bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-cell genomic and transcriptomic landscapes of primary and metastatic colorectal cancer tumors
Authors: Wang Rui , Li Jingyun , Zhou Xin , Mao Yunuo , Wang Wendong , Gao Shuai , Wang Wei , Gao Yuan , Chen Kexuan , Yu Shuntai , Wu Xinglong , Wen Lu , Ge Hao , Fu Wei , Tang Fuchou 
Published: August 2022

AbstractBackgroundColorectal cancer (CRC) ranks as the second-leading cause of cancer-related death worldwide with metastases being the main cause of cancer-related death. Here, we investigated the genomic and transcriptomic alterations in matching adjacent normal tissues, primary tumors, and metastatic tumors of CRC patients.MethodsWe performed whole genome sequencing (WGS), multi-region whole exome sequencing (WES), simultaneous single-cell RNA-Seq, and single-cell targeted cDNA Sanger sequencing on matching adjacent normal tissues, primary tumors, and metastatic tumors from 12 metastatic colorectal cancer patients (n=84 for genomes,n=81 for exomes,n=9120 for single cells). Patient-derived tumor organoids were used to estimate the anti-tumor effects of a PPAR inhibitor, and self-renewal and differentiation ability of stem cell-like tumor cells.ResultsWe found that the PPAR signaling pathway was prevalently and aberrantly activated in CRC tumors. Blocking of PPAR pathway both suppressed the growth and promoted the apoptosis of CRC organoids in vitro, indicating that aberrant activation of the PPAR signaling pathway plays a critical role in CRC tumorigenesis. Using matched samples from the same patient, distinct origins of the metastasized tumors between lymph node and liver were revealed, which was further verified by both copy number variation and mitochondrial mutation profiles at single-cell resolution. By combining single-cell RNA-Seq and single-cell point mutation identification by targeted cDNA Sanger sequencing, we revealed important phenotypic differences between cancer cells with and without critical point mutations (KRASandTP53) in the same patient in vivo at single-cell resolution.ConclusionsOur data provides deep insights into how driver mutations interfere with the transcriptomic state of cancer cells in vivo at a single-cell resolution. Our findings offer novel knowledge on metastatic mechanisms as well as potential markers and therapeutic targets for CRC diagnosis and therapy. The high-precision single-cell RNA-seq dataset of matched adjacent normal tissues, primary tumors, and metastases from CRCs may serve as a rich resource for further studies.
Ulceroglandular form of tularemia after squirrel bite: a case report
Authors: Borgschulte Hannah Sophia , Jacob Daniela , Zeeh Jörg , Scholz Holger C. , Heuner Klaus 
Published: August 2022

Abstract
Background
The diagnosis of tularemia is not often considered in Germany as the disease is still rare in this country. Nonetheless, Francisella tularensis, the causative agent of tularemia, can infect numerous animal species and should, therefore, not be neglected as a dangerous pathogen. Tularemia can lead to massively swollen lymph nodes and might even be fatal without antibiotic treatment. To our knowledge, the case described here is the first report of the disease caused by a squirrel bite in Germany.

Case presentation
A 59-year-old German woman with a past medical history of hypothyroidism and cutaneous lupus erythematosus presented at the emergency room at St. Katharinen Hospital with ongoing symptoms and a swollen right elbow persisting despite antibiotic therapy with cefuroxime for 7 days after she had been bitten (right hand) by a wild squirrel (Eurasian red squirrel). After another 7 days of therapy with piperacillin/tazobactam, laboratory analysis using real-time polymerase chain reaction (PCR) confirmed the suspected diagnosis of tularemia on day 14. After starting the recommended antibiotic treatment with ciprofloxacin, the patient recovered rapidly.

Conclusion
This is the first report of a case of tularemia caused by a squirrel bite in Germany. A naturally infected squirrel has recently been reported in Switzerland for the first time. The number of human cases of tularemia has been increasing over the last years and, therefore, tularemia should be taken into consideration as a diagnosis, especially in a patient bitten by an animal who also presents with headache, increasing pain, lymphadenitis, and fever, as well as impaired wound healing. The pathogen can easily be identified by a specific real-time PCR assay of wound swabs and/or by antibody detection, for example by enzyme-linked immunosorbent assay (ELISA), if the incident dates back longer than 2 weeks.
Undifferentiated embryonal sarcoma of liver arising within mesenchymal hamartoma in a child "case report"
Authors: Mohamed Elshaimaa M. , Zeidan Mohamed , Gazzaz Tamadir Fadel , Abdullah Nouf S. , Abolyazid Sherif Maher , Elaryan Ahmed 
Published: August 2022

AbstractBackgroundPrimary pediatric liver tumors are scarce. Undifferentiated embryonal sarcoma of the liver (UESL) embraces nine to fifteen percent of the pediatric hepatic neoplasms. Mesenchymal hamartoma of the liver (MHL) is the second most prevalent benign pediatric hepatic neoplasm following infantile hemangioendothelioma.Case presentationA 6-year-old female child presented with vague diffuse abdominal pain and palpable right lumbar mass by clinical examination. The US showed a well-circumscribed large right hepatic complex multilocular cystic lesion with multiple internal septations and some turbid loculi. The constellation of CT and dynamic MRI findings raised the presence of atypical suspicious complex cystic hepatic mass lesion with hemorrhagic, calcific entities and internal soft tissue enhancement. The histopathological correlation proved UESL on the background of MHL.ConclusionsA case of a pediatric hepatic complex cystic lesion, which had typical ultrasound features of MHL, however, CT and MRI had atypical suspicious criteria. Finally, our case is presented as UESL in the background of MHL based upon pathological diagnosis. The radiologists must be familiar with overlapped entities between MHL, UESL, and other differential diagnosis entities regarding pediatric hepatic neoplasms.
Overcoming Barriers in Neurosurgical Education: A Novel Approach to Practical Ventriculostomy Simulation
Authors: Amini Amir , Zeller Yannic , Stein Klaus-Peter , Hartmann Karl , Wartmann Thomas , Wex Cora , Mirzaee Elyas , Swiatek Vanessa M. , Saalfeld Sylvia , Haghikia Aiden , Dumitru Claudia A. , Sandalcioglu I. Erol , Neyazi Belal 
Published: August 2022

BACKGROUND:
In the high-risk, high-stakes specialty of neurosurgery, traditional teaching methods often fail to provide young residents with the proficiency needed to perform complex procedures in stressful situations, with direct effects on patient outcomes. Physical simulators provide the freedom of focused, hands-on training in a more controlled environment. However, the adoption of simulators in neurosurgical training remains a challenge because of high acquisition costs, complex production processes, and lack of realism.

OBJECTIVE:
To introduce an easily reproducible, cost-effective simulator for external ventricular drain placements through various ventriculostomy approaches with life-like tactile brain characteristics based on real patients' data.

METHODS:
Whole brain and skull reconstruction from patient's computed tomography and MRI data were achieved using freeware and a desktop 3-dimensional printer. Subsequently, a negative brain silicone mold was created. Based on neurosurgical expertise and rheological measurements of brain tissue, gelatin in various concentrations was tested to cast tactilely realistic brain simulants. A sample group of 16 neurosurgeons and medical students tested and evaluated the simulator in respect to realism, haptics, and general usage, scored on a 5-point Likert scale.

RESULTS:
We saw a rapid and significant improvement of accuracy among novice medical students. All participants deemed the simulator as highly realistic, effective, and superior to conventional training methods.

CONCLUSION:
We were able to demonstrate that building and implementing a high-fidelity simulator for one of the most important neurosurgical procedures as an effective educational and training tool is achievable in a timely manner and without extensive investments.
Efficacy and Safety of Subfascial Epidural Drainage Protocol After Intraoperative Durotomy in Posterior Thoracic and Lumbar Spine Surgery: Reoperation Prevention and Outcomes Among Drained and Undrained Cohorts
Authors: Wilson Christopher , McVeigh Luke , Williams Acacia , Acchiardo Joseph , Bradbury Jamie 
Published: August 2022

BACKGROUND:
Persistent cerebrospinal fluid (CSF) egress after durotomy in posterior thoracic or lumbar spine surgery may cause devastating complications. Persistent CSF leaks may require reoperation, which confers additional cost and morbidity.

OBJECTIVE:
To evaluate the efficacy of our subfascial epidural drainage protocol in the setting of durotomy to prevent reoperation.

METHODS:
A retrospective cohort study of drained and undrained cohorts was completed to identify factors associated with reoperation for persistent CSF leak-related symptoms. The efficacy and safety of this 7-day subfascial epidural drainage protocol was assessed by comparing reoperation incidence, perioperative complications, rehabilitation necessity, and readmissions.

RESULTS:
In total, 156 patients underwent subfascial epidural drainage, and 14 were not drained. Subfascial drainage for up to 7 days was associated with a significantly lower incidence of reoperation than no drainage (3.3% vs 14%, respectively; P = .03). Perioperative complication incidence was similar between cohorts (12.8% vs 21.4%, respectively; P = .37), and length of stay was unchanged regardless of drainage (median 7 days). Subfascial drainage conferred a nearly 2-fold relative risk reduction in inpatient rehabilitation requirement (RR 0.55) and 3-fold relative risk reduction in 30-day (RR 0.31) and 90-day readmission (RR 0.36). Factors associated with reoperation among drained patients included drainage longer than 7 days, tobacco use, age younger than 50 years, and longer segment operations. Revision spine surgery was associated with reoperation among undrained patients.

CONCLUSION:
When followed after durotomy, our subfascial epidural drainage protocol results in fewer reoperations than in an undrained cohort without prohibitive cost and no added morbidity.
Extensive Symptomatic Thoracolumbar Epidural Lipomatosis Treated With Minimally Invasive Hemilaminectomies: Technical Case Report
Authors: Fuentes Angelica M. , Housley Steven B. , Starling Robert V. , Mullin Jeffrey P. 
Published: August 2022

BACKGROUND AND IMPORTANCE:
Spinal epidural lipomatosis is a rare condition commonly associated with chronic corticosteroid use and obesity that involves deposition of adipose tissue in the epidural space of the spinal canal. This accumulation of adipose tissue may cause compression of the spinal cord and/or nerve roots and result in compressive symptoms such as myelopathy or radiculopathy. Spinal involvement is usually confined to either the thoracic or lumbar spine but can infrequently affect both regions. Depending on pre-existing conditions, treatment options include weight loss and discontinuation of exogenous steroid use, both of which have been shown to be effective therapeutic methods. Surgical decompression may be useful for appropriately selected patients in whom conservative therapy has failed or who experience acute neurological deterioration, although this is rarely indicated.

CLINICAL PRESENTATION:
In this study, we describe a patient receiving long-term corticosteroid therapy who presented with symptomatic epidural lipomatosis that involved the thoracic and lumbar spine. She was treated with decompression by continuous T3-L5 hemilaminectomies performed through 5 small incisions of alternating laterality. After surgery, the patient experienced clinical improvement and was able to return to her baseline.

CONCLUSION:
We illustrate a successful spinal decompression of extensive epidural lipomatosis through a less-invasive surgical approach using several small incisions to accomplish uninterrupted hemilaminectomies. This alternative approach to a standard continuous incision can be considered in cases of extensive spinal epidural lipomatosis in patients with multiple medical comorbidities in whom wound healing is believed to be an issue and for whom minimizing blood loss is crucial.
Comparison of Intraoperative Indocyanine Green Videoangiography vs Postoperative Catheter Angiography to Confirm Microsurgical Occlusion of Spinal Dorsal Intradural Arteriovenous Fistulas
Authors: Karahalios Katherine , Srinivasan Visish M. , Scherschinski Lea , DiDomenico Joseph D. , Catapano Joshua S. , Safaee Michael M. , Lawton Michael T. 
Published: August 2022

BACKGROUND:
Dorsal intradural arteriovenous fistulas (DI-AVFs) represent 80% of spinal AVFs. Microsurgical clip occlusion is a durable treatment that uses preoperative and postoperative digital subtraction angiography (DSA) as standard practice. Intraoperative indocyanine green videoangiography (ICG-VA) is a valuable intraoperative adjunct in these cases. Intraoperative ICG-VA findings have not been compared with postoperative DSA findings.

OBJECTIVE:
To assess the diagnostic value of intraoperative ICG-VA vs postoperative DSA for spinal DI-AVFs.

METHODS:
A multi-institutional database of vascular malformations was queried for all surgically managed cases of DI-AVF. Patients with both intraoperative ICG-VA and postoperative DSA were included. Demographic and radiologic data, intraoperative findings, and surgical outcomes data were retrospectively analyzed.

RESULTS:
Forty-five patients with DI-AVF were identified (male sex, 32; mean age, 61.9 [range, 26-85] years). All DI-AVFs were treated with interruption of the fistula with clip occlusion of the draining vein. Intraoperative ICG-VA showed complete obliteration in all patients. Postoperative DSA was performed for 40 patients and confirmed complete obliteration in all patients. The negative predictive value of ICG-VA confirming complete occlusion of the DI-AVFs was 100%. Eighteen patients (47%) experienced clinical improvement, and 16 (42%) experienced no change in condition.

CONCLUSION:
ICG-VA is useful for intraoperative identification of DI-AVFs and confirmation of complete microsurgical occlusion. Correlation between intraoperative ICG-VA and postoperative DSA findings demonstrates the diagnostic power of ICG-VA. This finding suggests that postoperative DSA is unnecessary when intraoperative ICG-VA confirms complete occlusion of the DI-AVF, which will spare patients the procedural risk and cost of this invasive procedure.
The influence of sleep disturbances on the development of insulin resistance - a literature review
Authors: Chmura Anna , Skowrońska Katarzyna , Karaś Anna , Baciur Patrycja , Białas Filip 
Published: August 2022

Introduction and purpose of the work: Sleep is essential for the proper functioning of the body. Adequate quality and quantity of sleep affects metabolic processes, including glucose metabolism, as well as the sensitivity of tissues to insulin, the reduction of which is called insulin resistance. It leads to an increased production of glucose in order to maintain normal blood glucose levels. Insulin resistance is a modifiable risk factor of, inter alia, type 2 diabetes. The aim of this study is to summarize the current knowledge on the relationship between sleep deprivation and an increased risk of developing insulin resistance.
State of knowledge: Sleep undoubtedly has a strong influence on glucose metabolism and insulin sensitivity. Numerous studies show that even partial sleep deprivation lowers insulin sensitivity. The available literature shows that shift work and a shifted bedtime, combined with an insufficient amount of it, lead to a significant reduction in insulin sensitivity. The positive effect of increasing the time of night rest on the sensitivity of tissues to insulin may be an element of the prevention of diseases such as obesity or type 2 diabetes. Moreover, disturbances in sleep continuity lead to formation of insulin resistance. An example would be obstructive sleep apnea, the treatment of which affects metabolic processes.
Summary: Adequate sleep hygiene is an extremely important part of a healthy lifestyle. More research is needed on the relationship between sleep and the regulation of carbohydrate metabolism, due to the fact that the appropriate sleep-wake rhythm may give hope for improvement in health in people with metabolic disorders and may be an important protective factor for many diseases.
Point-of-care ultrasound of abdominal as an useful diagnostic tool for the general practitioner
Authors: Szwed Monika , Metelski Jakub , Metelska Aleksandra , Nieścior Hubert , Sereda Dominika , Piekarski Paweł 
Published: August 2022

Introduction and purpose
Ultrasonography (US) is a safe, non-invasive and widespread diagnostic tool. Point-of-care ultrasound (POCUS) is more and more often used in a general practitioner’s (GP) office as an element complementing the medical and physical examination. The aim of the study is to present ultrasonography as a useful diagnostic tool in the practice of a general practitioner (GP).
Description of the state of knowledge
Abdominal pain and gastrointestinal infections are among the most common reasons for patients visiting their GPs. A point-of-care ultrasound examination enable the shortening of the time necessary to make a diagnosis as well as the fastest possible implementation of appropriate treatment. This is especially important in acute conditions such as cholecystitis, cholelithiasis, appendicitis or renal colic.Patients who underwent ultrasound examination during their GP visit gave them a better understanding of their health problem, increased their sense of securityand confidence in the diagnosis made by the doctor.
Summary
Point-of-care ultrasound is an examination that is increasingly used by doctors working in primary care as a diagnostic tool ensuring earlier and more precise diagnosis. GP familiarization with ultrasound could reduce the number of incorrect referrals as well as improve the interpretation of the results. Performing the POCUS examination during a visit to the primary care physician allows GP to make a quick diagnosis and make a decision about conservative treatment, referral to the appropriate specialist or hospitalization.
Primary adrenal insufficiency - Addison's disease
Authors: Metelski Jakub , Metelska Aleksandra , Sereda Dominika , Nieścior Hubert , Szwed Monika 
Published: August 2022

Introduction and purpose
Addison's syndrome is defined as primary adrenal insufficiency, the symptoms of which result from hormonal deficiencies: glucocorticosteroids, mineralocorticosteroids and androgens. Currently, autoimmunity is considered the most common cause of Addison's Syndrome. Antibodies are most often directed against the enzymes 21-hydroxylase and 17-hydroxylase involved in steroidogenesis.
The aim of the study is to present a typical clinical course, diagnostic path and current therapeutic options of Addison's syndrome.
Description of the state of knowledge
Currently, in developed countries, the number of cases is 100-140 people per million people. Initially, Addison's syndrome runs secretly. The clinical picture is closely correlated with the degree of adrenal cortex destruction. The most common symptoms include hypotonia, weight loss, weakness, salt craving, gastrointestinal disorders, and hyperpigmentation of the skin and mucous membranes. In extreme cases, adrenal crisis may develop, characterized by rapid clinical deterioration with hypotension, fever, vomiting, dehydration, and loss of consciousness.
Diagnostics uses the measurement of the concentration of morning cortisol and corticotropin (ACTH) in the blood, and in doubtful situations, additionally a stimulation test using synthetic ACTH.
Summary
A diagnosis of Addison's syndrome requires end-of-life hormonal substitution. For this purpose, hydrocortisone or prednisone and fludrocortisone are used. In stressful situations, the doses of glucocorticoids should be adequately increased. Patients with adrenal crisis require intensive fluid resuscitation to restore intravascular volume, correct hypoglycemia and electrolyte disturbances, and administer rapidly high doses of hydrocortisone.
Within-Field Variability in Nutrients for Site-Specific Agricultural Management in Irrigated Cornfield
Authors: Kumar Hemendra , Srivastava Puneet , Lamba Jasmeet , Ortiz Brenda V. , Way Thomas R , Sangha Laljeet , Takhellambam Bijoychandra S. , Morata Guilherme , Molinari Roberto 
Published: August 2022

HighlightsPhosphorus and nitrogen in soil and plants varied during the growing season across the cornfield.Spatial variability in nutrients caused spatial variability in plant growth and crop yield across the cornfield.Hydrological characteristics and soil hydraulic properties were responsible for spatial variability in nutrients.Need to consider spatial variability in nutrients in delineating management zones before adopting management practices.Abstract. The adoption of precision agricultural practices in Alabama has been increasing in recent years. Although challenging, understanding nutrient variability in agricultural fields is important for site-specific management. This study investigated phosphorus (P) and nitrogen (N) variability in an irrigated cornfield located in the Town Creek Watershed of Tennessee Valley Region of Alabama, USA during the 2019 growing season. Three different irrigation management zones (high yield-HY, moderate yield-MY, and low yield-LY) were delineated based on ten years of historical records of crop yield, soil texture, and measured topography using the Management Zone Analyst (MZA) software. The soil samples at 0 to 15 cm, 15 to 30 cm, and 30 to 60 cm depths were collected five different times during the 2019 growing season. Both manure and inorganic fertilizer were uniformly applied during the growing season. At all soil depths, HY and MY zones had higher soil nutrient concentrations than the field average nutrient concentration. However, the LY zone had below field average soil nutrient concentration in the entire soil profile. The plants (above-ground) in HY and MY zones had higher than average nutrient concentrations and the plants in the LY zone had lower than average nutrient concentrations throughout the cornfield. This site-specific nutrient variation in these zones was due to within-field terrain attributes, differences in soil properties, and surface runoff losses. A significant difference was recorded in the corn yield in the HY and LY zones of the field. Two extreme groups of nutrients were found in the cornfield similar to irrigation management zones (HY and LY). A zone with a higher yield also had higher soil and plant nutrients in the zone (HY), and a zone with a lower yield also had lower soil and plant nutrients in the zone (LY). Incorporating nutrient variability for site-specific management in management zone delineation can help with reducing nutrient application, nutrient loss, and improving yield. This study supports the adopting of precision agricultural management practices based on in-field nutrient variability. Keywords: Corn, Crop yield variability, Irrigation, Management zones, Nitrogen, Nutrient variability, Phosphorus, Site-specific management, Topographical wetness index (TWI).