bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Mysterious Role of Epidural Fat Tissue in Spine Surgery
Authors: Alonge Emmanuel O. , Guo Chaofeng , Wang Yuxiang , Zhang Hongqi 
Published: December 2021

Background:
Though both neurosurgeons and orthopedic spinal surgeons are keenly aware of the clinical importance of epidural fat (EF), surgical practice varies amongst individual surgeons and across both fields. Thus, an in-depth understanding of the anatomical structure and composition of EF is vital, as it will play a significant role in the therapeutic management and the surgical choice of treatment.

Objective:
We aim to extensively review the anatomical and biological properties of EF and further outline the surgical importance of EF management.

Study Methodology:
(i) MEDLINE search 1966–July 2019. Keywords: Review of the Literature. Authorship, Meta-analysis, Descriptive/Narrative overview; (ii) CINAHL search from 1982 to May 2019. Keywords: Review of the Literature spinal epidural fat; Authorship; Meta-analysis; Descriptive/Narrative overview; (iii) Hand searches of the references of retrieved literature; (iv) Personal and college libraries were searched for texts on research methods and literature reviews; and (v) 200 articles were downloaded, 50 were excluded because of similarity of topics and also because of new update on the same topics. (vi) Discussions with experts in the field of reviews of the literature.

Discussion:
Though excessive or reductive amounts of EF usually exacerbates neurological symptoms and lead to various pathologic conditions such as spinal epidural lipomatosis, but there is no basic science, experimental, or clinical research that proves the role of EF in the aforementioned pathologic situations.

Conclusion:
Anatomical illustration, biological function and properties of EF knowledge may lead to changes in the stages of the surgical approach to avoid postoperative complications. However, the role of EF is exclusively bound to a scientific hypothesis as one cannot be sure if an excessive or reductive amount in EF is entirely responsible for the pathologic findings, or just only an incidental finding.
Just-in-Time Continuing Education: Perceived and Unperceived, Pull and Push Taxonomy
Authors: Yilmaz Yusuf , Papanagnou Dimitrios , Fornari Alice , Chan Teresa M. 
Published: December 2021

Abstract
We live in a world where “just-in-time” (JiT) methodologies are increasingly used. Continuing professional development (CPD), including faculty development, has the opportunity to leverage online technologies in a JiT format to further support learner engagement and program sustainability. In this article, the authors propose a model that can serve as a taxonomy for defining and implementing JiT continuing education (JiTCE). The anatomy of JiTCE describes four mechanisms to address CPD needs and delivery procedures: perceived and unperceived, as well as pull and push (PUPP) taxonomy. JiTCE PUPP taxonomy defines four components for designing and developing a program with JiT: on-demand learning, subscription-based learning, performance feedback–driven learning, and data-driven learning. These methods, as backbones, use various online technologies, which offer fundamental support for JiTCE. Delivery systems and technologies are provided as specific examples for JiTCE throughout the article. JiTCE introduces a novel taxonomy to meet continuing education needs and provides an organized approach to design and deploy programming in a sustainable way. Online technologies are evolving everyday and are an indispensable part of both clinical practice and medical education. Pull–push and perceived–unperceived axes can help guide new opportunities for instructional designers and curriculum developers to leverage best practices to align with CPD offerings, which include cutting-edge technologies.
Professional Development Coaching for Health Professions Graduate Faculty: A Pilot Implementation
Authors: Pearce Michelle J. 
Published: December 2021

Introduction:
Organizations have offered executive coaching to their senior leaders for several decades and report improvement in performance, leadership, self-efficacy, and goal attainment. Despite this success, little research exists on coaching programs for faculty who may also benefit from this resource. We sought to develop, implement, and evaluate a professional development coaching program for diverse graduate faculty at a health professions university.

Methods:
We implemented a professional development coaching program to provide one-on-one support for interested faculty. Faculty were offered four 1-hour or eight half-hour sessions each academic semester by eight trained volunteer coaches unaffiliated with the university. We had 67 faculty members participate across the academic year. They were asked to complete a brief impact survey at the end of each semester.

Results:
The coaches provided 378 sessions, totaling 281 hours of coaching. Survey results revealed that coaching was effective in helping faculty achieve their professional goals and empowered them for future professional success. Faculty were highly satisfied with the program.

Discussion:
There is early evidence that professional development coaching can help faculty reach their professional goals and add value to an institution. The program may be a helpful model for developing and implementing coaching programs on other campuses.
In Vivo Reflectance Confocal Microscopy of Adnexal Tumors: Evaluation of Trichoepithelioma, Sebaceoma, and Fibrofolliculoma
Authors: Rosales-Duran Sharon , Ricaurte-Jiménez Marcela , Ferreira Paula S. , Sangueza Martin , Lourenço Silvia V. , Nico Marcello M. S. 
Published: December 2021

Abstract:
Cutaneous adnexal tumors are benign and malignant neoplasms that undergo morphological differentiation into cutaneous adnexa, comprising pilosebaceous, eccrine, or apocrine units. Reflectance confocal microscopy is a noninvasive diagnostic method that enables in vivo visualization of tissues at a similar resolution as conventional histopathology. The use of this method in skin imaging over the past several years has improved dermatological diagnoses, potentiating its wide application, especially for benign and malignant skin tumors. We describe the use of reflectance confocal microscopy in cases of trichoepithelioma, sebaceoma, and fibrofolliculoma and correlate the resulting clinical, histopathological, and confocal microscopy images.
Primary Cutaneous Anaplastic Large Cell Lymphoma With 6p25.3 Rearrangement and Epidermotropism
Authors: Dutra Eduardo , Maia Tiago , Cabeçadas José 
Published: December 2021

Abstract:
Primary cutaneous anaplastic large cell lymphoma may harbor a 6p25.3 rearrangement, which has been associated with an epidermotropic small cell component. We report the case of a patient with said lymphoma harboring that rearrangement. It presented as a forehead nodule, histologically composed of an intermediate-to-large cell dermal component alongside a small-to-intermediate cell epidermotropic component. After multiple cutaneous and regional lymph node relapses, disease progression has been documented to a distant lymph node, despite local radiotherapy of the cutaneous lesions, chemotherapy, and anti-CD30 therapy, albeit with an indolent course over 6 years. Cases of pcALCL with nonregional lymph node involvement are unusual. Nevertheless, in this case, progression to a distant lymph node was not associated with an aggressive transformation of the disease.
Follicular Melanocytes in Frontal Fibrosing Alopecia: An Immunohistochemical Study With Trichoscopic Correlation
Authors: Salas-Callo Corina Isabel , Carvalho Quintella Danielle , Saceda-Corralo David , Pirmez Rodrigo 
Published: December 2021

Background:
Frontal fibrosing alopecia (FFA) is a scarring alopecia that affects the frontotemporal hairline. Clinically, it may develop with cutaneous hypopigmentation of the affected areas, which has been associated with a reduction in the epidermal melanocyte count. In trichoscopy, peripilar white halos can be observed, which have been associated with fibrosis in other scarring alopecias.

Objective:
To evaluate the trichoscopic, histopathological and immunohistochemical characteristics of the peripilar white halos in FFA patients.

Materials and methods:
We conducted a descriptive cross-sectional study that included 12 patients with FFA presenting peripilar white halos. Two 2-mm punch trichoscopy-guided biopsies were performed in all patients, one fragment for vertical section and another for horizontal section. The vertical sections were stained with Fontana-Mason and Melan-A.

Results:
On trichoscopic examination, peripilar white halos ≤ 1 mm in size were observed on the affected scalp. In vertical sections, a reduction in basal melanin pigmentation and a decrease in the melanocyte count in the upper segment of the hair follicle were observed with Fontana-Masson staining and Melan-A immunostaining, respectively.

Limitations:
The small sample size and absence of a control group.

Conclusion:
This study shows follicular melanocyte involvement in FFA, and this finding may be associated with the peripilar white halos observed in trichoscopy.
Local Tumor Infiltration and Locoregional Recurrence in Desmoplastic Cutaneous Squamous Cell Carcinoma
Authors: Kofler Katrin , Breuninger Helmut , Eigentler Thomas , Kofler Lukas , Schaefer Viola , Blumenstock Gunnar , Häfner Hans-Martin , Schnabl Saskia Maria 
Published: December 2021

BACKGROUND
Perusal of the literature of cutaneous squamous cell carcinoma (SCC) reveals that the role of the desmoplastic subtype is indistinct. Data on local infiltration and recurrence are inconsistent dependent on surgical technique, histological method, and investigated collective.

OBJECTIVE
The aim of the study was to analyze local infiltration and locoregional recurrence of the desmoplastic subtype under a uniform procedure.

METHODS AND MATERIALS
Between 2005 and 2015, 320 SCCs were analyzed and histological sections of all tumors were examined. Data collection included locoregional recurrence, metastasis rate, and tumor-specific death. The median follow-up was 36.5 months.

RESULTS
The desmoplastic subtype required significant more re-excisions (70.0% vs 23.9%, p < .001), more interventions until tumor-free margins were achieved (maximal 6 vs 2; p < .001), showed more widespread tumor infiltration with larger excisional margins (median 9 mm, 2–51 mm vs median 4 mm, 1–10 mm; p < .001), and a 5-fold higher local recurrence rate (26.7% vs 5.0%, p < .001). The metastasis rate (16.6% vs 2.3%, p < .001) was increased.

CONCLUSION
The desmoplastic subtype is characterized by a widespread local infiltration associated with perineural infiltration. It seems to be a marker for decreased histological detectability with a high rate of locoregional recurrence and metastasis.
Compensatory Considerations for Radiological Emergency Response and Public Protective Actions during the COVID-19 Pandemic
Authors: Leek Angela E. , Semancik Jeffrey D. 
Published: December 2021

Abstract
Epidemiological evidence and models have demonstrated that the current COVID-19 pandemic introduces a significant public risk to implementing large-scale community evacuations in response to disasters. While guidance documented in the US Environmental Protection Agency Protective Action Guidance (PAG) Manual is widely accepted as the standard basis for public and emergency worker protective actions for a radiological emergency, it is based primarily on assessing the risks associated with the radiological factors alone. However, as demonstrated in response to the nuclear incident in Fukushima, these events seldom occur in isolation from other risk-inducing events. Today, the COVID-19 pandemic represents a significant public health risk that must also be considered alongside the radiation risks in determining appropriate public and emergency worker protection action decisions. In particular, the significant public health risks associated with community transmission and mortality of COVID-19 challenge our most familiar and rehearsed radiological response strategies. The 1992 and 2017 US Environmental Protection Agency PAG manuals allow for considerations in protective action decision making. Much of the radiation emergency response community has been conditioned through decades of structured training and exercises to focus public protection considerations on specific guidelines referenced numerically in tables within the manual. Discussion regarding adjustment of specific PAG values is provided in the footnotes and bases portions of the PAG manual but is often not included in jurisdictional plans or routinely considered in exercises. However, when properly applied, the protective action guidance provides the necessary flexibility for decision-makers to account for additional public health risks or impediments, and jurisdictions can use this guidance to build a more effective response strategy. The authors have applied the full guidance and flexibility provided in the 2017 US Environmental Protection Agency PAG Manual to develop more specific guidance for their respective jurisdictions’ radiation emergency response plans and will outline a process for consideration of protective action decisions to maximize the protection of public health and safety.
SEED: An Operational Numerical Tool for Dosimetric Reconstruction in Case of External Radiological Overexposure
Authors: Entine F. , Garnier G. , Dondey M. , Rizzi Y. , Gobert A. , Bassinet C. , Papin S. , Pennacino I. , Cazoulat A. , Amabile J.C. , Huet C. 
Published: December 2021

Abstract
In the event of a radiological accident involving external exposure of one or more victims and potential high doses, it is essential to know the dose distribution within the body in order to sort the victims according to the severity of the irradiation and then to take them to the most suitable medical facilities. However, there are currently few techniques that can be rapidly deployed on field and capable of characterizing an irradiation. Therefore, a numerical simulation tool has been designed. It can be implemented by a doctor/physicist pairing, projected within a limited time as close as possible to the irradiation accident and emergency response teams. Called SEED (Simulation of External Exposures & Dosimetry), this tool (dedicated to dose reconstruction in case of external exposure) allows a rapid modeling of the irradiation scene and a visual exchange with the victims and witnesses of the event. The user can navigate in three dimensions in the accident scene thanks to a graphical user interface including a “first person” camera. To validate the performance of the SEED tool, two dosimetric benchmarking exercises were performed. The first consisted in comparing the dose value provided by SEED to that given by a reference calculation code: MCNPX. The purpose of the second validation was to perform an experiment irradiating a physical dummy equipped with dosimeters and to reconstruct this irradiation using SEED. These two validation protocols have shown satisfactory results with mean difference less than 2% and 12% for the first and second exercises, respectively. They confirm that this new tool is able to provide useful information to medical teams in charge of dosimetric triage in case of a major external exposure event.
Why don't all nurse practitioners precept? A comparative study
Authors: DeClerk Leonie , Lefler Leanne , Nagel Corey , Mitchell Anita , Rojo Martha , Sparbel Kathleen 
Published: December 2021

ABSTRACT

Background:
Preceptors are integral in nurse practitioner (NP) education. A shortage of willing preceptors limits graduations from NP programs. However, little is known about why NPs decide not to precept.

Purpose:
To identify the factors significantly associated with NPs' status as currently, previously, or never precepting, using the Integrated Behavioral Model as the conceptual framework.

Methodology:
This was a cross-sectional, comparative, descriptive study of NPs using survey methodology. Our survey was based on published surveys with items added and adapted to reflect our framework. Subscales included personal factors, primary determinants of intent to precept, and external factors. We mailed recruitment postcards, with an online survey link, to all NPs in Arkansas. Data were analyzed using bivariate and stepwise multinomial logistic regression for each subscale.

Results:
We obtained 261 responses. Participants who had previously and/or never precepted differed from current preceptors on multiple variables on bivariate analysis. Predictive personal factors included experience and hours worked per week. Predictive primary determinants included knowing NPs that precept, support for precepting, recognition of preceptors, and clinical expertise. Predictive external factors included space, liability, having a “gatekeeper,” NP program, importance of precepting, and number of requests.

Conclusions:
Different factors predict NPs who currently, previously, and have never precepted. However, frequency of requests predicted both nonprecepting groups. Various supports in the clinical setting and program factors predicted one or other nonprecepting group.

Implications:
Strategies should be developed to ensure all potential preceptors are recruited, increase support for precepting, and ensure educational programs meet preceptors' needs.
Nutritional therapy in critically ill patients with diabetes
Authors: Doola Ra’eesa , Preiser Jean-Charles 
Published: December 2021

Purpose of review
There has been a significant increase in nutrition therapy related studies within the critical care cohort in recent years. Management of patients with both diabetes and stress hyperglycaemia through targeted nutrition interventions is no exception. The aim of this review is to outline current available diabetes specific nutrition formula, its impact on gastric emptying and subsequently glycaemic control as well as explore recent literature on the efficacy of utilizing nutrition support to optimize glycaemic control in critically ill patients.

Recent findings
Studies explored within this review were similar in terms of outcomes measures, focusing primarily on insulin use and glycaemic control. Although there were promising results in terms of the impact of diabetes-specific nutrition formula on these outcome measures, there were no significant associations with clinical outcomes.

Summary
The use of diabetes-specific formulae in critically ill patients with pre-existing diabetes and stress hyperglycaemia can be considered a logical approach to minimize the risks associated with high doses of insulin. Additional research is required to address the effects of these formulae on the dysglycaemia, nursing workload, safety of glycaemic control and cost-effectiveness.
Safety of breast/chest-feeding by those infected by SARS-CoV-2
Authors: Powell Rebecca L.R. 
Published: December 2021

Purpose of review
One important question from the outset of the pandemic has been whether a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected person's milk might be a vehicle for SARS-CoV-2 transmission. This review summarizes the most recent data on this topic.

Recent findings
A SARS-CoV-2 sIgA response in milk after infection is very common. To date, there has been no evidence that SARS-CoV-2 transmits via human milk. Though viral RNA has been identified in a minority of milk samples studied, infectious virus particles have not.

Summary
The highly dominant transmission route for SARS-CoV-2 is via inhalation of respiratory droplets containing virus particles. Other routes of transmission are possible, including fecal–oral, trans-placental, and to a much lesser extent, via a contaminated surface. SARS-CoV-2 cannot transmit via human milk. There is no evidence that infants should be separated from SARS-CoV-2-infected mothers who are well enough to establish or continue breastfeeding.
Renal allograft-related inflammation complicated by acute coronary syndromes
Authors: Pliquett Rainer U. , Tannapfel Andrea , Daneschnejad Sait S. 
Published: December 2021

Abstract

Introduction:
Persistent systemic inflammation is considered to be predictive for future cardiovascular events. Here, in a patient with pyelonephritis of his failed renal allograft, consecutive coronary angiograms proved that coronary artery disease progressed within 3 weeks, when infection was uncontrolled.

Patient concerns:
A 52-year-old male type 2 diabetic with a failed renal allograft suffering from hematuria, leukocyturia, and chest pain at rest was hospitalized.

Diagnoses:
An acute coronary syndrome in presence of pyelonephritis was diagnosed. Besides pyelonephritis, the histological examination of the kidney transplant revealed signs of chronic rejection and the presence of a renal cell carcinoma in situ.

Interventions:
A percutaneous coronary intervention was performed, and an elective surgery for allograft removal was scheduled. However, within 5 weeks after discharge, two more surges of infection coincided with episodes of unstable angina.

Outcomes:
Once the renal allograft has been removed, systemic inflammation was contained. The patient was not re-hospitalized for acute-coronary syndrome within the next 12 months.

Conclusion:
Surges of systemic inflammation due to infection were paralleled by instability of coronary plaques as documented by repeat coronary angiograms.
The efficacy of dexmedetomidine for the prevention of catheter-related bladder discomfort
Authors: Lu Jia , Yang Xiamin , Zhang Jie , Huang Yuelong 
Published: December 2021

Abstract

Background:
The effective therapy to reduce postoperative catheter-related bladder discomfort (CRBD) remained unknown.

Objective:
We attempted to manage the systematic review and a meta-analysis to clarify the efficacy of dexmedetomidine (DEX) in potential prevention on CRBD.

Methods:
We performed the meta-analysis on randomized clinical trials (RCTs), and searched the databases from Web of Sciences, Embase and referred Cochrane Library published from October 2016 to September 2020. Data extraction was carefully conducted by 2 authors, respectively. Meta-analysis that was applied synthetically concerns the incidence and severity of CRBD and the treatment effect of DEX on CRBD.

Results:
We acquired 5 RCTs with interventions of DEX on CRBD. Meta-analysis showed DEX has significantly reduced the incidence and severity of CRBD compared with control at 0 hour (risk ratios [RR] = 0.40, 95% CI = 0.53–0.29, P < .01), 1 hour (RR = 0.44, 95% CI = 0.34–0.57, P < .01), and 2 hours (RR = 0.43, 95% CI = 0.32–0.58, P < .01) and 6 hours (RR = 0.43, 95% CI = 0.29–0.63, P < .01). DEX was also associated with lower incidence of moderate to severe CRBD at 0, 1, and 6 hours after surgery. There were no significant differences in adverse events other than bradycardia, hypotension, and hypertension.

Conclusion:
The 5 RCTs showed great effectiveness in reducing the incidence and severity of the early and later postoperative CRBD. Meta-analysis showed that DEX interventions were useful in preventing the early and later postoperative CRBD without significant side effects.