bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Community Health Worker Model to Support Hereditary Cancer Risk Assessment and Genetic Testing
Authors: Marsh Leah , Mendoza Marlene , Tatsugawa Zina , Pineda Elizabeth , Markovic Daniela , Holschneider Christine H. , Zakhour Mae 
Published: August 2023

OBJECTIVE:
To evaluate the effects of a community health worker–supported hereditary cancer risk-assessment and genetic testing program in a safety-net hospital serving more than 70% medically underserved patients.

METHODS:
This community health worker pilot program began in January 2020 at women’s health clinics by administering original National Comprehensive Cancer Network (NCCN)–based questionnaires. Patients meeting high-risk criteria were offered video-based genetic education and testing, notified of results using telehealth, and offered indicated counseling. We compared the rate of genetic counseling and testing in the first 18 months of the pilot program with that in the prior 18 months.

RESULTS:
In the first 18 months of the pilot program, 940 patients were screened through the community health worker program: 196 were identified as high-risk, 103 patients were tested, and pathogenic variants were identified in 10 (9.7%), two of whom had a personal cancer history. In addition, 73 patients were tested per usual practice by a certified genetic counselor: pathogenic variants were identified in 16 (21.9%), 11 (68.8%) of whom had a personal cancer history. In the 18 months before the program, 68 patients underwent genetic testing with a certified genetic counselor, pathogenic variants were identified in 16 (23.5%), 13 (81.3%) of whom had a personal cancer history. The community health worker program led to a significant increase in testing among unaffected patients based on family history alone (odds ratio [OR] 7.0; 95% CI 3.7–13.2; P<.001), paralleled by a respective significant increase in the identification of pathogenic variants (OR 4.33; 95% CI 1.0–18.9; P=.051).

CONCLUSION:
This pilot program demonstrates the feasibility of a community health worker–supported program, using self-administered questionnaires and telehealth-based genetic services in a primarily medically underserved population. This program improved the detection of unaffected high-risk patients based on family history, increasing the volume of tests performed for this indication. Programs of this type may improve family history–based hereditary cancer testing in medically underserved patients, further enabling cancer-prevention strategies.
Large Publication Gap for Gynecologic Cancers in High–Impact Factor Journals
Authors: Sinha Nikita , McDonald Amanda , Barry Danika , Barber Emma L. 
Published: August 2023

OBJECTIVE:
To analyze research publication trends in high–impact factor journals, comparing gynecologic cancers with other cancers from 2000 to 2018.

METHODS:
Abstracts from the 55 journals with the highest impact factors, as measured by Clarivate, from 2000 to 2018 were extracted from PubMed. We developed an algorithm to search the title of the abstract to determine whether the abstract was about cancer and to identify the cancer type. The algorithm was validated against the gold standard of human review in 1,143 abstracts. Article proportion was compared with site-specific incidence, mortality, and lethality from the National Cancer Institute’s Surveillance, Epidemiology and End Results database using scatterplots and nonparametric Wilcoxon signed-rank test.

RESULTS:
We identified 128,377 articles; 31,045 (24.1%) were about cancer and 1,189 (3.8%) were about gynecologic cancers. Gynecologic cancers (ovarian, cervical, and uterine) were all poorly represented in high–impact factor journals compared with their incidence, mortality, and lethality. Ovarian, uterine, and cervical cancers ranked in the bottom half of Article-to-Lethality scores (P<.01 for all comparisons). Analyses of the trends for gynecologic cancers over the past 18 years showed no change over time in Article-to-Lethality scores. Comparison of rankings by lethality with rankings by funding indicates relative underfunding of the gynecologic cancers.

CONCLUSION:
Research publications in high–impact factor journals by cancer site are not proportionate with individual cancer burden on society. Gynecologic cancers are significantly underrepresented in research publications relative to their disease burden, indicating a disparity that persists over the past 18 years. Relative underfunding of gynecologic cancers likely contributes to this publication gap.
The “Standing Peanut” Scaphoid View: A Semi-supinated Radiographic View for Intraoperative Evaluation of Screw Placement in Scaphoid Waist Fractures
Authors: Shiver A. Luke , Wallace Doyle R. , Dolan Joshua D. , Jones Keri L. , Fulcher S. Mark 
Published: August 2023

Scaphoid waist fractures are the most common fracture of the scaphoid. Operative management is indicated with unstable fractures and often for nondisplaced waist fractures to decrease time to union and return to work/sport. Screw placement within the central axis of the scaphoid is paramount and correlates with outcomes. Assessment of intrascaphoid screw placement is classically done via intraoperative fluoroscopy. An additional fluoroscopic view is presented to assist in confirming implant positioning.
Along with the standard anterioposterior, lateral, pronated oblique, and “scaphoid” view we obtain a “standing peanut” view for assessment of central screw placement. This view also allows for further evaluation of center/center positioning and better assessment of fixation crossing the fracture into the proximal pole. The “standing peanut” view is best obtained in a sequential manner beginning with the forearm in neutral rotation. First, the forearm is then supinated 30 degrees; next, the wrist is placed at 45 degrees of ulnar deviation. Then finally, 10 degrees of wrist extension. We utilize this additional intraoperative view in conjunction with the standard fluoroscopic views for assessing and ensuring center-center implant positioning, particularly within the proximal pole.
When ensuring center-center positioning, we prefer this view as an adjunct view to the standard fluoroscopic views intraoperatively. It provides a beneficial view of the proximal pole delineating the number of screw threads that have obtained proximal pole purchase. We have found it particularly useful in the setting of scaphoid waist fracture nonunion with the classic ‘humpback’ deformity after correction with volar interposition grafting. Standard radiographic views may be misinterpreted regarding implant positioning if there remains any residual flexion. The view requires little in the way of training to obtain once appreciated and exposes the patient to minimal additional radiation.
Features of functional and dysfunctional CD8+ T cells to guide HIV vaccine development
Authors: Bhattacharyya Shaown , Crain Charles R. , Goldberg Benjamin , Gaiha Gaurav D. 
Published: August 2023

Purpose of review
CD8+ T cell responses are a key component of the host immune response to human immunodeficiency virus (HIV) but vary significantly across individuals with distinct clinical outcomes. These differences help inform the qualitative features of HIV-specific CD8+ T cells that we should aim to induce by vaccination.

Recent findings
We review previous and more recent findings on the features of dysfunctional and functional CD8+ T cell responses that develop in individuals with uncontrolled and controlled HIV infection, with particular emphasis on proliferation, cytotoxic effector function, epitope specificity, and responses in lymph nodes. We also discuss the implications of these findings for both prophylactic and therapeutic T cell vaccine development within the context of T cell vaccine trials.

Summary
The induction of HIV specific CD8+ T cell responses is an important goal of ongoing vaccine efforts. Emerging data on the key features of CD8+ T cell responses that distinguish individuals who spontaneously control from those with progressive disease continues to provide key guidance.
Removal of an Intraosseous Venous Malformation of the Maxilla via a Transoral-transconjunctival-Transcaruncular Approach
Authors: Kamboj Alisha , Caruana Salvatore M. , Winn Bryan J. 
Published: August 2023

Summary:
Intraosseous vascular anomalies represent less than 1% of all bony tumors. When they involve the maxillofacial skeleton, these masses may cause substantial morbidity and aesthetic concern. Herein, we highlight a case of a maxillary intraosseous venous malformation manifesting as functional lacrimal duct obstruction with epiphora, sinus pressure, and increasing medial canthal/maxillary fullness over 2 years in a young, healthy woman. Surgical excision of the lesion was accomplished without a skin incision by coupling a transoral, midface degloving technique with a transconjunctival–transcaruncular approach. This minimally invasive technique led to complete resolution of symptoms and a satisfactory cosmetic outcome, without a cutaneous scar.
Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the Hand
Authors: Reynoso Rafael , Echeverría Alfonso , Saldivar Rodea Carlos Alberto 
Published: August 2023

Summary:
A significant proportion of high-flow arteriovenous malformations (AVMs) in the hand are complex to treat due to their multicentricity, size, and risk of jeopardizing distal circulation. Therefore, AVMs are frequently considered “inoperable.” We present the case of a multifocal recurrent AVM treated in conjunction with the interventional radiology department, with intra-arterial embolization and excision followed by immediate distal revascularization to replace the resulting arterial deficit. This is a case of a 24-year-old woman with a high-flow multifocal AVM in her right hand, partially excised 2 years ago, showing a pulsatile mass in the palm and dorsum of the right hand, and a reporting pain of 8 of 10 on the visual analogue scale. The procedure was performed in our hybrid operating room. This procedure lasted 4 hours, with intraoperative bleeding of 75 mL. Three weeks after the procedure, patency and good circulation of the three revascularized fingers was demonstrated using arteriography and no evidence of vascular anomalies were found. No skin loss occurred, and no reintervention was required. For radical excision of this complex high-flow recurrent AVM, detailed intraoperative documentation of its afferent and immediate embolization with gelatin-based hemostatic agents allowed its obliteration with a low reactive material. We consider that this approach might be an option to treat AVMs that are currently considered inoperable.
A Novel No Foil-to-Skin Contact Technique for Vacuum-assisted Wound Closure in Patients with Sensitive Skin
Authors: Iliev Iliyan Emilov , Koutny-Adensamer Anna-Maria , Herbst Friedrich , Dauser Bernhard 
Published: August 2023

Background:
In some patients with chronic wounds, the surrounding skin is so injured due to various underlying conditions that negative pressure dressing cannot be applied or cannot function properly. Having faced this problem in our everyday practice, we developed a new skin-sparing technique for vacuum-assisted wound closure, which ensures that the peri-wound skin does not come into contact with the transparent adhesive films.

Methods:
For 9 months (April–December 2022), we performed 32 vacuum wound dressings with the newly developed technique using the 3M ActiV.A.C. Therapy Unit and accessories, and Convatec’s VARIHESIVE, avoiding skin contact with the adhesive films.

Results:
Seven patients with 11 wounds who had sensitive skin or allergy to the conventionally used adhesive films were successfully treated with the new technique. The negative pressure wound dressings remained intact and functioned properly for up to 168 hours without compromising patients’ daily activities and therapy.

Conclusion:
The novel “no foil-to-skin contact” technique for vacuum-assisted wound closure can successfully be incorporated in the treatment of patients in whom conventional negative pressure dressings are otherwise not applicable.
Legal Ramifications of Publishing Patient Photographs: A Review of Legal Cases
Authors: Patmon Darin , Sandhu Harminder , Girotto John , Ford Ronald 
Published: August 2023

Background:
The use of photography in plastic surgery has become standard of practice in recent years. Patient photographs have diverse utility and can be used to visualize medical progression, and as an educational and marketing tool. With increased publication of patient photographs outside the healthcare records, it is important to understand patient privacy rights and how they pertain to images. Additionally, it is valuable to understand the legal consequences associated with dissemination of patient photographs without proper consent.

Methods:
A retrospective analysis of the Lexis+ legal database was conducted to obtain cases that involved the improper dissemination of patient photographs or videos by surgeons. Inclusion criteria included civil cases in which the defendant was a surgeon being sued for the improper use of patient photographs. Criminal cases were excluded from analysis.

Results:
A total of 23 cases met the inclusion criteria for our study. On average, 2.13 defendants were listed per case, often including the accused surgeon and their employer. Prior photographic consent was obtained in 69.57% (n = 16) of cases. In the remaining seven cases, the defendant did not obtain consent. In all seven of these cases, either the court ruled in favor of the plaintiff or both parties reached a settlement outside court.

Conclusions:
To mitigate risk, surgeons should maintain two separate photographic consent forms for internal and external use. Additionally, a formal audit process should be established to ensure proper consent has been established before publishing patient photographs external to the electronic medical records.
USP5 promotes lipopolysaccharide-induced apoptosis and inflammatory response by stabilizing the TXNIP protein
Authors: Shi Songchang , Pan Xiaobin , Chen Minyong , Zhang Lihui , Zhang Shujuan , Wang Xincai , Shi Songjing , Chen Zhixin , Lin Wei , Jiang Yi 
Published: August 2023

Background:
The role of thioredoxin-interacting protein (TXNIP) in lipopolysaccharide-induced liver injury in mice has been reported, but the underlying mechanisms are poorly understood.

Methods:
We overexpressed deubiquitinase in cells overexpressing TXNIP and then detected the level of TXNIP to screen out the deubiquitinase regulating TXNIP; the interaction between TXNIP and deubiquitinase was verified by coimmunoprecipitation. After knockdown of a deubiquitinase and overexpression of TXNIP in Huh7 and HepG2 cells, lipopolysaccharide was used to establish a cellular inflammatory model to explore the role of deubiquitinase and TXNIP in hepatocyte inflammation.

Results:
In this study, we discovered that ubiquitin-specific protease 5 (USP5) interacts with TXNIP and stabilizes it through deubiquitylation in Huh-7 and HepG2 cells after treatment with lipopolysaccharide. In lipopolysaccharide-treated Huh-7 and HepG2 cells, USP5 knockdown increased cell viability, reduced apoptosis, and decreased the expression of inflammatory factors, including NLRP3, IL-1β, IL-18, ASC, and procaspase-1. Overexpression of TXNIP reversed the phenotype induced by knockdown USP5.

Conclusions:
In summary, USP5 promotes lipopolysaccharide-induced apoptosis and inflammatory response by stabilizing the TXNIP protein.
Intermittent fasting improves hepatic end points in nonalcoholic fatty liver disease: A systematic review and meta-analysis
Authors: Lange Marcia , Nadkarni Devika , Martin Lily , Newberry Carolyn , Kumar Sonal , Kushner Tatyana 
Published: August 2023

Background and Aims:
Despite NAFLD being the most prevalent liver disease globally, currently there are no FDA-approved treatments, and weight loss through caloric restriction and enhanced physical activity is the recommended treatment strategy. Intermittent fasting (IF) has been proposed as an alternative strategy with additional cardiometabolic benefits. In this systematic review and meta-analysis, we evaluated the anthropometric, biochemical, and hepatic impacts of IF in patients with NAFLD.

Methods:
MEDLINE, EMBASE, Cochrane Central, and conference abstracts were searched for IF interventions in adults with NAFLD until April 2, 2023. Meta-analysis with a random effects model was used to compare pre-intervention and post-intervention changes in anthropometric, biochemical, and hepatic end points in the IF intervention group with the control group. Publication bias was assessed using Egger’s test.

Results:
Fourteen studies were included in the systematic review and ten in the meta-analysis (n = 840 participants, 44.64% male). Studies varied in modalities for NAFLD diagnosis, duration of IF (4–52 weeks), and type of IF (5:2 diet, modern alternate-day fasting, time-restricted eating, or religious fasting). Body weight, body mass index, and waist to hip ratio all significantly improved following fasting intervention (p< 0.05). Adults with NAFLD showed an improvement in serum alanine transaminase, aspartate aminotransferase, hepatic steatosis (controlled attenuation parameter measured by vibration-controlled transient elastography), and hepatic stiffness (measured by vibration-controlled transient elastography) after fasting intervention (p < 0.05).

Conclusions:
There is limited, but moderate- to high-quality evidence to suggest that IF can improve hepatic end points and promote weight loss in adults with NAFLD. Larger randomized controlled studies with extended duration are needed to further validate our findings.
High rifaximin out-of-pocket costs are associated with decreased treatment retention among patients with hepatic encephalopathy
Authors: Aby Elizabeth S. , Shen Tsung-Hua , Murugappan Meena N. , Stenehjem David D. , Leventhal Thomas M. 
Published: August 2023

Background and Aims:
Hepatic encephalopathy (HE) is associated with significant morbidity and mortality for those with cirrhosis. Despite the known benefits of rifaximin use for HE, treatment retention remains low. This study aimed to evaluate the impact of out-of-pocket (OOP) rifaximin cost on treatment retention among commercially insured patients in the United States.

Methods:
Adult patients with cirrhosis and HE were identified from the IBM MarketScan claims database. Those who began rifaximin treatment between January 1, 2011, and December 1, 2021 were included. Regression models were used to analyze the relationship between patients’ 30-day OOP rifaximin cost and rifaximin retention (≥80% eligible days with rifaximin supply) at 180, 360, and 540 days. Models were controlled for patient demographic and clinical characteristics including age, sex, comorbid conditions, Charlson comorbidity index (CCI), and lactulose use.

Results:
A total of 6839 adult patients were included. Most patients were between 55 and 64 years (57.1%), male (60.4%), and living in urban settings (84.6%). Treatment retention was low for all time periods; retention rates for rifaximin were 42%, 25%, and 16% at 180, 360, and 540 days, respectively. In multivariable analysis, 30-day OOP costs of ≥ $150 were associated with a decreased likelihood of rifaximin retention at 180, 360, and 540 days [relative risk (RR) = 0.67, RR = 0.62, and R = 0.60, respectively]. Younger age was associated with reduced treatment retention for all time periods. Metastatic cancer and depression were associated with reduced treatment retention at 180 days (RR = 0.70 and RR = 0.87, respectively).

Conclusions:
Rates of rifaximin treatment retention are low despite the known benefits of rifaximin use for breakthrough HE. High 30-day OOP cost is associated with reduced rifaximin treatment retention.
Behavioral weight-loss interventions for patients with NAFLD: A systematic scoping review
Authors: Balakrishnan Maya , Liu Kyle , Schmitt Sydney , Heredia Natalia I. , Sisson Amy , Montealegre Jane R. , Hernaez Ruben , Kanwal Fasiha , Foreyt John 
Published: August 2023

Background:
Clinically significant weight loss—which requires sustained dietary and physical activity changes—is central to treating NAFLD. Although behavioral interventions have demonstrated effectiveness in promoting weight loss among primary prevention populations, the data are limited among patients with NAFLD who need weight loss for treatment. We undertook this scoping review to map the existing data on the characteristics, weight-loss outcomes, and determinants of success of interventions evaluated among patients with NAFLD.

Methods:
We searched Medline, EMBASE, Cochrane, PsycINFO, and Web of Science from inception to January 1, 2023 to identify publications reporting weight loss among adults with NAFLD in behavioral weight-loss interventions. We summarized interventions and classified them as successful if there was an average weight loss of ≥ 5% from baseline across enrolled participants or achieved by ≥ 50% of enrolled participants.

Results:
We included 28 studies: 10 randomized control trials, ten quasi-experimental, and 8 observational studies. Intervention delivery, duration, and counseling frequency varied; 12 were successful. Retention was highest among telephone interventions and lowest among “real-world” face-to-face interventions. Patients who were women, younger, and/or had multiple metabolic conditions were most likely to dropout. Successful interventions had biweekly counseling, specific physical activity, and calorie targets, behavioral theory grounding, and promoted goal-setting, self-monitoring, and problem-solving.

Conclusion:
There are limited data on behavioral weight-loss interventions in NAFLD. Research is needed to develop effective interventions generalizable to diverse patient populations and that maximize adherence, particularly among patients who are diabetic, women, and younger.
Discrimination between keratoconus, forme fruste keratoconus, and normal eyes using a novel OCT-based tomographer
Authors: Saad Alain , Debellemanière Guillaume , Zeboulon Pierre , Rizk Maria , Rouger Hélène , Mazharian Adrien , Grise-Dulac Alice , Panthier Christophe , Gatinel Damien 
Published: August 2023

Purpose:
To combine objective machine-derived corneal parameters obtained with new swept-source optical coherence tomography (SS-OCT) tomographer (Anterion) to differentiate between normal (N), keratoconus (KC) and forme fruste KC (FFKC).

Setting:
Laser Center, Hôpital Fondation Adolphe de Rothschild, Paris, France.

Design:
Retrospective study.

Methods:
281 eyes of 281 patients were included and divided into 3 groups: N (n = 156), FFKC (n = 43), and KC (n = 82). Eyes were included in each group based on objective evaluation using Nidek Corneal Navigator, and subjective evaluation by authors. The SS-OCT system provided anterior and posterior corneal surface and pachymetry derived variables. The training set was composed of 143 eyes (95 N, 43 FFKC). Discriminant analysis was used to determine the group of an observation based on a set of variables. The obtained formula was tested in the validation set composed of 61 N and 82 KC.

Results:
Among curvature parameters, the FFKC had significantly higher irregularity index at 3 mm and 5 mm, higher inferior-superior index, higher SteepK-OppositeK index and inferiorly decentered posterior steepest keratometry. Among thickness parameters: central pachymetry, thinnest pachymetry, percentage of thickness increase from center to periphery, and inferior decentration of the thinnest point were statistically different between groups. Combination of multiple variables into a discriminant function (F1) included 5 parameters and reached an area under the receiver operating characteristic curve (AUROC) of 0.95 (sensitivity = 75%, specificity = 98.5%) for detection of FFKC. F1 differentiates N from KC with AUROC = 0.99 (sensitivity = 99%, specificity = 99%).

Conclusions:
Combining anterior and posterior curvatures variables along with pachymetric data obtained from SS-OCT allowed automated detection of early KC and KC with very good accuracy (87% and 99.5% respectively).