bluuebunny/crossref_metadata_2025 huggingface dataset:
Arthroscopic Tibio-talar Calcaneal Nailing for Complex Distal Third and Intra-Articular Tibia Fractures
Authors: Harris Hannah , Sorensen Hanna , Martin Kevin D.
Published: February 2023

Distal tibia fractures are complex injuries with a high complication rate and unclear guidelines regarding operative timing for reduction and fixation. A tibial plafond fracture, or pilon fracture, is a fracture of the distal end of the tibia, often associated with complex comminuted fragments and surrounding soft-tissue injury compromise. Appropriate management of distal tibial and pilon fractures remains a challenge and existing research proves current surgical approaches have poor clinical outcomes. We propose that primary hindfoot arthrodesis using a tibio-talar calcaneal nail may be used as a successful method for treating complex distal tibial and pilon fractures, notably in those with coexisting medical comorbidities (diabetes, neuropathy, dementia, and compromised soft-tissue). The overall perioperative complication rate in this high-risk cohort may be reduced given a lesser invasive method for fixation. We hypothesize that primary hindfoot arthrodesis using an arthroscopic preparation and tibio-talar calcaneal nail for periarticular ankle trauma is a safe and effective surgical approach with optimal fracture alignment and stability.

Level of Evidence: Level V.
CircRNA circ_POLA2 overexpression suppresses cell apoptosis by downregulating PTEN in glioblastoma
Authors: Xie Fangmin , Cheng Yuanyuan , Gao Xin , Song Sixin , Zhao Xu , Meng Xianbing , Shang Zhende , Yang Mingfeng
Published: February 2023

The oncogenic role of circ_POLA2 has only been explored in lung cancer, whereas the role of which in glioblastoma (GBM) is unclear. Our research explored the involvement of circ_POLA2 in GBM. Circ_POLA2 and phosphatasetensinhomolog (PTEN) mRNA levels in GBM and paired nontumor tissues collected from 58 GBM patients were analyzed by real-time quantitative PCR (RT-qPCR). Circ_POLA2 and PTEN were overexpressed in GBM cells to study their interaction by RT-qPCR and Western blot. The roles of circ_POLA2 and PTEN in regulating GBM cell apoptosis were explored using cell apoptosis assay. Our data revealed that circ_POLA2 was upregulated and PTEN was downregulated in GBM. PTEN showed an inverse correlation to circ_POLA2 across GBM tissues, In GBM cells, circ_POLA2 overexpression decreased PTEN accumulation, but PTEN overexpression failed to significantly affect circ_POLA2 expression. Moreover, PTEN reduced the inhibitory effects of circ_POLA2 on GBM cell apoptosis. Circ_POLA2 is overexpressed in MCL and might promote GBM cell apoptosis through downregulating PTEN.
Long-term response of more than 9 years to regorafenib in a heavily pretreated patient with metastatic colorectal cancer
Authors: Cosso Federica , Lavacchi Daniele , Fancelli Sara , Caliman Enrico , Brugia Marco , Rossi Gemma , Winchler Costanza , Pillozzi Serena , Antonuzzo Lorenzo
Published: February 2023

Colorectal cancer (CRC) is the third most common cancer worldwide, with approximately 1.9 million new diagnoses and 935 000 deaths annually. Overall, there is accumulating evidence that receiving all available treatments leads to a survival advantage and, although tailored treatments might be appropriate for selected patients, the one-size-fits-all approach is still widely used in chemo-refractory patients. Currently, different antiangiogenics and multitarget agents are indicated in treatment of metastatic CRC (mCRC) whereas the identification of useful predictive factors for the treatment response is lacking. Analysis of potential predictive biomarkers of efficacy of regorafenib is still ongoing but may prove to be difficult because of its nonspecific activity across a wide range of angiogenic, oncogenic, stromal, and intracellular signaling kinases. We present a case of a 57-year-old Caucasian woman diagnosed with recurrence after curative surgery for rectal adenocarcinoma stage III (ypT3N2). Despite undergoing multiple lines of standard chemotherapy, disease control could not be maintained. Consequently, regorafenib, a multikinase inhibitor with antiangiogenic proprieties, was started as a late-line treatment and a dose reduction strategy allowed a long-term response of more than 9 years with good tolerability.
A case of lung adenocarcinoma with MET∆ex14 mutation regressed after preoperative treatment with savolitinib, and successfully underwent radical resection
Authors: Yang Feng , Chen Quan-Fang
Published: February 2023

Non-small cell lung carcinoma (NSCLC) is a complex disease, with many different potential gene mutations that drive its formation, occurrence, and development. It is estimated that about 3% of NSCLC patients are accompanied by MET exon 14 skipping (METex14) mutations, and the prognosis of such patients is generally poor, which forms a formidable challenge for us. Savolitinib (Orpathys) is the first highly selective MET inhibitor in China. Here, we presented an NSCLC patient with MET∆ex14 mutation, who was initially uncertain whether existed intrapulmonary metastasis and recently underwent percutaneous coronary intervention for acute myocardial infarction and received savolitinib 600 mg once a day. The tumor was significantly shrunk 6 months later, and no metastatic lesions were found. Eventually, it was determined that the patient was in the early stage of lung cancer. After experts’ consultation and evaluation, the patient accepted radical tumor resection and recovered well. Therefore, savolitinib is an important treatment strategy for NSCLC patients with MET∆ex14 mutation, who was not suitable for surgery. Our experience may provide supporting evidence and guidance for implementing an effective therapeutic strategy for similar cases.
Myricetin is effective and selective in inhibiting imatinib-resistant chronic myeloid leukemia stem and differentiated cells through targeting eIF4E
Authors: Cai Fangfang , Li Bibao , Li Jiang , Ding Yong , Xu Dandan , Huang Fei
Published: February 2023

Although imatinib has revolutionized the treatment of chronic myeloid leukemia (CML), s develop resistance to imatinib when progress to blast phase and relapse. Myricetin, a flavonoid compound found in natural plants, has multiple biological functions. In this study, we show that myricetin demonstrated potent efficacy in imatinib-resistant CML CD34+ stem/progenitor cells with less toxicity in normal bone marrow. Myricetin is also active against imatinib-resistant CML bulk cells. The in vitro observations on the therapeutic effects of myricetin were translatable to in vivo imatinib-resistant CML xenograft mouse models. Mechanism studies showed that myricetin decreased the phosphorylation of eIF4E and Ak strain transforming, and the protein level of c-Myc and Cyclin D1. Rescue studies using eIF4E (S209D) and (S209A) confirmed that eIF4E phosphorylation inhibition was the mechanism of myricetin’s action in CML. Our results suggest that myricetin may be a potential lead for drug development to overcome imatinib resistance in CML.
Aumolertinib effectively reduces clinical symptoms of an EGFR L858R-mutant non-small cell lung cancer case coupled with osimertinib-induced severe thrombocytopenia: a case report
Authors: Hu Yong , Quan Ya-Ping , Duan Yong-Wei , Li Hao , Shen Jie , Lin Nan , Wang Cheng , Tian Bin , Li Jia-jia
Published: February 2023

Replacement of first-generation or second-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) with third-generation EGFR-TKIs remains the current standard of care for T790M mutations in patients with non-small cell lung cancer. Osimertinib is one of the first third-generation EGFR-TKIs to be approved and is also the most widely studied in clinical research. There has been widespread concern about the adverse effects of osimertinib such as cardiotoxicity and interstitial lung disease, but few articles have reported severe thrombocytopenia after osimertinib treatment. This article reports a 64-year-old woman with non-small cell lung cancer initially diagnosed with cT2aN1M1a, EGFR p.L858R, who developed disease progression and T790M after 32 months of first-line treatment with gefitinib (250 mg/day) before switching to second-line treatment with osimertinib (80 mg/day). Severe thrombocytopenia and active bleeding occurred after treatment with osimertinib, which improved with recombinant human thrombopoietin and platelet transfusion. Treatment was replaced with aumolertinib (110 mg/day). After platelet stabilization with aumolertinib treatment in combination with chest radiotherapy, this patient had progression-free survival for 9 months and overall survival for over 45 months. In conclusion, from our experience, aumolertinib has good efficacy and mild adverse effects, and is a good choice for non-small cell lung cancer patients with T790M, especially for patients at high risk of thrombocytopenia.
Electrochemotherapy with bleomycin as an effective local treatment for Kaposi’s sarcoma: a case report
Authors: Niccolò Allievi , Elena Manzo , Nadiane Paderno , Barbara Merelli , Gianlorenzo Imberti , Dario Piazzalunga
Published: February 2023

An elderly female patient with a long-standing history of Kaposi’s sarcoma of the lower limbs was referred to the Surgical Department after the subsequential failure of multiple lines of systemic chemotherapy. The patient was also complaining of increasing symptoms including intractable pruritus, which negatively impacted her quality of life. She underwent palliative electrochemotherapy with bleomycin (15 g/m2) on the sarcomatous lesions of the left foot and ankle, which lead to complete clinical response and resolution of symptoms; no adverse events were reported. Electrochemotherapy is a valid option in the palliative treatment of Kaposi’s sarcoma, as it may lead to satisfactory clinical response and symptom control.
Growth differentiation factor 15 is required for triple-negative breast cancer cell growth and chemoresistance
Authors: He Yanling , Zhang Xinyuan , Zhang Yunli , Luo Wenwen , Zhu Zhenyun , Song Kai , Shi Jian
Published: February 2023

Growth differentiation factor 15 (GDF15) is a pleiotropic cytokine, which is involved in the cellular stress response following acute damage. However, the functional role of GDF15 in triple-negative breast cancer (TNBC) has not been fully elucidated. ELISA, Western blot, and PCR assays as well as bioinformatics analyses were conducted to observe the expression of GDF15. Cell Counting Kit-8, 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and crystal violet staining assays were conducted to evaluate paclitaxel resistance and cell viability. Cell apoptosis was analyzed by Western blotting. Murine xenograft model assay was employed to evaluate tumor growth in vivo. Our data indicate that GDF15 is markedly elevated in paclitaxel-resistant TNBC cells, which is significantly associated with unfavorable prognosis. Silencing of GDF15 robustly inhibits the proliferation of tumor cells and increases their sensitivity to paclitaxel in vitro and in vivo, whereas the treatment of purified GDF15 protein confers breast cancer cells with chemoresistance ability. Moreover, GDF15 activates protein kinase B (AKT) /mammalian target of rapamycin (mTOR) signaling, inhibition of AKT or mTOR reverses the prosurvival effect of GDF15 and enhances the antitumor efficacy of paclitaxel in TNBC cells. Altogether, our study uncovers the role of GDF15 in tumor growth and paclitaxel resistance, implicating a potential therapeutic target for TNBC.
Circular RNA circ_0000212 accelerates cervical cancer progression by acting as a miR-625-5p sponge to upregulate PTP4A1
Authors: Li Hu , Zheng Shaolie , Wan Ting , Yang Xiang , Ouyang Yuan , Xia Hong , Wang Xiaoyu
Published: February 2023

Background

Cervical cancer is one of the most common malignant tumors in women. Circular RNA (circRNA) has been shown to play a crucial role in cervical cancer. Here, the aim of this study was to explore the functions and a novel miRNA/mRNA network underlying circ_0000212 in cervical cancer regulation.

Methods

The expression of circ_000212, miR-625-5p and Protein Tyrosine Phosphatase 4A1 (PTP4A1) mRNA was measured by quantitative real-time PCR (qRT-PCR). 5-ethynyl-2’-deoxyuridine assay was conducted to detect the proliferation of cervical cancer cells. Wound healing and transwell assays were employed to assess cell migration and invasion. The angiogenesis abilities of cervical cancer cells were evaluated by tube formation assay. Flow cytometry was performed for analyzing cell apoptosis. The expression of PTP4A1 protein and apoptosis-relative protein were detected via western blot. The dual-luciferase reporter and RNA immunoprecipitation (RIP) assays were employed to clarify the interaction between circ_0000212 or PTP4A1 and miR-625-5p. The impact of circ_0000212 on cervical cancer growth in vivo was detected by xenograft assay.

Results

Circ_0000212 and PTP4A1 were highly expressed and miR-625-5p expression level was decreased in cervical cancer. Circ_0000212 silencing suppressed cervical cancer cell proliferation, migration, invasion and angiogenesis while promoting apoptosis. MiR-625-5p was targeted by circ_0000212, and miR-625-5p inhibition reversed the effects of circ_0000212 knockdown. MiR-625-5p directly targeted PTP4A1, and the inhibitory effect of miR-625-5p on the malignant progression of cervical cancer was reversed after PTP4A1 overexpression. In-vivo assays validated that circ_0000212 promoted cervical cancer tumor growth in vivo.

Conclusion.

circ_0000212 acted as an oncogene in cervical cancer progression, and knockdown of circ_0000212 repressed cervical cancer development by increasing miR-625-5p and decreasing PTP4A1.
LncRNA ARAP1-AS1 targets miR-516b-5p/PDE5A axis to facilitate the progression of thyroid cancer
Authors: Du Qiuli , Huang Lin , Guo Wei
Published: February 2023

Aim

Thyroid cancer (TC) remains a prevalent public health concern. To further study the molecular mechanism of TC development, we explored the regulatory mechanism and function of lncRNA ARAP1-AS1 in TC progression.

Methods

The verification of ARAP1-AS1, PDE5A and miR-516b-5p expression levels among the TC cell lines and tissues was fulfilled via RT-qPCR and western blot analyses. Cell Counting Kit-8 and colony formation experiments were executed to assess ARAP1-AS1’s biological function in vitro. Western blotting was conducted to assess apoptosis through the expressions of apoptotic markers. A tumor xenograft experiment was conducted to evaluate whether ARAP1-AS1 affected TC tumor development in vivo. The interactions of miR-516b-5p with ARAP1-AS1 and PDE5A were explored through a dual-luciferase reporter and RNA Binding Protein Immunoprecipitation assays, as well as through Pearson’s correlation analysis.

Results

ARAP1-AS1 and PDE5A were evidently upregulated in the TC cell lines and tissues whereas miR-516b-5p was poorly expressed. ARAP1-AS1 silencing in TC cells hampered cell proliferation, reduced their viability and boosted apoptosis. Moreover, it inhibited tumor growth in vivo. ARAP1-AS1 had been revealed to be correlated negatively to miR-516b-5p. Finally, we demonstrated that the miR-516b-5p inhibitor was capable of reversing ARAP1-AS1-knockdown’s repressive effects on TC cell development by means of regulating PDE5A expression.

Conclusion

ARAP1-AS1 partially facilitated TC cell development and survival through the modulation of miR-516b-5p/PDE5A axis. This contributes a novel biomarker and new perspectives for TC treatment.
Cancer-associated fibroblasts-derived exosomes from chemoresistant patients regulate cisplatin resistance and angiogenesis by delivering VEGFA in colorectal cancer
Authors: Shi Yuanyuan , Zhu Hua , Jiang Hang , Yue Hongqin , Yuan Fang , Wang Fusheng
Published: February 2023

The purpose of this study was to investigate the effect of chemoresistant cancer-associated fibroblasts (R-CAFs) against cisplatin (DDP) on colorectal cancer (CRC) progression. First, clinical tissue samples of chemoresistant or chemosensitive CRC patients were collected to isolate R-CAFs or chemosensitive CAFs (S-CAFs), respectively. HT29 cells or HUVECs were co-cultured with R-CAFs by transwell device. Then the proliferation and apoptosis of HT29 cells were detected with Cell Counting Kit-8 (CCK-8) and flow cytometry. Transwell assay and tube formation assay was used to detect the migration and angiogenesis of HUVECs. In addition, a colorectal cancer transplantation model was established subcutaneously in nude mice by injecting stably transfected HT29 cells and exosomes from different CAF groups, and then the tumor volume and weight were measured and recorded. Hematoxylin and eosin staining, immunohistochemistry, and terminal deoxynucleotidyl transferase dUTP Nick-End Labeling (TUNEL) staining were performed to characterize the histopathological characteristics and apoptosis level of tumor tissues, respectively. S-CAFs and R-CAFs were isolated successfully. HT29 cell co-culture with R-CAFs significantly affected the proliferation and apoptosis of HT29 cells. Exosomes derived from R-CAFs (R-CAFs-Exo) were delivered to HT29 cells, which could induce viability, suppress apoptosis and accelerate the angiogenesis of CRC. In addition, VEGFA was highly expressed in R-CAFs-Exo, which might indicate that R-CAFs could transmit VEGFA through exosomes. Overexpressed VEGFA in R-CAFs apparently regulates the viability, apoptosis, DDP resistance, and angiogenesis of CRC. In-vivo experiments confirmed that R-CAFs-Exo promoted the progression of CRC and DDP resistance by delivering VEGFA. R-CAFs-derived exosomes promote the viability, apoptosis, DDP resistance, and angiogenesis of CRC by delivering VEGFA.
Novel third-generation tyrosine kinase inhibitor for newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia: a case study
Authors: Tan Xu , Wen Qin , Chen Guo , Wan Kai , Liu Xue , Ma Ying-Ying , Wang Mai-Hong , Zhang Xi , Zhang Cheng
Published: February 2023

Although Philadelphia chromosome-positive acute leukemia (Ph+-ALL) has been revolutionized with tyrosine kinase inhibitors (TKIs), resistance and mutation are universal events during treatment with first-generation and second-generation TKIs. The present third-generation TKI has a dose-dependent, increased risk of serious cardiovascular events and the sensitivity is poor for patients with ≥2 mutations accompanied by the T315I mutation. Thus, novel and well-tolerated TKIs should be explored. This study analyzes the efficacy and advert effects of olverembatinib, a novel third TKI, in the treatment of newly diagnosed adult Ph+-ALL in induction therapy. Four adult patients with newly diagnosed Ph+-ALL were treated with olverembatinib as the first-line treatment. For induction therapy, these patients received 40 mg of oral olverembatinib quaque omni die for 28 days, 1 mg/kg/d of prednisone for 14 days, then tapered and stopped at 28 days and vindesine 4 mg/d at days 1, 8 and 15. After induction therapy, these patients received median or high-dose of cytarabine and methotrexate combined with oral olverembatinib as consolidation therapy. Then the allogeneic hematopoietic stem cell transplantation (allo-HSCT) was performed. All patients reached complete remission with a complete cytogenetic response after induction therapy. Two patients reached major molecular remission and one with complete molecular remission. Before allo-HSCT, all the patients achieved complete molecular remission. All the patients have survived disease-free for 3–6 months. No severe advert effects were observed. It is well-tolerated and effective for olverembatinib in the treatment of newly diagnosed adult patients with Ph+-ALL. A prospective study should be performed to further testify the role.
Novel LINC01923-anaplasticlymphoma kinase rearrangement identified in advanced lung adenocarcinoma with durable response to ensartinib: a case report
Authors: Wang Shujun , Xu Shuifeng , Ye Feibo , Zhu Chan , Yu Yangyang , Chen Jungang
Published: February 2023

Anaplastic lymphoma kinase (ALK) rearrangements are one of the most common mutations in nonsmall cell lung cancer. Majority of the ALK rearrangements were sensitive to crizotinib, yet some rare fusion types may less benefit. The patient with LINC01923-ALK fusion was treated with crizotinib for 1 week and developed an adverse rash reaction. Replaced with second-line treatment with esatinib, the patient had a partial response in the primary site and achieved a complete response in the brain metastases. The patient was treated successfully with ensartinib leading to a progression-free survival of 6 months (and counting). This is the first report on one lung adenocarcinoma patient with a novel LINC01923-ALK fusion beneficial from ensartinib, which provides more knowledge for ALK fusion spectrum.
The fibroblast growth factor receptor inhibitor, derazantinib, has strong efficacy in human gastric tumor models and synergizes with paclitaxel in vivo
Authors: McSheehy Paul M.J. , Forster-Gross Nicole , El Shemerly Mahmoud , Bachmann Felix , Roceri Mila , Hermann Norbert , Spickermann Jochen , Kellenberger Laurenz , Lane Heidi A.
Published: February 2023

Derazantinib (DZB) is an inhibitor of fibroblast growth factor receptors 1–3 (FGFR1–3), with additional activity against colony-stimulating-factor-1 receptor (CSF1R). We have profiled the activity of DZB in gastric cancer (GC) as monotherapy and combined with paclitaxel, and explored means of stratifying patients for treatment. The antiproliferative potency of DZB in vitro was quantified in 90 tumor cell lines and shown to correlate significantly with FGFR expression (<0.01) but not with FGFR DNA copy-number (CN) or FGFR mutations. In four GC cell lines in vitro, little or no synergy was observed with paclitaxel. In athymic nude mice, bearing cell-line derived xenografts (CDX) or patient-derived xenograft (PDX) GC models, DZB efficacy correlated highly significantly with FGFR gene expression (r
2 = 0.58; P = 0.0003; n = 18), but not FGFR mutations or DNA-CN. In FGFR-driven GC models, DZB had comparable efficacy to three other FGFR inhibitors and was more efficacious than paclitaxel. DZB had dose-dependent plasma pharmacokinetics but showed low brain penetration at all doses. GC models (one CDX and six PDX) were tested for sensitivity to the combination of DZB and paclitaxel and characterized by immunohistochemistry. The combination showed synergy (5) or additivity (2), and no antagonism, with synergy significantly associated (P < 0.05) with higher levels of M2-type macrophages. The association of strong efficacy of the combination in vivo with M2 macrophages, which are known to express CSF1R, and the absence of synergy in vitro is consistent with the tumor microenvironment also being a factor in DZB efficacy and suggests additional means by which DZB could be stratified for cancer treatment in the clinic.
The Efficacy and Safety of Tolvaptan in Heart Failure Patients with Congestive Signs: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Zeng Mei , Li Na , Chen Tongshuai , Ti Yun , Zhang Chunmei , Bu Peili
Published: February 2023

Objective:

The aim of this study was to investigate the efficacy and safety of tolvaptan, as well as the impact of its treatment dose and duration in heart failure patients with congestive signs.

Methods:

The PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched to collect data from all randomized controlled trials (RCT) examining the efficacy and safety of tolvaptan in heart failure patients with congestive signs compared with placebo or blank control until March 4, 2021. Urine volume, change in body weight, improvement in dyspnea, and reduction of edema were evaluated as efficacy indicators. All-cause mortality, worsening heart failure, and adverse events were considered safety indicators. The quality of eligible publications was assessed using the Cochrane risk of bias for RCTs.

Results:

Ten RCTs with 5980 patients were included in this analysis. Compared with control, tolvaptan significantly reduced weight in the short term (day 1, 7 RCTs, weighted mean difference (WMD): –1.09, 95% confidence interval (CI): –1.27 to –0.91; day 2, 2 RCTs, WMD: –1.67, 95% CI: –3.00 to –0.33; day 7, 4 RCTs, WMD: –0.95, 95% CI: –1.25 to –0.66), increased urine volume (WMD: 1825.72, 95% CI: 1438.38–2213.07), and relieved dyspnea (risk ratio (RR): 1.12, 95% CI: 1.05–1.19) without increasing the mortality rate (RR: 0.96, 95% CI: 0.87–1.06). Furthermore, the weight loss and increase in urine volume were not dose-dependent effects, and prolonged medication did not lead to sustained weight loss. In addition, there seemed to be more adverse events (RR: 1.17, 95% CI: 1.03–1.32) after treatment with tolvaptan. Further analysis revealed that patients treated with tolvaptan were more likely to report thirst (RR: 6.09, 95% CI: 3.37–11.00) and dry mouth (RR: 6.36, 95% CI: 4.09–9.90), as well as develop hypernatremia (RR: 12.76, 95% CI: 3.52–46.32).

Conclusions:

The meta-analysis shows that tolvaptan can improve congestion with no increase in mortality rate, but should be used to guard against adverse events. Deserve to be mentioned, the number of RCTs included was limited, suggesting that the observed results should be interpreted with caution. Additional robust clinical studies are warranted to validate the present findings.
Incidence of Major Adverse Cardiovascular and Cerebrovascular Events in Chinese Patients Undergoing Percutaneous Coronary Intervention with Iodixanol: An Observational Postauthorization Study
Authors: Wang Xiaozeng , Ma Dengfeng , Li Tianchang , Li Bao , Su Xi , Wu Yanqing , Du Zhimin , Ji Zheng , Yang Ping , Yang Baisong , Cao Xuebin , Li Junxia , Hou Fengxia , Cheng Ziping , Xu Banglong , Han Yaling
Published: February 2023

Objective:

This study aimed to evaluate the major adverse cardiovascular and cerebrovascular events (MACCEs) and overall safety profile associated with iodixanol in Chinese patients undergoing percutaneous coronary intervention (PCI).

Methods:

Patients at 30 centers in China registered in the OpenClinic v3.6 database from October 30, 2013, to October 7, 2015, were included in the study. The primary endpoint was in-hospital MACCEs including target lesion revascularization (TLR), stroke, stent thrombosis, cardiac death, and PCI-related myocardial infarction (MI) within 72 h post-PCI. Secondary endpoints were MACCEs from 72 h to 30 d post-PCI and other safety events within 30 d post-PCI.

Results:

A total of 3,042 patients were enrolled. The incidence of MACCEs within 72 h post-PCI was 2.33% (n = 71), including cardiac death (0.03%, n = 1) and PCI-related MI (2.30%, n = 70). The incidence of MACCEs from 72 h to 30 d post-PCI was 0.16% (n = 5), including cardiac death (0.10%, n = 3), PCI-related MI (0.03%, n = 1), and TLR for stent thrombosis (0.03%, n = 1). The incidence of composite angiographic or procedural complications was 2.86% (n = 87); 233 (7.86%) patients had results suggesting contrast-induced acute kidney injury.

Conclusions:

These findings indicate that the use of iodixanol in Chinese patients undergoing PCI is associated with a low incidence of MACCEs, confirming its safety in this population.
Defining Scholarship for Today and Tomorrow
Authors: Milner Robert J. , Flotte Terence R. , Thorndyke Luanne E.
Published: February 2023

Scholarship, required for academic advancement, has traditionally been defined narrowly, not keeping pace with the expansion of faculty academic activities in health professions schools. How can we refine the definition of scholarship so that it better aligns with the scope of current faculty practice within academic health systems? Revision of the academic policies for promotion and tenure at the University of Massachusetts Chan Medical School afforded an opportunity to redefine scholarship such that a broader platform was available for faculty recognition, aligning with current academic standards, yet providing flexibility for the future. The authors describe the historical context of the definition of scholarship and their institution's process to construct a definition of scholarship with three essential elements: advancement of knowledge, dissemination for critical review, and impact on a discipline, practice, or community. Application of this definition to team science and digital scholarship is also described. Following a widespread continuing education initiative, implementation of the new definition within promotion and tenure processes of the medical, nursing, and graduate schools resulted in broad acceptance across the institution. This forum article provides lessons in leading an academic health sciences institution to reassess academic processes and is a resource for advancing the vigorous debate on the evolving meaning and evaluation of scholarship.
A Performance-Based Competency Assessment of Pediatric Chest Radiograph Interpretation Among Practicing Physicians
Authors: Bregman Stacey , Thau Elana , Pusic Martin , Perez Manuela , Boutis Kathy
Published: February 2023

Background:

There is limited knowledge on pediatric chest radiograph (pCXR) interpretation skill among practicing physicians.

Objectives:

We systematically determined baseline interpretation skill, the number of pCXR cases physicians required complete to achieve a performance benchmark, and which diagnoses posed the greatest diagnostic challenge.

Methods:

Physicians interpreted 434 pCXR cases via a web-based platform until they achieved a performance benchmark of 85% accuracy, sensitivity, and specificity. Interpretation difficulty scores for each case were derived by applying one-parameter item response theory to participant data. We compared interpretation difficulty scores across diagnostic categories and described the diagnoses of the 30% most difficult-to-interpret cases.

Results:

240 physicians who practice in one of three geographic areas interpreted cases, yielding 56,833 pCXR case interpretations. The initial diagnostic performance (first 50 cases) of our participants demonstrated an accuracy of 68.9%, sensitivity of 69.4%, and a specificity of 68.4%. The median number of cases completed to achieve the performance benchmark was 102 (interquartile range 69, 176; min, max, 54, 431). Among the 30% most difficult-to-interpret cases, 39.2% were normal pCXR and 32.3% were cases of lobar pneumonia. Cases with a single trauma-related imaging finding, cardiac, hilar, and diaphragmatic pathologies were also among the most challenging.

Conclusions:

At baseline, practicing physicians misdiagnosed about one-third of pCXR and there was up to an eight-fold difference between participants in number of cases completed to achieve the standardized performance benchmark. We also identified the diagnoses with the greatest potential for educational intervention.
The Effect of Two Different Simulation Modalities in Palliative Care Teaching on Nursing Students' Knowledge, Satisfaction, Self-confidence, and Skills
Authors: Alwawi Abdallah , İnkaya Bahar
Published: February 2023

Nursing students from developing countries have limited opportunities to experience palliative care. Standardized patient and low-fidelity simulations can provide realistic palliative care experiences for students. However, limited research is available on simulation-based education in Palestine. Testing and using these two types of simulation methods may be the best solution for developing countries that lack adequate resources. This study aimed to test the effects of low-fidelity simulation compared with standardized patient simulation in palliative care teaching on nursing students' knowledge, satisfaction, confidence, and skills. The study was a randomized controlled trial of 70 nursing students in their sophomore year. Students' knowledge was assessed with the Palliative Care Quiz for Nursing test; satisfaction and confidence with the Learner Satisfaction and Self-confidence in Learning; and skills rated by two researchers. Students' knowledge improved significantly on the posttest compared with the pretest, without significant differences between both groups. The findings showed that the utilization of the two methods in students' clinical training for scenario has the same effect on the satisfaction and confidence. The skills of the standardized patient group improved significantly more than the low-fidelity group. The study revealed that both simulation modalities are effective for palliative care nursing students.
Natural Language Processing of Nursing Notes
Authors: Mitha Shazia , Schwartz Jessica , Hobensack Mollie , Cato Kenrick , Woo Kyungmi , Smaldone Arlene , Topaz Maxim
Published: February 2023

Natural language processing includes a variety of techniques that help to extract meaning from narrative data. In healthcare, medical natural language processing has been a growing field of study; however, little is known about its use in nursing. We searched PubMed, EMBASE, and CINAHL and found 689 studies, narrowed to 43 eligible studies using natural language processing in nursing notes. Data related to the study purpose, patient population, methodology, performance evaluation metrics, and quality indicators were extracted for each study. The majority (86%) of the studies were conducted from 2015 to 2021. Most of the studies (58%) used inpatient data. One of four studies used data from open-source databases. The most common standard terminologies used were the Unified Medical Language System and Systematized Nomenclature of Medicine, whereas nursing-specific standard terminologies were used only in eight studies. Full system performance metrics (eg, F score) were reported for 61% of applicable studies. The overall number of nursing natural language processing publications remains relatively small compared with the other medical literature. Future studies should evaluate and report appropriate performance metrics and use existing standard nursing terminologies to enable future scalability of the methods and findings.
Exploring the Relationship Between Usage and Outcomes of an eHealth Cardiac Rehabilitation Intervention
Authors: Su Jing Jing
Published: February 2023

This study aimed to explore the relationship between patients' characteristics and eHealth cardiac rehabilitation adherence and between eHealth usage metrics and behavior change. A subanalysis of 73 patients in the intervention group who received eHealth cardiac rehabilitation was conducted. Usage metrics on the number of Web site logins, health data uploads, and times of peer interaction and professional consultation were captured. Linear regression analysis was used. Participants (n = 73) were predominantly male with an average age of 55.53 (SD, 7.3) years. Younger age, having been treated with percutaneous coronary intervention, and hypertension predict higher Web site logins, whereas higher education, comorbidity with hypertension and diabetes, larger family size, and having been treated with percutaneous coronary intervention predict higher chatroom engagement. The Web site logins, Web site data uploads, chatroom nurse consultation, age, number of family members, drinking, and coresidency status were identified as significant correlates and explained 41.8% of the improvement in behavior change. This study demonstrated empirical evidence that Web site visits, health data uploads, and nurse consultations are crucial for behavior modification. Further studies may monitor usage metrics and investigate self-reported usage to explore the role of peer interaction in modifying behavior. Trial registration: Chinese Clinical Trial Registry: ChiCTR1800020411
Praying Online
Authors: Taylor Elizabeth Johnston , Paulien Jon
Published: February 2023

This article presents reflections and suggestions for nurse educators in a Christian institution who want to pray with students while teaching online. Suggestions primarily relate to recording prayers for class, including avoiding the appearance of coercion; being clear that students' participation in the recorded prayer will have no effect on grades; placing prayer in recorded material at a consistent location (such as the beginning or the end) so students know when it is coming; being creative in offering varying ways to pray; being authentic; and inviting student participation.
Cardiac Rehabilitation Programs: Content, Effectiveness, Limitations, and Gaps in Knowledge
Authors: Economidou Eleftheria C. , Lianopoulou Barbara , Soteriades Soteris , Soteriades Elpidoforos S.
Published: February 2023

Cardiac rehabilitation (CR) constitutes a valuable therapeutic approach for patients with a broad spectrum of cardiovascular diseases facilitating the development and maintenance of a desirable level of physical, social, and psychological functioning following the onset of cardiovascular disease. Nowadays, cardiac rehabilitation programs emphasize the use of a multidisciplinary approach. The current review aims at presenting the state-of-the-art knowledge on the indications of patients entering cardiac rehabilitation programs, including their core components, duration, and effectiveness. Following a careful review of the international literature, we conclude that there are significant differences between the most commonly cited international CR guidelines as well as additional limitations and gaps in knowledge. Despite the benefits associated with CR and despite their widespread acceptance, CR referrals and program attendance remains low, while many questions have not been so far addressed through scientific research. Overall, the findings of our study suggest a critical need for the development of robust and evidence-based standardized CR interventions to increase their use and effectiveness throughout the world.
The Evolution of Current Management for Carotid Artery Bifurcation Disease
Authors: Zohourian Tirajeh , Hines George
Published: February 2023

Options for treatment of symptomatic carotid bifurcation disease include carotid endarterectomy (CEA) and carotid artery stenting (CAS). While over the years CEA has established itself as the gold standard for carotid artery revascularization, results from recent trials have shown CAS to be safe and effective in selected patients. This review details the evolution of carotid artery bifurcation disease by highlighting key clinical trials.
Laparoscopic robotic takedown ureterostomy with extravesical cross-trigonal reimplantation after end cutaneous ureterostomy
Authors: Neeman Binyamin B. , Kocherov Stanislav , Jaber Jawdat , Neheman Amos , Chertin Boris
Published: February 2023

Introduction

The main goal of managing an obstructed megaureter (OMU) is to preserve the function of the affected kidney. To preserve the upper urinary tract, end cutaneous ureterostomy (ECU) seems to be a promising temporizing option.

We aimed to evaluate our experience with ECU in patients with primary and secondary OMU and to demonstrate an efficacy of robot-assisted laparoscopic takedown ureterostomy and subsequent extravesical ureteric reimplantation.

Materials and methods

Retrospective analysis of patients that underwent ECU due to primary or secondary megaureter between 2003 and 2020. Nineteen patients (12 males, 7 females) with a mean age of 4.2 ± 3.5 months (mean ± standard deviation) underwent ECU of 27 renal units. Of those, 11 (57.9%) had primary OMU and 8 (42.1%) had secondary OMU. Undiversion was performed in 16 (84%) out of 19 patients (20 renal units out of 27 [74%]).

Results

In the vast majority of the cases, we have observed improvement in the hydronephrosis and renal function after ureterostomy. After reimplantation ultrasonography showed either stable or further improvement in hydronephrosis in 80% of patients. Robot-assisted laparoscopic patients had shorter admission period and indwelling catheter time after the surgery.

Conclusions

End cutaneous ureterostomy is a safe and effective temporary procedure for the treatment of progressive primary and secondary megaureters. Robot-assisted laparoscopic takedown of ureterostomy with subsequent reimplantation seems to be a good alternative for undiversion and subsequent reimplantation in these patients.
Clinicopathologic and Dermoscopic Features of 20 Cases of Spark's Nevus, a Dermoscopic Simulator of Melanoma
Authors: Massone Cesare , Stanganelli Ignazio , Ingordo Vito , Ferrara Gerardo , Brunasso Alexandra Maria Giovanna , Siri Giacomo , Casazza Stefania , Gnone Matteo , Pizzichetta Maria Antonietta , Giovanni Biondo , Chiodi Stefano , Sola Simona
Published: February 2023

Spark's nevus is a particular type of melanocytic nevus, with histology that shows features of both Spitz and Clark nevus. Detailed dermoscopic features in a series of Spark nevi have not been described yet. We performed a monocentric retrospective observational study on 20 lesions of Spark nevus excised from 19 patients (M:F = 10:9; mean age: 37,6 years), reviewed by 5 experts in dermoscopy and 2 dermatopathologists. A histologic review confirmed that Spark nevi were mostly symmetric (80%), well circumscribed (100%), mainly compound (65%) melanocytic lesions with either epithelioid (55%) or spitzoid (45%) cell morphology and bridging of the nests (100%). Spark nevi were more frequently found on the trunk (85%) in patients with a history of sunburns in childhood (84%), with skin phototype III (79%), and with high nevus count (>100 nevi, 7 patients (36%)). On dermoscopy, we observed different general patterns: multicomponent (40%), reticular–globular–homogeneous (15%), globular homogeneous (15%), reticular (15%), reticular–globular (5%), homogeneous (5%), and globular (5%). Spark nevi showed frequently dermoscopic asymmetry (63%), brown color (90%) with areas of central hyperpigmentation (41%) and peripheral hypopigmentation (28%), atypical pigment network (48%), irregular globules (42%), irregular dots (31%), irregular blotches (16%), blue-whitish veil (13%), peripheral island (25%), irregular hyperpigmented areas (12%), and regression (33%). BRAF mutation was present in 7 of the 10 analyzed cases (70%); all these cases presented a history of evolution. In conclusion, Spark nevi occur on the trunk of young adults with high nevus count and history of sunburns; dermoscopic features are protean, often atypical and suspicious of melanoma.
Giant Hemosiderotic Adenodermatofibroma: A Case Report and Review of the Literature
Authors: Ha Megan V. , Andrasik Wyatt J. , Tamburro Joan
Published: February 2023

Adenodermatofibromas are an extremely rare subtype of dermatofibroma (DF) characterized by a dermal proliferation of spindle-shaped fibroblasts and histocytes, dilated glandular structures with apocrine secretion, and prominent vascular proliferation, with or without hemosiderotic features. We describe a recent extraordinary case of a hemosiderotic adenodermatofibroma in a 25-year-old female. We review histologic findings and theories behind etiology, as well as review the spectrum of clinical presentations for this lesion. We also discuss imaging findings that may make identification of these entities challenging.
Cutaneous Metastasis of Alveolar Rhabdomyosarcoma in a Child
Authors: Nör Felipe , Castro Juan Pablo , Wongpattaraworakul Wattawan , Buatti John M. , Gordon David , Powers Jennifer G. , Terry William , Hellstein John , Tanas Munir , Stone Mary
Published: February 2023

Rhabdomyosarcoma (RMS) is one of the most common soft tissue sarcomas in children. This lesion is classically included in the generic group of “small round blue cell tumors” along with other entities that share similar microscopic features. Although the head and neck region is a frequent site for primary tumors, cutaneous metastases of RMS involving this anatomical location are rare in the pediatric population. We report a case of a 12-year old girl previously diagnosed with a primary alveolar RMS involving the left maxillary sinus, presenting with a metastatic lesion on the skin of the left temple area. Along with a brief review of the previous case reports on the topic, we highlight the initial immunohistochemistry panel useful for diagnosing this tumor.
Psychosocial, Medical, and Demographic Variables Associated with Parent Mealtime Behavior in Young Children Recently Diagnosed with Type 1 Diabetes
Authors: Gonynor Caroline , Wang Christine , Tully Carrie , Monaghan Maureen , Streisand Randi , Hilliard Marisa E.
Published: February 2023

Objective:

Managing young children's mealtime concerns can be challenging after type 1 diabetes (T1D) diagnosis because of developmental factors and diabetes management demands. To identify potential intervention targets, we evaluated medical, psychosocial, and demographic factors in relation to parents' engagement in problem mealtime behaviors (e.g., pressure to eat, restriction).

Method:

Parents (N = 157) of young children (age 1–6 years) reported on psychosocial variables (parent fear of hypoglycemia, family functioning, parent problem solving, and parents' problem mealtime behavior frequency and perceptions of being problematic) within 2 months after T1D diagnosis. Hierarchical regression analyses examined associations among psychosocial variables, demographics (child sex, parent race/ethnicity), child continuous glucose monitor (CGM) use, and parents' problem mealtime behaviors.

Results:

Parents of children using CGMs reported parents' mealtime behaviors as more problematic than nonusers, but there were no differences for other medical or demographic variables. Models predicting parents' problem mealtime behavior frequency and problem perceptions that included psychosocial variables, demographic variables, and CGM use led to significant R2 of 0.14 and 0.16, respectively. CGM use and parent problem solving were significantly associated with parent mealtime behaviors being perceived as more problematic.

Conclusion:

Shortly after T1D diagnosis in young children, medical and parent psychosocial factors related to how frequently parents engaged in problem mealtime behaviors and the degree to which parents perceived them as problematic. Other factors may further explain the complexities of mealtime management. Considering parents' problem-solving skills and child treatment regimens may help guide interventions targeting mealtime challenges during the new diagnosis period.
Deep Shave Removal of Suspected Basal Cell Carcinoma: A Prospective Study
Authors: Dando Emily E. , Abban Cynthia , Shehu Wingrove Aurora , Pugliano-Mauro Melissa , Ferris Laura , Ho Jonhan , Patton Timothy
Published: February 2023

BACKGROUND

Diagnosis and treatment of basal cell carcinoma (BCC) in the same visit by shave removal may decrease health care spending and promote patient satisfaction.

OBJECTIVE

To prospectively evaluate deep shave removal of lesions clinically suspicious for low-risk BCC on the trunk or extremities in immunocompetent patients.

MATERIALS AND METHODS

Deep shave removal with the intent to remove the entire tumor was performed from January 2015 to June 2016, and patients were followed prospectively for clinical evidence of tumor recurrence.

RESULTS

Seventy-seven lesions were removed from 51 patients, including 29 (37%) superficial and nodular BCCs, 27 (35%) superficial BCCs, 16 (21%) nodular BCCs, and 5 (6%) non-BCCs. Fifteen BCCs (21%) had positive residual margins after deep shave removal, which was significantly more likely to occur in nodular compared with superficial BCCs (odds ratio = 7.8, 95% confidence interval = 1.4–43), and underwent re-excision. Fourteen specimens initially reported to have negative margins after deep shave underwent resectioning, which revealed positive margins in 4 specimens (28.6%). No BCCs have recurred clinically after an average follow-up of 50 months (SE 3.2).

CONCLUSION

Consider deep shave removal for low-risk BCCs on the trunk or extremities in immunocompetent patients hoping to avoid a second treatment visit.