bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidermolytic Hyperkeratosis in an Epidermoid (Infundibular) Cyst
Authors: Prestwood Courtney A. , Vandergriff Travis 
Published: December 2021

Abstract:
Epidermolytic hyperkeratosis (EHK) is an uncommon histopathologic reaction pattern that may represent a primary pathological process or a coincidental finding in a variety of neoplasms. We present a case of EHK in an epidermoid (infundibular) cyst. Histopathologically, EHK demonstrates vacuolar degeneration of keratinocytes in the spinous and granular cell layers, with disrupted cellular boundaries, enlarged basophilic keratohyalin-like granules and amorphous eosinophilic inclusions, along with massive hyperkeratosis. In addition to the morphologic description of EHK, we summarize the diagnoses in which EHK has been reported. Prior cases of EHK in an epidermoid (infundibular) cyst are summarized to compare findings. The significance of incidental EHK in skin lesions is unknown.
Cutaneous Involvement of Angioimmunoblastic T-Cell Lymphoma Masquerading as B-Cell Reactive Lymphoid Hyperplasia
Authors: Pesqué David , Marcantonio Orianna , Vázquez Ivonne , Papaleo Natalia , Sánchez-González Blanca , Gallardo Fernando , Colomo Luis , Pujol Ramon M. 
Published: December 2021

Abstract:A 59-year-old woman presented with a persistent eruption manifested as multiple agminated miliary facial papules. Histopathological examination showed prominent nodular dermal lymphoid infiltrates with hyperplastic follicles that were initially interpreted as B-cell reactive lymphoid hyperplasia. Several years later, an additional biopsy showed a dense perifollicular infiltrate with reactive primary and secondary follicles. Accompanying T cells corresponded to CD3/CD4/PD1/CXCL13-positive cells and scattered Epstein–Barr virus–positive B cells were identified by in situ hybridization. A monoclonal T-cell population was demonstrated by TCRγ and TCRβ Polymerase Chain Reaction amplification, as well as a minor abnormal circulating T-cell population by flow cytometry (0.62% of the white blood cells, CD4+CD3s-CD7−). A biopsy specimen from an enlarged right supraclavicular lymph node disclosed nodal involvement by angioimmunoblastic T-cell lymphoma. The observation of B-cell dermal nodular infiltrates with well-demarcated lymphoid aggregates forming primary lymphoid follicles may lead to overlook the T-cell component in some cases of angioimmunoblastic T-cell lymphoma. In such cases, a careful assessment of the apparently minor T-cell component is important to establish a correct diagnosis.
Dermoscopic Aspects of Traumatized Nevi After Dermabrasion
Authors: Dal`Forno Taciana , Milman Laura de Mattos , Bakos Lúcio , Bakos Renato Marchiori 
Published: December 2021

BACKGROUND
Melanocytic nevi submitted to trauma can undergo clinical, dermoscopic, and even histological changes, making it difficult to differentiate them from a melanoma.

OBJECTIVE
The aim of this study is to evaluate the dermoscopic changes of traumatized nevi after dermabrasion.

METHODS
Dermoscopic images of acquired melanocytic nevi were compared before and 4 weeks after half of their area had undergone dermabrasion.

RESULTS
The sample consisted of 50 lesions from 15 patients. The homogeneous pattern was the most frequent, followed by the reticular, cobblestone, and globular patterns. After dermabrasion, nearly half of the lesions (46%) became dermatoscopically asymmetric. Among all lesions, structureless areas, dotted vessels and erythema were the most frequent new dermoscopic structures.

CONCLUSION
Trauma after dermabrasion may induce significant dermoscopic changes in melanocytic nevi. Although the global pattern did not change, most of the lesions became asymmetric, with the appearance or fading of dermoscopic structures and colors. A history of recent trauma should be investigated when evaluating pigmented lesions.
Risk factors for cervical cancer among distinct populations in low-resource countries: feasibility of cervical cancer screen-and-treat program on ukerewe island of lake victoria, Tanzania
Authors: Hari Anjali Y. , Bernstein Megan , Temko Jamie , Brabender Danielle E. , Shen Aricia , Tewari Krishnansu S. 
Published: December 2021

Purpose of review
A mass cervical cancer screening using World Health Organization-endorsed visual inspection with acetic acid (VIA) and cryotherapy triage was conducted over 5 days at Nansio District Hospital on Ukerewe Island, Tanzania in Lake Victoria. The aim was to evaluate the feasibility of a pilot screen-and-treat on a lower resource island and compare the results to previously held screen-and-treats in higher resource mainland settings.

Recent findings
Two hundred and eight-two women underwent VIA on Ukerewe Island during July 2017. The frequency of abnormal VIA screens was nearly twice that observed on the mainland in 2016 (18.4% vs 10.7%, respectively; P = 0.0091). Island women had lower rates of grand multiparity (19.8% vs 26.8%, P = 0.02) and more island women did not know their HIV status (80% vs 50%, P < 0.0001). Overall, 31% of abnormal VIA screens occurred among women under 30 years between the two sites. Due to the cost of transporting CO2 tanks, cryotherapy was nearly twice as expensive on the island as compared to the mainland.

Summary
Although transfer of an entire pilot screen-and-treat program to Ukerewe Island is feasible and well-received, expenses associated with ferrying equipment may be prohibitive to long-term sustainability. Higher VIA positivity rates were observed on the island.
Dispersion Simulations of Radon Discharges between Neighboring Buildings and Their Sensitivity to Meteorology, Discharge Rate, and Building Geometry
Authors: Lebel Luke , John Aneesh , Korolevych Volodymyr 
Published: December 2021

Abstract
In northern climates, it is common to install the discharges of radon sub-slab depressurization systems near ground level. However, this also elevates the ground level outdoor radon concentrations and raises the possibility of radon re-entrainment into homes. The study aims to assess outdoor radon concentrations near above-ground-level discharges along the surfaces of an emitting building and its close neighbor and identify parameters that most influence the dilution. This study employs a series of computational fluid dynamics calculations to assess concentrations along the exhaust-facing and non-exhaust-facing surfaces of the buildings. Different meteorological, venting, and building geometry parameters are explored. Boundary conditions for the CFD calculations are based on field measurements of the ground-level wind speeds and seasonal air temperatures and atmospheric stabilities. Outdoor concentrations can be as high as 7% of the discharge gas, although these become smaller at greater distances from the vent. The direction of the prevailing wind is a particularly important parameter, as it influences the formation of circulating building cavities and building wakes where radon could accumulate. The wind speed, atmospheric stability, and season (plume buoyancy) also have important influences on the outdoor radon concentrations, as do the velocity of the vent system and the size of the buildings. The study has assessed the dilution of the radon-laden exhaust gas and determined the outdoor concentrations that can be expected under a variety of conditions. These results can be used to inform regulators about the potential for radon re-entrainment into homes.
Why Does the Severity of COVID-19 Differ With Age?
Authors: Zimmermann Petra , Curtis Nigel 
Published: December 2021

Although there are many hypotheses for the age-related difference in the severity of COVID-19, differences in innate, adaptive and heterologous immunity, together with differences in endothelial and clotting function, are the most likely mechanisms underlying the marked age gradient. Children have a faster and stronger innate immune response to SARS-CoV-2, especially in the nasal mucosa, which rapidly controls the virus. In contrast, adults can have an overactive, dysregulated and less effective innate response that leads to uncontrolled pro-inflammatory cytokine production and tissue injury. More recent exposure to other viruses and routine vaccines in children might be associated with protective cross-reactive antibodies and T cells against SARS-CoV-2.
There is less evidence to support other mechanisms that have been proposed to explain the age-related difference in outcome following SARS-CoV-2 infection, including pre-existing immunity from exposure to common circulating coronaviruses, differences in the distribution and expression of the entry receptors ACE2 and TMPRSS2, and difference in viral load.
Economic Evaluation of Universal Varicella Vaccination in Mexico
Authors: Chacon-Cruz Enrique , Meroc Estelle , Costa-Clemens Sue Ann , Clemens Ralf , Verstraeten Thomas 
Published: December 2021

Background:
Universal varicella vaccination has proven to be cost-effective (CE) in countries where implemented. However, this has not been evaluated for Mexico.

Methods:
The yearly disease burden (varicella cases/deaths, outpatient visits, and hospitalizations) was derived from Mexican seroprevalence data adjusted to the 2020 population. The yearly economic burden was calculated by combining disease with Mexican unit cost data from both health care and societal perspectives. Four different vaccination strategies were evaluated: (1) 1 dose of varicella vaccine at 1 year old; (2) 2 doses at 1 and 6 years; (3) 1 dose of varicella vaccine at 1 year, and quadrivalent measles-mumps-rubella-varicella vaccine at 6 years; (4) 2 doses of measles-mumps-rubella-varicella vaccine at 1 and 6 years. We developed an economic model for each vaccination strategy where 20 consecutive birth cohorts were simulated. Vaccination impact (number of avoided cases/deaths) was evaluated for a 20-year follow-up period based on vaccine effectiveness (87% and 97.4% for 1 and 2 doses), and assuming a 95% coverage. We estimated annual costs saved, incremental cost-effectiveness ratio, and costs per life year gained.

Results:
Avoided cases during the 20-year follow-up with 1, and 2 doses were 20,570,722 and 23,029,751, respectively. Strategies 1 and 2 were found to be cost saving, and strategy 3 to be CE. Strategy 4 was not CE. Strategies 1 and 2 would allow saving annually $53.16 and $34.41 million USD, respectively, to the Mexican society.

Conclusions:
Universal varicella vaccination, using 1 dose or 2 doses, would result in a cost-beneficial and CE public health intervention in Mexico.
Immature sword bean pods (Canavalia gladiata) inhibit adipogenesis in C3H10T1/2 cells and mice with high-fat diet–induced obesity
Authors: Hwang Hye-Jeong , Hwang Yu Jin , Kim Young Jun , Kim Mina , Hwang Kyung-A 
Published: December 2021

Background:
Sword bean (SB; Canavalia gladiata) is a perennial vine used as a food and medicinal plant in Asia. SB is rich in nutrients, such as flavonoids and urease, and has various functions, including beneficial effects on dysentery, nausea, and hemorrhoids, as well as anti-inflammatory and antioxidant activity. Various plant parts are used; however, little is known about the physiological effects of SB pods (SBP). In this study, the anti-obesity effects of SBP extract were evaluated.

Methods:
To investigate the anti-obesity effects of SBP extract, we confirmed the SBP extract downregulated lipogenesis-related genes and upregulated genes involved in lipolysis and brown adipocyte markers in differentiated C3H10T1/2 adipocytes in vitro. Next, we use a high-fat diet (HFD)–induced obesity mouse model to determine the anti-obesity effects of SBP extract.

Results:
Treatment with SBP extract significantly reduced adipocytes. The extract decreased the HFD-induced increases in body weight and plasma triglyceride levels in mice after 8 weeks. mRNA and protein levels of the adipogenesis and lipogenesis-related factors CCAAT/enhancer binding protein-β, CCAAT/enhancer binding protein-α, peroxisome proliferator-activated receptor-γ (PPARγ), and their target genes Ap2, SREBP-1c, FAS, and SCD-1 were reduced by SBP extract. In contrast, AMP-activated protein kinase and sirtuin1, involved in the thermogenic catabolism of fat, were activated by SBP extract in adipocytes and white adipose tissue, increasing the expression of peroxisome proliferator-activated receptor gamma coactivator-1α, peroxisome proliferator-activated receptor-α (PPARα), and uncoupling protein 1 and activating thermogenic activity.

Conclusion:
SBP extract exerts an anti-obesity effect by inhibiting lipogenesis-related factors and activating fat-catabolizing factors; it is, therefore, a promising functional food and natural anti-obesity agent.
Multimorbidity and Employment Outcomes Among Middle-Aged US Cancer Survivors
Authors: Ekenga Christine C. , Kim BoRin , Kwon Eunsun , Park Sojung 
Published: December 2021

Abstract

Objective
The objective of this study was to evaluate the relationship between multimorbidity and subsequent 2-year employment outcomes among middle-aged United States (US) cancer survivors. In addition, we examined whether the relationship differed by survivor characteristics.

Methods
Data of 633 cancer survivors (ages 51 to 64) from the 2014 Health and Retirement Study were used to identify multimorbidity profiles and evaluate associations between multimorbidity and prolonged unemployment during follow-up.

Results
Approximately 64% of cancer survivors met the criteria for multimorbidity. Latent class analysis revealed three distinct multimorbidity profiles distinguished by the presence or absence of psychiatric disorders. We observed a significant association between high psychiatric multimorbidity and prolonged unemployment after 2-year follow-up (relative risk = 2.78, 95% Confidence Interval = 1.28 to 6.00), with the effect more pronounced among low-income survivors.

Conclusions
Psychiatric multimorbidity was associated with prolonged unemployment among middle-aged cancer survivors, particularly among low-income survivors.
Social Network Lifestyle Interventions Reduce Non-Communicable Diseases Risk Factors in Financial Sector Employees
Authors: Hene Nceba , Wood Paola , Schwellnus Martin , Jordaan Esme , Laubscher Ria 
Published: December 2021

Objective:
To determine if scientifically based social network (Facebook) lifestyle interventions reduce 10-year cardiovascular disease (CVD) risk.

Methods:
Financial sector employees (n = 300) were equally randomly assigned: Facebook plus Health Professionals (FB+HP), Facebook (FB), or control (C). We report changes in 10-year Framingham risk score (FRS) for CVD (%) and risk factors over 12 months.

Results:
FRS did not change within and between groups. Overweight (–7.4% vs–5.6%, P
= 0.005) and diabetes risk (–10.7% vs 0.2%, P
= 0.011) reduced significantly in FB+HP versus FB and C, respectively. Inadequate fruit/vegetable intake (–9.4% vs 3.6%, P
= 0.011) and smoking (–0.7% vs 14.9%) reduced significantly in FB versus C. No significant changes in physical activity, central obesity, hypertension, and hypercholesterolemia between groups.

Conclusions:
Scientifically based social network lifestyle intervention programs could be included in workplace health promotional programmes to improve certain non-communicable disease risk factors.
Workplace Outreach Program Improves Management of Chronic Kidney Disease
Authors: Iakoubova Olga A. , Tong Carmen H. , Rowland Charles M. , Arellano Andre R. , Bare Lance A. , Fragala Maren S. , Birse Charles E. 
Published: December 2021

Objective
Assess whether an employee outreach program improved management of chronic kidney disease (CKD).

Methods
Participants with suspected CKD (eGFR <60 mL/min/1.73m2) identified in employee health assessments in 2017 and 2018 were contacted by phone and offered physician consultation. Subsequent nephrologist visits at 11 months of follow up were compared between those who were (outreach group) and were not (control group) successfully contacted.

Results
Most CKD risk factors at baseline were similar in outreach and control groups. At the end of the follow-up, outreach participants had more than 2-fold greater incidence of visiting a nephrologist compared with controls (HR = 2.3; 95% CI 1.2–4.2, P = 0.01), after adjusting for potential confounders. Conclusions: Employee outreach program increased utilization of nephrologist care.
Epicardial adipose tissue is a robust measure of increased risk of myocardial infarction – a meta-analysis on over 6600 patients and rationale for the EPIC-ACS study
Authors: Hendricks Stefanie , Dykun Iryna , Balcer Bastian , Totzeck Matthias , Rassaf Tienush , Mahabadi Amir Abbas 
Published: December 2021

Abstract

Background:
Epicardial adipose tissue (EAT) surrounds the heart and the coronary vessels. EAT produces pro- and anti-inflammatory cytokines. Several studies have already documented the association of EAT and cardiovascular risk factors as well as coronary artery disease manifestations. Currently computed tomography (CT) is considered the gold standard for measurement of 3-dimensional volume of EAT. In addition, echocardiography might be an easy accessible alternative in particular in an emergency setting.

Methods:
We performed a metaanalysis of existing studies describing the differences of EAT in patients with and without myocardial infarction. We used established databases and were searching for “epicardial adipose tissue” or “pericardial adipose tissue” and “myocardial infarction”, “coronary events”, or “acute coronary syndrome”. We included over 6600 patients from 7 studies. Random effect models were calculated and all analyses were performed by using the Review Manager 5.3.

Results:
Patients with myocardial infarction had 37% (confidence interval [0.21-0.54], P value <.001)] higher measures of EAT compared to patients without myocardial infarction. Comparing studies using echocardiography vs CT for assessment of EAT thickness, similar relative differences in EAT with wide overlap of confidence intervals were observed (for echocardiography: 0.4 [0.04-0.76], for CT: 0.36 [0.16-0.57], P value <.001 for both).

Conclusions:
Patients with myocardial infarction have more EAT as compared to patients without myocardial infarction independently of the used imaging modality. Further prospective studies are needed to evaluate, how quantification of EAT in clinical routine can improve patients management.
Association between intra-operative hemodynamic changes and corrective procedures during posterior spinal fusion in adolescent patients with scoliosis
Authors: Wada Kanichiro , Kumagai Gentaro , Kudo Hitoshi , Tanaka Sunao , Asari Toru , Fjita Yuki , Ishibashi Yasuyuki 
Published: December 2021

Abstract
Previous reports indicated that a decrease in intra-operative cardiac output and mean arterial pressure occurs due to thoracic cage deformities when patients with scoliosis are placed in the prone position. The aims of this study were to investigate the occurrence of hypotension during posterior spinal fusion in adolescent patients with scoliosis, and the association between hypotension, surgical procedures, changes of thoracic cage morphology.
This retrospective, single-center, case-control study included 106 patients who underwent surgeries for spinal deformity at our institute between June 2014 and March 2020. The inclusion criteria were: age ≤19 years at the time of surgery, lowest instrumented vertebra over L5, posterior spinal fusion as the first surgery for scoliosis, and no severe cardiac or pulmonary disease pre-operatively. Finally, 49 patients met the criteria, and were divided to 3 groups as follows: thoracic constructive curve using a 6.0-mm cobalt-chromium alloy circular rod (T-C group; n = 28); thoracolumbar/lumbar constructive curve using a 6.0-mm cobalt-chromium alloy circular rod (L-C group; n = 8); and thoracic constructive curve using a 5.5-mm cobalt-chromium alloy beam-like rod (T-B group; n = 13). The beam-like rod is characteristic as the rod is mounted to screw heads without cantilever force. Intra-operative changes in circulation associated with corrective procedures, perioperative data, and sagittal depth and sternum deviation of thoracic cage were compared between the 3 groups.
The T-C group had a higher rate of hypotension alarm than did the other groups (7 vs 0 vs 0; P = .047). Corrective procedures included rodding 4 times, rod rotation maneuver once, and direct vertebral rotation twice. Blood pressure was increased by pausing the correction procedures, increasing infusion, and administering vasopressors. The T-C and T-B groups had greater sternum deviation parameters than the L-C group, both before and after surgery. All parameters associated with sagittal depth and sternum deviation decreased significantly after surgery in the T-C and the T-B groups.
In corrective surgery for constructive thoracic scoliosis, the corrective procedures requiring the application of compression force in the forward direction should be closely monitored in view of their possible influence on circulatory conditions.
The factor influencing the rate of ROSC for nontraumatic OHCA in New Taipei city
Authors: Yu Yi-Chung , Hsu Chin-Wang , Hsu Shih-Chang , Chang Jin-Lin , Hsu Yuan-Pin , Lin Shih-Min , Liu Ying-Kuo 
Published: December 2021

Abstract
Return of spontaneous circulation (ROSC) from out-of-hospital cardiac arrest (OHCA) is critical for the Emergency Medical Services System. When compared to other developed countries, Taiwan has lower rate of ROSC in OHCA patients.
We conducted a retrospective study of cardiac arrest using The Emergency Medical Service Dispatching Center in Northern Taiwan and The Prehospital Care System of New Taipei City Paramedic Service. Patients suffering from nontraumatic OHCA between August of 2019 to February of 2020 were included. We analyzed the cardiopulmonary resuscitation (CPR) quality parameters such as chest compression interruptions, bystander CPR, shockable rhythm, CPR interruption, chest compression fraction (CCF) average, patient transportation in buildings, and adrenaline injection during CPR. Multivariable logistic regression analysis was performed to assess the relationship between potential independent variables and ROSC.
In our study, we involved 1265 subjects suffering from nontraumatic OHCA, among which 587 patients met inclusion criteria. We identified that CCF> 0.8, chest compression interruption greater than 3 times, and patient transportation in the building were the most critical factors influencing ROSC. However, patient transportation in a building was identified as a dependent predictor variable (P = .4752).
We concluded that CCF > 0.8 and chest compression interruption greater than 3 times were essential factors affecting the CPR ROSC rate. The most significant reason for suboptimal CCF and CPR interruption is patient transportation in a building. Improving the latter point could facilitate high-quality CPR.