bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Osteosarcoma from the Spine: A Population-Based Database Study
Authors: Tang Chao , Wang Ruiliang , Xu Hengyuan , Zhang Hailong
Published: August 2020

PurposeThe treatment of osteosarcoma of the spine remains controversial. Our aim is to explore the treatment of patients with spinal osteosarcoma. MethodsWe analyzed the date collected 727 spinal osteosarcoma patients from the Surveillance Epidemiology and End Results (SEER) databases between 1973 and 2015. X-tile software was performed to find the optimal cut-off values of age and economic income. Univariate and Multivariate Cox analyses were used to identify the independent prognostic factors. Logistic regression model was conducted to clear the factors associated to surgical compliance; Kaplan-Meier estimator method was adopted to analyze the Overall survival (OS) and Cancer-specific survival (CSS). ResultsAmong 727 eligible spinal osteosarcoma patients, 370 (50.9%) patients received surgical treatment, 357 (49.1%) cases without surgery. There were significant differences in the effects of age at diagnosis, SEER historic stage and tumor grade on surgical treatment (All P < 0.05). Surgery was an independent prognostic factor for OS and CSS of spinal osteosarcoma patients. Spinal osteosarcoma patients undergone surgery group showed favorable survival than the other group.ConclusionsSurgery can provide survival benefits for patients with osteosarcoma of the spine. Spinal osteosarcoma patients with undergone surgery have favorable survival and surgery can become a suitable treatment for patients.
Establishment of a pediatric surgical unit at a university hospital in Eastern Africa
Authors: Hubertus Jochen , Abera Gersam , Haileamlak Abraham , Siebeck Matthias , von Schweinitz Dietrich , Wagner Ferdinand , Eckle Rosa , Wessel Lucas , Ritz Laura Antonia , Berger Michael Fabian , Ardelean Mircia , Becker Kristina , Seifu Alemu
Published: August 2020

Background
Ethiopia is a rapidly developing country in Eastern Africa. 43.2% of the population is younger than 15. In contrast, until a few years ago, pediatric surgery was only available in Addis Ababa. Now, Ethiopia is making great efforts to improve the care of surgical ill children. JimmaChild was established to set up a pediatric surgery in Jimma.
Methods
JimmaChild developed from a scientific collaboration between Jimma University (JU) and Ludwig-Maximilians-University. The project was developed and realized by Ethiopian and German colleagues. A curriculum was written for this purpose. The pediatric surgical training of the fellows was carried out on-site by German pediatric surgeons.
Results
A new pediatric surgery was established at JU with its own operating room, ward, and staff. After two and a half years, two fellows completed their final examinations as pediatric surgeons. Among others, 850 elective surgeries were performed, 82% assisted by the German colleagues. The German colleagues rated the preparation for the trip, the on-site support, and the professional progress of the fellows mostly as good to very good. Reported problems in the program flow were also recognized and solved in part.
Conclusions
Best possible integration of the project into existing structures was achieved by close cooperation of Ethiopian and German colleagues during the project development. Problems were identified and addressed early on by external monitoring. As the project responsibility was mainly with the Ethiopian colleagues, a department was created that now exists independent of external funding and trains its own fellows.
The Extent of Participation in Urban Agriculture and Its Effect on Food Security in Africa and Asia: Evidence from Ghana and India
Authors: Bannor Richard Kwasi , Sharma Mohit , Oppong-Kyeremeh Helena
Published: August 2020

The authors have withdrawn this preprint due to erroneous posting.
High-dose vitamin C infusion for the treatment of critically ill COVID-19
Authors: Zhang Jing , Rao Xin , Li Yiming , Zhu Yuan , Liu Fang , Guo Guangling , Luo Guoshi , Meng Zhongji , Backer Daniel De , Xiang Hui , Peng Zhi-Yong
Published: August 2020

BackgroundNo specific medication has been proven effective for the treatment of patients with severe coronavirus disease 2019 (COVID-19). Here, we tested whether high-dose vitamin C infusion was effective for severe COVID-19.MethodsThis randomized, controlled clinical trial was performed at 3 hospitals in Hubei, China. Patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the ICU were randomly assigned in as 1:1 ratio to either the high-dose intravenous vitamin C (HDIVC) or the placebo. HDIVC group received 12 g of vitamin C/50 ml every 12 hours for 7 days at a rate of 12 ml/hour, and the placebo group received bacteriostatic water for injection in the same way. The primary outcome was invasive mechanical ventilation-free days in 28 days(IMVFD28). Secondary outcomes were 28-day mortality, organ failure, and inflammation progression.ResultsFifty-four critical COVID-19 patients were ultimately recruited. There was no difference in IMVFD28 between two groups. During the 7-day treatment period, patients in the HDIVC group had a steady rise in the PaO2/FiO2 (day 7: 229 vs. 151 mmHg, 95% CI 33 to 122, P = 0.01). Patients with SOFA scores ≥ 3 in the HDIVC group exhibited a significant reduction in 28-day mortality (P = 0.05) in univariate survival analysis. IL-6 in the VC group was lower than that in the placebo group (19.42 vs. 158.00; 95% CI -301.72 to -29.79; P = 0.04) on day 7.ConclusionThe addition of HDIVC may provide a protective clinical effect without any adverse events in critically ill patients with COVID-19.Clinicaltrial.gov identifer: NCT04264533
The Cingulate Structures in Autism Spectrum Disorder: Exploring Its Implication on Social Awareness and the Role of CNTNAP2
Authors: Chien Yi-Ling , Chen Yu-Chieh , Gau Susan Shur-Fen
Published: August 2020

Backgrounds Although evidence suggests that the activity of the anterior cingulate cortex involves social cognition, there are inconsistent results regarding the aberrant cingulate gray matter (GM) and scanty evidence about altered cortical thickness and white matter (WM) of cingulate in individuals with autism spectrum disorder (ASD). Evidence supports the association between the autism risk gene CNTNAP2 variants and altered brain connectivity. This study investigated the cingulate substructure and its association with social awareness deficits and the CNTNAP2 variants in individuals with ASD. Methods We assessed 122 individuals with ASD and 118 typically-developing controls (TDC) with MRI and clinical evaluation. The GM, WM volumes and cortical thickness of the cingulate gyrus were compared between ASD and TDC based on fine parcellation. Five SNPs of the CNTNAP2 linking to ASD and brain structural abnormality were genotyped. Results ASD individuals showed thinner cortical thickness in bilateral cingulate subregions than TDC but no significant group differences in GM and WM volumes. The WM volume of the right anterior cingulate gyrus was correlated with social awareness deficits in ASD. Two CNTNAP2 variants demonstrated the main effects on the WM volumes of the right middle cingulate gyrus and the cortical thickness of the right posterior ventral cingulate gyrus. Besides, the CNTNAP2 variants interacted with ASD status and age on the cortical thickness of the left anterior middle cingulate cortex.Limitations The CNTNAP2 variants selected in this study were based on the current literature that repeatedly revealed genetic associations with ASD and brain structures. Future studies may consider fine mapping or sequencing of this gene. Besides, we measured social awareness deficits by caregiver-report questionnaire. Although the observation from caregivers may reflect social function in daily life, a social cognition task may better provide a standardized measurement.Conclusions Our findings suggest that aberrant cingulate structure in ASD may be associated with the severity of autistic symptoms and genetic variants of the CNTNAP2. These novel findings need validation. Trial registration: ClinicalTrials.gov number, NCT01582256
Structural Equation Modeling for Identification of Patient Safety Antecedents in Primary Care
Authors: Kosiek Katarzyna , Staniec Iwona , Godycki-Cwirko Maciej , Depta Adam , Kowalczyk Anna
Published: August 2020

Background: To create an integrative model of patient safety, concerning antecedents based on the perception of patient safety improvement strategies expressed by primary care professionals: facilities available in the practice, communication and collaboration, education on patient safety and generic conditions for patient safety. Methods: We attended several conferences and seminars in Poland where we presented these strategies. In this way, we gained contacts with doctors potentially interested in patient safety. We ensured ourselves contact persons who could respond to our questionnaire. Those persons assured us that they would send the names of prospective respondents. In this research we were used questionnaire form research Gaal S, Verstappen W, Wensing M (1). The results were analyzed with SPSS 20 and AMOS. A hypothetical model of direct and indirect effects on patient safety in a primary care environment was created and analyzed using structural equation modeling (SEM). Results: Improved implementation of strategies was directly and indirectly associated with better patient safety. SEM proved to be an effective tool to analyse safety in primary care. The facilities in the practice appear to have no significant influence on patient safety management in the case of female respondents, those age lower than mean, current professional discipline is not GP and respondents not work in counselling centres.Conclusions: The following should be improved to ensure patient safety: Generic conditions for patient safety, facilities in the practice, communication and collaboration, and education on patient safety.
Tuberculosis (TB) in the Refugee Camps in Ethiopia: Trends of Case Notification, Profile, and Treatment Outcomes, 2014 to 2017
Authors: Legesse Tsegay , Admenur Goitom , Gebregzabher Selemawit , Woldegebriel Eyob , Fantahun Bexabeh , Tsegay Yemane , Bayssa Abeyot , Darge Berihu , Denbu Yidnekachew , Michalel Hayelom , Abera Kibebew , Alemayeh Abraham , Kebede Dejene , Kassa Desta
Published: August 2020

Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to evaluate the effectiveness of TB programs. This study aimed to determine trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods: This retrospective cohort study was conducted from October 2018-June 2019. Demographic and clinical data of all TB cases registered from 2014 to 2017 in 25 refugee camps located in seven refugee areas (Shire, Afar, Gambella, Asossa, Mizam, Jijiga, and Dollo Ado) were extracted using pre-tested data extraction format. Multivariate logistic regression was performed to calculate odds ratios and 95% confidence intervals for factors associated with unsuccessful outcomes.Results. A total of 1553 TB cases, mean age 27.7 years, were registered (2014-2017). Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in the number of notified TB cases (138 to 588 cases), in the percentage of EPTB (23.2% to 32.7%), bacteriologically confirmed pulmonary new and relapse (43.8% to 64.8%), and contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%). Treatment success rates for all TB cases remained lower at 72.7%-79.4% (on average 11.7% were not evaluated, 8.0% lost to follow-up (LTFU), 4.8% died, and 0.5% failed). Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive.Conclusions: This study has provided valuable evidences that can help to improve the TB programs. There was increased trend in number of notified TB cases, and in proportion of EPTB, childhood TB, and bacteriologically confirmed pulmonary new and relapse cases. Treatment success rate (2014-2017) was far below global target (90%), and “not evaluated” and LTFU treatment outcomes were higher, which need to be improved. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives who at risk for unsuccessful treatment.
Volatile metal emissions from volcanic degassing and lava-seawater interactions at Kīlauea Volcano, Hawai’i
Authors: Mason Emily , Wieser Penny , Liu Emma , Edmonds Marie , Ilyinskaya Evgenia , Whitty Rachel , Mather Tamsin , Elias Tamar , Nadeau Patricia , Wilkes Thomas , McGonigle Andrew , Pering Tom , Mims Forrest , Kern Christoph , Schneider David , Oppenheimer Clive
Published: August 2020

Volcanoes represent one of the largest natural sources of metals to Earth’s surface. Emissions of these pollutants and/or nutrients have important implications for the biosphere. We compare gas and particulate chemistry, including metals, of the substantial magmatic (≥200 kt/day SO2) and lava-seawater interaction (laze) plumes from the 2018 eruption of Kīlauea, Hawai’i. The magmatic plume contains abundant volatile chalcophile metals (e.g. Se), whereas the laze is enriched in seawater components (e.g. Cl), yet Cu concentrations are 105 times higher than seawater. High-temperature speciation modelling of magmatic gases at the lava-air interface emphasises chloride’s critical role in metal/metalloid complexation during degassing. In the laze, concentrations of moderately (Cu, Zn, Ag) to highly volatile (Bi, Cd) metals are elevated above seawater. These metals have an affinity for chloride and are derived from late-stage degassing of distal lavas, potentially facilitated by the HCl gas formed as seawater boils. Understanding these processes yields insights into the environmental impacts of volcanism in the present day and geological past.
The Intrinsically Disordered Region of GCE Protein Adopts a More Fixed Structure by Interacting With the LBD of the Nuclear Receptor FTZ-F1
Authors: Kolonko Marta , Bystranowska Dominika , Taube Michał , Kozak Maciej , Bostock Mark , Popowicz Grzegorz , Ożyhar Andrzej , Greb-Markiewicz Beata
Published: August 2020

The Drosophila melanogaster Germ cell-expressed protein (GCE) is a paralog of the juvenile hormone (JH) receptor - Methoprene tolerant protein (MET). Both proteins mediate JH function, preventing precocious differentiation during D. melanogaster development. Despite that GCE and MET are often referred to as equivalent JH receptors, their functions are not fully redundant and show tissue specificity. Both proteins belong to the family of bHLH-PAS transcription factors. The similarity of their primary structure is limited to defined bHLH and PAS domains, while their long C-terminal fragments (GCEC, METC) show significant differences and are expected to determine differences in GCE and MET protein activities. In this paper we present the structural characterization of GCEC as a coil-like intrinsically disordered protein (IDP) with highly elongated and asymmetric conformation. In comparison to previously characterized METC, GCEC is less compacted, contains more molecular recognition elements (MoREs) and exhibits a higher propensity for induced folding. The NMR shifts perturbation experiment and pull-down assay clearly demonstrated that the GCEC fragment is sufficient to form an interaction interface with the ligand binding domain (LBD) of the nuclear receptor Fushi Tarazu factor-1 (FTZ-F1). Significantly, these interactions can force GCEC to adopt more fixed structure that can modulate the activity, structure and functions of the full-length receptor. The discussed relation of protein functionality with the structural data of inherently disordered GCEC fragment is a novel look at this protein and contributes to a better understanding of the molecular basis of the functions of the C-terminal fragments of the bHLH-PAS family.
Role of Plastic Surgeons in the Trauma Center: National Level I Trauma Center Startup Experience in South Korea 
Authors: Lee Il Jae , Cha Bo Hwan , Hahn Hyung Min
Published: August 2020

Background: Although it is well-recognized that other surgical specialties perform various procedures related to trauma care, there is a lack of analyses focusing on the role of plastic surgical management in trauma centers in Korea. This retrospective study was designed to investigate the scope of plastic surgery services in acute trauma care, using clinical data obtained from a single, regional, level I, trauma center.Methods: This study included patients who presented to a single, regional, level I, trauma center in March 2016. Of them, patients with acute trauma to the facial soft tissue and skeleton, soft tissue of the upper and lower limbs, trunk and perineum, and other areas requiring plastic surgical procedures were included in the analysis. Data on patients’ demographics and detailed surgical procedures were acquired from electric medical records.Results: A total of 1,544 patients underwent surgery, and 2,217 procedures were recorded during the 2-year study period. In 2016, 1,062 procedures on 690 patients, and, in 2017, 1,155 procedures on 787 patients were registered. The head and neck region was the most commonly observed anatomical area that was operated on. The facial bone requiring the largest degree of surgical intervention was the mandible, followed by the zygomatic bone, nasal bones, orbital floor, and maxilla. Microsurgical procedures, such as flap surgery and microsurgery, were performed in 121 cases. Conclusion: Plastic surgeons work alongside experts from various specialties to restore the appearance and function of a specific anatomical area. Thus, plastic surgeons are an essential part of trauma centers.Trial registration: Not applicable.
Evaluation of the Efficacy of Unipolar and Bipolar Spinal Dorsal Root Ganglion Radiofrequency Thermocoagulation in the Treatment of Postherpetic Neuralgia: a Retrospective Study
Authors: Zhu Jianjun , Xie Keyue , Liu Songlei , He Qiuli , Luo Ge , Tao Jiachun , Wang Tingting , Xu Miao , Fu Jie , Huang Bin , Yao Ming
Published: August 2020

Background: At present, different views have been proposed on the radiofrequency treatment modes and parameters of radiofrequency thermocoagulation of the spinal dorsal root ganglion for the treatment of postherpetic neuralgia. It is urgent to identify a novel and more effective radiofrequency therapy for patients with postherpetic neuralgia. Methods: A total of 60 patients who underwent radiofrequency thermocoagulation therapy for postherpetic neuralgia in the pain department of our Hospital were retrospectively reviewed from January 2013 to November 2017. According to the different surgical methods, the patients were divided into the following groups: unipolar group (CRF) and bipolar group (DCRF). Subsequently, the pain scores (NRS) were evaluated at the following specific time points: before the operation, on the 1st day after the operation, in 3 and 6 months after the operation and in 1 and 2 years after the operation. Moreover, the incidence of intraoperative and postoperative complications and the degree of pain relief were evaluated in order to assess the efficacy and prognosis of radiofrequency thermocoagulation in the two groups. The in vitro ovalbumin experiment was used to indicate the effects of unipolar and bipolar radiofrequency thermocoagulation.Results: In this study, the intra-group comparison indicated that compared with the preoperative NRS, the postoperative NRS decreased significantly; the inter-group comparison demonstrated that the NRS of the DCRF group was lower than that of the CRF group at all time points from 6 months to 2 years following the operation. The total effective rate of the DCRF group was significantly higher than that of the CRF group in 2 years following the operation. The incidence of numbness in the DCRF group was higher than that noted in the CRF group at each time point following the operation. The ovalbumin experiments in vitro indicated that the effects of radiofrequency thermocoagulation were optimal when the distance between the two needles was 5 mm.Conclusion: Bipolar spinal root ganglion radiofrequency thermocoagulation exhibits a longer duration and higher effective rate in the treatment of postherpetic neuralgia and it’s a treatment method worth promoting.
Driving Force of Covid-19 Among People Living With HIV/AIDS in Wuhan, China
Authors: Guo Wei , Ming Fangzhao , Dong Yu , Zhang Qian , Liu Lian , Gao Ming , Zhang Xiaoxia , Mo Pingzheng , Feng Yong , Tang Weiming , Liang Ke
Published: August 2020

Background: Even people living with HIV/AIDS (PLWHA) were considered to be at increased risk of SARS-CoV-2 infection, the driving force among this group of individuals is still not clear. Methods: We investigated 1,701 PLWHA through a telephone interview and found 11 COVID-19 patients in four districts of Wuhan, China. The demographic features and major clinical characteristics of these patients were retrieved from the information management systems for COVID-19 patients of four districts’ CDC. Statistical analysis was performed to find out the driving force of COVID-19 among PLWHA.Results: The incidence proportion of COVID-19 in PLWHA is 0.6% (95% CI: 0.2% - 1.0%), which is comparable to the overall population incidence rate in Wuhan city (0.6%). Nine out of the 11 COVID-19/AIDS patients had relatively high CD4+ T lymphocyte count (>200/μl) and undetectable HIV viral load (＜20 copies/ml), and ten of them were on antiretroviral therapy. PLWHA who were old, had low CD4+ T lymphocyte count, infected HIV through homosexual activity, and had been diagnosed for HIV for a long time, were more likely to develop COVID-19.Conclusions: PLWHA has comparable COVID-19 morbidity rates as the general population, and older age, low CD4 count, long length since HIV diagnosis, and treatment-naive were potential driving forces of COVID-19 occurrence among PLWHA. Strategies in preventing SARS-CoV-2 infection among PLWHA with worse immune responses are needed. Article Summary Line: As COVID-19 continues to spread around the world, people living with HIV/AIDS (PLWHA) are also at risk of infection with SARS-CoV-2. We investigated the factors associated with SARS-CoV-2 infection among PLWHA in Wuhan, China.
Newborn Screening for SMA - Results After Two Years of a Large Pilot Project 
Authors: Vill Katharina , Schwartz Oliver , Blaschek Astrid , Gläser Dieter , Nennstiel Uta , Wirth Brunhilde , Burggraf Siegfried , Röschinger Wulf , Becker Marc , Czibere Ludwig , Durner Jürgen , Eggermann Katja , Olgemöller Bernhard , Harms Erik , Schara Ulrike , Kölbel Heike , Müller-Felber Wolfgang
Published: August 2020

Background: Spinal muscular atrophy (SMA) is the most common neurodegenerative disease in childhood. Since motor neuron injury is mostly not reversible, early diagnosis and treatment are essential to prevent major disability. The aim of this study was to assess the impact of newborn screening (NBS) for SMA on clinical outcome. Methods: The pilot project started in January 2018 in Germany and is still ongoing. Genetic screening via PCR of the SMN1 gene from dried blood spots was implemented in the routine NBS structure. Follow-up included neurophysiological examinations, CHOP INTEND and HINE-2.Results: Among 297,163 screened children, 43 cases of SMA were identified, resulting in an incidence of 1:6910. In 21 patients with ≤3 SMN2 copies, treatment with nusinersen according to the FDA/EMA guidelines was started age 14-39 days. Median follow-up period, regarding motor milestones was 12.3 months (range 1.5-26 months). All pre-symptomatically treated patients remained asymptomatic as far as age at last examination already allows this statement. 41% of patients with 2 SMN2 copies had already early, mostly subtle signs of disease. These patients reached motor milestones, however with a certain delay. None developed respiratory symptoms. Two untreated patients with 2 SMN2 copies died. Four untreated patients with 3 SMN2 copies, one of whom was initially diagnosed with 4 SMN2 copies by a different method, developed proximal weakness at ages 6-11 months. Two siblings of babies with 4 SMN2 copies were identified with a missed diagnosis of SMA 3. Conclusion: Identification of newborns with infantile SMA improves neurodevelopmental outcome enormously. It should be introduced in all countries where therapy is available. Detection of SMA via NBS did not increase the incidence compared to the known incidence rate. Early treatment of patients with 4 SMN2 copies should be considered.
New Detection and Treatment for Chlamydia Psittaci: A Case Report
Authors: Wu Xiaojing , Li Yang , Feng Yingying , Li Min , Tian Ye , Wang Qianlin , Lu Binghuai , Zhan Qingyuan
Published: August 2020

Background: The presentation of psittacosis can vary from subclinical infection to fatal pneumonia with a high mortality rate. Chlamydia psittaci infection during pregnancy is rare and might result in placental involvement, premature delivery or miscarriage. Herein, we report a case of severe pneumonia in a pregnant woman caused by C. psittaci.Case presentation: A 27-year-old female with a pregnancy at 22 weeks was admitted with hyperpyrexia, dry cough and dyspnea. Laboratory tests showed increased white blood cell count and slightly-elevated procalcitonin. Chest computed tomography scan revealed consolidation in the lingual and inferior lobe of the left lung. She suffered rapidly progressing respiratory failure and required mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Her sample of bronchoalveolar lavage fluid (BALF) was collected, from which C. psittaci was detected using next-generation sequencing (NGS). The pathogen was further confirmed by polymerase chain reaction (PCR) with the primers specific for the microorganism. Moreover, paired serum tests showed elevated C. psittaci group titer in both IgG and IgM. She was treated with azithromycin and tigecycline. After 24-day hospitalization, the patient was clinically well and discharged home.Conclusion: We report a case of severe pneumonia in a pregnant woman caused by C. psittaci, which diagnosed by NGS, and was cured without adverse effects on infant with tigecycline. The introduction of NGS and other effective assays might increase the detection rate. C. psittaci infection in pregnant women is very rare, but critical. Early diagnosis and correct treatment may save the mother and fetus. New tetracycline agent, tigecycline, may also be an effective alternative and should be further evaluated in psittacosis.
Intramasseteric Schwannoma Mimicking a Parotid Tumor: Case Report and Review of Literature
Authors: cai weixin , Xie Nan , Hu Jing , Wang Cheng
Published: August 2020

BackgroundSchwannoma is a benign neoplasm originating from Schwan cells of peripheral nerves as well as the cranial and spinal roots. It often occurred in head and neck region involving cranial nerves VII, VIII, and XII. However, schwannoma located in intramasseteric region is extremely uncommon. There have been only ten reported cases documented in English literatures to date. Case presentationHere, we report a rare intramasseteric schwannoma case, who presented a painless mass in the left cheek with 2 years evolution and was treated with surgical excision through trans-parotid approach. An uneventful recovery without salivary fistula or facial paralysis was recorded after the surgery. Due to its rarity and clinical significance, we also review intramasseteric schwannoma regarding its clinical characteristics and surgical managements.ConclusionIn a word, intramasseteric schwannoma is a benign lesion with favorable prognosis. MRI (magnetic resonance imaging) scanning is recommended for evaluation and differential diagnoses for this condition. Surgical excision of the tumor without parotidectomy is considered to be effective.
Evaluating the Impact of Financial Incentives on SNAP Transactions Shopping at Mobile Produce Markets
Authors: Rummo Pasquale , Lyerly Reece , Rose Jennifer , Malyuta Yelena , Cohen Eliza Dexter , Nunn Amy
Published: August 2020

Background. Offering financial incentives promotes increases in fruit and vegetable purchases in farmers’ markets and supermarkets. Yet, little is understood about whether food-insecure adults purchase more fruits and vegetables as a result of receiving financial incentives in mobile produce market settings.Methods. In 2018-2019, Food on the Move provided a 50% discount to customers using Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fruit and vegetables from 16 market locations in Rhode Island (n=412 market occasions). We used mixed multivariable linear regression to estimate the difference in total dollar sales per transaction per month between SNAP customers and non-SNAP customers. We also estimated the difference in out-of-pocket dollar sales per transaction per month between SNAP and non-SNAP customers, less the 50% discount. This reflects the actual amount spent on fresh fruits and vegetables purchased per visit. In both models, we controlled for the number of market sites per month, with fixed effects for quarter and year.Results. In 2018-2019, the majority of market transactions (n=13,165) were SNAP transactions [n=8,293 (66.0%)]. On average, customers spent $17.32 (SD=16.61) on fruits and vegetables per transaction per month. However, SNAP customers spent significantly more on FVs per transaction per month [$21.68 (SD=17.87)] compared to non-SNAP customers [$9.89 (SD=10.71)] (β=$10.54; 95% CI: 9.85, 11.23). Similarly, out-of-pocket dollar sales per transaction per month (i.e., less the 50% discount) were significantly higher among SNAP customers [$11.47 (SD=9.44)] relative to non-SNAP customers [$9.48 (SD=9.36)] (β=$1.86; 95% CI: 1.44, 2.27).Conclusions. Financial incentives contributed to higher fruit and vegetable purchases among low-income customers who shop at mobile produce markets compared to non-eligible customers. Higher spending on fruits and vegetables may promote healthy diet behaviors and reduce chronic disease risk among food-insecure adults.
Treatment Preference Among Patients With Spinal Muscular Atrophy (SMA): A Discrete Choice Experiment
Authors: Monnette Alisha , Chen Er , Hong Dongzhe , Bazzano Alessandra , Dixon Stacy , Arnold W. David , Shi Lizheng
Published: August 2020

OBJECTIVE: To examine patient/caregiver preference for key attributes of treatments for spinal muscular atrophy (SMA). BACKGROUND: In the rapidly evolving SMA treatment landscape, it is critically important to understand how attributes of potential treatments may impact patient/caregiver choices.DESIGN/METHODS: A discrete choice experiment survey was developed based on qualitative interviews. Patients with SMA (18 years) and caregivers of patients were recruited through a U.S. patient organization. Respondents made choices in each of 12 sets of hypothetical treatments. The relative importance of five treatment characteristics was compared (measured by regression coefficients [RC] of conditional logit models): (1) improvement or stabilization of motor function, (2) improvement or stabilization of breathing function, (3) indication for all ages or pediatric patients only, (4) route of administration (repeated intrathecal [IT] injections, one-time intravenous [IV] infusion, daily oral delivery) and (5) potential harm (mild, moderate, serious/life threatening).RESULTS: Patient ages ranged from less than 1 to 67 years (n=101, 65 self-reported and 36 caregiver-reported) and 64 were female. Total SMA subtypes included: type 1 (n=21), type 2 (n=48), type 3 (n=29), other (n=3). Prior spinal surgery was reported in 47 patients. Nusinersen and onasemnogene abeparvovec-xioi use were reported in 59 and 10 patients, respectively. Improvement in motor and breathing function was highly valued (RC: 0.65, 95% confidence interval [CI]: 0.47–0.83 and RC: 0.79, 95% CI: 0.60–0.98, respectively). Oral medication and one-time infusion were strongly preferred over repeated IT injections (RC: 0.80, 95% CI: 0.60–0.98 and RC: 0.51, 95% CI: 0.30–0.73, respectively). Patients least preferred an age-restricted label/approved use ( 2 years of age) (RC: -1.28, 95% CI: -1.47 to -1.09). Cross-attributes trade-off decision suggested a lower willingness for a high-risk therapy despite additional efficacy gain. For some patients, there may be willingness to trade off additional gains in efficacy for a change in route of administration from repeated intrathecal administration to oral medication.CONCLUSIONS: Improvements in motor/breathing function, broad indication, oral or one-time infusion, and minimal risk were preferred treatment attributes. Treatment decisions should be made in clinical context and be tailored to patient needs.
Contrast-enhanced Ultrasound Findings of Hemolymphangioma of the Kidney: The First Report in the Literature
Authors: Wang Hong , Yang Dan , Luo Yan , Peng Yulan , Ling Wenwu
Published: August 2020

Background: Hemolymphangioma is a rare vascular and lymphatic malformation. To the author’s knowledge, no cases of hemolymphangioma in the kidney have been reported in the literature. Case presentation: We herein report a case of a 68-year-old man with low back pain. NO abnormalities were revealed in laboratory data including liver, renal function and blood and urine sediments. Ultrasonography showed a huge separated cystic mass in the upper part of left kidney. In contrast-enhanced ultrasound(CEUS) , the lesion of the kidney was hyper-enhanced in the hyper-enhanced in the cortical phase, and hypo-enhancement in medulla and delayed phase. Nephrectomy was performed. The pathologicaI diagnosis was a hemolymphangioma of thekidney. His postoperative course was uneventful and he was discharged on the 12th d after surgery. Conclusions: Although rare, hemolymphangioma should be considered a differential diagnosis for masses occurring in the kidney. Complete surgical resection is the treatment of choice and affords a good prognosis.
Two novel anticancer compounds with minimum cardiotoxic property
Authors: Afsharirad Tayebeh , Tahmasvand Raheleh , Amini Mohsen , Daraei Bahram , Salimi Mona
Published: August 2020

Background: Although two novel synthesized compounds with tri-aryl structures (A and B) have been previously demonstrated to possess remarkable anti-breast cancer activity, their cardiotoxicity remains a major concern due to their mechanism of action. To address this concern, we assessed the ability of these compounds to cause toxicity towards H9c2 cardiomyocytes as an in vitro model of cardiotoxicity. Methods: Cytotoxic activity of both compounds was explored in vitro on H9c2 cells using MTT assay. Annexin V/PI method, intracellular ROS determination and mitochondrial membrane potential assay were applied to elucidate the mechanism of action of the cell death. Results: MTT assay revealed a concentration- and time-dependent cardiotoxicity. Findings of apoptosis by double staining with annexin V and propidium iodide divulged no cell death including apoptosis and necrosis at the concentration that were effective to inhibit cancer cells proliferation (10 µM) at 24 and 48 hours. Furthermore, flow cytometric measurement of membrane potential and ROS determination using DCFH-DA verified the safe concentration of the compounds against H9c2 cells with no cardiotoxic effect. However, the higher concentration of the compounds could induce cell death through ROS-mediated mitochondrial dysfunction. Conclusions: Altogether, the results represented two novel chemical molecules possessing anti-breast cancer activity with minimum cardiac side effect.
Clinician's Attitude to Enteral Nutrition with Percutaneous Endoscopic Gastrostomy: A Survey in China
Authors: Zhang Yijie , Ma Chen , Li Chenxi , Chen Qian , Shen Meifen , Wang Yuyu
Published: August 2020

Background: Percutaneous endoscopic gastrostomy (PEG) are recommended for long-term enteral nutrition. However, long-term nasogastric (NGT) feeding is still commonplace in China. We surveyed Chinese clinicians’ opinions toward PEG feeding in order to identify the potential barriers to acceptancy of PEG feeding.Methods: A self-reported questionnaire was developed and distributed to 600 doctors. Five-point Likert scales were used for most responses.Results: Of 525 respondents, the mainly nutritional support method was NGT while PEG was less used. Doctors working in the tertiary class A hospitals and radiotherapy department were more likely to choose PEG feeding (p=0.000). Overall, 241 (46%) participants do not know PEG and 284 (54%) have different understanding degree of PEG. Age (p=0.002), working life (p=0.044) and professionalism (p=0.005) were significantly related to the understanding of PEG. Levels of agreement was high (score of 3.47) for using PEG in patients with prolonged stroke-associated dysphagia. There was high agreement level in the statement that PEG was unnecessary when NGT could sustain the basic needs of patients, though better outcome can be predicted with PEG feeding. The listed factors influencing physicians' choice of PEG for long-term feeding scored high for all items, ranging from 3.57 to 3.89. Conclusions: Doctors’ insufficient knowledge of PEG feeding, resistance from patients and families, poor cooperation among healthcare professionals (HCPs) and between departments, and a crisis of doctor-patient trust all influence the medical decision-making process, all these factors leading physicians to prefer more conservative treatment to avoid disputes rather than better ones.
Quorum sensing-mediated inter-specific conidial anastomosis tube fusion between Colletotrichum gloeosporioides and Colletotrichum siamense.
Authors: Mehta Nikita , Baghela Abhishek
Published: August 2020

Many plant pathogenic filamentous fungi undergo fusion of conidia through conidial anastomosis tubes (CATs), which is believed to facilitate horizontal gene transfer between species. We discovered a remarkable inter-specific conidial anastomosis tube (CAT) fusion between two important plant fungal pathogens Colletotrichum gloeosporioides and Colletotrichum siamense. In an In vitro assay, under no selection pressure, the inter-specific CAT fusion was preferred with higher frequency (25%) than intra-specific CAT fusion (11%). Different stages of CAT fusion viz. CAT induction, homing, and fusion were observed during this inter-specific CAT fusion. The CAT fusion was found to be higher in absence of nutrients and in the presence of physiological stresses. This CAT fusion involved a quorum sensing phenomenon, wherein the CAT induction was dependent on conidial density and the secreted putative quorum sensing molecules were found to be lipid based in nature. Movement of nuclei, mitochondria, lysosomes and lipid droplets were observed during the CAT fusion. Post CAT fusion, the resulting conidia gave rise to putative recombinants with variable colony characteristics as compared to their parental strains. Few recombinants showed variable AFLP banding pattern compared to their parental strains, thereby suggesting a possible genetic exchange between the two species through CAT fusion. The recombinants exhibited variable fitness under different stress conditions. Our study signifies possible role of inter-specific CAT fusion in generation of genetic and phenotypic diversity in these fungal pathogens.
Risk factors for breast cancer development by tumor characteristics among women with benign breast disease
Authors: Figueroa Jonine , Gierach Gretchen L. , Duggan Máire A. , Fan Shaoqi , Pfeiffer Ruth M. , Wang Yihong , Falk Roni T. , Loudig Olivier , Abubakar Mustapha , Ginsberg Mindy , Kimes Teresa M. , Richert-Boe Kathryn , Rohan Thomas
Published: August 2020

Background: Among women diagnosed with invasive breast cancer, 30% have a prior diagnosis of benign breast disease (BBD). Thus, it is important to identify factors among BBD patients that elevate invasive cancer risk. In the general population, risk factors differ in their associations by clinical pathologic features; however, whether women with BBD show etiologic heterogeneity in the types of breast cancers they develop remains unknown. Methods: Using a nested case-control study of BBD and breast cancer risk conducted in a community healthcare plan (Kaiser Permanente Northwest), we assessed relationships of histologic features in BBD biopsies and patient characteristics with subsequent breast cancer risk, and tested for heterogeneity of associations by estrogen receptor (ER) status, tumor grade and size. The study included 514 invasive breast cancer cases (median follow-up of 9 years post-BBD diagnosis) and 514 matched controls, diagnosed with proliferative or non-proliferative BBD between 1971-2006, with follow-up through mid-2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using multivariable polytomous logistic regression models.Results: Breast cancers were predominantly ER-positive (86%), well- or moderately-differentiated (73%), small (74% <20mm) and stage I/II (91%). Having had an age at first birth <30 years was associated with reduced risk of ER-positive breast cancer (OR=0.69, 95%CI=0.49-0.98), but not of ER-negative disease (OR=1.08, 95%CI=0.51-2.30) p-heterogeneity=0.24. Compared to patients with non-proliferative BBD, proliferative BBD with atypia conferred higher risk for ER-positive (OR=5.48, 95%CI=2.14-14.01) than ER-negative disease (OR=1.52, 95%CI=0.18-13.05, with only one ER-negative case); p-heterogeneity=0.45. Presence of columnar cell lesions (CCLs) at BBD diagnosis was associated with 1.5-fold risk for both ER-positive and ER-negative tumors, with a 2-fold risk (95%CI=1.21-3.58) observed among postmenopausal women (56%), independent of proliferative BBD status with and without atypia. We did not identify statistically significant differences in risk factor associations by tumor grade or size.Conclusion: Most tumors that developed after a BBD diagnosis in this cohort were highly treatable low-stage ER-positive tumors. CCL in BBD biopsies may be associated with moderate increased risk, independent of BBD histology, and irrespective of ER status.
Down-regulated RPS-30 in Angiostrongylus Cantonensis L5 Plays a Defensive Role Against Damage Due to Oxidative Stress
Authors: Sun Weiwei , Yan Xiumei , Shi Qing , Zhang Yuanjiao , Huang Junting , Huang Huicong , Shi Hongfei , Yan Baolong
Published: August 2020

Background: Eosinophilic meningitis, caused by Angiostrongylus cantonensis L5, is mainly attributed to the Eosinophils, which contribute to tissue inflammatory responses in helminthic infections. Eosinophils are associated with helminthic killing, using the peroxidative oxidation and hydrogen peroxide (H2O2) generated by dismutation of superoxide produced during respiratory burst. In contrast, residing in the host with high level of eosinophils, helminthic worms have evolved to attenuate eosinophil-mediated tissue inflammatory responses for their survival in hosts. Our previous study demonstrated that the expression of Acan-rps-30 was significantly down-regulated in A. cantonensis L5 worms, which reside in the cerebrospinal fluid with high level of Eosinophils. Acan-RPS-30, a homologous protein of human Fau, which plays a pro-apoptotic regulatory role, may function in protecting worms from oxidative stress.Methods: RACE, genome Walking, bioinformatics were used to isolate and analyse the structural characterisation of Acan-RPS-30; qRT-PCR and microinjection was performed to detect the expression patterns of Acan-rps-30; feeding RNAi was used to ced-3 knock-down; microinjection was performed to construct transgenic worms; oxidative stress assay was used to determine the functions of Acan-RPS-30.Results: Our results showed that Acan-RPS-30 consisted of 130 amino acids, and was grouped into Clade V with C. elegans in phylogenetic analysis. It was expressed ubiquitously in worms and was down-regulated in both L5 and adult A. cantonensis. Worms expressing pCe-rps30::Acan-rps-30::rfp, with the refractile “button-like” apoptotic corpses, were susceptible to oxidative stress. Apoptosis genes ced-3 and ced-4 were both up-regulated in the transgenic worms. And the phenotype susceptible to oxidative stress could be converted with ced-3 defective mutation and RNAi. rps-30- /- mutant worms were resistant to oxidative stress, with ced-3 and ced-4 were both down-regulated. And the oxidative stress resistance phenotype could be rescued and inhibited by expressing pCe-rps30::Acan-rps-30::rfp in rps-30- /- mutant worms. Conclusion: In A. cantonensis L5 worms, down-regulated Acan-RPS-30 plays a defensive role against damage due to oxidative stress for worm survival through inhibiting apoptosis by regulating ced-3 down-regulated.
Low Serum Parathyroid Hormone is a Risk Factor for Peritonitis Episodes in Incident Peritoneal Dialysis Patients: A Retrospective Study 
Authors: Yang Yuqi , Da Jingjing , Jiang Yi , Yuan Jing , Zha Yan
Published: August 2020

Backgroud: Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear.Methods: We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH<150pg/mL; middle-PTH group, PTH=150-300pg/mL; high-PTH group, PTH>300pg/mL .Results: During a median follow-up of 29.5 (interquartile range 16-49) months, 73 (27.0%) peritonitis episodes occurred. Low PTH levels were associated with older age, higher calcium levels and lower alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014-2.663, P=0.044].Conclusions: Low PTH levels are independently associated with peritonitis in incident PD patients.
Screening of lncRNA Profiles During Intramuscular Adipogenic Differentiation Inlongissimus Dorsi and Semitendinosus Muscles in Pigs
Authors: Wang Xiaoyu , Peng Ying , Xu Meixue , Chen Xiaochang , Yang Gongshe , Shi Xine , Li Xiao
Published: August 2020

Background: Intramuscular fat content is an important factor that determines meat quality in pigs. In recent years, epigenetic regulation has increasingly studied the physiological model of intramuscular fat. Although long non-coding RNAs play essential roles in various biological processes, their role in intramuscular fat deposition in pigs remains largely unknown. Results: In this study, intramuscular preadipocytes in the longissimus dorsi and semitendinosus of Large White pigs were isolated and induced into adipogenic differentiation in vitro. High-throughput RNA-seq was then carried out to estimate the expression of lncRNAs at 0, 2, and 8 days post-differentiation. At this stage, 2135 lncRNAs, including 575 novel lncRNAs, were identified. lncRNAs are shorter, less expressed, and less conserved RNAs than protein-coding mRNAs. KEGG analysis showed that the differentially expressed lncRNAs were more common in pathways that are closely involved with adipogenesis and lipid metabolism. Of these, lnc_000368, a previously undescribed lncRNA, was found to gradually increase during the adipogenic process. qRT-PCR and a western blot revealed that the knockdown of lnc_000368 by siRNA significantly repressed the expression of adipogenic genes (PPARγ, aP2, CEBPβ) and lipolytic genes (ATGL and HSL). As a result, lipid accumulation in porcine intramuscular adipocytes was impaired by the silencing of lnc_000368, as indicated by Oil Red O staining. Conclusions: Overall, our study identified a genome-wide lncRNA profile related to porcine intramuscular fat deposition, and the results suggest that lnc_000368 is a potential target gene that might be targeted in pig breeding in the future.