bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent Advancements in Robotic-assisted Plastic Surgery Procedures: A Systematic Review
Authors: Kawashima Kazuho , Ghali Shadi , Nikkhah Dariush , Esmaeili Ali 
Published: January 2025

Background:
There has been a delayed, yet steady uptake of robotic-assisted surgery over the past decade within the field of plastic surgery. In an era of rapidly evolving scientific and technological development, there is a need for an update on the current literature for robotic-assisted plastic surgery procedures.

Methods:
Searches were conducted across major databases, including MEDLINE, Embase, and Central for published literature from March 2023 to December 2024. Only published articles written in English with full texts were considered for the final narrative synthesis.

Results:
Initially, we identified 1200 articles in the database search. Subsequently, 46 articles were included in our final narrative synthesis. Among the selected studies, 4 focused on reconstruction in transoral robotic surgery, 14 on breast surgery, 10 on robotic microsurgery, 5 on abdominal wall reconstruction, 6 on vaginoplasty, and 5 on flap harvest.

Conclusions:
The evidence to support the advantage of robotic plastic surgery procedures over traditional methods is relatively weak. However, there have been some advancements, specifically in transoral robotic surgery, robotic mastectomy, and breast reconstruction. Nevertheless, comprehensive exploration and prospective randomized trials are essential across all procedures to define the role of surgical robots in plastic surgery. The impediments to wider adoption include high costs, disruption to operative flow, and the absence of haptic feedback in robotic-assisted procedures within the specialty.
Meibomian Gland Structure and Function in Patients with Demodex Blepharitis
Authors: Yeu Elizabeth , Koetting Cecelia 
Published: January 2025

Purpose:
To compare structural and functional measures of meibomian gland dysfunction (MGD) in eyes with moderate to severe Demodex blepharitis (collarette grade 2-4) compared to those with collarette grade 0 (0-2 collarettes).

Setting:
Private clinical practice.

Design:
Retrospective, single-center, non-interventional, observational study.

Methods:
In this study, case records of patients aged ≥18 years with data available for collarettes and MGD signs (telangiectasia, meibum expressibility, meibum quality, and meibography) were included. Outcome measures were the comparison of the mean telangiectasia score, meibum expressibility score, meibum quality score, and meibomian gland atrophy score between eyes with moderate to severe Demodex blepharitis (collarette grade 2 to 4, or >10 collarettes) and those with collarette grade 0 (0-2 collarettes). Right and left eyes were analyzed separately.

Results:
The mean telangiectasia, meibum quality, and meibomian gland atrophy scores were statistically significantly worse in the collarette grade 2-4 group than in those in the collarette grade 0 group for both right and left eyes (even adjusting for age). There was a positive correlation between collarette grade and telangiectasia, meibum quality and meibomian gland atrophy scores.

Conclusion:
Structural and functional measures of MGD were significantly worse in eyes with collarette grade 2-4 than in those with collarette grade 0. Clinicians should routinely examine their patients for Demodex infestation and signs of MGD and treat both conditions as needed, especially in the perioperative setting.
Torsion and ruptured ovarian cystadenocarcinoma with internal bleeding complicated with retroperitoneal hematoma after tumor transection: A case report
Authors: Tien Chin-Tzu , Cheng Chiu-Hsuan , Hong Mun-Kun 
Published: January 2025

Rationale:
Ovarian tumor torsion is a critical gynecological emergency, predominantly affecting women of reproductive age, with benign teratomas being the most common culprits. In contrast, malignant ovarian tumors, such as mucinous cystadenocarcinoma, infrequently present with torsion due to their invasive and angiogenic characteristics. The occurrence of torsion in malignant tumors complicates diagnosis and management, particularly when associated with complications like congestion, infarction, and internal bleeding. This report details a rare case of primary ovarian mucinous cystadenocarcinoma presenting with acute torsion and significant internal bleeding. Our study highlights the diagnostic challenges and the urgent need for clear treatment guidelines, addressing an important gap in the existing literature regarding the management of torsion malignant ovarian tumors. By documenting this case, we aim to contribute to the understanding of this rare condition and provide insights that may help clinicians in similar scenarios.

Patient concerns:
A 51-year-old postmenopausal woman presented with acute abnormal pain. Transvaginal ultrasound examination showed an 8-cm heterogeneous right ovary mass without ovarian blood flow on color Doppler.

Diagnoses:
Laparoscopy revealed torsion and rupture of the right ovarian tumor with 900 mL hemoperitoneum. The patient underwent right salpingo-oophorectomy complicated by continuous oozing and hematoma formation in the infundibular ligament. Unexpectedly, histopathology revealed a mucinous cystadenocarcinoma of the right ovary, pT1c2.

Intervention:
The patient underwent staging surgery and prophylactic hyperthermic intraperitoneal chemotherapy.

Outcome:
After 4 years of follow-up, no tumor recurrence or metastasis was found.

Lessons:
Currently, there are no effective preoperative diagnostic and treatment guidelines for ruptured malignant ovarian tumors with torsion. The possibility of malignancy should be considered, and frozen section biopsy should be considered during surgery. Full detorsion before tumor resection to avoid incomplete pedicle coagulation and bleeding. Specimen removal by in-bag morcellation in minimally invasive surgery to prevent complications related to residual fragments of the specimen or dissemination of an occult malignancy.
Aggressive angiomyxoma of the vagina: A case report and literature review
Authors: Yu Bo Ram , Choi Won Ku , Cho Dong Hyu , Lee Na-Ri 
Published: January 2025

Rationale:
Aggressive angiomyxoma (AAM) is an exceptionally rare mesenchymal tumor that predominantly manifests in the female genital organs during the reproductive age. Its rarity alone makes it a fascinating subject for study. The diagnosis of AAM necessitates differentiation from other benign or mesenchymal tumors and can be confirmed through immunohistochemistry (IHC) staining. Surgical resection is the primary treatment, and adjuvant treatment can be used as hormonal therapy with gonadotropin-releasing hormone agonists, selective estrogen receptor modulators, and aromatase inhibitors.

Patient concerns:
A 44-year-old premenopausal Korean woman presented with a growing perineal mass and frequent urination.

Diagnoses:
Histopathological findings confirmed AAM, with IHC staining showing estrogen receptor, progesterone receptor, actin and desmin positivity, and CD34 and S100 negativity.

Interventions:
The mass was excised transvaginally under general anesthesia.

Outcomes:
The patient showed no signs of recurrence 6 months postoperatively.

Lessons:
AAM in the vagina is a rare tumor that requires differential diagnosis using IHC staining. Previously, we reviewed reported cases and confirmed the feasibility and effectiveness of surgery as the main treatment. This might reassure us about the potential successful treatment of AAM. Adjuvant hormonal therapy with gonadotropin-releasing hormone agonists, selective estrogen receptor modulators, and aromatase inhibitors can further reduce the risk of recurrence.
The case for value-based care in kidney transplantation: insights into geography, growth, and financial models
Authors: Paulus Amber B. , Kumar Dhiren , Pontinha Vasco M. 
Published: January 2025

Purpose of review
Kidney transplantation (KT) is the preferred treatment for end-stage renal disease (ESRD), yet systemic challenges, including geographic disparities, impede equitable access. This review evaluates transplant center activity and regional disparities using recent trends and discusses the potential of value-based care (VBC) models like the proposed Increasing Organ Transplant Access (IOTA) model to address these challenges.

Recent findings
Analysis of Organ Procurement and Transplantation Network (OPTN) data from 2021 to 2023 identified 185 of 322 transplant centers as potentially eligible for VBC inclusion. High ESRD prevalence states like Texas, California, and New York have the largest number of centers, while states like Wyoming and Vermont lack operational centers, creating access barriers. Growth in KT rates following the 2014 Kidney Allocation System (KAS) reforms has stabilized at 3–5% since 2023. Geographic disparities persist, with regions like the South Atlantic and Pacific showing high transplant activity but unmet demand relative to ESRD prevalence.

Summary
The proposed IOTA model could mitigate disparities by incentivizing infrastructure investment and prioritizing equitable access. Tailored VBC strategies are essential to addressing regional needs and improving KT equity and outcomes nationwide.
A 5-Year Single-center Experience on the Use of Emicizumab Prophylaxis in Children With Severe Hemophilia A With and Without Factor VIII Inhibitors
Authors: Ahmed Hasan Esraa Mohamed , Motwani Jayashree 
Published: January 2025

Objective:
Emicizumab promotes efficacious hemostasis in persons with hemophilia A persons with hemophilia A with and without inhibitors. Primary analyses of real-world data and clinical trials have shown emicizumab efficacy and safety; however, long-term data are limited.

Methods:
This retrospective study was conducted to assess real-world long-term outcomes of pediatric patients on emicizumab in our hemophilia center between the period of February 2018 and September 2023. Relevant demographic and clinical data were gathered.

Results:
Seventy-eight patients were enrolled. Previously untreated patients and minimally treated patients accounted for 14.1% and 10.3% of our recruited patients, respectively. One of 5 patients with active inhibitors experienced a single recombinant activated factor VII-treated bleeding episode while on emicizumab prophylaxis. Twenty-eight (28/78) patients underwent surgical/dental procedures without bleeding complications except for 2 patients (7.1%). Thirty-three patients experienced 62 factor-treated bleeding episodes with only 11 imaging-confirmed joint/muscle bleeding episodes among 8 patients. No major safety concerns were reported in the study and emicizumab was discontinued in 5 patients (2 for antidrug antibody development, 2 for joint bleeding, and 1 for non-compliance).

Conclusion:
Emicizumab prophylaxis was well tolerated with no new safety concerns, and 45 patients (57.7%) of our cohort exhibited zero-treated bleeds, which was comparable to other published experiences.
Lessons Learned in Virtual Launch of an Antenatal Opioid Exposure Study During the COVID-19 Pandemic
Authors: Newman Jamie E. , Dhawan Megan , Clarke Leslie , Owen Sharon , Beiersdorfer Traci , Parlberg Lindsay M. , Merhar Stephanie , DeMauro Sara B. , Lorch Scott A. , Wilson-Costello Deanne , Ambalavanan Namasivayam , Peralta-Carcelen Myriam , Poindexter Brenda , Davis Jonathan M. , Mack Nicole , Limperopoulos Catherine , Bann Carla M. 
Published: January 2025

Abstract

Background
The COVID-19 pandemic prompted researchers to develop new ways to design and launch studies and recruit and retain participants. Pregnant women and infants are considered vulnerable populations in research, and families affected by substance use are particularly difficult to recruit and retain. Recruitment for studies involving medical technologies such as MRI can also be difficult due to misconceptions and fear of the technologies.

Objectives
To describe “lessons learned” during the launch of the Outcomes of Babies with Opioid Exposure (OBOE) study, including successes and challenges when working with high-risk infants and families and the importance of engaging participants through recruitment materials and retention efforts.

Methods
The OBOE study is a multisite prospective longitudinal cohort study comparing infants with antenatal opioid exposure to unexposed controls from birth to 2 years of age. Chi-square tests were used to examine refusal reasons among caregivers of eligible infants by exposure group and differences in 6-month retention among subgroups based on social determinants of health.

Results
Four factors were essential in establishing the Consortium, implementing the study, and retaining participants: (a) creating venues for collaboration, (b) pivoting from in-person to virtual training, (c) anticipating potential enrollment barriers and addressing them directly, and (d) engaging participants through recruitment materials and retention efforts. With these factors in place, only 5% of caregivers of eligible opioid-exposed infants and 8% of control infants declined to participate in the study because of MRIs. Of 310 enrolled infants, 234 infants had attended the 6-month visit. Subgroups of enrolled infants were similar in retention at 6 months.

Discussion
Reporting our successes and challenges in setting up a nationwide consortium during the pandemic may help other consortia that need to be set up virtually. We anticipated that the serial MRIs would be a barrier to participation; however, few indicated they refused to participate because of MRIs, suggesting our efforts to address this potential barrier to enrollment were successful.
Caring for a patient with appendiceal cancer
Authors: Pullen Richard L. 
Published: January 2025

Abstract:
Appendiceal cancer (AC) is a rare malignancy, occurring in 1 to 2 individuals per million annually in the US. It is often diagnosed incidentally during appendectomies or imaging for unrelated conditions. This article explores the risk factors, clinical presentation, diagnostic methods, pathology, staging, and treatment options for AC, highlighting disparities in access to care across different demographics. This article also emphasizes the importance of early detection and tailored management strategies to enhance nurses' understanding and improve outcomes for patients with this uncommon but significant disease.
Growing grit
Authors: Keperling Heather 
Published: January 2025

Abstract

Purpose:
Grit, or a person's “perseverance and passion for long-term goals,” is a noted character trait for success. This qualitative descriptive study explored the experiences and challenges faced by nursing students, focusing on how these experiences shaped their educational journeys and exploring the role of perseverance and passion in nursing education and its potential for student success in a nursing education program.

Methods:
Purposive sampling was utilized to select study participants from higher education institutions in Southeastern Pennsylvania. To guide the interview, an interview protocol was developed which included a comparison table of the open-ended interview and probing questions and the Grit-S scale, an 8-item self-evaluation tool that quantifies perseverance of effort (perseverance) and consistency of interest (passion). Data were collected via semistructured virtual interview. Data were managed with ATLAS.ti 9 used in coding and analyzing transcripts and creating data visualization.

Results:
The data analysis identified four themes: managing goals, confronting challenges, emerging interests, and experiencing supportive relationships. The study identified student perceptions of the factors that impacted their perseverance for long-term goals and their passion for nursing, assisting in their success.

Conclusion:
Recognizing the crucial role played by perseverance and passion in a student's success empowers nursing programs and faculty to consider implementing strategies to nurture interest and support students as they pursue their long-term objectives. The results of this study supported the interplay of perseverance and passion. Recommendations for nursing education include fostering supportive relationships and student-centered instructional techniques as well as organizing seminars or similar programs during the first year of their curriculum to grow perseverance and inspire passion.
Intratumoral Heterogeneity of Primary Breast Cancer on 18F-FES PET/CT and dbPET Anticipated a Heterogeneous Response to Chemotherapy
Authors: Kitano Yurika , Miyake Kanae K. , Shimizu Yoichi , Kawashima Masahiro , Nakamoto Yuji 
Published: January 2025

Abstract
A 59-year-old woman with cT3N3M1 invasive breast cancer (ER low positive, PgR positive, HER2 negative) underwent PET/CT and dedicated breast PET scans using 18F-FDG and 18F-fluoroestradiol (18F-FES). While most primary tumor regions displayed low FES uptake, regions of high FES uptake were also identified. Following chemotherapy with the paclitaxel and bevacizumab, 18F-FDG PET/CT demonstrated a favorable response, but residual disease was noted in areas with high FES uptake on the pretreatment images. This case illustrated that 18F-FES PET can depict intratumoral heterogeneity within the primary tumor, which was strongly associated with a heterogeneous response to subsequent chemotherapy.
Significantly Elevated FDG Activity in Esophageal Inflammatory Myofibroblastic Tumor of a Pediatric Patient
Authors: Cheng Xin , Xue Liyan , Lin Lin , Li Jing , Wang Xuejuan 
Published: January 2025

Abstract
A 13-year-old girl presented with dysphagia underwent contrast-enhanced CT and endoscopy. The CT revealed cervical esophageal wall thickening with heterogeneous enhancement. Microscopic examination of the biopsy specimen suggested a possible mesenchymal tumor. She underwent an 18F-FDG PET/CT scan for staging. The scan showed local thickening of the cervical esophageal wall with heterogeneous and significantly elevated FDG activity. Subsequent immunohistochemical staining and fluorescence in situ hybridization confirmed the diagnosis of esophageal inflammatory myofibroblastic tumor.
Solitary Axillary Lymph Node Metastasis From Ovarian Cancer on 18F-FDG PET/CT
Authors: Yang Liu , Dong Ping , Li Lin 
Published: January 2025

Abstract
Solitary axillary lymph node metastasis from ovarian cancer is rare. A 74-year-old woman who had undergone hysterectomy and bilateral salpingo-oophorectomy for ovarian cancer 2 years ago presented to our hospital with enlarged axillary lymph node. 18F-FDG PET/CT revealed left axillary lymphadenopathy with an SUVmax of 8.92. The postbiopsy pathology confirmed metastasis of poorly differentiated ovarian adenocarcinoma. This case highlights the need to consider ovarian cancer metastasis in cases of solitary axillary lymphadenopathy with intense FDG uptake, especially in patients with a recent history of ovarian cancer.
Detection and characterization of Hepatitis B virus double-stranded linear DNA-derived covalently closed circular DNA in chronic hepatitis B patients
Authors: Liu Hsin-Ni , Kim Elena , Wang Zhili , Nguyen ThiThuyTu , Shieh Fwu-Shan , Liu Yuanjie , Ghany Marc G. , Chung Raymond T. , Sterling Richard K. , Lin Selena Y , Guo Haitao , Lau Daryl T-Y , Su Ying-Hsiu 
Published: January 2025

AbstractBackground and AimsHepatitis B virus (HBV) generates a double-stranded linear DNA (dslDNA) byproduct during replication. This dslDNA can undergo intermolecular and intramolecular nonhomologous end-joining (NHEJ) recombination, resulting in viral integration and dslDNA derived covalently closed circular DNAs (dsl-cccDNAs), respectively. The insertions and deletions (INDELs) at the end-joining site around the direct repeat (DR) 1 motif have been used to differentiate dsl-cccDNA from the authentic cccDNA. The frequency and characteristics of dsl-cccDNA in chronic hepatitis B (CHB) patients remain unclear.MethodsHBV-targeted next-generation sequencing (NGS) was used to identify 32 dsl-cccDNA positive candidates, 22 HBeAg(+) and 10 HBeAg(-), from 56 liver biopsies of antiviral treatment-naive CHB patients for dsl-cccDNA confirmation and characterization by cccDNA-PCR NGS. INDELs within the DR2-1 region (nt 1600–1840) of the cccDNA were analyzed.ResultsVarious clonally expanded, heterogenous ∼22-nt deletions in the X-gene were detected in all 32 samples, which are likely quasi-species from the authentic cccDNA. We, therefore, defined dsl-cccDNA only by the presence of INDELs clustered at the DR1 surrounding region (nt 1800–1840). The percentage of dsl-cccDNA in total cccDNA was higher among HBeAg(+) compared to HBeAg(-) samples [11.32 (3.24–26.94)%vs.7.72 (2.16–28.23)%, p=0.01]. The diversity of dsl-cccDNA species correlated with cccDNA levels (log-transformed; r=0.82, p<0.001), HBeAg(+) CHB (p<0.001), and serum HBV DNA (p<0.001).Conclusionsdsl-cccDNA is more prevalent and heterogenous among the HBeAg(+) CHB subjects, which is likely due to the active viral cccDNA transcription and reverse transcription at the HBeAg(+) phase. The existence of replication-defective dsl-cccDNA may facilitate immune evasion and HBV integration, and complicate HBV pathogenesis. The potential impact of dsl-cccDNA in HBV therapeutic response deserves further assessment.
Who am I? Optimal Tissue for Germline Genetic Testing Post-Stem Cell Transplantation
Authors: Mertens Matthias , Sadlo Mona , Kühl Jörn-Sven , Metzeler Klaus , Zschenderlein Louisa , Edelmann Jeanett , Lehmann Claudia , Thull Sarah , Karakaya Mert , Velmans Clara , Tumewu Theresa , Böhme Matthias , Klötzer Christina , Weigert Anne , Vucinic Vladan , Hentschel Julia , Mertens Mareike 
Published: January 2025

AbstractWith advancements in genetic diagnostics and genotype-based therapeutics, the demand for germline genetic testing in post-hematopoietic stem cell transplantation patients is increasing. Due to genetic chimerism, blood samples can no longer be used for germline testing after transplantation. This study aims to identify the most suitable tissue for germline analysis following stem cell transplantation by investigating alternative tissue sources. Buccal swab, eyebrow hair, and nail samples were analyzed for donor-derived DNA using next-generation sequencing and short tandem repeat analysis, with linear regression used for evaluation. Factors such as HLA match, transplantation type, sex, and time after transplantation were also evaluated for their effect on donor-derived DNA share. Buccal swab and nail samples exhibited 25% and 22% higher proportions of donor-derived DNA compared to eyebrow hair follicles, respectively. The median donor DNA share in eyebrow hair follicles was 1% for NGS and 3% for STR. Factors such as matched related donors, higher HLA match, different donor-recipient sex, and longer time post-transplantation correlated with lower donor DNA shares. Eyebrow hair follicles are a promising tissue for accurate germline genetic testing in post-SCT patients. Patient characteristics like donor relatedness, HLA match, sex match, and time after transplantation should be considered.