bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spheno-Orbital Meningioma - Treatment Outcomes and Factors Influencing Recurrence
Authors: Tran Ann Q. , Maniar Arpita , Tooley Andrea A. , North Victoria S. , Sisti Michael B. , Kazim Michael 
Published: May 2023

Purpose:
To determine treatment outcomes, recurrence rates, and predictors of recurrence, to inform future therapeutic approaches for spheno-orbital meningiomas (SOM).

Methods:
A retrospective single-center study of SOM treated from 1990 to 2021 was conducted with comprehensive neuro-ophthalmologic follow-up at Columbia University Medical Center (CUMC). Recurrence requiring reintervention was defined clinically as worsening of visual acuity, visual field defect, or ocular motility after an initial period of stabilization or 6 months of improvement following treatment, or radiologically as either a regrowth with an increase in tumor size by 20% at the site of previous growth or a new region of tumor growth.

Results:
In total 46 patients met the inclusion criteria. The mean follow-up was 106 months (range 1–303). Dictated by the phenotype of the disease, patients underwent either gross- (50%), near- (17%), or subtotal resection (26%). Removal of the anterior clinoid process (ACP) was performed in 52% of patients. Nine patients (20%) required an enucleation or exenteration. Radiotherapy was employed at some point of treatment in 50% of cases. Inherited cases (24%) were referred to CUMC for treatment following 1 or more recurrences. The total recurrence rate, including inherited cases, was 54%, occurring at a mean interval of 43 months. The recurrence rate of patients treated solely at CUMC was 40%, occurring at a mean interval of 41 months. A subset of patients (32%) had 2 or more recurrences. Histopathology at the first surgery was WHO grade I (87%) and II (13%) and at the final surgery was WHO grade I (74%), II (21%), and III (4%). A subset of grade I tumors that received radiotherapy (35%) evolved to a higher grade or developed multiple recurrences without a change in histologic grade I. Grade II tumors and treatment with radiotherapy increased the odds of recurrence. Removal of the ACP and gross total resection decreased the odds of recurrence.

Conclusion:
Due to the routinely long interval to tumor recurrence, lifelong surveillance of patients with SOM is prudent. ACP resection and gross total resection, where possible, reduce tumor recurrence and the need for further treatment. Radiotherapy should be reserved for higher-grade meningiomas and select grade I tumors.
Association between Cardiovascular and Musculoskeletal Health in Firefighters
Authors: Ras Jaron , Soteriades Elpidoforos S. , Smith Denise L. , Kengne Andre P. , Leach Lloyd 
Published: May 2023

ObjectiveThe aim of the study is to determine the association between cardiovascular health (CVH) and musculoskeletal health in firefighters.MethodsThis cross-sectional study involved 309 full-time firefighters aged 20 to 65 years. Cardiovascular health encompassed cardiovascular disease risk factors, risk scores, CVH metrics, and heart rate variability. Musculoskeletal health was assessed using two validated questionnaires.ResultsIncreasing age (P= 0.004), body mass index (P< 0.001), body fat percentage (P< 0.001), diastolic blood pressure (P= 0.003), total cholesterol (P= 0.006), and Framingham risk score (P= 0.011) increased the risk of reporting musculoskeletal injuries (MSIs). Obesity (P= 0.018), hypertension (P= 0.034), and dyslipidemia (P= 0.005) increased the risk of reporting MSIs. Musculoskeletal discomfort was associated with total cholesterol (P= 0.0.34) and low-density lipoprotein (P= 0.014).ConclusionsAdverse cardiovascular disease risk profile was associated with MSIs and musculoskeletal discomfort in firefighters. Firefighters should maintain an ideal CVH profile, especially as they age.
Survival outcomes of neoadjuvant therapy followed by radical resection versus upfront surgery for stage I–III pancreatic ductal adenocarcinoma: a retrospective cohort study
Authors: Zou Yiping , Gao Song , Yu Xin , Zhou Tianxing , Xie Yongjie , Guo Xiaofan , An Ran , Wang Xiuchao , Zhao Tiansuo , Chang Antao , Gao Chuntao , Yu Jun , Hao Jihui 
Published: May 2023

Background:
Neoadjuvant therapy remains controversial in treating resectable pancreatic ductal adenocarcinoma (PDAC) patients. This study aims to assess the impact of neoadjuvant therapy on survival in patients with PDAC according to their clinical stage.

Methods:
Patients with resected clinical Stage I–III PDAC from 2010 to 2019 were identified in the surveillance, epidemiology, and end results database. A propensity score matching method was utilized within each stage to reduce potential selection bias between patients who underwent neoadjuvant chemotherapy followed by surgery and patients who underwent upfront surgery. An overall survival (OS) analysis was performed using the Kaplan–Meier method and a multivariate Cox proportional hazards model.

Results:
A total of 13 674 patients were included in the study. The majority of the patients (N=10 715, 78.4%) underwent upfront surgery. Patients receiving neoadjuvant therapy followed by surgery had significantly longer OS than those with upfront surgery. Subgroup analysis revealed that the neoadjuvant chemoradiotherapy group’s OS is comparable to neoadjuvant chemotherapy. In clinical Stage IA PDAC, there was no difference in survival between the neoadjuvant treatment and upfront surgery groups before or after matching. In stage IB-III patients, neoadjuvant therapy followed by surgery improved OS before and after matching compared to upfront surgery. The results revealed the same OS benefits using the multivariate Cox proportional hazards model.

Conclusion:
Neoadjuvant therapy followed by surgery could improve OS over upfront surgery in Stage IB-III PDAC but did not provide a significant survival advantage in Stage IA PDAC.
Nerve-sparing technique in RPLND for testicular cancer
Authors: Nalavenkata Sunny , Li Thomas , Patel Manish I. 
Published: May 2023

Purpose of review
The management of testicular cancer has evolved over time with multimodal therapy. Retroperitoneal lymph node dissection (RPLND), which is a complex and potentially morbid treatment option, remains the mainstay in surgical treatment. This article reviews the surgical template, approach and anatomical considerations with regards to nerve spare in RPLND.

Recent findings
The standard full bilateral RPLND template has evolved over time to include the area between the renal hilum, bifurcation of the common iliac vessels, and the ureters. Morbidity with regards to ejaculatory dysfunction has led to further refinements in this procedure. Advancements in anatomical understanding of the retroperitoneal structures and their relationship to the sympathetic chain and hypogastric plexus has allowed for modification of surgical templates. Further refinements in surgical nerve sparing techniques have improved functional outcomes without sacrificing oncological outcomes. Finally, extraperitoneal access to the retroperitoneum and minimally invasive platforms have been implemented to further reduce morbidity.

Summary
RPLND requires strict adherence to oncological surgical principles regardless of template, approach and technique. Contemporary evidence shows that outcomes are best for advanced testis cancer patients when managed at high volume tertiary care facilities with surgical expertise and access to multidisciplinary care.
Effect of Artificial Intelligence Course in Nursing on Students' Medical Artificial Intelligence Readiness
Authors: Taskiran Nihal 
Published: May 2023

Background:
It is predicted that artificial intelligence (AI) will transform nursing across all domains of nursing practice, including administration, clinical care, education, policy, and research.

Purpose:
This study examined the impact of an AI course in the nursing curriculum on students' medical AI readiness.

Design and Methods:
This comparative quasi-experimental study was conducted with a total of 300 3rd-year nursing students, 129 in the control group and 171 in the experimental group. Students in the experimental group received 28 hours of AI training. The students in the control group were not given any training. Data were collected by a socio-demographic form and the Medical Artificial Intelligence Readiness Scale.

Results:
An AI course should be included in the nursing curriculum, according to 67.8% of students in the experimental group and 57.4% of students in the control group. The mean score of the experimental group on medical AI readiness was higher (P < .05) and the effect size of the course on readiness was −0.29.

Conclusions:
An AI nursing course positively affects students' readiness for medical AI.
Uterine Tumor Resembling Ovarian Sex Cord Tumors: 23 Cases Indicating Molecular Heterogeneity With Variable Biological Behavior
Authors: Bi Rui , Yao Qianlan , Ji Gang , Bai Qianming , Li Anqi , Liu Zebing , Cheng Yufan , Tu Xiaoyu , Yu Lin , Chang Bin , Huang Dan , Ge Huijuan , Zuo Ke , Li Hui , Chang Heng , Cai Xu , Jiang Wenhua , Zhou Xiaoyan , Yang Wentao 
Published: May 2023

Uterine tumor resembling ovarian sex cord tumor (UTROSCT) is a rare mesenchymal neoplasm that mainly harborsNCOA1-3rearrangements with partner genesESR1orGREB1. Here, we explored 23 UTROSCTs by targeted RNA sequencing. The association between molecular diversity and clinicopathologic features was investigated. The mean age of our cohort was 43 years (23–65 y). Only 15 patients (65%) were originally diagnosed with UTROSCTs. Mitotic figures ranged from 1 to 7/10 high power fields, of primary tumors and increased from 1 to 9/10 high power fields in recurrent tumors. Five types of gene fusions were identified in these patients, includingGREB1::NCOA2(n=7),GREB1::NCOA1(n=5),ESR1::NCOA2(n=3),ESR1::NCOA3(n=7), andGTF2A1::NCOA2(n=1). To our knowledge, our group included the largest cohort of tumors withGREB1::NCOA2fusions. Recurrences were most common in patients withGREB1::NCOA2fusion (57%), followed by 40% (GREB1::NCOA1), 33% (ESR1::NCOA2), and 14% (ESR1::NCOA3). The recurrent patient who harboredan ESR1::NCOA2fusion was characterized by extensive rhabdoid features. Both of the recurrent patients who harboredGREB1::NCOA1andESR1::NCOA3had the largest tumor sizes in their own gene alteration groups, and another recurrentGREB1::NCOA1patient had extrauterine involvement. TheGREB1-rearranged patients were of older age, larger tumor size, and higher stage than non-GREB1-rearranged patients (P=0.004, 0.028, and 0.016, respectively). In addition, theGREB1-rearranged tumors presented more commonly as intramural masses rather than non-GREB1-rearranged tumors presenting as polypoid/submucosal masses (P=0.021). Microscopically, nested and whorled patterns were frequently seen inGREB1-rearranged patients (P=0.006). Of note, estrogen receptor expression was weaker than progesterone receptor in all 12GREB1-rearranged tumors, whereas the similar staining intensity of estrogen receptor and progesterone receptor was observed in all 11 non-GREB1-rearranged tumors (P<0.0001). This study demonstrated that UTROSCTs were present at a younger age in the Chinese population. The genetic heterogeneity of UTROSCTs was correlated with variable recurrence rate. Tumors withGREB1::NCOA2fusions are more likely to recur compared with those with other genetic alterations.
A Decade of Nipple-Sparing Mastectomy: Lessons Learned in 3035 Immediate Implant-based Breast Reconstructions
Authors: Lin Alex M. , Lorenzi Roberto , Van Der Hulst Juliette E. , Liao Eric C. , Austen William G. , Webster Alexandra , Smith Barbara L. , Colwell Amy S. 
Published: May 2023

Background
Nipple-sparing mastectomy is commonly performed for breast cancer treatment or prevention. We present one of the largest breast reconstruction series in the literature.

Methods
A single institution retrospective review was conducted 2007-2019.

Results
Our query identified 3,035 implant-based breast reconstructions after nipple-sparing mastectomy including 2043 direct-to-implant and 992 tissue expander-implant reconstructions. The overall major complication rate was 9.15% and nipple necrosis rate 1.20%. Therapeutic mastectomy was associated with higher overall complications and explantations compared to prophylactic mastectomy (p<0.01). Comparing unilateral and bilateral procedures, bilateral mastectomy had increased risk for complications (OR 1.46, C.I. 0.997-2.145, p=0.05). Tissue-expander reconstructions had higher rates of nipple necrosis (1.9% vs. 0.88%, p=0.015), infection (4.2% vs. 2.8%, p=0.04), and explantation (5.1% vs. 3.5%, p=0.04) compared to direct-to-implant reconstruction. When assessing plane of reconstruction, we found similar rates of complications between subpectoral dual plane and prepectoral reconstruction. There was no difference in complications between reconstruction with acellular dermal matrix or mesh compared to total or partial muscle coverage without ADM/mesh (OR 0.749, 95% C.I. 0.404-1.391, p=0.361). Multivariable regression analysis revealed preoperative radiotherapy (OR 2.465, 95% C.I. 1.579-3.848, p<0.001), smoking (2.53, 95% C.I. 1.581-4.054, p<0.001), and a periareolar incision (OR 3.657, 95% C.I. 2.276-5.875, p<0.001) to be the strongest predictors of complications and nipple necrosis (p<0.05).

Conclusions
Nipple-sparing mastectomy and immediate breast reconstruction has a low rate of complications. In this series, radiation, smoking, and incision choice predicted overall complications and nipple necrosis while direct-to-implant reconstruction and acellular dermal matrix or mesh did not increase risk.
Improving Facial Fat Graft Survival Using Stromal Vascular Fraction-Enriched Lipotransfer: A Prospective Multicenter, Randomized Controlled Study
Authors: Wufuer Maierdanjiang , Choi Tae Hyun , Najmiddinov Bakhtiyor , Kim Junhyung , Choi Jaehoon , Kim Taeyoung , Park Yongsoo , Kim Ji-hoon , Jeon Heejung , Kim Byung Jun 
Published: May 2023

Background
Although previous clinical studies have reported that cell-assisted lipotransfer increases the fat survival rate in facial fat transplants, most were case studies without quantitative evaluation. A multi-center, prospective, randomized, controlled study was performed to evaluate the safety and efficacy of the stromal vascular fraction (SVF) in facial fat grafts.

Methods
Twenty-three participants were enrolled for autologous fat transfer in the face, and randomly assigned to the experimental (n=11) and control (n=12) groups. Fat survival was assessed using magnetic resonance imaging at 6 and 24 weeks postoperatively. Subjective evaluations were performed by the patients and surgeons. To address safety concerns, results of an SVF culture and the postoperative complications were recorded.

Results
The overall fat survival rate was significantly higher in the experimental group than in the control group (6 weeks: 74.5±9.99% vs. 66.55±13.77%, p<0.025; 24 weeks: 71.27±10.43% vs. 61.98±13.46%, p<0.012). Specifically, graft survival in the forehead was 12.82% higher in the experimental group when compared with that in the control group at 6 weeks (p<0.023). Furthermore, graft survival in the forehead (p<0.021) and cheeks (p<0.035) was superior in the experimental group at 24 weeks. At 24 weeks, the aesthetic scores given by the surgeons were higher in the experimental group than in the control group (p<0.03); however, no significant intergroup differences were noted in the patient-evaluated scores. Neither bacterial growth from SVF cultures nor postoperative complications were noted.

Conclusions
SVF enrichment for autologous fat grafting can be a safe and effective technique for increasing the fat retention rate.
Cognitive Impairment and the Associated Factors Among Older People in Rural Central Tanzania
Authors: Masika Golden M. , Nyundo Azan , Msisiri Laidi 
Published: May 2023

Aim:
This study examined the profile of cognitive impairment and associated factors among older people in rural central Tanzania.

Methods:
We conducted a cross-sectional study involving 462 community-dwelling older adults. We performed cognitive, psychosocial, and clinical assessments and face-to-face interviews with all older adults. Descriptive, bivariate and multivariate linear regression analyses were performed to determine the participant’s cognitive performance and the associated factors.

Results:
The mean cognitive score on the Identification and Intervention for Dementia in Elderly Africans cognitive test was 11.04 (SD=2.89). Per the proposed cut-off scores to define probable and possible dementia, 13.2% of the population had probable dementia and another 13.9% had possible dementia. Increase in age was associated with poor cognitive performance (β=−0.076, 95% CI=−0.109 to −0.043, P<0.001); whereas male sex (β=0.989, 95% CI=0.333 to 1.645, P=0.003), higher educational attainment (β=2.575, 95% CI=0.557 to 4.594, P=0.013) and performance in instrumental activities of daily living (β=0.552, 95% CI=0.376 to 0.729, P<0.001) were associated with higher cognitive performance.

Discussion:
Older people in rural settings of central Tanzania have poor cognitive functions and are at high risk of further cognitive decline. Preventive and therapeutic programs for the affected older people are warranted to prevent further decline and maintain quality of life.
Improved characterization of circulating tumor cells and cancer-associated fibroblasts in breast cancer patients using imaging flow cytometry
Authors: Muchlińska Anna , Wenta Robert , Ścińska Wiktoria , Markiewicz Aleksandra , Suchodolska Grażyna , Senkus Elżbieta , Żaczek Anna J , Bednarz-Knoll Natalia 
Published: May 2023

AbstractCirculating tumor cells (CTCs) and circulating cancer-associated fibroblasts (cCAFs) have been individually considered as strong indicators of cancer progression. However, technical limitations have prevented their simultaneous analysis in the context of CTC phenotypes different from epithelial. This study aimed to analyze CTCs and cCAFs simultaneously in peripheral blood of 210 breast cancer patients using DAPI/pan-keratin (K)/vimentin (V)/alpha-SMA/CD29/CD45/CD31 immunofluorescent staining and novel technology - imaging flow cytometry (imFC). Single and clustered CTCs of different sizes and phenotypes (i.e. epithelial phenotype K+/V-, and epithelial-mesenchymal transition (EMT)-related such as K+/V+, K-/V+ and K-/V-) were detected in 27.6% of the samples and correlated with metastases. EMT-related CTCs interacted more frequently with normal cells and tended to occur in patients with tumors progressing during therapy, while cCAFs coincided with CTCs (mainly K+/V- and K-/V-) in 7 (3.3%) patients and seemed to correlate with the presence of metastases, particularly visceral ones. This study emphasizes advantages of imFC in the field of liquid biopsy and highlights the importance of multimarker detailed analysis of different subpopulations and phenotypes of cancer progression-related cells i.e. CTCs and cCAFs. Co-detection of CTCs and cCAFs might improve the identification of patients at higher risk of progression and their monitoring during therapy.Simple SummaryLiquid biopsy is promising but challenging tool potentially upgrading cancer patients diagnostics and bringing new insights into tumor biology. Here, we applied a unique approach to detect CTCs and cCAFs in one-tube assay using imaging flow cytometry enabling improved enumeration, multimarker-based phenotyping and detailed morhopological characterization of those rare cells. We showed that EMT-related CTCs might contribute to breast cancer progression, whereas coincidence of CTCs and cCAFs might be signature of metastasis.
Two sample Mendelian Randomisation using an outcome from a multilevel model of disease progression
Authors: Lawton Michael , Ben-Shlomo Yoav , Gkatzionis Apostolos , Hu Michele T. , Grosset Donald , Tilling Kate 
Published: May 2023

ABSTRACTIdentifying factors that are causes of disease progression, especially in neurodegenerative diseases, is of considerable interest. Disease progression can be described as a trajectory of outcome over time - for example, a linear trajectory having both an intercept (severity at time zero) and a slope (rate of change). A technique for identifying causal relationships between one exposure and one outcome in observational data whilst avoiding bias due to confounding is two sample Mendelian Randomisation (2SMR). We consider a multivariate approach to 2SMR using a multilevel model for disease progression to estimate the causal effect an exposure has on the intercept and slope. We carry out a simulation study comparing a naïve univariate 2SMR approach to a multivariate 2SMR approach with one exposure that effects both the intercept and slope of an outcome that changes linearly with time since diagnosis. The simulation study results for both approaches were similar and approximately unbiased (bias for intercept ranges from -1.6% to 1.5% and the slope -0.7% to 4.1%) with appropriate coverage of the 95% confidence intervals (for intercept 94.1%-96.2% and the slope 94.7%-96.0%). The multivariate approach gives a better joint coverage of both the intercept and slope effects (93.3%-95.8% for multivariate approach compared to 89.0%-92.5% for the naïve approach). We also apply our method to two Parkinson’s cohorts to examine the effect body mass index has on disease progression. There was no strong evidence that BMI affects disease progression, however the confidence intervals for both intercept and slope were wide.
Backscattering amplitude in Ultrasound Localization Microscopy
Authors: Renaudin Noemi , Pezet Sophie , Ialy-Radio Nathalie , Demene Charlie , Tanter Mickael 
Published: May 2023

AbstractIn the last decade, Ultrafast Ultrasound Localisation Microscopy has taken non-invasive deep vascular imaging down to the microscopic level. By imaging diluted suspensions of circulating microbubbles in the blood stream at kHz framerate and localising the center of their individual point spread function with a sub-resolution precision, it enabled to break the unvanquished trade-off between depth of imaging and resolution by microscopically mapping the microbubbles flux and velocities deep into tissue. However, ULM also suffers limitations. Many small vessels are not visible in the ULM images due to the noise level in areas dimly explored by the microbubbles. Moreover, as the vast majority of studies are performed using 2D imaging, quantification is limited to in-plane velocity or flux measurements which hinders the accurate velocity determination and quantification. Here we show that the backscattering amplitude of each individual microbubble can also be exploited to produce backscattering images of the vascularization with a higher sensitivity compared to conventional ULM images. By providing valuable information about the relative distance of the microbubble to the 2D imaging plane in the out-of-plane direction, backscattering ULM images introduces a physically relevant 3D rendering perception in the vascular maps. It also retrieves the missing information about the out-of-plane motion of microbubbles and provides a way to improve 3D flow and velocity quantification using 2D ULM. These results pave the way to improved visualization and quantification for 2D and 3D ULM.