bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Reflectance Confocal Microscopy in the Evaluation of Pigmented Oral Lesions and Their Relationship With Histopathological Aspects
Authors: Luppi Juliana Bronzato , Pereira de Souza Renata , Florezi Giovanna Piacenza , Nico Marcello Menta Simonsen , Lourenço Silvia Vanessa 
Published: May 2022

Abstract:
Oral pigmentations are a heterogeneous group and can be the result of physiological activity of oral mucosal melanocytes, secondary to exogenous causes, associated with systemic or local diseases, or due to proliferative activity of melanocytes. Their diagnosis is critical because these lesions can be markers of internal diseases or, in the case of melanocytic proliferative processes, they may represent a malignant neoplasm. In the past decade, the use of reflectance confocal microscopy, a noninvasive imaging tool, has aided the analysis of such lesions, but the establishment of firm criteria in their evaluation is still lacking. This study evaluated a series of 19 cases of pigmented oral lesions and correlated the reflectance confocal microscopy findings with histopathological classical criteria. We found 13 cases of melanotic macule, 1 of them associated with Peutz–Jeghers syndrome and 2 with Laugier–Hunzinker syndrome; 1 melanocytic nevus; 2 lentigo maligna; 2 pigmented actinic cheilitis; and 1 case of postinflammatory pigmentation secondary to a lupus erythematosus oral discoid lesion. The main difference between benign and malignant lesions was the presence of atypical proliferation in lentigo maligna. Langerhans cells with thick dendritic processes, which may be present in other benign and inflammatory pigmentations is one of the main reasons for diagnostic pitfalls.
Next-Generation Sequencing Reveals a New Class of Melanocytic Neoplasms With Hybrid Genomic Features of PEM Including Protein Kinase R 1 Alpha Gene Inactivation and Spitz Tumor–Defining Protein Kinase Fusions
Authors: Zhao Jeffrey , Lampley Nathaniel , Benton Sarah , Olivares Shantel , Zhang Bin , Roth Andrew , Boutko Anastasiya , Zembowicz Artur , Gerami Pedram 
Published: May 2022

Background:
Pigmented epithelioid melanocytoma (PEM) is a subtype of melanocytic tumor with frequent involvement of the sentinel lymph node but rare distant metastasis. Rendering a diagnosis and prognosis based on histology can be challenging. Recent genomic studies identified 2 molecular variants of PEM. One variant is characterized by the activation of the mitogen-activated protein kinase pathway and inactivation of the PRKAR1a gene. The other is associated with genomic fusions involving the protein kinase C (PRKC) gene family.

Objective:
We investigated the molecular and clinicopathologic features of previously unreported PEM cases to improve tumor classification and report new classes of PEM.

Methods:
Next-generation sequencing and histomorphologic assessment was performed on 13 PEM cases.

Results:
We identified 2 novel PEM classes. Three cases harbored PRKAR1a inactivation and genomic fusions (ALK, NTRK, and MAP3K8). These tumors had overlapping histologic features with pigmented Spitz neoplasms. Three cases had genomic fusions involving PRKCB. These cases had overlapping features with PRKCA fusions but, in 2 cases, had a notable spindle cell component.

Limitations:
The overall sample size and amount of clinical follow-up is limited, leaving some uncertainty regarding the expected clinical course of these novel cases.

Conclusions:
PRKAR1a-inactivated/Spitz fusion–associated PEMs and PRKCB fusion–associated PEMs represent 2 new molecular classes of PEM.
PREDICTIVE FACTORS ASSOCIATED WITH ANATOMICAL AND FUNCTIONAL OUTCOMES AFTER PANRETINAL PHOTOCOAGULATION IN PEOPLE WITH PROLIFERATIVE DIABETIC RETINOPATHY
Authors: Perais Jennifer A. , McCullough Philip G. , McLaughlin Grainne A. , Pritchard Edward W. J. , Reid Gerard A. , Mohite Ajay A. , Virgili Gianni , Lois Noemi 
Published: May 2022

Purpose:
To determine effects of baseline characteristics and laser type performed on outcomes in people with proliferative diabetic retinopathy (PDR) undergoing panretinal photocoagulation (PRP).

Methods:
Medical records of all consecutive patients with PDR naïve to PRP, identified using an electronic database, evaluated at the Macula Clinic, Belfast Health and Social Care Trust, receiving their first PRP between January 1, 2016, and June 30, 2017, and followed for a minimum of 6 months after stabilization of PDR, were retrospectively reviewed. Outcomes included time to stabilization after PRP, progression of PDR, and mean change in the best-corrected visual acuity from baseline to the last follow-up. Cox regression was used to estimate hazard ratios (HRs) for the effect of baseline characteristics and type of laser on outcomes after treatment.

Results:
One hundred and fourteen patients (135 eyes) with a mean age of 56.9 (SD: 12.9) years were included, 67% males. People receiving pattern or mixed laser had a statistically significantly delayed stabilization (HR: 0.57, P = 0.020; and HR: 0.44, P ≤ 0.001, respectively) and increased risk of progression (HR: 1.87, P = 0.045; and HR: 1.96, P = 0.028, respectively) when compared with those receiving standard laser. Among other potential predictors in multivariable regression analysis, only vitreous hemorrhage and fibrosis or traction at baseline increased the risk of progression (HR: 1.58, P = 0.047; and HR: 4.29, P ≤ 0.001, respectively). Baseline characteristics and type of laser had no statistically significant effect on vision.

Conclusion:
These findings should be considered when selecting laser treatment, planning surveillance, and counselling patients with PDR undergoing PRP.
Globe Fixation Caused by Intraocular Migration of an Orbital Floor Implant
Authors: De Clerck Ivo , Veckeneer Marc , Reyntjens Bruno , De Groot Veva 
Published: May 2022

A 30-year-old male presented with diplopia 1 month after implantation of an orbital floor plate for a blowout fracture. The orbital plate was removed 3 months later, however, the fixation bar was left in place as it had migrated full thickness through the inferior oblique muscle, sclera, choroid, and retina.
After 5 years of head tilt, the patient was referred to our department with a metallic intraocular foreign body visible in fundo and an important elevation deficit. CT imaging confirmed our clinical suspicion of a retained fixation bar. The extraocular part of the fixation bar was removed via a transconjunctival inferior orbitotomy, leaving the intraocular part in place due to the high risk of ocular complications upon removal. Postoperative ocular motility improved greatly and the patient no longer experiences diplopia in daily life. Orbital plate migration is a rare complication that should be considered in de novo diplopia after orbital reconstruction.
Lessons learned from hepatocellular carcinoma may cause a paradigm shift in intraductal papillary mucinous neoplasms: a narrative review and discussion of conceptual similarities in tumor progression and recurrence
Authors: Margonis Georgios Antonios , Andreatos Nikolaos , Wang Jane , Weiss Matthew J. , Wolfgang Christopher L. 
Published: May 2022

Abstract
Although the natural history of recurrence/progression in patients with intraductal papillary mucinous neoplasms (IPMN) of the pancreas has not been studied thoroughly, the three principal mechanisms have been identified: (a) presence of residual disease at the transection margin, (b) presence of intraductal/intraparenchymal metastases and (c) development of new primary lesions. Mechanisms (a) and (b) result in metastatic lesions that are genetically related to the primary, while new primary lesions (mechanism c) are genetically distinct. Interestingly, recurrence/progression in IPMN displays conceptual parallels with the well-established paradigm of disease recurrence in patients with hepatocellular carcinoma (HCC). Specifically, patients with HCC may also develop recurrent tumors due to microscopic residual disease/intrahepatic metastasis which are genetically similar to the primary while the development of genetically unrelated, de novo HCC after curative-intent resection is also common. The latter has been attributed to the presence of a widespread genetic abnormality (“field defect”) in the liver (ie, cirrhosis). Given the conceptual similarities between IPMN and HCC, a pancreatic “field defect”may also be hypothesized to exist. This review does not suggest that HCC and IPMN have identical pathogeneses, but rather that they have conceptual similarities in tumor recurrence/progression; thus, lessons learned from HCC could be applied to IPMN research and subsequent management. Conceptual similarities in tumor progression and recurrence may also be observed between IPMN and other malignancies. However, HCC was selected because it is well studied and can serve as a paradigm.
An evaluation of safety and survival for patients with locally advanced pancreatic cancer treated with irreversible electroporation combined with chemotherapy: a retrospectively observational study
Authors: He Chaobin , Wang Jun , Mao Yize , Lao Xiangming , Li Shengping 
Published: May 2022

Abstract

Objective:
Irreversible electroporation (IRE) is emerging as a new therapy for locally advanced pancreatic cancer (LAPC). We aimed to conduct survival and safety analyses in LAPC patients after treatment with IRE combined with chemotherapy.

Methods:
A total of 64 patients with LAPC who had received IRE and chemotherapy were retrospectively collected from August 2015 to March 2019 at Sun Yat-sen University Cancer Center. Overall survival (OS) and progression-free survival (PFS) were evaluated using Kaplan-Meier method and compared by the log-rank test. A multivariate Cox regression model was used to determine the prognostic factors of survival. The perioperative complications of IRE were also evaluated. The study was approved by the Institutional Review Board of Sun Yat-sen University Cancer Center (approval No. C2021-003).

Results:
The median survival of all included patients were 24.63 (95% confidence interval: 21.78–27.49) for overall survival and 13.00 (95% confidence interval: 8.81–17.19) months for progression-free survival, with 96.8%, 51.9%, 18.3%; and 52.3%, 21.5%, 7.9% as the 1-, 2- and 3-year OS and PFS rates, respectively. Tumor size [OS, hazard ratio (HR)=1.768, P = 0.048; PFS, HR = 0.304, P = 0.010], neoadjuvant chemotherapy (OS, HR = 0.338, P = 0.030; PFS, HR = 0.358, P = 0.034), carbohydrate antigen 19-9 variation after IRE (OS, HR = 19.320, P = 0.003; PFS, HR = 14.591, P = 0.021) and tumor response after neoadjuvant chemotherapy (OS, HR = 8.779, P = 0.033; PFS, HR = 5.562, P = 0.008) were predictive factors of survival in patients with LAPC after IRE. Complications were observed in 20.3% of patients. Grade B pancreatic fistula was the most common complication. The complication rates of the late treatment group (6.1%) were significantly lower than those of the first 15 patients after IRE treatment (66.7%). The median length of hospital stay of late treatment group was 8.6 days, which was also shorter than that of the early treatment group (10.0 days).

Conclusions:
IRE combined with chemotherapy could improve survival of LAPC patients with acceptable complication rates. Therefore, it may be a suitable method for LAPC but should be validated in prospective randomized trials.
Asynchronous Peer Review Feedback in an Undergraduate Nursing Course
Authors: Brown Lynn Greenleaf , Cicchino Amy 
Published: May 2022

Background:
Because patient care depends on nurses' ability to effectively communicate, nursing students need opportunities to develop written and oral communication skills through low-stakes activities. However, content-intensive classes and clinical schedules are obstacles to explicit writing support. Online asynchronous peer review can be an effective solution.

Purpose:
Students participated in an online asynchronous peer review intervention. Students reported their perceptions of the peer review and subsequent revisions.

Methods:
The authors developed a peer review activity, designed to guide students to give online asynchronous feedback. Students evaluated its effectiveness and value through pre- and posttest surveys.

Results:
Ninety-four percent (n = 68) of participants reported peer review as beneficial to the writing process, with 74% reporting they revised their writing in meaningful ways. Students felt peer feedback was useful, positive, valid, and reliable.

Conclusion:
Findings suggest that even when delivered asynchronously online, peer review can support nursing students' writing process and scaffold content learning.
A scoping review of psychosocial oncology interventions promoting posttraumatic growth
Authors: Wong Kennedy L. , McClure Kelly S. , Psillos Danielle E. 
Published: May 2022

Abstract

Problem Identification:
Many cancer patients experience posttraumatic growth (PTG), and psycho-oncologists are exploring ways to facilitate PTG through psychosocial intervention. This study utilized a scoping review protocol to provide a comprehensive evaluation of psychosocial interventions aiming to promote PTG in oncology.

Literature Search:
Three databases were used to identify empirical studies implementing psychosocial interventions to promote PTG in cancer patients, according to Calhoun and Tedeschi's Posttraumatic Growth Inventory.

Data Evaluation:
Two independent reviewers screened articles for inclusion and extracted data for qualitative synthesis. 8275 abstracts and 116 full-text articles were assessed, with 33 studies included in this review.

Conclusions:
Common treatment components of psychoeducation, peer support, and mindfulness skills identified by this review may be considered for future interventions targeting post-traumatic growth. The results of this review also identified areas where PTG research may be strengthened, including standardized reporting of PTG outcomes and cancer-related variables.
Eye Sphincter Reanimation in Facial Paralysis
Authors: Carlson Terri L. , Hamidian Jahromi Alireza , Chelnis James G. , Konofaos Petros 
Published: May 2022

Abstract
Facial nerve paralysis (FNP) sequela includes dysregulation of the ocular surface protective mechanism, nasolacrimal system pump failure and punctal eversion causing chronic epiphora, foreign body sensation, corneal injury, and, in the most severe cases, visual loss, particularly in the presence of comorbid corneal hypesthesia. Concerns over the ocular surface protection in FNP patients have led to the development of numerous static and dynamic procedures. While initial assessment of the FNP patients is complex and requires a comprehensive understanding of the blink reflex physiology, clinical evaluation and the use of additional work should be directed toward potential eye sphincter reanimation using a multidisciplinary approach. As with any treatment algorithm, numerous factors must be considered to provide an individualized treatment plan. In the case of FNP, it is important to consider denervation time, patient age, cause of paralysis, and neurologic severity of the paralysis. The aim of this article is to provide a thorough review of the physiology of the blink reflex, evaluation of the eye sphincter mechanism in FNP, and a comprehensive treatment algorithm incorporating static and dynamic procedures, along with a historical perspective.
The Tai Chi Flap
Authors: Cai Tingting , Chen Shuhong , Li Qunxing , Fang Zezhen , Cao Haotian , Xie Zhijun , Liu Niu , Li Yanyan , Ye Xiuhua , Li Jinsong , Fan Song 
Published: May 2022

ObjectiveTai Chi is an ancient philosophy used to explain the universe. The Tai Chi symbol is represented by Yin/Yang fishes. The authors describe a novel radial forearm flap (RFF) design for the reconstruction of circular defects based on the Tai Chi symbol.MethodsEleven consecutive patients with craniofacial skin or mucus defects underwent reconstruction with a Tai Chi RFF. Patient perioperative and follow-up information was collected.ResultsThe diameter of the Tai Chi RFF was 5 to 6 cm. All flaps healed uneventfully without ischemic problems, and all donor site defects were closed primarily without skin grafts. Remarkably, 2 patients received a tattoo to mark the Tai Chi symbol and greatly appreciate the shape of the flap.ConclusionsThe Tai Chi flap is an economically friendly flap design that can be used to prevent skin grafts while providing psychological comfort to patients.
Genetics, Clinical Presentation, Radiological Features, and Midterm Outcome of Closing Wedge Osteotomy in Children With Brachydactyly Type C
Authors: Al-Qattan Mohammad M. 
Published: May 2022

Background
Brachydactyly (BD) type C is a rare form of familial BD caused by GDF5 mutations. Some of the affected children have severe clinodactyly requiring surgery. The literature is limited to case reports.

Patients and Methods
The current retrospective study included 15 Saudi Arabian families with 42 affected children seen by the author for 25 years. A total of 23 digits (in 23 hands) underwent surgical correction of clinodactyly using a closing wedge osteotomy. The current study reports on the genetics, clinical presentation, radiological features, and midterm outcome of surgery.

Results
Genetic analysis was done in 6 families and confirmed the presence of 2 novel missense mutations (p.Met173Val in 3 families and p.Thr203Asn in 3 families) in the GDF5 gene. All cases in the study group demonstrated the classical clinical and radiographic features of BD type C. However, only 1 hand showed all the features of angel-shaped bony defect. The clinodactyly defect was mostly observed in the index or middle fingers. Surgery for the clinodactyly defect was only done if there was finger overlap. Closing wedge osteotomy was done in a total of 23 digits with a satisfactory outcome.

Conclusions
This study represents the largest reported series of children undergoing surgery for correction of BD type C clinodactyly with a uniform technique performed by a single surgeon. The closing wedge osteotomy used resulted in good midterm outcomes, although long-term follow-up is lacking.
GeneVector: Identification of transcriptional programs using dense vector representations defined by mutual information
Authors: Ceglia Nicholas , Sethna Zachary , Freeman Samuel S. , Uhlitz Florian , Bojilova Viktoria , Rusk Nicole , Burman Bharat , Chow Andrew , Salehi Sohrab , Kabeer Farhia , Aparicio Samuel , Greenbaum Benjamin , Shah Sohrab P. , McPherson Andrew 
Published: May 2022

AbstractDeciphering individual cell phenotypes from cell-specific transcriptional processes requires high dimensional single cell RNA sequencing. However, current dimensionality reduction methods aggregate sparse gene information across cells, without directly measuring the relationships that exist between genes. By performing dimensionality reduction with respect to gene co-expression, low-dimensional features can model these gene-specific relationships and leverage shared signal to overcome sparsity. We describe GeneVector, a scalable framework for dimensionality reduction implemented as a vector space model using mutual information between gene expression. Unlike other methods, including principal component analysis and variational autoencoders, GeneVector uses latent space arithmetic in a lower dimensional gene embedding to identify transcriptional programs and classify cell types. In this work, we show in four single cell RNA-seq datasets that GeneVector was able to capture phenotypespecific pathways, perform batch effect correction, interactively annotate cell types, and identify pathway variation with treatment over time.
Survival analysis of coronary care unit patients from MIMIC IV database
Authors: Lanzieri Pedro G. , Palmer Dayanna Q. , Gismondi Ronaldo A. , T. Baltar Valéria , Seixas Flavio L. 
Published: May 2022

AbstractThe profile of hospitalizations in coronary care units (CCU) includes patients with different age groups, multiple comorbidities and causes of hospitalization that may or may not be primarily cardiac. This study aimed to estimate survival time and evaluate the association and impact of different factors on this time in a cohort of patients admitted to CCU. A cohort of 7120 adult patients admitted to CCU was analyzed from a subset of data from the MIMIC-IV database (Medical Information Mart for Intensive Care, version 4). A descriptive analysis was performed using Kaplan-Meier survival analysis, with a Log-rank test to establish comparisons between groups. Survival regression was modeled using Cox’s proportional risk models for the multiple analysis. The p-value was defined as ¡ 0.05 as statistically significant. In patients who died during hospitalization, there was a higher average age, longer hospital stay, and a higher rate of heart and respiratory rate, all with p ¡ 0.001. Median overall survival was 28 days (95% CI 26-30 days). The survival probability curve presented a higher inclination in the first weeks, reaching a stable value close to 20% at 10 weeks after hospitalization. When Cox’s regression adjusted for age, gender and comorbidities was performed, hyperpotassemia was shown to be an independent risk factor for in-hospital mortality (RR = 1.22, 95% CI: 1.14-1.30) in this group of patients. These results reinforced that the electronic health record may contain, already in the first hours of hospitalization, relevant information to understand the progression of diseases and identify future directions for research. This study is expected to clarify important topics related to the MIMIC-IV database and enable further research using this patient database. Knowledge of the characteristics of the CCU population can allow better management of physical and human hospital resources.