bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing Incidence and Decreasing Mortality of Melanoma in Elderly Adults: An Epidemiologic Study in Olmsted County, Minnesota
Authors: Proffer Sydney L. , Reinhart Jacob P. , Campbell Elliott H. , Crum Olivia M. , Gibson Lawrence E. , Brewer Jerry D. , Demer Addison M. 
Published: October 2023

BACKGROUND AND OBJECTIVE
Primary cutaneous melanoma incidence is increasing in elderly individuals. This population-based cohort examines incidence and mortality rates among adults aged 61 years and older with cutaneous melanoma.

MATERIALS AND METHODS
Using the Rochester Epidemiology Project, patients aged 61 years of age or older with a first lifetime diagnosis of cutaneous melanoma between January 1, 1970 and December 31, 2020 were identified.

RESULTS
The age- and sex-adjusted incidence rate increased from 16.4 (95% CI, 8.2–24.6) per 100,000 person-years in 1970 to 1979 to 201.5 (95% CI, 185.1–217.8) per 100,000 person-years in 2011 to 2020 (12.3-fold increase). There was a 16.0x increase in males and an 8.5× increase in females. Melanoma incidence has stabilized in males (1.2-fold increase, p = .11) and continues to significantly increase in females (2.7-fold increase, p < .001). Older age at diagnosis was significantly associated with an increased risk of death (HR 1.23 per 5-year increase in age at diagnosis, 95% CI, 1.02–1.47).

CONCLUSION
Melanoma incidence continues to increase since 1970. The incidence has risen in elderly females, but has stabilized in males. Mortality has decreased throughout this period.
Economic impact of urinary incontinence and pelvic organ prolapse in women in Belize
Authors: Zillioux Jacqueline , Yeaman Clinton , Desai Raj , Sharma Devang , Balkrishnan Rajesh , Rapp David 
Published: October 2023

Introduction:
Urinary incontinence (UI) and pelvic organ prolapse (POP) are prevalent in low-income and middle-income countries (LMIC). Although the significant clinical and social impacts of UI/POP are well-described, less is known regarding their microeconomic impacts. This study aimed to assess the microeconomic impact of UI/POP in the LMIC country of Belize.

Methods:
The authors performed a prospective survey-based assessment of patients with urologic disease during surgical trips to Belize in 2019–2021 by the charity Global Surgical Expedition. This study is a post-hoc analysis focused on a subset with urogynecologic disorders. Patients completed a 17-item survey focused on disease impact on work, caretaker responsibilities, and finances. The primary study outcome was income loss resulting from work impairment or absence related to UI/POP, calculated using the validated work productivity and activity impairment questionnaire.

Results:
Forty-nine women with UI (n=15) and POP (n=34) completed surveys. The majority (73% UI; 88% POP) reported their condition negatively impacted their lives. In the analysis of 21 patients able to provide financial data, 6 (29%) patients reported missing work and 10 (48%) reported impairment at work due to UI/POP. This resulted in a loss of 6.7% (UI) and 8.5% (POP) in total income per capita. When also accounting for direct treatment costs, the total cost attributable to UI/POP was 28% (2%, 51%) of weekly income.

Conclusions:
In Belize, UI and POP significantly impair work and caretaking responsibilities, resulting in considerable lost income and cost. Efforts are thus necessary to provide surgical care for UI/POP in LMIC to address not only the quality of life but also the financial health of individuals and families.
The Inflammatory and Cytological Effect of Repeated Povidone-Iodine Application in Patients Receiving Intravitreal Injections
Authors: Akbulut Ersin , Kirik Furkan , Ekinci Aslanoglu Cansu , Hekimoglu Emine Rümeysa , Haciosmanoglu Aldogan Ebru , Ozdemir Mehmet Hakan 
Published: October 2023

Objective:
To investigate the effect of repeated povidone-iodine (PVI) application on the ocular surface parameters of patients who received intravitreal injections.

Materials and methods:
In this prospective study, 52 eyes of 52 patients with age-related macular degeneration who underwent unilateral intravitreal injection at least three times in the last 1 year (intravitreal injection [IVI] group), 52 fellow eyes with no previous intravitreal injection (NIVI group), and 51 eyes of 51 healthy subjects (control) were included. Tear break-up time (TBUT), the Schirmer test, the Oxford staining score, the Ocular Surface Disease Index questionnaire, conjunctival impression cytology, and tear inflammatory cytokine levels (interleukin [IL]-1β and IL-6) were analyzed in all participants.

Results:
The IVI group had lower TBUT and higher Oxford staining score than the NIVI and control groups (P<0.05). No significant difference was found between the groups in the Schirmer test (P=0.161). Conjunctival impression cytology analysis revealed that the IVI group had a significantly lower goblet cell count and significantly higher Nelson staging result than the NIVI and control groups (P<0.05). As a result of tear cytokine analysis, although IVI and NIVI groups had higher IL-1β and IL-6 levels than the control group (P<0.05), there was no difference between NIVI and IVI groups (P≥0.05).

Conclusion:
Repeated PVI application caused cytotoxic injury to the ocular surface, resulting in goblet cell loss and squamous metaplasia of epithelial cells. As a result, the stability of the tear film layer was found to be impaired and ocular surface–related symptoms developed in patients.
Diagnostic accuracy of plasma brain natriuretic peptide for evaluation of dyspnea NYHA-III and NYHA-IV in emergency department of tertiary care hospital
Authors: Saghir Hina , Andaleeb Hina , Azhar Amina , Babu Sadia , Fatima Saadia , Mumtaz Hassan 
Published: October 2023

Objective:
To determine the diagnostic accuracy of breathing not properly (BNP) for evaluation of dyspnea NYHA III and IV due to systolic heart failure in emergency department patients keeping echocardiography as the gold standard.

Study design:
Cross-sectional validation study. Setting: Department of Accident and Emergency Duration of Study: 25 July 2022–25 January 2023.

Subjects and methods:
A total of 115 of both sexes presenting with acute onset of dyspnea and having NYHA Class III and IV were included. Emergency nursing staff had immediately taken a single venous blood sample for BNP and creatinine levels and a 2D echo was performed. Ejection fraction was recorded, and the diagnosis of systolic heart failure on the basis of an ejection fraction, that is less than or equal to 45% was documented.

Results:
The age range in this study was from 18 to 65 years, with a mean age of 49.147±8.73 years. Mean BNP levels were 139.452±84.04 pg/ml. Patients with NYHA class III was 67.8 and 32.2% belongs to NYHA class IV. BNP levels greater than or equal to 100 pg/ml diagnosed 76 (66.1%) and echocardiography has diagnosed 68 (59.1%) patients with heart failure. BNP levels greater than or equal to 100 pg/ml had shown sensitivity 94.1%, specificity 74.5%, and diagnostic accuracy 86%, positive predictive value 84.21%, negative prediction value 89.74%, likelihood positive ratio 3.68 and likelihood negative ratio was 0.08 in diagnosis of heart failure.

Conclusion:
BNP estimation is a sensible and particular procedure for diagnosing CHF in patients who present to the emergency department with acute dyspnea and may add extra advantages to the administration of patients with congestive heart failure (CHF) in our population.
Eosinophil values in exacerbation and stable chronic obstructive pulmonary disease and its relationship to maintenance therapy in stable chronic obstructive pulmonary disease patients
Authors: Fachri Muhammad , Hatta Mochammad , Lestari Fira Indah , Akaputra Risky , Fatimah Fatimah , Wahab Athariq , Arliniy Yunita , Dwiyanti Ressy , Syukri Ahmad , Junita Ade Rifka , Febrianti Andini , Primaguna Muhammad Reza , Azhar Azhar 
Published: October 2023

Background:
Chronic obstructive pulmonary disease (COPD) is characterised by persistent and progressive airflow limitations. The study aimed to determine the relationship between eosinophil values in patients with stable and exacerbated COPD, and the relationship of eosinophil values with two drug regimens used as maintenance therapy in stable COPD.

Materials and methods:
This cross-sectional study and the variables used in this study were eosinophil counts in stable and exacerbated COPD patients.

Results:
Eighty-three patients with stable and exacerbated COPD were included. Stable COPD (63.9%) was predominant, with the highest degree of symptoms in group A 18 patients (34%) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2; 35 patients (66%). The degree of COPD exacerbation was dominated by Type II COPD 15 patients (50%). Eosinophil counts in patients with stable COPD were less than 100 cells/mm3 37 patients (44.6%), while in patients with COPD exacerbation, it was greater than 100 cells/mm3 with a total of 30 patients (36.1%). Long acting muscarinic antagonist class of drugs was the most used treatment as maintenance therapy in stable COPD 34 patients (64.2%).

Conclusion:
The eosinophil counts in patients with COPD exacerbation were significantly higher than those in patients with stable COPD. The provision of maintenance therapy in the long acting β-2 agonist + inhaled glucocorticosteroid group of stable COPD patients was generally provided to COPD patients with eosinophil values greater than 100 cells/mm3, and the provision of long-term maintenance therapy in stable COPD patients was generally given to COPD patients with eosinophil values less than 100 cells/mm3.
Optimization of tissue microarray technique for breast cancer patients: a short communication
Authors: Harfouch Rim M. , Al-Shehabi Zuheir , Asaad Remal , Aljamali Majd , Issa Rana , Elshimali Yahya , Vadgama Jay 
Published: October 2023

Background:
Tissue microarray (TMA) is a novel technique for studying different types of cancer tissues in one block. TMA is not yet established in Syria, so we aimed in this project to apply and set the most optimal conditions of TMA creation of breast cancer tissues at the Pathology Department of our institute.

Materials and Methods:
Eighty-eight blocks of breast cancer tissues were selected, considering the inclusion criteria. The tissue specimens of breast cancer patients were manually placed in the block by punching a core from a paraffin block, which was then released into a recipient block using a small trocar. Three different conditions were tested on the constructed TMA block.

Results:
We determined the most effective parameters that proved high quality: incubating the newly constructed block at a temperature of 43°C for 24 h in the oven and then cutting it the next day after cooling it to room temperature; also, cutting with a 5 μm thickness created the preferable stained slides later. CD3 staining showed high expression of tumor-infiltrating lymphocytes among triple-negative breast cancer patients and high expression of CD3 in triple-negative cancer patients.

Conclusion:
The optimization of parameters presented in our study resulted in perfect TMA generation and successful immunohistochemistry staining for cancer research at our institution.
A case report on enormous haemangioma of liver
Authors: Baral Pratik , Singh Bhandari Ramesh , Pradhan Sumita , Maharjan Narendra , Mainali Prakash , Regmi Dipesh , Kandel Krishna 
Published: October 2023

Introduction:
Hemangiomas are the most common benign liver tumour. These tumours arise from the proliferation of vascular endothelial cells and increase in size owing to dilation. If their diameter exceeds 5 cm, they are classified as giant hemangiomas, while those surpassing 15 cm are considered enormous hemangiomas.

Case presentation:
A 38-year-old female patient presented with complaints of abdominal fullness for 18 months. Contrast-enhanced computed tomography was performed and two hemangiomas were diagnosed; the , larger one was an enormous hemangioma of size 20 × 16 cm. Non-anatomical hepatic resection was performed to remove the hemangiomas. The patient recovered well, without any complications.

Clinical discussion:
Hepatic hemangiomas are common, but hemangiomas greater than 15 cm in size are rare. They usually require no treatment unless the patient is symptomatic. Hepatectomy and enucleation of hemangioma are the most common surgical procedure for such hemangioma.

Conclusions:
Rarely, large hepatic hemangioma can be the cause of abdominal fullness lasting for months. Often, surgical intervention is required.
68Ga-FAPI PET/CT Imaging
Authors: Al-Ibraheem Akram , Abdlkadir Ahmed Saad , Alalawi Hasan , Badarneh Mohannad 
Published: October 2023

Abstract

68Ga-FAPI has been introduced recently in many nuclear medicine centers. Many pitfalls have been discussed previously. However, not all pitfalls are currently addressed in the literature. To our knowledge, this is the first reported case to address nonspecific 68Ga-FAPI expression at anorectal sphincter. A 69-year-old woman was diagnosed with intrahepatic cholangiocarcinoma. A 68Ga-FAPI scan was performed after diagnostic workup and chemoradiotherapy. In addition to 68Ga-FAPI–avid lesion at primary site, several nononcological ancillary findings have been observed. This includes unaddressed 68Ga-FAPI–avid focus within anorectal sphincter. Moreover, the same noteworthy findings were observed in the musculoskeletal and gynecological systems.
Impact of patient, system, and environmental factors on utilization of air medical transport after trauma
Authors: Beiriger Jamison , Lu Liling , Silver David , Brown Joshua B. 
Published: October 2023

BACKGROUND
Air medical transport (AMT) improves outcomes for severely injured patients. The decision to fly patients is complex and must consider multiple factors. Our objective was to evaluate the interaction between geography, patient and environmental factors, and emergency medical services (EMS) system resources on AMT after trauma. We hypothesize that significant geographic variation in AMT utilization will be associated with varying levels of patient, environmental, and EMS resources.

METHODS
Patients transported by EMS in the Pennsylvania state trauma registry 2000 to 2017 were included. We used our previously developed Air Medical Prehospital Triage (AMPT; ≥2 points triage to AMT) score and Geographic Emergency Medical Services Index (GEMSI; higher indicates more system resources) as measures for patient factors and EMS resources, respectively. A mixed-effects logistic regression model determined the association of AMT utilization with patient, system, and environmental variables.

RESULTS
There were 195,354 patients included. Fifty-five percent of variation in AMT utilization was attributed to geographic differences. Triage to AMT by the AMPT score was associated with nearly twice the odds of AMT utilization (adjusted odds ratio, 1.894; 95% confidence interval, 1.765–2.032; p < 0.001). Each 1-point increase in GEMSI was associated with a 6.1% reduction in odds of AMT (0.939; 0.922–0.957; p < 0.001). Younger age, rural location, and more severe injuries were also associated with increased odds of AMT (p < 0.05). When categorized by GEMSI level, the AMPT score and patient factors were more important for predicting AMT utilization in the middle tercile (moderate EMS resources) compared with the lower (low EMS resources) and higher tercile (high EMS resources). Weather, season, time-of-day, and traffic were all associated with AMT utilization (p < 0.05).

CONCLUSION
Patient, system, and environmental factors are associated with AMT utilization, which varies geographically and by EMS/trauma system resource availability. A more comprehensive approach to AMT triage could reduce variation and allow more tailored efforts toward optimizing resource allocation and outcomes.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Polycladospora coralii gen. nov., sp. nov., a novel member of the family Thermoactinomycetaceae isolated from stony coral in the South China Sea
Authors: Mo Kunlian , Huang Huiqin , Ye Lin , Wu Qingjuan , Hu Yong hua 
Published: October 2023

Two novel filamentous bacteria, designated as IB182353T and IB182357, were isolated from stony coral of the South China Sea. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strains IB182353T and IB182357 were closely related to

Hazenella coriacea

DSM 45707T (with 93.4 and 93.5% similarity, respectively). The average nucleotide identity, average amino acid identity and digital DNA–DNA hybridization results showed that the pairwise similarities between isolate IB182353T and the other recognized

Thermoactinomycetaceae

species were less than 68.9, 60.5 and 21.1 %, respectively. Both strains produced aerial and substrate mycelia, grew optimally at 25–30 °C, pH 8.0–9.0 and with 2–3 % (w/v) NaCl. The cell-wall peptidoglycan type was meso-DAP and the whole-cell hydrolysates contained ribose. The polar lipids consisted of phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, one unidentified aminophospholipid and three unidentified phospholipids. The genomic DNA G+C content was 39.5 mol%. Strain IB182353T was distinguishable from its related type strains by the contents of two fatty acids, iso-C15 : 0 and iso-C17 : 1
ω10c. Based on polyphasic taxonomic characterization, we propose that strains IB182353T and IB182357 represent a novel genus and species within the family

Thermoactinomycetaceae

, for which the name Polycladospora coralii gen. nov. sp. nov. is proposed. The type strain is IB182353T (=MCCC 1K04631T=JCM 34206T).
Predicting efficacy of immunotherapy in mice with triple negative breast cancer using a cholesterol PET radiotracer
Authors: Ciavattone Nicholas G. , Guan Jenny , Farfel Alex , Desmond Timothy , Viglianti Benjamin L. , Scott Peter JH , Brooks Allen F. , Luker Gary D. 
Published: October 2023

AbstractPredicting the response to cancer immunotherapy remains an unmet challenge in triple-negative breast cancer (TNBC) and other malignancies. T cells, the major target of current checkpoint inhibitor immunotherapies, accumulate cholesterol during activation to support proliferation and signaling. The requirement of cholesterol for anti-tumor functions of T cells led us to hypothesize that quantifying cellular accumulation of this molecule could distinguish successful from ineffective checkpoint immunotherapy. To analyze accumulation of cholesterol by T cells in the immune microenvironment of breast cancer, we leveraged a novel positron emission tomography (PET) radiotracer, FNP-59. FNP-59 is an analog of cholesterol that our group has validated as an imaging biomarker for cholesterol uptake in pre-clinical models and initial human studies. In immunocompetent mouse models of TNBC, we found that elevated uptake of exogenous labeled cholesterol analogs functions as a marker for T cell activation. When comparing immune checkpoint inhibitor (ICI)-responsive EO771 tumors to non-responsive AT-3 tumors, we found significantly higher uptake of a fluorescent cholesterol analog in T cells of the ICI-responsive tumors both in vitro and in vivo. Using the FNP-59 radiotracer, we discovered that accumulation of cholesterol by T cells increased further in ICI-responding tumors that received ant-PD-1 checkpoint immunotherapy. We verified these data by mining single cell sequencing data from patients with TNBC. Patients with tumors containing cycling T cells showed gene expression signatures of cholesterol uptake and trafficking. These results suggest that uptake of exogenous cholesterol analogs by tumor-infiltrating T cells predict T cell activation and success of ICI therapy.
Akkermansia muciniphilaidentified as key strain to alleviate gut barrier injury through Wnt signaling pathway
Authors: Ma Xin , Li Meng , Zhang Yuanyuan , Xu Tingting , Zhou Xinchen , Qian Mengqi , Yang Zhiren , Han Xinyan 
Published: October 2023

ABSTRACTAs the largest mucosal surface, the gut has built a physical, chemical, microbial and immune barrier to protect the body against pathogen invasion. The disturbance of gut microbiota aggravates pathogenic bacteria invasion and gut barrier injury. Fecal microbiota transplantation (FMT) is a promising treatment for microbiome-related disorders, where beneficial strain engraftment is a significant factor influencing FMT outcomes. The aim of this research was to explore the effect of FMT on antibiotic-induced microbiome-disordered (AIMD) model infected with enterotoxigenicEscherichia coli(ETEC). We used piglet, mouse and intestinal organoid models to explore the protective effects and mechanisms of FMT on ETEC infection. The results showed that FMT regulated gut microbiota and enhanced the protection of AIMD piglets against ETEC K88 challenge, as demonstrated by reduced intestinal pathogen colonization and alleviated gut barrier injury.Akkermansia muciniphila(A. muciniphila) andBacteroides fragilis(B. fragilis) were identified as two strains that may play key roles in FMT. We further investigated the alleviatory effects of these two strains on ETEC infection in AIMD mice model, which revealed thatA. muciniphilaandB. fragilisrelieved ETEC-induced intestinal inflammation by maintaining the proportion of Treg/Th17 cells and epithelial damage by moderately activating the Wnt/β-catenin signaling pathway, while the effect ofA. muciniphilawas better thanB. fragilis. We therefore identified whetherA. muciniphilaprotected against ETEC infection using basal-out and apical-out intestinal organoid models.A. muciniphiladid protect the intestinal stem cells and stimulate proliferation and differentiation of intestinal epithelium, and the protective effects ofA. muciniphilawas reversed by Wnt inhibitor. FMT alleviated ETEC-induced gut barrier injury and intestinal inflammation in AIMD model.A. muciniphila was identified as key strain in FMT to promote proliferation and differentiation of intestinal stem cells by mediating the Wnt/β-catenin signaling pathway.
Retrospective study of botulinum neurotoxin for hemifacial spasm: experience over 25 years
Authors: Lee Moon Keen 
Published: October 2023

ABSTRACTIntroductionHemifacial spasm (HFS) is a not uncommon, debilitating movement disorder. This retrospective study examines 25 years of experience with Botulinum neurotoxin (BoNT) injections for HFS in Malaysia.ObjectiveTo assess BoNT’s long-term effectiveness in treating HFS in a private practice.MethodsData from 35 patients, including demographics, treatment outcomes, and complications, were collected from a private clinic over 25 years.ResultsBoNT demonstrated a decreasing dose trend over time, with extended treatment intervals. Complications were rare and transient, with high patient retention.ConclusionBoNT is a safe and effective long-term HFS treatment, enhancing accessibility in private practice, complementing public healthcare services.