bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment of a 7-miRNA–Based Risk Score System for Predicting Prognosis of Pancreatic Cancer
Authors: Zhuang Hongkai , Ma Zuyi , Huang Kaijun , Zhou Zixuan , Huang Bowen , Sun Zhonghai , Hou Baohua , Zhang Chuanzhao 
Published: May 2020

ObjectiveThis study developed a prognosis-associated miRNA (PAM)-based risk score system to predict overall survival for pancreatic cancer.MethodsWe screened potential PAMs using bioinformatics technology. A risk score system integrating the PAMs was established, and the predictive value was evaluated. The targets of these PAMs were identified and functional enrichment analysis was performed.ResultsSeven PAMs (hsa-mir-188, hsa-mir-1301, hsa-mir-424, hsa-mir-5010, hsa-mir-584, hsa-mir-5091, and hsa-mir-3613) were identified. We also developed a risk score system, which showed a high Harrell concordance index (C-index, 0.723) for overall survival in the Cancer Genome Atlas data sets. The areas under the curve of the receiver operating characteristic curve at the 1-, 2-, and 3-year survival points were 0.718, 0.832, and 0.903, respectively. In addition, both the C-index and the areas under the curve for recurrence-free survival showed a good outcome, indicating that the system had a satisfactory predictive power. Furthermore, 49 target genes of PAMs were identified. Functional enrichment analysis revealed that these targets may be involved in various biological pathways, including the transforming growth factor β signaling pathway, Notch signaling, and downregulation of SMAD2/3.ConclusionsThe findings of this study suggest that the 7-miRNA–based risk score system is a promising prognostic model for pancreatic cancer.
Extrapancreatic Nerve Plexus Invasion on Imaging Predicts Poor Survival After Upfront Surgery for Anatomically Resectable Pancreatic Cancer
Authors: Sugimoto Motokazu , Kobayashi Tatsushi , Kobayashi Shin , Takahashi Shinichiro , Konishi Masaru , Mitsunaga Shuichi , Ikeda Masafumi , Gotohda Naoto 
Published: May 2020

Objectives
This study aimed to analyze the risk factors for poor survival of the patients with anatomically resectable pancreatic ductal adenocarcinoma (PDAC), focusing on detailed computed tomography (CT) findings of tumor extent to the peripancreatic tissue.

Methods
The study included 192 patients who underwent upfront pancreaticoduodenectomy for anatomically resectable PDAC. Preoperative CT images were rereviewed by an experienced radiologist for the pattern of tumor extension to the surrounding tissue: biliary, duodenal, serosal, retroperitoneal, portal venous, arterial, extrapancreatic nerve plexus, and other-organ invasion. Imaging findings and other clinical data that could be obtained before surgery were evaluated for their association with a shorter disease-specific survival (DSS) and recurrence-free survival (RFS).

Results
Of the 192 anatomically resectable PDAC patients, extrapancreatic nerve plexus invasion was observed on CT in 38 patients (20%), and this finding was independently associated with a shorter DSS (hazard ratio, 2.258; P < 0.001) and RFS (hazard ratio, 2.665; P < 0.001). The median survival of patients with and without extrapancreatic nerve plexus invasion on CT was 19.7 versus 38.5 months (P < 0.001).

Conclusions
Extrapancreatic nerve plexus invasion was shown as an only CT finding associated with a shorter DSS and RFS after upfront surgery for the patients with anatomically resectable PDAC.
Adenosquamous Carcinoma of the Pancreas Comprise a Heterogeneous Group of Tumors With the Worst Outcome
Authors: Boecker Joerg , Feyerabend Bernd , Tiemann Katharina , Buchwalow Igor , Wagner Kim C. , Oldhafer Karl J. , Andruszkow Julia , Daniels Thies , Boessow Dorthe , Boecker Werner , Neumann Ulf Peter 
Published: May 2020

Objectives
Information of the clinicopathological characteristics and outcome data of patients with adenosquamous carcinoma of the pancreas (ASCAP) remains limited. This study's aim is to describe the clinical, pathological, and molecular characteristics of 25 resected ASCAPs.

Methods
Of all 25 cases, patient characteristics, follow-up data, and pathological/immunohistological features were reviewed and analyzed.

Results
In this 3-institutional retrospective analysis of 562 pancreatic cancer patients, we identified 25 cases with histologically confirmed ASCAP (4.4%). Follow-up was available in 21 ASCAP and 50 pancreatic ductal adenocarcinoma control patients with a median overall survival of 8.2 and 21 months, respectively. Age, tumor size, localization in the tail, lymph node status, and resection margin seem to be the most significant factors of survival in our ASCAP cohort. In contrast to pancreatic ductal adenocarcinoma, positive expression of p63, keratins K5/14, and the epidermal growth factor receptor are a robust marker profile of these tumors.

Conclusions
Adenosquamous carcinoma of the pancreas comprises a group of neoplasms in which stage and adverse morphological features contribute to its bad prognosis. Further work must be pursued to improve detection and treatment options to reduce mortality. Specifically, differences in biology might become a target for the development of possible therapies.
Pancreatoduodenectomy With Arterial Resection for Locally Advanced Pancreatic Cancer of the Head
Authors: Haines Morgan , Chua Terence C. , Jamieson Nigel B. , Mittal Anubhav , Gill Anthony J. , Samra Jaswinder S. 
Published: May 2020

Abstract
The development of increasingly effective chemotherapy regimens and increasing tumor necrosis is allowing radical pancreatectomy to be re-evaluated. This systematic review examines the outcome of patients with locally advanced cancer of the pancreatic head after pancreatectomy with arterial resection. Electronic searches were performed on PubMed and Medline databases between January 2000 and December 2018. The end points were to determine the safety and overall survival after arterial resection in pancreatectomy. Thirteen studies with 467 patients were included. Celiac, hepatic, mesenteric, and splenic arteries were resected across all studies. The median overall morbidity was 52% (range, 37%–100%) and with major complications occurring in a median of 25% (range, 12%–54%) of patients. The median 90-day mortality was 5% (range, 0%–17%). R0 was achieved in 66% (range, 43%–100%) and R1 in 31% (range, 0%–74%). The median survival was 17 (range, 7–29) months with a 1- and 3-year survival of 59% (range, 16%–92%) and 17% (range, 0%–13%), respectively. Pancreatectomy with arterial resection may be safely performed in high-volume centers with acceptable survival results in highly selected patients. Pooling of data through a multi-institutional registry will allow a more accurate assessment of the safety and efficacy of this treatment strategy.
Characteristics of Lung Metastasis as an Initial Recurrence Pattern After Curative Resection of Pancreatic Cancer
Authors: Morimoto Daishi , Yamada Suguru , Sonohara Fuminori , Takami Hideki , Hayashi Masamichi , Kanda Mitsuro , Tanaka Chie , Kobayashi Daisuke , Nakayama Goro , Koike Masahiko , Fujiwara Michitaka , Fujii Tsutomu , Kodera Yasuhiro 
Published: May 2020

Objectives
Understanding the disparity in clinical course because of differences in initial recurrence patterns could lead to a more accurate estimation of prognosis and optimal treatment.

Methods
Patients who underwent resection for pancreatic cancer between January 2003 and December 2016 were identified from a prospective database. We analyzed the association between clinicopathological information or survival outcomes and initial recurrence patterns.

Results
The most frequent recurrence pattern was locoregional recurrence (n = 84, 31.3%), followed by simultaneous multiple recurrences (n = 65, 24.2%), liver metastasis (n = 53, 19.8%), peritoneal dissemination (n = 41, 15.3%), and lung metastasis (n = 20, 7.5%). In addition, survival outcomes were significantly longer in the lung metastasis group than in the other recurrence pattern group (recurrence-free survival, 18.2 vs 8.2 months, P < 0.001; overall survival, 86.4 vs 21.0 months, P < 0.001; and survival after recurrence, 37.1 vs 9.3 months, P < 0.001). The lung metastasis group had a significantly higher proportion of pancreatic body and tail cancer (P < 0.002) and arterial invasion (P = 0.006) than the other recurrence pattern group.

Conclusions
Lung metastasis as an initial recurrence pattern frequently occurred in patients with body and tail cancer and patients with arterial invasion.
The Effect of Cognitive Impairment on the Prognosis of Major Depressive Disorder
Authors: Zhang Bao-Hua , Feng Lei , Feng Yuan , Xin Li-Min , Zhu Xiao-Yu , Tan Yun-Long , Wang Gang 
Published: May 2020

Abstract
The study recruited 168 patients diagnosed with major depressive disorder (MDD). The nine-item Patient Health Questionnaire (PHQ-9) and Perceived Deficits Questionnaire for Depression (PDQ-D) were lower and the Digit Symbol Substitution Test (DSST) was higher in the community volunteers than those in MDD patients. Depression-related scores (17-item Hamilton Depression Rating Scale [HAMD-17], Clinical Global Impressions–Severity of Illness Scale [CGI-S], and PHQ-9), functioning-related scores (Sheehan Disability Scale [SDS]), and Work Efficiency and Activity Damage–Specific Health Problems questionnaire work productivity loss were decreased, and the quality of life–related scores (European Quality of life–5 Dimensions [EQ-5D] utility score) were increased in the MDD patients. PDQ-D was decreased and DSST was increased with the increase of follow-up time. Linear regression indicated that cognitive symptoms (PDQ-D and DSST) improved more slowly than depressive symptoms (PHQ-9). At baseline, PDQ-D was related with functioning (SDS and work productivity loss). PDQ-D and DSST were related with EQ-5D utility score. In addition, at month 6, PDQ-D was related with functioning (SDS and work productivity loss) and EQ-5D utility score. Cognitive impairment might be a risk for MDD and MDD-related changes in the functioning and quality of life.
Incorporating a Microlearning Wellness Intervention Into Nursing Student Curricula
Authors: Gawlik Kate , Guo Jinghong , Tan Alai , Overcash Janine 
Published: May 2020

Background
Cultivating healthy lifestyle beliefs (HLBs) can result in positive health outcomes for students during their nursing program.

Purpose
The purpose of the study was to determine the effectiveness of short wellness interventions (microlearning) in nursing courses on reducing stress and anxiety and enhancing HLB.

Methods
Microlearning wellness interventions were offered to graduate and undergraduate nursing students in this cluster randomized intervention study. The Perceived Stress Scale 4, Generalized Anxiety Disorder 7, and Healthy Lifestyle Beliefs Scales were administered. Student perceptions were evaluated using a short answer narrative.

Results
The intervention group reported higher HLB (P = .15), lower anxiety (P = .06), and lower stress (P = .06) compared with the control group after adjusting for baseline differences. Student comments were favorable and included enjoying the activities, weight loss success, and mindfulness strategies.

Conclusions
Incorporating wellness interventions into nursing curricula demonstrates a positive trend toward reducing anxiety and stress and improving HLB.
Rewriting the Microaggression Narrative
Authors: Carter Brigit M. , McMillian-Bohler Jacquelyn 
Published: May 2020

Background
It is recognized that expanding the number of racial/ethnic minority nurses is key to addressing the challenges of health disparities. However, some schools of nursing have not typically experienced diversity.

Problem
Diverse nursing students experience increasingly high rates of exposure to microaggression, discrimination, and bias in the clinical and classroom settings. Providing nursing students with strategies to respond to microaggressions can reduce barriers to nursing education.

Approach
An interactive workshop based on the Theater of the Oppressed performance technique was developed to increase students' ability to recognize/respond to microaggressions.

Outcomes
Students (n = 97) completed a preworkshop-postworkshop evaluation. After participation, students indicated an improved ability to recognize microaggressions with intent to respond when they occur.

Conclusions
Race was the most common microaggression addressed in the skits, followed by gender and ability. The interactive nature of the workshop allowed students to practice strategies to address microaggressions.
The Role of Obesity in the Development and Management of Gynecologic Cancer
Authors: Staley S. Allison , Tucker Katherine R. , Clark Leslie H. 
Published: May 2020

Importance
Endometrial cancer is the most common gynecologic malignancy, with an estimated 54,000 new cases and 10,000 deaths in the United States in 2015. The obesity epidemic directly contributes to the escalating prevalence of chronic diseases, including obesity-related cancers. Patient body weight and nutritional status markedly impact perioperative oncologic care, chemotherapy administration, recurrence risk, and survivorship goals.

Objective
The objective of this review is to explore the association between obesity and the development, treatment, and survival outcomes of gynecologic cancers.

Evidence Acquisition
A systematic literature review was performed utilizing PubMed and ClinicalTrials.gov.

Conclusions and Relevance
Caring for obese women with gynecologic cancers presents unique challenges. A coordinated multidisciplinary and system effort is required to address the prevention and treatment of obesity, as the sequela of this disease is a clear risk factor for the development of gynecologic malignancy and other comorbidities. Health care providers must be ready to address this worldwide health problem.

Target Audience
Obstetricians, gynecologists, family physicians, midwives, nurse practitioners, and dietitians

Learning Objectives
After completion of this activity, the learner should be better able to describe the pathophysiologic correlation between obesity and common gynecologic malignancies; identify limitations in cancer care due to obesity and associated comorbidities; and counsel patients regarding management strategies for treatment of obesity.
Association of Powder Use in the Genital Area With Risk of Ovarian Cancer
Authors: O'Brien Katie M. , Tworoger Shelley S. , Harris Holly R. , Anderson Garnet L. , Weinberg Clarice R. , Trabert Britton , Kaunitz Andrew M. , D'Aloisio Aimee A. , Sandler Dale P. , Wentzensen Nicolas 
Published: May 2020

(Abstracted from JAMA 2020;323(1):49–59)
The International Agency for Research on Cancer has concluded that use of mineral talc-containing powders, sometimes used by women on their genitals, has “possible” evidence of carcinogenic risk. Case-control studies have demonstrated a significant association between the ever use of powder in the genital area and ovarian cancer; however, these studies may have been limited by recall bias and a surge in media coverage.
Prolapse Recurrence After Sacrocolpopexy Mesh Removal: A Retrospective Cohort Study
Authors: Sassani Jessica C. , Ross James H. , Lopa Samia , Handzel Robert M. , Bradley Megan S. , Bonidie Michael 
Published: May 2020

(Abstracted from Female Pelvic Med Reconstr Surg 2020;26:92–96)
More than 20% of the adult female population have symptomatic pelvic organ prolapse (POP) and other pelvic floor disorders. Currently, recommended surgical repair procedures for pelvic floor disorders include native tissue repair and mesh sacrocolpopexy.
Single-Cell Transcriptomic Atlas of Primate Ovarian Aging
Authors: Wang Si , Zheng Yuxuan , Li Jingyi , Yu Yang , Zhang Weiqi , Song Moshi , Liu Zunpeng , Min Zheying , Hu Huifang , Jing Ying , He Xiaojuan , Sun Liang , Ma Lifang , Esteban Concepcion Rodriguez , Chan Piu , Qiao Jie , Zhou Qi , Belmonte Juan Carlos Izpisua , Qu Jing , Tang Fuchou , Liu Guang-Hui 
Published: May 2020

(Abstracted from Cell 2020;180(3):585–600.e19)
Age-associated declines in female fertility evident after only 30 years of age involve a decrease in total follicle number and oocyte quality. In addition, physiologic age–related changes include increased fibrosis, expanded stromal cell compartment, and changed ovarian medullary and cortex volume.
Acute Ataxia in Childhood
Authors: Kirik Serkan , Aslan Mahmut , Özgör Bilge , Güngör Serdal , Aslan Neslihan 
Published: May 2020

Background
Acute ataxia is a common reason for presentation to the pediatric emergency department and the pediatric neurology clinic in childhood. Its incidence is between 1/100,000 and 1/500,000. Its most common reason is infections.

Objective
The aim of this study was to examine the clinical presentation, etiological factors, and prognosis of patients presenting to our regional tertiary pediatric neurology clinic with a diagnosis of acute ataxia.

Methods
An evaluation was made of patients younger than 18 years diagnosed with acute ataxia in our tertiary pediatric neurology clinic between 2009 and 2016.

Results
Thirty-nine children were included in the analysis. Sex, age, diagnoses, treatment options, and clinical and radiological findings were evaluated. Acute postinfectious cerebellar ataxia was the most common diagnosis (21/39 [51.2%]). No agent could be identified in viral serological examination in 34 patients (87.2%). Rotavirus was identified in 2 (10.5%) of the acute postinfectious cerebellar ataxia cases, and varicella-zoster virus, herpes simplex virus, and hepatitis A positivities were each identified in 1 case. In 20 (51.2%) of 39 patients, varying treatments were applied according to the primary etiology.

Conclusions
Acute ataxia is a significant neurological problem in childhood. In this study, Rotavirus was the most common infectious agent. It may be related to vaccination. This study can be considered of value as the most comprehensive study conducted to date on this subject in the eastern region of Turkey.
Quality Assurance and Performance Improvement Project for Suspected Appendicitis
Authors: AlFraih Yasser , Robinson Tessa , Stein Nina , Kam April , Flageole Helene 
Published: May 2020

Introduction:
Considerable variability exists in the diagnosis and management of acute appendicitis, affecting both quality and costs of care. This prospective cohort study aimed to decrease unnecessary radiological investigations, standardize radiological imaging, avoid unnecessary hospital admissions, and decrease our institution rate of negative appendectomy.

Methods:
A multidisciplinary appendicitis care pathway was implemented. This pathway involved the use of the Pediatric Appendicitis Score, standardization of ultrasound reporting, and risk stratification to determine patient disposition. Patients were prospectively enrolled in the pathway and compared a preimplementation retrospective cohort.

Results:
We included 235 patients in this study that took place between February 2017 and January 2018. An 88.5% pathway adherence rate for appropriate referral for ultrasounds, an 84% compliance rate for correct risk stratification, and the need for a surgical consult were achieved. After implementation, standardization of ultrasound (U/S) reporting increased from 0% to 78%. The rate of computed tomography utilization decreased from 7.3% to 4.7%. An appendectomy was completed in 68 (29%) of patients. There was only 1 (1.5%) negative appendectomy, compared to the prepathway institutional negative appendectomy rate of 4%.

Conclusion:
The implementation of a standardized, evidence-based, appendicitis care pathway has the potential to improve quality of care by reducing negative appendectomies, unnecessary computed tomography scans, and unnecessary hospital admissions. The participation of the emergency and diagnostic imaging departments is critical to the successful implementation of this quality improvement measure. This simple, effective model can be easily implemented at other centers to improve the care of children.
Disseminated Bacillus Calmette-Guérin Infection Detected on FDG PET/CT Following Intravesical Bacillus Calmette-Guérin Therapy
Authors: Curley Michael , Bhardwaj Hemant 
Published: May 2020

Abstract
We report the case of a 64-year-old man who presented with back pain, anorexia, and weight loss 9 months following bacillus Calmette-Guérin immunotherapy for high-grade transitional cell carcinoma of the bladder. A FDG PET/CT was performed, which demonstrated osteolysis and intense FDG avidity of the T6/T7 and T8/T9 vertebral endplates. In addition, an aneurysm with FDG-avid soft tissue was present of the distal left common iliac artery. The provisional diagnosis was disseminated bacillus Calmette-Guérin infection, resulting in spondylodiscitis and a mycotic aneurysm. A CT-guided vertebral biopsy confirmed the presence of Mycobacterium tuberculosis DNA on polymerase chain reaction testing.
Posttreatment FDG-Avid Splenic Lesions in DLBCL and HD
Authors: Nachmias Boaz , Godefroy Jeremy , Rozenbach Eyal , Ganzel Chezi , Bar-Shalom Rachel , Goldschmidt Neta , Vainstein Vladimir 
Published: May 2020

Abstract
Residual end of treatment (EOT) FDG-avid lesions are often due to infectious or inflammatory process and not due to refractory lymphoma. Nonetheless, such lesions prompt diagnostic and therapeutic interventions. We evaluate clinical and radiological characteristics of patients with EOT FDG-avid splenic lesions. Comparing metabolic volume (MV) ratio between EOT to interim, showed a marked difference between false positive and true positive lesions (0.5 vs 3.6, P = 0.02). EOT SUVmax was also significantly different between the groups (7 vs. 19, P = 0.02). We suggest EOT/interim-MV ratio as a tool to identify patients at low risk of refractory disease allowing non-invasive surveillance.
Radioiodine Retention Within Dilated Common Biliary Duct Mimicking Metastatic Thyroid Cancer Diagnosed by the Combination of SPECT/CT and MRI
Authors: Dai Hongyuan , Huang Rui 
Published: May 2020

Abstract
A 55-year-old woman with papillary thyroid carcinoma under total thyroidectomy and cervical lymph node dissection was referred for 131I radioiodine therapy. Posttherapeutic whole-body scintigraphy revealed increased focal uptake in the right upper abdomen, which localized to the region of the head of the pancreas on SPECT/CT fusion images. Further evaluation with MRI affirmed the radioiodine retention corresponded to bile duct dilation.
18F-FDG PET/CT Imaging of Vasculitis Complicated With Relapsing Polychondritis
Authors: Kamada Hiroki , Takanami Kentaro , Toyama Yoshitaka , Saito Mioko , Takase Kei 
Published: May 2020

Abstract
We present a case of a 38-year-old woman who complained with cough, fever, and back pain with a weight loss. 18F-FDG PET/CT to search fever origin revealed uptake in the tracheobronchial and the left auricular cartilage and wall of the thoracic aorta. She underwent biopsy of the left auricle and was diagnosed with relapsing polychondritis (RP) complicating vasculitis. After steroid therapy, FDG PET/CT demonstrated regression of inflammation, showing decreases in the uptakes. Vasculitis should be considered in case of RP with systemic manifestations. Our case demonstrated the utility of FDG PET/CT in evaluation of RP lesions including aortitis.
A Case of Coronavirus Infection Incidentally Found on FDG PET/CT Scan
Authors: Doroudinia Abtin , Tavakoli Mehrdad 
Published: May 2020

Abstract
We present a highly suspicious case of COVID-19 infection, incidentally found on 18F-FDG PET/CT images. Patient was scanned on February, 25, 2020, when COVID-19 outbreak was unrecognized in our country. She admitted having recent occasional dry cough and fever. A retrospective review of her clinical and laboratory data was strongly suggestive for diagnosis of COVID-19 infection. PET/CT images demonstrated hypermetabolic diffuse ground glass opacities in both lungs with bilateral nodules. There was no evidence of pleural effusion or prominent mediastinal or hilar lymphadenopathy. Radiologists must be aware of COVID-19 presentations on PET/CT scan images during COVID-19 outbreak.