadaveric models with continuous extracorporeal perfusion allows for intraindividual image quality comparisons between PCD-CT and EID-CT on variable dose levels. With superior luminal contrast attenuation and denoising in angiographies of the peripheral arterial runoff, PCD-CT displayed potential for radiation saving of up to 83% compared with EID-CT.
FDG-Avid Malakoplakia of the Ureter Mimicking Malignancy
Authors: Zhao Qian , Dong Aisheng , Zuo Changjing , Chen Haige 
Published: September 2023

AbstractMalacoplakia is a rare chronic granulomatous disease and frequently associated withEscherichia coliinfection. We describe the contrast-enhanced CT and FDG PET/CT findings in a case of bladder and ureteral malakoplakia withE. coliurinary tract infection. Contrast-enhanced CT showed multiple enhancing mural nodules in the bladder and left ureter, ranging from several millimeters to 3.1 cm. The ureteral nodules showed significantly increased FDG uptake with SUVmaxof 20.4, due to histiocyte, lymphocyte, and plasma cell infiltrates revealed by histopathology.
Increased 18F-FAPI Uptake in Radiation-Induced Liver Injury
Authors: Zhang Jing , Jiang Shuqin , Zhang Rusen , Zhang Linqi 
Published: September 2023

Abstract
A 51-year-old woman with breast cancer underwent a complete surgical resection and chemoradiotherapy approximately 3 months ago. Follow-up abdominal ultrasound detected a new lesion with decreased echogenicity in the hepatic segment IV/VIII. 18F-FDG PET/CT showed the hepatic lesion without abnormal uptake. The patient was subsequently enrolled in a clinical trial of 18F-FAPI PET/CT to assess the hepatic lesion. An intense 18F-FAPI activity was identified in the hepatic lesion. Finally, pathological analysis combined with imaging follow-up confirmed the diagnosis of radiation-induced liver injury.
Topical 188Re Ionizing Radiation Therapy Exerts High Efficacy in Curing Nonmelanoma Skin Cancer
Authors: Tietze Julia K. , Heuschkel Martin , Krönert Maila I. C. , Kurth Jens , Bandow Gesine , Ojak Gregor , Grünwald Pavel , Herold Johanna Isabelle , Thiem Alexander , Dreßler Miriam , Krause Bernd J. , Emmert Steffen , Schwarzenböck Sarah M. 
Published: September 2023

Purpose of the report
Nonmelanoma skin cancer (NMSC) is the most frequent malignancy. Surgical intervention is the common treatment but may lead to disappointing results; alternative treatment options are needed.

Methods
In this monocentric pilot study, topical 188Re resin was investigated as a treatment for invasive NMSC up to 3-mm thickness. Twenty-two patients with 40 histologically confirmed NMSCs with a median size of 1.25 cm2 (range, 0.04–16.8 cm2) and a median tumor thickness of 0.35 mm (range, 0.1–2.1 mm) were included. Patients were treated once with 188Re resin with a targeted dose of 50 Gy. The median applied activity was 111.4 MBq (range, 21.0–168.0 MBq), and the median treatment time was 89 minutes (range, 38–175 minutes). The response rate, adverse events, and cosmetic outcome were assessed at 14 days, 4 months, and 12 months.

Results
Response rate at 12 months was 97.5%, with 95% complete responses (clinically or histologically proven in case of clinical doubt). Most adverse events were reported at 14 days, with 20% itching and 12.5% mostly minor pain. Forty-nine percent of the lesions showed hypopigmentation only at 12 months. Forty-one percent of the lesions were graded as cosmetically superior to the expected result after surgery and 51.3% as comparable to successful surgery. The cosmetic outcome on the head and face was superior compared with the trunk and leg (P = 0.003).

Conclusion

188Re resin is a highly effective treatment for NMSC up to 3-mm thickness and a valid alternative to surgery, specifically for tumors located on sensitive areas such as nose or ear.
hART: Deep Learning-Informed Lifespan Heart Failure Risk Trajectories
Authors: Moroz Harry , Li Yue , Marelli Ariane 
Published: September 2023

AbstractHeart failure (HF) results in persistent risk and long-term comorbidities. This is particularly true for patients with lifelong HF sequelae of cardiovascular disease such as patients with congenital heart disease (CHD). We developedhART(heart failure Attentive Risk Trajectory), a deep-learning model to predict HF trajectories in CHD patients.hARTis designed to capture the contextual relationships between medical events within a patient’s history. It is trained to predict future HF risk by using the masked self-attention mechanism that forces it to focus only on the most relevant segments of the past medical events. To demonstrate the utility ofhART, we used a large cohort containing healthcare administrative data from the Quebec CHD database (137,493 patients, 35-year follow-up).hARTachieves an area under the precision-recall of 28% for HF risk prediction, which is 33% improvement over existing methods. Patients with severe CHD lesion showed a consistently elevated predicted HF risks throughout their lifespan, and patients with genetic syndromes exhibited elevated HF risks until the age of 50. The impact of the birth condition decreases on long-term HF risk. The timing of interventions such as arrhythmia surgery had varying impacts on the lifespan HF risk among the individuals. Arrhythmic surgery performed at a younger age had minimal long-term effects on HF risk, while surgeries during adulthood had a significant lasting impact. Together, we show thathARTcan detect meaningful lifelong HF risk in CHD patients by capturing both long and short-range dependencies in their past medical events. Our code is available athttps://github.com/li-lab-mcgill/hART-heart-failure-Attentive-Risk-Trajectory.
ChatGPT 4 Versus ChatGPT 3.5 on The Final FRCR Part A Sample Questions. Assessing Performance and Accuracy of Explanations
Authors: Ghosn Youssef , Sardouk Omar El , Jabbour Yara , Jrad Manal , Kamareddine Mohammed Hussein , Abbas Nada , Saade Charbel , Ghanem Alain Abi 
Published: September 2023

AbstractObjectiveTo evaluate the performance of two versions of ChatGPT, GPT4 and GPT3.5, on the Final FRCR (Part A) also referred to as FRCR Part 2A radiology exam. The primary objective is to assess whether these large language models (LLMs) can effectively answer radiology test questions while providing accurate explanations for the answers.MethodsThe evaluation involves a total of 281 multiple choice questions, combining the 41 FRCR sample questions found on The Royal Collage of Radiologists website and 240 questions from a supplementary test bank. Both GPT4 and GPT3.5 were given the 281 questions with the answer choices, and their responses were assessed for correctness and accuracy of the explanations provided. The 41 FRCR sample questions difficulty was ranked into “low order” and “high order” questions. A significance level of p<0.05 was used.ResultsGPT4 demonstrated significant improvement over GPT3.5 in answering the 281 questions, achieving 76.5% correct answers compared to 52.7%, respectively (p<0.001). GPT4 demonstrated significant improvement over GPT3.5 in providing accurate explanations for the 41 FRCR sample questions, with an accuracy of 65.9% and 31.7% respectively (p=0.002). The difficulty of the question did not significantly affect the models’ performances.ConclusionThe findings of this study demonstrate a significant improvement in the performance of GPT4 compared to GPT3.5 on FRCR style examination. However, the accuracy of the provided explanations might limit the models’ reliability as learning tools.Advances in KnowledgeThe study indirectly explores the potential of LLMs to contribute to the diagnostic accuracy and efficiency of medical imaging while raising questions about the current LLMs limitations in providing reliable explanations for radiology related questions hindering its uses for learning and in clinical practice.HighlightsChatGPT4 passed an FRCR part 2A style exam while ChatGPT3.5 did not.ChatGPT4 showed significantly higher correctness of answers and accuracy of explanations.No significant difference in performance was observed between “high order” and “lower order” questions.Explanation accuracy was lower than correct answers rate limiting the Models’ reliability aslearning tools.
Design, conduct, analysis, and reporting of therapeutic efficacy studies in Visceral Leishmaniasis: A systematic review of published reports, 2000-2021
Authors: Dahal Prabin , Singh-Phulgenda Sauman , Naylor Caitlin , Brack Matthew , Chatterjee Mitali , Alves Fabiana , Guerin Philippe J , Stepniewska Kasia 
Published: September 2023

AbstractA systematic review (SR) of published efficacy studies in visceral leishmaniasis (VL) was carried out to describe methodological aspect of design, analysis, conduct and reporting. Studies published during 2000-2021 and indexed in the Infectious Diseases Data Observatory (IDDO) VL library of clinical studies were eligible for inclusion (n=89 studies). The IDDO VL library is a living SR of prospective therapeutic studies (PROSPERO: CRD42021284622) and is updated bi-annually. A total of 40 (44.9%) studies were randomised, 33 (37.1%) were single-armed, 14 (15.7%) were non-randomised multi-armed studies, and randomisation was unclear in 2 (2.2%). After initial screening, patients were enrolled into the study upon confirmation of VL using parasitological method in 26 (29.2%), and serological and parasitological method in 63 (70.8%). Post-treatment follow-up duration was <6months in 3 (3.3%) studies, 6-months in 75 (84.3%), and >6months in 11 (12.4%) studies. Relapse was defined solely based on clinical suspicion in 4 (4.5%) studies, parasitological demonstration in 64 (71.9%), using molecular/serological/parasitological in 6 (6.7%), and was unclear in 15 (16.9%). Quality control of laboratory measures adopted was unclear in 66 (74.2%) studies, sample size calculation was reported in only 34 (38.2%) studies, and cured proportion was presented only as a point estimate in 39 (43.8%) studies. This review highlights substantial variations in definitions adopted for patient screening, disease diagnosis and therapeutic outcomes suggesting an urgent need for harmonisation of VL clinical trials protocol.