bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aberrant methylation of yes-associated protein (YAP1) as a potential biomarker in breast cancer
Authors: Ramadan Ragaa Abdelkader , Elkarmouty Ahmed , Elnaggar Mostafa 
Published: November 2019

Abstract
Background
Breast cancer (BC) represents the most prevalent malignancy among women, and it is characterized by high mortality especially in late stages. BC tumorigenesis was linked to epigenetic alterations namely methylation. Yes-associated protein (YAP1) is the leading downstream effector of the Hippo pathway. It may enhance or inhibit oncogenesis based on the tissue involved.

Aim
This case-control study aimed to analyze the methylation degree of promoter region of YAP1 gene in BC patients by applying methylation-specific polymerase chain reaction (MSP) analysis.

Methods
Genomic deoxyribonucleic acid (DNA) was isolated from 50 paired tumor and adjacent noncancerous breast tissue samples and subjected to bisulfite conversion. Methylation condition of YAP1 gene was studied by MSP and evaluated as a possible biomarker for diagnosing BC and its differentiation from corresponding normal tissues. We also correlated the aberrant methylation with clinicopathological criteria.

Results
Increased methylation of the YAP1 gene promoter region in BC tumor tissue was detected in 68% of the studied BC tissue samples. There was a significant change in the frequency of YAP1 methylated genotype between breast tumor tissues compared to that in adjacent non-cancerous tissue (p < 0.001). YAP1 can discriminate early from late-stage BC with a sensitivity of 96.88% and specificity of 83.33%.

Conclusions
Gene analysis of YAP1 using conventional MSP in tissue specimens can be considered a possible biomarker to distinguish BC from normal breast tissue as well as between early- and late-stage BC.
Surgery for autoimmune aortitis: unanswered questions
Authors: Arafat Amr A. 
Published: November 2019

AbstractBackgroundThe aorta is rarely affected by autoimmune vasculitis, which can lead to aortic dilatation requiring surgery. Autoimmune aortitis may affect one aortic segment or the entire aorta, and in some cases, the aorta may be affected at different time intervals. Because of the rarity of the disease and the limited cases described in the literature, management of autoimmune aortitis is still controversial. We aimed to review the current literature evidence regarding these controversial aspects for the management of autoimmune aortitis and give recommendations based on this evidence.Main textImmunosuppressants are generally indicated in vasculitis to halt the progression of the disease; however, its role after the occurrence of aortic dilatation is debatable since further aortic dilatation would eventually occur because of the weakness of the arterial wall. In patients with a localized ascending aortic dilatation who required surgery, the optimal approach for the distal aorta is not known. If the probability of disease progression is high, it is not known whether the patients would benefit from postoperative immunosuppressants or further distal aortic intervention may be required. The risk of rupture of the weakened aortic wall was not established, and it is debatable at which diameter should these patients have surgery. In patients with previous ascending surgery for autoimmune aortitis, the endovascular management of the distal aortic disease has not been studied. The inflammatory process may extend to affect the aortic valve or the coronary vessels, which may require special attention during the procedure.ConclusionPatients with diagnosed autoimmune aortitis are prone to the development of the distal aortic disease, and endovascular intervention is feasible in those patients. Patients with concomitant aortic valve can be managed with the aortic valve-sparing procedure, and preoperative screening for coronary disease is recommended. Immunosuppressants should be used early before aortic dilatation, and its role postoperatively is controversial.
Nationwide Survey of Patients’ Perspectives Regarding Their Radiation and Multidisciplinary Cancer Treatment Experiences
Authors: Shaverdian Narek , Yeboa Debra N. , Gardner Liz , Harari Paul M. , Liao Kaiping , McCloskey Susan , Tuli Richard , Vapiwala Neha , Jagsi Reshma 
Published: November 2019

PURPOSE: The perspectives of patients with cancer about their treatment can inform interventions to improve the approaches of treating oncologists and experiences of future patients. We sought to identify areas where current toxicity management, informed consent processes, and physician-patient communication merit improvement. METHODS: In a Web-based survey administered from March to May 2018 using quota-based sampling to draw a nationwide sample of US patients with cancer treated with radiotherapy within the past 5 years, we evaluated patient perceptions of adequacy of information about adverse effects, severity of actual adverse effects experienced, and experiences divergent from expectations. RESULTS: Among 403 respondents, 18% felt inadequately informed about what adverse effects to expect from radiotherapy, and 37% experienced radiation adverse effects that they wished they had known more about. Similar proportions of patients treated with chemotherapy (36%) and surgery (34%) experienced toxicities related to those treatments that they wished they had known more about. Patients who noted their adverse effects to be minimal versus severe were significantly more likely to feel informed about radiotherapy adverse effects (odds ratio, 13.05; 95% CI, 5.6 to 30.38; P < .001). Across all evaluated measures, a majority of patients indicated that they did not experience the potentially anticipated radiotherapy adverse effect or that it was the same as or better than expected. CONCLUSION: This study suggests that experiences with radiation adverse effects generally are congruent with expectations. Nevertheless, improvement of pretreatment counseling across all cancer therapy modalities seems warranted to improve informed decision making and treatment experiences.
Safety of High-Dose Vitamin D Supplementation: Secondary Analysis of a Randomized Controlled Trial
Authors: Billington Emma O , Burt Lauren A , Rose Marianne S , Davison Erin M , Gaudet Sharon , Kan Michelle , Boyd Steven K , Hanley David A 
Published: November 2019

Abstract

Context
More than 3% of adults report vitamin D intakes of 4000 IU/day or more, but the safety of this practice is unknown.

Objective
The objective of this work is to establish whether vitamin D doses up to 10 000 IU/day are safe and well tolerated.

Design
The Calgary Vitamin D Study was a 3-year, double-blind, randomized controlled trial.

Setting
A single-center study was conducted at the University of Calgary, Canada.

Participants
Participants included healthy adults (n = 373) ages 55 to 70 years with serum 25-hydroxyvitamin D 30 to 125 nmol/L.

Interventions
Participants were randomly assigned 1:1:1 to vitamin D3 400, 4000, or 10 000 IU/day. Calcium supplementation was initiated if dietary calcium intake was less than 1200 mg/day.

Main Outcome Measures
In these prespecified secondary analyses, changes in serum 25-hydroxyvitamin D, calcium, creatinine, 24-hour urine calcium excretion, and incidence of adverse events were assessed. Between-group differences in adverse events were examined using incident rate differences and logistic regression.

Results
Of 373 participants (400: 124, 4000: 125, 10 000: 124), 49% were male, mean (SD) age was 64 (4) years, and 25-hydroxyvitamin D 78.0 (19.5) nmol/L. Serum calcium, creatinine, and 24-hour urine calcium excretion did not differ between treatments. Mild hypercalcemia (2.56-2.64 mmol/L) occurred in 15 (4%) participants (400: 0%, 4000: 3%, 10 000: 9%, P = .002); all cases resolved on repeat testing. Hypercalciuria occurred in 87 (23%) participants (400: 17%, 4000: 22%, 10 000: 31%, P = .01). Clinical adverse events were experienced by 365 (97.9%) participants and were balanced across treatment arms.

Conclusions
The safety profile of vitamin D supplementation is similar for doses of 400, 4000, and 10 000 IU/day. Hypercalciuria was common and occurred more frequently with higher doses. Hypercalcemia occurred more frequently with higher doses but was rare, mild, and transient.
Case Report: Intussepting mucocele appendix
Authors: Crawley-Smith Tom 
Published: November 2019

Background: A case study of a presentation of a mucocele appendix, a rare condition accounting for 0.2% of appendicectomies. The case and operative management are discussed along with the possible progression to pseudomyxoma peritoneii and its differing management. Case: A 15-year-old girl had two presentations with atypical Right Iliac Fossa pain over 2 months. This was investigated with ultrasound and CT which revealed a calcified, intussusepting mucocele of the appendix. This was surgically resected with partial Right Hemicolectomy. The patient was discharged on day 3 with no complications. Discussion: The presentation, malignant potential, investigation and management of the mucocele appendix are discussed. The rare presentation of a mucocele appendix necessitates care to eliminate the risk of pseudomyxoma peritoneii. The operative management should minimise disturbance of the peritoneum in this presentation. In this case, due to an intersussepting nature a limited Right Hemicolectomy had to be performed. This is compared to the literature.
SCIMITAR+ Trial: A randomised study within a trial (SWAT) of a contingent financial reward to improve trial follow-up
Authors: Arundel Catherine , Coleman Elizabeth , Fairhurst Caroline , Peckham Emily , Bailey Della , Gilbody Simon 
Published: November 2019

Background: To evaluate the effectiveness of a contingent financial incentive (£10 note in addition to a routinely provided £10 voucher) versus no contingent financial incentive, on improving the retention rate in a randomised controlled trial (RCT). Methods: A two arm ‘Study within a Trial’ (SWAT) embedded within a host RCT (SCIMITAR+). Participants were randomised to the SWAT using a 2:1 (intervention:control) allocation ratio. The primary outcome measure was the proportion of participants completing a CO breath measurement at the first SCIMITAR+ follow up time point (6 months). Secondary outcomes were withdrawing from follow-up after contact and time from assessment due date to completion. Analyses were conducted using logistic or Cox Proportional Hazards regression as appropriate. Results: A total of 434 participants were randomised into this SWAT. Completion of the CO breath measurement at 6 months was 88.5% (n=247) in the intervention arm of the SWAT and 85.4% (n=123) in the control arm. The difference (3.1%) was not statistically significant (p=0.36; OR 1.29, 95% CI 0.71-2.33, p=0.41). There was also no evidence of a difference in the proportion of participants withdrawing from follow-up after contact (intervention n=7 (2.5%), control n=5 (3.5%); OR 0.76, 95% CI 0.23-2.44, p=0.64), nor in terms of proximity of 6-month visit completion to due date (HR 1.07, 95% CI 0.86-1.33, p=0.55). Conclusion: Contingent financial incentives did not statistically significantly increase rates of face-to-face follow-up completion within the SCIMITAR+ trial population. However, the sample size of this SWAT was constrained by the size of the host trial and power was limited. This SWAT adds to the body of evidence for initiatives to increase response rates in trials.
Point-of-care testing and treatment of sexually transmitted infections to improve birth outcomes in high-burden, low-income settings: Study protocol for a cluster randomized crossover trial (the WANTAIM Trial, Papua New Guinea)
Authors: Vallely Andrew J. , Pomat William S. , Homer Caroline , Guy Rebecca , Luchters Stanley , Mola Glen D. L. , Kariwiga Grace , Vallely Lisa M. , Wiseman Virginia , Morgan Chris , Wand Handan , Rogerson Stephen J. , Tabrizi Sepehr N. , Whiley David M. , Low Nicola , Peeling Rosanna , Siba Peter , Riddell Michaela , Laman Moses , Bolnga John , Robinson Leanne J. , Morewaya Jacob , Badman Steven G. , Batura Neha , Kelly-Hanku Angela , Toliman Pamela J. , Peter Wilfred , Babona Delly , Peach Elizabeth , Garland Suzanne M. , Kaldor John M. 
Published: November 2019

Background:Chlamydia trachomatis,Neisseria gonorrhoeae,Trichomonas vaginalisand bacterial vaginosis have been associated with preterm birth and low birth weight, and are highly prevalent among pregnant women in many low- and middle-income settings. There is conflicting evidence on the potential benefits of screening and treating these infections in pregnancy. Newly available diagnostic technologies make it possible, for the first time, to conduct definitive field trials to fill this knowledge gap. The primary aim of this study is to evaluate whether antenatal point-of-care testing and immediate treatment of these curable sexually transmitted and genital infections (STIs) leads to reduction in preterm birth and low birth weight.Methods: The Women and Newborn Trial of Antenatal Interventions and Management (WANTAIM) is a cluster-randomised crossover trial in Papua New Guinea to compare point-of-care STI testing and immediate treatment with standard antenatal care (which includes the WHO-endorsed STI ‘syndromic’ management strategy based on clinical features alone without laboratory confirmation). The unit of randomisation is a primary health care facility and its catchment communities. The primary outcome is a composite measure of two events: the proportion of women and their newborns in each trial arm, who experience either preterm birth (delivery <37 completed weeks of gestation as determined by ultrasound) and/or low birth weight (<2500 g measured within 72 hours of birth). The trial will also evaluate neonatal outcomes, as well as the cost-effectiveness, acceptability and health system requirements of this strategy, compared with standard care.Conclusions:WANTAIM is the first randomised trial to evaluate the effectiveness, cost-effectiveness, acceptability and health system requirements of point-of-care STI testing and treatment to improve birth outcomes in high-burden settings. If the intervention is proven to have an impact, the trial will hasten access to these technologies and could improve maternal and neonatal health in high-burden settings worldwide.Registration:ISRCTN37134032.
Patient Safety Indicator‐12 Rarely Identifies Problems with Quality of Care in Perioperative Venous Thromboembolism
Authors: Held Nicole , Jung Benjamin , Sommervold Lori , Singh Siddhartha , Kreuziger Lisa Baumann 
Published: November 2019

BACKGROUNDPatient safety indicators (PSI) were developed for hospitals to screen for healthcare‐associated adverse events. PSIs are believed to be preventable and have become a part of major pay‐for‐performance programs. PSI‐12 captures perioperative venous thromboembolism (VTE), which contributes to morbidity and mortality of hospitalized patients. We aimed to evaluate PSI‐12 events at our institution to identify areas for improvement of perioperative VTE prevention.METHODSWe identified PSI‐12 events from June 2015 to June 2017 using the Agency for Healthcare Research and Quality software version 5. Events were reviewed using our electronic medical record to identify further details of each event.RESULTSA total of 154 perioperative VTE cases were analyzed in the 2‐year period. Pulmonary embolism (PE) occurred in 62.9% of cases, deep venous thrombosis (DVT) in 24%, and concurrent DVT/PE in 12.9%. The mean age of patients was 56 years old. Deficiencies in guideline‐appropriate prophylaxis were identified in only 17 (11%) of cases. Unfractionated heparin was used in 61 cases, enoxaparin in 31 cases, and nine events occurred on therapeutic anticoagulation. Mechanical prophylaxis was used in 51 cases because of bleeding risk, thrombocytopenia, and/or liver associated coagulopathy. Four events occurred prior to the index procedure, with another eight cases occurring intraoperatively, or on the day of the procedure.CONCLUSIONSPSI‐12 has several limitations in identifying quality of care issues in perioperative VTE. While it may be useful as a screening tool, further research for improvements are needed if it will remain one of the key measures in pay‐for‐performance.
The Association between Limited English Proficiency and Sepsis Mortality
Authors: Jacobs Zachary G , Prasad Priya A , Fang Margaret C , Abe‐Jones Yumiko , Kangelaris Kirsten N 
Published: November 2019

BACKGROUNDLimited English proficiency (LEP) has been implicated in poor health outcomes. Sepsis is a frequently fatal syndrome that is commonly encountered in hospital medicine. The impact of LEP on sepsis mortality is not currently known.OBJECTIVETo determine the association between LEP and sepsis mortality.DESIGNRetrospective cohort study.SETTING800‐bed, tertiary care, academic medical center.PATIENTSElectronic health record data were obtained for adults admitted to the hospital with sepsis between June 1, 2012 and December 31, 2016.MEASUREMENTSThe primary predictor was LEP. Patients were defined as having LEP if their self‐reported primary language was anything other than English and interpreter services were required during hospitalization. The primary outcome was inpatient mortality. Mortality was compared across races stratified by LEP using chi‐squared tests of significance. Bivariable and multivariable logistic regressions were performed to investigate the association between mortality, race, and LEP, adjusting for baseline characteristics, comorbidities, and illness severity.RESULTSAmong 8,974 patients with sepsis, we found that 1 in 5 had LEP, 62% of whom were Asian. LEP was highly associated with death across all races except those identifying as Black and Latino. LEP was associated with a 31% increased odds of mortality after adjusting for illness severity, comorbidities, and other baseline characteristics, including race (OR 1.31, 95% CI 1.06‐1.63, P = .02).CONCLUSIONSIn a single‐center study of patients hospitalized with sepsis, LEP was associated with mortality across nearly all races. This is a novel finding that will require further exploration into the causal nature of this association.
GPU-enabled design of an adaptable pattern recognition system for discriminating squamous intraepithelial lesions of the cervix
Authors: Konstandinou Christos , Kostopoulos Spiros , Glotsos Dimitris , Pappa Dimitra , Ravazoula Panagiota , Michail George , Kalatzis Ioannis , Asvestas Pantelis , Lavdas Eleftherios , Cavouras Dionisis , Sakellaropoulos George 
Published: November 2019

Abstract
The aim of the present study was to design an adaptable pattern recognition (PR) system to discriminate low- from high-grade squamous intraepithelial lesions (LSIL and HSIL, respectively) of the cervix using microscopy images of hematoxylin and eosin (H&E)-stained biopsy material from two different medical centers. Clinical material comprised H&E-stained biopsies of 66 patients diagnosed with LSIL (34 cases) or HSIL (32 cases). Regions of interest were selected from each patient’s digitized microscopy images. Seventy-seven features were generated, regarding the texture, morphology and spatial distribution of nuclei. The probabilistic neural network (PNN) classifier, the exhaustive search feature selection method, the leave-one-out (LOO) and the bootstrap validation methods were used to design the PR system and to assess its precision. Optimal PR system design and evaluation were made feasible by the employment of graphics processing unit (GPU) and Compute Unified Device Architecture (CUDA) technologies. The accuracy of the PR-system was 93% and 88.6% when using the LOO and bootstrap validation methods, respectively. The proposed PR system for discriminating LSIL from HSIL of the cervix was designed to operate in a clinical environment, having the capability of being redesigned when new verified cases are added to its repository and when data from other medical centers are included, following similar biopsy material preparation procedures.
Circular RNA hsa_circ_0001178 facilitates the invasion and metastasis of colorectal cancer through upregulating ZEB1 via sponging multiple miRNAs
Authors: Ren Chunfeng , Zhang Zhenmin , Wang Shunhua , Zhu Weitao , Zheng Peiguo , Wang Wanhai 
Published: November 2019

Abstract
Metastasis is the main cause of increasing cancer morbidity and mortality. However, the underlying mechanism of cancer metastasis remains largely unknown. In the present study, we identified one circular RNA (circRNA) closely related to the metastasis of colorectal cancer (CRC), namely hsa_circ_0001178. CRC patients with high hsa_circ_0001178 were more prone to have metastatic clinical features, advanced TNM stage and adverse prognosis. Stable knockdown of hsa_circ_0001178 significantly weakened CRC cell migratory and invasive capabilities in vitro as well as lung and liver metastases in vivo. Mechanistic study revealed that hsa_circ_0001178 acted as a competing endogenous RNA (ceRNA) for miR-382/587/616 to upregulate ZEB1 (a key trigger of epithelial-to-mesenchymal transition), thereby promoting CRC metastatic dissemination. Of note, ZEB1 could also increase hsa_circ_0001178 expression via physically binding to hsa_circ_0001178 promoter region. Collectively, our data uncover the crucial role of hsa_circ_0001178 in CRC metastasis, and targeted therapy based on this positive feedback ceRNA axis may be a promising treatment for metastatic CRC patients.
The Influence of the Agglomeration Process on Stability of Microencapsulated β-Carotene
Authors: Dłużewska Elżbieta , Florowska Anna , Domian Ewa , Wojciechowska Maria , Maszewska Magdalena 
Published: November 2019

AbstractEffects of agglomeration of β-carotene microencapsulated by spray drying on its stability were analysed. Mixtures of Arabic gum (GA), maltodextrin (MD), modified starch (OSA), and whey protein (WP) were used as carriers. GA + MD and OSA + MD microcapsules were subjected to agglomeration. All the samples were stored for 60 days with access to daylight. Stability of the emulsions had a significant effect on efficiency of microencapsulation but had no effect on β-carotene retention during sample storage. Among the tested samples, the highest retention of colorant characterized the samples containing GA + MD. The agglomeration process reduced the content of β-carotene in the microcapsules almost by half. However, retention of the colorant during storage of the microcapsules was increased most of all and half-life of β-carotene was significantly prolonged. Changes in L*and a*colour parameters during storage were more limited in the case of agglomerated samples.