bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genes and speciation: is it time to abandon the biological species concept?
Authors: Wang Xinfeng , He Ziwen , Shi Suhua , Wu Chung-I 
Published: December 2019

Abstract
The biological species concept (BSC) is the cornerstone of neo-Darwinian thinking. In BSC, species do not exchange genes either during or after speciation. However, as gene flow during speciation is increasingly being reported in a substantial literature, it seems time to reassess the revered, but often doubted, BSC. Contrary to the common perception, BSC should expect substantial gene flow at the onset of speciation, not least because geographical isolation develops gradually. Although BSC does not stipulate how speciation begins, it does require a sustained period of isolation for speciation to complete its course. Evidence against BSC must demonstrate that the observed gene flow does not merely occur at the onset of speciation but continues until its completion. Importantly, recent genomic analyses cannot reject this more realistic version of BSC, although future analyses may still prove it wrong. The ultimate acceptance or rejection of BSC is not merely about a historical debate; rather, it is about the fundamental nature of species – are species (and, hence, divergent adaptations) driven by a relatively small number of genes, or by thousands of them? Many levels of biology, ranging from taxonomy to biodiversity, depend on this resolution.
Alveolar soft part sarcoma mimics prostate cancer metastasis
Authors: Principe Daniel R , Mohindra Nisha A , Munshi Hidayatullah G , Kamath Suneel D 
Published: December 2019

Abstract
A 61-year-old man presented to the oncology clinic with Gleason 9 (4 + 5) prostate cancer. Staging CT showed multiple nodules in both lungs. Since the lung lesions were too small for biopsy, he was started on anti-androgen therapy for suspected metastatic, hormone-sensitive prostate cancer. While his prostate-specific antigen decreased from 32 to &lt;0.1 ng/ml, the multiple lung lesions showed no response on subsequent imaging. The patient presented during follow-up with severe right leg pain, at which time magnetic resonance imaging revealed a large, hyperintense mass in the femur. The mass was resected along with two lung nodules, with pathology demonstrating metastatic alveolar soft part sarcoma. This serves as an important reminder that lesions suspicious for metastases may be due to cancers of multiple primary origins, particularly if the pattern of metastasis is atypical or there is varied response to therapy.
Insufficient initial treatment but good recovery after diagnosis of pulmonary actinomycosis
Authors: Ito Toshiki , Yoshida Takayuki , Sakuraba Motoki , Tanaka Akihiko , Hamada Kunio , Ito Akihide 
Published: December 2019

Abstract
Actinomycosis is an infrequent invasive bacterial disease. Although multiple different clinical features of actinomycosis have been described, pulmonary actinomycosis (PA) is a rare but challenging diagnosis and complete cure to make. Here we report the case of a 41-year-old Asian woman who had a mass-like consolidation in the right middle lung field. The lung lesion was exacerbated after initial treatment. After diagnosis of PA, thoracoscopic resection combined with intravenous and oral penicillin made a good recovery.
Undescended retropharyngeal parathyroid adenoma with adjacent thymic tissue in a 13-year-old boy with primary hyperparathyroidism
Authors: Kordahi Anthony M , Newfield Ron S , Bickler Stephen W , Mo Jun Q , Khanna Paritosh C , Bykowski Julie , Bouvet Michael 
Published: December 2019

ABSTRACT
We describe a rare presentation of a symptomatic parathyroid adenoma located in an ectopic retropharyngeal position in a 13-year-old boy. Preoperative CT scan and MRI demonstrated the ectopic location of the parathyroid adenoma. The patient underwent successful parathyroidectomy with cure of his hyperparathyroidism. On pathologic exam, the specimen was made up of a parathyroid adenoma and adjacent thymic tissue, indicating that it was likely an undescended lower parathyroid gland arising from the third pharyngeal pouch. Ectopic retropharyngeal parathyroid adenomas are very rare and to our knowledge, none have been previously described in adolescents.
A case report of a rare omental extramedullary hematopoiesis in an adult: ‘an idiopathic finding’
Authors: Haykal Tarek , Yelangi Anitha , Pandit Trailokya , Bachuwa Ghassan , Azher Qazi 
Published: December 2019

Abstract
This is a case of a 62-year-old female, known to have multiple medical problems, who presented to her primary care physician with an intermittent abdominal pain and discomfort for a few months. The initial work-up showed mild leucocytosis and a small mass in the omentum. Given that the most concerning differential diagnosis was malignancy, the patient was referred to oncology, where biopsy of the mass showed omentum extramedullary hematopoiesis. The differential diagnosis was wide; however, a repeat computed tomography (CT) scan of the abdomen and pelvis did show persistence of the omental mass. After ruling out any possible causes, including myelofibrosis, with a normal bone marrow, her extramedullary hematopoiesis was deemed of unknown origin and with no clear explanation. Therefore, the patient was diagnosed with a rare adult idiopathic omental extramedullary hematopoiesis that was stable over time.
Network Analysis Indicates That Avolition Is the Most Central Domain for the Successful Treatment of Negative Symptoms: Evidence From the Roluperidone Randomized Clinical Trial
Authors: Strauss Gregory P , Zamani Esfahlani Farnaz , Sayama Hiroki , Kirkpatrick Brian , Opler Mark G , Saoud Jay B , Davidson Michael , Luthringer Remy 
Published: December 2019

Abstract
A recent conceptual development in schizophrenia is to view its manifestations as interactive networks rather than individual symptoms. Negative symptoms, which are associated with poor functional outcome and reduced rates of recovery, represent a critical need in schizophrenia therapeutics. MIN101 (roluperidone), a compound in development, demonstrated efficacy in the treatment of negative symptoms in schizophrenia. However, it is unclear how the drug achieved its effect from a network perspective. The current study evaluated the efficacy of roluperidone from a network perspective. In this randomized clinical trial, participants with schizophrenia and moderate to severe negative symptoms were randomly assigned to roluperidone 32 mg (n = 78), 64 mg (n = 83), or placebo (N = 83). Macroscopic network properties were evaluated to determine whether roluperidone altered the overall density of the interconnections among symptoms. Microscopic properties were evaluated to examine which individual symptoms were most influential (ie, interconnected) on other symptoms in the network and are responsible for successful treatment effects. Participants receiving roluperidone did not differ from those randomized to placebo on macroscopic properties. However, microscopic properties (degree and closeness centrality) indicated that avolition was highly central in patients receiving placebo and that roluperidone reduced this level of centrality. These findings suggest that decoupling the influence of motivational processes from other negative symptom domains is essential for producing global improvements. The search for pathophysiological mechanisms and targeted treatment development should be focused on avolition, with the expectation of improvement in the entire constellation of negative symptoms if avolition is effectively treated.
Occupational exposures and idiopathic pulmonary fibrosis
Authors: Walters Gareth I. 
Published: December 2019

Purpose of review
A recent meta-analysis of data from international case–control studies reports a population attributable fraction of 16% for occupational factors in the cause of idiopathic pulmonary fibrosis (IPF). Smoking, genetic factors and other prevalent diseases only partly explain IPF, and so this review aims to summarize recent progress in establishing which occupational exposures are important in cause.

Recent findings
IPF is a rare disease, although it is the commonest idiopathic interstitial pneumonia. Epidemiological study suggests that incidence of IPF is increasing, particularly in older men. There are significant associations with IPF and occupational exposures to organic dust, including livestock, birds and animal feed, metal dust, wood dust and silica/minerals. Estimates of effect vary between studies, and are influenced by the distribution of employment, study design and case definition. Inhalation of asbestos fibres is a known cause of usual interstitial pneumonia (as seen histologically in IPF), though there are significant linear relationships between asbestos consumption, and mortality from both IPF and mesothelioma, leading to the hypothesis that low-level asbestos exposure may cause IPF.

Summary
Research must focus on exposure–response relationships between asbestos and other occupational inhaled hazards, and IPF. Funding bodies and policy makers should acknowledge the significant occupational burden on IPF.
An Integrative Review of Clinical Characteristics of Infants With Diaper Dermatitis
Authors: Esser Media S. , Johnson Teresa S. 
Published: December 2019

Background:
Diaper dermatitis (DD) severity is demonstrated by the degree of erythema and skin breakdown. Many studies describe diaper dermatitis, but lack a full description of clinical characteristic (CC) involvement.

Purpose:
The purpose of this literature review is to explore the descriptions of CC of infants with DD provided within infant DD literature.

Search Strategy:
PubMed and Web of Science were searched using the keywords: diaper dermatitis, diaper rash, infant, and neonate. The inclusion criteria for this project are as follows: published after 1990, English language, include skin assessment or evaluation, and infant/children < two years of age. Review and opinion articles were excluded.

Results:
A total of 454 studies were retrieved, 27 remained after review for duplicates and relevance. The CC described most often were: type of feeds, stool frequency, history of DD, use of antibiotics, and delivery mode.

Synthesis of Evidence:
The studies reported inconsistent CC and a lack of correlation between these characteristics and the condition of diapered skin. Many studies focused solely on the efficacy of interventions lacking description of possible relationships between DD and CC.

Implications for Practice:
Skin condition outcome variables can be improved with the acknowledgment of the impact CC have on the development of DD. The combination of assessment measures and CC may ultimately demonstrate more merit or rigor for describing DD severity and skin condition.

Implications for Research:
Future research should expand this exploration to include environmental or contributing factors to continue to identify additional risk factors for DD.
Predictors of Parental Presence in the Neonatal Intensive Care Unit
Authors: Head Zauche Lauren , Zauche Michael S. , Dunlop Anne L. , Williams Bryan L. 
Published: December 2019

Background:
Parental presence in the neonatal intensive care unit (NICU) may affect preterm infants' developmental outcomes. However, few studies have described predictors of parental presence in the NICU.

Purpose:
To identify sociodemographic, clinical, environmental, and maternal psychological factors that predict parent presence in the NICU.

Methods:
Using a prospective cohort design, 66 preterm infants between 32 and 40 weeks' corrected gestational age were recruited at 2 level III NICUs in the United States. Data for length of parental presence were collected for 48 consecutive hours from daily visitation logs and medical records. A general linear model was estimated to identify significant predictors of parental presence.

Results:
Parental presence varied considerably, with a mean percentage of visitation time of 32.40%. The number of children at home (P = .003), presence of neurological comorbidity (P < .001), room type (P < .001), surgical history (P < .001), and perceived stressfulness of the NICU (P = .03) each had large main effects on parental presence, and room type and surgical history (P = .004) had a large interaction effect on parental presence. These predictors accounted for 65.8% of the variance in parental presence.

Implications for Research:
Future research aimed at understanding predictors of parent presence is essential for developing interventions and designing NICUs that support parental presence.

Implications for Practice:
Understanding factors that contribute to parental presence may help healthcare providers identify infants at risk for low parental presence and thus be able to provide greater support to these infants and their families. As a result, this may help improve outcomes and attachment.
The Phenomenon of Trombley-Brennan Terminal Tissue Injury in a Neonate
Authors: Jacob Ani , Grabher Deborah 
Published: December 2019

Background:
Trombley-Brennan terminal tissue injury (TB-TTI), also known as skin failure, was first identified in 2009 among critically ill adults receiving palliative care. Identification of this skin injury can be misinterpreted as a pressure ulcer. However, this phenomenon is now accepted as an early sign of impending death among critically ill adults.

Clinical Findings:
This case study describes TB-TTI in a terminally ill infant in a neonatal intensive care unit evidenced by intact, 2-cm oval skin discoloration on the lateral side of both knees with rapid progression in size.

Primary Diagnosis:
TB-TTI was identified on the day of death in an infant with a primary diagnosis of hypoxic-ischemic encephalopathy born at 32 weeks' gestation.

Interventions:
The neonatal intensive care unit (NICU) team mobilized the NICU advanced care team, institution's ethical council, and “Team Lavender” to provide infant comfort measures and emotional support to the family and care givers.

Outcomes:
Infant death occurred 8 hours after TB-TTI was identified.

Practice recommendations:
To our knowledge, this case study of TB-TTI in a terminally ill neonate in the NICU has not been previously described in the neonatal or pediatric population. Early recognition of the phenomenon can enable the healthcare team to provide timely emotional, spiritual, and psychosocial support to the family and allow time to “be present” with the infant at “end of life.” Future work should explore additional signs of TB-TTI and the occurrence rate.
Vicarious Posttraumatic Growth in NICU Nurses
Authors: Beck Cheryl Tatano , Casavant Sharon 
Published: December 2019

Background:
When posttraumatic growth occurs in clinicians as a result of their caring for patients and families who are traumatized, it is termed vicarious posttraumatic growth.

Purpose:
(1) To determine the level of vicarious posttraumatic growth and the disruption of core beliefs in neonatal intensive care unit (NICU) nurses who have cared for critically ill infants and their families. (2) To explore those quantitative findings through nurses' qualitative descriptions of their growth.

Methods:
A mixed method with a convergent parallel design was used to address the study aims. A targeted sample of neonatal nurses was recruited from the National Association of Neonatal Nurses (NANN) through the MyNANN Community message board. The sample consisted of 109 NICU nurses who completed the quantitative strand and 61 (55%) who completed the qualitative strand. Nurses completed the Posttraumatic Growth Inventory, the Core Beliefs Inventory, and described their experiences of any positive changes in their beliefs or life as a result of caring for critically ill infants. IBM SPSS 25.0 and Krippendorff's content analysis were used to analyze the quantitative and qualitative data, respectively.

Results:
NICU nurses reported a moderate degree of vicarious posttraumatic growth and disruption of their assumptive world. Appreciation of Life was the Posttraumatic Growth Inventory dimension that reflected the highest growth and Spiritual Change the lowest.

Implications for Practice:
Providing posttraumatic growth interventions has the potential to help NICU nurses find meaning through their experience.

Implications for Research:
Future surveys need to include a higher response rate to generalize the findings. A video abstract is available.

Video Abstract available at:
https://journals.na.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=36
The metabolic signature of T cells in rheumatoid arthritis
Authors: Weyand Cornelia M. , Wu Bowen , Goronzy Jörg J. 
Published: December 2019

Purpose of review
Rheumatoid arthritis (RA) is a prototypic autoimmune disease manifesting as chronic inflammation of the synovium and leading to acceleration of cardiovascular disease and shortening of life expectancy. The basic defect causing autoimmunity has remained elusive, but recent insights have challenged the notion that autoantigen is the core driver.

Recent findings
Emerging data have added metabolic cues involved in the proper maintenance and activation of immune cells as pathogenic regulators. Specifically, studies have unveiled metabolic pathways that enforce T cell fate decisions promoting tissue inflammation; including T cell tissue invasiveness, T cell cytokine release, T cell-dependent macrophage activation and inflammatory T cell death. At the center of the metabolic abnormalities lies the mitochondria, which is consistently underperforming in RA T cells. The mitochondrial defect results at least partially from insufficient DNA repair and leads to lipid droplet accumulation, formation of invasive membrane ruffles, inflammasome activation and pyroptotic T cell death.

Summary
T cells in patients with RA, even naïve T cells never having been involved in inflammatory lesions, have a unique metabolic signature and the changes in intracellular metabolites drive pathogenic T cell behavior. Recognizing the role of metabolic signals in cell fate decisions opens the possibility for immunomodulation long before the end stage synovial inflammation encountered in clinical practice.
Metabolic pathways mediate pathogenesis and offer targets for treatment in rheumatic diseases
Authors: Wyman Brandon , Perl Andras 
Published: December 2019

Purpose of review
The cause of autoimmune diseases remains incompletely understood. Here, we highlight recent advances in the role of proinflammatory metabolic pathways in autoimmune disease, including treatment with antioxidants and mechanistic target of rapamycin (mTOR) inhibitors.

Recent findings
Recent studies show that mTOR pathway activation, glucose utilization, mitochondrial oxidative phosphorylation, and antioxidant defenses play critical roles in the pathogenesis of autoimmune diseases, including rheumatoid arthritis, immune thrombocytopenia, Sjögren's syndrome, large vessel vasculitis, and systemic lupus erythematosus. mTOR activity leads to Th1 and Th17 cell proliferation, Treg depletion, plasma cell differentiation, macrophage dysfunction, and increased antibody and immune complex production, ultimately resulting in tissue inflammation. mTOR also affects the function of connective tissue cells, including fibroblast-like synoviocytes, endothelial cells, and podocytes. mTOR inhibition via rapamycin and N-acetylcysteine, and blockade of glucose utilization show clinical efficacy in both mouse models and clinical trials, such as systemic lupus erythematosus.

Summary
The mTOR pathway is a central regulator of growth and survival signals, integrating environmental cues to control cell proliferation and differentiation. Activation of mTOR underlies inflammatory lineage specification, and mTOR blockade-based therapies show promising efficacy in several autoimmune diseases.
Breast Reconstruction Utilizing Buried Dermato-cutaneous Skin Flaps and Immediate Adipocyte Transfer: A Minimally Invasive Autologous Breast Reconstruction Technique
Authors: Goldman Boris E. , Capasse Jeanne S. , McGregor Andrew , H. M. Cheng Zandra 
Published: December 2019

Background:
Autologous breast reconstruction historically required flaps that were invasive, required prolonged operative times and recoveries, and resulted in varying degrees of donor site morbidity. We present our early results with a minimally invasive completely autologous breast reconstruction technique utilizing buried dermato-cutaneous (DMC) flaps and immediate fat grafting. A 25-patient, 43-breast consecutive case series is presented.

Methods:
Select patients desiring autologous breast reconstruction who had sufficient breast ptosis and fat donor tissue were offered breast reconstruction with buried folded over DMC flaps with adipocyte transfer (DCAT). A Wise pattern mastectomy was performed, and fat was transferred into an inferiorly based, buried and folded DMC flap. Fat was also immediately grafted into the pectoralis, subpectoral space, and below pectoralis and serratus fascia. Most patients underwent additional fat grafting at 3-month intervals to complete the reconstruction.

Results:
Twenty-five consecutive patients (43 breasts) underwent the DCAT procedure with 18 (42%) free nipple grafts. Eight patients (8 breasts) had prior breast radiation, and 2 patients (2 breasts) required postmastectomy radiation. Average fat grafted at initial mastectomy was 70 mL per breast (range 50–103 mL). Nineteen patients (76%) underwent additional outpatient fat grafting. Two additional outpatient fat graft sessions (range 0–3) at 3-month intervals completed the reconstruction. Average fat grafted at the second stage was 217 mL (range 50–320 mL). Average follow-up was 20 months from DCAT and 12 months from last fat graft.

Conclusion:
The DCAT procedure appears to provide a minimally invasive, autologous breast reconstruction alternative in select patients.
Interpositional Arthroplasty Using Mammary Capsule for Finger Joints: A Novel Technique
Authors: Mesa Felipe , López Federico , Mesa Sara 
Published: December 2019

Summary:
Degenerative osteoarthritis frequently affects the hands, altering the movements; surgical therapy includes arthrodesis and arthroplasty. We report the case of a female patient who presented arthrosis in the hands, severe on the proximal interphalangeal (PIP) joints, initially in her right index finger, and subsequently in the index and middle left fingers. At first, she received treatment in the PIP joint of the right index finger with a silicone implant; later on, she presented fracture of it and required replacement 8 years later. In the PIP joints of index and middle left fingers, treatment was made with interposition arthroplasty by mammary implant capsule. We present the postoperative progression of the silicone versus mammary capsule interposition arthroplasty. It is remarkable that, over time, articular function of the intervened joints with capsular arthroplasty remained stable with good motion, while range of motion in other fingers was reduced as a consequence of osteoarthritis. The frequency of patients presenting simultaneously with mammary capsule contracture and osteoarthritis is low, but this novel technique is nonetheless worthwhile to take into consideration.