bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrathyroidal Thymic Carcinoma: A Retrospective Case Series Study
Authors: Liang Jinhui , Huang Mei , Huang Helang , Li Li , Luo Hailin , Mao Weidong , Gao Shan , Xu Haoxiang 
Published: November 2022

Objective Intrathyroidal thymic carcinoma (ITC) is a rare low-grade malignant thyroid tumor. There is neither sufficient understanding of this tumor nor its clinical treatment. This study is to explore the clinicopathological features, treatment, and prognosis of ITC and thereby provide a reference for the diagnosis and treatment of the disease. Methods The clinical, pathological, therapeutic, and prognostic data of 13 patients with ITC were retrospectively analyzed. Results The case series comprised 7 males and 6 females, with an average age of 51.9 ± 10.1 years. After surgical resection, all patients received post-operative neck radiotherapy at dosages of 60–66 Gy. Five patients with level VI lymph node metastasis additionally received 6 courses of cisplatin chemotherapy. All patients were followed-up for 21–132 months (median = 66 months), and all of them survived without recurrence or metastasis. Conclusions The diagnosis of ITC depends mainly on pathological and immunohistochemical results, particularly CD5 positive staining. Surgical resection is the preferred primary treatment modality which can be supplemented with radiotherapy and chemotherapy to reduce the risk of recurrence and metastasis.
Feasibility and performance of a combined extracorporeal assisted cardiac resuscitation and an organ donation program after uncontrolled cardiocirculatory death (Maastricht II)
Authors: Nobre de Jesus Gustavo , Neves Inês , Gouveia João , Ribeiro João 
Published: November 2022

Introduction Approximately 500.000 people in Europe sustain cardiac arrest (CA) every year, being myocardial infarction the main etiology. Interest has been raised in a new approach to refractory cardiac arrest (rCA) using extra-corporeal oxygenation (ECMO). In settings where it can be rapidly implemented, ECMO assisted resuscitation (ECPR) may be considered. Additionally, donation after circulatory death, which seeks to obtain solid organs donation from patients suffering rCA, has increased its role effectively increasing the pool of donors. Combined programs with integration of ECPR and uncontrolled donation after circulatory determination of death (uDCDD) are worldwide limited and experience integrating these two techniques is lacking. Methods We report a 24 months experience of ECPR and uDCDD kidney transplantation based on a management protocol in a university teaching hospital in the urban area of Lisbon. Results Over a period of 24 months, 58 patients were admitted to our ICU with rCA, 6 (10%) in the ECPR program and 52 (90%) in the uDCDD. Seventy-eight percent of patients were male, with an average age of 49 year-old. CA was witnessed in 83% of cases and initial rhythm was ventricular fibrillation in 20 cases (35%). 13 (25%) patients were effective organ donors. Refusal for effective donation was mainly due to prior comorbidities. Discussion The development of an integrated program for ECPR and uDCDD is feasible and requires a well-established and efficient activation program. In an era of significant organ shortage, it provides a viable option for increasing the organ donation pool, with promising results.
Preoperative ultrasound-guided bilateral thoracic erector spinae plane block within an enhanced recovery program is associated with decreased intraoperative lactate levels in cardiac surgery
Authors: Demir Aslı Z , Özgök Ayşegül , Balcı Eda , Karaca Okay G , Şimşek Erdal , Günaydin Serdar 
Published: November 2022

Introduction In the perioperative period, regional analgesia techniques may play an increasingly important role in “Enhanced Recovery After Surgery (ERAS)” programs, as they can facilitate recovery. We hypothesized that Erector Spinae Plane (ESP) block could improve regional perfusion, thereby limiting blood lactate increase. Therefore, we aimed to evaluate the effect of ESP block on intraoperative blood lactate levels in patients scheduled for elective on-pump cardiac surgery with ERAS protocol. Methods A total of 68 adult patients scheduled for on-pump cardiac surgery were included. All patients were randomized to the ESP group and the non-ESP group. Blood lactate analyses were performed at intraoperative five-time points. C-Reactive protein (CRP) values were also measured. Results Blood lactate values were significantly lower in the ESP group than in the Non-ESP group, at the end of CPB [1.78 (1.23–2.78) mmol L−1 to 2.63 (1.70–3.12) mmol L−1] and during the sternal closure period [1.78 (1.27–2.42) mmol L−1 to 2.40 (2.14–2.80) mmol L−1] ( p = 0.039, p = 0.009). In addition, CRP values were significantly lower in the ESP group in the postoperative period [0.048 (0.036–0.105) g L−1 to 0.090 (0.049–0.154) g L−1] ( p = 0.035). Conclusions This study showed that preoperative bilateral single-shot ESP block significantly reduces intraoperative final blood lactate and postoperative CRP values. We consider that these results are related to the attenuation of intraoperative hypoperfusion and the alleviation of surgery-related postoperative inflammation. ERAS programs aim to achieve the rapid recovery of patients, a decrease in inflammation, and high-quality analgesia with less opioid consumption. Therefore, our results also prove that it is easier to reach the primary goals of ERAS programs with the application of ESP block in cardiac surgery.
Tracheotomy in ventilator-dependent patients with COVID-19: a cross-sectional study of analgesia and sedative requirements
Authors: Wiemann Brianne , Mitchell Jessica , Sarangarm Preeyaporn , Miskimins Richard 
Published: November 2022

Objective During March 2020 in the United States, demand for sedatives increased by 91%, that for analgesics rose by 79%, and demand for neuromuscular blockers increased by 105%, all owing to the number of COVID-19 cases requiring invasive mechanical ventilation (MV). We hypothesize that analgesic and sedative requirements decrease following tracheotomy in this patient population. Methods In this cross-sectional study, we conducted a retrospective chart review to identify patients with COVID-19 who underwent tracheotomy (T) at an academic medical center between March 2020 and January 2021. We used a paired Student t-test to compare total oral morphine equivalents (OMEs), total lorazepam equivalents, 24-hour average dexmedetomidine dosage in μg/kg/hour, and 24-hour average propofol dosage in μg/kg/minute on days T−1 and T+2 for each patient. Results Of 50 patients, 46 required opioids before and after tracheotomy (mean decrease of 49.4 mg OMEs). Eight patients required benzodiazepine infusion (mean decrease of 45.1 mg lorazepam equivalents. Fifteen patients required dexmedetomidine infusion (mean decrease 0.34 μg/kg/hour). Seventeen patients required propofol (mean decrease 20.5 μg/kg/minute). Conclusions When appropriate personal protective equipment is available, use of tracheotomy in patients with COVID-19 who require MV may help to conserve medication supplies in times of extreme shortages.
Calretinin Staining in Anorectal Line Biopsies Accurately Distinguished Hirschsprung Disease in a Retrospective Study
Authors: Logan Suzanna J. , Yin Hong , Rogers Beverly , Arva Nicoleta , Conces Miriam R. , Cope-Yokoyama Sandy , Dehner Louis P. , Galliani Carlos , Garg Shipra , He Mai , Husain Aliya N. , Keisling Matthew , Krishnan Chandra , Puscasiu Elena , Rossi Christopher , Siddiqui Faiza , Sutton Lisa , Terry Jefferson , Thaker Ameet I. , Huang Yuan , Zhang Jie , McCracken Courtney , Rytting Heather 
Published: November 2022

Introduction: The absence of submucosal ganglion cells does not reliably distinguish Hirschsprung disease from non Hirschsprung disease in anorectal line biopsies. Calretinin staining might be helpful in these biopsies. To determine its value, we analyzed calretinin positive mucosal neurites in anorectal line biopsies. Methods: Two pediatric pathologists, without access to patient data, evaluated calretinin positive mucosal neurites in anorectal line junctional mucosa in archival rectal biopsies contributed by 17 institutions. A separate investigator compiled patient information and sent data for statistical analysis. Results: Biopsies with anorectal junctional mucosa from 115 patients were evaluated for calretinin positive mucosal neurites. 20/20 Hirschsprung disease biopsies were negative. 87/88 non Hirschsprung disease biopsies and 7/7 post pullthrough Hirschsprung disease neorectal biopsies were positive. Statistical analysis of the 108 non pullthrough biopsies yielded an accuracy of 99.1% (sensitivity 100%, specificity 98.9%). Age range was preterm to 16 years. Biopsy size was less than 1 mm to over 1 cm. Conclusions: Absence of calretinin positive mucosal neurites at the anorectal line was highly accurate in distinguishing Hirschsprung disease from non Hirschsprung disease cases in this blinded retrospective study. Calretinin staining is useful for interpreting biopsies from the physiologic hypoganglionic zone up to the anorectal line.
Morphometric and Hemodynamic Analysis of the Compressed Iliac Vein
Authors: Wang Hongyu , Jia Wei , Xi Yifeng , Li Yuan , Fan Yubo , Deng Xiaoyan , Chen Zengsheng 
Published: November 2022

Purpose: To investigate the relationship between the morphological structure and hemodynamic properties of the compressed iliac vein and explore the reason for the formation of thrombosis in the compressed iliac vein. Materials and Methods: A total of 11 patients with iliac vein compression syndrome (IVCS) were included in this study, and their iliac veins were reconstructed in 3 dimensions (3D). The morphological structures of the iliac veins (confluence angle, degree of stenosis) were analyzed based on the 3D model. Variations in the hemodynamic properties of the iliac vein were investigated at 4 typical moments in one cardiac cycle, and the relationship between the different morphological configurations and the pressure difference was investigated. Results: In the region of the compressed iliac vein, the blood flow velocity is accelerated and the pressure changes abruptly accompanied by the increase in pressure difference. Higher time averaged wall shear stress (TAWSS) and lower relative residence time (RRT) appeared in stenosis regions of compressed iliac vein, while TAWSS was low and RRT was large near the stenosis position. There was a strong positive correlation between the degree of stenosis and the pressure difference (r=0.894), and a positive correlation between the confluence angle of the iliac vein and the pressure difference (r=0.638). Conclusion: The morphological structure of the compressed iliac vein has an obvious influence on the hemodynamic surroundings; the pressure difference becomes larger when the degree of stenosis and the confluence angle increase. The iliac vein luminal areas with low TAWSS and high RRT near the compressed location can impede blood flow and lead to accumulation of blood components, which may increase the risk of thrombosis formation and should be fully considered in the treatment of IVCS.
Adverse effects of methylene blue in peripheral neurons: An in vitro electrophysiology and cell culture study
Authors: Uhelski Megan L , Johns Malcolm E , Horrmann Alec , Mohamed Sadiq , Sohail Ayesha , Khasabova Iryna A , Simone Donald A , Banik Ratan K 
Published: November 2022

Methylene blue (MB) is an effective treatment for methemoglobinemia, ifosfamide-induced encephalopathy, cyanide poisoning, and refractory vasoplegia. However, clinical case reports and preclinical studies indicate potentially neurotoxic activity of MB at certain concentrations. The exact mechanisms of MB neurotoxicity are not known, and while the effects of MB on neuronal tissue from different brain regions and myenteric ganglia have been examined, its effects on primary afferent neurons from dorsal root ganglia (DRG) have not been studied. Mouse DRG were exposed to MB (0.3–10 μM) in vitro to assess neurite outgrowth. Increasing concentrations of MB (0.3–10 μM) were associated with neurotoxicity as shown by a substantial loss of cells with neurite formation, particularly at 10 μM. In parallel experiments, cultured rat DRG neurons were treated with MB (100 μM) to examine how MB affects electrical membrane properties of small-diameter sensory neurons. MB decreased peak inward and outward current densities, decreased action potential amplitude, overshoot, afterhyperpolarization, increased action potential rise time, and decreased action potential firing in response to current stimulation. MB induced dose-dependent toxicity in peripheral neurons, in vitro. These findings are consistent with studies in brain and myenteric ganglion neurons showing increased neuronal loss and altered membrane electrical properties after MB application. Further research is needed to parse out the toxicity profile for MB to minimize damage to neuronal structures and reduce side effects in clinical settings.
Risk of prostate cancer in patients with inflammatory bowel disease: a nationwide cohort study in South Korea
Authors: Na Ji Eun , Kim Tae Jun , Lee Yeong Chan , Kim Ji Eun , Kim Eun Ran , Hong Sung Noh , Chang Dong Kyung , Kim Young-Ho 
Published: November 2022

Background: Several studies have suggested an association between inflammatory bowel disease (IBD) and the risk of prostate cancer development. However, these findings are inconsistent, and studies based on Asian populations are limited. Objectives: We compared the risk of prostate cancer according to IBD status using the Korean National Health Insurance Service database. Design: A population-based retrospective cohort of age-matched 59,044 non-IBD patients and 14,761 IBD patients between January 2009 and December 2011 was analyzed up to December 2017. Methods: The risk of prostate cancer was compared between patients with IBD and controls using the Cox proportional hazards regression model and Kaplan-Meier survival analysis. Results: During a median follow-up of 6 years, the incidence rate of prostate cancer was 264 per 100,000 person-years in non-IBD patients and 242 per 100,000 person-years in patients with IBD. IBD status was not associated with the risk of prostate cancer compared to non-IBD [adjusted hazard ratio (aHR) 0.93, 95% confidence interval (CI): 0.80–1.08, p = 0.32). The cumulative incidence of prostate cancer did not differ by IBD status (non-IBD patients versus IBD patients: log-rank p = 0.27; non-IBD patients versus ulcerative colitis versus Crohn’s disease: log-rank p = 0.42). In multivariate analysis, age was an independent risk factor for the development of prostate cancer (HR 1.03, 95% CI: 1.02–1.03, p < 0.001). Conclusion: In our population-based study, IBD status was not associated with the risk of prostate cancer.
Endoscopic submucosal dissection versus esophagectomy for t1 esophageal squamous cell carcinoma: a propensity score-matched analysis
Authors: Qian Meng , Feng Shuo , Zhou Hangcheng , Chen Lijie , Wang Song , Zhang Kaiguang 
Published: November 2022

Background: Endoscopic submucosal dissection (ESD) has been a preferred treatment option for superficial esophageal squamous cell carcinoma (SESCC). Objectives: To compare the outcomes of ESD and esophagectomy in the treatment of SESCC, especially for lesions invading muscularis mucosa or submucosa (pT1a-MM/T1b). Design: We retrospectively analyzed data from patients with SESCC who underwent ESD or esophagectomy between 2015 and 2021. Methods: After propensity score matching, overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and treatment-related events were compared between the ESD and esophagectomy groups. Furthermore, we performed a Cox regression analysis to identify factors associated with survival. Results: OS and DSS were significantly higher in the ESD group ( n = 508) than that in the esophagectomy group ( n = 466). After matching, 404 patients (202 per group) were included in the study. No significant differences were found between the ESD and esophagectomy groups in OS ( p = 0.566), RFS ( p = 0.586), and DSS ( p = 0.912). The ESD group showed less blood loss, shorter procedure duration and hospital stay, lower hospital cost, and fewer adverse events. However, a lower R0 resection rate was observed in the ESD group compared to the esophagectomy group. Subgroup analysis showed comparable survival outcomes between the two groups. In Cox regression analysis, age was the independent factor associated with OS. Conclusion: In the treatment of SESCC, ESD showed sufficient safety and advantages. Even for pT1a-MM/pT1b SESCC, ESD may be an alternative treatment to esophagectomy.
Efficacy and safety of cariprazine augmentation in patients treated with clozapine: a pilot study
Authors: Pappa Sofia , Kalniunas Arturas , Sharma Hitendra , Raza-Syed Ali , Kamal Manzar , Larkin Fintan 
Published: November 2022

Background: Cariprazine, a novel antipsychotic drug, is a partial agonist of dopamine D2/D3 receptors with preferential binding to the D3 receptor. There has been an increasing interest in cariprazine augmentation to clozapine; however, the evidence thus far has been only limited to case reports and case series. Objectives: To evaluate the efficacy and safety of the augmentation of clozapine with cariprazine in patients with sub-optimal treatment response. Methods: Demographic and clinical information of the study population were collected from the electronic records and PANSS scale administered at baseline and 3 months. Tolerability and discontinuation reasons where applicable were also recorded. Results: Ten patients (four men and six women) with a mean age of 36.5 years (range = 26–45) were included. Reasons for cariprazine initiation included inadequate treatment response, persistent negative symptoms and/or tolerability issues with clozapine or previous augmentation options. Two patients discontinued cariprazine within the first 6 weeks due to restlessness and poor response, respectively. There was a significant reduction in the median total PANSS score from baseline to 3 months (from 59 to 22.5, p < 0.05), median positive PANSS score (from 11.5 to 5.5, p < 0.05) and in the median negative PANSS score (from 15.5 to 3, p < 0.05) which correspond to a 48%, 33.8% and 65.8% mean score reduction, respectively. Conclusion: This is the first pilot study evaluating the effectiveness of clozapine augmentation. The preliminary evidence suggests that this may be a safe and effective practice in patients failing to adequately respond to or tolerate clozapine and/or previous augmentation strategies.
Kalithallite, K3Tl3+Cl6⋅2H2O, a new mineral with trivalent thallium from the Tolbachik volcano, Kamchatka, Russia
Authors: Pekov Igor V. , Krzhizhanovskaya Maria G. , Yapaskurt Vasiliy O. , Belakovskiy Dmitry I. , Sidorov Evgeny G. , Zhegunov Pavel S. 
Published: November 2022

AbstractA new mineral kalithallite, K3Tl3+Cl6⋅2H2O, was found in an active fumarole belonging to the Northern fumarole field at the First scoria cone of the Northern Breakthrough of the Great Tolbachik Fissure Eruption, Tolbachik volcano, Kamchatka, Russia. Kalithallite is a product of the relatively low-temperature (70–150°C) interactions involving high-temperature sublimate minerals, volcanic gas and atmospheric water vapour. The associated minerals are cryobostryxite, KZnCl3⋅2H2O, halite, sylvite, opal and gypsum. Kalithallite forms lamellar to tabular crystals up to 5 × 30 × 40 μm combined in open-work aggregates up to 1 mm across. It is transparent, colourless in individuals and white to pale cream coloured or pale beige in aggregates, with vitreous lustre. Dcalc = 3.01 g cm–3. Kalithallite is optically uniaxial (–), ɛ = 1.656(3) and ω = 1.662(3). The chemical composition (wt.%, electron-microprobe data, H2O calculated by stoichiometry) is: K 17.72, Zn 0.85, Tl 38.76, Cl 35.91, H2Ocalc 5.99, total 99.23. The empirical formula calculated on the basis of K+Zn+Tl+Cl = 10 apfu is K2.72Zn0.06Tl1.14Cl6.08⋅2H2O. Kalithallite is tetragonal, I4/mmm, a = 15.9333(5), c = 18.1088(7) Å, V = 4595.2(4) Å3 and Z = 14. The strongest reflections of the powder X-ray diffraction (XRD) pattern [d,Å(I)(hkl)] are: 5.98(100)(202); 5.64(36)(220); 3.984(20)(400); 3.528(30)(224); 3.315(22)(422); 2.890(15)(334); and 2.817(24)(206, 440). Kalithallite is isotypical to synthetic K3Tl3+Cl6⋅2H2O. The crystal structure was refined from the powder XRD data using the Rietveld method, RBragg = 0.55%, Rp = 0.56%, and Rwp = 0.75%. The structure contains Tl3+Cl6 octahedra and K-centred polyhedra of three types: KCl8, KCl8(H2O) and KCl7(H2O)2. The mineral is named as a kalium–thallium ordered compound.
Comparative genomics and genomic diversity of Pseudomonas syringae clade 2b-a in Australia
Authors: Djitro Noel , Roach Rebecca , Mann Rachel , Campbell Paul R. , Rodoni Brendan , Gambley Cherie 
Published: November 2022

Abstract
Background
A zucchini disease outbreak with unusual symptoms associated with Pseudomonas syringae clade 2b was identified in Bundaberg, Australia during autumn 2016. To investigate the genetic diversity of the 11 Australian isolates obtained from the outbreak, the genomes were compared to the publicly available P. syringae strains in phylogroup 2.

Results
Average nucleotide identity refined the P. syringae clade 2b-a into four clusters (Cluster A, B, C1 and C2), an expansion from the previously identified A, B and C. Australian isolates were in Cluster A, C1 and C2. Genomic analyses highlighted several key factors that may contribute to the virulence of these isolates. Six orthologous groups, including three virulence factors, were associated with P. syringae phylogroup 2 cucurbit-infecting strains. A region of genome plasticity analysis identified a type VI secretion system pathway in clade 2b-a strains which could also contribute to virulence. Pathogenicity assays on isolates KL004-k1, KFR003-1 and 77-4C, as representative isolates of Cluster A, C1 and C2, respectively, determined that all three isolates can infect pumpkin, squash, watermelon and zucchini var. Eva with different levels of disease severity. Subsequently, type III effectors were investigated and four type III effectors (avrRpt2, hopZ5, hopC1 and hopH1) were associated with host range. The hopZ effector family was also predicted to be associated with disease severity.

Conclusions
This study refined the taxonomy of the P. syringae clade 2b-a, supported the association between effector profile and pathogenicity in cucurbits established in a previous study and provides new insight into important genomic features of these strains. This study also provided a detailed and comprehensive resource for future genomic and functional studies of these strains.