bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early-stage multi-differentiated gastric carcinosarcoma and post-resection local recurrence: a case report
Authors: Shioya Akihiro , Kurose Nozomu , Mizutani Kenichi , Kumagai Motona , Kawaura Ken , Nakamura Naohiko , Kosaka Takeo , Motono Nozomu , Uramoto Hidetaka , Yamada Sohsuke 
Published: September 2020

Abstract
Background
Carcinosarcoma is a rare neoplasm with a poor prognosis that is most often discovered at an advanced stage; a gastric carcinosarcoma is even rarer than carcinosarcomas originating in other organs, such as the uterus. We report our experience with an early-stage multi-differentiated gastric carcinosarcoma.

Case presentation
A 68-year-old male patient presented with anemia, and his fecal occult blood test was positive. An endoscopic examination was conducted which revealed a hemorrhagic, irregular, protruding lesion in the stomach. The lesion was diagnosed as an adenocarcinoma by histopathological examination of the biopsy specimen, and a segmental gastrectomy was performed. A 41 × 29 × 18 mm3 protruding lesion was observed in the resection specimen, and histologically confirmed to be a gastric carcinosarcoma with mixed adenocarcinomatous and sarcomatous composition. Tumor invasion was limited to the submucosa. Besides the adenocarcinomatous portion, neuroendocrine differentiation and AFP-positive gastric carcinoma were present in the carcinomatous portion of the tumor; in the sarcomatous portion, chondrosarcomatous, leiomyosarcomatous, and rhabdomyosarcomatous components were observed in addition to the undifferentiated sarcomatous component. Furthermore, the tumor included SALL4-positive germ cell-like cells. Despite early-stage detection, the cancer recurred locally 14 months after tumor resection, which necessitated a total gastrectomy. At the 2-month follow-up after the total gastrectomy, the patient was alive. This patient had developed an esophageal squamous cell carcinoma and primary lung adenosquamous carcinoma, both of which were resected.

Conclusions
Few cases of early-stage gastric carcinosarcoma have been reported, but there are no reports of recurrence to date. Local recurrence as in this patient, and even in early-stage cases, requires cautious surveillance to check for post-resection recurrence and metastasis. The etiopathogenesis of carcinosarcoma has not yet been elucidated; however, in the present case, despite the tumor’s relatively small size, it exhibited various types of differentiation in both the carcinomatous and sarcomatous components and a proliferative germ cell-like portion, which suggests that the monoclonal origin hypothesis may be a valid theory for the carcinosarcoma.
Treatment options for infected bone defects in the lower extremities: free vascularized fibular graft or Ilizarov bone transport?
Authors: Ren Gao-hong , Li Runguang , Hu Yanjun , Chen Yirong , Chen Chaojie , Yu Bin 
Published: September 2020

Abstract

Objective
The objective was to explore the relative indications of free vascularized fibular graft (FVFG) and Ilizarov bone transport (IBT) in the treatment of infected bone defects of lower extremities via comparative analysis on the clinical characteristics and efficacies.

Methods
The clinical data of 66 cases with post-traumatic infected bone defects of the lower extremities who underwent FVFG (n = 23) or IBT (n = 43) from July 2014 to June 2018 were retrieved and retrospectively analyzed. Clinical characteristics, operation time, and intraoperative blood loss were statistically compared between two groups. Specifically, the clinical efficacies of two methods were statistically evaluated according to the external fixation time/index, recurrence rate of deep infection, incidence of complications, the times of reoperation, and final functional score of the affected extremities.

Results
Gender, age, cause of injury, Gustilo grade of initial injury, proportion of complicated injuries in other parts of the affected extremities, and numbers of femoral/tibial defect cases did not differ significantly between treatment groups, while infection site distribution after debridement (shaft/metaphysis) differed moderately, with metaphysis infection little more frequent in the FVFG group (P = 0.068). Femoral/tibial defect length was longer in the FVFG group (9.96 ± 2.27 vs. 8.74 ± 2.52 cm, P = 0.014). More patients in the FVFG group presented with moderate or complex wounds with soft-tissue defects. FVFG treatment required a longer surgical time (6.60 ± 1.34 vs. 3.12 ± 0.99 h) and resulted in greater intraoperative blood loss (873.91 ± 183.94 vs. 386.08 ± 131.98 ml; both P < 0.05) than the IBT group, while average follow-up time, recurrence rate of postoperative osteomyelitis, degree of bony union, and final functional scores did not differ between treatment groups. However, FVFG required a shorter external fixation time (7.04 ± 1.72 vs. 13.16 ± 2.92 months), yielded a lower external fixation index (0.73 ± 0.28 vs. 1.55 ± 0.28), and resulted in a lower incidence of postoperative complications (0.87 ± 0.76 vs. 2.21±1.78, times/case, P < 0.05). The times of reoperation in the two groups did not differ (0.78 ± 0.60 vs. 0.98 ± 0.99 times/case, P = 0.615).

Conclusion
Both FVFG and IBT are effective methods for repairing and reconstructing infected bone defects of the lower extremities, with unique advantages and limitations. Generally, FVFG is recommended for patients with soft tissue defects, bone defects adjacent to joints, large bone defects (particularly monocortical defects), and those who can tolerate microsurgery.
Management of a giant aortic root aneurysm in a young patient with Marfan syndrome: a case report
Authors: Shen Jiayu , Gan Changping , Rajaguru R. D. T. , Yuan Dou , Xiao Zhenghua 
Published: September 2020

Abstract
Introduction
Marfan syndrome (MFS) is a common heritable connective tissue disease involving multiple organs. Even though the clinical manifestations of MFS can be various, aortic root aneurysm is estimated as one of the most serious complications. We herein describe an individualized treatment decision-making process for a 23-year-old male with MFS, suffering from a giant but stable aortic root aneurysm which is extremely rare at his age.

Case
The patient, a 23-year-old male with a family history of MFS, presented to our cardiovascular department because of progressive exertional chest distress, fatigue and occasional precordial pain. Physical examinations revealed 190.5 cm of height, high myopia, and a diastolic murmur at the aortic valve area. Laboratory examinations for systemic vasculitis and infectious diseases were negative. Transthoracic echocardiography and enhanced thoracic computed tomography (CT) scan revealed the existence of a giant aortic root aneurysm (125.1 mm in short-axis), severe aortic valve regurgitation, cardiac dilatation (LV; 99 mm in diastolic diameter) and a poor ejection fraction (EF; 18%). Considering the risk of rupture or dissection of the dilated aortic root, we performed Bentall procedure based on the results of multidisciplinary team discussion and intraoperative exploration. Postoperative thoracic CT scan revealed a normal sized reconstructed aortic root, and the patient was discharged uneventfully 7 days later.

Conclusion
It is extremely rare to report such a giant aortic root aneurysm in a young patient. In the treatment decision-making process, the patient’s specific situation should be taken into consideration. A mechanical Bentall procedure seems to be an acceptable option for some selected cases.
Global health diplomacy: a solution to meet the needs of disabled people in Yemen
Authors: Shahabi Saeed , Jalali Maryam , Lankarani Kamran Bagheri 
Published: September 2020

AbstractPeople with disabilities (PWD) are one of the most vulnerable groups in society during armed conflicts. According to the statistics, four million persons with disability live in Yemen. Lack of access and the use of rehabilitation services make PWD unable to retrieve their social and economic roles, which would have substantial negative impacts both on their families and community. The conflict escalation, an increase in the number the of displaced, COVID-19 pandemic, an increase in non-communicable diseases, and the exacerbation of poverty and malnutrition have rapidly enhanced the population at risk of disability in Yemen. Accordingly, effective and comprehensive approaches such as global health diplomacy (GHD) should be considered to meet the emerged needs. GHD seeks to address the common challenges in the global health system by involving all key stakeholders and establishing negotiations and diplomatic dialogue among official actors. Given the presence of various regional and international actors in Yemen and the examples of the successful use of GHD under conflict and post-conflict conditions in Iraq and Afghanistan, the use of diplomacy is crucial to respond to the needs of PWD in this war-torn country appropriately.
LncRNA MALAT1 facilitates inflammasome activation via epigenetic suppression of Nrf2 in Parkinson’s disease
Authors: Cai Li-Jun , Tu Li , Huang Xiao-Mo , Huang Jia , Qiu Nan , Xie Guang-Hong , Liao Jian-Xiong , Du Wei , Zhang Ying-Yue , Tian Jin-Yong 
Published: September 2020

AbstractThe goal of the present study was to elucidate the mechanism by which long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (lncRNA MALAT1) promotes inflammation in Parkinson’s disease (PD). 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was used to induce PD development in C57BL/6 mice, and tyrosine hydroxylase (TH) expression was analysed by immunohistochemical analysis. Western blot and qPCR analyses were conducted to assess the expression of protein and mRNA levels, respectively. Lipopolysaccharide/adenosine triphosphate (LPS/ATP) was used to activate microglia in vitro. Chromatin immunoprecipitation (ChIP), RNA pull-down and RNA immunoprecipitation chip (RIP) assays were performed to investigate the interaction among specific molecules. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to evaluate cell viability and proliferation. Flow cytometry was performed to analyse cell apoptosis after staining. The dichlorofluorescein diacetate (DCFH-DA) assay was used to measure the generation of reactive oxygen species (ROS) in cells. The results showed that MALAT1 was highly expressed in the brains of MPTP-induced PD model mice and in LPS/ATP-induced microglia cells. Knockdown of MALAT1 inhibited elevated nuclear factor (erythroid-derived 2)-like-2 factor (NRF2) expression, thereby inhibiting inflammasome activation and ROS production. MALAT1 was shown to promote neuroinflammation by recruiting enhancer of zeste homologue 2 (EZH2) to the promoter of NRF2, suppressing Nrf2 expression. In summary, MALAT1 epigenetically inhibits NRF2, thereby inducing inflammasome activation and reactive oxygen species (ROS) production in PD mouse and microglial cell models.
Treatment of children with COVID-19: position paper of the Italian Society of Pediatric Infectious Disease
Authors: Venturini Elisabetta , Montagnani Carlotta , Garazzino Silvia , Donà Daniele , Pierantoni Luca , Lo Vecchio Andrea , Nicolini Giangiacomo , Bianchini Sonia , Krzysztofiak Andrzej , Galli Luisa , Villani Alberto , Castelli-Gattinara Guido ,   for the Italian SITIP-SIP SARS-Cov-2 pediatric infection study group
Published: September 2020

AbstractA statement of consensus was formulated after reviewing available literature on pediatric treatment strategies for COVID-19 by the Steering and Scientific Committee of the Italian Society of Infectious Pediatric Diseases in connection with the Italian Society of Paediatrics.
Novel LRPPRC compound heterozygous mutation in a child with early-onset Leigh syndrome French-Canadian type: case report of an Italian patient
Authors: Piro Ettore , Serra Gregorio , Antona Vincenzo , Giuffrè Mario , Giorgio Elisa , Sirchia Fabio , Schierz Ingrid Anne Mandy , Brusco Alfredo , Corsello Giovanni 
Published: September 2020

Abstract
Background
Mitochondrial diseases, also known as oxidative phosphorylation (OXPHOS) disorders, with a prevalence rate of 1:5000, are the most frequent inherited metabolic diseases. Leigh Syndrome French Canadian type (LSFC), is caused by mutations in the nuclear gene (2p16) leucine-rich pentatricopeptide repeat-containing (LRPPRC). It is an autosomal recessive neurogenetic OXPHOS disorder, phenotypically distinct from other types of Leigh syndrome, with a carrier frequency up to 1:23 and an incidence of 1:2063 in the Saguenay-Lac-St Jean region of Quebec. Recently, LSFC has also been reported outside the French-Canadian population.

Patient presentation
We report a male Italian (Sicilian) child, born preterm at 28 + 6/7 weeks gestation, carrying a novel LRPPRC compound heterozygous mutation, with facial dysmorphisms, neonatal hypotonia, non-epileptic paroxysmal motor phenomena, and absent sucking-swallowing-breathing coordination requiring, at 4.5 months, a percutaneous endoscopic gastrostomy tube placement. At 5 months brain Magnetic Resonance Imaging showed diffuse cortical atrophy, hypoplasia of corpus callosum, cerebellar vermis hypoplasia, and unfolded hippocampi. Both auditory and visual evoked potentials were pathological. In the following months Video EEG confirmed the persistence of sporadic non epileptic motor phenomena. No episode of metabolic decompensation, acidosis or ketosis, frequently observed in LSFC has been reported. Actually, aged 14 months corrected age for prematurity, the child shows a severe global developmental delay. Metabolic investigations and array Comparative Genomic Hybridization (aCGH) results were normal. Whole-genome sequencing (WGS) found a compound heterozygous mutation in the LRPPRC gene, c.1921–7A > G and c.2056A > G (p.Ile686Val), splicing-site and missense variants, inherited from the mother and the father, respectively.

Conclusions
We first characterized the clinical and molecular features of a novel LRPPRC variant in a male Sicilian child with early onset encephalopathy and psychomotor impairment. Our patient showed a phenotype characterized by a severe neurodevelopmental delay and absence of metabolic decompensation attributable to a probable residual enzymatic activity. LRPPRC is a rare cause of metabolic encephalopathy outside of Québec. Our patient adds to and broaden the spectrum of LSFC phenotypes. WGS analysis is a pivotal genetic test and should be performed in infants and children with hypotonia and developmental delay in whom metabolic investigations and aCGH are normal.
Field-deployable molecular diagnostic platform for arbovirus detection in Aedes aegypti
Authors: Rutkowski Natalie , Dong Yuemei , Dimopoulos George 
Published: September 2020

Abstract
Background
Surveillance of mosquito infection status is critical for planning and deployment of proper mosquito control initiatives. Point-of-care (POC) detection assays are necessary for monitoring the infection prevalence and geographical range of viruses in mosquito vector populations. We therefore assessed the novel real-time PCR (qPCR) bCUBE (Hyris, London, UK) molecular diagnostic system as a tool for virus detection.

Methods
Aedes aegypti Rps17 was used to validate and determine correlation coefficient for the novel bCUBE qPCR system to a laboratory standard StepOnePlus real-time PCR system (Applied Biosystems, Waltham, MA, USA). Experimentally infected Ae. aegypti were quantified for Zika (ZIKV) and dengue virus serotype 2 (DENV2) viral genomic RNA. Infection prevalence was compared to plaque assay.

Results
We developed and validated a novel qPCR system for the detection of ZIKV and DENV2 using the real-time qPCR system bCUBE. With bCUBE-based qRT-PCR, viral genomic RNA could be detected in individually infected Ae. aegypti mosquitoes and in pools of 5, 10 or 15 mosquitoes.

Conclusions
The portable qPCR bCUBE diagnostic system is capable of detecting Zika and dengue virus in mosquitoes and therefore has potential as a practical field-deployable diagnostic test for vector-borne disease surveillance programmes.
Interleukin (IL)-25 suppresses IL-22-induced osteoclastogenesis in rheumatoid arthritis via STAT3 and p38 MAPK/IκBα pathway
Authors: Min Hong Ki , Won Ji-Yeon , Kim Bo-Mi , Lee Kyung-Ann , Lee Seoung-Joon , Lee Sang-Heon , Kim Hae-Rim , Kim Kyoung-Woon 
Published: September 2020

Abstract
Background
The present study aimed to evaluate the suppressive role of interleukin (IL)-25 in IL-22-induced osteoclastogenesis and receptor activator of nuclear factor κB ligand (RANKL) expression in rheumatoid arthritis (RA).

Methods
Serum from patients with RA and osteoarthritis (OA), and healthy controls, and synovial fluid from patients with RA and OA were collected, and the levels of IL-22 and IL-25 were measured. RA and OA synovial tissues were stained against IL-25. Fibroblast-like synoviocytes (FLSs) of patients with RA were cultured with IL-22, in the presence or absence of IL-25, and RANKL expression was measured by real-time PCR and enzyme-linked immunosorbent assay (ELISA). Human peripheral blood monocytes were cultured under IL-22/RANKL + M-CSF, with or without IL-25, and tartrate-resistant acid phosphatase (TRAP)-positive cells and osteoclast-related markers were investigated to determine osteoclastogenesis.

Results
Serum and synovial IL-25 levels in RA were upregulated compared to those in OA and healthy control, and elevated expression of IL-25 in RA synovial tissue was re-confirmed. IL-25 and IL-22 levels showed significant correlation in serum and synovial fluid. Pre-treatment of FLS with IL-25 reduced IL-22-induced RANKL expression at the RNA level. The suppressive effects of IL-25 were confirmed to occur through the STAT3 and p38 MAPK/IκBα pathways. IL-25 reduced osteoclast differentiation and suppressed the expression of osteoclast-related markers.

Conclusion
In the current study, we demonstrated the regulatory effect of IL-25 on IL-22-induced osteoclastogenesis. Therapeutic approach involving augmentation of IL-25 regulatory response may serve as a novel treatment option for RA, especially by suppressing osteoclastogenesis.
The role of public-private partnerships in
extending public healthcare provision to irregular migrants: stopgap or foot in the
door?
Authors: Gottlieb Nora , Filc Dani , Davidovitch Nadav 
Published: September 2020

AbstractIn this commentary to the paper “Ensuring HIV care to undocumented
migrants in Israel: a public-private partnership case study” by Chemtob et al. we
discuss the role of public-private partnerships (PPPs) as a mechanism for
integrating previously excluded groups in public healthcare provision. Drawing on
PPP case-studies as well as on Israel’s pandemic preparedness policies during the
Covid-19 outbreak, we examine potential implications for the populations in question
and for health systems.In our view, Chemtob et al. describe an exceptional achievement, where a
PPP served as a stepping stone for the subsequent integration of irregular migrants’
in publicly funded HIV care. However, we argue that in many other cases PPPs are
liable to undermine public healthcare and inclusionary claims. This view is informed
by the fundamentally different concepts of healthcare that underlie PPPs and public
healthcare provision (namely, health care as a commodity vs. access to healthcare as
a right) and existing evidence on PPPs’ role in facilitating welfare retrenchment.
In contexts that are dominated by an exclusionary stance toward irregular migrants,
such as contemporary Israel, we believe that PPPs will become stopgaps that
undermine health rights, rather than a first foot in the door that leads toward
equitable provision of healthcare for all.
Experimental evaluation of flexible duplexing in multi-tier MIMO networks
Authors: Fanjul Jacobo , Fernández Renzo D. , Ibáñez Jesús , García-Naya José A. , Santamaria Ignacio 
Published: September 2020

AbstractIn this paper, we present an experimental evaluation of the performance benefits provided by flexible duplexing, an access technique that allows uplink and downlink cells to coexist within the same time-frequency resource blocks. In order to replicate a wireless multi-tier network composed of 1 macro-cell and 2 small cells, a measurement campaign has been conducted using an indoor wireless testbed comprised of a total of 6 multiple-input multiple-output (MIMO) software-defined radio (SDR) devices. Since each cell has a single active user, each uplink/downlink configuration can be identified with a different interference channel, over which interference alignment (IA) is used as an inter-cell interference management technique and compared to other existing methods. The obtained results show that flexible duplexing clearly outperforms the conventional time-division duplex (TDD) access approach, where all cells operate synchronized either in uplink or dowlink mode. Additionally, interference alignment consistently provides better results in most of the interference regimes when compared to minimum mean square error (MMSE)-based schemes. The impact of channel estimate quality on the different communication strategies is also studied. It is worth highlighting that the presented over-the-air (OTA) experiments represent the first implementation of IA with real-time precoding and decoding.
A note on degenerate r-Stirling numbers
Authors: Kim Taekyun , Kim Dae San , Lee Hyunseok , Park Jin-Woo 
Published: September 2020

AbstractThe aim of this paper is to study the unsigned degenerate r-Stirling numbers of the first kind as degenerate versions of the r-Stirling numbers of the first kind and the degenerate r-Stirling numbers of the second kind as those of the r-Stirling numbers of the second kind. For the degenerate r-Stirling numbers of both kinds, we derive recurrence relations, generating functions, explicit expressions, and some identities involving them.
Targeting α-synuclein by PD03 AFFITOPE® and Anle138b rescues neurodegenerative pathology in a model of multiple system atrophy: clinical relevance
Authors: Lemos Miguel , Venezia Serena , Refolo Violetta , Heras-Garvin Antonio , Schmidhuber Sabine , Giese Armin , Leonov Andrei , Ryazanov Sergey , Griesinger Christian , Galabova Gergana , Staffler Guenther , Wenning Gregor Karl , Stefanova Nadia 
Published: September 2020

Abstract
Background
Misfolded oligomeric α-synuclein plays a pivotal role in the pathogenesis of α-synucleinopathies including Parkinson’s disease and multiple system atrophy, and its detection parallels activation of microglia and a loss of neurons in the substantia nigra pars compacta. Here we aimed to analyze the therapeutic efficacy of PD03, a new AFFITOPE® immunotherapy approach, either alone or in combination with Anle138b, in a PLP-α-syn mouse model.

Methods
The PLP-α-syn mice were treated with PD03 immunotherapy, Anle138b, or a combination of two. Five months after study initiation, the mice underwent behavioral testing and were sacrificed for neuropathological analysis. The treatment groups were compared to the vehicle group with regard to motor performance, nigral neuronal loss, microglial activation and α-synuclein pathology.

Results
The PLP-α-syn mice receiving the PD03 or Anle138b single therapy showed improvement of gait deficits and preservation of nigral dopaminergic neurons associated with the reduced α-synuclein oligomer levels and decreased microglial activation. The combined therapy with Anle138b and PD03 resulted in lower IgG binding in the brain as compared to the single immunotherapy with PD03.

Conclusions
PD03 and Anle138b can selectively target oligomeric α-synuclein, resulting in attenuation of neurodegeneration in the PLP-α-syn mice. Both approaches are potential therapies that should be developed further for disease modification in α-synucleinopathies.