bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tubal choriocarcinoma presented as ruptured ectopic pregnancy: a case report and review of the literature
Authors: Xu Shengjie , Song Xiaohong , Jin Chengjuan , Li Yanli 
Published: September 2020

AbstractBackgroundTubal choriocarcinoma is an extremely rare but highly malignant trophoblastic tumor, which may be either gestational or non-gestational in origin. Due to atypical clinical manifestations and symptoms similar to ectopic pregnancy, it is easily to be confused with ectopic pregnancy. In addition, inadequate understanding of this rare disease by clinicians often leads to misdiagnosis or missed diagnosis, which in turn results in delayed treatment or even tumor metastasis.Case presentationThis report summarized a case of a woman who was finally diagnosed as tubal choriocarcinoma through the follow-up of serum β hCG levels and histopathological results after undergoing salpingectomy for being misdiagnosed as ectopic pregnancy. Five courses of adjuvant chemotherapy (5-fluorouracil, actinomycin-D, vinorelbine regime) have been administered to the patient in the prevention of any recurrences. During 1-year follow-up, the patient was asymptomatic and presented no evidence of recurrence.ConclusionsTubal choriocarcinoma is easily to be confused with ectopic pregnancy. By analyzing this case and previous related cases, we aimed to provide references for clinicians in the diagnosis and treatment of tubal choriocarcinoma.
Virtual reality-based treatment for regaining upper extremity function induces cortex grey matter changes in persons with acquired brain injury
Authors: Keller Jiří , Štětkářová Ivana , Macri Vince , Kühn Simone , Pětioký Jakub , Gualeni Stefano , Simmons С. Douglas , Arthanat Sajay , Zilber Paul 
Published: September 2020

Abstract
Background
Individuals with acquired brain injuries (ABI) are in need of neurorehabilitation and neurorepair. Virtual anatomical interactivity (VAI) presents a digital game-like format in which ABI survivors with upper limb paresis use an unaffected limb to control a standard input device and a commonplace computer mouse to control virtual limb movements and tasks in a virtual world.

Methods
In a prospective cohort study, 35 ambulatory survivors of ABI (25/71% stroke, 10/29% traumatic brain injury) were enrolled. The subjects were divided into three groups: group A received VAI therapy only, group B received VAI and physical/occupational therapy (P/OT), and group C received P/OT only. Motor skills were evaluated by muscle strength (hand key pinch strength, grasp, and three-jaw chuck pinch) and active range of motion (AROM) of the shoulder, elbow, and wrist. Changes were analyzed by ANOVA, ANCOVA, and one-tailed Pearson correlation analysis. MRI data was acquired for group A, and volumetric changes in grey matter were analyzed using voxel-based morphometry (VBM) and correlated with quantified motor skills.

Results
AROM of the shoulder, elbow, and wrist improved in all three groups. VBM revealed grey matter increases in five brain areas: the tail of the hippocampus, the left caudate, the rostral cingulate zone, the depth of the central sulcus, and the visual cortex. A positive correlation between the grey matter volumes in three cortical regions (motor and premotor and supplementary motor areas) and motor test results (power and AROM) was detected.

Conclusions
Our findings suggest that the VAI rehabilitation program significantly improved motor function and skills in the affected upper extremities of subjects with acquired brain injuries. Significant increases in grey matter volume in the motor and premotor regions of affected hemisphere and correlations of motor skills and volume in nonaffected brain regions were present, suggesting marked changes in structural brain plasticity.

Trial registration
The trial “Limitations of motor brain activity – use of virtual reality for simulation of therapeutic interventions” has been registered under reference number ISRCTN11757651.
De novo mosaic and partial monosomy of chromosome 21 in a case with superior vena cava duplication
Authors: Azad Abul Kalam , Yanakakis Lindsay , Issleb Samantha , Turina Jessica , Drabik Kelli , Bonner Christina , Simi Eve , Wagner Andrew , Fiddler Morry , Naeem Rizwan 
Published: September 2020

Abstract
Background
Full or partial monosomy of chromosome (chr) 21 is a very rare abnormal cytogenetic finding. It is characterized by variable sizes and deletion breakpoints on the long arm (q) of chr 21 that lead to a broad spectrum of phenotypes that include an increased risk of birth defects, developmental delay and intellectual deficit.

Case presentation
We report a 37-year-old G1P0 woman initially screened by non-invasive prenatal testing with no positive findings that was followed by an 18-week anatomy scan with a fetal finding of duplication of the superior vena cava (SVC). The medical and family history was otherwise uneventful. After appropriate genetic counseling, amniocentesis was performed to evaluate suspected chromosomal anomalies.

Conclusions
Interphase fluorescent in situ hybridization revealed loss of one chr 21 signal that was further delineated by chromosomal microarray analysis on uncultured amniocytes as a terminal 10 Mb deletion on chr 21q. Karyotype and microarrays on cultured amniocytes showed two cell lines for a mosaic 21q terminal deletion and monosomy 21. The combined molecular cytogenetics results reported following the ISCN 2016 guideline as mos 46,XX,del(21)(q22)dn[20]/45,XX,-21dn[10].nuc ish(D21S342/D21S341/D21S259x1)[100].arr[GRCh37] 21q11.2q22.12(15412676_36272993)x1~2,21q22.12q22.3(36431283_47612400)x1. Parental chromosomal analysis revealed normal karyotypes. Thus, this was a de novo mosaic full and partial monosomy of chr 21 in a case with SVC duplication. Despite the association of congenital heart disease with monsomy 21 we could not find any published literature or online databases for this cytogenetic abnormality. The patient terminated the pregnancy following the abnormal molecular cytogenetic results due to the possible challenges the baby would face if carried to term.
Can we safely reduce the administration of 131-iodine in patients with differentiated thyroid cancer? – experience of the Brugmann hospital in Brussels
Authors: Iconaru Laura , Baleanu Felicia , Taujan Georgiana , Duttmann Ruth , Spinato Linda , Karmali Rafik , Bergmann Pierre , Hambye Anne-Sophie 
Published: September 2020

Abstract
Background
131-iodine (131I) administration after surgery remains a standard practice in differentiated thyroid cancer (DTC). In 2014, the American Thyroid Association presented new guidelines for the staging and management of DTC, including no systematic 131I in patients at low-risk of recurrence and a reduced 131I activity in intermediate risk.
The present study aims at evaluating the rate of response to treatment following this new therapeutic management compared to our previous treatment strategy in patients with DTC of different risks of recurrence.

Methods
Patients treated and followed up for DTC according to the 2014-ATA guidelines (Group 2) were compared to those treated between 2007 and 2014 (Group 1) in terms of general characteristics, risk of recurrence (based on the 2015-ATA recommendations), preparation to 131I administration, cumulative administered 131I activity and response to treatment.

Results
In total, 136 patients were included: 78 in Group 1 and 58 in Group 2. The two groups were not statistically different in terms of clinical characteristics nor risk stratification: 42.3% in Group 1 and 31% in Group 2 were classified as low risk, 38.5 and 48.3% as intermediate risk and 19.2 and 20.7% as high risk (P = 0.38). Two patients (one in each group) with distant metastases were excluded from the analysis.
Preparation to 131I administration consisted in rhTSH stimulation in 23.4% of the patients in Group 1 and 100% in Group 2 (p < 0.001).
131I was administered to 46/77 patients (59.7%) in Group 1 (5 at low risk of recurrence) and 38/57 patients (66.7%) in Group 2 (0 with a low risk). Among the patients treated by 131I, median cumulative activity was significantly higher in Group 1 (3.70GBq [100 mCi] range 1.11–11.1 GBq [30–300 mCi]) than in Group 2 (1.11 GBq [30 mCi], range 1.11–7.4 GBq [30–200 mCi], P < 0.001). Complete response was found in 90.9% in Group 1 vs. 96.5% in Group 2 (P = 0.20).

Conclusions
Using the 2015-ATA evidence-based guidelines for the management of DTC, meaning no 131I administration in low-risk patients, a low activity in intermediate and even high risk patients, and a systematic use of rhTSH stimulation before 131I therapy allowed us to reduce significantly the median administered 131I activity, with a similar rate of complete therapeutic response.
Weight maintenance interventions for people with type 2 diabetes mellitus: a systematic review protocol
Authors: Sauchelli Sarah , Bradley Julia , Cox Jennifer , England Clare , Perry Rachel 
Published: September 2020

Abstract
Background
Weight loss maintenance is a challenge for people with type 2 diabetes mellitus (T2DM), which attenuates the long-term benefits of weight loss for diabetes management. Medication, specific dietary requirements and the psychosocial burden of T2DM signify that weight loss maintenance designed for obesity may not suit people with T2DM. The primary objective of this review is to comprehensively evaluate existing weight maintenance interventions for people with or at high risk of T2DM.

Methods
We registered a protocol for the systematic review and meta-analysis of randomised and non-randomised weight maintenance interventions for T2DM. Studies included will have been carried out in adults with clinical diagnosis of T2DM or pre-diabetes. All intervention types will be accepted (e.g. behavioural/lifestyle change and pharmacological). The primary outcomes will be weight control, glycaemic control and adverse effects. Secondary outcomes will include cardiovascular risk factors (e.g. total cholesterol, LDL-cholesterol, blood pressure control), psychological wellbeing (including health-related quality of life), change in glucose medication and waist circumference. Multiple electronic databases will be searched such as MEDLINE, EMBASE, Web of Science, PsychINFO and international registers (e.g. Cochrane Central Register of Controlled Trials, WHO ICTRP). OpenGrey will be searched for grey literature. Two researchers will screen all citations and abstracts. This process will also be conducted by an additional researcher using a semi-automated tool to reduce human error. Full-text articles will be further examined by the researchers to select a final set for further analysis, and a narrative synthesis of the evidence will be presented. Potential sources of heterogeneity will be assessed, and a meta-analysis will be conducted if feasible. Risk of bias will be evaluated using the Cochrane risk of bias tool and the certainty of evidence using the GRADE (grading of recommendations, assessment, development and evaluation) approach.

Discussion
This review will critically appraise existing weight maintenance interventions targeting T2DM. Findings will inform future intervention development to support people with T2DM delay weight regain and prolong successful diabetes management.

Systematic review registration
PROSPERO CRD42020168032
Antibiotics create a shift from mutualism to competition in human gut communities with a longer-lasting impact on fungi than bacteria
Authors: Seelbinder Bastian , Chen Jiarui , Brunke Sascha , Vazquez-Uribe Ruben , Santhaman Rakesh , Meyer Anne-Christin , de Oliveira Lino Felipe Senne , Chan Ka-Fai , Loos Daniel , Imamovic Lejla , Tsang Chi-Ching , Lam Rex Pui-kin , Sridhar Siddharth , Kang Kang , Hube Bernhard , Woo Patrick Chiu-yat , Sommer Morten Otto Alexander , Panagiotou Gianni 
Published: September 2020

AbstractBackgroundAntibiotic treatment has a well-established detrimental effect on the gut bacterial composition, but effects on the fungal community are less clear. Bacteria in the lumen of the gastrointestinal tract may limit fungal colonization and invasion. Antibiotic drugs targeting bacteria are therefore seen as an important risk factor for fungal infections and induced allergies. However, antibiotic effects on gut bacterial-fungal interactions, including disruption and resilience of fungal community compositions, were not investigated in humans. We analysed stool samples collected from 14 healthy human participants over 3 months following a 6-day antibiotic administration. We integrated data from shotgun metagenomics, metatranscriptomics, metabolomics, and fungal ITS2 sequencing.ResultsWhile the bacterial community recovered mostly over 3 months post treatment, the fungal community was shifted from mutualism at baseline to competition. Half of the bacterial-fungal interactions present before drug intervention had disappeared 3 months later. During treatment, fungal abundances were associated with the expression of bacterial genes with functions for cell growth and repair. By extending the metagenomic species approach, we revealed bacterial strains inhibiting the opportunistic fungal pathogenCandida albicans. We demonstrated in vitro howC.albicanspathogenicity and host cell damage might be controlled naturally in the human gut by bacterial metabolites such as propionate or 5-dodecenoate.ConclusionsWe demonstrated that antibacterial drugs have long-term influence on the human gut mycobiome. While bacterial communities recovered mostly 30-days post antibacterial treatment, the fungal community was shifted from mutualism towards competition.
Evolution and morphology of rafted blocks in an ancient deepwater mass-transport complex (Exmouth Plateau, offshore North West Australia)
Authors: Eruteya Ovie Emmanuel , Niyazi Yakufu , Omosanya Kamaldeen Olakunle , Ierodiaconou Daniel , Moscariello Andrea 
Published: September 2020

Submarine mass wasting plays a fundamental role in transporting substantial volumes of sediments basinward including gigantic slide blocks. However, the understanding of processes involved in block generation and their associated deformation until flow arrest remains limited, especially in data-starved deepwater settings. Here, 2D and 3D seismic reflection data from the Exmouth Plateau, offshore North West Australia are used to investigate the architecture of large blocks preserved within an ancient mass-transport complex (MTC) and their interaction with the basal shear surface (BSS). The evolution of the investigated MTC (MTC-BDF) is related to instability along the slope and flanks of an underlying bifurcative Miocene canyon. The MTC-BDF spans approximately 75 × 35 km containing at least 32 well-imaged blocks (within the 3D seismic coverage) encapsulated in a well-deformed debrite background. These carbonate blocks interpreted as rafted blocks have lengths ranging from 0.48 to 3.40 km with thicknesses reaching up to 165 m. Interestingly, the blocks are more abundant in a region characterized by moderate- to high-amplitude debrites. Erosional morphologies encompassing a unique groove and other circular- to irregularly shaped depressions mapped along the BSS provide evidence for the erosive nature of the flow. The origin of the groove is related to transported blocks gouging the BSS. Importantly, intrablock deformations are recorded within these blocks as fault and fold systems. This suggests a complex flow regime within MTC-BDF, with the deformations arising either during block transportation or possibly upon arrest of the failed mass while interacting with bathymetric elements. Our findings suggest that inherent deformations within these blocks may serve as high-permeability conduits with implications for deepwater drilling operations within this segment of the Exmouth Plateau and elsewhere in other hydrocarbon-rich deepwater settings.
The Clinical Features and Molecular Mechanisms of ACTH-secreting Pancreatic Neuroendocrine Tumors
Authors: Zhang Cui , Jin Jiabin , Xie Jing , Ye Lei , Su Tingwei , Jiang Lei , Zhou Weiwei , Jiang Yiran , Wu Luming , Wang Ting , Zhong Xu , Ning Guang , Shen Baiyong , Wang Weiqing 
Published: September 2020

Abstract

Objective
Pancreatic neuroendocrine tumors (pNETs) causing ectopic adrenal corticotropic hormone (ACTH) syndrome (EAS) are rare and aggressive with little known information. We aimed to elucidate the clinical features and molecular mechanisms of pNETs with EAS by methylation analysis.

Methods
Seven patients with ectopic ACTH-secreting pNETs who were diagnosed at Shanghai Clinical Endocrine and Metabolic Diseases Center and Pancreatic Disease Center in Ruijin Hospital between 2001 and 2019 were enrolled. Twenty patients with ectopic ACTH-secreting thymic neuroendocrine tumors (TNETs) and 7 with nonfunctional pNETs (nf-pNETs) were also enrolled as controls. We collected clinical data and measured POMC promoter CpG methylation.

Results
All 7 patients had elevated ACTH and urinary free cortisol (UFC) levels with positive ACTH staining in the pancreas and were diagnosed with ectopic ACTH-secreting pNET. Of the 7 patients, 6 underwent surgery and 1 underwent transarterial embolization (TAE). Two patients were free of disease after surgery; 2 died within 90 days after surgery; and 3 had metastases and died within 1 year. Compared with ACTH-secreting TNETs, ACTH-secreting pNETs had similar clinical and biochemical features but a significantly poorer prognosis. POMC promoter CpG methylation was significantly lower in ACTH-secreting pNETs than in nf-pNETs and normal pancreas.

Conclusions
ACTH-secreting pNETs are aggressive and fatal. Surgery is definitively curative for patients with resectable primary tumors without metastasis. Pro-opiomelanocortin (POMC) promoter hypomethylation caused pNETs to produce ACTH. This study further supplements the genetic features of ACTH-secreting NETs.
Quality of Life in Patients With Hypoparathyroidism After Treatment for Thyroid Cancer
Authors: Büttner Matthias , Locati Laura D , Pinto Monica , Araújo Cláudia , Tomaszewska Iwona M , Kiyota Naomi , Vidhubala E , Brannan Christine , Hammerlid Eva , Husson Olga , Salem Dina , Ioannidis Georgios , Gamper Eva , Arraras Juan Ignacio , Andry Guy , Inhestern Johanna , Theurer Juliane , Taylor Katherine , Singer Susanne 
Published: September 2020

AbstractPurposeSurgical complications such as hypoparathyroidism (HPT) or vocal cord palsy are seldom assessed when the quality of life (QOL) in thyroid cancer patients is investigated. The aim of this study was to measure the QOL difference in thyroid cancer survivors with and without HPT.MethodsParticipants for this analysis were enrolled in 13 countries from a study that pilot-tested a thyroid cancer–specific QOL instrument. They were included if they had been diagnosed with thyroid cancer at least 9 months previously. QOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) and some items on HPT symptoms (eg, tingling in fingers or toes). HPT status and other clinical data were extracted from the patients’ medical charts. Comparisons of QOL domains between patients with and without HPT were performed using Mann-Whitney U test. The occurrence of HPT-related symptoms was compared using chi-square tests. Multiple ordinal regression analysis was performed to evaluate factors that might affect QOL.ResultsEighty-nine patients participated in this study, 17 of whom were considered to have HPT. Patients in the HPT group reported significantly reduced QOL in 9 of the 15 scales of the EORTC QLQ-C30 compared to patients without HPT. Regression analysis showed that HPT was independently negatively associated with various scales of the QLQ-C30. Both groups showed a high prevalence of typical HPT symptoms.ConclusionThyroid cancer patients with HPT report significantly impaired QOL compared to thyroid cancer survivors without HPT. The assessment of HPT should be considered when measuring QOL in thyroid cancer patients.
Associations of BMI and Serum Urate with Developing Dementia: A Prospective Cohort Study
Authors: Cao Zhi , Xu Chenjie , Yang Hongxi , Li Shu , Xu Fusheng , Zhang Yuan , Wang Yaogang 
Published: September 2020

Abstract

Context
Recent studies have suggested that a higher body mass index (BMI) and serum urate levels were associated with a lower risk of developing dementia. However, these reverse relationships remain controversial, and whether serum urate and BMI confound each other is not well established.

Objectives
To investigate the independent associations of BMI and urate, as well as their interaction with the risk of developing dementia.

Design and Settings
We analyzed a cohort of 502 528 individuals derived from the UK Biobank that included people aged 37–73 years for whom BMI and urate were recorded between 2006 and 2010. Dementia was ascertained at follow-up using electronic health records.

Results
During a median of 8.1 years of follow-up, a total of 2138 participants developed dementia. People who were underweight had an increased risk of dementia (hazard ratio [HR] = 1.91, 95% confidence interval [CI]: 1.24–2.97) compared with people of a healthy weight. However, the risk of dementia continued to fall as weight increased, as those who were overweight and obese were 19% (HR = 0.81, 95%: 0.73–0.90) and 22% (HR = 0.78, 95% CI: 0.68–0.88) were less likely to develop dementia than people of a healthy weight. People in the highest quintile of urate were also associated with a 25% (HR = 0.75, 95% CI: 0.64–0.87) reduction in the risk of developing dementia compared with those who were in the lowest quintile. There was a significant multiplicative interaction between BMI and urate in relation to dementia (P for interaction = 0.004), and obesity strengthens the protective effect of serum urate on the risk of dementia.

Conclusion
Both BMI and urate are independent predictors of dementia, and there are inverse monotonic and dose-response associations of BMI and urate with dementia.
Dire, Médire, Dédire
Authors: Fleck Stephen H. 
Published: September 2020

Abstract
The article analyzes the triviality of Austin’s version of everyday-world speech act theory (which explicitly excluded fictional uses of language) in favor of its specific value for investigation of fictionality, invoking ideas of Pierre Bourdieu and Émile Benveniste. Noting the thematic prominence in the Misanthrope of two of Austin’s favorite examples of speech acts, for marriage (“I do”) and courtroom testimony (“I swear to tell the truth . . . ”), the article examines the work’s dramatic ambiguities in relation to Austin’s theory—and in particular, its shortcomings. Molière thus articulates the profoundly divided nature of Alceste indicated by Donneau de Visé (“ridicule”/“juste”), Rousseau (“un homme droit, sincère, estimable,” but also facing the world as “un personnage ridicule”), and recently by Georges Forestier and Claude Bourqui (the melancholic, jealous lover vs. the philosophe misanthrope, the world champion of sincerity), permanently at war with himself, in a war he is bound to lose. The article concludes that Molière constructs much of the famously conversational dramatic texture and indeterminate conclusion not through “successful” speech acts, but rather through failed ones; a reflection, too, of the rapidly transforming social values of the play’s historical moment.