bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of an invasive ductal carcinoma in a contralateral composite nipple graft after an autologous breast reconstruction: a case report
Authors: Kimura Mariko , Narui Kazutaka , Shima Hidetaka , Ikejima Shizune , Muto Mayu , Satake Toshihiko , Tanabe Mikiko , Inayama Yoshiaki , Adachi Shoko , Yamada Akimitsu , Shimada Kazuhiro , Sugae Sadatoshi , Ichikawa Yasushi , Ishikawa Takashi , Endo Itaru 
Published: August 2020

Abstract
Background
Nipple-areola complex (NAC) reconstruction is a technique used in breast reconstructive surgery, which is performed during the final stage of breast reconstruction after total mastectomy of primary breast cancer. Composite nipple grafts utilizing the contralateral NAC are common; however, to our knowledge, there are no reports of new primary invasive ductal carcinoma development within the graft. Here, we describe one such case for the first time.

Case presentation
A 54-year-old woman was referred to us by the Department of Plastic and Reconstructive Surgery in our medical center for further evaluation of right nipple erosion. She had undergone total mastectomy of the right breast following a breast cancer diagnosis 15 years ago, at which time tumor biological profiling revealed the following: estrogen receptor (ER), positive; progesterone receptor (PgR), negative; and human epidermal growth factor receptor 2 (HER2), undetermined. She received adjuvant chemotherapy and endocrine therapy. She defaulted endocrine therapy for a few years, and 7 years after surgery, she underwent autologous breast reconstruction with a deep inferior epigastric perforator (DIEP) flap. In the following year, NAC reconstruction was performed using a composite graft technique. Seven years after the NAC reconstruction, erosion appeared on the nipple grafted from its contralateral counterpart; scrape cytology revealed malignancy. The skin on the right side of her chest around the NAC and subcutaneous fat tissue consisted of transferred tissue from the abdomen, as the DIEP flap and grafted nipple were located on the graft skin. The right nipple carcinoma arose from the tissue taken from the left nipple. Magnetic resonance imaging (MRI) or computed tomography showed no malignant findings in the left breast. As the malignant lesion seemed limited to the area around the grafted right nipple on MRI, surgical resection with sufficient lateral and deep margins was performed around the right nipple. Pathological findings revealed invasive ductal carcinoma with comedo ductal components infiltrating the graft skin and underlying adipose tissue. Immunohistochemistry revealed positive for ER, PgR, and HER2.

Conclusions
To our knowledge, this is the first case involving the development of invasive ductal carcinoma in a nipple graft constructed on the skin of a DIEP flap, with the origin from the contralateral breast’s nipple.
Potential assessment and experimental analysis of solar vegetable dryer: in case of northern Ethiopia
Authors: Sintie Yihun Tefera , Aduye Gebrie Teshome 
Published: August 2020

AbstractThe traditional vegetable drying (open-air/sun drying) method of harvesting of tomato, potato and onion in the Fogera District in Amhara regional state, Ethiopia, leads to loss of product, reduction in the quality of product and economic loss for the poor farmers. So, this experiment aimed to show the effectiveness of solar dryer technology by increasing the quality of the product in tomato, potato, and onion in Fogera district Northwest Ethiopia, 2018. A simple solar vegetable dryer is experimentally analyzed to alleviate the problem associated with vegetable processing in Woreta city. The first law of thermodynamics energy analysis was carried out to estimate the amount of useful energy gained from solar air dryer and energy utilization ratio of the drying chamber and the energy through drying box. The magnitude of the exergy inflow, outflow and exergy losses in the drying chamber during the drying process was determined by applying the second law of thermodynamics. The average solar drying efficiency was found to be 75.01% to 86.70% for tomato, 75.70% to 87.90% for potato and 58.7% to 85.5% for onion. Regrading the drying period, it took 33 h for tomato, 27 h for potato and 44 h for onion during the experimental test.
Study protocol: a lifestyle intervention for African American and Hispanic prostate cancer survivors on active surveillance and their partners
Authors: Cho Dalnim , Basen-Engquist Karen , Acquati Chiara , Ma Hilary , Pettaway Curtis , Li Yisheng , Diep Cassandra S. , McNeill Lorna H. 
Published: August 2020

Abstract
Background
Prostate cancer is the most commonly diagnosed cancer in both African American and Hispanic men. Active surveillance is a treatment option for low- or very low-risk prostate cancer survivors, and lifestyle interventions have been found to reduce the disease progression and improve the quality of life for both survivors and their partners. To date, no lifestyle interventions that specifically target African American or Hispanic men and their partners exist. This protocol describes a study that tests the feasibility of a randomized controlled trial, a lifestyle intervention developed to enhance healthy lifestyle and quality of life among African American and Hispanic men on active surveillance and their partners.

Methods
A mixed-method study, including a two-arm randomized controlled trial (n = 30 dyads in the intervention arm and n = 10 dyads in the control arm) and in-depth interviews, will be conducted. Intervention arm participants will receive bi-weekly health coaching calls (a total of 12 calls based on Motivational Interviewing), as well as physical activity-specific (e.g., power point slides, print materials about physical activity, and activity trackers for self-monitoring) and nutrition-specific education (e.g., two nutrition counseling sessions from a registered dietitian, print materials about nutrition, and food intake recording for self-monitoring) over 6 months. All participants will be assessed at baseline, month 3, and month 6. Blood will be collected at baseline and month 6 from the prostate cancer survivors. Finally, in-depth interviews will be conducted with subsamples (up to n = 15 dyads in the intervention arm and up to n = 5 dyads in the control arm) at baseline and months 3 and 6 to conduct a process evaluation and further refine the intervention.

Discussion
If effective, the intervention may have a higher health impact compared with a typical lifestyle intervention targeting only survivors (or partners), as it improves both survivors’ (tertiary prevention) and partners’ health (primary prevention). Results from this study will provide important information regarding recruiting racial/ethnic minority cancer survivors and their partners. Lessons learned from this study will be used to apply for a large-scale grant to test the impact of the dyadic intervention in a fully powered sample.

Trial registration
ClinicalTrials.gov (NCT No. 03575832) registered on 3 July 2018.
Pediatric size phlebotomy tubes and transfusions in adult critically ill patients: a pilot randomized controlled trial
Authors: Barreda Garcia Javier , Xian Jonathan Z. , Pedroza Claudia , Salahuddin Moiz , Mak Garbo , Keene Anabelle , Cherian Sujith V. , Young Alisha Y. , Vijhani Praveen , Doshi Pratik B. 
Published: August 2020

Abstract
Background
Transfusion of red blood cells (RBC) is common, can have adverse effects, and is a costly and limited resource. Interventions that reduce iatrogenic blood losses could reduce transfusions. The objectives of this pilot trial were to assess the feasibility (acceptability of the intervention and suitability of eligibility criteria) and potential effectiveness of pediatric size phlebotomy tubes in adult critically ill patients.

Methods
We conducted a pilot, randomized controlled trial in the medical intensive care unit (ICU) of a university-affiliated, tertiary care referral hospital from November 2017 to September 2018. A total of 200 patients with hemoglobin of at least 7 g/dL and without bleeding were randomized to pediatric or adult size phlebotomy tubes. Stratification was according to baseline hemoglobin (7–9.49 g/dL, 9.5–11.99 g/dL, and 12 g/dL or greater). Acceptability was measured via the number of blood test recollections and the number of patients that discontinued the use of pediatric tubes. The suitability of patient eligibility criteria was determined by identifying baseline characteristics associated with RBC transfusions. Potential effectiveness was estimated from the time to RBC transfusion or to hemoglobin level below 7 g/dL.

Results
The use of pediatric tubes was acceptable as patients experienced a low number of tests recollections (on average 1 every 57 days), and none of the participants discontinued their use. The baseline hemoglobin category was the only factor that appeared to be independently associated with RBC transfusions. A total of 6 patients (6%) in the pediatric tube group and 11 patients (11%) in the adult tube group (hazard ratio, 0.69; 95% CI, 0.25 to 1.9) received an RBC transfusion or reached hemoglobin below 7 g/dL. Almost all of these patients (16 of 17 participants) had baseline hemoglobin of 7–9.49 g/dL.

Conclusions
This pilot study suggests that pediatric phlebotomy tubes are acceptable to patients and can therefore be used in adult ICU patients. A future study should focus on patients with hemoglobin levels below 9.5 g/dL, as these patients have a high risk of transfusions. This intervention has the potential of being successful in selected patients. A definitive trial is warranted.

Trial registration
ClinicalTrials.gov, NCT03286465. Retrospectively registered on September 18, 2017.
Assessment of the correlation between various risk factors and orofacial cleft disorder spectrum: a retrospective case-control study
Authors: Cheshmi Behzad , Jafari Zahra , Naseri Mohammad Ali , Davari Heidar Ali 
Published: August 2020

Abstract
Background
Orofacial clefts (OFCs) comprise a wide range of malformations, including cleft lip, cleft palate, and cleft lip with cleft palate, which can vary in terms of etiology, severity, and disease burden.

Objective(s)
This study aimed to evaluate the correlation between various risk factors and orofacial cleft disorder spectrum in newborns.

Study design
A total of 323 cases and 400 controls were enrolled in this study and evaluated in terms of the maternal history of abortion or miscarriage, child’s sex, maternal and paternal age, maternal history of systemic disease, history of medication therapy during pregnancy, birth order, consanguineous marriage, and complications during pregnancy.

Results
Analysis of the results suggested that consanguineous marriage, a maternal history of abortion/miscarriage, and complications during pregnancy could potentially increase the risk of OFCs in children (P < 0.05). However, the analyses revealed that the other variables could not potentially increase the risk of OFCs (P > 0.05).

Conclusion(s)
Multiple cofactors may simultaneously contribute to the formation of such abnormalities; therefore, a comprehensive, multidisciplinary care program is necessary to ensure a successful pregnancy period and the birth of a healthy newborn.
Atlas-based measures of left ventricular shape may improve characterization of adverse remodeling in anthracycline-exposed childhood cancer survivors: a cross-sectional imaging study
Authors: Narayan Hari K. , Xu Ronghui , Forsch Nickolas , Govil Sachin , Iukuridze David , Lindenfeld Lanie , Adler Eric , Hegde Sanjeet , Tremoulet Adriana , Ky Bonnie , Armenian Saro , Omens Jeffrey , McCulloch Andrew D. 
Published: August 2020

AbstractBackgroundAdverse cardiac remodeling is an important precursor to anthracycline-related cardiac dysfunction, however conventional remodeling indices are limited. We sought to examine the utility of statistical atlas-derived measures of ventricular shape to improve the identification of adverse anthracycline-related remodeling in childhood cancer survivors.MethodsWe analyzed cardiac magnetic resonance imaging from a cross-sectional cohort of 20 childhood cancer survivors who were treated with low (< 250 mg/m2[N = 10]) or high (≥250 mg/m2[N = 10]) dose anthracyclines, matched 1:1 by sex and age between dose groups. We reconstructed 3D computational models of left ventricular end-diastolic shape for each subject and assessed the ability of conventional remodeling indices (volume, mass, and mass to volume ratio) vs. shape modes derived from a statistical shape atlas of an asymptomatic reference population to stratify anthracycline-related remodeling. We compared conventional parameters and five atlas-based shape modes: 1) between survivors and the reference population (N = 1991) using multivariable linear regression, and 2) within survivors by anthracycline dose (low versus high) using two-sided T-tests, multivariable logistic regression, and receiver operating characteristic curves.ResultsCompared with the reference population, survivors had differences in conventional measures (lower volume and mass) and shape modes (corresponding to lower overall size and lower sphericity; allp < 0.001). Among survivors, differences in a shape mode corresponding to increased basal cavity size and altered mitral annular orientation in the high-dose group were observed (p = 0.039). Collectively, atlas-based shape modes in conjunction with conventional measures discriminated survivors who received low vs. high anthracycline dosage (area under the curve [AUC] 0.930, 95% confidence interval 0.816, 1.00) significantly better than conventional measures alone (AUC 0.710, 95% confidence interval 0.473, 0.947; AUC comparisonp = 0.0498).ConclusionsCompared with a reference population, heart size is smaller in anthracycline-exposed childhood cancer survivors. Atlas-based measures of left ventricular shape may improve the detection of anthracycline dose-related remodeling differences.
Multisensory inclusive design with sensory substitution
Authors: Lloyd-Esenkaya Tayfun , Lloyd-Esenkaya Vanessa , O’Neill Eamonn , Proulx Michael J. 
Published: August 2020

AbstractSensory substitution techniques are perceptual and cognitive phenomena used to represent one sensory form with an alternative. Current applications of sensory substitution techniques are typically focused on the development of assistive technologies whereby visually impaired users can acquire visual information via auditory and tactile cross-modal feedback. But despite their evident success in scientific research and furthering theory development in cognition, sensory substitution techniques have not yet gained widespread adoption within sensory-impaired populations. Here we argue that shifting the focus from assistive to mainstream applications may resolve some of the current issues regarding the use of sensory substitution devices to improve outcomes for those with disabilities. This article provides a tutorial guide on how to use research into multisensory processing and sensory substitution techniques from the cognitive sciences to design new inclusive cross-modal displays. A greater focus on developing inclusive mainstream applications could lead to innovative technologies that could be enjoyed by every person.
Patient-reported outcome measures for retinoblastoma: a scoping review
Authors: Janic Ana , Bowden Sylvie , Levy Sarah , Stinson Jennifer , Dimaras Helen 
Published: August 2020

Abstract
Background
Retinoblastoma is a childhood retinal cancer with lifelong consequences such as vision loss and increased risk of second cancer. Patient-reported outcome measures (PROMs) are instruments that measure outcomes related to health directly reported by patients. The purpose of this study was to determine the scope, characteristics and quality of PROMs used in retinoblastoma and related fields of pediatric ophthalmology and pediatric oncology.

Methods
Databases MEDLINE and Embase were searched for studies in the English language that reported on PROMs used in retinoblastoma, pediatric oncology, or pediatric ophthalmology; grey literature and studies reporting on developmental PROM phases were excluded. PROMs were grouped by the construct measured and domains assessed, and classified as condition-specific or generic. A subsequent search was then conducted in MEDLINE and Embase for studies assessing measurement properties of the identified PROMs. PROMs with associated studies were assessed for their methodologic quality using the COnsensus-based standard for the Selection of health Measurement INstruments (COSMIN) strategy.

Results
Among 110 eligible studies uncovered by the database searches, 143 PROMs were identified: one retinoblastoma-specific, 56 ophthalmology- and 86 oncology-related. The most common construct measured was ‘health-related quality of life’ and the most common domain assessed was emotional well-being. Of the 143 PROMs, 100 had associated validation studies; the one retinoblastoma-specific PROM was not validated. Quality assessment revealed 34/100 PROMs received a score of sufficient quality in both subcategories of ‘overall content validity’; 3/100 received a score of sufficient quality in both subcategories of ‘internal structure’; 0/100 received a score of sufficient quality in all three subcategories of ‘remaining measurement properties’. The Patient-Reported Outcome Measure Information System (PROMIS) Pediatric Profile-25 was the highest-scoring PROM identified, meeting COSMIN standards for 2/3 measurement property categories (and 5/7 subcategories). Eleven additional PROMs were identified which had sufficient scores in 1/3 measurement property categories (and 5/7 subcategories).

Conclusion
The study identified several PROMs from the pediatric ophthalmology and pediatric oncology literature that could be relevant to the retinoblastoma population, but many have limits to their validation. Future development of a retinoblastoma-specific PROM, performed in partnership with retinoblastoma patients to support optimal content validity, could first focus on the selection and definition of the optimal construct to measure, followed potentially by adaptation and further validation of the relevant PROMs with strong methodologic quality identified in this study.
An observational field study of the cloacal microbiota in adult laying hens with and without access to an outdoor range
Authors: Schreuder Janneke , Velkers Francisca C. , Bouwstra Ruth J. , Beerens Nancy , Stegeman J. Arjan , de Boer Willem F. , van Hooft P. , Elbers Armin R. W. , Bossers Alex , Jurburg Stephanie D. 
Published: August 2020

Abstract
Background
Laying hens with access to outdoor ranges are exposed to additional environmental factors and microorganisms, including potential pathogens. Differences in composition of the cloacal microbial community between indoor- and outdoor-housed layers may serve as an indicator for exposure to the outdoor environment, including its pathogens, and may yield insights into factors affecting the chickens’ microbiota community dynamics. However, little is known about the influence of outdoor housing on microbiota community composition in commercial layer flocks. We performed a cross-sectional field study to evaluate differences in the cloacal microbiota of indoor- vs outdoor-layers across farms.
Eight layer flocks (four indoor, four outdoor) from five commercial poultry farms were sampled. Indoor and outdoor flocks with the same rearing flock of origin, age, and breed were selected. In each flock, cloacal swabs were taken from ten layers, and microbiota were analysed with 16S rRNA gene amplicon sequencing.

Results
Housing type (indoor vs outdoor), rearing farm, farm and poultry house within the farm all significantly contributed to bacterial community composition. Poultry house explained most of the variation (20.9%), while housing type only explained 0.2% of the variation in community composition. Bacterial diversity was higher in indoor-layers than in outdoor-layers, and indoor-layers also had more variation in their bacterial community composition. No phyla or genera were found to be differentially abundant between indoor and outdoor poultry houses. One amplicon sequence variant was exclusively present in outdoor-layers across all outdoor poultry houses, and was identified as Dietzia maris.

Conclusions
This study shows that exposure to an outdoor environment is responsible for a relatively small proportion of the community variation in the microbiota of layers. The poultry house, farm, and rearing flock play a much greater role in determining the cloacal microbiota composition of adult laying hens. Overall, measuring differences in cloacal microbiota of layers as an indicator for the level of exposure to potential pathogens and biosecurity seems of limited practical use. To gain more insight into environmental drivers of the gut microbiota, future research should aim at investigating community composition of commercial layer flocks over time.
Opioids and the Hypothalamic-Pituitary-Gonadal (HPG) Axis
Authors: Wehbeh Leen , Dobs Adrian S 
Published: August 2020

Abstract

Context
Hypogonadism is a well-established consequence of opioid use. It has been reported in both men and women, although more widely studied in men.

Evidence Acquisition
PubMed was searched for articles in English until December 2019 for opioids and hypogonadism. Bibliography of retrieved articles was searched for relevant articles.

Evidence Synthesis
The prevalence of opioid-induced hypogonadism (OIH) varies between studies but was reported to be 69% in a recent systematic review. There is large heterogeneity in the studies, with different factors shown to have stronger association with hypogonadism such as specific types of opioids, higher doses, and longer durations of use. The consequences of OIH include sexual dysfunction, depression, decreased quality of life, and low bone density. There is paucity of randomized controlled trials assessing the efficacy of testosterone replacement therapy (TRT) for OIH in men, and even less studies on treating OIH in women. TRT studies in men reported varying outcomes with some studies favoring and others showing no clear benefit of TRT on different measures.

Conclusions
Despite the high prevalence of OIH, it remains underrecognized and undertreated with multiple endocrine and metabolic consequences. A reasonable approach in patients using opioids includes informing them of this complication and its potential consequences, screening for signs and symptoms of hypogonadism then sex hormone levels if prolonged opioid use &gt; 3 months, and treating patients diagnosed with hypogonadism, if and when clinically indicated, with sex hormones if chronic opioids are planned to be continued for ≥ 6 months.