bluuebunny/crossref_metadata_2025_split huggingface dataset:
Syphilitic Folliculitis: A Case Report With Demonstration of Spirochetes Showing Follicular Epitheliotropism
Authors: Isler Madeleine F. , Hoskins Sidney , Esparza Edward M. , Ruhoy Steven M. 
Published: August 2022

Abstract:
We report a case of a 59-year-old man presenting with a widespread follicular-based papular rash with a several-month history of myalgias, lymphadenopathy, fatigue, and weight loss who was diagnosed with acute syphilitic folliculitis by tissue biopsy analysis with immunohistochemical demonstration of spirochetes in hair follicle epithelium. Serologic analysis also showed evidence of Treponema sp. infection. Owing to the rising number of syphilis cases in the last decade, it is important to recognize classic cutaneous findings of syphilis in addition to unusual presentations such as syphilitic folliculitis.
Trichorhinophalangeal Syndrome Type 1–Positive Cells in Breast Dermal Granulation Tissues and Scars: A Potential Diagnostic Pitfall
Authors: Cho Woo Cheal , Nagarajan Priyadharsini , Ding Qingqing , Prieto Victor G. , Torres-Cabala Carlos A. 
Published: August 2022

Abstract:
Trichorhinophalangeal syndrome type 1 (TRPS1) immunohistochemistry has been gaining popularity in recent years in the field of surgical pathology for its utility as a highly sensitive and specific marker for breast carcinomas, including those with triple-negative phenotype. More recent data suggest TRPS1 may also prove its utility in the diagnosis of mesenchymal tumors arising in the breast parenchyma, including malignant phyllodes tumors and primary chondrosarcomas and osteosarcomas of the breast. However, little is known about TRPS1 expression in nontumor cells, such as stromal fibroblasts/myofibroblasts of dermal granulation tissues and scars. Here, we describe our unique experience with TRPS1-positive cells, morphologically consistent with reactive fibroblasts/myofibroblasts, seen in dermal granulation tissues and scars from breast skin specimens of a 51-year-old woman with a history of bilateral invasive ductal carcinomas of the breast, status after bilateral total mastectomy and chemoradiation, who presented with nonhealing wounds on the chests. To the best of our knowledge, this is the first reported case of strong TRPS1 expression in dermal granulation tissue/scar. As the usage of TRPS1 immunohistochemistry in routine clinical practice, including in the field of dermatopathology, will likely increase over time, awareness of this potential diagnostic pitfall is important to avoid overinterpretation of the findings.
Microsecretory Adenocarcinoma of the Ear Canal: Novel Cutaneous Analog of a Salivary Gland Neoplasm
Authors: Chan May P. , Flack Allen B. , Grisel Jedidiah J. , Harms Paul W. , McHugh Jonathan B. 
Published: August 2022

Abstract:
Microsecretory adenocarcinoma (MSA) of the salivary gland is a new entity recently added to the World Health Organization Classification of Head and Neck Tumors. This tumor is characterized by a recurrent MEF2C-SS18 translocation. We present a nodular tumor confined to the dermis of the ear canal of a 44-year-old patient, which demonstrated classic histopathologic features and molecular alteration of MSA. Specifically, the tumor was composed of numerous tubules and microcysts filled with abundant basophilic mucinous secretion and associated with a fibromyxoid stroma. The tumor cells were diffusely positive for CK7 and SOX10 and variably positive for S100 and p63. Breakapart fluorescence in situ hybridization for SS18 confirmed rearrangement of this gene. Together, these findings support a primary cutaneous MSA, presumably arising from ceruminous glands of the ear canal. Based on current knowledge of its salivary gland counterpart, cutaneous MSA is expected to be locally invasive but unlikely to recur or metastasize on complete excision.
ENDOGENOUS FUNGAL ENDOPHTHALMITIS AFTER COVID-19 INFECTION: CASE REPORT AND REVIEW OF LITERATURE
Authors: Zaslavsky Kirill , Grewal Parampal S. , Cruz-Pimentel Miguel , Qian Jenny , Derzko-Dzulynsky Larissa , Yan Peng 
Published: August 2022

Purpose:
The purpose of this study was to describe a case of endogenous endophthalmitis (EE) after severe COVID-19 disease, review patient outcomes with EE after COVID-19 infection, and review evidence regarding risk factors for developing EE.

Methods:
This is a review of health records, imaging, intravitreal injection, and pars plana vitrectomy for bilateral fungal EE after severe COVID-19 disease, and is a literature review on outcomes in EE after COVID-19 disease.

Results:
Sixty-three year-old man with diabetes and hypertension was admitted to hospital for severe COVID-19 disease for 3 months. His stay required intensive care unit admission, intubation, high-dose corticosteroids, tocilizumab, and was complicated by bacteremia, empyema, and fungal esophagitis. He developed floaters and bilateral vision loss (visual acuity 20/40 in the right eye, counting fingers in the left eye) with vitritis 2.5 months into his stay that did not respond to intravitreal voriconazole. Pars plana vitrectomy was performed for both eyes, resulting in visual acuity of 20/40 in the right eye, 20/30 in the left eye. Vitreous cultures were positive for Candida albicans. Endogenous endophthalmitis after COVID-19 disease has been reported in 22 patients to date, and outcomes are poor, with 40%+ of eyes legally blind (20/200 or worse). Although influenced by availability of imaging modalities and degree of training of the evaluating physician, misdiagnosis can affect ¼ of cases, delaying treatment. Age, male sex, and diabetes increase the risk of severe COVID-19, which requires prolonged hospitalization, invasive catheterization, and immunosuppression, which in turn increases the risk of nosocomial infection.

Conclusion:
Low threshold for suspecting EE in patients presenting with floaters and decreased vision after severe COVID-19 disease is necessary to ensure prompt recognition and treatment.
Prevaccine Human Papillomavirus Status in Invasive and Intraepithelial Lesions of the Vulva in New Zealand Women
Authors: Bigby Susan M. , Eva Lois J. , Tous Sara , de Sanjosé Silvia , Bosch Xavier , Alemany Laia , Chang Kevin C.T. , Jones Ronald W. 
Published: August 2022

Objective
The human papillomavirus (HPV) vaccine, introduced in New Zealand (NZ) in 2008, is predicted to substantially lower the incidence of HPV-associated precancers and cancers. The aim of this study is to estimate the proportion of vulvar intraepithelial neoplasia (VIN) lesions and invasive vulvar squamous cell carcinomas (SCCV) attributable to HPV in NZ women treated by the Auckland Regional Gynecological Oncology Service, covering an estimated 50% of the NZ population.

Materials and Methods
Polymerase chain reaction and reverse hybridization were used to analyze retrospective histologically proven SCCV from 1990 to 2007 and VIN lesions from 2000 to 2007 for HPV content and genotype in a collaborative study with the Catalan Institute of Oncology. Immunohistochemistry for p16INK4a was performed on SCCV, which were attributed to HPV if both tested positive.

Results
Polymerase chain reaction testing for HPV content and genotype was performed on 66 VIN lesions (all high-grade squamous intraepithelial lesions) and 189 SCCV. In addition, p16 immunohistochemistry was performed on 168 of the 189 SCCV (88.9%) tested for HPV-DNA. Overall, 61 SCCV cases (36.3%) were attributed to HPV (HPV+/p16+), and 89 SCCV cases (53%) were considered to have developed independently of HPV (HPV−/p16−). Known high-risk HPV genotypes were present in 96.8% of HPV-DNA–positive vulvar high-grade squamous intraepithelial lesions and 98.4% of HPV-attributable SCCV. Human papillomavirus 16 represented the most common genotype in both.

Conclusions
Overall, the HPV vaccine is likely to substantially alter the profile of SCCV in our region. The results provide a baseline assessment of the HPV status of vulvar neoplasia before the introduction of the HPV vaccine.
Development and Validation of a Novel 1-year Mortality Risk Score That Includes the Use of Antithrombotic in Patients With Overt Gastrointestinal Bleeding
Authors: Nammour Tarek , El Jamal Lara , Hosni Mohammad N. , Tamim Hani , Kerbage Anthony , Hashash Jana G. , Shaib Yasser H. , Daniel Fady , Francis Fadi , Mourad Fadi H. , Soweid Assaad , Sharara Ala I. , Makki Maha , Rockey Don C. , Barada Kassem 
Published: August 2022

Goals and Background:
We aimed to develop a novel 1-year mortality risk-scoring system that includes use of antithrombotic (AT) drugs and to validate it against other scoring systems in patients with acute gastrointestinal bleeding (GIB).

Study:
We developed a risk-scoring system from prospectively collected data on patients admitted with GIB between January 2013 and August 2020, who had at least 1- year of follow-up. Independent predictors of 1-year mortality were determined after adjusting for the following confounders: the age-adjusted Charlson Comorbidity Index (CCI) (divided into 4 groups: CCI-0=0, CCI-1=1 to 3, CCI-2=4 to 6, CCI-3 ≥7), need for blood transfusion, GIB severity, need for endoscopic therapy, and type of AT. The risk score was based on independent predictors.

Results:
Five hundred seventy-six patients were included and 123 (21%) died at 1-year follow-up. Our risk -score was based on the following: CCI-2 (2 points), CCI-3 (4 points), need for blood transfusion (1 point), and no use of aspirin (1 point), as aspirin use was protective (maximum score=6). Patients with higher risk scores had higher mortality. The model had a better predictive accuracy [AUC=0.82, 95% confidence interval (0.78-0.86), P<0.0001] than the Rockall score for upper GIB (Area Under the Curve (AUC)=0.68, P<<0.0001), the Oakland score for lower GIB (AUC=0.69, p=0.004), or the Shock Index for all (AUC=0.54, P<0.0001).

Conclusion:
A simple and novel score that includes use of AT upon admission accurately predicts 1-year mortality in patients with GIB. This scoring system may help guide follow-up decisions and inform the prognosis of patients with GIB.
Global Burden of Nonalcoholic Fatty Liver Disease, 1990 to 2019
Authors: Jiang Wei , Mao Xianhua , Liu Zhenqiu , Zhang Tiejun , Jin Li , Chen Xingdong 
Published: August 2022

Background:
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver diseases worldwide. We provided a comprehensive description regarding the disease burden of NAFLD in 204 countries and territories.

Materials and Methods:
We reported the deaths and disability-adjusted life years (DALYs) related to NAFLD in the Global Burden of Disease database by sex, age, specific causes, and regions. Estimated annual percentage change was applied to describe the changing trends.

Results:
Globally, the NAFLD-related deaths and DALYs in 2019 were 0.17 million [95% uncertainty interval (UI): 0.13 to 0.21] and 4.42 million (95% UI: 3.35 to 5.67), increased by 80.2% and 62.9% compared with 1990, respectively. The overall age-standardized rate of mortality and DALYs (ASMR and ASDR) showed a downward trend from 1990 to 2019, the estimated annual percentage change were −0.67 (95% confidence interval: −0.76, −0.57) and −0.82 (95% confidence interval: −0.93, −0.7), respectively. NAFLD-related deaths due to cirrhosis and liver cancer increased by 76.7% and 95.1% between 1990 and 2019. The ASMR and ASDR were the highest in the middle and low sociodemographical index regions in 2019, respectively. Of the 21 Global Burden of Disease regions, Eastern Europe, Central Asia, High-income North America, and Australasia experienced an increase in both ASMR and ASDR.

Conclusions:
NAFLD imposes heavy disease burden on humankind worldwide, especially in countries with low-to-middle sociodemographical index level. More potent measures are urgently needed in regions with rising age-standardized rate to forestall the increase of NAFLD disease burden.
Psychosocial Exoskeletons
Authors: Yager Joel 
Published: August 2022

Abstract
In medical therapeutics, exoskeleton refers to external protections, supports, and appliances. By analogy, psychosocial exoskeletons can be envisioned as assistive psychological and social structures that brace and extend individuals' coping abilities. This article considers the utility of defining “psychosocial exoskeletons” as a framework to encompass psychological and social devices that enhance coping, and “therapeutic psychosocial exoskeletons” as devices assisting psychiatric treatment. Clinical observations were augmented via selective narrative review using PubMed and PsychInfo.
A range of psychological and social devices were identified that constitute psychosocial exoskeletons. In extremes, psychosocial exoskeletons may prescribe comprehensive lifestyles including dress, rites, taboos, and acceptable relationships. These devices may enhance normal or psychopathological development.
Therapeutic psychosocial exoskeletons consist of intentionally prescribed psychotherapeutic and sociotherapeutic interventions assembled to address patient-centered problems. Elements may include counseling and psychotherapies, peer-based recovery programs, institutional programs, and social interventions involving financial assistance, supported employment, pets, and other practical resources.
Enhancing DNP Project Success
Authors: Bradley Callie , Boykin Allison , Kilmer Michele 
Published: August 2022

Background:
The Doctor of Nursing Practice (DNP) project is the culmination of DNP education, serving as evidence of knowledge preparation and skill achievement in translating evidence into practice.

Problem:
Review of sample DNP projects from 2015 to 2019 revealed that multiple projects had fatal flaws in the Methods and Evaluation sections, rendering the resulting DNP project with diminished value.

Approach:
We established a collaborative relationship with an educational statistics program and associated consulting center to develop and integrate statistical resources directly into the planning and evaluating stages of the DNP project process. The pilot program included workshops and individual consulting sessions provided to the student aimed at reducing fatal flaws and improving research design and evaluation analyses.

Outcomes:
Initial and follow-up surveys were adapted from the Course Experience Questionnaire to assess student satisfaction and perceived knowledge gains. Project rigor and value were assessed using the DNP-Project Critical Appraisal Tool (PCAT).

Conclusions:
The pilot program showed a decrease in the number of fatal flaws and an increase in PCAT scores on the targeted Design and Evaluation sections.
Get2PrEP: An Electronic Medical Record Laboratory Comment Increased Safe Sex Counseling But Not Preexposure Prophylaxis Services at a Large Urban Academic Medical Center in Northern Manhattan
Authors: Spicehandler Rebecca , Zucker Jason , Yumori Caitlin , Adan Matthew , Carnevale Caroline , Theodore Deborah , Castor Delivette , Meyers Kathrine , Whittier Susan , Yin Michael T. , Cohall Alwyn , Olender Susan , Gordon Peter , Sobieszczyk Magdalena E. 
Published: August 2022

Background
HIV preexposure prophylaxis (PrEP) remains underutilized despite its efficacy and potential population impact. Achieving PrEP's full potential depends on providers who are knowledgeable and comfortable prescribing it to individuals at risk of acquiring HIV. Previous educational interventions targeting provider-related uptake barriers have had limited success. We designed and tested an electronic medical record (EMR) interpretative comment to improve the delivery of PrEP.

Methods
An EMR comment provided information on PrEP eligibility and referral resources to providers delivering positive chlamydia and gonorrhea results. Positive test results for bacterial sexually transmitted infections before intervention (January 1, 2019–August 23, 2019) and after intervention (August 24, 2019–December 31, 2019) were identified. A retrospective chart review was conducted to ascertain provider documentation of PrEP discussions or provision, HIV prevention discussions, and HIV screening. Pretest-posttest analysis was performed to compare the provision of PrEP and HIV prevention services.

Results
We reviewed 856 preintervention encounters spanning 8 months and 461 postencounters spanning 4 months. Patient demographics were comparable. We observed an increase in provider documentation of safe sex and condom counseling (odds ratios [ORs], 1.2 [95% confidence interval {CI}, 1.07–1.18] and 1.11 [95% CI, 1.05–1.17], respectively), and the absence of any HIV prevention discussion decreased (OR, 0.85; 95% CI, 0.80–0.90), but not HIV screening or PrEP documentation.

Conclusions
We demonstrated that an EMR laboratory comment had a modest effect on increasing risk reduction counseling, although not HIV screening or PrEP prescriptions. Future strategies to encourage provider delivery of sexual health services may benefit from more targeted strategies that combine behavioral and information technology approaches.
Advancing Sexual Harassment Prevention and Elimination in the Sciences: “Every sexual health organization must do something similar.”
Authors: Jennings Jacky M. , Grieb Suzanne M. , Rietmeijer Cornelis , Gaydos Charlotte A. , Hawkins Rima , Thurston Rebecca C. , Blanchard James , Cameron Caroline E. , Lewis David A. 
Published: August 2022

Introduction
Sexual harassment is pervasive in science. A 2018 report found that the prevalence of sexual harassment in academia in the U.S. is 58%. An activity held at an international scientific congress was designed to advance sexual harassment prevention and elimination and empower binary and non-binary persons at risk for harassment, discrimination, and violence. The objective is to describe the activity and outcomes to provide a promising model for other scientific communities.

Methods
A description of the plenary and key components as well as the data collection and analysis of selected outcomes are provided.

Results
Among 1,338 congress participants from 61 countries, 526 (39%) attended the #MeToo plenary and the majority engaged in some way during the plenary session. Engagement included standing for the pledge (~85%), participating in the question and answer session (n = 5), seeking counseling (n = 3), and/or providing written post-it comments (n = 96). Respondents to a post-congress survey (N = 388, 24% of all attendees) ranked the plenary as number one among 14 congressional plenaries. In post-analysis, the written post-it comments were sorted into 14 themes within 6 domains including: (1) emotional responses, (2) barriers to speaking out, (3) public health priorities, (4) reframing narratives about the issue, (5) allyship, and (6) moving the issue forward.

Conclusions
Scientific organizations, agencies, and institutions have an important role to play in setting norms and changing enabling policies towards a zero-tolerance culture of sexual harassment. The activity presented offers a promising model for scientific communities with similar goals. The outcomes suggest that the plenary successfully engaged participants and had a measurable impact on the participants.
Current Estimate of Hearing Aid Utilization in the United States
Authors: Nassiri Ashley M. , Ricketts Todd A. , Carlson Matthew L. 
Published: August 2022

Objective:
To present key data from a private marketing report that characterizes US hearing aid (HA) utilization, HA candidate and user population sizes, and HA pricing.

Patients:
HA candidates and users in the United States.

Interventions:
Hearing amplification.

Main Outcome Measures:
HA utilization, HA candidate and user population sizes, HA market size and value, and HA pricing.

Results:
In 2015, an estimated 8.5 million HA users accounted for a total of 15.4 million individual HA devices in the United States. Approximately 81% of HA users owned bilateral devices. In 2015, approximately 87% of devices were purchased as replacements by current HA users, while the remaining 13% of devices were purchased by new HA users. HA utilization rates among the candidate population approximated 21% in 2015, which was stable over the 3-year study period. In 2015, there was a net increase of 696,060 individuals who met HA candidacy criteria but did not undergo treatment with HAs, adding to the backlog of 31.0 million untreated HA candidates who existed before that year. The HA market was valued at $6.0 billion in 2015, with an average retail selling price of $1798 per device ($3596 per pair). In the same year, the average manufacturer selling price was $495 per device ($990 per pair), or nearly 1 quarter of the retail price.

Conclusions:
HAs are substantially under-utilized in the United States with an annually growing backlog of untreated HA candidates.
Augmented Reality Microscopy in the Management of Cerebellopontine Lesions and Microvascular Decompression: A Pilot Study
Authors: Kashat Lawrence , Parikh Purven , Rahman Khalil , Ryan Tessa , Lafreniere Denis , Bulsara Ketan R. , Roberts Daniel S. 
Published: August 2022

Objective:
To evaluate whether augmented reality microscopy surgical fluorescence technology, already Food and Drug Administration approved for vascular neurosurgery, can aid in lateral skull base surgery during cerebellopontine (CPA) tumor resection and microvascular decompression.

Study Design:
Pilot prospective uncontrolled observational cohort study.

Setting:
An academic tertiary care hospital.

Patients:
Those who underwent retrosigmoid craniotomy for CPA tumor resection or microvascular decompression for hemifacial spasm, trigeminal neuralgia or pulsatile tinnitus. 11 patients were recruited: 4 underwent CPA tumor resection and 7 underwent microvascular decompression.

Interventions:
Augmented reality microscopy with fluorescence imaging was utilized to visualize vascular flow intraoperatively. A postoperative surgeon questionnaire was administered to assess the intraoperative efficacy of this technology.

Main Outcome Measures:
Efficacy of technology in aiding with CPA tumor resection and microvascular decompression.

Results:
For all 7 microvascular decompression cases, surgeons agreed that the technology aided in identifying areas where disease was affecting tissues with no cases of vascular occlusion identified. In 3 of the 4 CPA tumor resection cases, surgeons agreed that the technology identified areas of vascular flow within the CPA and the tumor. Vascular patency of the sigmoid-transverse sinus was also confirmed. No significant adverse effects were noted except 1 instance of severe-to-profound sensorineural hearing loss.

Conclusions:
Our study shows that the augmented reality fluorescence technology works during lateral skull base surgery as it can confirm intraoperative vascular integrity. Our data also suggest that this technology may improve visualization of ambiguous vasculature and blood flow to diseased tissue.
New-onset myasthenia gravis confirmed by electrodiagnostic studies after a third dose of SARS-CoV-2 mRNA-1273 vaccine: a case report
Authors: Slavin Eileen , Fitzig Jeremy , Neubert Colleen , Garcia-Lopez Francisco , Cuevas-Trisan Ramon 
Published: August 2022

Abstract
COVID-19 vaccine-related pathology is a rare occurrence with few reported cases. We report on a case of a 60-year-old man experiencing symptoms of dysphagia, dysarthria, diplopia, and weakness with onset six days after receiving a third full dose of SARS-CoV-2 vaccine (mRNA-1273 vaccine) in August 2021, which he received outside of the CDC recommended guidelines, at four months after his second dose of the Moderna vaccination course in March 2021. FDA Emergency Use Authorization for mRNA-1273 booster was established in October 2021.
Over the next month, the patient’s symptoms progressed including his inability to swallow, requiring hospitalization due to dehydration and malnutrition. Evaluation including laboratory prompted referral for electrodiagnostic studies consisting of repetitive nerve stimulation studies and needle electromyography, confirming a case of new onset bulbar myasthenia gravis.