bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is there a correlation between preoperative neutrophil-to-lymphocyte, platelet-to-lymphocyte, and lymphocyte-to-monocyte ratios and postoperative pain in video-assisted thoracoscopic surgery?
Authors: Ülger Gülay , Baldemir Ramazan , Zengin Musa , Sazak Hilal , Alagöz Ali 
Published: May 2022

Abstract
Many thoracic surgery procedures are now performed with video-assisted thoracoscopic surgery (VATS). Postoperative pain is a common condition in patients undergoing VATS. In this study, we aimed to investigate whether neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are effective in evaluating postoperative pain in patients undergoing VATS.
This prospective observational study was performed between March 2021 and September 2021 at a tertiary thoracic surgery center. The study included patients who had undergone elective VATS. Preoperative and postoperative NLR, PLR, LMR, hemogram values and postoperative visual analog scale (VAS) were recorded.
A total of 105 patients were analyzed. A positive correlation was observed between postoperative monocyte, neutrophils and VAS resting and VAS cough levels in the early postoperative period. No significant correlation was found between preoperative and postoperative NLR, PLR, and LMR values and VAS rest and VAS cough values. When compared to the preoperative period, a negative correlation was found between the change in the postoperative LMR value and the VAS rest and VAS cough values in the early postoperative period.
When compared to the preoperative period, the change in postoperative neutrophil, postoperative monocytes, and postoperative LMR values in patients undergoing VATS in thoracic surgery can be used as a guide in the objective evaluation of postoperative acute pain. It is the belief of the researchers that comprehensive new studies on this subject will contribute significantly to the determination of objective criteria in postoperative pain evaluation.
Supportive management of patients with pheochromocytoma/paraganglioma undergoing noninvasive treatment
Authors: Talvacchio Sara , Nazari Matthew A. , Pacak Karel 
Published: May 2022

Purpose of review
Many publications review perioperative management of pheochromocytomas/paragangliomas (PPGLs); however, a large population, including 10–20% of metastatic PPGL patients, have inoperable disease. This has necessitated the development of noninvasive treatments (e.g., radio/chemotherapy), which, in affording disease-modification, have led to an ever-growing population of surviving patients with inoperable PPGL. These patients experience debilitating symptoms arising from discomforts related to the masses themselves (e.g., pain from osseous metastasis) and symptoms from tumoral catecholamine production and release. Unfortunately, management of these conditions is not yet well-defined. Adding further insult-to-injury, these noninvasive treatments can trigger catecholamine release, worsening catecholamine-induced symptoms. Herein, we detail these ailments and their management, especially while patients receive these noninvasive treatments.

Recent findings
Improved diagnostic evaluations have allowed for earlier detection of PPGL, prolonging survival in patients with inoperable PPGLs. Accordingly, noninvasive treatment strategies have rapidly evolved alongside state-of- the-art theranostics and genetic testing, which inform ongoing management and therapeutic response.

Summary
While treatments afford improved survival, there must be a corresponding attention to quality-of-life. This is ensured by employing supportive management, which mitigates debilitating symptoms. This is best accomplished with a multidisciplinary approach and familiarity with genetic and biochemical determinants which guide patient education and management.
The uncommon forms of congenital adrenal hyperplasia
Authors: Auchus Richard J. 
Published: May 2022

Purpose of review
Clinicians recognize 21-hydroxylase deficiency as the most common form of congenital adrenal hyperplasia (CAH), and many papers have been published on this condition. In contrast, much less awareness has been addressed to the other, rare forms of CAH.

Recent findings
The second most common form of CAH varies with country and ethnic background. In Brazil, 17-hydroxylase/17,20-lyase deficiency is the second most common, whereas 11-hydroxylase deficiency is most common in the Middle East. In Japan and Korea, both congenital lipoid adrenal hyperplasia and P450-oxidoreductase deficiency are more common than in the rest of the world. Finally, 3β-hydroxysteroid dehydrogenase/isomerase deficiency is rare worldwide, but pockets of affected populations, such as the Amish in Lancaster County, Pennsylvania are found. The treatment of each form varies by both the nature of steroids produced in excess above the enzymatic block and the deficiencies of steroids other than cortisol past these blocks.

Summary
This article summarizes the pathophysiology, diagnosis, and management of rare forms of CAH.
The role for long-term use of dehydroepiandrosterone in adrenal insufficiency
Authors: Bennett Gillian , Cussen Leanne , O’Reilly Michael W. 
Published: May 2022

Purpose of review
Dehydroepiandrosterone (DHEA) is an androgen produced by the zona reticularis of the adrenal gland. Patients with adrenal insufficiency will have a deficiency of DHEA. Unlike glucocorticoid and mineralocorticoid replacement, DHEA supplementation is not considered essential for life and is therefore not routinely replaced in adrenal failure. DHEA deficiency is associated with morbidity, including adverse impacts on metabolic function, quality of life and sexuality in multiple studies. The role for replacement, however, remains unclear.

Recent findings
The benefits of DHEA supplementation have been definitively demonstrated in a number of historical studies of patients with primary and secondary adrenal insufficiency. Beneficial impacts on quality of life, body composition, bone health and metabolic markers have been demonstrated. However, published data are inconsistent; controversies persist around the exact role of DHEA replacement and around which patient cohorts are most likely to benefit. There is also a paucity of recent randomized controlled trials in the medical literature to inform on optimal dose and duration of DHEA replacement in adrenal failure.

Summary
Here, we review the evidence for DHEA supplementation in patients with adrenal insufficiency. We highlight knowledge gaps in the medical literature and areas that should be prioritized for future research endeavours.
An Independent Seizure-Onset Zone in Medial Temporal Lobe Found by 18F-FDG PET Imaging Besides Epileptogenic Periventricular Nodular Heterotopia
Authors: Guo Ruijie , Jin Liri , Dou Wanchen , Liu Linwen , Cui Ruixue 
Published: May 2022

Abstract
A 23-year-old man with drug-resistant epilepsy was admitted for presurgical evaluation. The epileptogenic zone could not be derived from seizure semiology and scalp electroencephalographic monitoring definitely. MRI showed periventricular nodular heterotopia in occipital horn of left lateral ventricle with high FDG uptake on interictal 18F-FDG PET scan, whereas the hypometabolic zone in the left medial temporal lobe was also found on PET with no abnormality on MRI. Stereoelectroencephalographic implantation was performed to identify the seizure-onset zone. Two independent epileptogenic foci located in periventricular nodular heterotopia and left hippocampus were validated by stereoelectroencephalographic monitoring and the outcome of subsequent thermocoagulation.
Lipid-Poor Renal Angiomyolipoma Mimicking Renal Cell Carcinoma on 68Ga-FAPI-04 PET/CT
Authors: Dong Aisheng , Yang Qing , Hua Meimian , Cheng Chao , Zuo Changjing 
Published: May 2022

Abstract
FAPI PET/CT findings of renal tumors have been rarely reported. We describe 68Ga-FAPI-04 PET/CT findings in 1 case with lipid-poor renal angiomyolipoma and 1 case with high-grade clear cell renal cell carcinoma. Both tumors showed intense 68Ga-FAPI-04 uptake. These 2 cases indicate that lipid-poor renal angiomyolipoma should be included in the differential diagnosis of FAPI-avid renal tumors.
FDG PET/CT in a Case With Cellular Schwannoma of the Kidney
Authors: Yu Zhongfei , Zhang Jian , Dong Aisheng , Zhu Yuzhao 
Published: May 2022

Abstract
Schwannoma of the kidney is exceedingly rare. We describe contrast-enhanced CT and FDG PET/CT findings in a case with renal cellular schwannoma. Contrast-enhanced CT showed the enhancing tumor was located in the anterior middle portion of the left kidney, encasing the renal vessels and compressing the renal pelvis. The tumor showed inhomogeneous FDG uptake with SUVmax of 8.6 mimicking renal cell carcinoma. This case indicates renal schwannoma should be included in the differential diagnosis of FDG-avid renal lesions.
Arachidicoccus terrestris sp. nov., isolated from greenhouse soil
Authors: Won Miyoung , Weon Hang-Yeon , Hong Seung-Beom , Han Byeong-Hak , Kwon Soon-Wo 
Published: May 2022

A Gram-stain-negative, aerobic, non-motile, rod-shaped or occasionally filamentous-shaped bacterial strain, designated 5GH13-10T, was isolated from greenhouse soil sampled in Yeoju-si, Republic of Korea. Colonies were milky-coloured, round and convex, and catalase- and oxidase-positive. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain 5GH13-10T was related to the genus

Arachidicoccus

and had highest 16S rRNA gene sequence identity with

Arachidicoccus rhizosphaerae

Vu-144T (98.4 %). The major cellular fatty acids were iso-C15 : 0, iso-C15 : 1 G, iso-C17 : 0 3-OH and summed feature 3 (C16 : 1
ω6c and/or C16 : 1
ω7c). The predominant quinone was menaquinone MK-7, and the polar lipids were composed of phosphatidylethanolamine, one unidentified aminolipid, three unidentified aminophospholipids, one unidentified phospholipid and five unidentified lipids. The genomic DNA G+C content of strain 5GH13-10T was 43.8 mol%. The average nucleotide identity values between strain 5GH13-10T and the closely related species

Arachidicoccus ginsenosidivorans

Gsoil 809T,

Arachidicoccus rhizosphaerae

Vu-144T and Archidicoccus soli KIS59-12T were 74.86, 74.74 and 69.52 %, and the digital DNA-DNA hybridization values were 20.0, 19.8 and 18.6 %, respectively. Combined phenotypic, phylogenetic and genomic data demonstrated that strain 5GH13-10T is representative of a novel species of the genus

Arachidicoccus

, for which we propose the name Arachidicoccus terrestris sp. nov. (type strain 5GH13-10T=KACC 18014T=NBRC 113162T).
Safety and feasibility of fecal microbiota transplantation for Parkinson’s disease patients: a protocol for a self-controlled interventional donor-FMT pilot study
Authors: Vendrik Karuna E.W. , Bekker-Chernova Vlada O. , Kuijper Ed J. , Terveer Elisabeth M. , van Hilten Jacobus J. , Contarino Maria Fiorella 
Published: May 2022

AbstractSeveral experimental studies suggest a role of the gut microbiota in the pathophysiology of Parkinson’s disease (PD) via the gut-brain axis. In addition, the gut microbiota can influence the metabolism of levodopa, which is the mainstay of treatment of PD. Therefore, modifying the gut microbiota by fecal microbiota transplantation (FMT) could be a supportive treatment strategy. We developed a study protocol for a single center, prospective, self-controlled, interventional, safety and feasibility donor-FMT pilot study with randomization and double blinded allocation of donor feces. The primary objectives are to assess feasibility and safety of FMT in PD patients. Secondary objectives are to explore whether FMT leads to alterations of motor complications and PD symptoms in the short term, determine alterations in gut microbiota composition and donor-recipient microbiota similarities and their association with PD symptoms and motor complications, assess the ease of the study protocol and examine FMT-related adverse events in PD patients. The study population will consist of 16 idiopathic PD patients that use levodopa and experience motor complications. They will receive FMT with feces from one of two selected healthy human donors. Patients will be pretreated with vancomycin and bowel lavage to increase donor feces engraftment, and domperidone to prevent nausea and regurgitation. The FMT will be performed via direct injection of the fecal suspension into the duodenum via a gastroscope. There will be six follow-up moments during three months. Blood will be drawn on three occasions. Physical examination, filling in of questionnaires and a diary, and collection of stool samples are performed at baseline and each in-person follow-up visit (except for the FMT visit). This study was approved by the Medical Ethical Committee Leiden Den Haag Delft (ref. P20.087) and is registered in the Netherlands Trial Register (NL9438). Study results will be disseminated through publication in peer-reviewed journals and international conferences.
PK-RNN-V E: A Deep Learning Model Approach to Vancomycin Therapeutic Drug Monitoring Using Electronic Health Record Data
Authors: Nigo Masayuki , Tran Hong Thoai Nga , Xie Ziqian , Feng Han , Mao Bingyu , Rasmy Laila , Miao Hongyu , Zhi Degui 
Published: May 2022

AbstractVancomycin is a commonly used antimicrobial in hospitals, and therapeutic drug monitoring (TDM) is required to optimize its efficacy and avoid toxicities. Bayesian models are currently recommended to predict the antibiotic levels. These models, however, although using carefully designed lab observations, were often developed in limited patient populations. The increasing availability of electronic health record (EHR) data offers an opportunity to develop TDM models for real-world patient populations. Here, we present a deep learning-based pharmacokinetic prediction model for vancomycin (PK-RNN-V E) using a large EHR dataset of 5,483 patients with 55,336 vancomycin administrations. PK-RNN-V E takes the patient’s real-time sparse and irregular observations and offers dynamic predictions. Our results show that RNN-PK-V E offers a root mean squared error (RMSE) of 5.39 and outperforms the traditional Bayesian model (VTDM model) with an RMSE of 6.29. We believe that PK-RNN-V E can provide a pharmacokinetic model for vancomycin and other antimicrobials that require TDM.Statement of SignificanceProblemCurrent traditional Bayesian models for vancomycin levels were tested in only a limited patient population and take limited patient-specific features. Hence, a more flexible and powerful model, such as deep-learning models, may provide significant advantages.What is Already KnownThe Bayesian models do not predict the vancomycin levels well in patient populations with unstable hemodynamic status and fluctuating kidney functions.What this Paper AddsDeep-learning based pharmacokinetic model for vancomycin (PK-RNN-V E) provided better prediction accuracy with integrating multiple patient-specific features from time sequence electronic health record data. This study proved the concept of model.
Atovaquone for Treatment of COVID-19: A Prospective Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Authors: Jain Mamta K. , Lemos James A. de , McGuire Darren K. , Ayers Colby , Eiston Jennifer L. , Sanchez Claudia L. , Kamel Dena , Meisner Jessica A. , Thomas Emilia V. , Hegde Anita A. , Mocherla Satish , Strebe Joslyn K. , Li Xilong , Williams Noelle S. , Xing Chao , Ahmed Mahmoud S. , Wang Ping , Sadek Hesham A. , Schoggins John W. 
Published: May 2022

ABSTRACTBackgroundAn in-silico screen was performed to identify FDA approved drugs that inhibit SARS-CoV-2 main protease (Mpro), followed by in vitro viral replication assays, and in vivo pharmacokinetic studies in mice. These studies identified atovaquone as a promising candidate for inhibiting viral replication.MethodsA 2-center, randomized, double-blind, placebo-controlled trial was performed among patients hospitalized with COVID-19 infection. Enrolled patients were randomized 2:1 to atovaquone 1500 mg BID versus matched placebo. Patients received standard of care treatment including remdesivir, dexamethasone, or convalescent plasma as deemed necessary by the treating team. Saliva was collected at baseline and twice per day for up to 10 days for RNA extraction for SARS-CoV-2 viral load measurement by quantitative reverse-transcriptase PCR. The primary outcome was the between group difference in log-transformed viral load (copies/mL) using a generalized linear mixed-effect models of repeated measures from all samples.ResultsOf the 61 patients enrolled; 41 received atovaquone and 19 received placebo. Overall, the population was predominately male (63%) and Hispanic (70%), with a mean age of 51 years, enrolled a mean of 5 days from symptom onset. The log10 viral load was 5.25 copies/mL vs. 4.79 copies/mL at baseline in the atovaquone vs. placebo group. Change in viral load did not differ over time between the atovaquone plus standard of care arm versus the placebo plus standard of care arm. Pharmacokinetic (PK) studies of atovaquone plasma concentration demonstrated a wide variation in atovaquone levels, with an inverse correlation between BMI and atovaquone levels, (Rho -0.45, p=0.02). In post hoc analysis, an inverse correlation was observed between atovaquone levels and viral load (Rho -0.54, p= 0.005).ConclusionIn this prospective, randomized, placebo-controlled trial, atovaquone did not demonstrate evidence of enhanced SARS-CoV-2 viral clearance compared with placebo. However, based on the observed inverse correlation between atovaquone levels and viral load, additional PK-guided studies may be warranted to examine the antiviral effect of atovaquone in COVID-19 patients.clincialtrials.gov (NCT04456153).
Real world costs and barriers to the successful implementation of rectal artesunate as pre-referral treatment for severe malaria in Sub-Saharan Africa
Authors: Lambiris Mark , Ndongala Guy , Ssempala Richard , Balogun Victor , Musiitwa Michael , Kagwire Fred , Olosunde Oluseyi , Emedo Emmanel , Luketa Sylvie , Sangare Moulaye , Buj Valentina , Delvento Giulia , Galactionova Katya , Okitawutshu Jean , Tshefu Antoinette , Omoluabi Elizabeth , Awor Phyllis , Signorell Aita , Hetzel Manuel W. , Lee Tristan T. , Brunner Nina C. , Cereghetti Nadja , Visser Theodoor , Napier Harriet G. , Burri Christian , Lengeler Christian 
Published: May 2022

AbstractBackgroundRectal artesunate (RAS), an efficacious pre-referral treatment for severe malaria in children, was deployed at scale in Uganda, Nigeria and DR Congo. In addition to distributing RAS, implementation required additional investments in crucial but neglected components in the care for severe malaria. We examined the real-world costs and barriers to RAS implementation.MethodsWe collected primary data on baseline health system gaps and subsequent RAS implementation expenditures. We calculated the equivalent annual cost of RAS implementation per child under 5 at risk of severe malaria, from a health system perspective, separating neglected routine health system components from incremental RAS introduction costs.FindingsThe largest baseline gaps were irregular health worker supervisions, inadequate referral facility worker training, and inadequate malaria commodity supplies. Health worker training and behaviour change campaigns were the largest startup costs, while supervision and supply chain management accounted for most annual routine costs. The equivalent annual costs of preparing the health system for treating severe malaria with RAS were $2.31, $2.20 and 4.15 per child at risk in Uganda, Nigeria and DRC. The incremental costs of introducing RAS, net of routine neglected components, accounted for a minority at $0.72, $0.59 and $0.94.InterpretationWhile RAS has been touted as a cost-effective pre-referral treatment for severe malaria in children, its real-world potential is limited by weak and under-financed continuums of care. Scaling up RAS or other interventions relying on community healthcare providers only makes sense alongside additional, essential health system investments sustained over the long-term.FundingUnitaid
Using the Excitation/Inhibition Ratio to Optimize the Classification of Autism and Schizophrenia
Authors: Uscătescu Lavinia Carmen , Hyatt Christopher J. , Dunn Jack , Kronbichler Martin , Calhoun Vince , Corbera Silvia , Pelphrey Kevin , Pittman Brian , Pearlson Godfrey , Assaf Michal 
Published: May 2022

AbstractThe excitation/inhibition (E/I) ratio has been shown to be imbalanced in individuals diagnosed with autism (AT) or schizophrenia (SZ), relative to neurotypically developed controls (TD). However, the degree of E/I imbalance overlap between SZ and AT has not been extensively compared. Our main objectives were (1) to quantify group differences in the E/I ratio between TD, AT, and SZ, (2) to assess the potential of the E/I ratio for differential diagnosis, and (3) to verify the replicability of our findings in a second, independently-acquired dataset. For each participant, we computed the Hurst exponent (H), an indicator of the E/I ratio, from the timecourses of 53 independent components covering the entire brain. Using Random Forest (RF), we ran a classification analysis using the largerof the two datasets (exploratory dataset; 519 TD, 200 AT, 355 SZ) to determine which of the 53 H would yield the highest performance in classifying SZ and AT. Next, taking the ten most important H from the exploratory dataset and the clinical and phenotypic information collected in the replication dataset (55 TD, 30 AT, 39 SZ), we used RF to compare classification performance using five feature sets: (a) H only; (b) Positive and Negative Syndrome Scale (PANSS) and the Autism Diagnostic Observation Schedule (ADOS) only; (c) PANSS, ADOS, Bermond–Vorst Alexithymia Questionnaire (BVAQ), Empathy Quotient (EQ), and IQ; (d) H, PANSS and ADOS; (e) H, PANSS, ADOS, BVAQ, EQ and IQ. Classification performance using H only was higher in the exploratory dataset (AUC = 84%) compared to the replication dataset (AUC = 72%). In the replication dataset, the highest classification performance was obtained when combining H with PANSS, ADOS, BVAQ, EQ and IQ (i.e., model e; AUC = 83%).