bluuebunny/crossref_metadata_2025_split huggingface dataset:
The inclusion of mobilisation with movement to a standard exercise programme for patients with rotator cuff related pain: a randomised, placebo-controlled protocol trial
Authors: Baeske Rafael , Hall Toby , Silva Marcelo Faria 
Published: November 2020

AbstractBackgroundRotator cuff related pain (RCRP) is one of the most common sources of musculoskeletal shoulder pain affecting the general population. Conservative treatment, in the form of exercise, is considered the first line approach, nonetheless, improvements seem to be modest. One therapeutic modality that might be an adjunct to the treatment of this condition is mobilisation with movement (MWM). MWM is a pain-free manual procedure that targets restricted and painful movements, commonly seen in patients with RCRP. The purpose of clinical trial is to determine whether MWM with exercise has benefits over sham MWM with exercise in RCRP.MethodsA randomised, sham-controlled trial of 70 adults complaining of RCRP will compare the effects of MWM combined with exercise over sham MWM with exercise. Participants will be allocated to one of two groups: exercise and MWM (EG) or exercise and sham MWM (CG). Two weekly individual treatment sessions will be conducted over five weeks. All assessments will be performed by a blinded assessor. Primary outcome measures will be the shoulder pain and disability index (SPADI) and the numeric pain rating scale (NPRS), assessed at baseline, discharge and one-month follow-up. Secondary outcome measures will be active range of motion, self-efficacy and the global rating of change scale. The analyses will be conducted considering a statistically significantp-value ≤0.05. Normality will be assessed with the Kolmogorov-Smirnov test and homogeneity with the Levene’s test. For the primary outcome measures (SPADI and NPRS) and self-efficacy, a 2 × 3 ANOVA with treatment group (EG versus CG) and time (baseline, end of the treatment and follow-up) factors will be performed. Separate 2 × 2 ANOVA will be used for range of motion (baseline and end of the treatment). Global rating scale of change analysis will be conducted using descriptive statistics. Intention-to-treat analysis will be adopted.DiscussionAs there is a paucity of longitudinal studies investigating the use of MWM in patients with RCRP, this study will help to better understand its role together with a structured exercise programme.Trial registrationClinical Trials Registry numberNCT04175184. November, 2019.
A rare case of duodenal diaphragm in an adult during ERCP treatment for choledocholithiasis
Authors: Wu Liying , Jia Guofa , Hu Yiheng , Zhu Liangsong , Wang Shuhai 
Published: November 2020

Abstract
Background
Duodenal Diaphragm in adults is very uncommon, caused by congenital and acquired changes. It is reported that acquired duodenal diaphragm is related to the long-term use of nonsteroidal anti-inflammatory drugs.

Case summary
We report an adult presentation of duodenal diaphragm in a 77-year-old woman, suffered from acute cholangitis and choledocholithiasis. She was performed endoscopic retrograde cholangiopancreatography (ERCP) procedure to remove the stone in common bile duct (CBD). After the stenosis ring dilated by endoscopic balloon dilatation, ERCP procedure was applied, and the CBD stone was removed successfully.

Conclusion
Duodenal diaphragm is difficult to diagnose in clinic. Although the patient in this case had relatively mild symptoms of incomplete upper hemi-abdominal obstruction, these symptoms could be obscured by the emergency acute upper abdominal pain with fever as clinical manifestations of acute cholangitis.
Dynamic AFM detection of the oxidation-induced changes in size, stiffness, and stickiness of low-density lipoprotein
Authors: Wang Kun , Li Yuanfang , Luo Chao , Chen Yong 
Published: November 2020

Abstract
Background
Low-density lipoprotein (LDL) is an important plasma lipoprotein transporting lipids to peripheral tissues/cells. The oxidation of LDL plays critical roles in atherogenesis and its oxidized form (oxLDL) is an important risk factor of atherosclerosis. The biomechanical properties of LDL/oxLDL are closely correlated with the disease. To date, however, the oxidation-induced changes in size and biomechanical properties (stiffness and stickiness) of LDL particles are less investigated.

Methods
In this study, copper-induced LDL oxidation was confirmed by detecting electrophoretic mobility, malondialdehyde production, and conjugated diene formation. Then, the topographical and biomechanical mappings of LDL particles before/after and during oxidation were performed by using atomic force microscopy (AFM) and the size and biomechanical forces of particles were measured and quantitatively analyzed.

Results
Oxidation induced a significant decrease in size and stiffness (Young’s modulus) but a significant increase in stickiness (adhesion force) of LDL particles. The smaller, softer, and stickier characteristics of oxidized LDL (oxLDL) partially explains its pro-atherosclerotic role.

Conclusions
The data implies that LDL oxidation probably aggravates atherogenesis by changing the size and biomechanical properties of LDL particles. The data may provide important information for a better understanding of LDL/oxLDL and atherosclerosis.
microRNA-96 promotes occurrence and progression of colorectal cancer via regulation of the AMPKα2-FTO-m6A/MYC axis
Authors: Yue Caifeng , Chen Jierong , Li Ziyue , Li Laisheng , Chen Jugao , Guo Yunmiao 
Published: November 2020

Abstract
Background
Colorectal cancer (CRC) is one of the frequently occurred malignancies in the world. To date, several onco-microRNAs (miRNAs or miRs), including miR-96, have been identified in the pathogenesis of CRC. In the present study, we aimed to corroborate the oncogenic effect of miR-96 on CRC and to identify the specific mechanisms related to AMPKα2/FTO/m6A/MYC.

Methods
RT-qPCR and Western blot analysis were performed to examine the expression pattern of miR-96, AMPKα2, FTO and MYC in the clinical CRC tissues and cells. The relationship between miR-96 and AMPKα2 was then predicted using in silico analysis and identified by dual-luciferase reporter assay. Gain- or loss-of-function approaches were manipulated to evaluate the modulatory effects of miR-96, AMPKα2, FTO and MYC on cell growth, cycle progression and apoptosis. The mechanism of FTO-mediated m6A modification of MYC was analyzed via Me-RIP and PAR-CLIP analysis. The mediatory effects of miR-96 antagomir on cancerogenesis were validated in vivo.

Results
miR-96, FTO and MYC were upregulated, while AMPKα2 was downregulated in CRC tissues and cells. miR-96 could down-regulate AMPKα2, which led to increased expression of FTO and subsequent upregulated expression of MYC via blocking its m6A modification. This mechanism was involved in the pro-proliferative and anti-apoptotic roles of miR-96 in CRC cells. Besides, down-regulation of miR-96 exerted inhibitory effect on tumor growth in vivo.

Conclusions
Taken together, miR-96 antagomir could potentially retard the cancerogenesis in CRC via AMPKα2-dependent inhibition of FTO and blocking FTO-mediated m6A modification of MYC, highlighting novel mechanisms associated with colorectal cancerogenesis.
Fluctuation in anti-cyclic citrullinated protein antibody level predicts relapse from remission in rheumatoid arthritis: KURAMA cohort
Authors: Murata Koichi , Ito Hiromu , Hashimoto Motomu , Murakami Kosaku , Watanabe Ryu , Tanaka Masao , Yamamoto Wataru , Matsuda Shuichi 
Published: November 2020

Abstract
Background
The positivity of anti-citrullinated protein/peptide antibodies (ACPAs) is a clinically useful diagnostic and prognostic marker in rheumatoid arthritis (RA). However, the significance of ACPA titer and its fluctuation remain unclear. This study aimed to assess the role of ACPA titer and its fluctuation on disease activity and the prognosis of RA.

Methods
Data obtained from the Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) cohort was analyzed. Patients whose ACPA was measured at least twice between 2011 and 2019 and whose ACPA was positive at least once were included in this study. The association between the clinical variable and ACPA titer or its change was investigated.

Results
ACPA titer was measured in a total of 3286 patients, 1806 of whom were ACPA-positive at least once. Among them, the ACPA titer level was measured more than once in 1355 patients. Very weak correlation was observed between the ACPA titer level and disease activity. Additionally, there was no trend in the fluctuation of ACPA titer level in each patient; ACPA titer level fluctuated in some patients, but not in others. Patients with high variable levels of ACPA titer were more likely to relapse from remission. In the analysis of two consecutive ACPA measurements, the titer changes predicted the relapse from remission within a year of the second measurement.

Conclusions
The ACPA titer level fluctuated in some patients. Very weak correlation was observed between the ACPA titer level and disease activity. Fluctuation in ACPA titer level predicted relapse from remission in patients with RA.
Successful treatment of highly recurrent facial baroparesis in a frequent high-altitude traveler: a case report
Authors: Caffrey Jason P. , Adams Jason W. , Costantino Isabel , Klepper Kristin , Kari Elina , Brown Lori A. 
Published: November 2020

Abstract

Background
Facial baroparesis is a palsy of the seventh cranial nerve resulting from increased pressure compressing the nerve along its course through the middle ear cavity. It is a rare condition, most commonly reported in barotraumatic environments, in particular scuba diving and high-altitude air travel. We report here an unusual case of highly frequent baroparesis, workup, and successful treatment.

Case presentation
A 57-year-old Caucasian male frequent commercial airline traveler presented with a 4-year history of recurrent episodes of right-sided facial paralysis and otalgia, increasing in both frequency and severity. Incidents occurred almost exclusively during rapid altitude changes in aircraft, mostly ascent, but also during rapid altitude change in an automobile. Self-treatment included nasal and oral decongestants, nasal corticosteroids, and warm packs. Temporal bone computed tomography (CT) scan revealed possible right-sided dehiscence of the tympanic bone segment; audiogram and magnetic resonance imaging of the internal auditory canals were unremarkable. After a diagnosis of facial nerve baroparesis was made, the patient underwent myringotomy with insertion of a pressure equalization tube (PET) into the right tympanic membrane. Despite re-exposure to altitude change multiple times weekly post-treatment, the patient reported being symptom-free for more than 6 months following intervention.

Conclusions
Prompt PET insertion may represent the preferred treatment for individuals who suffer recurrent episodes of facial baroparesis. Education regarding this rare condition may prevent unnecessary testing and treatment of affected patients. Future studies should explore the pathophysiology and risk factors, compare therapeutic options, and provide follow-up data to optimize the management of affected patients.
On a variant of Čebyšev’s inequality of the Mercer type
Authors: Matković Anita , Pečarić Josip 
Published: November 2020

AbstractWe consider the discrete Jensen–Mercer inequality and Čebyšev’s inequality of the Mercer type. We establish bounds for Čebyšev’s functional of the Mercer type and bounds for the Jensen–Mercer functional in terms of the discrete Ostrowski inequality. Consequentially, we obtain new refinements of the considered inequalities.
Anomalous systemic arterial supply to the basal segment of the lung with giant aberrant artery: a case report
Authors: Utsumi Takahiro , Hino Haruaki , Kuwauchi Shintaro , Zempo Nobuya , Ishida Kaori , Maru Natsumi , Matsui Hiroshi , Taniguchi Yohei , Saito Tomohito , Tsuta Koji , Murakawa Tomohiro 
Published: November 2020

Abstract

Background
Anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a relatively rare congenital anomaly characterized by aberrant systemic arterial blood flow to the basal segment of the lung. We experienced a rare presentation of ABLL, in which a giant aberrant artery with the same dimensions as that of the descending aorta flowed from the celiac artery to left lower lobe.

Case presentation
An otherwise healthy 42-year-old man was referred to our department due to an abnormal chest X-ray. Enhanced computed tomography revealed a huge and winding aberrant artery with mural thrombus originating from the celiac artery and perfusing into the left lower lobe. We diagnosed giant ABLL and considered possible concomitant pulmonary arteriovenous fistula. The diameter of the aberrant artery was > 30 mm and high-pressure flow was assumed; therefore, we performed staged resection of the left lower lobectomy including division of the aberrant artery at the pulmonary ligament and subsequent embolization of the remnant arterial flow uneventfully. Pathologically, the aberrant artery was abundant with elastic fibers, and dissections of the tunica media and mural thrombus were observed; however, arteriovenous fistula was not confirmed. At 6 postoperative months, enhanced computed tomography showed the aberrant artery to be completely occluded without any symptoms.

Conclusions
We present a case of ABLL that was successfully managed by surgical resection of the left lower lobe with most of the giant aberrant artery and subsequent embolization of the remnant portion. Our study demonstrates that a staged surgical therapy is an acceptable approach for ABLL in case of complication with a giant aberrant artery.
Treatment efficacy and re-infection rates of soil-transmitted helminths following mebendazole treatment in schoolchildren, Northwest Ethiopia
Authors: Zeleke Ayalew Jejaw , Bayih Abebe Genetu , Afework Solomon , Gilleard John S. 
Published: November 2020

Abstract

Background
Transmission of soil-transmitted helminth (STH) infection remains high in Ethiopia. This study aimed at assessing the therapeutic efficacy of mebendazole against soil-transmitted helminths and determining the re-infection rates of the parasites among schoolchildren in Northwest Ethiopia.

Methods
A school-based cross-sectional study was conducted. Data was collected using a structured questionnaire. Stool specimens were examined using direct wet mount microscopy and Kato-Katz methods. Schoolchildren who tested positive for soil-transmitted helminths were treated with 500 mg single-dose of mebendazole. Cure and egg reduction rates were evaluated 2 to 3 weeks post treatment. Moreover, the re-infection rate of these parasites among those who were cured was determined 1 year after treatment. Data were analyzed using SPSS version 20. P value < 0.05 was considered as statistically significant.

Result
A drug efficacy study was conducted on 62, 52, and 14 children infected by Ascaris lumbricoides (A. lumbricoides), hookworm, and Trichuris trichiura (T. trichiura), respectively. The cure rates (CR) of mebendazole against A. lumbricoides, hookworm, and T. trichiura were found to be 96.9%, 23.1%, and, 28.6%, respectively. The egg reduction rate (ERR) of A. lumbricoides was found to be 99.6% whereas 49.6% and 56.3% were reported for hookworm and T. trichiura, respectively. Eighty schoolchildren who were treated and cured from any STH infections were included for the determination of re-infection rate. Out of 80 children, 36.3% (29/80) were found to be re-infected after 1 year: 22 (75.9%), 6 (20.7%), and 1 (1.3%) of study participants were re-infected with A. lumbricoides, hookworm, and both infections, respectively. All re-infections were grouped under the “light infection” category.

Conclusion
Mebendazole was found to be highly effective against A. lumbricoides, but had relatively low efficacy against hookworms and T. trichiura. These results bring into question the use of mebendazole in STH mass drug administration (MDA) programs in this region if albendazole, a drug with higher efficacy against hookworms, is available. Moreover, a significant number of treated children were re-infected with either or both of A. lumbricoides or hookworms 1 year after treatment emphasizing the need for better integrated intestinal helminthiasis control measures.
Preliminary Experience of Treating Children and Young Adults With Image-Guided Proton Beam Therapy in India
Authors: Chilukuri Srinivas , Burela Nagarjuna , Uppuluri Ramya , Indumathi D. , Nangia Sapna , Panda Pankaj Kumar , Shamurailatpam Dayananda Sharma , Raj Revathi , Raja Thirumalai , Jalali Rakesh 
Published: November 2020

PURPOSE Proton beam therapy (PBT) has been a preferred modality in pediatric malignancies requiring radiotherapy. We report our preliminary experience of treating consecutive patients younger than 25 years with image-guided pencil beam scanning PBT from the first and only center on the Indian subcontinent. METHODS Patients were selected for PBT on the basis of a multidisciplinary tumor board decision. Patient demographic data, as well as tumor and treatment-related characteristics of the cohort, were captured. Patient and treatment-related factors and their association with acute toxicities were analyzed using univariable and multivariable analyses. RESULTS Forty-seven patients (27 with CNS and 20 with non-CNS tumors) with a median age of 9 years (range, 2-25 years) were evaluated. Most common diagnoses were ependymoma, rhabdomyosarcoma, and glioma. Seventy-seven percent of patients traveled more than 500 km, and 70% of them lived in metropolitan cities. Forty-nine percent of patients had recurrent disease at presentation, and 15% had received a previous course of radiation. The median dose delivered was 54.8 cobalt gray equivalents (range, 40.0-70.4 cobalt gray equivalents) to a median clinical target volume of 175 mL (range, 18.7-3,083.0 mL), with 34% of patients requiring concurrent chemotherapy (CCT). Acute grade 2 and grade 3 dermatitis, mucositis, and hematologic toxicity was noted in 45% and 2%, 34% and 0%, and 38% and 30% of patients, respectively. Grade 2 fatigue was noted in 26% of patients. On multivariable analysis, for CNS tumors, both CCT and craniospinal irradiation were independently associated with ≥ 2 grade hematologic toxicity, whereas among non-CNS tumors, a clinical target volume > 150 mL was associated with ≥ 2 grade fatigue, head and neck irradiation was associated with ≥ 2 grade mucositis, and CCT was associated with grade ≥ 2 hematologic toxicity. CONCLUSION This study demonstrates safe implementation of a PBT program for children and young adults on the Indian subcontinent. Image-guided pencil beam scanning PBT in judiciously selected patients is feasible and can be delivered with acceptable acute toxicities.
Germline DLST Variants Promote Epigenetic Modifications in Pheochromocytoma-Paraganglioma
Authors: Buffet Alexandre , Zhang Juan , Rebel Heggert , Corssmit Eleonora P M , Jansen Jeroen C , Hensen Erik F , Bovée Judith V M G , Morini Aurélien , Gimenez-Roqueplo Anne-Paule , Hes Frederik J , Devilee Peter , Favier Judith , Bayley Jean-Pierre 
Published: November 2020

Abstract

Context
Pheochromocytomas and paragangliomas (PPGLs) are neuroendocrine tumors in which altered central metabolism appears to be a major driver of tumorigenesis, and many PPGL genes encode proteins involved in the tricarboxylic acid (TCA) cycle.

Objective/design
While about 40% of PPGL cases carry a variant in a known gene, many cases remain unexplained. In patients with unexplained PPGL showing clear evidence of a familial burden or multiple tumors, we aimed to identify causative factors using genetic analysis of patient DNA and functional analyses of identified DNA variants in patient tumor material and engineered cell lines.

Patients and Setting
Patients with a likely familial cancer burden of pheochromocytomas and/or paragangliomas and under investigation in a clinical genetic and clinical research setting in university hospitals.

Results
While investigating unexplained PPGL cases, we identified a novel variant, c.1151C&gt;T, p.(Pro384Leu), in exon 14 of the gene encoding dihydrolipoamide S-succinyltransferase (DLST), a component of the multi-enzyme complex 2-oxoglutarate dehydrogenase. Targeted sequence analysis of further unexplained cases identified a patient carrying a tumor with compound heterozygous variants in DLST, consisting of a germline variant, c.1121G&gt;A, p.(Gly374Glu), together with a somatic missense variant identified in tumor DNA, c.1147A&gt;G, p.(Thr383Ala), both located in exon 14. Using a range of in silico and functional assays we show that these variants are predicted to be pathogenic, profoundly impact enzyme activity, and result in DNA hypermethylation.

Conclusions
The identification and functional analysis of these DLST variants further validates DLST as an additional PPGL gene involved in the TCA cycle.
Platelet Activation In Situ in Breasts at High Risk of Cancer: Relationship with Mammographic Density and Estradiol
Authors: Mijic Sofija , Dabrosin Charlotta 
Published: November 2020

Abstract

Context
High mammographic density in postmenopausal women is an independent risk factor for breast cancer by undetermined mechanisms. No preventive therapy for this risk group is available. Activated platelets release growth factors that modulate the microenvironment into a protumorigenic state. Estrogens may affect the risk of breast cancer and platelet function. Whether platelets are activated in situ in breast cancer or in normal breast tissue at high risk of breast cancer and the association to estradiol remains elusive.

Objective
To investigate whether platelets are activated in situ in breast cancers and in dense breast tissue of postmenopausal women and explore correlations between estradiol, released platelet factors, and inflammatory proteins.

Setting and design
Sampling of in vivo proteins was performed using microdialysis in a total of 71 women: 10 with breast cancer, 42 healthy postmenopausal women with different breast densities, and 19 premenopausal women.

Results
Our data demonstrate increased levels of coagulation factors in dense breast tissue similar to that found in breast cancers, indicating excessive platelet activation. Premenopausal breasts exhibited similar levels of coagulation factors as postmenopausal dense breasts. Out of 13 coagulations factors that were upregulated in dense breasts, 5 exhibited significant correlations with estradiol, both locally in the breast and systemically. In breast tissue, positive correlations between coagulation factors and key inflammatory proteins and matrix metalloproteinases were detected.

Conclusions
Breast density, not estradiol, is the major determinant of local platelet activation. Inactivation of platelets may be a therapeutic strategy for cancer prevention in postmenopausal women with dense breasts.