bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy and Safety of Tolvaptan in Heart Failure Patients with Congestive Signs: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Zeng Mei , Li Na , Chen Tongshuai , Ti Yun , Zhang Chunmei , Bu Peili 
Published: February 2023

Objective:
The aim of this study was to investigate the efficacy and safety of tolvaptan, as well as the impact of its treatment dose and duration in heart failure patients with congestive signs.

Methods:
The PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched to collect data from all randomized controlled trials (RCT) examining the efficacy and safety of tolvaptan in heart failure patients with congestive signs compared with placebo or blank control until March 4, 2021. Urine volume, change in body weight, improvement in dyspnea, and reduction of edema were evaluated as efficacy indicators. All-cause mortality, worsening heart failure, and adverse events were considered safety indicators. The quality of eligible publications was assessed using the Cochrane risk of bias for RCTs.

Results:
Ten RCTs with 5980 patients were included in this analysis. Compared with control, tolvaptan significantly reduced weight in the short term (day 1, 7 RCTs, weighted mean difference (WMD): –1.09, 95% confidence interval (CI): –1.27 to –0.91; day 2, 2 RCTs, WMD: –1.67, 95% CI: –3.00 to –0.33; day 7, 4 RCTs, WMD: –0.95, 95% CI: –1.25 to –0.66), increased urine volume (WMD: 1825.72, 95% CI: 1438.38–2213.07), and relieved dyspnea (risk ratio (RR): 1.12, 95% CI: 1.05–1.19) without increasing the mortality rate (RR: 0.96, 95% CI: 0.87–1.06). Furthermore, the weight loss and increase in urine volume were not dose-dependent effects, and prolonged medication did not lead to sustained weight loss. In addition, there seemed to be more adverse events (RR: 1.17, 95% CI: 1.03–1.32) after treatment with tolvaptan. Further analysis revealed that patients treated with tolvaptan were more likely to report thirst (RR: 6.09, 95% CI: 3.37–11.00) and dry mouth (RR: 6.36, 95% CI: 4.09–9.90), as well as develop hypernatremia (RR: 12.76, 95% CI: 3.52–46.32).

Conclusions:
The meta-analysis shows that tolvaptan can improve congestion with no increase in mortality rate, but should be used to guard against adverse events. Deserve to be mentioned, the number of RCTs included was limited, suggesting that the observed results should be interpreted with caution. Additional robust clinical studies are warranted to validate the present findings.
Incidence of Major Adverse Cardiovascular and Cerebrovascular Events in Chinese Patients Undergoing Percutaneous Coronary Intervention with Iodixanol: An Observational Postauthorization Study
Authors: Wang Xiaozeng , Ma Dengfeng , Li Tianchang , Li Bao , Su Xi , Wu Yanqing , Du Zhimin , Ji Zheng , Yang Ping , Yang Baisong , Cao Xuebin , Li Junxia , Hou Fengxia , Cheng Ziping , Xu Banglong , Han Yaling 
Published: February 2023

Objective:
This study aimed to evaluate the major adverse cardiovascular and cerebrovascular events (MACCEs) and overall safety profile associated with iodixanol in Chinese patients undergoing percutaneous coronary intervention (PCI).

Methods:
Patients at 30 centers in China registered in the OpenClinic v3.6 database from October 30, 2013, to October 7, 2015, were included in the study. The primary endpoint was in-hospital MACCEs including target lesion revascularization (TLR), stroke, stent thrombosis, cardiac death, and PCI-related myocardial infarction (MI) within 72 h post-PCI. Secondary endpoints were MACCEs from 72 h to 30 d post-PCI and other safety events within 30 d post-PCI.

Results:
A total of 3,042 patients were enrolled. The incidence of MACCEs within 72 h post-PCI was 2.33% (n = 71), including cardiac death (0.03%, n = 1) and PCI-related MI (2.30%, n = 70). The incidence of MACCEs from 72 h to 30 d post-PCI was 0.16% (n = 5), including cardiac death (0.10%, n = 3), PCI-related MI (0.03%, n = 1), and TLR for stent thrombosis (0.03%, n = 1). The incidence of composite angiographic or procedural complications was 2.86% (n = 87); 233 (7.86%) patients had results suggesting contrast-induced acute kidney injury.

Conclusions:
These findings indicate that the use of iodixanol in Chinese patients undergoing PCI is associated with a low incidence of MACCEs, confirming its safety in this population.
Defining Scholarship for Today and Tomorrow
Authors: Milner Robert J. , Flotte Terence R. , Thorndyke Luanne E. 
Published: February 2023

Abstract:
Scholarship, required for academic advancement, has traditionally been defined narrowly, not keeping pace with the expansion of faculty academic activities in health professions schools. How can we refine the definition of scholarship so that it better aligns with the scope of current faculty practice within academic health systems? Revision of the academic policies for promotion and tenure at the University of Massachusetts Chan Medical School afforded an opportunity to redefine scholarship such that a broader platform was available for faculty recognition, aligning with current academic standards, yet providing flexibility for the future. The authors describe the historical context of the definition of scholarship and their institution's process to construct a definition of scholarship with three essential elements: advancement of knowledge, dissemination for critical review, and impact on a discipline, practice, or community. Application of this definition to team science and digital scholarship is also described. Following a widespread continuing education initiative, implementation of the new definition within promotion and tenure processes of the medical, nursing, and graduate schools resulted in broad acceptance across the institution. This forum article provides lessons in leading an academic health sciences institution to reassess academic processes and is a resource for advancing the vigorous debate on the evolving meaning and evaluation of scholarship.
A Performance-Based Competency Assessment of Pediatric Chest Radiograph Interpretation Among Practicing Physicians
Authors: Bregman Stacey , Thau Elana , Pusic Martin , Perez Manuela , Boutis Kathy 
Published: February 2023

Background:
There is limited knowledge on pediatric chest radiograph (pCXR) interpretation skill among practicing physicians.

Objectives:
We systematically determined baseline interpretation skill, the number of pCXR cases physicians required complete to achieve a performance benchmark, and which diagnoses posed the greatest diagnostic challenge.

Methods:
Physicians interpreted 434 pCXR cases via a web-based platform until they achieved a performance benchmark of 85% accuracy, sensitivity, and specificity. Interpretation difficulty scores for each case were derived by applying one-parameter item response theory to participant data. We compared interpretation difficulty scores across diagnostic categories and described the diagnoses of the 30% most difficult-to-interpret cases.

Results:
240 physicians who practice in one of three geographic areas interpreted cases, yielding 56,833 pCXR case interpretations. The initial diagnostic performance (first 50 cases) of our participants demonstrated an accuracy of 68.9%, sensitivity of 69.4%, and a specificity of 68.4%. The median number of cases completed to achieve the performance benchmark was 102 (interquartile range 69, 176; min, max, 54, 431). Among the 30% most difficult-to-interpret cases, 39.2% were normal pCXR and 32.3% were cases of lobar pneumonia. Cases with a single trauma-related imaging finding, cardiac, hilar, and diaphragmatic pathologies were also among the most challenging.

Conclusions:
At baseline, practicing physicians misdiagnosed about one-third of pCXR and there was up to an eight-fold difference between participants in number of cases completed to achieve the standardized performance benchmark. We also identified the diagnoses with the greatest potential for educational intervention.
Praying Online
Authors: Taylor Elizabeth Johnston , Paulien Jon 
Published: February 2023

ABSTRACT:
This article presents reflections and suggestions for nurse educators in a Christian institution who want to pray with students while teaching online. Suggestions primarily relate to recording prayers for class, including avoiding the appearance of coercion; being clear that students' participation in the recorded prayer will have no effect on grades; placing prayer in recorded material at a consistent location (such as the beginning or the end) so students know when it is coming; being creative in offering varying ways to pray; being authentic; and inviting student participation.
Laparoscopic robotic takedown ureterostomy with extravesical cross-trigonal reimplantation after end cutaneous ureterostomy
Authors: Neeman Binyamin B. , Kocherov Stanislav , Jaber Jawdat , Neheman Amos , Chertin Boris 
Published: February 2023

Abstract

Introduction
The main goal of managing an obstructed megaureter (OMU) is to preserve the function of the affected kidney. To preserve the upper urinary tract, end cutaneous ureterostomy (ECU) seems to be a promising temporizing option.
We aimed to evaluate our experience with ECU in patients with primary and secondary OMU and to demonstrate an efficacy of robot-assisted laparoscopic takedown ureterostomy and subsequent extravesical ureteric reimplantation.

Materials and methods
Retrospective analysis of patients that underwent ECU due to primary or secondary megaureter between 2003 and 2020. Nineteen patients (12 males, 7 females) with a mean age of 4.2 ± 3.5 months (mean ± standard deviation) underwent ECU of 27 renal units. Of those, 11 (57.9%) had primary OMU and 8 (42.1%) had secondary OMU. Undiversion was performed in 16 (84%) out of 19 patients (20 renal units out of 27 [74%]).

Results
In the vast majority of the cases, we have observed improvement in the hydronephrosis and renal function after ureterostomy. After reimplantation ultrasonography showed either stable or further improvement in hydronephrosis in 80% of patients. Robot-assisted laparoscopic patients had shorter admission period and indwelling catheter time after the surgery.

Conclusions
End cutaneous ureterostomy is a safe and effective temporary procedure for the treatment of progressive primary and secondary megaureters. Robot-assisted laparoscopic takedown of ureterostomy with subsequent reimplantation seems to be a good alternative for undiversion and subsequent reimplantation in these patients.
Clinicopathologic and Dermoscopic Features of 20 Cases of Spark's Nevus, a Dermoscopic Simulator of Melanoma
Authors: Massone Cesare , Stanganelli Ignazio , Ingordo Vito , Ferrara Gerardo , Brunasso Alexandra Maria Giovanna , Siri Giacomo , Casazza Stefania , Gnone Matteo , Pizzichetta Maria Antonietta , Giovanni Biondo , Chiodi Stefano , Sola Simona 
Published: February 2023

Abstract:
Spark's nevus is a particular type of melanocytic nevus, with histology that shows features of both Spitz and Clark nevus. Detailed dermoscopic features in a series of Spark nevi have not been described yet. We performed a monocentric retrospective observational study on 20 lesions of Spark nevus excised from 19 patients (M:F = 10:9; mean age: 37,6 years), reviewed by 5 experts in dermoscopy and 2 dermatopathologists. A histologic review confirmed that Spark nevi were mostly symmetric (80%), well circumscribed (100%), mainly compound (65%) melanocytic lesions with either epithelioid (55%) or spitzoid (45%) cell morphology and bridging of the nests (100%). Spark nevi were more frequently found on the trunk (85%) in patients with a history of sunburns in childhood (84%), with skin phototype III (79%), and with high nevus count (>100 nevi, 7 patients (36%)). On dermoscopy, we observed different general patterns: multicomponent (40%), reticular–globular–homogeneous (15%), globular homogeneous (15%), reticular (15%), reticular–globular (5%), homogeneous (5%), and globular (5%). Spark nevi showed frequently dermoscopic asymmetry (63%), brown color (90%) with areas of central hyperpigmentation (41%) and peripheral hypopigmentation (28%), atypical pigment network (48%), irregular globules (42%), irregular dots (31%), irregular blotches (16%), blue-whitish veil (13%), peripheral island (25%), irregular hyperpigmented areas (12%), and regression (33%). BRAF mutation was present in 7 of the 10 analyzed cases (70%); all these cases presented a history of evolution. In conclusion, Spark nevi occur on the trunk of young adults with high nevus count and history of sunburns; dermoscopic features are protean, often atypical and suspicious of melanoma.
Giant Hemosiderotic Adenodermatofibroma: A Case Report and Review of the Literature
Authors: Ha Megan V. , Andrasik Wyatt J. , Tamburro Joan 
Published: February 2023

Abstract:
Adenodermatofibromas are an extremely rare subtype of dermatofibroma (DF) characterized by a dermal proliferation of spindle-shaped fibroblasts and histocytes, dilated glandular structures with apocrine secretion, and prominent vascular proliferation, with or without hemosiderotic features. We describe a recent extraordinary case of a hemosiderotic adenodermatofibroma in a 25-year-old female. We review histologic findings and theories behind etiology, as well as review the spectrum of clinical presentations for this lesion. We also discuss imaging findings that may make identification of these entities challenging.
Cutaneous Metastasis of Alveolar Rhabdomyosarcoma in a Child
Authors: Nör Felipe , Castro Juan Pablo , Wongpattaraworakul Wattawan , Buatti John M. , Gordon David , Powers Jennifer G. , Terry William , Hellstein John , Tanas Munir , Stone Mary 
Published: February 2023

Abstract:
Rhabdomyosarcoma (RMS) is one of the most common soft tissue sarcomas in children. This lesion is classically included in the generic group of “small round blue cell tumors” along with other entities that share similar microscopic features. Although the head and neck region is a frequent site for primary tumors, cutaneous metastases of RMS involving this anatomical location are rare in the pediatric population. We report a case of a 12-year old girl previously diagnosed with a primary alveolar RMS involving the left maxillary sinus, presenting with a metastatic lesion on the skin of the left temple area. Along with a brief review of the previous case reports on the topic, we highlight the initial immunohistochemistry panel useful for diagnosing this tumor.
Psychosocial, Medical, and Demographic Variables Associated with Parent Mealtime Behavior in Young Children Recently Diagnosed with Type 1 Diabetes
Authors: Gonynor Caroline , Wang Christine , Tully Carrie , Monaghan Maureen , Streisand Randi , Hilliard Marisa E. 
Published: February 2023

Abstract:

Objective:
Managing young children's mealtime concerns can be challenging after type 1 diabetes (T1D) diagnosis because of developmental factors and diabetes management demands. To identify potential intervention targets, we evaluated medical, psychosocial, and demographic factors in relation to parents' engagement in problem mealtime behaviors (e.g., pressure to eat, restriction).

Method:
Parents (N = 157) of young children (age 1–6 years) reported on psychosocial variables (parent fear of hypoglycemia, family functioning, parent problem solving, and parents' problem mealtime behavior frequency and perceptions of being problematic) within 2 months after T1D diagnosis. Hierarchical regression analyses examined associations among psychosocial variables, demographics (child sex, parent race/ethnicity), child continuous glucose monitor (CGM) use, and parents' problem mealtime behaviors.

Results:
Parents of children using CGMs reported parents' mealtime behaviors as more problematic than nonusers, but there were no differences for other medical or demographic variables. Models predicting parents' problem mealtime behavior frequency and problem perceptions that included psychosocial variables, demographic variables, and CGM use led to significant R2 of 0.14 and 0.16, respectively. CGM use and parent problem solving were significantly associated with parent mealtime behaviors being perceived as more problematic.

Conclusion:
Shortly after T1D diagnosis in young children, medical and parent psychosocial factors related to how frequently parents engaged in problem mealtime behaviors and the degree to which parents perceived them as problematic. Other factors may further explain the complexities of mealtime management. Considering parents' problem-solving skills and child treatment regimens may help guide interventions targeting mealtime challenges during the new diagnosis period.
Deep Shave Removal of Suspected Basal Cell Carcinoma: A Prospective Study
Authors: Dando Emily E. , Abban Cynthia , Shehu Wingrove Aurora , Pugliano-Mauro Melissa , Ferris Laura , Ho Jonhan , Patton Timothy 
Published: February 2023

BACKGROUND
Diagnosis and treatment of basal cell carcinoma (BCC) in the same visit by shave removal may decrease health care spending and promote patient satisfaction.

OBJECTIVE
To prospectively evaluate deep shave removal of lesions clinically suspicious for low-risk BCC on the trunk or extremities in immunocompetent patients.

MATERIALS AND METHODS
Deep shave removal with the intent to remove the entire tumor was performed from January 2015 to June 2016, and patients were followed prospectively for clinical evidence of tumor recurrence.

RESULTS
Seventy-seven lesions were removed from 51 patients, including 29 (37%) superficial and nodular BCCs, 27 (35%) superficial BCCs, 16 (21%) nodular BCCs, and 5 (6%) non-BCCs. Fifteen BCCs (21%) had positive residual margins after deep shave removal, which was significantly more likely to occur in nodular compared with superficial BCCs (odds ratio = 7.8, 95% confidence interval = 1.4–43), and underwent re-excision. Fourteen specimens initially reported to have negative margins after deep shave underwent resectioning, which revealed positive margins in 4 specimens (28.6%). No BCCs have recurred clinically after an average follow-up of 50 months (SE 3.2).

CONCLUSION
Consider deep shave removal for low-risk BCCs on the trunk or extremities in immunocompetent patients hoping to avoid a second treatment visit.
Clinical Anatomy of the Chin Evaluated by 3-Dimensional Tomography and Cadaveric Dissection: Implications for Safety and Optimal Injection Techniques in Chinese
Authors: Li Xin-Rui , Hong Wei-Jin , Li Zhen-Hao , Luo Cheng-En , Jiang Xuan-Yu , Luo Sheng-Kang 
Published: February 2023

BACKGROUND:
Soft tissue fillers have been widely used for the correction of chin volume loss because of congenital conditions and aging.

OBJECTIVE:
This study aimed to discuss anatomical concerns for chin filler injections, which may help to reduce the incidence of severe intravascular embolization complications and improve patient satisfaction.

METHODS AND MATERIALS:
We scanned 40 cadaveric heads with a contrast agent using a 64-row spiral computed tomography scanner. The scan was visualized by a Philips IntelliSpace workstation and analyzed by Materialise's interactive m image control system software to measure and quantify the arterial data. Twenty of 40 cadavers were dissected to define the layers of tissue.

RESULTS:
In total, 221 arteries passed through the sagittal plane of 40 specimens. The number of superficial arteries (163 of 221) was much greater than the number of deep arteries (58 of 221). The number of arteries gradually decreased with distance from the lower lip vermilion border plane, which formed the lower third of the face.

CONCLUSION:
This study introduces a safe and effective technique for administering chin filler injections that minimizes risks and improves patient satisfaction.
Reconstruction of Macrocheilia on the Lower Lip Through Bilateral Limited Excision and a Stepwise Single-Stage Approach (BLESS)
Authors: Yu Wenxin , Zhu Jiafang , Han Yue , Ma Gang , Lin Xiaoxi 
Published: February 2023

BACKGROUND
The surgical management of macrocheilia secondary to port-wine stains is complicated.

OBJECTIVE
This study aimed to propose an innovative method for treating macrocheilia on the lower lip.

METHODS
Patients who underwent the reconstruction of macrocheilia on the lower lip through the innovative approach were examined. Their preoperative and postoperative standard photographs were taken to evaluate the changes in lip length and thickness. The scores on Vancouver scar scale (VSS) and visual analog scale (VAS) were evaluated.

RESULTS
Thirty-two patients who underwent the reconstruction of macrocheilia were examined. A follow-up of 12.2 months (6–36 months) was conducted. The lower lip contour and the mentolabial groove were reconstructed to normal appearance. The lip length was shortened from 5.38 ± 0.49 cm pretreatment to 4.59 ± 0.30 cm posttreatment (p = .016). The exposed vermilion was shortened from 2.05 ± 0.48 cm to 1.26 ± 0.12 cm posttreatment (p < .01). The mean VSS and VAS scores were 2.2 ± 1.5 and 8.4 ± 1.3, respectively.

CONCLUSION
The bilateral limited excision and stepwise single-stage approach were safe and effective for reconstructing prominent macrocheilia on the lower lip. The technique was also easy to command for the beginners.
Development of a Dose-Adjusted Polygenic Risk Model for Anthracycline-Induced Cardiotoxicity
Authors: Siemens Angela , Rassekh Shahrad Rod , Ross Colin J. D. , Carleton Bruce C. 
Published: February 2023

Background:
Anthracyclines, which are effective chemotherapeutic agents, cause cardiac dysfunction in up to 57% of patients. The cumulative anthracycline dose is a crucial predictor of cardiotoxicity; however, the cumulative dose alone cannot explain all cardiotoxic events. Strongly associated genetic variants in SLC28A3, UGT1A6, and RARG contribute to anthracycline-induced cardiotoxicity in pediatric patients and may help identify those most susceptible. This study aimed to examine how these pharmacogenetic effects are modulated by cumulative anthracycline doses in the development of cardiotoxicity.

Methods:
A total of 595 anthracycline-treated children were genotyped and cardiotoxicity cases were identified. A dose-stratified analysis was performed to compare the contributions of SLC28A3 rs7853758, UGT1A6 rs17863783, and RARG rs2229774 variants to the development of cardiotoxicity in low-dose (<150 mg/m2 cumulative dose) and high-dose (>250 mg/m2 cumulative dose) patient groups. Logistic regression was used to model the relationships between the cumulative anthracycline dose, genetic variants, and cardiotoxicity in the full cohort.

Results:
At < 150 mg/m2 cumulative anthracycline dose, the SLC28A3 protective variant did not reach statistical significance [odds ratio (OR) 0.46 (95% confidence interval (CI) 0.10–1.45), P = 0.23], but it was statistically significant at doses >250 mg/m2 [OR 0.43 (95% CI 0.22–0.78), P = 0.0093]. Conversely, the UGT1A6 and RARG risk variants were either statistically significant or approaching significance at doses <150 mg/m2 [OR 7.18 (95% CI 1.78–28.4), P = 0.0045 for UGT1A6 and OR 2.76 (95% CI 0.89–7.63), P = 0.057 for RARG], but not at doses >250 mg/m2 [OR 2.91 (95% CI 0.80–11.0), P = 0.10; OR 1.56 (95% CI 0.89–2.75), P = 0.12].

Conclusions:
These findings suggest that the SLC28A3 variant imparts more significant protection for patients receiving higher anthracycline doses, whereas the UGT1A6 and RARG risk variants significantly increased the risk of cardiotoxicity at low anthracycline doses.