bluuebunny/crossref_metadata_2025_split huggingface dataset:
Troponoid Compounds as Therapeutic Agents and as Targets and Templates for Chemical Synthesis
Authors: Banwell Martin G. , Tan Shen , Chen Qi , Lan Ping 
Published: August 2022

AbstractThe renewed interest in troponoid compounds as potential therapeutic agents and the ongoing discovery of new, naturally occurring and biologically active members of the class has resulted in an attendant focus on developing and deploying methods for their synthesis. This account highlights some of the significant recent developments in the area of troponoid chemistry that serve to contextualize our group’s longstanding and ongoing interest in the synthesis of such compounds through the cyclopropane-mediated ring-expansion of cyclohexanoid and benzenoid compounds. The various means by which such conversions can be accomplished and their application to the synthesis of both natural and non-natural troponoids are detailed.1	Introduction2	Naturally Occurring Troponoid Compounds and Their Biogenesis3	Medicinal Chemistry Aspects of Troponoid Compounds4	Troponoids in Materials Science5	Troponoids as Scaffolds in Chemical Synthesis6	An Overview of the Methods Available for Preparing Troponoids7	Cyclopropane-Mediated Ring-Expansion Reactions Leading to Troponoids8	Conclusions
Levels, Trends, and Risk Factors for Stillbirths in the United States: 2000–2017
Authors: Wolfson Carrie , Qian Jiage , Creanga Andreea A. 
Published: August 2022

Objective This study documents 2000 to 2017 trends in stillbirth rates and changes in associations between known maternal and fetal risk factors and stillbirths for 2000 to 2002 versus 2015 to 2017 in the United States.
Study Design We conducted a retrospective, population-based analysis of stillbirths and live-births using national vital statistics data. We calculated annual stillbirth rates overall and by gestational age; and examined stillbirth rates by maternal age, race-ethnicity, and state for 2000 to 2002 versus 2015 to 2017. We used Chi-squared tests to examine associations between maternal and fetal risk factors separately for early (20–27 weeks) and late (28+ weeks) stillbirths compared with live-births for 2000 to 2002 versus 2015 to 2017.
Results Stillbirth rates declined by 7.5% (p < 0.001) during 2000 to 2006 but remained flat at approximately 6 stillbirths per 1,000 births thereafter. Throughout 2000 to 2017, there were significant improvements in stillbirth rates at 39+ weeks nationally (p < 0.001), but rates varied greatly between and within states. Sociodemographic (advanced maternal age, Black race, low education, unmarried status, and rural residence), obstetric, and other medical factors (>3 births, use of infertility treatment, maternal obesity, diabetes, chronic hypertension, eclampsia, no prenatal care, and tobacco use) were significantly more prevalent in women with late than early stillbirths or live births. Notably, late and total stillbirth rates were approximately 30% higher for women >35 years than for women <35 years and twice as high for non-Hispanic Black than non-Hispanic White women; American Indian/Alaska Native women represented the only racial-ethnic group with significantly higher late stillbirth rates in 2015 to 2017 than in 2000 to 2002. Pregnancy and fetal factors (multiple pregnancy, male fetus, and breech presentation) were more prevalent in women with early than late stillbirths or live births.
Conclusion U.S. stillbirth rates have plateaued since 2006. There are persistent differential risk profiles for early versus late stillbirths which can inform stillbirth prevention strategies (e.g., close observation of women with risk factors for stillbirth) and new research into the causes of stillbirths by gestational age.
Key Points
An Electronic Medical Record Intervention to Increase Early Screening Rates for Gestational Diabetes
Authors: Jagannatham Shobha , Lozano Melissa , Brustman Lois 
Published: August 2022

Objectives Our objective was to implement an electronic medical record reminder to perform the early gestational diabetes mellitus (GDM) screening test and to evaluate if this intervention increased screening rates.
Study Design We performed a retrospective chart review of all deliveries at Mount Sinai West in January 2020 to determine the number of patients that met criteria for and actually underwent early GDM screening. A total of 314 patients had complete charts with pregnancy data. The following American College of Obstetricians and Gynecologists (ACOG)-defined risk factors were collected: body mass index greater than 25 (Asians greater than 23), history of GDM, history of macrosomia, hypertension (systolic >140 or diastolic >90), polycystic ovarian syndrome, hemoglobin A1c above 5.7, cardiovascular disease, and family history of diabetes. We used this data to advocate for and design an electronic medical record-based intervention to remind obstetric providers to complete the early glucose challenge test screening for eligible patients at the first prenatal visit.
Results Our investigation confirms there is a low adherence rate of 12% at our facility to ACOG's updated early GDM screening guidelines (12 out of 97 patients). Furthermore, nearly one-fifth (16 out of 85) of eligible patients who did not receive screening were eventually diagnosed with GDM by screening at 24 to 28 weeks. After implementing an electronic medical record reminder at the initial prenatal visit, screening rates more than doubled to 28% (33 out of 115 eligible patients). The most common diabetic risk factors were high-risk ethnic background, current hypertension, family history of diabetes, history of polycystic ovarian syndrome, and body mass index of 40 or greater.
Conclusion Our data suggests that obstetricians could be missing an opportunity to improve maternal and neonatal outcomes by diagnosing GDM earlier in pregnancy, as recommended by ACOG. The adoption of an electronic medical record reminder seems to improve the rate of indicated early GDM screening.
Key Points
Experiences and Outcomes in Olfactory Neuroblastoma Over A Decade at a Tertiary Cancer Center
Authors: Korra Himabindu , Gandi Joseph Benjamin , Nanuvala Prathyusha , Ardha Aarathi 
Published: August 2022

Abstract
Background Olfactory neuroblastoma is a rare epithelial malignancy arising from the odorant receptors in the nasal mucosa or along the cribriform plate of the ethmoid bone. Clinical presentation includes nasal stuffiness, local pain, epistaxis, anosmia, visual impairment, proptosis, headache, and seizures. Radiologic imaging with CT or MRI, an ophthalmic evaluation, and histopathologic confirmation with immunohistochemistry are parts of the initial diagnostic workup. Although surgery, chemotherapy, and radiation have an equally important role in the management, earlier stages may preferably be treated with surgery or radiotherapy and the later stages with a multimodality approach.
Materials and Methods We conducted a retrospective review of 13 patients diagnosed with olfactory neuroblastoma, registered at Mehdi Nawaz Jung Regional Cancer Center over a decade (2010–2019). We analyzed the age and sex distribution, performance status at presentation, clinical symptomatology, and the Kadish stage. In addition, the therapeutic aspects of patients were studied.
Results The most common presentation noted was nasal stuffiness, followed by epistaxis and proptosis. The majority of patients had good performance status at presentation. Ten patients presented with a Kadish stage C, while the remaining patients presented with Kadish stage B. Cervical nodal metastasis was seen in three patients, four patients received multimodality treatment with neoadjuvant chemoradiotherapy followed by surgery, two patients received neoadjuvant chemotherapy followed by radiation, two patients received only surgery, and one patient received surgery followed by adjuvant radiation. Conformal radiation techniques were used to deliver doses as high as 50 to 66 Gy in 2 Gy per fraction. Two patients presented with distant metastasis during follow-up, one with bone metastasis, and the other with retroperitoneal nodal metastasis; they received palliative chemotherapy and conformal radiation to the primary site.
Conclusion This study concludes that neoadjuvant chemotherapy followed by radiation gives the best outcomes. It has been observed that in multi-modality treatment, radiotherapy played a significant role in improving overall survival and better outcomes. Multidisciplinary discussions provide a better sequencing of management.
Growing Teratoma Syndrome—A Clinicoradiological Series
Authors: Prineethi Sheena , Irodi Aparna , Eapen Anu , Milton Sharon , Joel Anjana 
Published: August 2022

Abstract
Context Growing teratoma syndrome (GTS) is a rare entity seen following chemotherapy for metastatic nonseminomatous germ cell tumors, characterized by increase in size of the metastatic deposits, with normal serum tumor markers.
Aims In this article, we aim to describe the various clinicoradiological presentations of GTS treated at our center.
Design All patients who satisfied the GTS criteria from 2001 to 2019 were included. Characteristic imaging appearances along with sites of primary lesion and metastatic disease, stage and risk stratification at diagnosis, details of chemotherapy, details of surgical treatment and histopathology, levels of tumor markers, serum β-human chorionic gonadotropin, lactate dehydrogenase, and alpha fetoprotein levels at baseline and at the end of all chemotherapy were analyzed.
Results The significant radiological findings observed were an increase in the fat and cystic components and appearance of coarse calcifications within the lesions. Majority of the cases were male patients (87.5%) with testicular primaries and GTS transformation in nodal metastases being the most common occurrence (75%). All eight cases (100%) showed an increase in size and cystic component, whereas four out of eight cases (50%) had presence of internal septations and internal calcification.
Conclusion Early recognition of this entity and clinical decision making through serial radiological imaging are of utmost importance as these growing deposits are resistant to chemotherapy and radiotherapy, with complete surgical excision being the only curative and definitive treatment option.
Complete Colonic Duplication and Perineal Fistula: Transanal Mucosectomy of the Ectopic Rectum
Authors: Duess Johannes W. , Zimmermann Peter , Hirsch Franz W. , Graefe Daniel , Lacher Martin , Gosemann Jan-Hendrik 
Published: August 2022

Abstract
Background Colonic duplication may present in different anatomic variants. The surgical approach towards these anomalies can be challenging and has implications for subsequent future continence.
Case Description We report on a 1-year-old girl with congenital heart defect and pacemaker who was referred to us with an anorectal malformation. The patient was stooling from both an anus and a perineal fistula. Examination under anesthesia revealed an orthotopic and age-appropriate sized anus with surrounding sphincter and a second rectal lumen ending as a perineal fistula. A computed tomography and contrast enema indicated colonic duplication. Exploratory laparotomy showed a duplicated terminal ileum leading to two ceca and appendices, which joined to a duplicated colon with a septum and common mesentery. At the rectosigmoid junction, one part of the duplication ended as a perineal fistula, the second one led to the (orthotope) anus. The common colonic wall was divided using a stapler. The rectal duplication leading to the perineal fistula was not completely resected but treated by mucosectomy only (Soave plane) leaving its muscular cuff in place. Finally, an ileostomy was created. The postoperative course was uneventful. A contrast enema prior to ostomy takedown demonstrated a well-configurated colon and rectum without stenosis or impaction. The girl is currently continent with a complete resolution of her constipation.
Conclusion In cases of complete colonic duplication division of the common wall is simple and safe. Mucosectomy of the ectopic rectum limits pelvic dissection and preserves the entire muscular wall of the duplicated orthotope rectum.
Appropriate Method of TIBC Estimation in Reference to Serum Transferrin Levels
Authors: Mahant Hardik , Jain Shilpa , Patel Arpita , Lapani Bhumi 
Published: August 2022

Abstract
Background The currently available various methods of estimation of total iron binding capacity (TIBC) show marked variation in reference range. Although serum transferrin (TF) level is a sensitive indicator of iron status, its measurement requires immunoassay equipment which may not be available in many routine biochemistry laboratories. So, this study was planned to find the most appropriate method to estimate TIBC.
Objectives This study aimed to compare different methods of TIBC estimation and to corelate the TIBC values obtained by different methods with serum TF concentration.
Material and Methods This analytical cross-sectional study was performed in the clinical chemistry laboratory of the Biochemistry Department of Medical College Baroda & SSG Hospital, Vadodara, Gujarat, on 250 leftover serum samples destined to be discarded. In all these samples, serum TIBC was estimated by direct method, indirect method, as well as calculated method (iron + unsaturated iron binding capacity [UIBC]) along with the measurement of serum TF level.
Statistical Analysis Among the different methods, repeated analysis of variance (ANOVA) analysis and Bland–Altman plot were used to find out significance of difference. Correlation coefficients were found between different methods of TIBC estimation and serum TF levels.
Results The means of TIBC by calculated, indirect, and direct methods were 344.51, 342.23, and 378.24 µg/dL, respectively. The mean of serum TF was 295.3 mg/dL. There was statistically significant difference between TIBC by direct and indirect methods and between direct and calculated methods. There was a strong positive correlation between TIBC by direct method and serum TF (r = 0.888, p < 0.0001), but there was moderate correlation between TIBC by indirect method and serum TF (r = 0.748, p < 0.04), and between TIBC by calculated method and serum TF (r = 0.725, p < 0.05).
Conclusion Among different methods of estimation of TIBC, direct method is more reliable in reference to serum TF levels.
Bland Urine Sediment in a Child with Acute Kidney Injury
Authors: Kundavaram Rajkumar , Sharma Tanya , Joshi Deepti , Kumar Amber , Malik Shikha , Bhatt Girish C. 
Published: August 2022

AbstractTubulointerstitial nephritis (TIN) or acute interstitial nephritis (AIN) is a renal lesion characterized by inflammatory infiltrate limited to the renal interstitium and tubules. Three-fourths of the cases are drug induced, other causes being systemic and autoimmune diseases, and infections. Various drugs have been implicated, the most common being antibiotics such as β-lactams. Cephalosporins causing AIN have been reported uncommonly, particularly in children. Although renal biopsy confirms the diagnosis, urinalysis provides pertinent diagnostic clues against the backdrop of the clinico-laboratory profile. The presence of white blood cells, white cell casts, and red blood cells in urine sediment have been described in literature. However, a relatively normal urinalysis may be present in some cases and may pose a diagnostic challenge. We present a case of ceftriaxone-induced AIN in a child with bland urine sediment at initial presentation. To the best of our knowledge, this is the first report of ceftriaxone-induced AIN in the pediatric age group.
A Rare Case of Colonic Triplication with Associated Imperforate Anus in a Newborn Male
Authors: McKenna Elise , Ho Christina , Badillo Andrea , Villalona Gustavo , Levitt Marc A. 
Published: August 2022

AbstractWe present a case of a newborn male with imperforate anus who was found to have colonic triplication with a high rectovesical fistula. The case is presented with a focus on surgical strategies for the management of this rare malformation.
Graft and Patient Outcomes of Kidney Transplant Tourism: A Single-Center Experience
Authors: Altheaby Abdulrahman , Owaidah Kenana , Alotaibi Aljowharah , Salem Rahaf , Algain Rihaf , Alotaibi Areij , Alnasrullah Ahmad , Shaheen Mohammed F. , Tawhari Mohammed , Abdulgadir Mohamad 
Published: August 2022

Abstract
Background The supply-demand mismatch between organ donor and patient waiting for transplant has led to the growth of transplant tourism. This type of transplant is considered unethical and illegal, as it is usually performed in poor environments and carries a higher risk of infectious, vascular, and immunological complications.
Methods In this single-centered retrospective cohort study, we compared patients who underwent transplant tourism to patients who were transplanted locally and followed up in our hospital from January 2015 to December 2018.
Result A total of 254 local transplants and 60 patients from the transplant tourism group were included. Transplant tourism recipients were younger otherwise both groups were similar in gender, body mass index, diabetes, and hypertension. Recipients in the transplant tourism group had a significantly higher rate of delayed graft function (18.3% vs. 6.3%, p 0.005), acute rejection (40% vs. 7.9%, p < 0.001), and higher posttransplant infection in general. With more urological complications and higher graft failure at 3-years' follow-up (11.7% vs. 0.8%, p < 0.001).
Conclusion Transplant tourism is associated with a higher risk of infection and poor graft outcomes. Extra efforts are required to cut down transplant tourism by educating patients about its clinical risk and ethical considerations. In addition, measures to increase the number of deceased donor pool to provide a better alternative options for patients are essential.
Radiological Features of Zollinger–Ellison Syndrome: A Report of Two Cases
Authors: Pratap Thara , Jalal Muhammed Jasim Abdul , Jacob Dhanya , Mahadevan Pushpa , Nair Seethal S. , Raja Senthil 
Published: August 2022

AbstractHypersecretion of gastrin from duodenal or pancreatic gastrinomas results in a rare clinical entity called Zollinger–Ellison syndrome (ZES). It mostly presents with abdominal pain and diarrhea. ZES may be sporadic or occur in association with multiple endocrine neoplasia type 1. Usually, ZES manifests between 20 and 50 years.We report two cases of patients who presented with abdominal pain, vomiting, watery diarrhea, and significant weight loss.
Comparison of the Sensitivity of 68Ga-DOTATATE PET/CT with Other Imaging Modalities in Detecting Head and Neck Paraganglioma: Experience from Western India
Authors: Dodamani Manjunath Havalappa , Jaiswal Sanjeet Kumar , Sarathi Vijaya , Marfatia Hetal , D'Cruz Anil , Malhotra Gaurav , Hira Priya , Patil Virendra A. , Lila Anurag R. , Shah Nalini S. , Bandgar Tushar R. 
Published: August 2022

Abstract
Background This study aimed to compare the sensitivity of 68Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) with other imaging modalities in the detection of head and neck paraganglioma (HNPGL).
Methods The data of consecutive HNPGL patients (n = 34) who had undergone at least 68Ga-DOTATATE PET/CT and anatomical imaging (contrast-enhanced computed tomography/magnetic resonance imaging [CECT/MRI]) were retrospectively reviewed. The diagnosis of HNPGL (the primary tumor) was confirmed either by histopathology (n = 10) or was based on clinical follow-up and correlation of anatomical with functional imaging in whom histopathology was not available (n = 24). The sensitivities of 68Ga DOTATATE PET/CT, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT), 131I-metaiodobenzylguanidine (131I-MIBG) scintigraphy, and CECT/MRI for primary HNPGL, associated primary pheochromocytoma + sympathetic paraganglioma (PCC + sPGL), and metastatic lesions were analyzed.
Results Thirty-four patients (males: 15) [isolated HNPGL: 26, HNPGL + PCC: 04, HNPGL+ sPGL: 03, HNPGL + PCC + sPGL: 01] harboring 50 primary lesions were included. For total lesions, 68Ga-DOTATATE PET/CT (99.3%) had significantly higher lesion-wise sensitivity than 18F-FDG PET/CT (81.6%, p = 0.0164), 131I-MIBG (15.2%, p ≤0.0001), CECT (46.3%, p ≤ 0.0001) but similar sensitivity as MRI neck (97%, p = 0.79). On head-to-head comparison (21 primary HNPGL and 39 metastatic lesions), 68Ga DOTATATE PET/CT had significantly higher lesion-wise sensitivities for the detection of metastatic (100 vs. 71.9%, p = 0.04) and total lesions (100 vs. 77.2%, p ≤ 0.0001).
Conclusion 68Ga-DOTATATE PET/CT was the most sensitive imaging modality for the detection of HNPGL and related lesions with significantly higher lesion-wise sensitivities than those of 18F-FDG PET/CT, 131I-MIBG, and CECT.
Look Out for Fever: Clinical Profile of Dengue in Young Adults in a Tertiary Care Center in North India
Authors: Kaur Gursheen , Kumar Vipin , Puri Sandeep , Tyagi Ruchita , Singh Ashwajit , Kaur Harpreet 
Published: August 2022

Abstract
Background Dengue fever (DF) is a common viral disease, clinical manifestations of which vary from influenza-like illness (DF) to life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The aim of this article was to study the clinical profile of DF in young adults.
Material and Methods This was an observational study conducted in the department of medicine over a period of 2 years (January 1, 2013—December 31, 2014). Patients aged between 18 and 30 years with serology proven (nonstructural protein 1 [NS1]/dengue immunoglobulin M [IgM]) DF were included in this study. The clinical and laboratory data was recorded and analyzed.
Results Out of 418 cases, the incidence of DF, DHF, and DSS was 87.32, 7.66, and 5.02%, respectively. The most common presentations were fever (99.76%) followed by vomiting (29.43%), pain abdomen (17.94%), myalgias (13.16%), petechial rash (12.92%), and bleeding (10.29%). Dengue NS1 and IgM antibodies were positive in 87.3% and 88.12% of the patients, respectively. Ascites, splenomegaly, hepatomegaly, pleural effusion, gall bladder wall edema, and pericardial effusion were present in 8.13, 6.94, 6.70, 5.98, 2.63, and 0.72% of the patients, respectively. Complications included bleeding (10.29%), acute respiratory distress syndrome (1.67%), myocarditis (1.44%), seizures (1.44%), hemarthrosis (0.24%), and encephalopathy (0.24%). The mortality rate was 3.35% with death of 14 patients. Shock, bleeding, and elevated serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase levels predicted adverse outcome.
Conclusion DF can present with a plethora of clinical manifestations in endemic areas. Adverse outcome is more likely if patients have elevated SGOT levels, shock, and bleeding. Continuous seroepidemiological surveillance is essential to control outbreak and minimize morbidity and mortality.