bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proliferating Pilar Tumors in the Scalp Over a Period of 23 Years in a General Hospital in Mexico City
Authors: Juan David Dufflart Ocampo , María de los Ángeles Villeda Aguilar , Claudia Ileana Sáenz Corral , María Elisa Vega Memije 
Published: July 2023

BACKGROUND
Proliferating pilar tumors are an unusual skin tumor, and they have a cystic component with trichilemmal keratinization and epithelial proliferation. These arise from the outer root sheath of hair follicles. It mainly affects women. The scalp is the most affected area. Diagnosis can be made by biopsy. Surgical excision is the best treatment option.

OBJECTIVE
Report the frequency of proliferating pilar tumors in the scalp in general hospital in Mexico over a period of 23 years.

METHODS
The authors reviewed the database of the dermatopathology service of the General Hospital "Dr Manuel Gea González" from 1999 to August 2022, selecting diagnosticated cases of proliferating pilar tumor, pilar cyst, trichilemmal cyst, or proliferating trichilemmal cyst in the scalp.

RESULTS
The authors discovered 17 cases, 13 were women, the average age was 54.9 years, all the tumors affecting the scalp, and just 3 cases were reported as malignant.

CONCLUSION
In comparison with the existing data, the authors can observe that most of their patients were women and the scalp is the most affected area. Most did not present associated symptoms. As the authors can see, most are benign and long-lasting: however, the authors cannot ignore that a small percentage can be malignant.
Increasing nonalcoholic fatty liver disease–related mortality rates in the United States from 1999 to 2022
Authors: Ilyas Fariha , Ali Hassam , Patel Pratik , Sarfraz Shiza , Basuli Debargha , Giammarino Alexa , Satapathy Sanjaya Kumar 
Published: July 2023

Background:
We examined trends in NAFLD-related mortality in the United States from 1999 to 2022, focusing on sex, racial differences, and specific age groups.

Methods:
We analyzed age-adjusted mortality rates (AAMRs) for NAFLD-related deaths using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database and assessed differences between sex and racial groups.

Results:
Between 1999 and 2022, NAFLD-related mortality rose from an age-adjusted mortality rate (AAMR) of 0.2 to 1.7 per 100,000, with an average annual percent change (AAPC) of 10.0% (p < 0.001). In all, 85.4% of the cases were reported after 2008. Females (0.2–2 per 100,000, AAPC: 11.7%, p < 0.001) saw a steeper increase than males (0.2–1.3 per 100,000, AAPC: 9.3%, p < 0.001). White individuals’ AAMR rose from 0.2 to 1.9 per 100,000 (AAPC: 10.8%, p < 0.001). Asian or Pacific Islanders (AAPI) increased from 0.2 in 2013 to 0.5 in 2022 (AAPC: 12.13%, p = 0.002), and American Indians or Alaska Natives (AI/AN) from 1 in 2013 to 2.2 in 2022 (AAPC: 7.9%, p = 0.001). African Americans (AA) showed an insignificant change (0.3–0.5 per 100,000, AAPC: 0.7%, p = 0.498). Regarding age, individuals 45–64 saw AAMR rise from 0.3 to 1.2 per 100,000 (AAPC: 6.5%, p < 0.001), and those 65+ from 0.2 to 6 per 100,000 (AAPC: 16.5%, p < 0.001). No change was observed in the 25–44 age group (AAMR: 0.2 per 100,000, AAPC: 0.0%, p = 0.008).

Conclusion:
We report increased NAFLD-related mortality among both sexes and certain racial groups. The mortality rate increased for older populations, emphasizing the need for targeted public health measures and evidence-based interventions.
Extended Dehydration of Corneal Allogenic Intrastromal Ring Segments to Facilitate Insertion: The Corneal Jerky Technique
Authors: Awwad Shady T. , Jacob Soosan , Assaf Jad F. , Bteich Yara 
Published: July 2023

Purpose:
The aim of this study was to describe a new technique to facilitate the insertion of corneal allogenic intrastromal ring segments.

Methods:
A single-segment corneal allogenic intrastromal ring segment (CAIRS) was trephined from donor corneas and allowed to markedly dehydrate for 75 minutes before the start of the procedure with a room humidity of 35% to 45%. The duration of the insertion step and the intrastromal segment size at 1 week as measured by optical coherence tomography were compared with previously performed single-segment CAIRS procedures using the conventional technique.

Results:
A total of 41 eyes of 36 patients underwent 1-segment CAIRS insertion of the same trephination size (750 µm). Fifteen eyes underwent the conventional insertion procedure, and 26 eyes had a dehydrated segment inserted. The time taken to insert the CAIRS analyzed by surgical video recording starting after the femtosecond tunnel creation and initiation of the insertion to the segment ironing step was 282 ± 103 and 97 ± 23 seconds for the conventional and the dehydrated segment technique, respectively (P < 0.001). Anterior segment optical coherence tomography performed 1 week postoperatively revealed similar segment thickness and width of 471.3 ± 54.1 μm and 1285.1 ± 191.0 μm for the conventional allogenic segments and 483.4 ± 58.3 μm and 1227.2 ± 165.2 μm for the dehydrated segments (P = 0.515 and 0.314, respectively).

Conclusions:
Markedly dehydrated corneal allogenic segments are easier and faster to insert than the nondehydrated ones while maintaining similar sizes intrastromally. This dehydration technique makes the procedure similar to the one with synthetic segments and hence reduces the learning curve.
Rare Case of Thygeson Superficial Punctate Keratitis After COVID-19 Vaccination
Authors: Hutchinson Kelly Ann , Peretz Daniel , Darvish Mahshad , Talajic Julia , Choremis Johanna 
Published: July 2023

Purpose:
The aim of this study was to elucidate a rare corneal association of the coronavirus disease 2019 (COVID-19) vaccine. Although cases of corneal involvement after vaccination have been reported, we present the first case of Thygeson superficial punctate keratitis (TSPK) linked to the COVID-19 vaccine.

Methods:
This study is a case report.

Results:
A 25-year-old woman was assessed in the ophthalmology clinic for recurrent ocular surface symptoms after receiving the COVID-19 vaccine. She was followed in clinic and was found to have a remitting and recurring pattern of bilateral intraepithelial corneal opacities with associated subepithelial haze primarily overlying the pupillary area. These corneal lesions responded well to topical corticosteroid ophthalmic drops. Based on the clinical appearance, the response to treatment, negative herpes simplex virus serology, and the temporal relationship between vaccination and ocular findings, a diagnosis of COVID-19 vaccine-induced TSPK was suspected.

Conclusions:
Although the COVID-19 vaccine remains overwhelmingly safe, clinicians should be aware of possible corneal side effects, including TSPK. Prompt ophthalmic assessment in those presenting with ocular symptoms after vaccination is encouraged.
Evaluation of long-term clinical outcomes after toric implantable collamer lens implantation
Authors: Shiga Suguru , Kojima Takashi , Horai Rie , Nakamura Tomoaki 
Published: July 2023

Purpose:
To evaluate the long-term (8-10 years) outcomes of toric implantable collamer lens (TICL) surgery.

Setting:
Nagoya Eye Clinic, Nagoya, Aichi, Japan.

Design:
Retrospective observational study.

Methods:
Patients who underwent TICL surgery from 2005 to 2009 to correct myopia and myopic astigmatism were enrolled. The safety, efficacy, predictability, astigmatism correction efficacy, and complications were evaluated using preoperative, 1-year postoperative, and final examination data.

Results:
133 eyes of 77 patients were included. At the final visit, the mean uncorrected and corrected visual acuities were −0.01 ± 0.2 and −0.17 ± 0.05, respectively. The mean safety and efficacy indices were 0.91 ± 0.26 and 0.68 ± 0.21, respectively. The manifest astigmatism was −0.45 ± 0.43 diopters (D). The mean corneal astigmatism change from 1 year postoperatively to the final visit was 0.40 ± 0.26 D. Of the 38 eyes with a change in corneal astigmatism ≥0.5 D, 30 eyes (78.9%) changed to against-the-rule (ATR) astigmatism, 1 (2.6%) changed to oblique astigmatism, and 7 (18.4%) changed to with-the-rule (WTR) astigmatism. The mean manifest astigmatism change from 1 year postoperatively to the final visit was 0.43 ± 0.52 D. Of the 60 eyes with a change in manifest astigmatism ≥0.5 D, 25 (41.7%) changed to ATR astigmatism, 18 (30.0%) changed to oblique astigmatism, and 17 (28.3%) changed to WTR astigmatism. During follow-up, 8 (6.0%) of 133 eyes developed anterior subcapsular cataracts, among which 4 (3.0%) underwent TICL removal and phacoemulsification and aspiration. No vision-threatening complications occurred.

Conclusions:
TICL surgery showed good long-term astigmatism-correcting effects, although the long-term uncorrected visual acuity decreased. The procedure was effective in correcting myopia and astigmatism.
Multimodality imaging in cardiogenic shock: state-of-the art
Authors: Tavazzi Guido , Corradi Francesco , Vandenbriele Christophe , Alviar Carlos L. 
Published: July 2023

Purpose of review
There is emerging evidence on the role of the multimodality imaging in the setting of cardiogenic shock. The utility of different imaging modalities, along with their pitfalls and limitations, and their integration in a multiparametric approach are discussed in the current review.

Recent findings
The evaluation of congestion and perfusion in patients with shock has allowed a better understanding of the underlying physiopathological mechanisms. Integration of echocardiography, using more physiological parameters, with lung ultrasound, as well as the Doppler evaluation of abdominal blood flow dynamics, has led to a better stratification in patinas with hemodynamic instability.

Summary
Although validation of the integrated approaches and single parameters are needed, the physiopathological-driven approach using ultrasound in patients with cardiogenic shock on top of the clinical and biochemical evaluation, may aid to a quicker and more detailed evaluation of patient's phenotype.
The impact of concomitant metabolic dysfunction-associated fatty liver disease on adverse outcomes in patients with hepatitis B cirrhosis: a propensity score matching study
Authors: Wang Xinyu , Wei Shuhang , Wei Yingnan , Wang Xueqi , Xiao Feng , Feng Yuemin , Zhu Qiang 
Published: July 2023

Background and aims
In cirrhotic patients, the clinical relevance of metabolic dysfunction-associated fatty liver disease (MAFLD) is unclear. We aimed to research the relationship between MAFLD and adverse clinical outcomes in patients with hepatitis B cirrhosis.

Methods
A total of 439 patients with hepatitis B cirrhosis were enrolled. Abdominal MRI and computed tomography were used to calculate liver fat content in order to evaluate steatosis. The Kaplan–Meier method was implemented to generate survival curves. The independent risk factors for prognosis were identified by multiple Cox regression. Propensity score matching (PSM) was used to reduce the influence of confounding factors. This study explored the relevance between MAFLD and mortality, first decompensation and further decompensation.

Results
In our study, most patients were decompensated cirrhosis (n = 332, 75.6%) and the ratio of decompensated cirrhosis patients in non-MAFLD to MAFLD group was 199 : 133. Compared to the non-MAFLD group, patients with MAFLD had worse liver function which mainly reflected that there were more Child–Pugh C patients and higher model for end-stage liver disease score in the MAFLD group. A total of 207 adverse clinical events occurred in the total cohort during a median follow-up of 47 months, including 45 deaths, 28 hepatocellular carcinoma, 23 first decompensation and 111 further decompensation. Cox multivariate analysis showed that MAFLD was an independent risk factor for death [hazard ratio (HR) 1.931; 95% confidence interval (CI) 1.019–3.660; P = 0.044 HR 2.645; 95% CI, 1.145–6.115; P = 0.023] and further decompensation (HR 1.859; 95% CI, 1.261–2.741; P = 0.002 HR 1.953; 95% CI, 1.195–3.192; P = 0.008) before and after PSM. In decompensated group with MAFLD, diabetes had a more significant effect on adverse prognosis than overweight or obesity and other metabolic risk factors.

Conclusion
In patients with hepatitis B cirrhosis, concomitant MAFLD can predict a higher risk of further decompensation and death among decompensated individuals. According to patients among MAFLD, diabetes may be a major factor in the occurrence of adverse clinical events.
Clinical value of combined serum MMP-2, MMP-9 and TIMP-1 for the prognosis of perianal fistula patients who received minimally invasive surgery
Authors: Du Chang-Liang , Zhang Xuehui , Yang Haichun 
Published: July 2023

Objective
This study aimed to investigate the clinical value of combined serum matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) for the prognosis of perianal fistula patients.

Methods
Patients diagnosed and treated for perianal fistula by minimally invasive surgery (MIS) were enrolled. The concentrations of serum MMP-2, MMP-9 and TIMP-1 were measured at 24 h after surgery. Different levels of wound secretion, growth of granulation tissue and wound pain were used as criteria to evaluate surgical incision healing. The receiver operating characteristic curve was used to analyze the predicted assessment value.

Results
The concentrations of serum MMP-2 and MMP-9 were significantly higher, while the concentrations of serum TIMP-1 at 24 h after surgery were significantly lower in the poor healing group than in the good healing group. It was further found that high levels of serum MMP-2 and MMP-9 were risk factors for poor healing, while high concentrations of serum TIMP-1 at 24 h after surgery were protective factors for poor healing.

Conclusion
High concentrations of serum MMP-2 and MMP-9 and low concentrations of serum TIMP at 24 h after surgery are risk factors for poor healing in perianal fistula patients who receive MIS, and the combined test has a higher predictive value.
Sodium-glucose cotransporter-2 inhibitors improve FibroScan-aspartate aminotransferase scores in patients with nonalcoholic fatty liver disease complicated by type 2 diabetes
Authors: Ogawa Yutaro , Nakahara Takashi , Ando Yuwa , Yamaoka Kenji , Fujii Yasutoshi , Uchikawa Shinsuke , Fujino Hatsue , Ono Atsushi , Murakami Eisuke , Kawaoka Tomokazu , Miki Daiki , Yamauchi Masami , Tsuge Masataka , Imamura Michio , Oka Shiro 
Published: July 2023

Background and aim
Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease caused by excessive lipid accumulation in the liver, and its global incidence is increasing. Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are oral antidiabetes drugs that promote glucose excretion into the urine and have been reported to exert therapeutic effects in NAFLD, but liver stiffness measurements (LSMs) determined by transient elastography are inconsistent. In addition, the effects of SGLT2is on the FibroScan-aspartate aminotransferase (FAST) scores have not been reported. We evaluated the effect of SGLT2is on patients with NAFLD complicated by type 2 diabetes using biochemical tests, transient elastography, and FAST scores.

Methods
Fifty-two patients with type 2 diabetes complicated by NAFLD who started SGLT2i treatment between 2014 and 2020 at our hospital were selected from the database. Pre- and post-treatment serum parameters, transient elastography, and FAST scores were compared.

Results
After 48 weeks of SGLT2i treatment, body weight, fasting blood glucose, hemoglobin A1c, AST, alanine aminotransferase, gamma-glutamyltransferase, uric acid, fibrosis-4 index, and AST to platelet ratio index improved. Median LSM decreased from 7.0 kPa to 6.2 kPa (P = 0.023) and the median controlled attenuation parameter decreased from 304 dB/m to 283 dB/m (P = 0.022). Median FAST score decreased from 0.40 to 0.22 (P < 0.001), and the number of cases with a cutoff value of ≥0.35 decreased from 15 to 6 (P = 0.001).

Conclusion
SGLT2i use not only improves weight loss and blood glucose levels but also improves hepatic fibrosis by ameliorating hepatic steatosis and inflammation.
Baseline albumin-bilirubin score: a predictor for HBeAg clearance in patients with chronic hepatitis B after nucleos(t)ide analogue treatment
Authors: Zhang Yao , Gu Yan , Yin Shengxia , Wang Jian , Zhang Zhiyi , Liu Yilin , Chen Yun , Zhan Jie , Xue Ruifei , Yan Xiaomin , Zhang Shaoqiu , Ding Weimao , Chen Yuxin , Li Jie , Huang Rui , Wu Chao 
Published: July 2023

Background
Serum biomarkers for predicting HBeAg clearance in patients with chronic hepatitis B (CHB) virus infection during antiviral therapy remain lacking. This study aimed to investigate baseline albumin-bilirubin (ALBI) score for assessing HBeAg clearance in HBeAg-positive CHB patients treated with nucleos(t)ide analogues (NAs).

Methods
Six hundred and ninety-nine HBeAg-positive CHB patients treated with first-line NAs were retrospectively included. Kaplan–Meier curves were used to compare the possibility of HBeAg clearance and HBeAg seroconversion in different ALBI groups. Cox regression models were used to identify factors associated with HBeAg clearance and HBeAg seroconversion.

Results
Of the patients, 69.8% were male, with a median age of 36.0 years. 174 (24.9%) patients achieved HBeAg clearance after a median of 92.0 (interquartile range 48.0–134.0) weeks of antiviral treatment and 108 (15.5%) patients achieved HBeAg seroconversion. 74.0% and 26.0% of patients were classified as ALBI grade 1 and ALBI grade 2-3, respectively. ALBI grade 2-3 was identified as an independent predictor of HBeAg clearance (hazard ratio 1.570, 95% confidence interval 1.071–2.301, P = 0.021). The cumulative incidence of HBeAg clearance and HBeAg seroconversion was significantly higher in ALBI grade 2-3 group than group of ALBI grade 1 (P < 0.001). Similar results were observed in different subgroups with different antiviral drugs, cirrhosis status, and ALT levels.

Conclusion
Baseline ALBI score may be a valuable indicator for predicting antiviral response in HBeAg-positive CHB patients treated with NAs.
Effect of aspirin use on survival in patients with hepatocellular carcinoma
Authors: Aktan Hakan , Ozdemir Asena Ayca , Karaoğullarindan Ümit 
Published: July 2023

Background
Hepatocellular carcinoma (HCC) is the seventh most prevalent cancer globally and is the third leading cause of cancer-related mortality.

Aim
The aim of this study was to evaluate the effect of aspirin use on the survival rates of individuals diagnosed with HCC.

Methods
The patients were divided into two groups: those who used aspirin and those who did not. Aspirin use was defined as individuals who had used aspirin either before or after the diagnosis of HCC. Aspirin usage was determined based on prescription records. The criteria for aspirin use were defined as a minimum of 3 months and a minimum daily dose of 100 mg. Survival time; The time elapsed after the diagnosis of HCC was calculated as ‘months’

Result
Of the 300 cohorts studied in our study, 104 (34.6%) were using aspirin, while 196 (65.4%) were not. It was observed that bleeding occurred only in the patient group taking aspirin (P = 0.002). When evaluated in terms of survival time, it was observed that it was significantly higher in the patient group using aspirin (P = 0.001). Aspirin use was identified as factors that significantly impact survival (P < 0.05). Aspirin use was identified as independent risk factors that significantly impact of survival (P < 0.05).

Conclusion
The aspirin group had a similar metabolic and liver reserve as the other group and had a longer survival despite being older and more comorbid diseases.
The diagnostic accuracy of endoscopic ultrasound vs. contrast-enhanced computed tomography in local staging of pancreatic adenocarcinoma: a bi-national multicenter study
Authors: Sbeit Wisam , Salman Mahmoud , Khalaileh Abed , Zoabi Ahmad , Bramnik Zakhar , Hovel David , Mahamid Mahmud , Israeli Eran , Katz Lior , Khoury Reem , Mubariki Nama , Lisotti Andrea , Awadie Halim , Khoury Tawfik 
Published: July 2023

Background
Identification of pancreatic cancer (PC) local invasion is crucial to optimize patients’ selection for surgery.

Aims
To determine the diagnostic accuracy of contrast-enhanced computed tomography (CECT) and endoscopic ultrasound (EUS) in local staging of PC.

Methods
We performed a multicenter study including all patients with PC who underwent surgery.

Results
One hundred twelve patients were included. Surgical findings of peri-pancreatic lymph nodes (LN), vascular and adjacent organ involvement were seen in 67 (59.8%), 33 (29.5%) and 19 patients (17%), respectively. The diagnostic performance of EUS was better than CECT in peri-pancreatic LN. The sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) of CECT vs. EUS were 28.4%, 80%, 67.9% and 42.9% vs. 70.2%, 75.6%, 81% and 63%, respectively. For vascular and adjacent organ involvement, the sensitivity, specificity, PPV and NPV were 45.5%, 93.7%, 75%, 80.4% and 31.6%, 89.2%, 37.5% and 86.5% for CECT, respectively, vs. 63.6%, 93.7%, 80.8%, 86.1% and 36.8%, 94.6%, 58.3% and 88% for EUS, respectively. Combining both CECT and EUS, the sensitivity for peri-pancreatic LN, vascular and adjacent organ involvement improved (76.1%, 78.8% and 42%), respectively.

Conclusion
EUS was superior to CECT in local staging. Combined EUS and CECT had a higher sensitivity than either alone.
Immunotherapy combinations for metastatic castration-resistant prostate cancer – failed trials and future aspects
Authors: Slovin Susan F. 
Published: July 2023

Purpose of review
Immunotherapy, a treatment modality currently synonymous with immune checkpoint blockade remains a challenge for prostate cancer. Despite multiple phase 3 trials using checkpoint inhibitors in combinatorial approaches, there have been no benefits to date in overall survival or radiographic progression free survival. However, newer strategies prevail that are directed to a variety of unique cell surface antigens. These strategies include unique vaccines, chimeric antigen receptor (CAR) T, bispecific T cell engager platforms, and antibody-drug conjugates.

Recent findings
New antigens are being targeted by various immunologic strategies. These antigens are pan-carcinoma as they may be expressed on a variety of cancers but remains effective targets for therapeutic attack.

Summary
Immunotherapy with checkpoint inhibitors alone or in combination with a variety of agents such as chemotherapy, poly-ADP ribose polymerase (PARP) inhibitors or novel biologics have met with failure in the endpoints of overall survival (OS) and radiographic progresson-free survival (rPFS). Despite these efforts, other immunologic efforts to develop unique tumor-targeted strategies should be continued.