bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hingeless arm for space robotics actuated through shape memory alloys
Authors: Biasutti Tiziana , Rigamonti Daniela , Casciaro Emanuele , Grande Antonio Mattia , Bettini Paolo 
Published: November 2023

Abstract
Operating outside the spacecraft via remotely controlled structures is an important opportunity in different space applications. The research in this area is focused on designing robots that are sufficiently flexible to allow inspection in locations where access is difficult or impossible for astronauts, while minimizing weight and bulk. The purpose of the research is to design a borescope for space applications with no hinges or other mechanisms, exploiting biomimetic design concepts. This is pursued by giving to the borescope a backbone exoskeleton provided by a continuous structure made of fibre reinforced composite material and using NiTi wires as tendons, taking advantage of their low weight and dimensions, which allow them to be embedded between the composite layers during the lamination process. After a study of the state of the art of flexible structures, concentrated in the medical and robotic fields, the research work unfolded in two phases. In the first design phase, several composite layup solutions were considered and analysed using finite element models, leading to the definition of the borescope geometrical parameters and to an initial estimate of the displacements that can be achieved. In the second experimental phase, seven prototypes were produced and tested, with one or more wires, to validate the design and to search for a configuration that can be actuated in different directions. The borescope prototypes resulted flexible enough to achieve an extended degree of bending and at the same time sufficiently rigid to allow complete rearm of the NiTi wires. The numerical and experimental study led to the definition of the design parameters, the number of wires, and the manufacturing technique to integrate NiTi actuators.
Nontrivial solutions for homogeneous linear equations over some non-quotient hyperfields
Authors: Hobby David , Jun Jaiung 
Published: November 2023

We introduce a class of hyperfields which includes several constructions of non-quotient hyperfields. We then use it to partially answer a question posed by M. Baker and T. Zhang: Does a system of homogeneous linear equations with more unknowns than equations always have a nonzero solution? We also consider a class of hyperfields that was claimed in the literature to be non-quotient, and show that this is false.
Exploring HPV as an Etiologic Factor for Breast Cancer
Authors: Ateek G N , Leon M , Hernandez Gonzalo D , Stewart B , Petty D 
Published: November 2023

Abstract

Introduction/Objective
Breast ducts communicate with skin, which can expose one to infectious agents. Recent studies demonstrate differences between breast microbiome in normal tissues versus tumor, suggesting a potential role in carcinogenesis. Human Papilloma Virus (HPV) is the etiologic factor in numerous cancers, and studies suggest it may play a role in breast carcinoma. A recent case report identified an analogue to HPV-related multiphenotypic sinonasal carcinoma in the breast. This sinonasal tumor, closely associated with HPV type 33, consists of adenoid cystic-like morphology, basaloid and/or squamous cytology and multi-lineage differentiation (ductal and myoepithelial). Our aim was to determine if HPV is a driver of breast carcinomas with the outlined phenotype by testing with immunohistochemistry (IHC) for p16 and in-situ hybridization (ISH) for High Risk HPV (HR-HPV) E6/E7 mRNA.

Methods/Case Report
Breast cases from 2010- June 2022 were searched with the terms “adenoid cystic,” “myoepithelial differentiation,” or “basaloid.” Cases of adenoid cystic carcinoma with a diagnostic fusion were excluded. Those with basaloid and/or squamous morphologic features containing ductal and myoepithelial differentiation proven by IHC were included. Nine identified cases were submitted for p16 IHC and HR-HPV ISH.

Results (if a Case Study enter NA)
Patients ranged in age from 50 to 85. No cases resulted with positive HR-HPV, however all cases displayed staining for p16. All cases with benign breast tissue (6/9) exhibited some p16 positivity within luminal and myoepithelial cells.

Conclusion
HR-HPV ISH is a sensitive test; however, no cases were positive. Most tumors and benign breast expressed p16 in some form. p16 in basal-like breast cancer has been described, but only 3/7 cases with biomarkers were triple negative. Accordingly, p16 is not a reliable screening tool if detection of HPV becomes clinically relevant in the future. In this series, the phenotypic features assessed do not appear to be consistent harbingers of HPV infection. More studies are needed to assess the breast microbiome and oncogenic organisms to identify potential new therapeutic targets.
Developing a Novel Non-invasive Serum-based Diagnostic Test for Early Detection of Colorectal Cancer
Authors: Addissouky T A , El Agroudy A E , Khalil A A 
Published: November 2023

Abstract

Introduction/Objective
Colorectal cancer (CRC) is the third-most common cancer worldwide, and early detection is vital for successful treatment and improved outcomes. Current screening methods such as colonoscopy, fecal occult blood tests, and stool DNA tests have limitations such as patient discomfort, cost, and low sensitivity and specificity most commonly diagnosed cancer worldwide with a high mortality rate. Early detection remains a crucial factor in reducing the burden of CRC. Currently, the gold standard for CRC diagnosis is colonoscopy, but it may not be feasible for widespread screening due to its invasiveness, cost, and patient compliance issues. Therefore, there is a great need to identify reliable biomarkers that can detect CRC at an early stage. This study aimed to evaluate the effectiveness of updated novel biomarkers for early detection of CRC.

Methods/Case Report
This study was conducted on 158 patients with suspected or confirmed CRC. The study population included patients of both genders, aged above 18 years, and with a history of CRC or other relevant risk factors. Blood samples were collected from all included patients, and the biomarkers (CTCS, miRNAs, ctDNA, and Methylated DNA markers ) were measured using enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) tests. Novel biomarkers compared their diagnostic performance with existing biomarkers such as fecal occult blood tests (FOBTs), fecal immunochemical tests (FITs), and CEA.

Results (if a Case Study enter NA)
The studied biomarkers (CTCs, microRNAs, ctDNA, and Methylated DNA markers) have high sensitivity from 78.8 % to 96.72% and accuracy from 83.76% to 94.83% as well as their cut-off which approved the objective of this study. Overall, these novel biomarkers show promise for early detection of colorectal cancer and may improve screening and early detection efforts.

Conclusion
The evaluation of the studied biomarkers (Circulating Tumor Cells, microRNAs, Circulating tumor DNA, and Methylated DNA markers) for early detection of CRC has substantial clinical and public health implications. The identification of reliable biomarkers for CRC screening can avoid unnecessary colonoscopies, reduce the burden on healthcare costs, and improve the detection of early-stage CRC.
EVALUATION AND IMPLIMENTATION OF A COMMERCIAL QUALITY CONTROL PRODUCT TO MONITOR SERUM INDICES DETECTION IN DAILY ROUTINE USE
Authors: Yagoot Abobaker M , Khalil Haitham , Borai Anwar , Yagoot A M 
Published: November 2023

Abstract

Introduction/Objective
Clinical Chemistry analyzers measure serum indices of each sample. Serum indices affect patient result. Yet there is no current common practice of monitoring the Instruments ability to measure serum indices using a commercial QC product. In this study, we focused on such Q.C. product evaluation.

Methods/Case Report
We evaluated the implementation of daily routine use of serum indices QC. We used a commercially available Bio-Rad (Hercules, California, United States) LiquichekTM Serum Indices QC material on Abbott (Abbott Park, Illinois, United States) Architect c8000 Chemistry analyzers in National Guard Hospital, Jeddah, Saudi Arabia. We run the QC twice a day in three Instruments for Two months. Data transferred to Bio-Rad Unity Real Time, a QC data management software. Mean, standard deviation and coefficient of variation calculated for each Instrument.

Results (if a Case Study enter NA)
A total of 1,296 data points were collected. The QC performed well with a precision of % CV ≤ 1.97% Hemolysis, ≤ 2.67% Icterus and ≤ 6.80% Lipemia. The three instruments performed with a slightly different mean. No “out of control” situations observed. TAT was not affected. To mimic a possible day-to-day Lab scenario, the saline bottle used as HIL reagent was deliberately contaminated using a few drops of whole blood to study the effect of gross hemolysis reagent contamination on HIL readings. The commercial HIL quality control detected the problem. Its performance showed increase in Hemolysis, slight decrease in Icterus and a slight increase in Lipemia readings.

Conclusion
Bio-Rad Liquichek Serum Indices QC is easy to use with a long shelf life. It helps to monitor the instrument’s ability to detect the sample integrity. Results can be compared to peer group unlike the home brewed QC. Peer group comparison helps to monitor and troubleshoot any bias or shift from the peer group and brings benefit to the total QC process.
A Case Report of a Complex Constitutional Karyotype Resulting in Three Derivative Chromosomes Characterized by Chromosomal Analysis, Florescent in situ Hybridization (FISH), and Chromosome Microarray
Authors: Beaudry S , Nagy J 
Published: November 2023

Abstract

Introduction/Objective
Structurally complex karyotypes are rarely identified in the postnatal constitutional setting. Abnormalities involving multiple chromosomes are likely to have a deleterious effect or be incompatible with life. Herein, we describe a case of a structurally complex karyotype in a newborn male.

Methods/Case Report
A newborn male presented at birth with microcephaly, severe ventriculomegaly, cerebellar hypoplasia and absent cavum septum pellucidum. Seizures, optic nerve dysplasia, and feeding difficulties were later noted. Microarray testing revealed eight small deletions of unclear significance on chromosome 7, with three located on the p arm and five clustered on the q arm. The deletions were gene poor, and none contained known haploinsufficient genes. Based on this finding a structural abnormality involving chromosome 7 was suspected.
Karyotype revealed a structurally abnormal chromosome 7 and a complex rearrangement between chromosomes 11 and 18. Chromosome paint and metaphase FISH studies were performed to further characterize the abnormalities. Based on results from these cytogenetic tests, the observed abnormalities were characterized as an insertion on chromosome 7, and a translocation between chromosome 11 and 18 with an inversion on the derivative 18 [46,XY,ins(7)(p21q22q11.2),der(11)t(11;18)(q14.2;p11.2),der(18)(11qter→11q21::18q11.2→18p11.2::11q14.2→11q21::
18q11.2→18qter)]. Rapid whole genome sequencing was done at an outside institution which was negative.

Results (if a Case Study enter NA)
NA

Conclusion
The exact cause of this individual’s phenotypic findings is unknown. Although the genomic imbalance detected by CMA is small, the complex structural abnormalities likely contribute to the clinical findings. Further supporting a deleterious effect of the karyotype findings is the negative whole genome sequencing results in this individual. Some apparently balance rearrangements have been shown to disrupt genes or important regulator elements. It is possible that a gene was disrupted at the breakpoint of one or more of the detected abnormalities or the rearrangement resulted in abnormal gene regulation. Additional submicroscopic abnormalities may also be present that were not detectable by the methodologies used.
Gastric glomus tumor mimicking neuroendocrine tumor on fine needle aspiration: a diagnostic pitfall
Authors: Khan J , Cramer H M , Dave N , Segura S 
Published: November 2023

Abstract

Introduction/Objective
Glomus tumors (GT) are mesenchymal neoplasms of modified smooth muscle that most commonly affect subungual regions of distal extremities. Although they can occur everywhere in the body, gastric involvement is rare. Gastric GT is usually benign but given the overlapping morphologic and immunohistochemical features with other gastric mesenchymal tumors, GT is commonly misdiagnosed.

Methods/Case Report
We present two cases of gastric GT initially diagnosed as well-differentiated neuroendocrine tumor (WDNT), G1 on fine needle aspiration (FNA). A 57-year-old female presented with an incidental 1.5 cm gastric submucosal lesion discovered on endoscopy performed for esophageal food impaction. The second case is of a 73- year-old male with a 1.7 cm submucosal lesion found on endoscopy for reflux. Both lesions were located in the gastric antrum. FNA showed clusters of relatively uniform cells with moderate cytoplasm, round nuclei, and stippled chromatin. Tumor cells were focally positive for synaptophysin, while negative for CK7, CD117, DOG-1, and chromogranin. Ki-67 proliferative index was &lt;3%. A diagnosis of WDNT, G1 was made. Subsequent partial gastrectomy showed a submucosal epithelioid neoplasm composed of cells with eosinophilic to clear cytoplasm, and distinct cellular membranes. Focally dilated, tumor-associated thin-walled vessels were noted.
Immunohistochemically, the tumor was positive for SMA, calponin, and synaptophysin, and negative for CK AE1/AE3 and chromogranin, supporting the diagnosis of gastric GT.

Results (if a Case Study enter NA)
N/A

Conclusion
The rarity of gastric GT, combined with the morphological and immunohistochemical similarity with WDNT, led to diagnostic pitfalls in these cases. With the increased detection and sampling of incidental gastric lesions, cytopathologists should be aware of this uncommon tumor and its mimics, and as such, expand their differential diagnoses.
Selpercatinib-induced hepatotoxicity: A rare case report
Authors: Liang G , Lin J , Zhang D 
Published: November 2023

Abstract

Introduction/Objective
Selpercatinib (Retevmo) is a highly selective rearranged during transfection (RET) kinase inhibitor indicated for treatment of solid tumors with RET gene mutation or fusion, such as medullary thyroid carcinoma or non-small cell lung carcinoma. Among selpercatinib’s side effects, severe hepatotoxicity was only seen in 3% of the patients. Here we report a case of selpercatinib-induced hepatotoxicity, which has not been well characterized before.

Methods/Case Report
The patient was a 56-year-old female who had medullary thyroid carcinoma with RET M918T mutation (pT3aN1b) status post total thyroidectomy. Recurrence occurred and selpercatinib treatment was initiated. Then the patient complained of mouth sores, tongue sensitivity, and lower extremity cramping. The dosage was reduced to half. The magnetic resonance imaging on day 67 of selpercatinib treatment showed heterogeneous enhancement in the right hepatic lobe, compatible with parenchymal liver disease/hepatitis, trace perihepatic ascites, and mild splenomegaly. On day 71, liver function abnormalities were detected (ALK 315 IU/L, ALT 745 IU/L, AST 899 IU/L, total bilirubin 7.7 mg/dL). Workups including autoimmune hepatitis serology, viral hepatitis, or other infections were all negative. She had no history of other drug use. On day 72, a liver biopsy was performed that demonstrated mild to moderate portal lymphocyte-predominant mixed inflammation with interface activity. The lobules showed marked inflammation with hepatocyte disorganization, acidophil bodies, hepatocyte dropout, and rare lipogranulomas. Bile duct injury and patchy canalicular cholestasis were also noted. Trichrome stain showed focal bridging fibrosis.
Overall, the histologic findings were acute and chronic hepatitis pattern injury, favor selpercatinib-induced hepatotoxicity. Selpercatinib was discontinued. All liver enzymes gradually returned to normal levels on day 169.

Results (if a Case Study enter NA)
NA

Conclusion
Our study suggests that screening patients for abnormal liver function tests prior to and monitoring periodically during selpercatinib treatment is necessary. Based on the severity of hepatotoxicity, withholding, reducing the dose, or permanently discontinuing selpercatinib is recommended.
Impact of Online Tumor Board Simulation for Optimizing Testing and Treatment of Patients with BRAFV600E- mutant Metastatic Colorectal Cancer
Authors: Kelly M , Beumer K 
Published: November 2023

Abstract

Introduction/Objective
Approximately 10% of patients with metastatic colorectal cancer (mCRC) have BRAF genetic mutations, 90% of which result in a V600E substitution. Although there are targeted therapies available, there has been confusion about new and emerging testing and treatment options for BRAFV600E-mutant mCRC.

Methods/Case Report
To meet these needs, ASCP designed a 60-minute, self-paced, CME/CMLE online tumor board simulation to: increase knowledge, skills, and competence of pathologists and laboratory professionals to ensure patients with mCRC are appropriately and efficiently tested for BRAF mutations in accordance with NCCN guidelines, and enable pathologists to guide medical oncologists in the appropriate diagnosis, testing, and treatment of patients with mCRC. In the simulation, an expert pathologist and oncologist presented patient cases involving BRAFV600E-mutant mCRC. Learners answered questions designed to help them carefully consider the nuances of each case, building their knowledge and skills related to the detection and optimal management of patients with BRAF-mutant mCRC.

Results (if a Case Study enter NA)
250+ learners have participated, with results demonstrating greater understanding of the NCCN guidelines for molecular testing of patients with mCRC, the clinicopathologic characteristics of BRAF-mutant mCRC. The tumor board simulation also increased awareness of strategies for improving turnaround times in biomarker testing for patients with mCRC, as well as current and emerging treatment options for BRAFV600E-mutant mCRC, which were two of the main goals of the education.

Conclusion
This project advanced knowledge, skills, and competence among pathologists and laboratory professionals, particularly those in community practice, to help ensure that patients who may be eligible for new and emerging therapies for BRAFV600E-mutant mCRC receive effective, optimized, and timely biomarker testing and treatment. The education may be useful to learners who want an increased understanding of BRAF mutations and their role in treatment selection.
Cystic pheochromocytoma: a rare variant of adrenal gland tumor case report
Authors: Zhong X , Kokabee M , Sham S , Grasso M , Unger P 
Published: November 2023

Abstract

Introduction/Objective
Pheochromocytoma is the primary adrenal medullary tumor in adults. Patients usually present with sustained or sporadic hypertension. The tumors are almost always solid. Cystic pheochromocytoma (CP) is extremely rare with only a few cases reported in the literature. Patients with CP may be asymptomatic and normotensive and be diagnosed incidentally on imaging or intraoperatively.

Methods/Case Report
We report a case of an 82-year-old male with a large CP who presented with back pain. The patient was hypertensive preoperatively (140/85 mmHg). Imaging showed a 5.4 cm complex right adrenal mass that could not be further classified. Labs showed markedly increased 24hr urine normetanephrine (1342 ug/24hr). The patient was presumed to have a pheochromocytoma and was preoperatively treated with an alpha-blocker. At surgery an 8.0 cm multiloculated cystic adrenal mass was removed, and grossly the specimen consisted of a brown, multicystic mass filled with brown liquid. Histology revealed the septa to contain nests of polygonal cells with vacuolated to basophilic granular cytoplasm with moderate nuclear pleomorphism . Immunohistochemical staining was positive for synaptophysin, chromogranin and S-100, which confirmed the diagnosis of CP. Patient’s postoperative blood pressure was 130/60 mmHg.

Results (if a Case Study enter NA)
NA

Conclusion
Cystic pheochromocytoma has to be in the differential for a retroperitoneal cystic mass in order that clinicians, radiologists as well as pathologists undertake proper patient management and diagnosis.
Diagnostic role and prognostic impact of PSAP immunohistochemistry: A tissue microarray study on 31,358 cancer tissues from 127 different tumor types
Authors: Tribian L S , Lennartz M , Blessin N C , Kind S , Viehweger F , Menz A , Burandt E , Sauter G , Simon R , Kluth M , Bernreuther C 
Published: November 2023

Abstract

Introduction/Objective
Prostatic specific acid phosphatase (PSAP) protein is produced in prostate epithelial cells and it is used as an immunohistochemical marker for prostate cancer. However, studies have reported PSAP expression to occur in various other tumor entities as well.

Methods/Case Report
Prostatic specific acid phosphatase (PSAP) protein is produced in prostate epithelial cells and it is used as an immunohistochemical marker for prostate cancer. However, studies have reported PSAP expression to occur in various other tumor entities as well.

Results (if a Case Study enter NA)
In prostate cancer, PSAP staining was seen in 100% of Gleason 3 + 3, 95.5% Gleason 4 + 4, 93.8% recurrent prostate cancer under androgen deprivation therapy, 91.0% Gleason 5 + 5 and 31.2% small cell neuroendocrine prostate cancer. Reduced PSAP staining was strongly linked to high pT stage, high Gleason grade, lymph node metastasis, early PSA-recurrence (p&lt;0.0001 each),high androgen receptor expression and TMPRSS2:ERG fusions. In multivariate analyses, low PSAP expression was able to predict PSA recurrence independent of pre- and postoperative prognostic markers in ERG negative cancers. In extra-prostatic cancers, PSAP immunostaining was only seen in 3 of 94 (3.2%) neuroendocrine tumors of the pancreas and in 1 of 129 (0.8%) diffuse type gastric adenocarcinomas.

Conclusion
A positive PSAP immunostaining is highly specific for prostate cancer and reduced PSAP expression is associated with an aggressive prostate cancer phenotype. The independent association of reduced PSAP expression with poor prognosis in ERG negative prostate cancer makes PSAP measurement a candidate marker for prognostic multiparameter panels for prostate cancer.