bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of superficial lymphatic malformation with dermoscopy and reflectance confocal microscopy
Authors: Lin Er‐Yi , Rao Lang , Wang Xiao‐Hua 
Published: February 2023

AbstractBackgroundSuperficial lymphatic malformation (SLM) is a congenital disorder of the lymphatic channels. It usually appears as clusters of vesicles filled with lymphatic fluid and blood on the skin that resemble frogspawn, making it difficult to distinguish from haemangiomas, angiokeratomas, and pyogenic granulomas. Although pathological results have diagnostic values, the significance of noninvasive examination in the diagnosis and differential diagnosis is also worth exploring.Materials and MethodsA 24‐year‐old female presented with a history of multiple asymptomatic, pink lesions located on the chest since age 10. Histopathological examination was performed, and results informed the diagnosis of SLM. Lesions were detected by dermoscopy and reflectance confocal microscopy (RCM).ResultsDermoscopy (polarized, 30×) revealed multiple yellowish‐red lacunae in a light red background that were separated by pale septa and “hypopyon sign” was observed. RCM displayed a honeycomb pattern and multiple dark cavities in the upper dermal layers separated by thin septa with a few hypo‐refractile cells at the periphery that demonstrated slow fluid flow via dynamic scanning.ConclusionWe described a case of SLM detected by dermoscopy and RCM. Dermoscopic and RCM features may provide a potentially powerful, noninvasive instrument for the recognition and differentiation of SLM.
Dissociative Amnesia? It Might be Organic Memory Loss!
Authors: Jelicic Marko 
Published: February 2023

AbstractThis article discusses the possibility of practitioners who mistake organic memory loss for dissociative amnesia. It starts with the case of a young man with complete retrograde amnesia due to a traumatic head injury. Because he did not show any gross neurological abnormalities, a neurologist thought his amnesia had a psychological origin. An extensive neuropsychological examination revealed that the man did have an organic reason for his amnesia. Next, the existence of dissociative memory loss as well as isolated organic retrograde amnesia is considered. While cases of organic memory loss are well‐documented, there is hardly any evidence for dissociative amnesia. It is argued that organic memory loss might be mistakenly taken for dissociative amnesia. In line with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, practitioners are advised to rule out the possibility of organic memory loss, before diagnosing a patient with dissociative amnesia.
Severe fetal anemia caused by anti‐Jra: Burst forming unit‐erythroid colony formation inhibition assay suggesting possible erythroid suppression mechanism
Authors: Tran Ann , Yan Matthew T. S. , Branch Donald R. , Blacquiere Megan , Pineault Nicolas , Pasha Roya , Clarke Gwen 
Published: February 2023

AbstractBackgroundThe Jr blood group system includes a single, high‐prevalence antigen, Jra, encoded by the ABCG2 gene. The impact of anti‐Jra in pregnancy is variable, ranging from no clinical effect to severe anemia including some fetal deaths. Case reports have postulated that anti‐Jra mediated fetal anemia is poorly hemolytic, suggesting other mechanisms of anemia may be involved.Study Design and MethodsWe describe the case of severe anti‐Jra mediated fetal anemia. At Canadian Blood Services laboratories, maternal anti‐Jra was tested for phagocytic activity via a monocyte monolayer assay (MMA) and erythroid suppression via inhibition of burst forming unit‐erythroid (BFU‐E) colony formation assays. The New York Blood Center sequenced exons 4 and 7 of the ABCG2 gene.Results and DiscussionSequencing of exons 4 and 7 of the ABCG2 gene revealed maternal compound heterozygosity for two nonsense mutations at exon 7 (c.706 C > T and c.784G > T). Fetal sequencing revealed the c.706C > T polymorphism. The MMA showed a borderline phagocytic index (around the cutoff of five for both donor segments tested [5 ± 1 and 7 ± 3]). The BFU‐E colony formation inhibition assay suggested a dose‐dependent inhibition of BFU‐E colony formation with inhibition percentages of 4%, 11%, and 43% at maternal serum concentrations of 2%, 5%, and 10%, respectively. Our findings support the hypothesis that anti‐Jra may impair erythropoiesis leading to clinically significant fetal/neonatal anemia. A referral to maternal fetal medicine is recommended if anti‐Jra is detected in pregnancy, regardless of the titer.
Thoracic CT incidental pulmonary bullae in dogs: Characterization, interobserver variability, and general anesthesia risks
Authors: Kim Won Suk , Ward Michael , Huynh Elizabeth , Griffin Lynn , Heo Jin , Vinayak Arathi 
Published: February 2023

AbstractRuptures of pulmonary blebs and bullae are the most common cause of spontaneous pneumothorax in dogs. Incidental bullae/blebs have been documented in otherwise healthy people, however information for veterinary patients is currently lacking. Objectives of this retrospective, observer agreement, analytical study were to characterize incidental bullae in thoracic CT studies of dogs, assess interobserver variability for characterizing the bullae, and assess anesthesia risks. Inclusion criteria were dogs presenting for non‐pneumothorax related reasons that had a thoracic CT at a single specialty and emergency hospital from 2012 to 2021 and had a bulla listed in the CT report. Medical records for dogs meeting inclusion criteria were reviewed to collect data on signalment, weight, total number of general anesthesia procedures 2 years prior and 2 years following the CT scan, and adverse anesthesia events. In addition, the CT images were reviewed by three American College of Veterinary Radiology‐certified veterinary radiologists to collect data on the location, size, number of bullae and thickness of the bulla wall. A total of 1119 dogs met initial inclusion criteria and 74 dogs were included in analyses. There was no sex predilection for incidental pulmonary bullae. Bullae were more commonly found in older (median age 11.3 years), large breed dogs (median weight 20.7 kg). A solitary bulla of less than 1 cm was the most common finding with no apparent predilection for a particular lung lobe. There was strong correlation among the three radiologists for bulla location, size, and number, but weak correlations for bulla wall thickness. No adverse anesthesia events were found following CT anesthesia or following repetitive anesthesia procedures.
Assessment of parental decision making in congenital heart disease, cardiomyopathy and heart transplantation: an observational study analysing decisional characteristics and preferences
Authors: Tadros Hanna J , Saidi Arwa , Rawlinson Alana R , Cattier Celine , Black Erik W , Rackley Jennifer , Breault Leah , Pietra Biagio A , Fricker Fredrick J , Gupta Dipankar 
Published: February 2023

ObjectiveWe explore shared decision making (DM) in guardians of children with heart disease by assessing the desired weight of influence on DM and factors that may alter the relative weight of parent or medical team influence.MethodsGuardians of patients <21 years and admitted >1 week in the paediatric cardiac intensive care unit (PCICU) were recruited. Twelve vignettes were designed including technical (antibiotic selection, intubation, peripherally inserted central catheter placement, ventricular assist device placement, heart transplant, organ rejection, heart rhythm abnormalities and resuscitation effort) and non-technical vignettes (cessation of life-sustaining therapies, depression treatment, obesity and palliative care referral). Participants responded to questions on DM characteristics and one question querying preference for relative weight of parent or medical team influence on DM.ResultsOf 209 participants approached, 183 were included. Most responded with equal desire of medical team and parental influence on DM in all vignettes (range 41.0%–66.7%). Technical scenarios formed one cluster based on DM characteristics, compared with non-technical scenarios. Factors that increase the relative weight of parental influence on DM include desired input and involvement in big-picture goals (OR 0.274, CI [0.217 to 0.346]; OR 0.794, CI [0.640 to 0.986]). Factors that increase the relative weight of medical team influence on DM include perception of medical expertise needed (OR 1.949 [1.630 to 2.330]), urgency (OR 1.373 [1.138 to 1.658]), benefit (OR 1.415 [1.172 to 1.710]), number of PCICU admissions (OR 1.134 [1.024 to 1.256]) and private insurance (OR 1.921 [1.144 to 3.226]).ConclusionAlthough factors may alter the weight of influence on DM, most parents desire equal parental and medical team influence on DM.
Effect of early childhood development interventions delivered by healthcare providers to improve cognitive outcomes in children at 0–36 months: a systematic review and meta-analysis
Authors: Hirve Raeena , Adams Claire , Kelly Clare B , McAullay Daniel , Hurt Lisa , Edmond Karen M , Strobel Natalie 
Published: February 2023

ObjectiveTo determine the effect of early childhood development interventions delivered by healthcare providers (HCP-ECD) on child cognition and maternal mental health.DesignSystematic review, meta-analysis.SettingHealthcare setting or home.ParticipantsInfants under 1 month of age.InterventionsHCP-ECD interventions that supported responsive caregiving, early learning and motor stimulation. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects and Cochrane Database of Systematic Reviews were searched until 15 November 2021. Studies reporting prespecified outcomes were pooled using standard meta-analytical methods.Main outcome measuresCognitive development in children at 0–36 months.ResultsForty-two randomised controlled trials with 15 557 infants were included in the narrative synthesis. Twenty-seven trials were included in the meta-analyses. Pooled data from 13 trials suggest that HCP-ECD interventions may improve cognitive outcomes in children between 0 and 36 months (Bayley Scales of Infant Development version IIII (BSID-III) mean difference (MD) 2.65; 95% CI 0.61 to 4.70; 2482 participants; low certainty of evidence). Pooled data from nine trials suggest improvements in motor development (BSID-III MD 4.01; 95% CI 1.54 to 6.48; 1437 participants; low certainty of evidence). There was no evidence of improvement in maternal mental health (standardised MD −0.13; 95% CI −0.28 to 0.03; 2806 participants; 11 trials; low certainty of evidence).ConclusionsWe report promising evidence, particularly for cognitive and motor outcomes, of the effect of HCP-ECD interventions. However, effect sizes were small, and the certainty of evidence ranged from very low to moderate. Additional high-quality research is required.PROSPERO registration numberCRD42019122021.
Development of indicators for integrated antenatal care service provision: a feasibility study in Burkina Faso, Kenya, Malawi, Senegal and Sierra Leone
Authors: Sheffel Ashley , Tampe Tova , Katwan Elizabeth , Moran Allisyn C 
Published: February 2023

ObjectivesWhile service integration has gained prominence as an objective of many global initiatives, there is no widely recognised single definition of integration nor a clear understanding of how programmes are integrated into health systems to achieve improved health outcomes. This study aims to review measurement approaches for integrated antenatal care (ANC) services, propose and operationalise indicators for measuring ANC service integration and inform an integrated ANC indicator recommendation for use in low-income and middle-income countries (LMICs).DesignFeasibility study.SettingBurkina Faso, Kenya, Malawi, Senegal and Sierra Leone.MethodsOur six-step approach included: (1) conceptualise ANC service integration models; (2) conduct a targeted literature review on measurement of ANC service integration; (3) develop criteria for ANC service integration indicators; (4) propose indicators for ANC service integration; (5) use extant data to operationalise the indicators; and (6) synthesise information to make an integrated ANC indicator recommendation for use in LMICs.ResultsGiven the multidimensionality of integration, we outlined three models for conceptualising ANC service integration: integrated health systems, continuity of care and coordinated care. Looking across ANC service integration estimates, there were large differences between estimates for ANC service integration depending on the model used, and in some countries, the ANC integration indicator definition within a model. No one integrated ANC indicator was consistently the highest estimate for ANC service integration. However, continuity of care was consistently the lowest estimate for ANC service integration.ConclusionsIntegrated ANC services are foundational to ensuring universal health coverage. However, our findings demonstrate the complexities in monitoring indicators of ANC service quality using extant data in LMICs. Given the challenges, it is recommended that countries focus on monitoring measures of service quality. In addition, efforts should be made to improve data collection tools and routine health information systems to better capture measures of service integration.
Heat transfer in granular media consisting of particles in humid air at low confining pressure
Authors: Persson B. N. J. 
Published: February 2023

AbstractI study the heat transfer in systems of weakly interacting particles at low confining pressure in the normal atmosphere. The particles have surface roughness with self-affine fractal properties, as expected for mineral particles produced by fracture, e.g., by crunching brittle materials in a mortar. I show that for small particles (say$$<10 \ \mathrm{\mu m}$$<10μm) with hydrophilic surfaces, at large humidity water capillary bridges dominate the heat transfer, while for big particles heat transfer via the air dominates. This differs from vacuum conditions where the propagating electromagnetic (EM) waves give the dominant heat transfer for large particles, while for small particles both the evanescent EM-waves and the phononic contribution from the area of real contact are most important.
Assessment of Safety, Effects, and Muscle-Specific Accumulation of Dietary Butylated Hydroxytoluene (BHT) in Paralichthys olivaceus
Authors: Lee Seunghan , Kim Min-Gi , Hur Sang-Woo , Katya Kumar , Kim Kang-Woong , Lee Bong-Joo 
Published: February 2023

Butylated hydroxytoluene (BHT) is a commonly used antioxidant added to animal/fish feed to limit lipid autoxidation and peroxidation. Although there have been reviews and reports of BHT toxicity in animals, limited information is available with respect to the toxic effects and accumulation of BHT due to oral exposure in aquaculture species. Therefore, 120 days of feeding trial was conducted to evaluate the effects of dietary BHT on the marine fish olive flounder Paralichthys olivaceus. Graded levels of BHT were added to the basal diet in increments of 0, 10, 20, 40, 80, and 160 mg BHT/kg, corresponding to 0 (BHT0), 11 (BHT11), 19 (BHT19), 35 (BHT35), 85 (BHT85), and 121 (BHT121) mg BHT/kg diets, respectively. Fish with an average weight of

77.5
±
0.3

g (

mean
±
SD

) were fed one of the six experimental diets in triplicate groups. Growth performance, feed utilization, and survival rate were not significantly affected by the dietary BHT levels among all experimental groups, whereas BHT concentration in the muscle tissue was found to increase in a dose-dependent manner up to 60 days of the experimental period. Thereafter, BHT accumulation in muscle tissue showed a declining trend among all treatment groups. Furthermore, the whole-body proximate composition, nonspecific immune responses, and hematological parameters (except triglycerides) were not significantly influenced by the dietary levels of BHT. Blood triglyceride content was significantly higher in fish fed the BHT-free diet compared to all other treatment groups. Thus, this study demonstrates that dietary BHT (up to 121 mg/kg) is a safe and effective antioxidant without exhibiting any adverse effects on the growth performance, body composition, and immune responses in the marine fish olive flounder, P. olivaceus.
Brief Report: Combination of Osimertinib and Dacomitinib to Mitigate Primary and Acquired Resistance inEGFR-Mutant Lung Adenocarcinomas
Authors: Elkrief Arielle , Makhnin Alex , Moses Khadeja A. , Ahn Linda S. , Preeshagul Isabel R. , Iqbal Afsheen N. , Hayes Sara A. , Plodkowski Andrew J. , Paik Paul K. , Ladanyi Marc , Kris Mark G. , Riely Gregory J. , Michor Franziska , Yu Helena A. 
Published: February 2023

AbstractPurpose:Primary and acquired resistance to osimertinib remain significant challenges for patients with EGFR-mutant lung cancers. Acquired EGFR alterations such as EGFR T790M or C797S mediate resistance to EGFR tyrosine kinase inhibitors (TKI) and combination therapy with dual EGFR TKIs may prevent or reverse on-target resistance.Patients and Methods:We conducted two prospective, phase I/II trials assessing combination osimertinib and dacomitinib to address on-target resistance in the primary and acquired resistance settings. In the initial therapy study, patients received dacomitinib and osimertinib in combination as initial therapy. In the acquired resistance trial, dacomitinib with or without osimertinib was administered to patients with EGFR-mutant lung cancers with disease progression on osimertinib alone and evidence of an acquired EGFR second-site mutation.Results:Cutaneous toxicities occurred in 93% (any grade) of patients and diarrhea in 72% (any grade) with the combination. As initial therapy, the overall response to the combination was 73% [95% confidence interval (CI), 50%–88%]. No acquired secondary alterations in EGFR were observed in any patients at progression. In the acquired resistance setting, the overall response was 14% (95% CI, 1%–58%).Conclusions:We observed no acquired secondary EGFR alterations with dual inhibition of EGFR as up-front treatment, but this regimen was associated with greater toxicity. The combination was not effective in reversing acquired resistance after development of a second-site acquired EGFR alteration. Our study highlights the need to develop better strategies to address on-target resistance in patients with EGFR-mutant lung cancers.
Calciprotein Particles Induce Endothelial Dysfunction by Impairing Endothelial Nitric Oxide Metabolism
Authors: Feenstra Lian , Kutikhin Anton G. , Shishkova Daria K. , Buikema Hendrik , Zeper Lara W. , Bourgonje Arno R. , Krenning Guido , Hillebrands Jan-Luuk 
Published: February 2023

Background:
Calciprotein particles (CPPs) are associated with the development of vascular calcifications in chronic kidney disease. The role of endothelial cells (ECs) in this process is unknown. Here, we investigated the interaction of CPPs and ECs, thereby focusing on endothelial nitric oxide metabolism and oxidative stress.

Methods:

CPPs were generated in calcium- and phosphate-enriched medium. Human umbilical vein endothelial cells were exposed to different concentrations of CPPs (0–100 µg/mL) for 24 or 72 hours. Ex vivo porcine coronary artery rings were used to measure endothelial cell–dependent vascular smooth muscle cell relaxation after CPP exposure. Serum samples from an early chronic kidney disease cohort (n=245) were analyzed for calcification propensity (measure for CPP formation) and nitrate and nitrite levels (NO
x
).

Results:

CPP exposure for 24 hours reduced eNOS (endothelial nitric oxide synthase) mRNA expression and decreased nitrite production, indicating reduced nitric oxide bioavailability. Also, 24-hour CPP exposure caused increased mitochondria-derived superoxide generation, together with nitrotyrosine protein residue formation. Long-term (72 hours) exposure of human umbilical vein endothelial cells to CPPs induced eNOS uncoupling and decreased eNOS protein expression, indicating further impairment of the nitric oxide pathway. The ex vivo porcine coronary artery model showed a significant reduction in endothelial-dependent vascular smooth muscle cell relaxation after CPP exposure. A negative association was observed between NO
x
levels and calcification propensity (r=−0.136;
P
=0.049) in sera of (early) chronic kidney disease patients.

Conclusions:
CPPs cause endothelial cell dysfunction by impairing nitric oxide metabolism and generating oxidative stress. Our findings provide new evidence for direct effects of CPPs on ECs and pathways involved.
Abstract TP65: An Automated Algorithm For The Nih Stroke Scale Assessment
Authors: Andrade Joao B , Camilo Millene , Domingues Renan , Kuster Gustavo W , Pacheco Evelyn , Frigini Tiago , Vieira Neto Ronan J , Fornazari Ana , Ferraz Hanna , Lacerda Cassio , Gagliardi Vivian , Viana Patricia , Pellegrino Mateus , Zaveri Daniel , Sampaio Silva Gisele 
Published: February 2023

The NIH Stroke Scale (NIHSS) is widely adopted in clinical practice. Despite being originally designed for research use, the NIHSS is a valued resource for communication and prognostication, and it is useful for the decision-making process regarding reperfusion therapies and prophylaxis. However, its assessment can be laborious and complex among even certified healthcare providers. In the context of increasing telemedicine use, an accurate assessment of the NIHSS may be crucial in acute stroke management
We aimed to create and validate an automated tool for the NIHSS (SPOKES) in a national telemedicine service.
A board of five certified vascular neurologists created an NIHSS algorithm based on a tree decision, including tips and hints in the main questions and auxiliary boxes. We randomized 22 spoke hospitals using an automated tool to invite emergency physicians not certified in the NIHSS to use or not the SPOKES. NIHSS-certified and blinded neurologists from a hub hospital performed a double-check of each item of the NIHSS.

From June to August 2022, we included 144 cases from 10 spoke hospitals. Our algorithm was fully adopted in 27 cases (19%). The median of reported NIHSS was 3 [1, 5] and 3 [2, 7] points among users and non-users, p=0.38. The general difference between the reported and the double-checked score was 0 [0, 1] points – there was no difference between those who used or did not the SPOKES (p=0.12). A complete concordant score was achieved at 66.7% (n=18/27) and 45.3% (n=53/117), χ
2
=0.036, among users and non-users, respectively. In a bivariate regression analysis, the SPOKES increased the chance of complete agreement [OR 2.4, 95%CI 1-5.8, p=0.049]. There was no difference regarding discrepant scores (≥4 points), χ
2
=0.46. Among SPOKES cases, treatment with tPA was indicated in 11.1%, versus 12.7% among non-users (p=0.59).

Despite the small number of included cases, our algorithm seems to be a promising tool for the NIHSS assessment in a national telemedicine service, increasing the chance of a complete agreement with certified neurologists. The tool is free and available at
www.spokes-nihss.com