bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Occupational Exposure to Eye Lens Dosimetry for Interventional Radiology Workers in China During 2017–2019
Authors: Li Mengxue , Fan Shengnan , Zhang Xianpeng , Hao Shuxia , Zhao Yu , Deng Jun , Sun Quanfu 
Published: June 2022

Abstract
The eye lens is a sensitive tissue to ionizing radiation and recently has been recognized as more radiosensitive than previously considered. The International Commission on Radiological Protection (ICRP) has recommended a considerable reduction in the equivalent dose limit of eye lens from 150 mSv y−1 to 20 mSv y−1, averaged over a defined period of 5 y. In this paper, the eye lens dose of interventional radiology workers in China during 2017–2019 is analyzed to understand the current status of eye lens occupational exposure and to provide decision-making suggestions for health supervision departments using data obtained from the National Radiological Health Information Platform in China. A total of 3,026 eye lens dose records of interventional radiology workers were collected. The average annual eye lens dose (AAELD) for interventional radiology workers ranged from 1.07 to 1.51 mSv during 2017-2019 and was 1.44 mSv for all monitored interventional radiology workers, with 2,973 records (98.2%) lower than the public limit of 15 mSv and 33 records (1.1%) exceeding the newly revised occupational eye lens dose limit of 20 mSv y−1. During the period of 2017-2019, the AAELDs of interventional radiologists (1.61 mSv) and of interventional cardiologists (1.59 mSv) were significantly higher than that of other interventional workers (0.62 mSv); the AAELD of doctors (1.50 mSv) was significantly higher than that of nurses (1.01 mSv); the AAELD of western China (2.00 mSv) was significantly higher than that of eastern (1.11 mSv) and central China (1.27 mSv); and the AAELD of males (1.59 mSv) was significantly higher than that of females (0.84 mSv). The eye lens dose of interventional radiology workers meets the Chinese standard limit of 150 mSv y−1, while some cases exceed the one recommended by ICRP. The study shows that the interventional radiology workers’ eye lens dosimetry data complied with the existing Chinese eye lens dose limits. However, education, training, and supervision of radiation protection also should be strengthened continuously for interventional radiology workers, especially for the interventional radiologists and interventional cardiologists. Significant attention should be paid to the radiation protection of underdeveloped regions in China in future works.
Complete and long-lasting response to immunotherapy
Authors: Silva Diogo J. , Mesquita Alexandra 
Published: June 2022

Abstract

Introduction:
Bladder cancer is the tenth most common cancer worldwide, with Europe having the highest incidence rates. Regarding the treatment of metastatic disease, first-line treatment for fit patients is cisplatin-containing combination chemotherapy. However, a significant percentage of patients are ineligible for platinum-based chemotherapy, or progress under these regimens. Recently, immune checkpoint blockade has become a treatment option for this group of patients. In this report, we present the case of a male patient diagnosed with metastatic bladder cancer who did not tolerate cisplatin-containing chemotherapy and achieved complete response after treatment with pembrolizumab.

Patient concerns:
A 58 years-old Caucasian man with a medical history of high-grade urothelial carcinoma pT3bN0R0 under a watchful waiting strategy for 6 months presented to the Medical Oncology appointment with two axillary and cervical adenopathies.

Diagnosis:
Cervicothoracoabdominal computed tomography confirmed the presence of two large necrotic lymphadenopathies in the cervical and axillary lymphatic chains, and bone scintigraphy revealed dorsal (D11) and lumbar (L5) metastatic lesions. Ultrasonography-guided biopsy of the axillary nodule revealed the presence of metastatic tissue of primary urothelial origin.

Interventions:
The patient was initiated on a palliative chemotherapy regimen of carboplatin area under the curve 5 plus gemcitabine (1000 mg/m2). During the first cycle of chemotherapy, acute kidney failure akin 2 developed due to nonobstructive toxic acute tubular necrosis with progressive deterioration of kidney function. Therefore, palliative chemotherapy with carboplatin plus gemcitabine was changed to 200 mg of pembrolizumab every 21 days.

Outcomes:
Overal survival of 57 months with an immune complete response according to the immune Response Evaluation Criteria in Solid Tumours criteria and an excellent quality of life.

Conclusion:
This case illustrates that second-line therapy with ICIs (pembrolizumab or atezolizumab) has favourable results in achieving an immune complete response after intolerance to cisplatin-based regimens. ICIs provide durable responses that improve overall survival and quality of life.
Hematological indices reference intervals for a healthy Arab population in Qatar
Authors: Yassin Mohamed A. , Soliman Ashraf T. , Nashwan Abdulqadir J. , Alamami Ans A. , Abdulla Mohammad A. J. , Hmissi Saloua M. , Aldapt Mahmood B. , Chandra Prem , Suliman Aasir M. , Ibrahim Ezzeddin A. , Yassin Khadra S. , Allahverdi Niloofar , Mohamed Shehab F. 
Published: June 2022

Abstract
Hematologic reference intervals vary with gender, age, ethnicity, and geographic area. Therefore, local or national laboratory reference ranges are essential to enhance the accuracy when diagnosing health conditions. Still, no comprehensive list of reference ranges tailored to the Arab population living in Qatar. Accordingly, this study aims at establishing a hematology reference guide for Arabs in Qatar.
This is a retrospective study where 750 healthy volunteers (18–69 years) from 2015 to 2019 were included, analyzed by an automated hematology analyzer. Arab adults were divided into African (Egypt, Libya, Tunisia, Morocco) and Asian (Syria, Lebanon, Jordon, Palestine, Qatar). The Cell-Dyn and Sysmex were used for measuring hematological parameters.
The mean +/- 2SD were established for all the study groups. Arab males had significantly higher Hb, Hct, red cell distribution width, absolute neutrophil count, lymphocytes, and monocyte counts than females. Asian-Arab males had significantly higher Hb concentration and higher WBC, lymphocytes, and eosinophils than African Arabs. Asian-Arab young (>18: < 40 years) males had significantly higher Hb and lymphocytes and lower monocytes than older males (>40 years). African-Arab young males had significantly higher lymphocytes and lower monocytes than older males. Asian-Arab young females had higher WBC and absolute neutrophil count than older Asian Arabs.
The findings of this study will help in establishing specific reference intervals in the Arab world. The differences in hematology reference intervals considering age, gender, and geographical location highlight the importance of establishing blood reference intervals in each country considering the ethnic diversity of each country.
Changes in pain scores and walking distance after epidural steroid injection in patients with lumbar central spinal stenosis
Authors: Kim Minsoo , Cho Soyeon , Noh Yeonji , Goh Daehun , Son Hee-Jeong , Huh Jin , Kang Seong-Sik , Hwang Byeongmun 
Published: June 2022

Abstract
Lumbar spinal stenosis is a common degenerative disorder that is characterized by pain and neurogenic claudication. Previous studies have evaluated the effects of an epidural steroid injection (ESI) on spinal stenosis, based on changes to the spinal canal diameter.
This study aimed to examine the impact of the ESI on pain scores and walking distance in patients with lumbar central spinal stenosis, stratified based on disease severity, which was graded according to the degree of cauda equina separation.
We reviewed the medical records of patients who received the ESI for lumbar spinal central canal stenosis. A total of 128 patients were divided into moderate and severe groups, based on the degree of cauda equina separation.
Relative to baseline values, 2 weeks after the ESI, the moderate group showed a significant decrease in the numeric rating scale (NRS) scores and an increase in walking distance. Meanwhile, the severe group showed a significant decrease in the NRS scores and no significant change in walking distance. The moderate group had lower NRS scores and a longer walking distance than did the severe group 2 weeks after the ESI. The proportion of patients with improved levels of satisfaction was higher in the moderate group than in the severe group.
Lumbar interlaminar ESI may reduce pain scores and increase walking distance in patients with moderate lumbar spinal central canal stenosis. Patients with moderate spinal stenosis achieved better outcomes than did patients with severe stenosis.
Concomitant post-traumatic ocular and cerebral fat embolism syndrome and thrombotic pulmonary embolism
Authors: Li Ying-Sheng , Liu Yi-Hsueh , Chou Hung-Da , Tseng Hsiang-Jui , Fu Yin-Chih , Liu Wen-Chih 
Published: June 2022

Abstract

Rationale:
Fat embolism syndrome (FES) is composed of a triad of symptoms, including respiratory distress, neurologic deficit, and petechiae. Respiratory distress usually presents first before the other symptoms. Thrombotic pulmonary embolism (TPE) is a differential diagnosis of FES. Trauma is a risk factor for both diseases; however, co-occurrence is rare.

Patient concerns:
A 35-year-old male patient presented with altered consciousness, focal neurologic deficit, and respiratory distress after a left femoral subtrochanteric fracture and subsequent open reduction and internal fixation with an intramedullary nail.

Diagnosis:
Computed tomography pulmonary angiography (CTPA) revealed lower pulmonary artery filling defects and ground-glass opacities in bilateral lung, indicating TPE and FES, respectively.

Interventions:
Heparin was initially added and subsequently switched to apixaban. The symptoms improved quickly without major bleeding complications.

Lession Subsections:
Concomitant TPE and FES after trauma are rare and require different treatment approaches. Due to clinical similarities, prompt chest CTPA was advised to detect TPE that was treated with anticoagulant therapy instead of supportive care for FES.
Katanin subunits p60 and p80, potential biomarkers for papillary thyroid carcinoma to distinguish nodular goiter: STROBE
Authors: Wu Zhangming , Guo Miao , Yang Jing , Xiao Yanjie , Liu Wei 
Published: June 2022

Abstract
Katanin subunits p60 and p80 are involved in microtubule-mediated cytoskeletal organization during cell division. Their aberrant expression has been found in prostate, breast, and non-small cell lung (NSCLC) cancers. It has recently been reported that compared with adjacent papillary thyroid carcinoma (PTC) tissues, both are highly expressed in tumor tissues. Here, we investigated whether katanin subunits p60 and p80 can be used as potential biomarkers for PTC to distinguish nodular goiter (NG).
Immunohistochemistry was performed to investigate the expression of katanin subunits p60 and p80 in the tissues of 97 cases of PTC and NG. This cohort included 87 cases with PTC (74 classical or conventional (CPTC) and 13 follicular (FVPTC) variants) and 10 cases with NG.
We found that katanin subunits p60 and p80 were expressed in PTC, but not in NG. The cutoff values of katanin p60 and p80 for PTC were 22.43% and 0.83%, respectively. The katanin subunit p60 was significantly associated with lymph node metastasis. Katanin subunit p80 was more highly expressed in CPTC than in FVPTC. The expression of the katanin subunit p60 was positively correlated with the expression of katanin p80 in PTC. Importantly, we found that overexpression of katanin p60 increased the expression of katanin p80 in a human papillary thyroid carcinoma KTC-1 cell line, which further supports the existence of katanin p60 and p80 feedback loops.
Our results indicate that katanin subunits p60 and p80 may be used as potential PTC biomarkers to distinguish NG and may be novel therapeutic targets for PTC.
Granulocytic sarcoma of cervix
Authors: Ye Zhongxue , Jiang Yafen 
Published: June 2022

Abstract

Rationale:
Granulocytic sarcoma (GS) is an uncommon extramedullary tumor, and involvement of the female reproductive system is very rare.

Patient concerns:
We present a case of cervical GS in a 45-year-old woman who presented with repeated vaginal bleeding after sex for 1 month.

Diagnosis:
The patient was diagnosed with cervical GS mainly based on pathological immunohistochemical examination and further progressed to acute myeloid leukemia (AML) based on bone marrow puncture and cytogenetic analysis.

Interventions and outcomes:
The patient underwent hysterectomy and bilateral adnexectomy, and subsequently received AML-type chemotherapy. She relapsed 3 months after therapy and progressed to AML. The patient was then treated with chemotherapy with cytosine arabinoside and idarubicin again and achieved complete remission after 1 cycle. Currently, she is still receiving therapy combined with cytosine arabinoside and idarubicin, and has been alive for 13 months.

Lessons:
Although GS of the reproductive system is rare, it should be included in the differential diagnosis of gynecological neoplasms and should be treated with AML-type chemotherapy protocols.
Anesthetic management for cesarean section in parturient with an uncorrected single ventricle
Authors: Du Yu , Yang-Liu Yingzi , Chen Bin , Wang Ji 
Published: June 2022

Abstract

Rationale:
Patients with a single ventricle, who have not undergone surgery, reportedly have a lower survival rate. Furthermore, multiple pregnancies are rare among these females. We reported a case of anesthesia management of cesarean section in an uncorrected single-ventricular multi-pregnancy woman and review the anesthesia management of the published similar cases.

Patient concerns:
An uncorrected single ventricular pregnant woman with a cardiac function of New York Heart Association class II, who had experienced one spontaneous abortion and three vaginal deliveries, was scheduled for cesarean section at 37+6 weeks of gestation.

Diagnoses
: Echocardiography revealed a complex congenital heart disease in the mother: a single ventricle (the left ventricle is dominant), atrioventricular valve ectopic, double-inlet left ventricle, abnormal location of the great arteries, probably pulmonary stenosis, atrial septal defect, and left-to-right shunt. The fetus was in breech presentation with umbilical cord around the neck.

Interventions:
Cesarean section was successfully performed under the combined spinal epidural anesthesia with careful monitoring.

Outcomes
: Both mother and newborn recovered good and were discharged from the hospital 5 days after surgery without any adverse reactions.

Lessons:
Single ventricular pregnant woman with a cardiac function of New York Heart Association class I–II could tolerate pregnancy and delivery well. Both general and regional anesthesia are applicable to cesarean section in these patients. The principle of anesthesia management is to maintain the appropriate balance between systemic vascular resistance and pulmonary vascular resistance, as well as to maintain preload and cardiac output.
Pancarpal dissociation, a very rare type of injury
Authors: Park Ho Youn , Sur Yoo Joon , Lim Dohyung , Lee Kwansoo , Park Il-Jung 
Published: June 2022

Abstract

Rationale:
Pan-carpal dissociation is very rare injury and there is little information as to diagnosis, treatment, and prognosis of this injury.

Patient concerns:
A 35-year-man presented to our hospital with severe pain and swelling of the left wrist and forearm after slipping and falling while riding a motorcycle.

Diagnosis:
The wrist simple radiographs demonstrated unrecognizable severe fracture-dislocation of the carpal bones concomitant with fractures of the radioulnar shaft. Three-dimensional computed tomography revealed a capitate fracture-dislocation, as well as hamate dislocation, lunotriquetral (LT), and scapholunate (SL) dissociation. These findings suggested pan-carpal dissociation.

Interventions:
To prevent compartment syndrome, fasciotomy, carpal tunnel release, and open reduction and plate fixation for both bone fracture were performed first. Then, for pan-carpal dissociation, the capitate, carpometacarpal joint (CMCJ), and hamate were reduced and fixed first. Then, the SL, LT, and other intercarpal ligaments were repaired. Finally, additional trans-carpal pins to reinforce the ligament repair and 2.0 mm plate to buttress the third CMCJ were fixed. The patient was instructed to begin gentle range of motion exercises of the wrist with pins from four weeks after surgery and all pins were removed at six weeks postoperatively.

Outcomes:
12 months after the operation, the patient exhibited almost full range of motion with mild pain with VAS (Visual analogue scale) 1–2 at rest and VAS 3–4 with effort. Quick DASH (the disabilities of the arm, shoulder and hand) score was 25 and modified Mayo score was 70. The radiographs demonstrated union of the radioulnar shaft, and the carpal bone alignment was successfully maintained

Lessons:
Pan-carpal dissociation can be diagnosed in patients with capitate fracture-dislocation, hamate dislocation, LT, and SL dissociation. This pattern of injury is very rare and the authors recommend reduction and fixation of the distal carpal row, followed by the proximal row to facilitate an easy approach to the distal carpal row. Although it is very severe injury, rigid anatomical fixation and an early rehabilitation can lead to favorable functional outcomes.
Training School Counselors and Nurses to Enhance Collaboration Through Animal-Assisted Therapy
Authors: Yordy Beverly Morgan , Tuttle Malti , Meyer Jill M. 
Published: June 2022

Purpose/Aims
The school nurse and school counselor serve an important role to foster student academic achievement, physical and mental health, and connectiveness. Each is paramount to student success; therefore, efforts should be made to further enhance collaborative efforts. Researchers sought to determine if an online training course centered on integrative methods would enhance collaboration between the school nurse and counselor.

Design
This study used a quasi-experimental design with 3 data points (pretest, posttest, and 6-month follow-up), assessing the impact of educational content and knowledge application based on an online training module incorporating animal-assisted therapy (AAT) concepts and the school counselor and school nurse collaboration model.

Methods
The continuing professional development questionnaire was used to evaluate professionals' behavior, specifically focusing on how knowledge translates into practice. The intervention included a training course designed for school nurses and counselors. Researchers analyzed data to determine how their collaboration and endorsement of AAT changed over time.

Results
School counselors endorsed collaboration and intention of AAT application in schools at a higher rate than school nurses. However, after the intervention, differences between school counselors and nurses diminished over time.

Conclusion
The findings provide recommendations for the clinical nurse specialist to implement evidence-based programs targeting school nurse and school counselor collaboration.
Superficial CD34-Positive Fibroblastic Tumor
Authors: Anderson William J. , Mertens Fredrik , Mariño-Enríquez Adrián , Hornick Jason L. , Fletcher Christopher D.M. 
Published: June 2022

Superficial CD34-positive fibroblastic tumor (SCD34FT) is a rare soft tissue neoplasm that shows overlapping features with PRDM10-rearranged soft tissue tumor (PRDM10-STT). This study characterizes the clinicopathologic, immunohistochemical, and molecular features of SCD34FT in a series of 59 cases. Fluorescence in situ hybridization to assess for PRDM10 rearrangement was performed in 12 tumors. Immunohistochemistry for CADM3 and WT1 was performed; CADM3 was also assessed in histologic mimics. Our cohort of 33 male and 26 female had a median age of 42 (range: 14 to 85) years. Tumors were most commonly located in the lower limb (73%), upper limb (8%), back (7%), and supraclavicular region (3%). The median tumor size was 3.0 cm (range: 1.0 to 9.0 cm). Clinical follow-up in 32 patients (median duration: 26 mo) revealed 2 local recurrences (6%). One patient developed regional lymph node metastases which were completely excised. Microscopically, SCD34FT comprised spindled and pleomorphic cells with glassy cytoplasm and occasional granular cell change. Fluorescence in situ hybridization confirmed PRDM10 rearrangement in 3/8 cases (38%). SCD34FT frequently expressed CADM3 (95%) and WT1 (75%). CADM3 was less diffusely positive in pleomorphic hyalinizing angiectatic tumor (40%), pleomorphic liposarcoma (20%), and undifferentiated pleomorphic sarcoma (10%). We corroborate that SCD34FT is indolent but may rarely metastasize to lymph nodes without adverse outcomes. CADM3 and WT1 may be useful in the distinction from histologic mimics. Since cases of SCD34FT with and without demonstrable PRDM10 rearrangement were clinicopathologically indistinguishable, our study further supports that SCD34FT and PRDM10-STT likely constitute a single entity.
68Ga-FAPI-46 and 18F-FDG in Advanced Metastatic Pancreatic Cancer
Authors: Kaghazchi Fatemeh , Divband Ghasemali , Amini Hamidreza , Adinehpour Zohreh , Akbarian Aghdam Ramin 
Published: June 2022

Abstract
Recently imaging with new PET radiotracers that act as fibroblast activation protein inhibitors (FAPIs) showed promising results in oncology and even nononcology imaging. Here we report a case of advanced pancreatic adenocarcinoma, imaged with both 18F-FDG and 68Ga-FAPI-46 PET/CT scans. The result indicated that imaging with 68Ga-FAPI-46 showed significant improvement in detection of metastases as well as local malignancy recurrence. Moreover, the intensity and SUVs of the lesions were higher in 68Ga-FAPI-46 scan compared with 18F-FDG.
Epiglottic Polymorphous Adenocarcinoma With Multiple Bone Metastases Detected by 68Ga-FAPI PET/CT
Authors: Pang Yizhen , Meng Tinghua , Xu Weizhi , Kong Lei , Chen Haojun 
Published: June 2022

Abstract
Polymorphous adenocarcinoma (PAC) is generally an indolent tumor that mostly commonly affects the minor salivary gland. Polymorphous adenocarcinoma with distant metastases is extremely rare. In this case, we reported 18F-FDG and 68Ga-FAPI PET/CT imaging findings in a rare case of epiglottic PAC with multiple bone metastases. 68Ga-FAPI PET/CT showed superiority over 18F-FDG PET/CT for detecting the primary and metastatic PAC. This case highlighted that 68Ga-FAPI may be a promising radiopharmaceutical in the diagnosis of PAC, especially for detecting the PACs arising in uncommon sites.
Infectious Aortic Aneurysm in a Patient With Leriche Syndrome
Authors: Norikane Takashi , Yamamoto Yuka , Takami Yasukage , Tani Ryosuke , Nishiyama Yoshihiro 
Published: June 2022

Abstract
Leriche syndrome is a relatively rare atherosclerotic occlusive disease characterized by total occlusion of the abdominal aorta and/or both iliac arteries. The typical clinical manifestations of Leriche syndrome include intermittent claudication, fatigue, and leg pain. We present the case of a 56-year-old man with Leriche syndrome accompanied by an infectious abdominal aortic aneurysm. 18F-FDG PET angiography/CT and 18F-FDG PET/CT provided important information about the thrombus and infected sites.