bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of fine‐needle aspiration of lymph nodes: A cancer center’s experience
Authors: Bueno Adriana Passos , Palu Rafael Felipe , Dalcin José Francisco , Moraes Lucas Neves , da Silva Eveline Cristina , Novaes Silva Tulio , Saieg Mauro Ajaj 
Published: September 2021

AbstractIntroductionLymph node fine needle aspiration (LN‐FNA) is a minimally invasive method of evaluating lymphadenopathy. Nonetheless, its use is not widely accepted due to the lack of guidelines and a cytopathological categorisation that directly relates to management. We report our experience with LN FNA at a large Cancer Center in Latin America.MethodsWe retrospectively collected cytological cases of lymph node FNA from the department of pathology at AC Camargo Cancer Center performed over a 2‐year period. Data extracted included LN location, age, sex and final cytological diagnosis. Patients that had undergone neoadjuvant chemotherapy and/or cases for which the surgery specimen location was not clearly reported were excluded. For those cases with surgical reports, risk of malignancy was calculated for each diagnostic category, along with overall performance of cytology. False positive cases were reviewed to assess any possible misinterpretation or sampling errors.ResultsA total of 1730 LN‐FNA were distributed as follows: 62 (3.5%) non‐diagnostic (ND); 1123 (64.9%) negative (NEG), 19 (1.1%) atypical (ATY), 53 (3.1%) suspicious for malignancy (SUS), and 473 (27.3%) positive (POS). Surgical reports were available for 560 cases (32.4%). Risk of malignancy (ROM) for each category was 33.3% for ND, 29.9% for NEG, 25% for ATY, 74.2% for SUS and 99.6% for POS. Overall sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were 78.5%, 99.4%, 70.2% and 99.6%, respectively.ConclusionLymph node FNA is a very specific and accurate exam, which is reliable in the detection of lymph node metastasis and other causes of lymphadenopathy.
Chronotype and well‐being in adults with established type 2 diabetes: A cross‐sectional study
Authors: Quinn Lauren M. , Hadjiconstantinou Michelle , Brady Emer M. , Bodicoat Danielle H. , Henson Joseph J. , Hall Andrew P. , Davies Melanie J. 
Published: September 2021

AbstractAims‘Chronotype’ describes an individual's sleep–wake schedule, and can be classified into morning, intermediate or evening types. Evening chronotype has been widely associated with increased cardiometabolic risk and mortality in people with type 2 diabetes. We explored associations between chronotype and markers of well‐being in people with type 2 diabetes.MethodsParticipants of the ‘Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control’ (CODEC) observational study completed questionnaires to determine chronotype (Morningness–Eveningness Questionnaire, MEQ) and concurrent measures of well‐being (Diabetes‐related Distress scale, Patient Health Questionnaire‐9 to measure depression, and Self‐Compassion Scale), as a secondary endpoint of the study. Adjusted generalised linear models were used to compare well‐being between chronotype subgroups in this cohort.ResultsOf the 808 individuals included in the CODEC study, from convenience sampling, 476 individuals completed the psychosocial questionnaire substudy. Of these, 67% (n = 321) were male, and 86% (n = 408) were white European. From the MEQ, 24% (n = 114) were morning chronotype, 24% (n = 113) were evening and 52% (n = 249) were intermediate chronotype. Diabetes‐related distress was significantly higher in evening chronotypes (exponentiated adjusted coefficient = 1.18 (CI: 1.05–1.32)), compared to morning (padjusted = 0.005) and intermediate chronotypes (padjusted = 0.039). Similarly, depression was significantly higher in evening chronotypes (exponentiated adjusted coefficient = 1.84 (CI: 1.28–2.65)) compared to morning (padjusted = 0.001) and intermediate chronotypes (padjusted = 0.016).DiscussionEvening chronotype in people with type 2 diabetes may be associated with higher levels of diabetes‐related distress and depression. These findings warrant further investigation to establish causality and evidence‐based interventions that negate the effects of evening chronotype in people with type 2 diabetes.
3‐Dimensional simulations and student learning in orthodontic education
Authors: Ho Angus Cheuk Hin , Liao Chongshan , Lu Jiajing , Shan Zhiyi , Gu Min , Bridges Susan M. , Yang Yanqi 
Published: September 2021

AbstractIntroductionThe electronic dental model (e‐model) is an example of a digital 3‐dimensional technology to support inquiry‐based learning in undergraduate dental education. As student perceptions of and engagement with e‐models vary, it is uncertain whether these perceptions have implications for their learning processes and outcomes.Materials and MethodsThird‐year dental students (N = 40) completed a questionnaire to identify their perceptions of and preferences for model modalities. They were divided into three groups based on their preference: Preferring plaster models (Group 1); Preferring e‐models (Group 2); No preference (Group 3). Students from three groups (N = 9) attended a hands‐on digital occlusion evaluation workshop, and then completed a case‐based diagnostic evaluation test using digital occlusion evaluation software. Camtasia Studio™ recorded real‐time and on‐screen data of the number of mouse‐clicks and time spent.ResultsStudents reported positive feedbacks on the use of e‐models, and 72.5% of the students preferred combination use of e‐models and plaster models. After attending the hands‐on digital dental occlusion evaluation workshop, Group 2 scored higher on the diagnostic evaluation test (p < .05) and registered more mouse‐clicks than Group 1 when evaluating the arch symmetry (p < .05). Group 2 registered fewer mouse‐clicks than Group 3 during tooth size measurement (p < .05). There was no significant difference regarding the time used to answer the knowledge questions amongst the three groups.ConclusionUndergraduate dental students indicated a generally high acceptance of e‐models for their learning in orthodontics, and more prefer a blended approach. Students preferring e‐models presented higher performance outcomes, which supports cognitive load theory regarding prior exposure to simulation‐based environments.
Relationship between primary stroke center volume and time to endovascular thrombectomy in acute ischemic stroke
Authors: van Meenen Laura C. C. , den Hartog Sanne J. , Groot Adrien E. , Emmer Bart J. , Smeekes Martin D. , Siegers Arjen , Kommer Geert Jan , Majoie Charles B. L. M. , Roos Yvo B. W. E. M. , van Es Adriaan C. G. M. , Dippel Diederik W. , van der Worp H. Bart , Lingsma Hester F. , Roozenbeek Bob , Coutinho Jonathan M. ,   the MR CLEAN Registry Investigators
Published: September 2021

AbstractBackground and purposeWe investigated whether the annual volume of patients with acute ischemic stroke referred from a primary stroke center (PSC) for endovascular treatment (EVT) is associated with treatment times and functional outcome.MethodsWe used data from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) registry (2014–2017). We included patients with acute ischemic stroke of the anterior circulation who were transferred from a PSC to a comprehensive stroke center (CSC) for EVT. We examined the association between EVT referral volume of PSCs and treatment times and functional outcome using multivariable regression modeling. The main outcomes were time from arrival at the PSC to groin puncture (PSC‐door‐to‐groin time), adjusted for estimated ambulance travel times, time from arrival at the CSC to groin puncture (CSC‐door‐to‐groin time), and modified Rankin Scale (mRS) score at 90 days after stroke.ResultsOf the 3637 patients in the registry, 1541 patients (42%) from 65 PSCs were included. Mean age was 71 years (SD ± 13.3), median National Institutes of Health Stroke Scale score was 16 (interquartile range [IQR]: 12–19), and median time from stroke onset to arrival at the PSC was 53 min (IQR: 38–90). Eighty‐three percent had received intravenous thrombolysis. EVT referral volume was not associated with PSC‐door‐to‐groin time (adjusted coefficient: −0.49 min/annual referral, 95% confidence interval [CI]: −1.27 to 0.29), CSC‐door‐to‐groin time (adjusted coefficient: −0.34 min/annual referral, 95% CI: −0.69 to 0.01) or 90‐day mRS score (adjusted common odds ratio: 0.99, 95% CI: 0.96–1.01).ConclusionsIn patients transferred from a PSC for EVT, higher PSC volumes do not seem to translate into better workflow metrics or patient outcome.
Potential of intraoperative ultrasonographic assessment of the spinal cord central echo complex in predicting postoperative neurological recovery of degenerative cervical myelopathy
Authors: Chen Guoliang , Wu Huachuan , Chen Ningning , Wang Meng , Shi Liangyu , Li Jiachun , Wei Fuxin , Xu Zuofeng , Liu Xizhe , Liu Shaoyu 
Published: September 2021

AbstractBackground and purposeThe spinal cord central echo complex (SCCEC) is a special ultrasonography‐based intramedullary structure, but its clinical significance in degenerative cervical myelopathy (DCM) is undefined. This study aimed to explore the potential of the SCCEC in predicting postoperative neurological recovery in DCM.MethodsThirty‐two DCM patients who underwent intraoperative ultrasonography‐guided French‐door laminoplasty were prospectively enrolled. The modified Japanese Orthopaedic Association (mJOA) score was evaluated preoperatively and 12 months postoperatively. SCCEC width (SCCEC‐W), and anteroposterior diameter (APD) and transverse diameter (TD) of the spinal cord were measured on transverse ultrasonographic images, while the tissue widths from anterior and posterior borders of the spinal cord to the SCCEC were measured on sagittal ultrasonographic images. The APD of the spinal cord and occupying rate of the spinal canal were measured on preoperative magnetic resonance imaging (MRI).ResultsAll patients achieved improvements in mJOA scores, with an average recovery rate (RR) of 68.69 ± 20.22%. Spearman correlation analysis revealed that SCCEC‐W, and ratios between the SCCEC‐W and APD/TD based on ultrasonography, correlated moderately with mJOA score RR, with coefficients of −0.527, −0.605 and −0.514, respectively. The ratio between SCCEC‐W and ultrasonographic TD correlated moderately with preoperative APD of the spinal cord. The MRI measurements and ultrasonography‐based tissue widths showed no significant correlation with mJOA score RR.ConclusionsThe SCCEC may have predictive potential as an intraoperative indicator of neurological recovery in treating DCM. SCCEC‐W may be related to spinal cord compression in DCM.
Neoproterozoic syn‐glacial carbonate precipitation and implications for a snowball Earth
Authors: Hood Ashleigh v. S. , Penman Donald E. , Lechte Maxwell A. , Wallace Malcolm W. , Giddings Jonathan A. , Planavsky Noah J. 
Published: September 2021

AbstractThe Neoproterozoic ‘snowball Earth’ hypothesis suggests that a runaway ice–albedo feedback led to two intense glaciations around 717–635 million years ago, and this global ice cover would have drastically impacted biogeochemical cycles. Testing the predictions of this hypothesis against the rock record is key to understanding Earth’s surface evolution in the Neoproterozoic. A central tenet of the snowball Earth hypothesis is that extremely high atmospheric CO2 levels—supplied by volcanic degassing over millions of years—would be required to overcome a strong ice–albedo feedback and trigger deglaciation. This requires severely diminished continental weathering (and associated CO2 drawdown) during glaciation, and implies that carbonate minerals would not precipitate from syn‐glacial seawater due to a lack of alkalinity influxes into ice‐covered oceans. In this scenario, syn‐glacial seawater chemistry should instead be dominated by chemical exchange with the oceanic crust and volcanic systems, developing low pH and low Mg/Ca ratios. However, sedimentary rocks deposited during the Sturtian glaciation from the Adelaide Fold Belt—and contemporaneous successions globally—show evidence for syn‐sedimentary dolomite precipitation in glaciomarine environments. The dolomitic composition of these syn‐glacial sediments and post‐glacial ‘cap carbonates’ implies that carbonate precipitation and Mg cycling must have remained active during the ~50 million‐year Sturtian glaciation. These syn‐glacial carbonates highlight a gap in our understanding of continental weathering—and therefore, the carbon cycle—during snowball Earth. In light of these observations, a Precambrian global biogeochemical model (PreCOSCIOUS) was modified to explore scenarios of syn‐glacial chemical weathering, ocean chemistry and Sturtian carbonate mineralogy. Modelling results suggest that a small degree of chemical weathering during glaciation would have been capable of maintaining high seawater Mg/Ca ratios and carbonate precipitation throughout the Sturtian glaciation. This is consistent with a severe ice age during the Sturtian, but challenges predictions of biogeochemical cycling during the endmember ‘hard snowball’ models. A small degree of continental weathering might also help explain the extreme duration of the Sturtian glaciation, which appears to have been the longest ice age in Earth history.
Ocean warming threatens key trophic interactions supporting a commercial fishery in a climate change hotspot
Authors: Holland Owen J. , Young Mary A. , Sherman Craig D. H. , Tan Mun Hua , Gorfine Harry , Matthews Ty , Miller Adam D. 
Published: September 2021

AbstractWorldwide, rising ocean temperatures are causing declines and range shifts in marine species. The direct effects of climate change on the biology of marine organisms are often well documented; yet, knowledge on the indirect effects, particularly through trophic interactions, is largely lacking. We provide evidence of ocean warming decoupling critical trophic interactions supporting a commercially important mollusc in a climate change hotspot. Dietary assessments of the Australian blacklip abalone (Haliotis rubra) indicate primary dependency on a widespread macroalgal species (Phyllospora comosa) which we show to be in state of decline due to ocean warming, resulting in abalone biomass reductions. Niche models suggest further declines in P. comosa over the coming decades and ongoing risks to H. rubra. This study highlights the importance of studies from climate change hotspots and understanding the interplay between climate and trophic interactions when determining the likely response of marine species to environmental changes.
Academic mothers with disabilities: Navigating academia and parenthood during COVID‐19
Authors: Wagner Kathryn , Pennell Summer Melody , Eilert Meike , Lim Stacey R. 
Published: September 2021

AbstractAcademic mothers (including nonbinary, trans, and genderqueer parents) have always faced challenges in their profession due to systemic barriers and a “motherhood tax”; however, COVID‐19 has exacerbated already existing inequalities (Oleschuk, 2020). This study examines how the pandemic has affected academic mothers with mental health and physical disabilities, as these voices often remain hidden and unheard in academia despite increased awareness of their presence (Brown & Leigh, 2018; Kelly & Senior, 2020). Here, we share the voices of 23 participants using a qualitative methodology drawing from social justice and feminist theories to highlight the lived experience of academic mothers with mental and/or physical disabilities and their experiences as a scholar and parent during COVID‐19. Understanding the lived experience of this intersectional population can provide invaluable insights into ableist privilege within higher education, especially in the context of COVID‐19 which has substantially disrupted work and homelife routines.
Cutaneous manifestations in children with SARS‐CoV‐2 infection and/or COVID‐19: what do we know after 10 months under this pandemic?
Authors: Li Hongxin , Zhao Yong , Zhou Lin 
Published: September 2021

AbstractBackgroundSevere acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has become a global crisis. However, cutaneous manifestations in children with SARS‐CoV‐2 infection have received little attention.ObjectiveOur study was aimed to present clinical and cutaneous manifestations of children with SARS‐CoV‐2 and to provide the basis for early diagnosis.MethodsWe analyzed the clinical data of COVID‐19 infected (CI) children worldwide from December 2019 to October 6, 2020, by using search terms “COVID‐19,” “SARS‐CoV‐2,” “Coronavirus” in combination with “cutaneous,” “lesion,” “rash,” “skin,” “dermatology,” “epidermis,” “dermis,” “multisystem inflammatory syndrome.” We collected and analyzed the general information, clinical symptoms, cutaneous manifestations, laboratory examination results, history of close contact with CI patients or suspected CI patients, and outcome in CI children.ResultsAmong 90 CI children, there were 46 boys (59%) and 32 girls (41%). Erythema was the most frequent lesion, followed by conjunctivitis, and edematous lesions. Face was the most commonly affected location including lips, conjunctivae, tongue, eyes, and eyelids. Sixty‐three (73.3%) patients had multisystem inflammatory syndrome (MIS‐C). As for clinical symptoms, 70 (81.4%) CI children suffered fever, and 34 (39.5%) patients had lung involvement. Meanwhile, 65.1% of patients had cardiac involvement, 4.7% of patients were asymptomatic, and 71.6% of patients received intravenous immunoglobulin, as well as 31.1% of CI children received systemic corticosteroids. Three children were dead. The most frequent route of infection was familial clustering. As silent virus carriers of CI children, it is important to find out the clinical and cutaneous manifestations in CI children to prevent and control COVID‐19 transmission.
The role of interleukin‐17 (IL‐17) in the pathogenesis of discoid lupus erythematosus and lichen planopilaris: is immunohistochemistry for IL‐17 a promising way to differentiate these entities?
Authors: Shahidi Dadras Mohammad , Rakhshan Azadeh , Dadkhahfar Sahar , Barat Tara 
Published: September 2021

AbstractBackgroundInterleukin‐17 (IL‐17) is a pro‐inflammatory mediator which its excess secretion by immune cells is found in many chronic autoimmune diseases. This survey is aimed to compare the amount and pattern of distribution of IL‐17 positive cells in lichen planopilaris (LPP) and discoid lupus erythematosus (DLE) which are of the most frequent causes of primary cicatricial alopecia (CA).MethodsBiopsies of lesional scalp skin from adult LPP (n = 30), DLE patients (n = 19), and control scalp skin (n = 18) were analyzed by immunohistochemistry (IHC) method using rabbit polyclonal antibody against IL‐17. Cells stained positive for IL‐17 and their pattern of distribution were assessed and compared between these groups.ResultsThe mean of IL‐17 positive cell counts per high power field (HPF) in both LPP and DLE groups was significantly higher in comparison with the control group (both p < .0001). The LPP group had higher values of IL‐17 positive cell counts per HPF (47.56 ± 13.37) compared to the DLE group (22.21 ± 11.06) (p < .0001). More than 30 IL‐17 positive cell counts in IHC have a sensitivity of 90% and a specificity of 78% for differentiating LPP from DLE.ConclusionsOur findings suggest that IL‐17 is effective in the pathogenesis of DLE and LPP and its role is more prominent in LPP. IL‐17 positive cells in IHC can distinguish DLE from LPP with satisfactory sensitivity and specificity.
Trends and safety of robot‐assisted partial nephrectomy during the initial 2‐year period after government approval in Japan: A nationwide database study from 2016 to 2018
Authors: Yokoyama Minato , Ishioka Junichiro , Toba Mikayo , Fukushima Hiroshi , Tanaka Hajime , Yoshida Soichiro , Matsuoka Yoh , Ai Masumi , Fushimi Kiyohide , Fujii Yasuhisa 
Published: September 2021

ObjectivesTo evaluate the trends and safety of robot‐assisted partial nephrectomy during the initial 2‐year period after government approval for this type of procedure in April 2016.MethodsThis nationwide retrospective study included 3722 received robot‐assisted partial nephrectomy cases carried out from April 2016 to March 2018 in 124 participating institutions. The institutions were divided into lower‐ and higher‐volume institutions according to the median of 19 robot‐assisted partial nephrectomy cases during the study period. Surgical outcomes between 616 cases from lower‐volume institutions and 3106 cases from higher‐volume institutions were compared using propensity score matching.ResultsDuring the study period, both the number of robot‐assisted partial nephrectomy surgeries and the number of institutions in which the surgery was carried out steadily increased. Overall, the median anesthesia time was 217 min, the median postoperative length of stay was 9 days, and the proportion of blood transfusions, complications and readmissions were 0.8%, 5.1% and 1.0%, respectively. There were no significant differences in anesthesia time, incidence of blood transfusions, and complication rates between the lower‐volume and higher‐volume institutions. However, a slightly, but significantly, longer postoperative length of stay and a lower incidence of readmission were observed in lower‐volume institutions both before and after propensity score matching.ConclusionsRobot‐assisted partial nephrectomy has become widespread during the initial 2‐year period after government approval with an acceptable safety profile, regardless of the institutional caseloads. This technique has become a standard of care for stage 1 renal cancer patients in Japan.
Survey study of trends in adult nephrology advanced training in Australia and New Zealand
Authors: Yaxley Julian , Campbell Scott B. , Gray Nicholas A. , Viecelli Andrea K. 
Published: September 2021

AbstractBackgroundThere has been considerable growth in nephrology advanced trainee numbers in Australia and New Zealand, with uncertain effects on clinical experience, competence and employment outcomes.AimsTo review the perceived adequacy and temporal trends of advanced training in nephrology in Australia and New Zealand by evaluating training experiences, personal views on important aspects of training and nephrology, career paths and early employment outcomes.MethodsAn online survey was distributed to members of the Australian and New Zealand Society of Nephrology through email in December 2020. Responses were sought from current trainees and from nephrologists qualifying since 2014. Likert scale proportions were calculated and group comparisons made using the Chi‐squared test.ResultsA total of 88 participants returned the survey yielding a response rate of 32%, with a representative sample of trainees and consultants from across Australia and New Zealand. Training was reported as adequate in most aspects of clinical nephrology, although 88% of respondents felt poorly prepared for entering private practice and 61% reported inadequate training in kidney histopathology. Exposure to clinical procedures was variable, with adequate training in percutaneous kidney biopsy, but mostly inadequate training in dialysis access insertion. Sixty‐nine percent of nephrologists completed their advanced training entirely in large urban centres and 85% worked in an urban area after training. Only 23% of consultants were engaged in full‐time clinical employment in their first‐year post‐training and 78% were undertaking at least one of dual specialty training or a higher degree by research. Demand for subspecialty fellowships was high.ConclusionTrainees and nephrologists in Australia and New Zealand are currently satisfied with their training in most aspects of nephrology; however, some clinical experiences are perceived as inadequate and early career paths after advanced training are increasingly diverse.