bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chest pain in the emergency department: From score to core—A prospective clinical study
Authors: Juknevičienė Renata , Juknevičius Vytautas , Jasiūnas Eugenijus , Raščiūtė Beatričė , Barysienė Jūratė , Matačiūnas Mindaugas , Vitkus Dalius , Laucevičius Aleksandras , Šerpytis Pranas 
Published: July 2022

High-sensitivity troponin assay brought new challenges as we detect elevated concentration in many other diseases, and it became difficult to distinguish the real cause of this elevation. In this notion, diagnosis of acute coronary syndrome (ACS) remains a challenge in emergency department (ED).
We aim to examine different approaches for rule-in and rule-out of ACS using risk scores, copeptin, and coronary computed tomography angiography (CCTA).
A prospective observational study was designed to evaluate chest pain patients. Consecutive adult patients admitted to the ED with a chief complaint of chest pain due to any cause were included.
All patients were followed-up for 6 months after discharge for major adverse cardiovascular events and readmissions. Admission data, ED processes, and diagnoses were analyzed.
One hundred forty-six patients were included, average age was 63 ± 13.4 years, and 95 (65.1%) were male. Global Registry of Acute Coronary Events (GRACE) and History, ECG, Age, Risk factors, Troponin (HEART) scores showed good prognostic abilities, but HEART combination with copeptin improves diagnoses of myocardial infarction (area under the curve [AUC] 0.764 vs AUC 0.864 P = .0008). Patients with elevated copeptin were older, had higher risk scores, and were more likely to be admitted to hospital and diagnosed with ACS in ED. For copeptin, AUC was 0.715 (95% confidence interval 0.629–0.803), and for combination with troponin, AUC of 0.770 (0.703–0.855) did not improve rule-in of myocardial infarction. High-sensitivity troponin I assay alongside prior stroke, history of carotid stenosis, dyslipidemia, use of diuretics, and electrocardiogram changes (left bundle branch block or ST depression) are good predictors of myocardial infarction (χ² = 52.29, AUC = 0.875 [0.813–0.937], P < .001). The regression analysis showed that combination of copeptin and CCTA without significant stenosis can be used for ACS rule-out (χ² = 26.36, P < .001, AUC = 0.772 [0.681–0.863], negative predictive value of 96.25%).
For rule-in of ACS, practitioner should consider not only scores for risk stratification but carefully analyze medical history and nonspecific electrocardiogram changes and even with normal troponin results, we strongly suggest thorough evaluation in chest pain unit. For rule-out of ACS combination of copeptin and CCTA holds great potential.
Early prediction of diabetes by applying data mining techniques: A retrospective cohort study
Authors: Al Yousef Mohammed Zeyad , Yasky Adel Fouad , Al Shammari Riyad , Ferwana Mazen S. 
Published: July 2022

Background:
Saudi Arabia ranks 7th globally in terms of diabetes prevalence, and its prevalence is expected to reach 45.36% by 2030. The cost of diabetes is expected to increase to 27 billion Saudi riyals in cases where undiagnosed individuals are also documented. Prevention and early detection can effectively address these challenges.

Objective:
To improve healthcare services and assist in building predictive models to estimate the probability of diabetes in patients.

Methods:
A chart review, which was a retrospective cohort study, was conducted at the National Guard Health Affairs in Riyadh, Saudi Arabia. Data were collected from 5 hospitals using National Guard Health Affairs databases. We used 38 attributes of 21431 patients between 2015 and 2019. The following phases were performed: (1) data collection, (2) data preparation, (3) data mining and model building, and (4) model evaluation and validation. Subsequently, 6 algorithms were compared with and without the synthetic minority oversampling technique.

Results:
The highest performance was found in the Bayesian network, which had an area under the curve of 0.75 and 0.71.

Conclusion:
Although the results were acceptable, they could be improved. In this context, missing data owing to technical issues played a major role in affecting the performance of our model. Nevertheless, the model could be used in prevention, health monitoring programs, and as an automated mass population screening tool without the need for extra costs compared to traditional methods.
Renal amyloidogenic leukocyte chemotactic factor 2 combined with IgA nephropathy: A case report
Authors: Xu Hongzhao , Jia Ye , Wang Xueyao , Wang Hui , Yu Jinyu , Hao Wu 
Published: July 2022

Rationale:
Amyloidogenic leukocyte chemotactic factor 2 (ALECT2) was recently considered as a new clinicopathologic type of amyloid, which frequently affects kidney in adults and results in different degrees of renal insufficiency and failure with or without proteinuria. Here, we present a case of combining LECT2-associated renal amyloidosis with immunoglobulin (Ig)A nephropathy.

Patient concerns:
A 71-year-old Chinese man presented with edema of both lower extremities.

Diagnoses:
There was pale eosinophilic material strongly positive for the Congo red stain in interstitium with demonstrated apple green birefringence under polarized light. Immunofluorescent stain was positive for IgA deposits (4+), IgG deposits (2+), C3 deposits (3+) within the mesangium and capillary wall. Immunohistochemistry was positive for κ (+), λ (2+) in mesangial area, and LECT2 (2+) in the interstitium. On electron microscopy, there were electron-dense deposits within mesangial area and subendothelial and randomly orientated and nonbranching fibrils 10 nm in size found in the interstitium areas. Liquid chromatography tandem mass spectrometry was performed on peptides extracted from Congo red-positive, microdissected areas of the paraffin-embedded kidney specimen. LECT 2-associated renal amyloidosis with IgA nephropathy was pathologically confirmed by renal biopsy.

Interventions:
Steroids (60 mg/d) were used to treat IgA nephropathy daily. Antihypertensive treatment was switched to an angiotensin-converting enzyme inhibitor.

Outcomes:
One year after diagnosis, creatine remained stable in the normal range, and 24-hour proteinuria decreased to 2.9 g.

Lessons:
To date, ALECT2 has still not been comprehensively investigated. The findings of this research provide insights for concurrent IgA nephropathy with ALECT2.
Formation of multiple ganglion cysts along the flexor tendon after open A1 pulley release for trigger finger: A case report
Authors: Lee Young Keun 
Published: July 2022

Rationale:
When surgical treatment is indicated for primary trigger finger, open A1 pulley release has traditionally been recommended with generally good results. However, ganglion cysts of the flexor tendon sheath as a complication after an open A1 pulley release were rarely reported. Therefore, the purpose of this study is to report a case of multiple ganglion cysts arising from the flexor tendon sheath in a patient undergoing an open A1 pulley release for trigger finger disorder with a review of the relevant literature.

Patient concerns and diagnosis:
A 65-year-old right-handed farmer was referred to our hospital for swelling in the left long finger (LLF). One year before the visit, the patient was diagnosed with trigger finger in the LLF at other hospital and an open A1 pulley release was performed, but the swelling of the finger persisted. The patient had no history of trauma or evidence of systemic disease such as rheumatoid or other inflammatory arthritis. The patient was diagnosed with multiple ganglion cysts of flexor tendon sheath after investigation.

Intervention and outcomes:
We successfully excised cystic masses and debrided the partially ruptured flexor digitorum superficialis (FDS) tendon and sutured it using 5/0 prolene. At 12-month follow-up, the patient was completely asymptomatic with excellent range of motion in the distal interphalangeal (DIP) joint (0°–60°) of his LLF, showing no recurrence of ganglion cyst.

Lessons:
Trigger finger is a common condition that clinicians encounter frequently. However, this familiarity may lead to inattentive treatment. Nevertheless, through this case, clinicians should devote careful attention when performing open A1 pulley release to prevent partial rupture of the flexor tendon in the A1 pulley. If ganglion cysts occur, we believe that surgical excision can yield good results.
Safety of vaginal delivery in women with placental chorioangiomas diagnosed by prenatal ultrasound: A retrospective cohort study
Authors: Zou Jiashan , Ding Weimin , Chen Qin , Bai Xiaoxia , Li Baohua 
Published: July 2022

This study aimed to examine the maternal and neonatal outcomes in different mode of delivery in pregnant women with placental chorioangiomas, in order to determine the safety of vaginal delivery.
We conducted a retrospective study of 54 women with placental chorioangioma diagnosed by prenatal ultrasound and subsequently proven histologically, excluding those who underwent cesarean section for obstetric indications. The mode of delivery was divided into a vaginal delivery group (23 women) and a cesarean section group (31 women). The indication of cesarean section group was only for placental chorioangioma, no other obstetric indications. The maternal characteristics, pregnancy outcomes and the color doppler imaging characteristics of placental chorioangioma of the 2 groups were compared, and the clinical characteristics of women in the vaginal delivery group were described in detail.
The incidence of placental chorioangioma was nearly 0.43‰ in our study. There was no significant difference in the maternal characteristics and pregnancy outcomes between the 2 groups. 82.6% (19/23) of the women successfully delivered vaginally and 4 failed who turned to cesarean section in the vaginal delivery group; among them, 17 women had giant chorioangiomas (>4 cm in diameter). The direct cause of vaginal delivery failure was fetal distress, persistent occiput posterior fetal position and cephalopelvic disproportion.
Pregnant women with placental chorioangiomas and no other obstetric indications for cesarean section may attempt a vaginal delivery, even with giant chorioangiomas. If there are risk factors of vaginal delivery failure, the progress of labor needs to be closely monitored.
Establishment of relapse risk model and multivariate logistic regression analysis on risk factors of relapse in children with primary nephrotic syndrome
Authors: Peng Qian-Qian , Zeng Ping , Jiang Xiao-Hua , Guan Feng-Jun 
Published: July 2022

This study aimed to investigate relapse risk factors in children with primary nephrotic syndrome (PNS) for prevention and early intervention via logistic regression.
One hundred thirty-seven children with PNS were enrolled in this study. Clinical variables were analyzed by single-factor and multiple regression analysis to establish the regression equation. The predictive ability of the regression equation was investigated by the receiver operating characteristic curve (ROC).
Files of 17 patients were lost, and 120 patients were enrolled finally in the study, among whom 55 cases (45.8%) had frequently relapsed. Single-factor analysis and multiple regression analysis revealed that concurrent infection on first onset, irregular glucocorticoid therapy, severe hypoalbuminemia, and persistent severe hyperlipidemia were the significant risk factors for frequent relapse on PNS (P < .05), among which infection remained to be the main inductive factor. Among the 4 indicators, serum albumin had the best diagnostic efficacy based on the area under the ROC curve (0.933), sensitivity (89.09%), and specificity (81.54%). The area under curve, sensitivity, and specificity for the combined diagnostic model of the 4 indices were 97.8%, 98.18%, and 90.77%, respectively, which had good predictive power for the relapse of patients.
Concurrent infection, irregular glucocorticoid therapy, severe hypoalbuminemia, and persistent severe hyperlipemia were all the risk factors for PNS relapse. The established logistic regression model based on these factors above is reliable for predicting frequent PNS relapse. Much attention should be paid to these critical factors, and early intervention should be taken to reduce the incidence of relapse.
Case report of transient corneal edema after immunization with adenovirus-vectored COVID-19 vaccine
Authors: Lee Jae Yeon , Han Sang Beom 
Published: July 2022

Rationale:
To report a case of bilateral transient corneal edema presumably associated with adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccination that resolved with eye drops treatment.

Patient concerns:
A 55-year-old Asian woman presented with sudden onset of bilateral visual disturbance developed 6 days after immunization with an adenovirus-vectored COVID-19 vaccine (AstraZeneca, London, United Kingdom). She underwent uneventful cataract surgery in right and left eyes 2 months ago and maintained good visual acuity bilaterally. Slit-lamp examination showed bilateral mild corneal edema that was confirmed with anterior segment optical coherent tomography. Anterior chamber and vitreous were clear bilaterally. Both fundi were normal.

Diagnoses:
The patient was diagnosed with corneal edema following adenovirus-vectored COVID-19 vaccination.

Interventions:
She was prescribed with prednisolone acetate 1% eye drops bilaterally.

Outcomes:
Treatment with topical steroid for 2 weeks resulted in resolution of the corneal edema and improvement of the visual acuity bilaterally.

Lessons:
This case suggests that transient corneal edema can develop following adenovirus-vectored COVID-19 vaccination. Prompt ophthalmologic evaluation and treatment may improve the corneal edema.
Top of basilar artery infarction
Authors: Daoud Mahmoud Hussien Salih , Abushama Ejlal Ahmed E. , Mahmmoud Abdallah H. , Eljack Moh. Mah. Fadelallah , Ahmed Khabab Abbasher Hussien Mohamed , Haroun Mazin S. Hassan , Hasabo Elfatih A. , Elsheikh Duaa Baderaldeen Ibraheem , Mohammed Sulieman Abdelkareim G. , Eltayeb Ahmed Eltayeb O. , Naimallah Yusif Abduelmagid , Ahmed Alameen Ahmed Alameen , Yousif Mohamed Y. , Mokhtar Asmaa Esam Abbas , Awadalbari Sara Nasreldeen Ibrahim , Eltayeb Rowida Babikir Osman , Elamin Abubakr Elmotesim Abdulla 
Published: July 2022

Rationale:
The posterior circulation represents 20% of blood supply to the brain, and its occlusion, commonly by embolism, causes brainstem, cerebellar, and lower cerebral infarctions. The clinical presentation varies from mild symptoms to severe neurological deficits or death. The duration of intervention is vital, commonly with antithrombotic drugs or through intervention.

Patient concerns:
The first case was a 36-year-old-female admitted due to snakebite. On admission, she developed acute kidney injury, sepsis, and compartment syndrome, for which she underwent fasciotomy, improved, and was discharged. Two days later, she presented with sudden onset of left-sided weakness. The second was an 85-year-old male with hypertension and end-stage renal disease on regular hemodialysis who presented with high-grade continuous fever associated with rigor, confusion, and decreased level of consciousness for 2 days. The third case was a 30-year-old woman admitted to the emergency department because of an abrupt loss of consciousness that occurred when she was going to the bathroom; she was unable to speak, swallow, or move her limbs. There was no fever, sphincteric disturbance, or seizure. She had a history of severe chronic bifrontal headache that started 4 months prior to elective cesarean section.

Diagnosis:
The patients were diagnosed as top of basilar artery infarction.

Interventions:
The first patient received enoxaparin, intravenous fluids, proton-pump inhibitors, antibiotics, and rivaroxaban. The second patient received intravenous antibiotics, dual antiplatelet therapy, enoxaparin, blood transfusions, and frequent hemodialysis sessions. The third patient received intravenous fluids, antibiotics, and oral anticoagulants (rivaroxaban 15 mg twice daily for 2 weeks then 20 mg once daily).

Outcomes:
The 3 patients were discharged following pharmacological treatment. The first and third cases showed improvement in their symptoms. However, the second patient developed bilateral epistaxis and bleeding after medication and did not show improvement in his symptoms; however, he died due to intradialytic hypotension.

Lessons:
We reported 3 Sudanese patients who had complicated medical sequelae due to top basilar artery occlusion, received anticoagulants and supportive therapy, and showed variable recovery over weeks, with the exception of 1 patient who died after follow-up.
Global Epidemiology of Gaucher Disease: an Updated Systematic Review and Meta-analysis
Authors: Wang Meimei , Li Fengqin , Zhang Jing , Lu Cheng , Kong Weijing 
Published: July 2022

Background:
Gaucher disease [GD], an autosomal recessive lysosomal storage disorder, is characterized by progressive lysosomal storage of glucocerebroside in macrophages predominantly in bone, bone marrow, liver, and spleen. Meta-analysis of global GD epidemiology was not available before this study.

Methods:
To provide a systematic review and meta-analysis of birth prevalence and prevalence of GD in multiple countries. MEDLINE and EMBASE databases were searched for original research articles on the epidemiology of GD from inception until July 21, 2021. Meta-analysis, adopting a random-effects logistic model, was performed to estimate the birth prevalence and prevalence of GD.

Results:
Eighteen studies that were screened of 1874 records were included for data extraction. The studies that fulfilled the criteria for inclusion involved 15 areas/countries. The global birth prevalence of GD was 1.5 cases [95% confidence interval: 1.0 to 2.0] per 100,000 live births. The global prevalence of GD was 0.9 cases [95% confidence interval: 0.7 to 1.1] per 100,000 inhabitants.

Conclusions:
This is the first comprehensive systematic review that presented quantitative data of GD global epidemiology. Quantitative data on global epidemiology of GD could be the fundamental to evaluate the global efforts on building a better world for GD patients.
Preferences for Weight Gain Compared With Other Antiretroviral Therapy Side Effects in People Living With HIV: A Discrete Choice Experiment
Authors: Tieosapjaroen Warittha , Fairley Christopher K. , Chow Eric P.F. , Aguirre Ivette , Hoy Jennifer F. , Ong Jason J. 
Published: July 2022

Backgroud:
Antiretroviral (ARV) side effects are a critical determinant of adherence among people living with HIV (PLWH). Integrase strand transfer inhibitors (INSTIs), a commonly used ARV, have been reported to cause weight gain. We determined the relative importance of weight gain compared with other side effects from the perspective of PLWH.

Setting:
Melbourne Sexual Health Centre and the Alfred Hospital in Victoria, Australia.

Methods:
We conducted a discrete choice experiment survey to explore PLWH's preferences for 8 short-term side effects (eg, weight gain and depression) and 4 long-term side effects (eg, long-term weight gain and risks of heart attack). We sent an anonymous survey link through short message service (SMS) and postcards to PLWH attending both centers between July and August 2021. The choice data were analyzed using random parameter logit (RPL) and latent class (LCM) models.

Results:
Three hundred thirty-five respondents were included: most were male (88.1%). In the RPL analyses, weight gain was the second most important attribute after depression for short-term side effects and the third most important attribute after risk of heart attack and kidney problem for long-term side effects. In the LCM analyses, 23.9% were most sensitive to short-term weight gain, whereas 16.0% were most sensitive to long-term weight gain.

Conclusions:
Weight gain was the second most important short-term side effect and the third most important long-term side effect in a cohort of Australian PLWH. However, weight gain was the most important side effect of ARV for a significant minority.
FDG PET/CT in Unilateral Renal Metastasis From Colon Cancer
Authors: Ji Xia , Dong Aisheng 
Published: July 2022

Abstract
Renal metastasis from colon cancer is rare. We describe FDG PET/CT findings in a case with a right renal and a postcaval lymph node metastasis from colon cancer. Both the renal tumor and postcaval lymph node showed increased FDG uptake with SUVmax of 6.1 for the renal tumor and 5.5 for the postcaval lymph node. The imaging findings mimicked a primary renal cancer with postcaval lymph node metastasis.
18F-FDOPA and MRI Findings in a Case of Multiple Sclerosis
Authors: Lersy François , Kremer Stéphane , Chibbaro Salvatore , Namer Izzie Jacques , Bund Caroline 
Published: July 2022

Abstract
A 39-year-old woman with no significant medical history underwent a brain MRI because of headaches and dysarthria having lasted 3 weeks. A tumor lesion was suspected. PET imaging was decided. She underwent FDG and FDOPA PET, leading to the diagnosis of low-grade glioma. Three months later, a new imaging assessment was organized. It showed a decrease in the hypermetabolism of the lesion and the appearance of a second lesion questioning the diagnosis. Further assessment led to the conclusion of a multiple sclerosis. This case illustrates that FDOPA PET uptake should be interpreted with caution in patients with suspected primary brain tumors.
Elevated 68Ga-FAPI Uptake by Primary Benign Intraosseous Meningioma
Authors: Gong Weidong , Yang Xiao , Li Lanying , Ma Jiao , Zhang Chunyin 
Published: July 2022

Abstract
Intraosseous meningioma is an extremely rare benign tumor. We present the 68Ga–fibroblast activation protein inhibitor (FAPI) PET/CT findings of primary intraosseous meningioma in a 71-year-old woman. 68Ga-FAPI PET/CT revealed an intraosseous mass in the right parietal bone with increased FAPI activity. Primary skull malignancy was suspected. However, pathological examination after resection of the mass in the right parietal bone confirmed the diagnosis of benign meningioma (WHO I). A final diagnosis of benign intraosseous meningioma was made.
Congenital Melanocytic Nevi Syndrome With Leptomeningeal Melanoma
Authors: Mohite Ashish , Agrawal Archi , Purandare Nilendu , Shah Sneha , Puranik Ameya , Choudhury Sayak , Dev Indraja , Ghosh Suchismita , Rangarajan Venkatesh 
Published: July 2022

Abstract
The incidence of congenital melanocytic nevi (CMNs) is 1% to 6% for small- to intermediate-size nevi to 1 in 500,000 for giant size nevi. Large and satellite CMNs are known to be associated with neurocutaneous melanosis and central nervous system malformations such as Dandy-Walker malformation, defects of the vertebra-skull, and intraspinal lipomas. We hereby present a case of CMN syndrome in an 18-year-old girl with leptomeningeal melanoma, evaluated with MRI, adequately staged, and screened with FDG PET.