bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating miR-3656 induces human umbilical vein endothelial cell injury by targeting eNOS and ADAMTS13: a novel biomarker for hypertension
Authors: Shi Jikang , Ren Yaxuan , Liu Sainan , Zhao Qian , Kong Fei , Guo Yanbo , Xu Jiayi , Liu Siyu , Qiao Yichun , Li Yong , Liu Yunkai , Liu Yawen , Cheng Yi 
Published: September 2021

Background:
Hypertension, as one of the most common chronic diseases, is a major public health issue. Previous studies have shown that there are miRNAs differentially expressed in hypertensive patients. In addition, hypertension is closely related to endothelial dysfunction, and miRNAs have been identified as important molecular mediators for endothelial function. Therefore, it is necessary to identify specific miRNAs related to hypertension and explore their molecular mechanism in the progression of hypertension.

Methods:
We investigated the association of circulating levels of miR-3656 with hypertension. Furthermore, in-vitro studies were performed to investigate its possible mechanisms for hypertension in that the direct target genes of miR-3656 were confirmed using dual-luciferase reporter assay; moreover, the effects of miR-3656 on proliferation, migration, apoptosis, and microvascular rarefaction of HUVECs were investigated using MTS kit, wound-healing assay, FITC Annexin V apoptosis detection kit, and tube formation assay, correspondingly.

Results:
Circulating miR-3656 was upregulated in patients with hypertension. MiR-3656 suppressed the proliferation, migration, and angiogenesis of HUVECs, but promoted the apoptosis of HUVECs. In addition, eNOS and ADAMTS13 were direct target genes of miR-3656, and overexpression of eNOS and ADAMTS13 abolished the effect of miR-3656 on HUVECs.

Conclusion:
MiR-3656 is a potential biomarker for hypertension. MiR-3656 is involved in endothelial cellular injury implicated in hypertension by targeting eNOS and ADAMTS13.
Nodal Merkel Cell Carcinoma With Neuroblastoma Differentiation: A Case Report and Review of the Literature
Authors: Mahapatra Lily , Mansour Mena , Chatterjee Deyali , Fields Ryan C. , Maluf Horacio , Dehner Louis P. 
Published: September 2021

Abstract
We report a case of a neuroendocrine carcinoma of the inguinal lymph node without a known identified primary site, which demonstrated the morphologic and immunophenotypic features of a Merkel cell carcinoma with neuroblastic differentiation. The neoplasm had a predominant high-grade neuroendocrine component with small cell features and a contiguous area with lobular foci of neuroblastic rosettes and fibrillary neuropil. Merkel cell carcinoma can occasionally demonstrate aberrant differentiation to other epithelial and nonepithelial cell lines, and this case is only the fourth in the available literature with neuroblastic differentiation. It is necessary to exclude a primary site of origin, but a few cases of primary neuroendocrine tumor of the lymph node have been described, with the inguinal region as the most common site of occurrence.
Spindle Cell Sinonasal Rhabdomyosarcoma in a 73-Year-Old Man: A Case Report
Authors: Wessinger Bronson C. , Morse Justin , Lewis James S. , Shinn Justin R. , Chandra Rakesh 
Published: September 2021

Introduction
Rhabdomyosarcoma (RMS) is a malignant soft tissue neoplasm differentiating into primitive mesenchymal cells with partial skeletal muscle differentiation. It is rare, especially in the sinonasal cavity. We review available literature on sinonasal RMS and present a case report involving spindle cell sinonasal RMS, one of the rarest subtypes.

Case Report
A 73-year-old man with months of right-sided epiphora and nasal obstruction had abnormal soft tissue and calcification in the right nasal cavity on computed tomography. Nasal endoscopy revealed a smooth, firm mass involving the inferior turbinate. The mass was removed en bloc via endoscopic partial medial maxillectomy and ethmoidectomy. Gross pathologic examination revealed a mottled red, tan, firm, bosselated, and glistening mass, with irregular fragments of soft tissue and bone. Histologic examination showed a variably myxoid and fibrous neoplasm with hyalinization. Tumor cells were spindled with moderate pleomorphism and low mitotic activity. Immunohistochemistry was extensively positive for desmin and myoD1 and focally positive for smooth muscle actin. A diagnosis of sinonasal RMS, grade 2, was made.

Discussion/Conclusion
This is the first reported case of spindle cell RMS originating from the inferior turbinate. Sinonasal RMS has the worst prognosis of all primary sites, especially with age older than 65 years, alveolar subtype, primary tumor greater than 5 cm, high stage/group, and distant metastases. While the risk stratification system accounts for surgical and pathologic factors, more research is needed to determine how this guides selection of resection and/or chemoradiation.
Heterotopic Ossification of the Mesentery: A Rare Postoperative Complication
Authors: Sura Gloria Hopkins , Jackson Nicole R. , Yodzis Shirley , Fox Sharon E. 
Published: September 2021

Abstract
Heterotopic ossification is a rare, reactive condition, sometimes classified as a “pseudotumor,” involving the formation of bone within the soft tissues (Int J Surg Case Rep 2014;5:476–479), This process can occur as an undesirable pathologic sequela of trauma and surgery (J Am Acad Orthop Surg 2004;12:116–125). The few cases reported in the literature are almost exclusively in men with a predominance in people of African ancestry (J Am Acad Orthop Surg 2004;12:116–125; Bone Joint J 2016;98-B:761–766; Case Rep Surg 2019;2019:4036716). Reports of heterotopic ossification have been described in medical literature since 1692 as myositis ossificans progressiva (JBJS 1938;20:661–674). It was not until 1999 that the term “heterotopic mesenteric ossification” was formally used by Wilson et al to describe a complication found in post–abdominal surgical patients (Am J Surg Pathol 1999;23:1464–1470). Although the exact pathologic mechanism of heterotopic mesenteric ossification has not been elucidated, some hypotheses include differentiation of mesenchymal progenitor cells toward an osteogenic lineage, as well as proliferation of dislocated fragments of bone from other regions of the body (J Gastrointest Surg 2015;19:579–580). Since the late 1900s, fewer than 40 cases of mesenteric ossification have been reported. Limited gross and histologic description is available for pathologists and surgeons to identify this phenomenon; however, further data can be acquired at autopsy. Awareness of this condition on the part of clinicians, and early review and recognition by pathologists, may alter surgical management decisions and improve upon morbidity and mortality in these patients. We present gross and histologic examination of an advanced case of heterotopic ossification at autopsy, with a review of current management recommendations.
Urinary Bladder Inflammatory Myofibroblastic Tumor With Mutated TP53 and PPFIBP1-ALK Gene Fusion
Authors: Barbieri Andreia N. , Tallman Christopher T. , Satkunasivam Raj , Annunziata Joseph , Thomas Jessica S. , Olsen Randall J. , Shen Steven S. , Thrall Michael J. , Schwartz Mary R. 
Published: September 2021

Abstract
Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm with distinct histologic features. Approximately 50% of these tumors harbor ALK gene rearrangements with multiple gene fusion partners described, a few of which are predictive of poor prognosis. One example is the ALK-RANBP2 gene rearrangement identified in cases of epithelioid myofibroblastic sarcomas. Many studies have attempted to identify other immunohistochemical or molecular features, which may be predictive of outcome, with conflicting results, particularly regarding the expression of p53. In addition, aberrant p53 expression may be used to favor a diagnosis of leiomyosarcoma over IMT. We present the case of a deeply invasive urinary bladder IMT with aberrant p53 expression and corresponding TP53 genomic alteration, the latter previously reported in only 2 unrelated cases of malignancy. Our case highlights that p53 aberrant expression and TP53 genomic alterations may be found in IMTs and may be related to IMT pathogenesis and prognosis. Furthermore, relying on absence of aberrant p53 expression in IMT in order to distinguish it from histologic mimickers may lead to potential diagnostic pitfalls. In addition, our case demonstrated weak immunohistochemical staining for ALK and was found to harbor a PPFIBP1-ALK gene fusion, previously described in only 2 reports of IMTs of the lung, also with associated negative or weak immunohistochemical staining for ALK.
Education in Autopsy: More Than the Y-Shaped Incision: Entrusting Trainees for the Future
Authors: Humphrey William O. , Mount Sharon L. 
Published: September 2021

Abstract
Training in autopsy encompasses the acquisition of skills and knowledge beyond the Y-shaped incision. In addition to learning basic tissue examination and processing skills, the autopsy service provides education in teamwork, professionalism and leadership, communication, public health, research, and self-reflection. Regardless of future specialization or practice setting, education provided by the autopsy has the potential to influence both the professional and personal lives of the trainees. Despite widespread agreement that autopsy education improves patient care, challenges to building and maintaining a dynamic and educational autopsy service exist and include factors that are both intrinsic and extrinsic to the practice of autopsy itself. Challenges including adequate volume of cases, knowledge of the procedure and skill in obtaining consent for autopsies, inclusion of an autopsy experience in medical school curriculums, competition for resident time, lack of subspecialists such as pediatric/perinatal and cardiac pathologists, and political action to gain support from regulatory bodies are addressed. Finally, we explore the way forward in autopsy education. Solutions such as the standardization of the educational autopsy, valuing the quality of competence over quantity of cases, and benefits of the Office of Decedent Affairs are discussed. By rededicating ourselves to the education of trainees via experiences on the autopsy service, we empower them to harness the many opportunities offered by the postmortem examination and ensure autopsy's seat at the table in 21st-century medicine.
Multipolar Neuropathology: Survival Strategies for Professional Loneliness
Authors: Richard Hope T. 
Published: September 2021

Abstract
The field of neuropathology has a rich history with strong ties to the clinical fields of neurosurgery and neurology. Until the mid-20th century, neuropathology was an apprenticeship in these fields after which it became a subspecialty within the field of pathology. Neuropathology remains a small subspecialty, encompassing only 2% of the actively practicing pathologists in the United States, which lends to the professional loneliness that may occur with neuropathologists. This review offers a guide that covers the most important aspects of a neuropathology practice, including the use of telepathology in a neuropathology practice, the most important aspects of intraoperative evaluation of surgical neuropathology specimens, fellowship training, and the role of neuropathologists in forensic pathology.
The End
Authors: Wiles Austin B. 
Published: September 2021

Abstract
Arguments in defense of the medical autopsy tend to be grounded in quantitative ideas of utility. As such, these defenses limit their techniques and core concepts to the same principles that ground the practice of contemporary medicine. While this tactic seems reasonable, as arguments should always be cognizant of the context for which they are intended, the practice of medical autopsy continues to decline. The conceptual framework of the practice of medicine itself plays a role in the decline of the autopsy. It is difficult to imagine stopping or reversing the effacement of the medical autopsy without overcoming this framework. This review examines the genealogy of arguments about the importance of medical autopsy and develops some new conceptual tools to defend it. Three related notions are explored. Each of these goes beyond the customary, and often unexamined, types of argumentation in contemporary medicine. This review seeks to answer the question: What if the autopsy was gone? What would an autopsy of the practice of autopsy itself reveal?
Staging of Resected Lung Cancers
Authors: Burke Allen , Legesse Teklu 
Published: September 2021

Abstract
In this review, the authors discuss the current pathologic staging of lung cancers, with emphasis on pointers to filling out synoptic forms. A table that combines clinical staging (which oncologists and surgeons use to direct care) with pathologic underpinnings is provided so that a pathologist can easily translate pTNM stage with clinical stage. The major areas of difficulty in pathologic staging are addressed in separate sections, including margins, multiple nodules, determination of invasion, treatment effect, and invasion of adjacent structures.
Eosinophilic Myocarditis: Differential Diagnosis on Endomyocardial Biopsy
Authors: Jacobs Jonathan , Burke Allen 
Published: September 2021

Abstract
Eosinophilic myocarditis has multiple causes. When diagnosed on biopsy, sampling precludes diagnosing a specific cause in most cases. We report a case of presumed eosinophilic granulomatosis with polyangiitis diagnosed on endomyocardial biopsy and discuss the differential diagnosis.
Rhinoscleroma: A Rare Chronic Infectious Cause of Nasal Mass Lesions in the United States
Authors: Oentoro Jaymie E. , Allard Felicia D. 
Published: September 2021

Abstract
Rhinoscleroma is a chronic, progressive, granulomatous infection of the upper airways due to Klebsiella rhinoscleromatis. It is endemic to certain regions of Africa, Southeast Asia, Mexico, Central and South America, and Central and Eastern Europe but is rarely seen in the United States. We report the case of a 33-year-old man who presented with a 6-month history of progressive bilateral nasal obstruction that was unresponsive to medical therapy. The patient underwent surgical excision with histologic findings diagnostic of rhinoscleroma. Herein, we present this uncommon case, review the clinical and diagnostic features of rhinoscleroma, and discuss potential clinical and histologic mimics.
Low-Grade Biphenotypic Sinonasal Sarcoma: Case Report, Current Understanding, and Differential Diagnosis
Authors: Coppock Joseph D. , Stelow Edward B. 
Published: September 2021

Abstract
Low-grade biphenotypic sinonasal sarcoma (BSS) is a rare, locally aggressive mesenchymal neoplasm of the sinonasal tract defined by dual expression of neural and myogenic antigens and recurrent PAX3 (paired box gene 3) gene rearrangements. We herein present the case of a 53-year-old woman with an incidentally identified lesion on surveillance magnetic resonance imaging for a pituitary microadenoma, ultimately leading to biopsy and resection of a low-grade BSS. Because of its relatively indolent behavior and extensive differential diagnosis, recognition and appropriate diagnostic workup of this entity are of utmost importance. The current understanding of low-grade BSS, its diagnosis, and differential diagnosis in the sinonasal tract are discussed.
Sinonasal Ameloblastoma: A Case Report and a Review of Gnathic Lesions That Occur in the Sinonasal Tract
Authors: Whitehair Rachel M. , Stelow Edward B. 
Published: September 2021

Abstract
Primary sinonasal ameloblastomas are rare, benign odontogenic lesions that are locally aggressive. We report a case of a primary sinonasal ameloblastoma in a 65-year-old man who presented with sinonasal obstruction and rhinorrhea. The clinicopathologic features of this entity are discussed, along with the differential diagnosis and other gnathic lesions that present as sinonasal lesions.
Nasal Chondromesenchymal Hamartoma in a Patient With DICER1-Predisposition Syndrome
Authors: Zadeh Sara L. , Stelow Ed B. 
Published: September 2021

Abstracts
Nasal chondromesenchymal hamartomas (CMHs) are extremely rare tumors that are sometimes seen in patients with germline DICER1 mutations. These patients are also at increased risk of pleuropulmonary blastomas, as well as other uncommon tumors. We present the case of an 8-year-old girl with a history of pleuropulmonary blastoma who presented with worsening nasal obstruction and clinical symptoms of sinusitis secondary to a nasal CMH. The diagnosis of nasal CMH is discussed, as well as DICER1 syndrome.
Considerations for Social Needs Screening in a Local Public Health Agency
Authors: Gordon Leslene E. , Nguyen Allison W. , Agrawal Kelli R. 
Published: September 2021

Context:
The social determinants of health impact the health outcomes of local public health agency clients. This report shows how the Florida Department of Health in Hillsborough County (DOH) sought to address this for its clients.

Program:
This midstream intervention identified individual DOH client needs and navigated clients to community resources to address these social needs.

Implementation:
During the 2019 program, 768 DOH clients were screened, with 77% reporting having 1 or more social needs.

Evaluation:
Staff and clients identified various challenges clients faced navigating resources on their own, and the value in having resource navigators within the local public health agency.

Discussion:
Program findings demonstrated alignment with priorities in the Community Health Assessment, leading to engagement of specific partners and planning for population-level policy interventions. Social needs screenings present a unique opportunity for local public health agencies to improve the circumstances of clients and implement health equity approaches in their communities.
Translabial Ultrasound for Assessment of Synthetic Midurethral Sling Complications
Authors: Wermuth Daniela Escobar , Sheridan Alison , Oliver Janine , Glanc Phyllis , Khatri Gaurav , Bagley Anjuli , Patel Nayana 
Published: September 2021

Abstract
Translabial ultrasound (TLUS) is an inexpensive, noninvasive imaging modality traditionally used for assessment of pelvic organ prolapse. The utility of TLUS has recently been expanded to the evaluation of synthetic midurethral slings (MUS) surgically implanted for management of stress urinary incontinence. The purpose of this article is to familiarize radiologists with translabial ultrasound technique and provide a technical protocol for TLUS execution because it can be optimized for imaging and assessment of MUS, including identification of MUS configuration and recognition of common complications. This article provides example images of transobturator and retropubic slings and their associated complications, as visualized on TLUS. Accurate imaging and assessment of MUS is helpful in the evaluation of the patient presenting with symptoms suspicious for sling-related complications and in the planning of surgical revision.
Magnetic Resonance Prediction of Lung Maturity in Fetuses With Congenital Diaphragmatic Hernia
Authors: Wiggins Eve , Zecevic Mladen , Hippe Dan S. , Moshiri Mariam , Winter Tom , Dubinsky Theodore J. 
Published: September 2021

Abstract
To determine if lung to liver MR T2 signal ratio is predictive of neonatal outcome in fetuses with congenital diaphragmatic hernia (CDH).
After Interal Review Board approval, the PACS systems at the University of Washington and University of Utah were searched for cases having an in utero fetal MR examination diagnostic of CDH. Inclusion criteria were at least 1 prior ultrasound demonstrating a CDH and an MR obtained within 1 week of that prior ultrasound.
A total of 69 patients from the University of Utah and 13 from the University of Washington satisfied the inclusion criteria for a total of 82. After adjusting for gestational age and contralateral lung volume, there was little apparent association between contralateral lung to liver MR T2 signal and 5-minute Apgar score and neonatal mortality When considering neonatal Apgar and mortality, increasing contralateral lung volume was significantly associated with lower risk (hazard ratio, 0.40 per doubling; 95% confidence interval, 0.24–0.69; P = 0.001) as expected.
Our data demonstrate that the lung to liver MR signal ratio was not predictive of outcome. The measurement of contralateral lung area, and gestational age at the time of the examination (time of diagnosis) are still the best predictors of poor neonatal outcome.
Behavioral Assessment of Patients With Disorders of Consciousness
Authors: Fitzpatrick-DeSalme Eileen , Long Angela , Patel Ferzeen , Whyte John 
Published: September 2021

Summary:
Brain injury resulting in coma may evolve into a prolonged disorder of consciousness, including the vegetative and minimally conscious states. Early detection of emerging consciousness has positive prognostic significance, and improvement in consciousness at any point may indicate the potential for meaningful communication and environmental control. Despite the importance of accurate assessment of consciousness, research indicates that as many as 40% of patients with a disorder of consciousness may be assessed incorrectly. Assessment of consciousness is challenging for many reasons, including the fact that consciousness cannot be measured directly but must be inferred from patterns of behavioral activity, that many patients have confounding deficits and treatments that may mask consciousness, and that patient performance may be highly variable over time. In this manuscript, we discuss strategies for optimizing patient status during assessment and review a number of structured assessment approaches that can be used. The available assessment techniques vary in their length and cost, and the expertise required to use them. Which of these approaches is most applicable to a given acute or subacute setting will vary with the volume of patients with a disorder of consciousness and the available resources. Importantly, lack of consciousness in the acute setting should not be used to justify the withdrawal of care or denial of rehabilitation services.