bluuebunny/crossref_metadata_2025_split huggingface dataset:
ROC-Analysis Derived Immunohistochemical P53 Cut-Off Scores as an Adjunct to Routine Histopathology for Better Diagnostic Compartmentalisation of Cervical Lesions
Authors: Shukla Ayushi , Sachan Rekha , Maurya Malti , Patel Munna Lal , Sankhwar Pushplata 
Published: July 2022

Objective
The aim of this study was to evaluate the predictive value of Immunohistochemical p53 cut-off scores as an adjunct to routine histopathology for better diagnosis of cervical lesions.

Materials and Methods
Prospective study carried out for 1 year. After ethical approval and informed consent, a total of 100 cervical tissue samples were analyzed; chronic cervicitis (CC)-15, cervical intraepithelial neoplasia (CIN)-40, and squamous cell carcinoma cervix (SCC)-45 (FIGO 2018 clinical staging). After routine processing of tissue specimen, hematoxylin and eosin (HE) staining was done. Grading of cervical precancerous lesions (CIN) was done as per World Health Organisation criteria as CIN 1,2 or 3. Broder’s grading was assigned for every SCC sample.

Results
Mean p53 scores of CC, CIN, and SCC cases were 0.0, 1.70, and 4.38, respectively, CIN 1, 2, and 3 were 1.07, 1.63, and 2.22, respectively. SCC was differentiated from CIN3 with p53 ≥4.5 as predictor for SCC, sensitivity and specificity were 57.8% and 88.9%, respectively. Overall diagnostic accuracy of the proposed scoring system for differentiating CC, CIN, and SCC was 61%, while the accuracy of previous methods of interpreting p53 immunoreactivity as immunoscore >2 or arbitrary cut-off of >10% cells with nuclear positivity was only 48%.

Conclusion
ROC-derived immunoscore cut-offs can provide the much-needed objectivity and optimal decision thresholds to immunohistochemistry interpretation.
The Relationship Between Nurses’ Ethical Reasoning with the Quality of Nursing Care
Authors: Safavi Firouzeh , Yousefi Zhila , Bavani Solmaz Mansour , Khodadadi Esmail 
Published: July 2022

Context
A high quality of nursing care is an important priority of nursing profession and directly associated with increased patient satisfaction. Evidence shows that ethical professional issues are challenging with significant influences on the quality of nursing care.

Aims
The aim of this study was to determine how quality of patient care relates to the nurses’ ethical reasoning as viewed by patients in medical wards.

Settings and Design
This study used a descriptive correlational design.

Subjects and Methods
Data collection tools included a Nursing Dilemma Test and Quality Patient Care Scale. In total, 180 hospitalized patients and 180 nurses who worked in medical wards of Hospitals in 2017 were enrolled. Sample selection was done by the census method.

Statistical Analysis Used
Data were analyzed by the SPSS software version 22.

Results
The means score for nurses’ quality care was 91.71 ± 14.81. Furthermore, the mean score for ethical reasoning among nurses was at an average level of 45.07 ± 6.12. There was no significant relationship between the quality of care and nurse’s ethical reasoning (P > 0.05).

Conclusions:
The results revealed that factors other than ethical reasoning of nurses are related to quality of care. Furthermore, nurses showed an average ability in ethical reasoning. So to improve this situation, healthcare system administrators can offer professional training programs to increase ethical sensitivity and reasoning among the nurses who face daily ethical issues.
Comparative analyses of paclitaxel/carboplatin with cisplatin/5-fluorouracil-based chemoradiation in locally advanced inoperable upper and middle third esophageal cancer
Authors: Kumar Divyesh , Dey Treshita , Khosla Divya , Gedela Sandeep , Oinam Arun S. , Kapoor Rakesh 
Published: July 2022

Introduction:
Chemoradiation therapy (CRT) remains the treatment of choice for inoperable locally advanced esophageal cancer (LAEC). Several CRT regimens are existent in esophageal cancer, but definitive conclusions are lacking. We performed a pilot study to compare treatment outcome, survival, and toxicities in inoperable upper and middle third esophageal cancer patients undergoing CRT using either paclitaxel/carboplatin or cisplatin/5FU based regimen.

Methods:
Patients were randomised in two arms (arm A and arm B). In Arm A, taxane-based (Paclitaxel+carboplatin) and in arm B non-taxane-based (cisplatin+5FU) doublet chemotherapy drugs were given concurrently with external beam radiation therapy (EBRT). EBRT in two phases up to a total dose of 54 Gy/27#@2Gy/# was given. Response was subsequently assessed using Response evaluation criteria in solid tumors (RECIST v1.1) and toxicities utilizing Common Terminology Criteria for Adverse Events (CTCAE v 4.0).

Result:
The overall response rate (ORR) in the taxane-based group was higher than the non-taxane-based group, but was not significantly different (p=0.851). Regarding hematological toxicities, anaemia and reduced cell counts were more in the taxane group compared to the non-taxane group while non-hematological toxicities were comparable. Similarly, better survival with late toxicities were seen with taxane-based arm when compared to non-taxane-based arm, though it was not statistically significant.

Conclusion:
Our pilot analysis highlights the fact that paclitaxel/carboplatin CRT shows better response, survival, and comparable toxicities when compared to cisplatin/5FU, though statistically nonsignificant. Further randomised prospective trials with large sample size are warranted.
Prediction of chronic kidney disease in abdominal cancers radiation therapy using the functional assays of normal tissue complication probability models
Authors: Haghbin Ameneh , Mostaar Ahmad , Paydar Reza , Bakhshandeh Mohsen , Nikoofar Alireza , Houshyari Mohammad , Cheraghi Susan 
Published: July 2022

Aim:
The purpose of this study is to predict chronic kidney disease (CKD) in the radiotherapy of abdominal cancers by evaluating clinical and functional assays of normal tissue complication probability (NTCP) models.

Materials and Methods:
Radiation renal damage was analyzed in 50 patients with abdominal cancers 12 months after radiotherapy through a clinical estimated glomerular filtration rate (eGFR). According to the common terminology criteria for the scoring system of adverse events, Grade 2 CKD (eGFR ≤30–59 ml/min/1.73 m2) was considered as the radiation therapy endpoint. Modeling and parameter estimation of NTCP models were performed for the Lyman-equivalent uniform dose (EUD), the logit-EUD critical volume (CV), the relative seriality, and the mean dose model.

Results:
The confidence interval of the fitted parameters was 95%. The parameter value of D50 was obtained 22–38 Gy, and the n and s parameters were equivalent to 0.006 –3 and 1, respectively. According to the Akaike's information criterion, the mean dose model predicts radiation-induced CKD more accurately than the other models.

Conclusion:
Although the renal medulla consists of many nephrons arranged in parallel, each nephron has a seriality architecture as renal functional subunits. Therefore, based on this principle and modeling results in this study, the whole kidney organs may have a serial–parallel combination or a secret architecture.
Diagnostic utility of CK19 and galectin-3 in differentiating papillary thyroid carcinoma from nonneoplastic lesions of thyroid
Authors: Prasad Priyanka Arvind , Raju Kalyani 
Published: July 2022

Background:
Thyroid neoplasm is one of the most common endocrine neoplasms. The diagnosis and the distinction between malignant and benign neoplasms can be difficult, but it has clinical, therapeutic, and prognostic significance. Hence, it is necessary to make precise diagnosis by using biomarkers.

Materials and Methods:
This is a laboratory observational study considering histologically diagnosed cases of papillary thyroid carcinoma (PTC) and nonneoplastic thyroid lesions. Immunohistochemistry (IHC) staining was done on tissue sections of all cases for CK19 and galectin-3 using appropriate positive and negative controls. The expression of immunomarkers was evaluated by a semi-quantitative method as negative, weak positive, moderate positive, and strong positive. The data were entered in Microsoft Excel sheet and were analyzed using SPSS 22 version software.

Results:
A total of 52 cases were considered for the study, of which 26 cases each were PTC and nonneoplastic lesions of thyroid. Among the 26 PTC cases, 6 were classical variant of PTC (CVPTC) and 20 were follicular variant of papillary thyroid carcinoma (FVPTC). Among 26 nonneoplastic cases, 13 each were nodular hyperplasia cases and lymphocytic thyroiditis. There was a statistically significant (P < 0.01) association of CK19 and galectin-3 expression between CVPTC and FVPTC. There was no statistically significant association (P = 0.271) of CK19 expression between PTC and nonneoplastic cases. There was a statistically significant association (P = 0.003) of galectin-3 expression between PTC and nonneoplastic cases.

Conclusion:
Galectin-3 expression can be used to differentiate PTC from nonneoplastic lesions of thyroid in ambiguous cases. Galectin-3 and CK19 expression can be used to classify PTC into CVPTC and FVPTC.
Assessment of angiogenesis using endoglin in salivary gland tumors – An immunohistochemical study
Authors: Gaonkar Pratyusha Prakash , Patankar Sangeeta R. , Sridharan Gokul 
Published: July 2022

Background:
Endoglin, a co-receptor of transforming growth factor (TGF)-β1 and TGF-β2, is indispensable for endothelial cell proliferation and modulation of tumor promotion activities of TGF-β1. The assessment of neovascularization using endoglin expression has been considered a potential predictor of prognosis in various solid malignancies.

Aims and Objectives:
To analyze the expression of endoglin by immunohistochemistry in both benign and malignant salivary gland tumors.

Materials and Methods:
Fifteen cases of benign salivary gland tumors and seventeen cases of malignant salivary gland tumors were included in the study, and immunohistochemistry was performed using anti-CD105 antibody using standard protocol.

Results and Conclusion:
The study demonstrated that there is increased endoglin expression in malignant tumors as compared to their benign counterparts which is suggestive of increased angiogenic activity in tumor areas and could be responsible for the aggressive behavior of the malignancies. The highest density of endoglin-positive blood vessels was observed in the inflammatory tumor stromal areas. Furthermore, a significant increase in endoglin expression was evident as the grade of malignant salivary gland tumor increased. The results of the study indicate that the increased expression of endoglin in high-grade malignancies contributes to their aggressive nature.
Distribution Pattern of Total Corneal Thickness in Keratoconus Versus Normal Eyes Using An Optical Coherence Tomography
Authors: Hashemi Hassan , Heidari Zahra , Mohammadpour Mehrdad , Momeni-Moghaddam Hamed , Khabazkhoob Mehdi 
Published: July 2022

Purpose:To evaluate the total corneal thickness distribution pattern using a high-resolution spectral-domain optical coherence tomography (HR SD-OCT) for distinguishing normal eyes from keratoconus (KCN).Methods:One hundred and forty-four patients were enrolled in three groups (55 normal, 45 mild KCN, and 44 moderate-to-severe KCN eyes) in this prospective diagnostic test study. Total corneal thickness was measured in 8 semi-meridians using HR SD-OCT (Heidelberg Engineering, Heidelberg, Germany) in 5 and 7 mm zones. The central corneal thickness (CCT), corneal focal thinning (minimum thickness [Min], min minus median and maximum [Min-Med, Min-Max]), and asymmetry indices (inferior minus superior [I-S] and supranasal minus infratemporal [SN-IT]) were calculated. One-way analysis of variance and the area under the receiver operating characteristic curve (AUC) were used for the analysis.Results:Thinner CCT, lower Min thickness, more negative Min-Max, Min-Med, and greater I-S and SN-IT were found in KCN eyes compared to the control group (P< 0.001). The inferior and IT semi-meridians were the thinnest locations in KCN cases in the 5 mm central zone (P< 0.001). CCT followed by Min-Med had the highest discriminative ability for differentiating mild KCN (AUC, sensitivity and specificity: 0.822, 87.0%, 60.37% and 0.805, 82.93%, 66.0%, respectively) and moderate-to-severe KCN (0.902, 87.82%, 73.08% and 0.892, 85.37%, and 78.85%, respectively) from normal corneas.Conclusion:The inferior and IT sectors of the cornea with the largest thickness changes in the 5 mm zone are the most common thinning sites in keratoconic corneas, and CCT and Min-Med are the most sensitive indices for the diagnosis of KCN.
Descemet's Stripping Automated Endothelial Keratoplasty Using Donor Tissue from An 83-Day-Old Infant
Authors: Ziakas Nikolaos , Chranioti Angeliki , Tzamalis Argyrios , Giannoulis Dimitrios , Kapantais Dimitrios , Tsatsos Michael , Tsaousis Konstantinos T. 
Published: July 2022

Purpose:
To report a case of Descemet stripping automated endothelial keratoplasty (DSAEK) combined with phacoemulsification in an adult recipient using endothelial graft from an 83-day-old infant donor.

Methods:
A corneoscleral button was obtained from an infant donor and a DSAEK graft was prepared using a microkeratome. In comparison to the standard technique of DSAEK graft preparation some modifications were made in order to avoid inadvertent perforation, as the donor cornea had a very spherical shape, probably due to the very young age of the donor. The DSAEK graft was transplanted to the left eye of a 68-year-old woman suffering from Fuchs' endothelial dystrophy. Her preoperative best-corrected visual acuity (BCVA) in that eye was 20/100 and central corneal thickness 831 μm.

Results:
An uneventful DSAEK combined with phacoemulsification was performed. The main complication noted was detachment of the peripheral part and contraction of the corneal graft, observed two months after the procedure. The implanted tissue remained centrally attached with a BCVA of 20/40, 3 years postoperatively.

Conclusion:
This case report highlights the difficulties emerging from preparation and implantation using an endothelial graft tissue from the youngest ever reported donor.
Effect of Prophylactic Aqueous Suppression on Ahmed Glaucoma Valve Surgery Success
Authors: Saha Rini , Dharia Riddhi Shah , Trope Graham E. , Buys Yvonne M. 
Published: July 2022

Purpose:
To evaluate the effect of prophylactic aqueous suppressants immediately post-Ahmed glaucoma valve (AGV) surgery on the rate of hypertensive phase and success.

Methods:
Retrospective case–control study of 80 eyes with refractory glaucoma undergoing AGV surgery. Forty eyes in the intervention group (preoperative aqueous suppressants continued postoperatively) and 40 in the control group (all glaucoma drops stopped after surgery and reintroduced as required) were included in this study. Patients were followed for 1 year. Data collected included intraocular pressure (IOP), number of glaucoma medications, and number of eyes requiring further IOP lowering surgery. The frequency of hypertensive phase and 1-year success was compared between the groups.

Results:
Hypertensive phase occurred in 22.5% of the intervention group compared to 42.5% of the control group; however, this difference was not statistically significant (P = 0.06). Success at 1 year (IOP ≤21 mmHg but ≥5 mmHg and 20% reduction from baseline without additional surgery) was similar in each group: 77.5% in the intervention group and 62.5% in the control group (P = 0.22). However, at 1 year, significantly more eyes in the intervention group had an IOP ≤17 mmHg (95% vs. 80%,P= 0.04). The mean time interval to a second IOP lowering procedure was significantly shorter in the control group (P < 0.005).

Conclusions:
With prophylactic preoperative aqueous suppressants, more eyes achieved an IOP of ≤17 mmHg. The time interval to repeat the glaucoma procedure was significantly shorter in the control group.
Comparing Pentacam Hr Screening Indices in Different Normal Corneal Thicknesses Among Refractive Surgery Candidates
Authors: Ghiasian Leila , Abdolalizadeh Parya , Hadavandkhani Ali , Eshaghi Acieh , Hadi Yasaman , Nadjafi-Semnani Fatemeh 
Published: July 2022

Purpose:To compare Pentacam indices in normal eyes with different corneal thicknesses.Methods:It is a retrospective observational study. Ninety-six normal eyes of 96 patients who were referred for refractive surgery in a tertiary university-based hospital from October 2015 to April 2019 were recruited consecutively. Corneal keratometry as well as Pentacam's software Belin-Ambrósio Enhanced Ectasia Display (BAD) parameters including pachymetry progression indices (PPIs), maximum Ambrosio's relational thickness (ART-max), corneal elevations, normalized deviations, BAD total deviation value (BAD-D), and anterior surface indices were measured by Pentacam HR (Type 70900). The included were classified as thin (26 eyes), average (45 eyes), and thick (25 eyes) corneas with the thinnest point thickness of ≤496 μm, 497–595 μm, and ≥596 μm, respectively. The specificities of all parameters were calculated based on routine cut-off values.Results:The refraction, keratometry, and elevations were not different (P> 0.05). All PPIs (minimum, average, and maximum) of thick corneas were significantly lower than average and thin corneas (P< 0.001). ART-max increased by thickening of the cornea (P< 0.001). BAD-D score and normalized indices of pachymetric parameters decreased with the increase of thickness (P< 0.001), while specificities of all indices increased with corneal thickening. More than 96% of thick corneas were classified as normal PPI-max (24/25), ART-max (25/25), and BAD-D (25/25), while nearly <54% of thin corneas (14/26 for PPI-max, 9/26 for ART-max, and 12/26 for BAD-D) were normal.Conclusions:The pachymetry-related indices and BAD-D were different among normal corneas with various thicknesses. The specificities of PPIs, ART-max, and BAD-D of thin corneas were lower than in thick corneas.
Efficacy and Safety of Aflibercept Therapy for Diabetic Macular Edema
Authors: Santhakumaran Sangeetha , Salimi Ali , Brunetti Vanessa C. , Galic John 
Published: July 2022

Purpose:
To assess the real-world efficacy and safety of aflibercept for the treatment of diabetic macular edema (DME).

Methods:
A systematic search was conducted across multiple databases. Articles were included if participants had DME and received aflibercept treatment for a minimum of 52 ± 4 weeks. Primary outcomes included changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT). A risk of bias assessment of studies was completed, pooled estimates were obtained, and a meta-regression was performed. Information on adverse events was collected.

Results:
The search yielded 2112 articles, of which 30 were included. Aflibercept was more effective than laser photocoagulation functionally (12-month BCVA-weighted mean difference [WMD] = 10.77 letters,P< 0.001; 24 months = 8.12 letters,P< 0.001) and anatomically (12-month CMT WMD = –114.12 μm,P< 0.001; 24 months = –90.4 μm,P= 0.004). Compared to bevacizumab, aflibercept was noninferior at improving BCVA at 12 months (WMD = 1.71 letters,P= 0.34) and 24 months (WMD = 1.58 letters,P= 0.083). One study found that aflibercept was more effective than bevacizumab anatomically at 1 and 2 years (P < 0.001 at 12 and 24 months). Compared to ranibizumab, aflibercept rendered a greater improvement in BCVA at 1 year (WMD = 1.76 letters,P= 0.001), but not 2 years (WMD = 1.66 letters,P= 0.072). CMT was not significantly different between both therapies at 12 months (WMD = −14.30 μm,P= 0.282) and 24 months (P = 0.08). One study reported greater functional improvement with aflibercept compared with dexamethasone (P = 0.004), but inferiority in reducing CMT (P < 0.001). Meta-regression analysis demonstrated that dosing schedule was found to impact outcomes at 12 and 24 months, while study design and sample size did not impact outcomes at 12 months. There were minimal safety concerns using aflibercept therapy.

Conclusions:
Aflibercept is a safe and effective therapy option for DME in the clinical setting, performing superiorly to laser photocoagulation. Evidence regarding comparisons with bevacizumab, ranibizumab, and dexamethasone is mixed and limited.
Early Macular Thickness Changes after Trabeculectomy and Combined Phaco-Trabeculectomy
Authors: Nilforushan Naveed , Loni Shima , Abdolalizadeh Parya , Miraftabi Arezoo , Banifatemi Mohammad , Rakhshan Reza , Jafari Samira , Abolfathzadeh Navid 
Published: July 2022

Purpose:
To assess postoperative changes in central retinal thickness (RT) following trabeculectomy and combined phaco-trabeculectomy using spectral domain-optical coherence tomography.

Methods:
In a prospective interventional comparative study, 64 consecutive glaucoma patients who underwent trabeculectomy (32 eyes) or phaco-trabeculectomy (32 eyes) were included. A macular thickness map using the Early Treatment Diabetic Retinopathy Study circles of 1 mm, 3 mm, and 6 mm was the standard to evaluate the 9-subfield thickness preoperatively and again at 1 and 3 months after surgery. Four subfields in each of the 3 mm and 6 mm rings were considered parafoveal and perifoveal regions, respectively.

Results:
Preoperative measurements were similar in the two groups, except patients in the combined group which were older (P = 0.002). The mean RT in the combined phaco-trabeculectomy group at month 1 was significantly higher than baseline measurements at central subfield retinal thickness (CSRT) (P = 0.01), temporal (P = 0.001), and inferior (P = 0.04) parafoveal and temporal (P = 0.01), superior (P = 0.02), and nasal (P < 0.001) perifoveal quadrants; however, RT changes in the trabeculectomy-only group were not statistically significant at months 1 and 3 (P > 0.05). The increase in the temporal perifoveal RT of the combined phaco-trabeculectomy group persisted at month 3 (P = 0.01), while the RT in other sectors returned to preoperative values. The two treatment groups did not differ in terms of changes in the CSRT over time (P = 0.37). In addition, no difference was observed between the treatment groups regarding the parafoveal RTs at each time points (0.06 ≤P ≤ 0.29).

Conclusions:
There was no significant difference in the pattern of changes of CSRT and parafoveal RT between trabeculectomy and combined phaco-trabeculectomy treatment groups up to 3 months after surgery. Some detectable increase in RT in the combined phaco-trabeculectomy will reverse to baseline values 3 months after surgery, except in the temporal perifoveal region.