bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significance of ST‐Segment elevation in V4R lead in patients with anterior myocardial infarction
Authors: Dehghani Pooyan , Zahedi Ali , Hassanzadeh Mani , Alavi Seyed Hosein , Jannati Mansour , Mehdipour Namdar Zahra , Aslani Amir 
Published: June 2021

AbstractBackgroundThere is some evidence of the association between ST‐segment elevation in the V4R chest lead and the likelihood of anterior wall myocardial infarction; however, the link of this phenomenon with the location and the severity of the coronary involvements in such patients remains uncertain. We aimed to investigate the ST‐segment elevation in V4R leads in patients with anterior myocardial infarction and also its effect on prognosis as well as the detection and prediction of the location of arterial stenosis in coronary angiography.MethodsData collection was performed by reviewing the hospital recorded files of 195 patients’ suspicion of acute myocardial infarction who have been referred within 2 h of the onset of cardiac symptoms. The patients were then categorized into two groups with and without ST elevation in the V4R chest lead.ResultsComparing two groups showed a significantly higher rate of concurrent ST‐segment elevation in V1 lead in those with ST‐segment elevation in V4R. Echocardiography on the day after anterior myocardial infarction showed LVEF <40% in 74% and 35.2% of patients with and without ST‐segment elevation in V4R, respectively, indicating a significant difference. The lesions on proximal LAD were more common in the group with ST‐segment elevation in V4R.ConclusionOur study emphasized a high likelihood of ST‐segment elevation in V4R lead concurrently with ST‐elevation in V1 lead. Also, the appearance of ST‐segment elevation in V4R lead can be accompanied with a lower LVEF, myocardial infarct size, involvement of proximal part of LAD, and Wrap around LAD.
A case of late postoperative intra‐abdominal hemorrhage developing 13 months after laparoscopic sleeve gastrectomy
Authors: Sasaki Takayoshi , Ishibashi Yuji , Hatao Fumihiko , Kawasaki Koichiro , Yamazaki Ryoto , Morita Yasuhiro , Imamura Kazuhiro 
Published: June 2021

AbstractA 29‐year‐old male patient underwent laparoscopic sleeve gastrectomy (LSG) for morbid obesity and was discharged without any complications. Thirteen months later, he visited the emergency room with epigastric pain. A few hours before onset, he had had a larger‐than‐usual meal and vomited afterwards. Enhanced abdominal computed tomography revealed a hematoma 127 × 63 mm in diameter around the stomach. Angiography revealed no extravasation or pseudoaneurysm. Upper gastrointestinal endoscopy found no ulcers or abnormality of the stapler line scar from the LSG. The patient's vital signs were stable, and his hemoglobin had not fallen below the previous day's value. Conservative treatment was therefore chosen. The patient was discharged in stable condition after 11 days of hospitalization. However, the exact source of the hemorrhage was unable to be detected on the imaging findings. In view of his clinical course and the hematoma location, omental vessels were suspected of being the source of the hemorrhage.
Responsibility beyond design: Physicians’ requirements for ethical medical AI
Authors: Sand Martin , Durán Juan Manuel , Jongsma Karin Rolanda 
Published: June 2021

AbstractMedical AI is increasingly being developed and tested to improve medical diagnosis, prediction and treatment of a wide array of medical conditions. Despite worries about the explainability and accuracy of such medical AI systems, it is reasonable to assume that they will be increasingly implemented in medical practice. Current ethical debates focus mainly on design requirements and suggest embedding certain values such as transparency, fairness, and explainability in the design of medical AI systems. Aside from concerns about their design, medical AI systems also raise questions with regard to physicians' responsibilities once these technologies are being implemented and used. How do physicians’ responsibilities change with the implementation of medical AI? Which set of competencies do physicians have to learn to responsibly interact with medical AI? In the present article, we will introduce the notion of forward‐looking responsibility and enumerate through this conceptual lens a number of competencies and duties that physicians ought to employ to responsibly utilize medical AI in practice. Those include amongst others understanding the range of reasonable outputs, being aware of own experience and skill decline, and monitoring potential accuracy decline of the AI systems.
Understanding and countering opioid‐induced respiratory depression
Authors: Bateman Jordan T. , Saunders Sandy E. , Levitt Erica S. 
Published: June 2021

Respiratory depression is the proximal cause of death in opioid overdose, yet the mechanisms underlying this potentially fatal outcome are not well understood. The goal of this review is to provide a comprehensive understanding of the pharmacological mechanisms of opioid‐induced respiratory depression, which could lead to improved therapeutic options to counter opioid overdose, as well as other detrimental effects of opioids on breathing. The development of tolerance in the respiratory system is also discussed, as are differences in the degree of respiratory depression caused by various opioid agonists. Finally, potential future therapeutic agents aimed at reversing or avoiding opioid‐induced respiratory depression through non‐opioid receptor targets are in development and could provide certain advantages over naloxone. By providing an overview of mechanisms and effects of opioids in the respiratory network, this review will benefit future research on countering opioid‐induced respiratory depression.LINKED ARTICLESThis article is part of a themed issue on Advances in Opioid Pharmacology at the Time of the Opioid Epidemic. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v180.7/issuetoc
Patients with acephalic spermatozoa syndrome linked to novel TSGA10/PMFBP1 variants have favorable pregnancy outcomes from intracytoplasmic sperm injection
Authors: Liu Gang , Xing Xiaowei , Zhang Huan , Zhu Wenbing , Lin Ge , Lu Guangxiu , Li Weina 
Published: June 2021

AbstractAcephalic spermatozoa syndrome is a rare form of teratozoospermia characterized by headless spermatozoa. Previous studies have found that variants in SUN5, PMFBP1, TSGA10, BRDT, and SPATC1L are associated with this phenotype. Many researchers have suggested that variants in TSGA10 without a proximal centriole might influence early embryonic development. This retrospective cohort study included 12 infertile men with severe acephalic spermatozoa in China. We identified six heterozygous variants and four homozygous variants in TSGA10/PMFBP1 in seven patients by whole‐exome sequencing (WES). Acephalic spermatozoa defects due to different genetic variations may affect only spermatozoa morphology but do not reduce the chances of fertilization, affect embryo quality at early stages or impair intracytoplasmic sperm injection (ICSI) outcomes. Patients with TSGA10/PMFBP1 variations were all expected to have good prognoses with ICSI.
Analytical survey of tattoo inks—A chemical and legal perspective with focus on sensitizing substances
Authors: Wang Xuying , Josefsson Leila , Meschnark Silvia , Lind Marie‐Louise , Emmer Åsa , Goessler Walter , Hedberg Yolanda S. 
Published: June 2021

AbstractBackgroundTattoo inks have been reported to elicit allergic contact dermatitis.ObjectivesTo investigate the labels and the contents of metals and pigments in tattoo inks, considering restrictions within the European Union.MethodsSeventy‐three tattoo inks currently available on the market, either bought or donated (already used), were investigated for trace metals and pigments by inductively coupled plasma mass spectrometry and by matrix‐assisted laser desorption/ionization time of flight tandem mass spectrometry.ResultsNinety‐three percent of the bought tattoo inks violated European, legal requirements on labeling. Fifty percent of the tattoo inks declared at least one pigment ingredient incorrectly. Sixty‐one percent of the inks contained pigments of concern, especially red inks. Iron, aluminium, titanium, and copper (most in green/blue inks) were the main metals detected in the inks. The level of metal impurities exceeded current restriction limits in only a few cases. Total chromium (0.35‐139 μg/g) and nickel (0.1‐41 μg/g) were found in almost all samples. The levels of iron, chromium, manganese, cobalt, nickel, zinc, lead, and arsenic were found to covary significantly.ConclusionsTo prevent contact allergy and toxic reactions among users it is important for tattoo ink manufacturers to follow the regulations and decrease nickel and chromium impurities.
Secondary skin involvement in classic Hodgkin lymphoma: Results of an international collaborative cutaneous lymphoma working group study of 25 patients
Authors: Gru Alejandro A. , Bacchi Carlos E. , Pulitzer Melissa , Bhagat Govind , Kempf Werner , Robson Alistair , Plaza Jose A. , Pincus Laura , Raghavan Shyam , Xu Mina , Vencato da Silva Tiago , Salavaggione Andrea L. , Subtil Antonio , Battistella Maxime 
Published: June 2021

AbstractBackgroundCutaneous involvement by classic Hodgkin lymphoma (CHL) is an extraordinarily rare phenomenon in the current era. To date, no single large case series of cutaneous involvement by Hodgkin lymphoma has ever been reported in the literature.MethodsA comprehensive search for cases designated “skin” and “Hodgkin” was performed at different institutions between 1990 and 2020. Twenty‐five cases were identified, and each case was independently reviewed by at least three board‐certified dermatopathologists and/or hematopathologists.ResultsAll cases represented examples of systemic CHL with secondary skin dissemination. A single lesion, usually a tumor, nodule or infiltrative plaque was observed in 56% of cases and multiple lesions were present in 28% of cases. Most patients (86%—12/14) had a diagnosis of stage IV disease at first diagnosis. The interval between the clinical (first) diagnosis of HL and the development of skin lesions ranged between 6 and 108 months (average 33.75 months). Comprehensive histopathologic evaluation of these cases (at the initial diagnosis) revealed a diagnosis of classic HL not otherwise specified (NOS) in 60% of cases (15/25), nodular sclerosis type in 24% (6/25), mixed cellularity in 12% (3/25), and lymphocyte depleted in 4% (1/25).ConclusionsWe provide documentation of a large series of CHL with secondary skin involvement in association with CHL with additional clinical, morphologic, and immunophenotypic features.
PRAME immunohistochemistry is useful in the evaluation of conjunctival melanomas, nevi, and primary acquired melanosis
Authors: LeBlanc Robert E. , Miller Donald M. , Zegans Michael E. 
Published: June 2021

AbstractBackgroundMany dermatopathologists find conjunctival melanocytic proliferations challenging because they are rare relative to their cutaneous counterparts and have nuanced morphology and nomenclature. PRAME immunohistochemistry has been widely adopted for distinguishing cutaneous nevi from melanoma, but limited data exist assessing its utility in evaluating conjunctival specimens. In particular, it is uncertain whether it can predict the risk of melanoma progression in primary acquired melanosis (PAM).MethodsThirty clinically annotated cases (two melanomas, three PAM with atypia, seven PAM without atypia, 15 nevi, two combined nevi, and a diagnostically challenging nevus with atypical features) were retrospectively evaluated with PRAME.ResultsStrong, diffuse PRAME expression was present in melanomas and PAM with high‐grade atypia, but not in PAM with low‐grade atypia, PAM without atypia, or nevi. Scattered, faintly PRAME‐positive intraepithelial melanocyte nuclei were identified in six nevi. A clonal nevus and nests of heavily pigmented type‐A melanocytes in two additional nevi had cytoplasmic staining.ConclusionsPRAME was useful for distinguishing melanoma and its probable precursors from benign conjunctival melanocytic proliferations in our cohort. The data alert us to two diagnostic pitfalls in nevi: scattered, PRAME‐positive intraepithelial melanocytes and cytoplasmic PRAME staining in type‐A melanocytes and melanophages. Larger scale investigations are warranted to further substantiate these promising findings.
A rare case of syringocystadenocarcinoma papilliferum of the breast: An institutional retrospective case review and brief literature review
Authors: McBride Jeffrey D. , Billings Steven D. , Komforti Miglena K. 
Published: June 2021

AbstractSyringocystadenocarcinoma papilliferum (SCACP) is a rare cutaneous adnexal tumor thought to originate from its benign counterpart, syringocystadenoma papilliferum. These tumors are predominantly located on the head and neck with their location on the breast extraordinarily reported; mammary localization poses a great diagnostic dilemma to the practicing pathologist. Herein, we report an unusual case of an 85‐year‐old woman with an outside diagnosis on a core needle biopsy of metaplastic mammary carcinoma. Upon consultative review of the partial mastectomy specimen, SCACP was identified. Herein, we review SCACP and the diagnostic challenge it poses, especially when localized to the breast. Furthermore, we perform a retrospective review of institutional pathology reports and identified four additional cases of SCACP diagnosed at our institution within the last decade. Finally, we briefly review the literature of SCACP. The entity of SCACP should be well known to pathologists to avoid misdiagnosis.
Precision therapy in the genetic epilepsies of childhood
Authors: Byrne Susan , Enright Noelle , Delanty Norman 
Published: June 2021

Despite recent advances in both the understanding and treatment of the epilepsies, the rate of refractory epilepsy has remained static for many years. However, given our greater understanding of the aetiology and genetic basis of many paediatric and adult epilepsies, there is now scope to expand treatment. In this review, we discuss the current and potential use of precision medicine in the genetic epilepsies of childhood. We will discuss how optimal control and a reduction in the rate of refractory seizures using targeted therapy could be developed and assessed. We propose a six‐tier approach to defining precision therapeutics in epilepsy and discuss how this can be incorporated into a clinical trial design. The lower tiers (1–2) represent therapies in common usage that we know work for certain epilepsy syndromes but do not precisely target the underlying problem. They work to reduce seizures but do not directly or effectively attenuate the developmental phenotype. The higher tiers (5–6) are currently purely speculative and look to a future with highly disease‐specific therapies based on correction of underlying genomic and proteomic issues. In order to achieve this, scientists will have to embark on a ‘whole‐omic’ approach to understand the underlying pathophysiology in order to design a precision therapy.
What this paper adds

Epilepsy treatment is classified into six tiers depending on how precisely the mechanism of action addresses the aetiology.

Tier 1 treatment is based on the historical response of certain epilepsy phenotypes to specific medication.

Tier 6 concerns therapy targeting genes and networks that rescue the whole phenotype.

Clinical trial infrastructure and population‐based disease registries are necessary so that patients can participate in trials for novel precision therapies.
Increased spindle density correlates with sleep continuity improvements following an eight‐week course of a melatonin agonist in people with depression: A proof‐of‐concept study with agomelatine
Authors: Porteous Meggan , Fogel Stuart , Ray Laura , Hickie Ian B. , Carpenter Joanne S. , Louati Khaoula , Robillard Rebecca 
Published: June 2021

AbstractSleep fragmentation and reductions in sleep spindles have been observed in individuals with depression. Sleep spindles are known to play a protective role for sleep, and there are indications that melatonin agents can enhance spindles in healthy people. Whether agomelatine, a melatonin agonist indicated for the treatment of depression, may increase spindle density sufficiently to impact sleep continuity in people with depression remains unknown. This proof‐of‐concept study investigated changes in spindles following agomelatine intake in young adults with depression and assessed how they may relate to potential changes in sleep continuity and depressive symptoms. This study was based on an open‐label design. Fifteen participants between 17 and 28 years of age (mean = 22.2; standard deviation [SD] = 3.4) with a diagnosis of a depressive disorder underwent polysomnography before and after an intervention including a 1 hr psychoeducation session centered on sleep and circadian rhythms, and an 8‐week course of agomelatine (25–50 mg) with a guided sleep phase advance. Fast spindle density significantly increased from pre‐ to post‐intervention. This increase in spindle density significantly correlated with a reduction in wake after sleep onset, and a similar trend was found with increased sleep efficiency. There was no significant correlation between spindle parameters and depressive symptoms. These findings suggest that agomelatine may contribute to enhanced sleep consolidation, possibly in part through the modulation of spindle production. This should be confirmed by larger randomized control trials.
Chemical characteristics of soil organic matter from integrated agricultural systems in southeastern Brazil
Authors: Tadini Amanda M. , Martin‐Neto Ladislau , Goranov Aleksandar I. , Milori Débora M. B. P. , Bernardi Alberto C. C. , Oliveira Patricia P. A. , Pezzopane José R. M. , Colnago Luiz A. , Hatcher Patrick G. 
Published: June 2021

AbstractSoil organic matter (SOM) plays an essential role in agronomic systems and is of great importance to environmental sustainability and carbon sequestration. This study evaluates the accumulation of carbon in soils from integrated agricultural systems (S) that include crop (C), livestock (L), and forest (F) components (in different combinations: CLFS, LFS and CLS) and an undisturbed native forest (NF) as a reference area. The study sites are part of the Embrapa Pecuária Sudeste research station located in the southeast of Brazil in a region of dystrophic Red‐Yellow Latosol soils. Stable carbon isotopic analysis (δ13C) and solid‐state 13C nuclear magnetic resonance (13C NMR) spectroscopy were used to evaluate the chemical characteristics of humic acid (HA) extracts of soils from different soil horizons. The findings were discussed in the context of laser‐induced fluorescence spectroscopy (LIFS) measurements on the whole soils and carbon content on both the whole soils and HA extracts. With increasing depth of the soil horizons, bulk SOM (in the whole soil) and a more recalcitrant humic fraction (the HA) became enriched in carbon, indicative of accumulation. Isotopic analysis revealed that SOM in the crop‐livestock‐forest system exhibited δ13C signatures corresponding to C4 plants (grass and corn). The native forest exhibited a uniform δ13C signature characteristic of C3 plants (native trees). Benzenepolycarboxylic acids (BPCA) quantification on limited samples revealed condensed aromatic structures in both crop‐livestock‐forest system and native forest. The absence of burning suggests that these compounds come from the humification of lignin. Based on structural characterization, carbon is sequestered as recalcitrant and long‐lived oxidized ligninaceous structures and condensed aromatic groups. The current research demonstrates the feasibility of novel agricultural approaches such as using crop‐livestock‐forest systems. Such pastureland management enhances higher agricultural productivity and sustainability, thus avoiding new deforestation of native areas.Highlights
Integrated agricultural systems enhance carbon enrichment in soil organic matter and humic acids.
Carbon stabilized in oxidized ligninaceous and condensed molecules promotes long‐term carbon storage.
Extended root systems are likely to play a critical role in carbon sequestration.
Integrated agricultural systems can be effective alternatives for reducing greenhouse gases.
A non‐contact device for fast screening of wound infections
Authors: Senkowsky Jon , Li Shuxin , Nair Ashwin , Pal Suvra , Hu Wenjing , Tang Liping 
Published: June 2021

AbstractScreening for wound infection relies on the expertise of the provider. Clinical diagnosis of infections based on wound swab/biopsy results often takes a few days and may not assess the full wound. There is a need for a non‐invasive tool that can quickly and accurately diagnose wound infection. Leukocyte esterase strips are used to identify various infectious diseases. However, it is not clear whether infected wounds also have elevated leukocyte esterase activities as compared with non‐infected wounds. To achieve the objective, a device was developed to detect elevated leukocyte esterase activities in wounds by measuring wound exudates adsorbed onto wound dressings in 3 minutes. The efficacy of the device in assessing leukocyte esterase activities across various chronic wounds was tested. Such measurements were unaffected by the type of underlying wound dressing. By correlating the device outputs with clinical adjudication of infection, we found that this device had high positive predictive values for diagnosing wound infection in a wide variety of chronic wounds. In addition, a positive device output increases the probability of detecting infected wounds, while the negative device output reduces the probability of detecting infected wounds. This rapid non‐contact and disposable diagnostic tool may serve as a rapid and accurate indication of infection in the chronic wound.
PAM: diverse roles in neuroendocrine cells, cardiomyocytes, and green algae
Authors: Bäck Nils , Mains Richard E. , Eipper Betty A. 
Published: June 2021

Our understanding of the ways in which peptides are used for communication in the nervous and endocrine systems began with the identification of oxytocin, vasopressin, and insulin, each of which is stored in electron‐dense granules, ready for release in response to an appropriate stimulus. For each of these peptides, entry of its newly synthesized precursor into the ER lumen is followed by transport through the secretory pathway, exposing the precursor to a sequence of environments and enzymes that produce the bioactive products stored in mature granules. A final step in the biosynthesis of many peptides is C‐terminal amidation by peptidylglycine α‐amidating monooxygenase (PAM), an ascorbate‐ and copper‐dependent membrane enzyme that enters secretory granules along with its soluble substrates. Biochemical and cell biological studies elucidated the highly conserved mechanism for amidated peptide production and raised many questions about PAM trafficking and the effects of PAM on cytoskeletal organization and gene expression. Phylogenetic studies and the discovery of active PAM in the ciliary membranes of Chlamydomonas reinhardtii, a green alga lacking secretory granules, suggested that a PAM‐like enzyme was present in the last eukaryotic common ancestor. While the catalytic features of human and C. reinhardtii PAM are strikingly similar, the trafficking of PAM in C. reinhardtii and neuroendocrine cells and secretion of its amidated products differ. A comparison of PAM function in neuroendocrine cells, atrial myocytes, and C. reinhardtii reveals multiple ways in which altered trafficking allows PAM to accomplish different tasks in different species and cell types.