bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry
Authors: Rotunno R. , Campana L.G. , Quaglino P. , de Terlizzi F. , Kunte C. , Odili J. , Gehl J. , Ribero S. , Liew S.H. , Marconato R. , Brizio M. , Curatolo P. 
Published: November 2017

AbstractBackgroundElectrochemotherapy (ECT) is currently used to treat unresectable superficial tumours of different histotypes through the combination of cytotoxic chemotherapy and local application of electric pulses. In 2006, a collaborative project defined the ESOPE (European Standard Operating Procedures of Electrochemotherapy) guidelines to standardize the procedure. The International Network for Sharing Practices of Electrochemotherapy (InspECT) aims to refine the ESOPE and improve clinical practice. Limiting patient exposure to systemic chemotherapy would be advisable to ameliorate ECT safety profile.ObjectiveThe aim of this study was to evaluate the efficacy and toxicity of ECT with reduced chemotherapy dosages.MethodsIn a retrospective analysis of a prospectively maintained database (InspECT registry), we evaluated the outcome of patients who received ECT with reduced dosages of bleomycin (7500, 10 000 or 13 500 IU/m2, instead of the standard dose of 15 000 IU/m2). Tumour response in melanoma patients was compared with melanoma patients of the InspECT registry who received the standard dose of bleomycin.ResultsWe identified 57 patients with 147 tumours (melanoma, 38.6%; squamous cell carcinoma, 22.8%; basal cell carcinoma, 17.5%; breast cancer 7%; Kaposi sarcoma 7%; other histotypes, 7.1%). Per‐tumour complete response (CR) rate at 60 days was 70.1% (partial, 16.3%); per‐patient CR was 57.9% (partial, 21.1%). Local pain was the most frequently reported side‐effect (n = 22 patients [39%]), mostly mild; two patients experienced flu‐like symptoms, one patient nausea. We observed the same CR rate (55%) in patients with melanoma treated by reduced or conventional bleomycin dosages (P = 1.00).ConclusionsElectrochemotherapy performed with reduced bleomycin dosages could be as effective as with currently recommended dose. Patients with impaired renal function or candidate to multiple ECT cycles could benefit from a reduced dose protocol. Our findings need prospective confirmation before being adopted in clinical practice.
Educational and practice gaps in the management of volar melanocytic lesions
Authors: Costello C.M. , Ghanavatian S. , Temkit M. , Buras M.R. , DiCaudo D.J. , Swanson D.L. , Mangold A.R. 
Published: November 2017

AbstractBackgroundThe benign and malignant patterns of acral melanocytic naevi (AMN) and acral melanomas (AM) have been defined in a series of retrospective studies. A three‐step algorithm was developed to determine when to biopsy acral melanocytic lesions. This algorithm has only been applied to a Japanese population.ObjectivesOur study aimed to review the current management strategy of acral melanocytic lesions and to investigate the utility of the three‐step algorithm in a predominately Caucasian cohort.MethodsA retrospective search of the pathology and image databases at Mayo Clinic was performed between the years 2006 and 2016. Only cases located on a volar surface with dermoscopic images were included. Two dermatologists reviewed all dermoscopic images and assigned a global dermoscopic pattern. Clinical and follow‐up data were gathered by chart review. All lesions with known diameter and pathological diagnosis were used for the three‐step algorithm.ResultsRegular fibrillar and ridge patterns were more likely to be biopsied (P = 0.01). The majority of AMN (58.1%) and AM (60%) biopsied were due to physician‐deemed concerning dermoscopic patterns. 39.2% of these cases were parallel furrow, lattice‐like or regular fibrillar. When patients were asked to follow‐up within a 3‐ to 6‐month period, only 16.7% of the patients returned within that interval. The three‐step algorithm would have correctly identified four of five AM for biopsy, missing a 6 mm, multicomponent, invasive melanoma.ConclusionWe found one major educational gap in the recognition of low‐risk lesions with high rates of biopsy of the fibrillary pattern. Recognizing low‐risk dermoscopic patterns could reduce the rate of biopsy of AMN by 23.3%. We identified two major practice gaps, poor patient compliance with follow‐up and the potential insensitivity of the three‐step algorithm to small multicomponent acral melanocytic lesions.
Novel device‐based acne treatments: comparison of a 1450‐nm diode laser and microneedling radiofrequency on mild‐to‐moderate acne vulgaris and seborrhoea in Korean patients through a 20‐week prospective, randomized, split‐face study
Authors: Kwon H.H. , Park H.Y. , Choi S.C. , Bae Y. , Jung J.Y. , Park G.‐H. 
Published: November 2017

AbstractBackgroundWhile device‐based acne treatments are widely applied for patients not tolerating conventional medications, related controlled studies have been still limited. Recently, non‐ablative 1450‐nm diode laser (DL) and fractional microneedling radiofrequency (FMR) have been effectively used for acne, in addition to well‐recognized dermal remodelling effects.ObjectiveTo compare the clinical course of acne treatment between DL and FMR.MethodsTwenty‐five Korean patients with mild‐to‐moderate facial acne completed treatments with DL and FMR through a 20‐week, randomized split‐face study. One randomly assigned half side of each patient's face received DL and the other side by FMR. Treatments were scheduled to receive three consecutive sessions at 4‐week intervals. Objective assessments including revised Leeds grades, lesion counts, sebum output measurements, and patients’ subjective satisfaction were investigated.ResultsBoth DL and FMR demonstrated steady improvement of acne and seborrhoea during treatment sessions. While results between two devices were similar during treatment sessions, FMR was superior to DL in the 12‐week follow‐up. Patients’ subjective assessments for seborrhoea improvement were similar between two devices, while those for acne, skin texture, and acne scars were more satisfactory for FMR. For safety profile, no significant difference was observed between two regimens, while mild postinflammatory hyperpigmentation was observed only in DL side.ConclusionBoth DL and FMR demonstrated efficacies for acne and seborrhoea, with reasonable safety profile. FMR was more effective than DL for the long‐term maintenance, and subjective assessments for texture and scar improvements. Therefore, a few sessions of these devices would be a viable option for acne treatments.
Non‐melanoma Hutchinson's sign: a reappraisal of this important, remarkable melanoma simulant
Authors: Baran L.R. , Ruben B.S. , Kechijian P. , Thomas L. 
Published: November 2017

AbstractBackgroundMore than 20 years ago, our reappraisal of the Hutchinson's sign (HS) gave birth to the concept of the pseudo‐Hutchinson's sign.ObjectivesWe have found it interesting to emphasize some important histologic points and to expand the list of the numerous HS simulants.MethodsWe have examined the cutaneous samples taken from the pigmented skin of patients in association with nail matrix biopsy. We have also extended the long list of non‐melanoma HS based on comprehensive literature review.ResultsHistologically, HS may present only as an epidermal pigmentation, depending on the area sampled. Occasionally, there may be a sparse junctional melanocytic proliferation which does not demonstrate cytologic atypia due to an underlying melanocytic naevus of the nail matrix. However, early HS often shows a melanoma in situ, with a HS at the proximal nail fold (PNF) and confluent “atypical” melanocytes in the nail matrix. Finally, involvement of the PNF, nail matrix and nail bed containing atypical melanocytes in irregular array may be seen in more advanced lesions. The recent literature on non‐melanoma HS simulants is summarized and clinical examples are provided.ConclusionThe mere presence of periungual pigmentation is neither clinically nor histologically pathognomonic of subungual melanoma and justifies the usefulness of this work stressing the non‐melanoma HS.
In vivo Confocal Laser Microscopy for monitoring of actinic keratosis treatment: a comparison with histopathologic assessment after treatment with topical 5% 5‐fluorouracil
Authors: Ishioka P. , Maia M. , Rodrigues S.B. , Lellis R.F. , Hirata S.H. 
Published: November 2017

AbstractBackgroundHistological examination is the gold standard for actinic keratosis diagnosis; however, it is not always a feasible approach. Reflectance confocal microscopy (RCM) is a non‐invasive technique that may be an alternative for monitoring actinic keratoses treatment response. Topical 5‐fluorouracil is indicated for actinic keratosis multiple lesions and for field cancerization treatment.ObjectivesTo assess the RCM accuracy, sensibility and specificity for actinic keratosis, considering as a gold standard the histopathological examination; as well as to evaluate the efficacy of 5% 5‐fluorouracil treatment.MethodsThis is a prospective study in actinic keratosis patients between August 2014 and November 2015. RCM analyses were performed in one randomly selected actinic keratosis lesion of the upper limbs by two independent observers before and after 5% 5‐fluorouracil treatment. At the end of treatment and with clinical bleaching of treated lesions, histological examination was performed by two pathologists.ResultsA total of 50 lesions were enroled, and 40 lesions presented complete clinical bleaching after treatment and were included in the final analysis. Accuracy, sensibility and specificity means among observers were 83.8%, 84.6% and 83.3%, respectively. After 5‐fluorouracil treatment, actinic keratosis was diagnosed in 45.0% (observer 1) and 32.5% (observer 2) of subjects according to RCM and in 32.5% of subjects according to histological examination. Considering RCM observers diagnosis, the concordance was substantial (k 0.637, P < 0.001). 5‐fluorouracil led to a reduction in 55.0%–67.5% of actinic keratoses according to RCM analysis.ConclusionThis study allows to validate RCM as a non‐invasive method capable of monitoring actinic keratosis therapeutic response to 5‐fluorouracil, presenting efficacy comparable to histological examination. Additionally, the results suggest that 5‐fluorouracil may be a satisfactory option for therapeutic control of this condition.
Clinical and genetic characteristics of xeroderma pigmentosum in Nepal
Authors: Espi P. , Parajuli S. , Benfodda M. , Lebre A.‐S. , Paudel U. , Grange A. , Grybek V. , Grange T. , Soufir N. , Grange F. 
Published: November 2017

AbstractBackgroundLittle is known about xeroderma pigmentosum (XP) in Himalayan countries.ObjectiveTo describe clinical characteristics of XP in Nepal and investigate its genetic bases.MethodsThis study was carried out on all consecutive patients referred for XP to a Nepalese tertiary referral centre in 2014–2015. Clinical data were collected using a standardized questionnaire. DNA was extracted from salivary samples, and next‐generation sequencing (NGS) was conducted using a panel covering all 8 known XP genes (classical XP (XP‐A to XP‐G) and XP variant) and a skin cancer modifier gene, the melanocortin 1 receptor gene (MC1R).ResultsSeventeen patients (median age: 15 years; range: 1–32) were included. Twelve had skin cancers (including a total of 8 squamous cell carcinomas, 60 basal cell carcinomas, ocular carcinomas requiring an orbital exenteration in 3 patients, but no melanoma). Fifteen patients carried the same homozygous non‐sense XPC mutation c.1243C>T, p.R415X. A homozygous non‐sense XPA mutation (p.W235X) was found in the only patient with a history of early severe sunburn reaction and associated neurological symptoms. Associated genetic alterations included heterozygous missense variants in XPD/ERCC2 gene and the presence of MC1R variant R163Q in 5 and 9 patients, respectively.ConclusionAlthough not previously reported, XP seems frequent in Nepal. Patients often presented with a very severe phenotype after a long history of excessive sun exposure without knowledge of the disease. Fifteen of 17 had the same p.R415X XPC mutation, which seems very specific of XP in Nepal, suggesting a founder effect. NGS analyses frequently revealed associated genetic alterations which could play a modifier role in the clinical expression of the disease.
Mathematical modeling of soybean drying by a fractional‐order kinetic model
Authors: Nicolin Douglas Junior , Defendi Rafael Oliveira , Rossoni Diogo Francisco , de Matos Jorge Luiz Mario 
Published: November 2017

AbstractIn this article, a mathematical model based on the generalization of first‐order kinetic model, to model soybean drying kinetic, is proposed by taking into account that the humidity variation rate is given by a derivative of arbitrary order. The Bootstrap technique was used to study the minimum required number of terms of the analytic solution to fit the parameters with stable variability. Results were highly successful for the estimated moisture curves. These results were compared with the first‐order kinetic model and with the classic Page model. Series solution minimum number of terms varied both with respect to the model parameters and temperature.Practical applicationsThe modeling procedure presented in this article presents the use of fractional calculus as a potential tool to generalize mathematical models based on differential equations. The proposed model proved to be statistically better than its version which was based on conventional calculus. Thus, the model proposed is suitable for modeling kinetic processes in general and can be used to project drying equipment. Due to the fact that drying of food could present nonexponential behavior, the fractional model proposed would be an adequate option to capture the characteristics of the kinetic curve which the conventional calculus cannot. In addition, this article presents a statistical approach to evaluate the correct number of terms to be used in an equation based on an infinite series in order to result the least variability possible. Such approach provides more reliable results when the model is applied to experimental data.
Measles vaccination status of nurses and associated factors during community measles outbreaks
Authors: Kim Kyung Mi , Choi Jeong Sil 
Published: November 2017

AimTo identify the measles vaccination status of nurses, their knowledge and health beliefs about measles, and the associated factors that influence their measles vaccination status during a community measles outbreak in South Korea.MethodsThe participants were 156 nurses from four hospitals in a region where a community measles outbreak occurred.ResultsThe measles vaccination rate of the nurses was 73.7%. The nurses’ health belief score about measles was 2.44 out of 4 and their knowledge score was 73.85 out of 100. The associated factors that influenced the nurses’ measles vaccination status included their experience of caring for patients with measles and a low level of perceived barriers to vaccination.ConclusionIn order to encourage an increased measles vaccination rate in nurses, hospitals should screen susceptible nurses and offer vaccination. Effective measles vaccination campaigns and educational programs are also required in hospitals.
Transforming nurse–patient relationships—A qualitative study of nurse self‐disclosure in mental health care
Authors: Unhjem Jeanette Varpen , Vatne Solfrid , Hem Marit Helene 
Published: November 2017

Aims and objectivesTo describe what and why nurses self‐disclose to patients in mental health care.BackgroundSelf‐disclosure is common, but controversial and difficult to delineate. Extant research suggests that self‐disclosure might have several potentially beneficial effects on therapeutic alliance and treatment outcome for patients in mental health care, but results are often mixed and limited by definitional inconsistencies.DesignMulti‐site study with purposive sampling and source triangulation.MethodQualitative descriptive study including data from 16 nurses taking part in participant observation, individual interviews and focus group interviews.ResultsSeparate analyses resulted in four themes addressing the research question of what nurses self‐disclose, and one main theme and four subthemes addressing why nurses self‐disclose. The content of self‐disclosure was captured in the four themes: Immediate family, Interests and activities, Life experiences and Identity. In addition, results showed that disclosures were common among the nurses. Self‐disclosure's potential to transform the nurse–patient relationship, making it more open, honest, close, reciprocal and equal, was the overarching reason why nurses shared personal information. The nurses also chose to self‐disclose to share existential and everyday sentiments, to give real‐life advice, because it felt natural and responsive to patients’ question to do so.ConclusionNurse self‐disclosure is common and cover a variety of personal information. Nurses have several reasons for choosing to self‐disclose, most of which are connected to improving the nurse–patient relationship.Relevance to clinical practiceSelf‐disclosure controversy can make it difficult for nurses to know whether they should share personal information or not. Insights into the diversity of and reasons for nurse self‐disclosure can help with deliberations on self‐disclosure.
Trends in the total numbers of HBV and HCV carriers in Japan from 2000 to 2011
Authors: Tanaka J. , Akita T. , Ohisa M. , Sakamune K. , Ko K. , Uchida S. , Satake M. 
Published: November 2017

SummaryWe estimated the total number of undiagnosed HBV and HCV carriers and patients with hepatitis virus‐related disease in Japan according to 6 different groups classified by their natural histories during 2011. In 2011, the total number of carriers and patients infected with HBV or HCV was estimated according to 6 groups using government reports and reports from the hepatitis epidemiology research group of The Ministry of Health, Labor and Welfare in Japan. In 2011, the total number of hepatitis virus carriers was estimated to be 2 090 128‐2 840 128 in which the estimated number of undiagnosed HCV and HBV carriers was 776 826 (HBV: 481 470; HCV: 295 356). The total number of treated patients, as either inpatients or outpatients, was estimated to be 811588 (HBV: 303 366; HCV: 520 600) in 2011. It is presumed that many carriers shirk consultation for many reasons, such as patients’ misunderstanding, lack of awareness and forgetfulness of their positive status. The numbers of infected patients who did not seek treatment increased gradually to 501 714‐1 251 714 (HBV: 333 791‐483 791; HCV: 167 923‐767 923) in 2011. Compared to 2000, the number of undiagnosed carriers was significantly reduced in 2011 probably because of the well‐organized, effective national hepatitis virus screening system that has been launched by the Japanese government since 2002. Moreover, the increase in the number of untreated persons who are aware of their positive status shows that more effort should be invested in improving the referral system from screening centres to core hospitals.
Highlighting patterns of fungal diversity and composition shaped by ocean currents using the East China Sea as a model
Authors: Li Wei , Wang Mengmeng , Pan Haoqin , Burgaud Gaëtan , Liang Shengkang , Guo Jiajia , Luo Tian , Li Zhaoxia , Zhang Shoumei , Cai Lei 
Published: November 2017

AbstractHow ocean currents shape fungal transport, dispersal and more broadly fungal biogeography remains poorly understood. The East China Sea (ECS) is a complex and dynamic habitat with different water masses blending microbial communities. The internal transcribed spacer 2 region of fungal rDNA was analysed in water and sediment samples directly collected from the coastal (CWM), Kuroshio (KSWM), Taiwan warm (TWM) and the shelf mixed water mass (MWM), coupled with hydrographic properties measurements, to determine how ocean currents impact the fungal community composition. Almost 9k fungal operational taxonomic units (OTUs) spanning six phyla, 25 known classes, 102 orders and 694 genera were obtained. The typical terrestrial and freshwater fungal genus, Byssochlamys, was dominant in the CWM, while increasing abundance of a specific OTU affiliated with Aspergillus was revealed from coastal to open ocean water masses (TWM and KSWM). Compared with water samples, sediment harboured an increased diversity with distinct fungal communities. The proximity of the Yangtze and Qiantang estuaries homogenizes the surface water and sediment communities. A significant influence of ocean currents on community structure was found, which is believed to reduce proportionally the variation explained by environmental parameters at the scale of the total water masses. Dissolved oxygen and depth were identified as the major parameters structuring the fungal community. Our results indicate that passive fungal dispersal driven by ocean currents and river run‐off, in conjunction with the distinct hydrographic conditions of individual water masses, shapes the fungal community composition and distribution pattern in the ECS.
Pleistocene climatic changes drive diversification across a tropical savanna
Authors: Potter Sally , Xue Alexander T. , Bragg Jason G. , Rosauer Dan F. , Roycroft Emily J. , Moritz Craig 
Published: November 2017

AbstractSpatial responses of species to past climate change depend on both intrinsic traits (climatic niche breadth, dispersal rates) and the scale of climatic fluctuations across the landscape. New capabilities in generating and analysing population genomic data, along with spatial modelling, have unleashed our capacity to infer how past climate changes have shaped populations, and by extension, complex communities. Combining these approaches, we uncover lineage diversity across four codistributed lizards from the Australian Monsoonal Tropics and explore how varying climatic tolerances interact with regional climate history to generate common vs. disparate responses to late Pleistocene change. We find more divergent spatial structuring and temporal demographic responses in the drier Kimberley region compared to the more mesic and consistently suitable Top End. We hypothesize that, in general, the effects of species’ traits on sensitivity to climate fluctuation will be more evident in climatically marginal regions. If true, this points to the need in climatically marginal areas to craft more species‐(or trait)‐specific strategies for persistence under future climate change.