bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fungal Flora Changes in Head-And-Neck Cancer Patients Receiving Radiotherapy
Authors: Reddy Pavan Kumar , Hasib AG , Rao Sandesh B , Athiyamaan MS , Shankar Sharaschandra , Sophia J Maria 
Published: February 2021

Background:
Oral mucositis is one of the primary toxicities of radiation in head-and-neck radiotherapy (RT). Oral fungal microflora changes have been studied to aggravate the inflammatory process leading to mucositis. The study evaluated the changes in oral fungal microflora during RT in head-and-neck cancer (HNC) using a single-institutional, prospective research and its correlation with oral mucositis.

Subjects and Methods:
A prospective single-institutional study was conducted on 68 biopsy-proven HNC patients on RT with or without chemotherapy treated in the Department of Radiation Oncology at Father Muller Medical College, Mangalore, between 2015 and 2017. Three samples of saliva were collected before RT, the end of the 3rd week of RT, and 4 weeks after the completion of RT and assessed for developing fungal flora changes by Sabouraud's dextrose agar growth media and CHROMagar in the number of patients. Mucositis grades are correlated with fungal pathogens. Statistical analysis was on fungal changes and mucositis using mean, percentage, standard deviation, and Chi-square test.

Results:
An increase in fungal microflora was found in patients receiving radiation or chemoradiation in head-and-neck malignancy. Among them, a significant increase was there in Candida albicans (1.5% of patients before RT to 44.1% of patients during RT) and Candida krusei (1.5% of patients before RT to 10.5% of patients during RT) during RT (P < 0.05). Aspergillus fumigatus was found during radiation and absent before and after radiation. Mucositis during radiation had a nonsignificant increasing trend for A. fumigatus and Candida species.

Conclusion:
There was a significant increase in C. albicans and C. krusei during RT when compared to before RT. A better understanding of the oral microflora's role in developing oral mucositis is needed to mitigate symptoms and improve treatment tolerance.
Orthopedic Day-case Surgery in Nigeria: A Single-center Experience
Authors: Malizu Echezona Valentine , Lasebikan Omolade Ayoola , Omoke Njoku Isaac 
Published: February 2021

Background: The concept of day-case surgeries is relevant in orthopedic specialty in developing countries, where orthopedic elective procedures have relatively longer duration of surgical waiting time, mainly due to lack of inpatient bed space. We aimed to determine the scope, safety and outcome of orthopedic day-case surgeries in a Nigerian setting, and identify potential areas for intervention to improve the practice.
Methods: This was a 12-month prospective study of 71 eligible, consenting and consecutive patients who presented at the National Orthopedic Hospital Enugu and were carefully selected and prepared for orthopedic day-case surgeries.
Results: Within the period of study, 53 of 540 elective orthopedic procedures were carried out as daycase, giving a day-case surgery rate of 9.8%. Of the patients enrolled, male to female ratio was 1.2:1 and age range was 8 months to 76 years. Eighteen (25.4%) patients had their day-case procedure cancelled on the day of surgery. The commonest procedure was removal of implant. Conversion rate was 32% mainly due to operation occurring late. Complication (mainly pain) rate was 30%, and correlated with duration of procedure (p<0.006). The satisfaction rate among patients was 98%; no re-admission or mortality was observed.
Conclusion: In this study, orthopedic day-case procedures were safe, though there was low use of daycase surgery in scope, complexity and number of procedures. This and the high conversion rate observed call for a dedicated day-case unit and measures to facilitate timelines of the procedures.
Keywords: Orthopedics, Day-case surgery
Fine root contribution to the soil carbon stock of an agroforestry system in a Caatinga-Atlantic Forest transition zone
Authors: Monroe Paulo Henrique Marques , Barreto-Garcia Patrícia Anjos Bittencourt , Lima Maida Cynthia Duca , Santos Rayka Kristian Alves , Oliveira Elismar Pereira , Silva Sarah Rabelo , Gama Dráuzio Correa 
Published: February 2021

The objective of this work was to evaluate the distribution of fine roots and its influence on the soil organic carbon stock, at a depth of 20 cm, in a Grevillea robusta and Coffea arabica agroforestry system. The study was conducted in an agroforestry system established 15 years ago in a transition area of Caatinga and Atlantic Forest biomes in Brazil. G. robusta trees representing the most frequent diameter class were selected, and three distances of these trees (0, 0.75 and 1.50 m) and two soil collection depths (0–10 and 10–20 cm) were defined. The root samples were scanned and quantified using a software program. There was a general predominance of roots with a diameter of 0.6 mm at the shortest distance from the surface layer, while there was a predominance of roots with a diameter of 0.4 mm in the 10–20 cm layer. The root carbon stock at a distance of 0.75 m was higher at a depth of 0–10 cm (0.60 Mg ha-1). The soil organic carbon stock also showed higher results in the 0–10 cm layer compared to the 10–20 cm layer, although with significant variation only in the distance of 1.5 m. There was a higher concentration of fine roots in the topsoil, probably influenced by a greater availability of water and nutrients from plant residues. The soil carbon stock is not closely related to root density or root carbon stock. The data presented in this study do not provide a definitive conclusion.
Economic evaluation of the impacts of water quality on fishery production in the Estuary Complex of Santos, São Vicente and Bertioga cities, in southeastern coast of Brazil
Authors: Barcellini Victor Carrozza , Paes Ângela Tavares , Miraglia Simone Georges El Khouri 
Published: February 2021

The present study proposes a diagnosis of water quality and fishery production in the Estuarine Complex of Santos, São Vicente, and Bertioga Cities as a requirement for economic valuation of water pollution impacts on fishing production. In the study period (2009–2014), three water quality parameters were identified (dissolved oxygen, total phosphorus, and nitrate), which occurred more frequently in non-conformity with Brazilian water standards, according to reports released by the Environmental Company of São Paulo State (Companhia Ambiental do Estado de São Paulo — CETESB). For data collection of fishery production, data from the monitoring of Institute of Fisheries of Santos City (Instituto de Pesca de Santos) were used, and 15 species were identified with higher occurrence in the study area. The relation between water quality parameters and fishery production was analyzed with mixed linear models, in which significant values for dissolved oxygen parameters, total phosphorus (positive relation), and nitrate (negative relation) were found. Environmental valuation considered only the direct use values (DUV) component of the valuation of fishery production variation in relation to water quality variation. For this purpose, the Marginal Productivity Method (MPM) of the dose-response function was used, which resulted in a range of monetary loss between US$ 24,760,550.22 and US$60,635,978.78. The obtained values represent only a portion of the valuation of economic and environmental loss in the fishing activity (part of DUV). Therefore, economic value calculated is conservative, and although it did not reached the total amount corresponding to all the impacts caused by poor water quality, given the limitations of methods and study period, the obtained values represent the minimum environmental monetary loss.
Laboratory Performance in Neonatal Bilirubin Testing Using Commutable Specimens: A Progress Report on a College of American Pathologists Study
Authors: Lo Stanley F. , Jendrzejczak Bernadine , Doumas Basil T. 
Published: February 2021

AbstractContext.—In 2003 the Chemistry Resource Committee of the College of American Pathologists introduced a commutable specimen in the Neonatal Bilirubin Surveys. This specimen was intended to help evaluate all bilirubin methods.Objective.—To evaluate the effect of commutable specimens on the performance of selected clinical analyzers in measuring neonatal bilirubin from 2003 through 2006.Design.—A human serum–based specimen enriched with unconjugated bilirubin in human serum has been included since 2003 in the Neonatal Bilirubin Surveys. The bilirubin values of these specimens were determined by the reference method and used to evaluate results reported by various chemistry analyzers.Results.—Coefficients of variation for College of American Pathologists All Data ranged from 4.9% to 6.2% for the Neonatal Bilirubin Survey. However, coefficients of variation for the 4 major instrument groups (Dimension, Olympus, Synchron, and Vitros), which report 65% of all results, varied from 2% to 3%. College of American Pathologists All Data mean bilirubin values were within 0.46 mg/dL (7.8 μmol/L) of the reference method mean in 2003; in subsequent years these differences became larger, peaking at 1.87 mg/dL (32 μmol/L) in 2005.Conclusions.—The large systematic error of bilirubin measurements is due primarily to failure of instrument manufacturers to produce reliable bilirubin calibrators. Primary calibrators should consist of human serum enriched with unconjugated bilirubin. Bilirubin values must be assigned by the reference method, the performance and robustness of which are reported in this article. Secondary calibrators distributed to users must be traceable to primary calibrators.
Ultrastructural Abnormalities of Respiratory Cilia: A 25-Year Experience
Authors: Plesec Thomas P. , Ruiz Angela , McMahon James T. , Prayson Richard A. 
Published: February 2021

Abstract
Context.—Ciliary dyskinesia is a rare, but significant, cause of chronic respiratory infections, and transmission electron microscopy is a critical adjunct to making the diagnosis.
Objective.—To investigate a single institution's experience with patients demonstrating abnormal ciliary ultrastructure.
Design.—Retrospective clinicopathologic review of 278 bronchial or nasal turbinate brushings or biopsies from 1983 through 2007.
Results.—There were 12 women and 9 men (mean age, 19.6 years; range, 1–54 years) with abnormal ciliary ultrastructure. Clinical history was unavailable in 3 patients, 15 (83%) of 18 patients presented with chronic or recurrent upper respiratory infections, and 3 (17%) presented with infertility. Seven (39%) of 18 patients had findings of Kartagener syndrome with situs inversus, dextrocardia, and bronchiectasis. Truncation or absence of inner or outer dynein arms occurred in 15 (71%) of 21 cases, and 5 (24%) revealed transposition defects with displacement of the central microtubules and peripheral doublets in 9 + 0 and 8 + 1 patterns. Radial spoke defects with microtubular disarray occurred in 4 (19%) of 21 cases. Compound cilia with multiple axonemes within a single outer sheath and supernumerary microtubules each occurred in 2 (10%) of the cases. Random ciliary orientation was also found in 2 (10%) of the cases, and dense granular basal body inclusions occurred in 1 case (5%). Multiple abnormalities occurred in 6 (29%) of the 21 cases.
Conclusions.—Most patients presented with chronic respiratory tract infections or infertility. Dynein arm defects, transposition defects, and radial spoke defects were the most commonly encountered abnormal findings. Less-frequent abnormal findings included compound cilia, supernumerary microtubules, and dense granular basal body inclusions.
Expression of the Serine Protease Kallikrein 7 and Its Inhibitor Antileukoprotease Is Decreased in Prostate Cancer
Authors: Xuan Qiang , Yang Xiaoli , Mo Linjian , Huang Fengyu , Pang Youhong , Qin Min , Chen Zhiqiang , He Min , Wang Qi , Mo Zeng-Nan 
Published: February 2021

AbstractContext.—Kallikreins are a subgroup of serine proteases with diverse physiologic functions. It has been confirmed that kallikrein 7 (KLK7) is differentially expressed in ovarian and breast cancer. Antileukoprotease (ALP) has been shown to be a specific inhibitor of human kallikrein 7 (hK7). Antileukoprotease overexpression is commonly associated with aggressive, high-risk, or metastatic cancer originating from various organs.Objective.—To investigate the expression and potential role of hK7 and its inhibitor ALP in prostate cancer.Design.—The mRNA expression of KLK7 and ALP transcript in benign prostate epithelial cells and prostate cancers was evaluated by semiquantitative reverse transcription–polymerase chain reaction. We examined hK7 and ALP protein expression by immunohistochemistry in 20 normal prostate tissues, 50 benign prostatic hyperplasia tissues, and 103 prostate cancers. Western blot examination showed protein expression of hK7 and ALP in benign prostate epithelial cells and prostate cancer cell lines.Results.—Semiquantitative polymerase chain reaction examination revealed that the mRNA level of KLK7 and ALP was significantly decreased in prostate cancers compared with that in benign prostate epithelial cells (P &lt; .001). Immunohistochemical expression of hK7 was observed in prostate epithelial cells, whereas little or no staining was observed in prostate cancer. Western blot analysis revealed that hK7 and ALP were decreased in malignant prostate epithelium.Conclusions.—Like hK7, ALP is down-regulated in prostate cancers, which begs the question of whether it remains an effective inhibitor of hK7 or whether it is discordant in time or space and is ineffective as an inhibitor of hK7. The function of KLK7 and ALP in prostate cancer should be further studied.
Notification of Critical Results: A College of American Pathologists Q-Probes Study of 121 Institutions
Authors: Valenstein Paul N. , Wagar Elizabeth A. , Stankovic Ana K. , Walsh Molly K. , Schneider Frank 
Published: February 2021

Abstract
Context.—Hospital accreditors are placing increased emphasis on the timeliness with which critical laboratory results are reported to caregivers.
Objective.—To measure the speed of critical result notification at a group of laboratories, identify factors associated with faster reporting, and place findings in the context of the time required to transport and test specimens and to correct critical abnormalities.
Design.—Contemporaneous review of 3545 inpatient and emergency department critical result notifications in 121 laboratories enrolled in the College of American Pathologists Q-Probes program.
Results.—The median laboratory required a median of 5 minutes for staff to notify someone about a critical result once testing was complete. Laboratories affiliated with smaller institutions (P = .01), rural laboratories (P = .001), and sites that called results before releasing them from the laboratory computer (P = .02) were able to notify caregivers more quickly. There was variation among institutions in the time it took to notify caregivers (interquartile range, 1.5–8 minutes). At the median facility, notification took place 56.5 minutes after the specimen had been collected.
Conclusions.—The time required to notify caregivers of a critical laboratory result is a small proportion of the time taken to collect and test specimens or the time that has been reported for caregivers to correct abnormalities. Although failure to notify caregivers of critical results may represent an important patient safety vulnerability, the timeliness of laboratory notification is a minor contributor to total test turnaround time at most institutions.
Adjunctive Human Papillomavirus DNA Testing Is a Useful Option in Some Clinical Settings for Disease Risk Assessment and Triage of Females With ASC-H Papanicolaou Test Results
Authors: Bandyopadhyay Sudeshna , Austin R. Marshall , Dabbs David , Zhao Chengquan 
Published: February 2021

Abstract
Context.—Recent guidelines recommend colposcopy for women with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H).
Objective.—To determine whether adjunctive high-risk human papillomavirus (hrHPV) testing is useful for disease risk assessment in females with ASC-H Papanicolaou (Pap) test results.
Design.—High-risk HPV prevalence and histopathologic follow-up data on 1187 females with ASC-H ThinPrep Pap test (TPPT) and hrHPV test results were analyzed.
Results.—ASC-H was reported in 1646 (0.006%) of 277 400 (270 338 TPPT and 7062 conventional) Pap test results. The difference in ASC-H detection rates between TPPTs and conventional Pap smears was statistically significant (0.60% vs 0.38%; P = .02). High-risk HPV was detected in 589 (49.6%) of 1187 females with ASC-H TPPT and hrHPV testing. The hrHPV DNA–positive rate in females younger than 40 years was 54.7%, significantly higher than the 36.5% in women 40 years and older. Among 505 females with histopathologic follow-up, cervical intraepithelial neoplasia 2/3 was identified in 32.7% of hrHPV-positive females compared with 1.2% in hrHPV-negative females. The sensitivity, specificity, positive predictive value, and negative predictive value of ASC-H cytology in conjunction with hrHPV DNA testing results for detection of cervical intraepithelial neoplasia 2/3 were 96.1% versus 100.0%, 54.0% versus 68.4%, 35.8% versus 20.8%, and 98.1% versus 100.0% in females younger than 40 years and women 40 years and older, respectively.
Conclusions.—Our data suggest that reflex hrHPV testing is a highly useful option for women with ASC-H Pap tests. Females with ASC-H and negative hrHPV testing may be more efficiently managed by follow-up with regular Pap and hrHPV testing rather than universal colposcopy, especially for women 40 years and older.
Lymphatic Vessel Density Is Not Associated With Lymph Node Metastasis in Non–Small Cell Lung Carcinoma
Authors: Faoro Leonardo , Hutto Joann Y. , Salgia Ravi , El-Zayaty Shady A. , Ferguson Mark K. , Cheney Richard T. , Reid Mary E. , Armato III Samuel G. , Krausz Thomas , Husain Aliya N. 
Published: February 2021

Abstract
Context.—Angiogenesis is essential for tumors to grow and metastasize. Lymphatic metastasis is also an important means of tumor spread. In non–small cell lung carcinoma, the relationship of lymphangiogenesis with lymph node metastasis and, ultimately, patient prognosis is unknown.
Objective.—To evaluate whether lymphangiogenesis is related to lymph node metastasis and/or overall survival.
Design.—Seventy-eight cases of non–small cell lung carcinoma diagnosed from 1987 to 2004 were retrospectively analyzed for intratumoral, peritumoral, and uninvolved adjacent lung tissue lymphatic vessel density (LVD) by D2-40 immunostaining. Lymphatics in 6 cases of squamous dysplasia/carcinoma in situ were similarly evaluated. Appropriate statistical methods were used.
Results.—Intratumoral and peritumoral LVD was significantly higher than in the uninvolved adjacent lung but showed no significant association with lymph node stage at the time of tumor resection. Survival in patients with above average D2-40 values was not significantly different when compared with those who had below average values (median survival, 895 vs 1131 days; P = .97). Furthermore, patients with affected lymph nodes had significantly shorter survival (median survival, 467 vs 1425 days; P = .002). Overall, regardless of lymph node status, there was a significantly higher intratumoral (P &lt; .001) and peritumoral (P &lt; .001) LVD when compared with the adjacent uninvolved lung LVD. There was a trend toward increasing LVD with higher grade of squamous dysplasia.
Conclusions.—The results suggest that although lymphangiogenesis occurs in association with non–small cell lung carcinoma, it may not be an important factor in lymph node metastasis. In fact, there is a suggestion that the number of lymphatics that a person inherently has appears to be more important than lymphangiogenesis when it comes to the development of lymph node metastasis.
Tissue Handling and Specimen Preparation in Surgical Pathology: Issues Concerning the Recovery of Nucleic Acids From Formalin-Fixed, Paraffin-Embedded Tissue
Authors: Hewitt Stephen M. , Lewis Fraser A. , Cao Yanxiang , Conrad Richard C. , Cronin Maureen , Danenberg Kathleen D. , Goralski Thomas J. , Langmore John P. , Raja Rajiv G. , Williams P. Mickey , Palma John F. , Warrington Janet A. 
Published: February 2021

AbstractContext.—Expression profiling by microarrays and real-time polymerase chain reaction–based assays is a powerful tool for classification and prognostication of disease; however, it remains a research tool, largely reliant on frozen tissue. Limiting the utility of expression profiling is the isolation of quality nucleic acids from formalin-fixed, paraffin-embedded tissue. The collection, handling, and processing of tissue directly impacts the biomolecules that can be recovered from it. High-quality nucleic acids can be obtained from formalin-fixed, paraffin-embedded tissue, but greater attention to all steps in the process of tissue handling and preparation is required.Objective.—To summarize the current state-of-the-art of preanalytic factors in tissue handling and processing as they impact the quality of RNA obtainable from formalin-fixed, paraffin-embedded tissue. The goals are to provide recommendations that will improve RNA quality for expression profiling from formalin-fixed, paraffin-embedded tissue and highlight areas for additional research. Tissue is an analyte and it must be handled in a standardized fashion to provide consistent results.Data Sources.—The literature was reviewed. Consultation with industry and academic leaders in the use of RNA for expression profiling was obtained to identify areas for additional research.Conclusions.—Development of RNA-based assays from formalin-fixed, paraffin-embedded tissue is feasible. Greater attention to tissue handing and processing is essential to improve the quality of biospecimens for the development of robust RNA-based assays. Standardization of procedures and vigorous testing of alternative protocols are required to ensure that these assays function as designed.
Intraductal Carcinoma Arising in Intraductal Papilloma in an Axillary Lymph Node: Review of the Literature and Proposed Theories of Evolution
Authors: Jaffer Shabnam , Lin Robert , Bleiweiss Ira J. , Nagi Chandandeep 
Published: February 2021

Abstract
We report a case of an axillary lymph node containing benign glandular lesions, intraductal papilloma with florid and atypical duct hyperplasia, and ductal carcinoma in situ. We propose 2 theories for the development of the intraductal papilloma: from adjacent benign glandular inclusions, or from displaced epithelial cells from a previous intraductal papilloma in the ipsilateral breast. This case identifies yet another etiology for false-positive sentinel lymph nodes morphologically and by immunohistochemistry.