bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adding “Unlikely” as a Clinical Qualifier Is Unlikely to Be of Help: A Retrospective, Single-Center, Cross-Sectional Cohort Study
Authors: Hong Jinpyo , Shoemaker Joshua , Scott Jennifer , Helm Klaus 
Published: August 2024

Abstract:
Clinical correlation is essential to accurate and efficient diagnosis and differential diagnosis in dermatopathology. Poor-quality clinical information can lead to failures and delays in patient care. Some clinicians use the term “unlikely” when submitting a specimen. How frequently the “unlikely” clinical diagnosis correlates with the final pathologic diagnosis is unknown. We studied 203 dermatopathology reports from December 8, 2020, to July 1, 2021, that included the qualifier “unlikely” on the requisition sheet. Samples were stratified into either an inflammatory or neoplastic cohort based on final histopathologic diagnosis, with the neoplastic cohort being further stratified into pigmented and nonpigmented cohorts. Statistical analyses were conducted. The “unlikely” diagnosis in the clinical differential diagnosis and the final histologic diagnosis were the same in 7.9% of the 203 samples studied. This occurred in 8.5% of the inflammatory cohort and 7.6% of the neoplastic cohort. We concluded that the use of the qualifier “unlikely” is not helpful. We acknowledge the limitations of our study because of a small sample.
Utility of PRAME Immunohistochemistry in the Detection of Subtle Melanoma Microsatellites
Authors: Daruish Maged , Karunaratne Sanwadana , Duffy-Gadd Paula , Hansford Samantha , Taibjee Saleem 
Published: August 2024

Abstract:
Microsatellitosis is well established as a prognostic factor in malignant melanoma. Its identification leads to subsequent upstaging with implications for further management. We describe 6 cases in which immunohistochemical staining for PReferentially expressed Antigen in MElanoma facilitated detection of small foci of micrometastasis on scanning magnification, which may be potentially missed in routine sections.
Clinicopathologic Correlation and Routine Immunostains Help Distinguish Congenital Disseminated Pyogenic Granuloma From Other Cutaneous Disseminated Vascular Proliferations of Infancy: Case Report and Literature Review
Authors: Schiele Kristan , Voronina Veronica , Marka Arthur , Mann Julianne , LeBlanc Robert E. 
Published: August 2024

Abstract:
The presence of multiple cutaneous vascular lesions in infancy can signal the possibility of visceral involvement. Dermatopathologists must appreciate how the differential diagnosis includes entities that have distinct therapeutic and prognostic implications. Fortunately, these rare entities can be distinguished histopathologically with the help of clinicopathologic correlation and immunohistochemistry. In this article, we discuss congenital disseminated pyogenic granuloma, multifocal infantile hemangioma, and multifocal lymphangioendotheliomatosis with thrombocytopenia. Subtle morphologic and immunophenotypic features permit their distinction, which in turn is important for identifying extracutaneous manifestations and effective treatments. We present a case of a 3-week-old infant with congenital disseminated pyogenic granuloma involving the skin and the liver whose lesions regressed without therapeutic intervention over 6 months of close follow-up. We review the literature on these rare, overlapping entities and present an approach to resolving the differential diagnosis.
Hearing Loss and Autism Spectrum Disorder
Authors: Pollick Sarah A. , Pesch Megan Honor , Spellun Arielle , Betances Elodie M. , Wiley Susan , Geer Leah C. , Prout Kerry K. , Hu Michelle , Nyp Sarah S. 
Published: August 2024

CASE:
Gretta is a 3.5-year-old girl with a history of congenital cytomegalovirus, congenital bilateral profound sensorineural hearing loss (SNHL), and bilateral vestibular dysfunction, resulting in frequent falls. She underwent cochlear implantation at 12 months of age and was diagnosed with autism spectrum disorder at 2.5 years of age.
On presentation for follow-up in the developmental-behavioral pediatrics (DBP) clinic, Gretta's mother reports that Gretta has refused to wear her cochlear implants for the past 5 months. Before that, she seemed to enjoy having access to sound and like dancing to music, and her receptive and expressive language skills, including speech, were progressing. Initially, the rejection of her devices occurred only at preschool. When frustrated or overwhelmed, she would close her eyes and remove her devices for up to 5 minutes before allowing them to be reapplied. Over time, this progressed to a complete refusal to wear her devices at school and then at home, rendering her without access to sound and spoken language.
Gretta's mood has become sullen, and she is now having tantrums at school. She physically startles when attempts are made to reintroduce her devices. Her ability to participate in classroom learning or interact with her classmates is limited, as she attends a spoken-language–focused preschool program. A board-certified behavioral analyst, hired by the family, recommended that Gretta not be allowed to participate in classroom activities unless she wears her devices. She now becomes visibly anxious even when in the same room as her devices and repetitively states “no implant, no implant.” Her mother is worried about her inability to communicate and has “no idea” what may have changed or sparked her initial refusal to wear the devices.
What factors would you consider when determining the cause and function of Gretta's refusal to wear the cochlear implants? How would you guide her parents, teachers, and clinicians to ensure the best developmental and behavioral outcomes for her?
Compliance With International Council of Ophthalmology Guidelines for Glaucoma Eye Care in Pakistan
Authors: Mahsood Yousaf Jamal , Nasir Ali Hassan , Wakil Hira , Farooq Saima 
Published: August 2024

Précis:
This study demonstrated that the compliance levels with International Council of Ophthalmology (ICO) Guidelines for glaucoma eye care were low for all the elements in both public and private health care settings.

Purpose:
To determine the compliance with the ICO guidelines for glaucoma eye care among Pakistani ophthalmologists and to compare differences among ophthalmologists practicing in public and private health care settings.

Materials and Methods:
This was a retrospective chart review, and the records were reviewed according to ICO guidelines. The ICO recommends that each patient with glaucoma be evaluated for 19 items from 3 elements which are history, examination, and investigations. Mean compliance was recorded for each of the 3 elements. The compliance of each item was also checked and then a compared between the 2 settings, that is, public and private health care settings.

Results:
A total of 394 records were analyzed, with a mean age of 51.9±14.9 years and 232 (58.9%) male patients. Most records were from private settings 339 (86%), and primary open angle glaucoma 163 (41.4%) was the most common diagnosis. Compliance was low for all elements; history (31.8%), examination (61.3%), and investigation (6%). Pupil reaction differed significantly between the 2 groups (P=0.001).

Conclusion:
Pakistan’s ophthalmologists, whether in public or private health care settings, lack knowledge of ICO guidelines for glaucoma eye care. This study emphasizes the importance of implementing these guidelines in the general ophthalmology curriculum.
Patients’ Acceptance of Glaucoma Therapy in Sub-Saharan Africa
Authors: Olawoye Olusola , Sarimiye Tarela , Washaya Jennifer , Gessesse Girum W. , Balo Komi , Agre Jeremie , Macheka Boniface , Kizor-Akaraiwe Nkiru , Pons Jonathan , Ashaye Adeyinka , Garba Farouk , Chitedze Richard , Ibanga Affiong , Mahdi Abdull , Ogunro Adunola , Budengeri Patrick , Ajibode Haroun Adetunji , Tamrat Lemlem , Onakoya Adeola , Okeke Suhanyah , Giorgis Abeba T. , Okosa Chimdi Chuka , Fowobaje Kayode , Cook Stephen , Lawrence Scott , Chan Ving Fai , Blanco Augusto Azuara , Congdon Nathan , Realini Tony ,   The STAGE Research Group
Published: August 2024

Précis:
Patients’ acceptance of glaucoma therapy was high overall in this study, but lower for surgery than for laser or medical therapy. Fear and cost were the leading reasons why patients declined recommended therapy and they were treatment-specific. Cost was the primary reason for declining medical and laser therapy, while fear was the most common reason for declining surgical therapy.

Purpose:
To determine the frequency at which patients newly diagnosed with glaucoma in sub-Saharan Africa (SSA) decline recommended therapy and to characterize the reasons for declining therapy.

Methods:
This was a multicenter, cross-sectional study conducted on adult patients at the time of glaucoma diagnosis at 27 centers in 10 countries in SSA. Data collected from the diagnostic encounter included demographics, clinical glaucoma characteristics, treatment recommendations, patient acceptance of therapy, and reasons for declining therapy.

Results:
Among 2282 eyes of 1198 patients offered treatment for glaucoma, initially recommended treatment was accepted in 2126 eyes (93.2%). Acceptance of therapy varied with the nature of treatment offered, with medical therapy accepted in 99.2% of eyes, laser therapy in 88.3%, and surgical therapy in 69.3%. The most common reasons cited for declining therapy were fear (42.9%) and cost (41.7%); cost was the primary reason for declining medical and laser therapy, while fear was the most common reason for declining surgical therapy. Most patients declining laser or surgical therapy accepted medical therapy as an alternate therapy (98.1%).

Conclusions:
Patients’ acceptance of glaucoma therapy was high overall, but lower for surgery than for laser or medical therapy. Most patients who declined laser or surgical therapy accepted medical therapy as an alternate therapy when offered. Educational interventions, sustainable incentives, and other approaches are needed to enhance patient acceptance of glaucoma therapy in this setting, particularly surgery, when needed.
Perspectives of Caregivers on Children Boarding With Mental Health Conditions
Authors: Collins Samantha C. , Ferrigno Nicholas K. , King Roz , Chumpitazi Corrie E. , Stanley Rachel M. , Pulcini Christian D. 
Published: August 2024

Objective
Addressing the acute mental healthcare needs of children is a national crisis. Despite the ongoing crisis, there are limited prior studies that capture caregiver perspectives on acute pediatric mental healthcare, notably in a general emergency department (ED) in a rural state. Based on these knowledge gaps, our objective was to assess caregiver opinions and perspectives of acute management for children boarding with mental health conditions.

Methods
Semistructured interviews were conducted with caregivers of patients (under 18 years old) with a primary mental health condition boarding in a general ED (length of stay ≥24 hours) within a qualitative grounded theory approach. An interview guide was developed a priori and reviewed among key stakeholders. A trained study team performed the interviews. A coding tree was developed through an iterative process that included double-coding transcripts and monitoring of interrater reliability to perform thematic analysis.

Results
Fourteen interviews were conducted to reach thematic saturation. Key themes elicited from caregivers included mental healthcare delivery, access to mental healthcare services, care setting, and level of support for families and caregivers. Most caregivers focused on the following challenges and suggestions: access to appropriate, evidence-based mental healthcare, improved communication between all stakeholders involved, and staff education on mental healthcare for children

Conclusions
Caregivers face considerable challenges in attaining timely and appropriate acute mental health care for their children. Immediate and innovative resource allocation is needed across the healthcare continuum to bolster the acute mental healthcare services currently offered to children and families, especially in the general ED setting.
New Assessment Method of Alveolar Bone Grafting Using Automatic Registration and AI-based Segmentation
Authors: Fujii Yasuyuki , Sugiyama-Tamura Tomoko , Sugisaki Risa , Chujo Yuri , Honda Aya , Kono Michihide , Chikazu Daichi 
Published: August 2024

Objective:
The aim of this Technical note is to present a new assessment method of alveolar bone grafts after secondary alveolar bone grafting using automatic registration and artificial intelligence (AI)-based segmentation.

Methods:
A total of 7 Japanese patients (4 men and 3 women) with a unilateral cleft lip, alveolus, and/or palate, who underwent secondary alveolar bone grafting between March 2021 and August 2022 were evaluated. Computed tomography (CT) analyses were performed about 1 month before the surgery, and 1 day and 6 months after the surgery. All CT images were imported into a 3-dimensional analysis workstation. CT images from after the surgery were superimposed onto CT images from before the surgery, by automatic rigid image registration. The segmentation of bone tissues was automatically performed by the AI-based function. Grafted bone was extracted by subtraction of the bone tissue after the surgery from the bone tissue before the surgery. The volumes and Hounsfield units (HUs) of the grafted bones were calculated. The intraclass correlation coefficient (ICC) was reviewed to assess inter-rater reliability.

Results:
The ICCs (2,1) of the volumes and HUs measured by the observers immediately after the surgery were 0.95 and 0.99, respectively. On the other hand, the ICCs (2,1) of the volumes and HUs measured by the observers 6 months after the surgery were 0.81 and 0.57, respectively.

Conclusions:
Our new assessment method enables simple and quick evaluation of residual grafted bone after secondary alveolar bone grafting and demonstrated relatively high inter-rater reliability.
Assessment of Novel Surgical Procedures Using Bone Morphogenic Protein-7 Infused Into Decellularised Muscle and Bioactive Ceramic: A Histological Analysis
Authors: Alfotawi Randa 
Published: August 2024

Objective:
Reconstruction of critical bone defects is considered a challenge due to vascular reperfusion injury that may occur. The present study hypothesized that the use of decellularized muscle scaffold (DMS) and bone morphogenic protein-7 (BMP-7), along with resorbable bioactive ceramic silica calcium phosphate cement (SCPC) seeded with human bone marrow stromal cells, can expedite bone formation and maturation.

Methods:
Surgical bone defects were created in 20 nude transgenic mice. In experimental group 1 (n = 10), a critical-size (4 mm) calvarial defect was made and grafted with DMS-BMP-7/SCPC. In situ human bone marrow stromal cells [human mesenchymal stromal cells (hMSC)] were seeded thereafter. As a control, group 2 (n = 10) was treated with DMS/SCPC seeded with hMSCs. After 8 weeks, bone regeneration was evaluated using histology and histomorphometry for both groups.

Results:
Histological examination showed bone regeneration crossing the gap (experimental group 1), bone regeneration was noted at the defect periphery, and scattered islands of bone at the canters of the defects (control group 2). New bone formation and maturation were superior in the groups treated with the DMS/BMP-7/SCPC/hMSC constructs. The quantitative histological assessment revealed that the average bone surface area was 255 ± 25 mm2, which was 1.5 times the surface area of group 2, which was reported at 170 ± 35 mm2. The reported difference was considered statistically significant (P < 0.05).

Conclusion:
The DMS-BMP-7/SCPC scaffold induced bone regeneration and neovascularization in critical-size defects.
Evidence for the Positive Impact of Centralization in Esophageal Cancer Surgery
Authors: Donlon Noel E. , Moran Brendan , Davern Maria , Davey Matthew G. , Kennedy Czara , Leahy Roisin , Moore Jenny , King Sinead , Lowery Maeve , Cunningham Moya , Donohoe Claire L. , O’Toole Dermot , Ravi Narayanasamy , Reynolds John V. 
Published: August 2024

Objective:
To analyze the impact of centralization on key metrics, outcomes, and patterns of care at the Irish National Center.

Background:
Overall survival rates for esophageal cancer in the West have doubled in the last 25 years. An international trend towards centralization may be relevant; however, this model remains controversial, with Ireland centralizing esophageal cancer surgery in 2011.

Methods:
All patients (n=1245) with adenocarcinoma of the esophagus or junction treated with curative intent involving surgery, including endoscopic surgery, were included (n=461 from 2000 to 2011, and 784 from 2012 to 2022). All data entry was prospectively recorded. Overall survival was measured (1) for the entire cohort, (2) for patients with locally advanced disease (cT2-3N0-3), and (3) for patients undergoing neoadjuvant therapy. All complications were recorded as per Esophageal Complication Consensus Group definitions, and the Clavien-Dindo severity classification. Data were analyzed using GraphPad Prism (v.6.0) for Windows and SPSS (v.23.0) software (SPSS) R Studio (R version 4.2.2). Survival times were calculated using a log-rank test and Cox regression analysis, and Kaplan-Meier curves were generated.

Results:
Endotherapy for cT1a/intramucosal cancer adenocarcinoma increased from 40 (9% total) to 245 (31% total) procedures between the pre-centralization and post-centralization (post-C) periods. A significantly (P < 0.001) higher proportion of patients with cT2-3N0-3 disease in the post-C period underwent neoadjuvant therapy (66% vs 53%). Operative mortality was lower (P=0.02) post-C, at 2% versus 4.5%, and ≥IIIa Clavien-Dindo major complications decreased from 33% to 25% (P < 0.01). Recurrence rates were lower post-C (38% vs 53%, P < 0.01). Median overall survival was 73.83 versus 47.23 months in the 2012 to 2022 and 2000 to 2011 cohorts, respectively (P < 0.001). For those who received neoadjuvant therapy, the median survival was 28.5 months pre-centralization and 42.5 months post-C (P < 0.001).

Conclusions:
These data highlight improvements in both operative outcomes and survival from the time of centralization, and a major expansion of endoscopic surgery. Although not providing proof, the study suggests a positive impact of formal centralization with governance on key quality metrics and an evolution in patterns of care.
A Meta-analysis of Different Acupuncture Modalities Combined With Antidepressants to Reduce Major Depressive Disorder
Authors: Shu Wanqing , Pan Yongzhen 
Published: August 2024

Objectives
Acupuncture is an effective therapy for depression. Nevertheless, the results of clinical studies on major depressive disorder (MDD) remain controversial.

Methods
By November 2023, English-language published randomized clinical trials involving acupuncture for treating MDD were searched. The analysis comprised 9 studies with 809 subjects who met the eligibility criteria. The quality of the included studies was evaluated using the Quality in Prognostic Studies (QUIPS) tool.

Results
Acupuncture moderately alleviated the severity of MDD, independent of the method used (standardized mean difference [SMD] = −0.55; confidence interval [CI] 95%: −1.19, 0.09; P = 0.08). The severity of MDD was moderated by MA, regardless of antidepressant use (SMD = −0.49; CI95%: −1.13, 0.14, P = 0.09). Subgroup analysis revealed a nonsignificant reduction in MDD severity when using manual acupuncture alone (SMD −0.52; CI95%: −1.47, 0.44, P = 0.18). MDD severity was reduced by the use of manual acupuncture and antidepressants (SMD = −0.47; CI95%: −0.88, −0.06). Laser acupuncture and electroacupuncture (with or without antidepressants) did not significantly affect the severity of MDD.

Conclusions
Manual acupuncture with or without antidepressants may alleviate the severity of MDD, but its clinical benefit for treating MDD is inconclusive.
SARS-CoV-2 genomic surveillance from community-distributed rapid antigen tests
Authors: Emmen Isla E. , Vuyk William C. , Lail Andrew J. , Wolf Sydney , O’Connor Eli J. , Dalvie Rhea , Bhasin Maansi , Virdi Aanya , White Caroline , Hassan Nura R. , Richardson Alex , VanSleet Grace , Weiler Andrea , Rounds-Dunn Savannah , Van Horn Kenneth , Gartler Marc , Jorgenson Jane , Spelman Michael , Ottosen Sean , Minor Nicholas R. , Wilson Nancy , Friedrich Thomas C. , O’Connor David H. 
Published: August 2024

AbstractIn the United States, SARS-CoV-2 genomic surveillance initially relied almost entirely on residual diagnostic specimens from nucleic acid amplification-based tests (NAATs). The use of NAATs waned after the end of the COVID-19 Public Health Emergency. We partnered with local- and state-level public health agencies and the Dane County Public Library System to continue genomic surveillance by obtaining SARS-CoV-2 genome sequences from freely available community rapid antigen tests (RATs). From August 15, 2023 to February 29, 2024 we received 227 tests, from which we generated 127 sequences with >10x depth of coverage for ≥90% of the genome. In a subset of tests, lower Ct values correlated with sequence success. Our results demonstrate that collecting and sequencing from RATs in partnership with community sites is a practical approach for sustaining SARS-CoV-2 genomic surveillance.
Multicellular, fluid flow-inclusive hepaticin vitromodels using NANOSTACKSTM: a human-relevant model for drug response prediction
Authors: Talari Abdullah , Sbordoni Raffaello , Hoti Valmira , Patel Imran I. , Martin Francis L. , Raza Ahtasham , Llabjani Valon 
Published: August 2024

AbstractDrug-induced liver injury (DILI) continues to be the leading cause of drug attrition during clinical trials as well as the number one cause of post-market drug withdrawal due to the limited predictive accuracy of preclinical animal and conventionalin vitromodels. In this study, the NANOSTACKSTMplatform was introduced as a novelin vitrotool to buildin vivo-relevant organ models for predicting drug responses. In particular, hepatic models including monocultures of primary human hepatocytes (PHH), tricultures of PHH, human stellate cells (HSC) and human liver endothelial cells (LECs), and tetracultures of PHH, HSC, LECs and human Kupffer cells (KC) were developed under static and fluid flow-inclusive conditions. All hepatic models were characterised by assessing albumin, urea, CYP3A4 and ATP production. In addition, the preclinical DILI screening potential of the fluid flow-inclusive monoculture and triculture models were assessed by testing the hepatotoxicity of Zileuton, Buspirone and Cyclophosphamide. NANOSTACKS™ represents a promising tool for the development of complexin vitromodels.
Orthopoxvirus-specific antibodies wane to undetectable levels one year after MVA-BN vaccination of at-risk individuals
Authors: van Leeuwen Leanne P. M. , Shamier Marc C. , Verstrepen Babs E. , Götz Hannelore M. , Schmitz Katharina S. , Akhiyate Najlae , Wijnans Koen , Bogers Susanne , van Royen Martin E. , van Gorp Eric C. M. , Koopmans Marion P. G. , de Vries Rory D. , GeurtsvanKessel Corine H. , Zaeck Luca M. 
Published: August 2024

AbstractIn response to the 2022-2023 mpox outbreak, widespread vaccination with modified vaccinia Ankara-Bavarian Nordic was initiated. Here, we demonstrate that orthopoxvirus-specific binding and MVA-neutralizing antibodies wane to undetectable levels one year post-vaccination in at-risk individuals without pre-existing immunity. Continuous surveillance is essential to understand the impact of declining antibody levels.