bluuebunny/crossref_metadata_2025_split huggingface dataset:
BIRC7 and STC2 Expression Are Associated With Tumorigenesis and Poor Outcome in Extrahepatic Cholangiocarcinoma
Authors: Li Jiequn , Yang Zhulin , Huang Shengfu , Li Daiqiang 
Published: November 2020

Background: Extrahepatic cholangiocarcinoma (EHCC) is a highly aggressive epithelial malignancy and has a poor prognosis for the insensitivity to therapies and difficulty in detection. Novel targets and biomarkers are urgently needed to develop for functional, diagnostic and prognostic application on EHCC. Methods: Immunohistochemical staining technique using the EnVision antibody complex was performed on the samples obtained from 100 EHCC, 30 peritumoral extrahepatic biliary tract (EHBT), 10 EHBT adenomas and 15 normal EHBT tissues. Results: The positive rates of BIRC7 and STC2 expression in tissues obtained from peritumoral EHBT, EHBT adenomas and normal EHBT were significantly lower than those in EHCC tissues. BIRC7 and STC2 proteins were expressed at significantly higher levels in patients with lymph node metastasis, invasion of adjacent tissues, and higher TNM stage (III and/or IV) and unable to undergo resection (biopsy only). Kaplan-Meier survival curves indicated that significantly decreased overall survival rate in patients with positive-BIRC7 or positive-STC2 expression compared with patients of negative-BIRC7 or negative-STC2 expression, respectively. Cox-proportional regression analysis demonstrated that positive-BIRC7 and positive-STC2 expression, along with poor differentiation of EHCC, tumor size >3 cm, lymph node metastasis, invasion of adjacent tissues and unable to undergo resection are independent prognostic factors of EHCC patients. Conclusions: The levels of BIRC7 and STC2 expression were correlated with clinicopathological characteristics of EHCC, and positive expression of BIRC7 and STC2 are associated with progression and poor clinical outcomes of EHCC. BIRC7 and STC2 might be a potential biomarker for EHCC in clinic.
Overexpression of DDR1 Promotes Migration, Invasion, Though EMT-Related Molecule Expression and COL4A1/DDR1/MMP-2 Signaling Axis
Authors: Xie Xin , He Hongchao , Zhang Ning , Wang Xiaojing , Rui Wenbin , Xu Danfeng , Zhu Yu 
Published: November 2020

Purpose: Discoidin domain receptor 1 (DDR1) belongs to a novel class of receptor tyrosine kinases. Previous evidence indicates that DDR1 overexpression promotes the aggressive growth of bladder cancer (BC) cells. This study aimed to investigate the molecular mechanisms by which DDR1 influences BC. Methods: DDR1 was transfected into human BC RT4 cells. DDR1, COL4A1, and MMP-2 expression in 30 BC tissues and paired adjacent tissues were examined by real-time polymerase chain reaction (RT-PCR) and immunohistochemistry. Transwell assays were conducted to determine cell migration and invasion. RT-PCR and western blot (WB) were also used to measure the DDR1, COL4A1, MMP-2, and EMT-related gene (ZEB1 and SLUG) expression in RT4 cells after DDR1 overexpression. Results: COL4A1 and MMP-2 interacted with DDR1 in the PPI network. RT-PCR and immunohistochemistry results showed that both mRNA and protein levels of DDR1 and COL4A1 were significantly increased in BC tissue, while the expression of MMP-2 was increased only at the mRNA level ( P < 0.05). Overexpression of DDR1 in RT4 cells significantly promoted their migratory and invasive capabilities in vitro ( P < 0.05). Moreover, overexpression of DDR1 in RT4 cells increased the mRNA and protein expression of ZEB1, SLUG, COL4A1, and MMP-2 ( P < 0.01). DDR1-mediated migration and invasion of RT4 cells were reversed after COL4A1-siRNA treatment. Conclusion: DDR1 may be a potential therapeutic target in BC patients.
The Role of the Persistent Sodium Current in Epilepsy
Authors: Wengert Eric R. , Patel Manoj K. 
Published: November 2020

Voltage-gated sodium channels (VGSCs) are foundational to excitable cell function: Their coordinated passage of sodium ions into the cell is critical for the generation and propagation of action potentials throughout the nervous system. The classical paradigm of action potential physiology states that sodium passes through the membrane only transiently (1-2 milliseconds), before the channels inactivate and cease to conduct sodium ions. However, in reality, a small fraction of the total sodium current (1%-2%) remains at steady state despite prolonged depolarization. While this persistent sodium current (INaP) contributes to normal physiological functioning of neurons, accumulating evidence indicates a particularly pathogenic role for an elevated INaP in epilepsy (reviewed previously 1 ). Due to significant advances over the past decade of epilepsy research concerning the importance of INaP in sodium channelopathies, this review seeks to summarize recent evidence and highlight promising novel anti-seizure medication strategies through preferentially targeting INaP.
Management of idiopathic intracranial hypertension in children utilizing venous sinus stenting
Authors: Schwarz Justin , Al Balushi Ali , Sundararajan Sri , Dinkin Marc , Oliveira Cristiano , Greenfield Jeffrey P , Patsalides Athos 
Published: November 2020

Background Venous sinus stenting (VSS) is an accepted and minimally invasive treatment for adult idiopathic intracranial hypertension (IIH) associated with lateral sinus stenosis (LSS). The efficacy and safety of venous sinus stenting (VSS) in children with IIH has not been established. Methods This is a retrospective analysis of IIH patients 18 years of age or younger with LSS treated with VSS at our institution. Included patients have fulminant disease course or are refractory or intolerant to medical management. Results Eight patients were identified; 4 males and 4 females. Mean age is 13.4 years (range 4–18). All patients had severe headaches, 5 had blurred vision, 3 had diplopia and 3 had pulsatile tinnitus. Papilledema was present in 4 patients. Three patients had prior surgical procedures. Four patients were intolerant to medical management, 3 were refractory and 1 had fulminant course. Cerebral venography demonstrated severe stenosis of the dominant sinus in 6 patients and of bilateral co-dominant sinuses in 2 patients. Six patients had intrinsic stenosis and 2 had extrinsic stenosis. Venous sinus stenting (VSS) resulted in improvement of symptoms, papilledema and normalization of CSF opening pressure in 7 patients. No immediate complications were observed. Mean follow-up period is 21 months (range 6–42). Two patients required re-stenting; one responded well and the other had persistent symptoms and underwent subsequent surgical procedures of CSF diversion, suboccipital decompression and duraplasty which were also ineffective. Conclusion VSS may provide a viable option for pediatric IIH patients who are intolerant to medication, have failed conservative management or prior surgical interventions, or present with fulminant disease.
Alleged Homicidal Choking in a Woman Recovering From Guillain-Barré Syndrome
Authors: Kitulwatte I. D. G. , Edirisinghe P.A.S. 
Published: November 2020

Few reported cases of homicidal choking in medical literature involve aged, infants, and debilitated. Whenever an allegation is made, the forensic expert is expected to provide a balanced opinion based on scientific evidence. We report a sudden death of a woman recovering from Guillain-Barré syndrome (GBS), with an allegation of homicidal choking. A 53-year-old female was diagnosed of having Guillain-Barré syndrome and was managed in the hospital. She was slowly recovering and liquid meals were replaced by solids and she was mobilized. A relation was feeding her when she developed a sudden cardiac arrest. Her sisters alleged intentional choking. At autopsy, there were a few seeds of rice in her trachea at the bifurcation and in the right bronchus. Stomach contained few seeds of rice mixed with mucous. The contents of the trachea were tested for pH and were acidic. Microscopy revealed widespread viral myocarditis. Myocarditis is reported to coexist with GBS rarely and can lead to a sudden cardiac arrest. Few seeds of rice in the trachea cannot cause death from choking. Further, the acidic pH of the contents indicated gastric origin and therefore possible agonal aspiration or postmortem regurgitation.
The Impact of Point-of-Care Hemoglobin A1c Testing on Population Health-Based Onsite Testing Adherence: A Primary-Care Quality Improvement Study
Authors: Crocker Joseph Benjamin , Lynch Stephen H. , Guarino Anthony J. , Lewandrowski Kent 
Published: November 2020

Background: The hemoglobin A1c (HbA1c) is a gold-standard test to diagnose and monitor diabetes mellitus and has been incorporated into population health performance metrics for quality care. However, patients and practices remain challenged in completing timely HbA1c tests. Point-of-care testing (POCT) for HbA1c provides a quick, easy, reliable method for monitoring diabetes in the primary care office setting. The objectives of this quality improvement study were to evaluate the impact of HbA1c POCT on onsite HbA1c testing frequency as a component of population health performance, as well as to measure the utility of HbA1c POCT in identifying clinically meaningful change in disease. Method: Prospective quality improvement cohort study among sequentially scheduled adult patients with diabetes due for HbA1c testing across three primary care practices. Results: Practices with HbA1c POCT were 3.7 times less likely to miss HbA1c testing at the time of the visit compared with practices in which HbA1c POCT was not available ( P < .001). Nearly one in four patients in each group were found to have clinically worsening diabetes (defined by an increase in HbA1c of ≥0.5% or 5.5 mmol/mol). Nearly half of those patients in the intervention group were identified by POCT. Conclusions: HbA1c POCT can improve population health-driven HbA1c testing adherence at office visits in primary care and may enable more timely intervention of diabetes management for patients with worsening disease.
Noise in Endoscopic Sinus and Skull Base Surgery Operating Rooms
Authors: Levin Marc , Zhou Kelvin , Sommer Ethan C. , Purohit Hitansh , Wells Jeffery , Pugi Jakob , Sommer Doron D. 
Published: November 2020

Background Noise in the operating room (OR) contributes to miscommunication among team members and may negatively impact patient outcomes. Objectives This study aimed to quantify noise levels during endoscopic sinus and skull base surgery. The secondary aim was to understand how OR team members perceive noise during endoscopic sinus and skull base surgery. Methods Noise levels were measured using the validated phone application SoundMeter X 10.0.4 (r1865) (Faber Acoustical, Utah, USA) at the ear-level of the surgeon, scrub nurse, circulating nurse, and anesthesiologist. At the end of each surgery, OR team members were asked to complete a six-question questionnaire about noise during that surgery. Results One thousand four hundred and two noise measurements were recorded across 353 trials. The loudest mean noise measurement was 84.51 dB and maximum noise measurement was 96.21 dB at the ear-level of the surgeon. Noise was significantly higher at the ear-level of the surgeon and scrub nurse in comparison to the circulating nurse (p = .000) and anesthesiologist (p = .000). Forty percent of questionnaire respondents believed noise was a problem and 38% stated that noise caused communication issues during surgery. Conclusion Surgeons and scrub nurses have significantly higher noise exposure in comparison to circulating nurses and anesthesiologists during endoscopic sinus and skull base surgery. For these members of the OR team, noise is also identified as problematic and causing issues with communication. Mechanisms to reduce potential noise may be implemented to improve communication and patient outcomes in endoscopic sinus and skull base surgery.
Diagnostic Criteria for Odontogenic Sinusitis: A Systematic Review
Authors: Allevi Fabiana , Fadda Gian Luca , Rosso Cecilia , Martino Federica , Pipolo Carlotta , Cavallo Giovanni , Felisati Giovanni , Saibene Alberto Maria 
Published: November 2020

Background Odontogenic sinusitis affects a significant proportion of patients with paranasal sinus infections. Nevertheless, no shared diagnostic criteria for this condition have yet been implemented and published studies differ in their definition of the disease. Objective The present systematic review of the literature was undertaken to characterize and analyze the different diagnostic criteria currently employed for odontogenic sinusitis. Methods Systematic searches for studies published between 2009 and 2019 were performed in Medline, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov databases. Search criteria were designed to identify all studies focusing, even partially, on odontogenic sinusitis. Human original studies except single case reports published in the English, French, German, Spanish, or Italian language were included. We removed duplicate abstracts and conducted full-text reads, data extraction, and quality assessment procedures (using the Oxford Centre for Evidence-based Medicine levels of evidence and National Heart Lung and Blood Institute Study Quality Assessment Tools). We reviewed articles for diagnostic criteria, both in terms of definition and etiology identification. Results Among 1,000 unique citations, 63 studies were deemed eligible. Most articles (n = 45) were retrospective case series; a single randomized clinical trial was available. Only 49 studies reported diagnostic criteria, yet relied marginally on published guidelines (n = 10 articles) for identifying sinusitis, often choosing instead to develop their own clinical (n = 15 articles), endoscopic (n = 12 articles), and/or radiologic (n = 30 articles) criteria. For odontogenic focus identification, 14 papers required a multidisciplinary evaluation, 11 papers required a time relationship between dental procedures and sinusitis, 24 papers required oroscopy and/or dental evaluation, and 53 papers required computed tomography. Conclusions Current diagnostic criteria for odontogenic sinusitis are extremely heterogeneous. Establishing shared diagnostic criteria aimed at defining both sinusitis and related odontogenic foci would spur collaboration between investigators and support more comprehensive outcomes evaluations together with a better understanding of treatment options.
Association between plasma levels of BDNF and the antisuicidal effects of repeated ketamine infusions in depression with suicidal ideation
Authors: Zheng Wei , Zhou Yan-Ling , Wang Cheng-Yu , Lan Xiao-Feng , Zhang Bin , Zhou Su-Miao , Yan Su , Yang Ming-Zhe , Nie Sha , Ning Yu-Ping 
Published: November 2020

Background: This study is the first to examine the association between plasma levels of brain-derived neurotrophic factor (BDNF) and the antisuicidal effects of repeated ketamine infusions in depressed patients with suicidal ideation. Methods: Fifty-seven depressed patients with suicidal ideation received six ketamine infusions (0.5 mg/kg) during a 12 days period. Suicidality was measured with the Scale for Suicidal Ideations (SSI-part 1), item 10 of the Montgomery–Åsberg Depression Rating Scale (MADRS), and item 3 of the Hamilton Depression Rating Scale (HAMD) at baseline, 1 day after the first infusion (1 day), 1 day after the sixth infusion (13 days), and at 2 weeks after the last infusion (26 days). Plasma levels of BDNF were measured by enzyme-linked immunosorbent assay at baseline, 13 days, and 26 days. Results: Overall, 46 (80.7%) depressed patients with suicidal ideation had an antisuicidal response at 13 days. Despite a significant reduction in suicidal symptoms over time, no changes in plasma levels of BDNF were found after ketamine treatment when compared with baseline. Correlation analysis showed that no significant association was observed between the plasma levels of BDNF and the changes in the severity of suicidal symptoms as measured by SSI-part 1, item 10 of the MADRS, or item 3 of the HAMD at 1 day, 13 days, and 26 days (all p < 0.05). Conclusion: Our results indicated that plasma levels of BDNF may not serve as a biomarker for determining the antisuicidal effects of six ketamine infusions in depressed patients with suicidal ideation.
Gifted Education in Hong Kong: A School-Based Support Program Catering to Learner Diversity
Authors: Cheung Ruby S. H. , Hui Anna N. N. , Cheung Alan C. K. 
Published: November 2020

Purpose: This study explores the contributions and effectiveness of the Jockey Club “Giftedness into Flourishing Talents” Project (Project GIFT) in supporting learner diversity in gifted education, including meeting the educational and psychological needs of highly capable and gifted students in Hong Kong. Design/Approach/Methods: This study investigates the effectiveness of Project GIFT in supporting the development of diversity in learning in 20 project schools. Through close cooperation with project schools, Project GIFT comprised six developmental areas: school development, curriculum development, teachers’ professional development, parent empowerment, student development, and financial support. To further assess the usefulness of the school-based support provided by Project GIFT, this study examines the implementation of school-based gifted education in two project schools based on the aforementioned components. Findings: This study reveals Project GIFT’s significant role in promoting school-based gifted education in Hong Kong schools. Indeed, it was the first cross-institutional and research-based educational program in gifted education that intervened at both Level 1 (whole class) and Level 2 (pullout) of the three-tiered policy stipulated by the Hong Kong Education Bureau. One of the few gifted education programs implemented in Asia, Project GIFT focused on six key components to specifically support high-ability and gifted students with diverse educational and affective needs. This study shows that Project GIFT significantly enhanced diversity in learning, its collaboration with two key schools resulting in the successful enhancement of school development, professional development, curriculum development, student development, parent empowerment, and financial support. Originality/Value: The article fills the research gap by examining the effectiveness of a school-based gifted education program focused on enriching and differentiating curricula for different regular and pull-out programs. In doing so, this article attests to the success of the program in addressing the educational and psychosocial needs of gifted students at local schools in Hong Kong.
More than Just Soup: Use of a Student-Led COVID-19 Social Pediatrics Initiative to Propose the Integration of Social Medicine Electives in Undergraduate Medical Education
Authors: Daccache Jennifer , Khoury Michel , Habibi Charlene , Bennett Susan 
Published: November 2020

Introduction: The need to educate medical students on the social forces shaping disease and health patterns is paramount in preparing incoming physicians with the aptitudes to address health inequities. Despite its well-documented merit as a model of practice, social medicine remains underrepresented at the undergraduate medical education level. We hypothesize that the success of this student-led COVID-19 initiative proposes a tangible and innovative solution to address the lack of social medicine exposure in undergraduate medical education. Methodology: We sought to evaluate the impact of sustaining clinical learning during the pandemic using the social pediatrics model as a didactic vector for clerkship students. We extracted learning objectives relevant to the teaching of social medicine from the Royal College of Physicians and Surgeons of Canada’s CanMEDS framework and developed a survey aimed at evaluating the attainability of each of those objectives. The survey was distributed to students enrolled in the social pediatrics COVID-19 initiative after 6 weeks (April-May), as well as a control group. Results: Completing the survey were 19 students from the University of Ottawa Faculty of Medicine, 7 in the intervention group and 12 in the control group. Students that participated in the social pediatrics initiative yielded significantly higher values for the achievement of 6 out of 9 social medicine learning objectives when compared to the control group. Although the values followed a similar trend for the remaining 3 objectives, favoring the intervention group, they were not statistically significant. Conclusion: The positive results from this study and the COVID-19 student-led initiative template can serve as a catalyst for curricular change so as to ensure graduates are adequately trained to contend with the realities of the social landscape in which they will practice. Future plans include the incorporation of interactive social medicine experiences throughout all 4 years of medical school.
Platelet extracellular vesicles mediate transfusion-related acute lung injury by imbalancing the sphingolipid rheostat
Authors: McVey Mark J. , Weidenfeld Sarah , Maishan Mazharul , Spring Chris , Kim Michael , Tabuchi Arata , Srbely Victoria , Takabe-French Alisa , Simmons Szandor , Arenz Christoph , Semple John W. , Kuebler Wolfgang M. 
Published: November 2020

Abstract
Transfusion-related acute lung injury (TRALI) is a hazardous transfusion complication with an associated mortality of 5% to 15%. We previously showed that stored (5 days) but not fresh platelets (1 day) cause TRALI via ceramide-mediated endothelial barrier dysfunction. As biological ceramides are hydrophobic, extracellular vesicles (EVs) may be required to shuttle these sphingolipids from platelets to endothelial cells. Adding to complexity, EV formation in turn requires ceramide. We hypothesized that ceramide-dependent EV formation from stored platelets and EV-dependent sphingolipid shuttling induces TRALI. EVs formed during storage of murine platelets were enumerated, characterized for sphingolipids, and applied in a murine TRALI model in vivo and for endothelial barrier assessment in vitro. Five-day EVs were more abundant, had higher long-chain ceramide (C16:0, C18:0, C20:0), and lower sphingosine-1-phosphate (S1P) content than 1-day EVs. Transfusion of 5-day, but not 1-day, EVs induced characteristic signs of lung injury in vivo and endothelial barrier disruption in vitro. Inhibition or supplementation of ceramide-forming sphingomyelinase reduced or enhanced the formation of EVs, respectively, but did not alter the injuriousness per individual EV. Barrier failure was attenuated when EVs were abundant in or supplemented with S1P. Stored human platelet 4-day EVs were more numerous compared with 2-day EVs, contained more long-chain ceramide and less S1P, and caused more endothelial cell barrier leak. Hence, platelet-derived EVs become more numerous and more injurious (more long-chain ceramide, less S1P) during storage. Blockade of sphingomyelinase, EV elimination, or supplementation of S1P during platelet storage may present promising strategies for TRALI prevention.