bluuebunny/crossref_metadata_2025_split huggingface dataset:
Best Practices for the Coordinated Care of Patients With Neuroendocrine Tumors Undergoing Peptide Receptor Radionuclide Therapy
Authors: Hendifar Andrew E. , Mehr Samuel H. , McHaffie Derek R. 
Published: May 2022

Abstract
Neuroendocrine tumors (NETs) are rare, diverse malignancies; approximately two thirds originate in the gastrointestinal tract and pancreas and are known as gastroenteropancreatic NET. Most cases are diagnosed in the advanced or metastatic setting and overexpress somatostatin receptors. Recommended first-line treatment is somatostatin analogs; however, disease progression is common. [177Lu]Lu-DOTA-TATE is a radiolabeled peptide receptor radionuclide therapy (PRRT) indicated for the treatment of adult patients with somatostatin receptor-positive foregut, midgut, and hindgut gastroenteropancreatic NETs and progression on first-line somatostatin analogs. Many primary oncology practices may lack the staff, expertise, and infrastructure to treat patients with PRRT and primary oncologists may therefore refer their patients to a NET specialist at a tertiary center for treatment. Given the amount of organization required, PRRT treatment may seem to be complex; however, this process will be managed by a care coordinator who acts as a consistent point of contact for primary physicians regarding the care of their patients and ensures blood tests and scans are scheduled. In this article, we share our opinions, procedures, workflow, best practice, and roles and responsibilities when caring for patients receiving [177Lu]Lu-DOTA-TATE and focus on the role of the primary oncologist before, during, and after PRRT treatment.
Efficacy and Safety of Peroral Pancreatoscopy Through the Fistula Created by Endoscopic Ultrasound–Guided Pancreaticogastrostomy
Authors: Suzuki Akinori , Ishii Shigeto , Fujisawa Toshio , Saito Hiroaki , Takasaki Yusuke , Takahashi Sho , Yamagata Wataru , Ochiai Kazushige , Tomishima Ko , Isayama Hiroyuki 
Published: May 2022

Objectives
Endoscopic ultrasound/endosonography-guided pancreaticogastrostomy (EUS-PGS) is a useful alternative when endoscopic retrograde pancreatography is difficult. Recently, many procedures, including peroral pancreatoscopy (POPS), have been performed through the mature fistula (MF) created by EUS-PGS. We evaluate the efficacy and safety of POPS to diagnose and treat pancreatic ductal stricture/pancreato-jejunal anastomotic stricture (PDS/PJAS) through the MF.

Methods
Twenty patients underwent EUS-PGS; 13 of these underwent POPS through the MF at Juntendo University Hospital. All patients were studied retrospectively in terms of technical and clinical success rates and adverse events (AEs).

Results
The technical and clinical success rates of EUS-PGS were 95% and 100%. The early and late AEs rates were 20% and 15%. The technical success rate of POPS was 100%, with one AE. Biopsy of PDS/PJAS under POPS guidance revealed recurrent/residual intrapapillary mucinous adenoma (3 patients) and benign fibrotic stricture (10 patients). In the latter patients, multiple plastic stents were placed to dilate PDS/PJAS. Four patients with improvement of PDS/PJAS were stent free, but the remaining patients were not yet.

Conclusions
Endoscopic ultrasound/endosonography-guided pancreaticogastrostomy and various procedures (including POPS) performed through the MF are feasible and effective and can diagnose and treat PDS/PJAS with acceptable AEs rates.
Efficacy and Safety of Neoadjuvant Chemoradiation Therapy Administered for 5 Versus 2 Weeks for Resectable and Borderline Resectable Pancreatic Cancer
Authors: Suto Hironobu , Okano Keiichi , Oshima Minoru , Ando Yasuhisa , Matsukawa Hiroyuki , Takahashi Shigeo , Shibata Toru , Kamada Hideki , Kobara Hideki , Tsuji Akihito , Masaki Tsutomu , Suzuki Yasuyuki 
Published: May 2022

Objectives
Indications of preoperative treatment for resectable (R-) or borderline resectable (BR-) pancreatic ductal adenocarcinoma (PDAC) are unclear, and the protocol remains to be standardized.

Methods
Included 65 patients with R- and BR-PDAC with venous involvement (V-) received neoadjuvant chemoradiotherapy with S-1 and 50 Gy of radiation as the 5-week regimen. The outcomes of this group were compared with those of 52 patients who underwent S-1 and 30 Gy of radiation as the 2-week regimen, previously collected as our prospective phase II study.

Results
Compared with the 2-week regimen, there were no significant differences in the rate of protocol completion, adverse events, mortality and morbidity, or R0 resection in the 5-week regimen. In subgroup analyses of R-PDAC, there were no significant differences in overall survival and recurrence-free survival between the groups. In contrast, the 5-week regimen had significantly better overall survival and recurrence-free survival than the 2-week regimen for BRV-PDAC. Similar results were observed after propensity score matching analysis.

Conclusions
The 5-week regimen of neoadjuvant chemoradiotherapy has good clinical efficacy and safety for R- and BRV-PDAC. The 5-week regimen could achieve better outcomes than the 2-week regimen for BRV-PDAC. In contrast, both regimens achieved similar outcomes for R-PDAC.
Determination of the Force Required to Produce Stab “Wounds” in Fruit Compared With Cadaveric Chest Tissue
Authors: Gitto Lorenzo , Serinelli Serenella , Werner Frederick W. , Ordway Nathaniel R. , Stoppacher Robert 
Published: May 2022

Abstract
In laymen's terms, it can be difficult to communicate how much force is needed to create a stab wound into a person's chest. Previous work has determined the force to puncture the skin, rib cartilage, or bone but without putting the results in terms that are easy to understand.
The purpose of this study was to determine the force needed to puncture 3 types of fruit using 3 different types of knives, namely, a steak knife, a butcher's knife, and a lock-blade knife, to help put these previous results in perspective.
There was wide variation in the force required to insert a knife into different fruits, but no force for any knife at any location for all fruits exceeded 93.1 N. Results show that force needed to penetrate the skin and allow for an 8-cm blade penetration into the chest is similar to the force required to insert a steak knife for a 6-cm distance into a cantaloupe. In addition, the force needed to penetrate the cartilage is most similar to stabbing a watermelon to 6 cm with a butcher knife. However, the forces required to penetrate the bone are greater than those required to penetrate any fruit with any type of blade.
Hormone -Refractory Prostatic Adenocarcinoma Mimicking Basal Cell Carcinoma: A Case Report
Authors: Caron Justin E. , Hart Steven D. , Chamie Karim , Ye Huihui 
Published: May 2022

Abstract
Prostate cancer is an androgen-driven malignancy. Patients with late-stage prostate cancer often receive androgen-deprivation therapy to suppress the disease progression. Under the selection pressure, some prostate cancers transform to androgen-independent cancers. Treatment-induced small cell neuroendocrine carcinoma is one of the examples. In the last decade, patients with disseminated prostate cancer frequently received second-generation androgen-deprivation agents, such as abiraterone, enzalutamide, and apalutamide. Those more potent drugs have led to an emergence of a novel type of androgen-independent carcinoma named “double-negative” prostate cancer, which is immunohistochemically negative for both neuroendocrine markers and androgen targets. In this report, we present a typical case of “double-negative” end-stage prostate cancer that morphologically resembled basal cell carcinoma of prostate, basaloid large nest type.
Prostatic Malakoplakia: Case Report and Review of the Literature
Authors: Chen Dong , Zou Qiong , Dehner Carina , Cao Dengfeng 
Published: May 2022

Abstract
A 69-year-old Asian man with a history of overactive bladder presented with postvoid dribbling and urinary incontinence in the past three years. He had cervical spinal stenosis surgery one month ago and two episodes of urinary tract infections with multidrug-resistant Escherichia coli species in urine culture in the last three months. Digital rectal examination revealed a 1-cm hard nontender nodule within the right side of his prostate, concerning for possible prostatic malignancy. Ultrasound study identified a hypoechoic area in the right lateral prostate. Serum prostate-specific antigen level was 2.03 ng/mL (reference range, ≤5.40 ng/mL). Biopsies of the prostate showed only focal chronic inflammation in the left lobe, but there were collections of abundant histiocytes with associated plasma cells and lymphocytes, as well as fibrosis in 5 of 7 cores in the right lobe. Within the histiocytic infiltrate, abundant Michaelis-Gutmann bodies, both intracytoplasmic and extracellular, were identified and confirmed with periodic–acid Schiff and von Kossa stains. The morphologic features and histochemical stains support the diagnosis of malakoplakia. So far, 68 cases of prostatic malakoplakia including ours have been reported (mean age, 63.5 years). Most patients presented with urinary tract symptoms and positive urine culture for E. coli. Eight patients also had associated prostatic adenocarcinoma. Serum prostate-specific antigen may be significantly elevated in patients with prostatic malakoplakia without associated adenocarcinoma. Prostatic malakoplakia can clinically and radiographically mimic prostatic adenocarcinoma. Pathologically malakoplakia should be distinguished from granulomatous prostatitis and other benign and malignant prostatic diseases.
Histopathologic Changes in a Hypogonadal Male on Exogenous Testosterone Diagnosed With Prostatic Adenocarcinoma: A Case Report
Authors: Yang David , Sun Yue 
Published: May 2022

Abstract
In the United States, prostatic adenocarcinoma is the most common nonskin cancer and second leading cause of cancer death. Pathologic diagnostics are paramount to guiding treatment but require an awareness that hormonal treatments have the capacity to alter the histological appearance of prostate cancer. This case highlights the importance of accurate diagnostics and grading through a discussion of histological findings in an unusual case of a male patient with hypogonadism on long-term exogenous testosterone who was diagnosed with prostatic adenocarcinoma.
Mixed Small Cell Neuroendocrine Carcinoma and Conventional Acinar Adenocarcinoma of the Prostate: A Case Report
Authors: Cordeiro-Rudnisky Fernanda , Wu Yubo , Sun Yue 
Published: May 2022

Abstract
Prostate cancer with neuroendocrine (NE) differentiation can be classified into six categories: conventional adenocarcinoma with NE differentiation, adenocarcinoma with Paneth cell–like NE differentiation, carcinoid tumor, small cell carcinoma, large cell carcinoma, and mixed NE carcinoma-acinar adenocarcinoma. Mixed NE carcinoma-acinar carcinoma is a biphasic carcinoma characterized by the presence of NE (small or large cell) carcinoma and conventional acinar adenocarcinoma. In rare cases, these two components overlap without discrete classic small cell carcinoma or a usual prostate adenocarcinoma component, making it particularly difficult to determine whether these overlapping cases should be diagnosed as small cell carcinoma or adenocarcinoma with a high Gleason score. Here, we present the case of a 74-year-old man who was diagnosed with mixed small cell NE carcinoma and conventional acinar adenocarcinoma of the prostate.
Blue Nevus of the Prostate: A Report of Two Cases and Review of the Literature
Authors: Legesse Teklu , Sesterhenn Isabell , Paulk Adina 
Published: May 2022

Abstract
Pigmented lesions of the prostate are very rare and include melanosis, blue nevus, and malignant melanoma. Of these lesions, blue nevus (also known as pigmented melanocytosis or pigmentary nevohyperplasia) is the most frequently reported one. It is morphologically similar to its much more common cutaneous counterpart and composed mainly of heavily pigmented spindle cells within the prostatic stroma. It is often discovered incidentally in needle biopsies, transurethral resection of the prostate, or prostatectomy specimens performed for prostatic cancer or benign prostatic hyperplasia. It is a benign lesion with no potential for malignant transformation. Recognition of this entity is important because of the differential diagnosis with the much rarer malignant melanoma involving the prostate. The pathologic features and differential diagnosis with relevant literature review are discussed in this report.
Cost-effectiveness Analysis of Peripherally Inserted Central Catheters Versus Central Venous Catheters for in-Hospital Parenteral Nutrition
Authors: Comas Mercè , Domingo Laia , Jansana Anna , Lafuente Elisabeth , Civit Anna , García-Pérez Lídia , Lasso de la Vega Carmen , Cots Francesc , Sala Maria , Castells Xavier 
Published: May 2022

Objective
Our objective was to evaluate the cost-effectiveness of the use of peripherally inserted central venous catheters (PICCs) by a vascular access team (VAT) versus central venous catheters (CVCs) for in-hospital total parenteral nutrition (TPN).

Methods
The study used a cost-effectiveness analysis based on observational data retrospectively obtained from electronic medical records from 2018 to 2019 in a teaching hospital. We included all interventional procedures requiring PICCs or CVCs with the indication of TPN. We recorded the costs of insertion, maintenance, removal, and complications. The main outcome measure was the incidence rate of catheter-associated bacteremia per 1000 catheter days. Cost-effectiveness analysis was performed from the hospital perspective within the context of the publicly funded Spanish health system. Confidence intervals for costs and effectiveness differences were calculated using bootstrap methods.

Results
We analyzed 233 CVCs and 292 PICCs from patients receiving TPN. Average duration was longer for PICC (13 versus 9.4 days, P < 0.001). The main reason for complications in both groups was suspected infection (9.77% CVC versus 5.18% PICC). Complication rates due to bacteremia were 2.44% for CVC and 1.15% for PICC. The difference in the incidence of bacteremia per 1000 catheter days was 1.29 (95% confidence interval, −0.89 to 3.90). Overall, costs were lower for PICCs than for CVCs: the difference in mean overall costs was −€559.9 (95% confidence interval, −€919.9 to −€225.4). Uncertainty analysis showed 86.37% of results with lower costs and higher effectiveness for PICC versus CVC.

Conclusions
Placement of PICC by VAT compared with CVC for TPN reduces costs and may decrease the rate of bacteremia.
Body Mass Index Is Not an Independent Factor Associated With Recovery Room Length of Stay for Patients Undergoing Outpatient Surgery
Authors: Alonso Stephany , Du Austin L , Waterman Ruth S. , Gabriel Rodney A. 
Published: May 2022

Objectives
Prolonged recovery time in the postanesthesia care unit (PACU) increases cost and administrative burden of outpatient surgical staff. The primary aim of this study was to determine whether body mass index (BMI) is associated with prolonged recovery in the PACU after outpatient surgery in a freestanding ambulatory surgery center.

Methods
We retrospectively studied 3 years of surgeries performed at a freestanding ambulatory surgery center. Mixed-effects logistic (for binary outcomes) and linear (for continuous outcomes) regressions were performed, in which the random effect was the surgical procedure. Prolonged PACU length of stay was modeled as a binary variable, that is, stay greater than the third quartile, and as a continuous variable, that is, actual duration of stay in minutes. We reported odds ratio and 95% confidence interval from the logistic regression and estimates with standard errors from the linear regression.

Results
Patients with obesity (BMI ≥ 30 kg/m2) did not demonstrate increased odds for prolonged PACU length of stay (all P > 0.05). Furthermore, BMI—represented as a continuous variable—was not associated with actual PACU length of stay (estimate = 0.05, standard error = 0.06, P = 0.41). No association was found between obesity and PACU length of stay on a subgroup analysis where only patients with obstructive sleep apnea were analyzed.

Conclusions
There was no association between BMI and PACU length of stay among patients who received outpatient surgery at a freestanding ambulatory surgery center.
Prescribe to Save Lives: Improving Buprenorphine Prescribing Among HIV Clinicians
Authors: Jawa Raagini , Walley Alexander Y. , Wilson Donna J. , Green Traci C. , McKenzie Michelle , Hoskinson Randall , Bratberg Jeffrey , Ramsey Susan , Rich Josiah D. , Friedmann Peter D. 
Published: May 2022

Background:
HIV clinicians are uniquely positioned to treat their patients with opioid use disorder using buprenorphine to prevent overdose death. The Prescribe to Save Lives (PtSL) study aimed to increase HIV clinicians' buprenorphine prescribing via an overdose prevention intervention.

Methods:
The quasi-experimental stepped-wedge study enrolled 22 Ryan White–funded HIV clinics and delivered a peer-to-peer training to clinicians with follow-up academic detailing that included overdose prevention education and introduced buprenorphine prescribing. Site-aggregated electronic medical record (EMR) data measured with the change in X-waivered clinicians and patients prescribed buprenorphine. Clinicians completed surveys preintervention and at 6- and 12-month postintervention that assessed buprenorphine training, prescribing, and attitudes. Analyses applied generalized estimating equation models, adjusting for time and clustering of repeated measures among individuals and sites.

Results:
Nineteen sites provided EMR prescribing data, and 122 clinicians returned surveys. Of the total patients with HIV across all sites, EMR data showed 0.38% were prescribed buprenorphine pre-intervention and 0.52% were prescribed buprenorphine postintervention. The intervention increased completion of a buprenorphine training course (adjusted odds ratio 2.54, 95% confidence interval: 1.38 to 4.68, P = 0.003) and obtaining an X-waiver (adjusted odds ratio 2.11, 95% confidence interval: 1.12 to 3.95, P = 0.02). There were nonsignificant increases at the clinic level, as well.

Conclusions:
Although the PtSL intervention resulted in increases in buprenorphine training and prescriber certification, there was no meaningful increase in buprenorphine prescribing. Engaging and teaching HIV clinicians about overdose and naloxone rescue may facilitate training in buprenorphine prescribing but will not result in more treatment with buprenorphine without additional interventions.
The whole blood microbiome of Indonesians reveals translocated and pathogenic microbiota
Authors: Bobowik Katalina , Fachrul Muhamad , Darusallam Chelzie Crenna , Kusuma Pradiptajati , Sudoyo Herawati , Febinia Clarissa A. , Malik Safarina G. , Wells Christine , Gallego Romero Irene 
Published: May 2022

AbstractPathogens found within local environments are a major cause of morbidity and mortality. This is particularly true in Indonesia, where infectious diseases such as malaria or dengue are a significant part of the disease burden. Unequal investment in medical funding throughout Indonesia, particularly in rural areas, has resulted in under-reporting of cases, making surveillance challenging. Here, we use transcriptome data from 117 healthy individuals living on the islands of Mentawai, Sumba, and the Indonesian side of New Guinea Island to explore which pathogens are present within whole blood. We detect a range of taxa within RNA-sequencing data generated from whole blood and find that two pathogens—Flaviviridae and Plasmodium—are the most predominantly abundant, both of which are most pronounced in the easternmost island within our Indonesian dataset. We also compare the Indonesian data to two other cohorts from Mali and UK and find a distinct microbiome profile for each group. This study provides a framework for RNA-seq as a possible retrospective surveillance tool and an insight to what makes up the transient human blood microbiome.
Jointly analyzing the association of human milk nutrients with cognition and temperament traits during the first 6 months of life
Authors: Li Tengfei , Samuel Tinu M. , Zhu Ziliang , Howell Brittany , Cho Seoyoon , Baluyot Kristine , Hazlett Heather , Elison Jed T. , Wu Di , Hauser Jonas , Sprenger Norbert , Zhu Hongtu , Lin Weili 
Published: May 2022

AbstractEarly dietary exposure via human milk (HM) components offers a window of opportunity to support cognitive and temperamental development. While several studies have focused on associations of few pre-selected HM components with cognition and temperament, it is highly plausible that HM components synergistically and jointly support cognitive and behavioral development in early life. We aimed to discern the combined associations of a wide array of HM nutrients with cognition and temperament during the first six months of life and explore if there were persistent effects up to 18 months old, when HM is the primary source of an infant’s nutrition. The Mullen Scales of Early Learning and Infant Behavior Questionnaires-Revised were used to assess cognition and temperament, respectively, of fifty-four exclusively/predominantly breastfed infants in the first 6 months of life, whose follow-ups were conducted at 6-9, 9-12 and 12-18 months old. HM samples were obtained from the mothers of the participants at less than 6 months of life and analyzed for fatty acids (total monounsaturated fatty acids, polyunsaturated fatty acid, total saturated fatty acid (TSFA), arachidonic acid (ARA), docosahexaenoic acid (DHA), ARA/DHA, omega-6/omega-3 polyunsaturated fatty acids ratio (n-6/n-3)), phospholipids (phosphatidylcholine, phosphatidylethanolamine (PE), phosphatidylinositol (PI), sphingomyelin) and choline (free choline, phosphocholine (PCho), glycerophosphocholine). Feature selection was performed to select nutrients associated with cognition and temperament, respectively. The combined effects of selected nutrients were analyzed using multiple regression. A positive association between the arachidonic acid (ARA) and surgency was observed (p= 0.024). Significant effect of DHA, n-6/n-3, PE and TSFA concentrations on receptive language (R2= 0.39,p= 0.025), and the elevated ARA, PCho, and PI with increased surgency (R2= 0.43,p= 0.003) was identified, suggesting that DHA and ARA may have distinct roles for temperament and language functions. Furthermore, the exploratory association analyses suggest that the effects of HM nutrients on R.L. and surgency may persist beyond the first 6 months of life, particularly surgency at 12-18 months (p= 0.002). Our studies highlighted that various HM nutrients work together to support the development of cognition and temperament traits during early infancy.
The plant nucleoplasmin AtFKBP43 needs its extended arms for histone interaction
Authors: Singh Ajit Kumar , Saharan Ketul , Baral Somanath , Vasudevan Dileep 
Published: May 2022

ABSTRACTThe nucleoplasmin family of histone chaperones is a key player in governing the dynamic architecture of chromatin, thereby regulating various DNA-templated processes. The crystal structure of the N-terminal domain of Arabidopsis thaliana FKBP43 (AtFKBP43), an FK506-binding immunophilin protein, revealed a characteristic nucleoplasmin fold, thus confirming it to be a member of the FKBP nucleoplasmin class. Small-Angle X-ray Scattering (SAXS) analyses confirmed its pentameric nature in solution, and additional studies confirmed the nucleoplasmin fold to be highly stable. The AtFKBP43 nucleoplasmin core domain could not interact with histones and required the acidic arms, C-terminal to the core, for histone association. Furthermore, SAXS generated low-resolution envelope structure, ITC, and AUC results revealed that an AtFKBP43 pentamer with C-terminal extensions interacts with H2A/H2B dimer and H3/H4 tetramer in an equimolar ratio. Put together, AtFKBP43 belongs to a hitherto unreported subclass of FKBP nucleoplasmins that requires the C-terminal acidic stretches emanating from the core domain for histone interaction.