bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous necrotizing granuloma of the cerebellum: a case report
Authors: Godbe Kerilyn N. , Saway Brian F. , Guilliams Evin L. , Entwistle John J. , Jarrett Robert W. 
Published: June 2020

Abstract
Background
Intracranial necrotizing granulomatous space-occupying lesions are sparsely reported in literature. Variability in presenting symptomatology and radiographic features makes diagnostic work-up difficult.

Case presentation
This report presents the case of a 77-year-old female with sinusitis and fatigue who underwent an MRI revealing a posterior fossa lesion compressing the fourth ventricle. Subsequent contrast CT of the chest, abdomen, and pelvis was negative for primary malignancy. Histopathologic examination of the lesion following biopsy showed it to be a necrotizing granuloma in an antineutrophil cytoplasmic antibody (ANCA) negative patient. The most likely diagnosis was determined to be spontaneous necrotizing granuloma, a rare entity with only one previous report noted.

Conclusions
Spontaneous necrotizing granuloma of the CNS is a rare entity that represents an important differential consideration in the work-up of space occupying lesions of the CNS.
Normal fertilisation rates and serum 25-OHD levels among couples undergoing in-vitro fertilisation: a prospective cohort study
Authors: Jiang Liu , Yang Juan , Song Jianyuan , Hu Yajun , Qian Kun 
Published: June 2020

Abstract
Background
The aim of this study was to explore the correlation between serum vitamin D levels in couples undergoing in-vitro fertilisation (IVF) and normal fertilisation process.

Methods
Between March 2016 and March 2017, we performed a prospective cohort study at an academic reproductive medicine centre to measure serum 25-hydroxyvitaminD (25-OHD) levels of 1232 couples before controlled ovarian stimulation. Generalized linear regression and binary multivariate logistic regression were employed to assess whether 25-OHD levels in men and women correlated with normal fertilisation rates and low fertilisation rate (LFR).

Results
Serum 25-OHD levels in women were classified into three groups: Group A, less than 10%; Group B, between 10 and 90%; and Group C, greater than 90%. Using generalized linear regression, we observed that female 25-OHD levels were related to normal fertilisation rates. Adjusted normal fertilisation rates from Group A to Group C in women were 59.50, 62.72, and 66.13%, respectively (P = 0.007). After binary logistic regression analysis, for women, compared with Group C, the ORs for LFR were 4.814 in Group A (95% CI, 1.266–18.309, P = 0.021) and were 3.204 in Group B (95% CI, 0.949–10.812, P = 0.061). Male 25-OHD levels were not related to the probability of low fertilisation rate (P > 0.05).

Conclusions
Circulating 25-OHD concentrations in women appear to be associated with normal fertilisation rates and low fertilisation rates in IVF cycles, but not in men. A further randomized controlled trial with vitamin D supplementation is needed to demonstrate whether female vitamin D levels exert an effect on the normal fertilisation process.

Trial registration
https://clinicaltrials.gov/;NCT03305510; Registered 08 October 2017 - Retrospectively registered.
miR-874 inhibits gastric cancer cell proliferation by targeting SPAG9
Authors: Sun Qin Hui , Yin Zong Xiu , Li Zhi , Tian Shu Bo , Wang Hong Chang , Zhang Fang Xu , Li Le Ping , Zheng Chun Ning , Kong Shuai 
Published: June 2020

Abstract
Background
microRNAs (miRNAs) play essential roles in the development and progression of gastric cancer (GC). Although aberrant miR-874 expression has been reported in various human cancers, its role in GC remains obscure.

Methods
miR-874 expression was assessed by real-time quantitative polymerase chain reaction (RT-qPCR) in 62 matched GC and adjacent normal tissues, as well as in GC cell lines and immortalized human gastric epithelial cells. CCK8 assay, colony formation assay, and flow cytometry were used to assess the role of miR-874 in GC cell proliferation and apoptosis in vitro. Additionally, to determine the effects of miR-874 on GC cell proliferation and apoptosis in vivo, BALB/c nude mice were injected with GC cells transfected with a miR-874 mimic. The role of miR-874 in SPAG9 expression was assessed by luciferase assay, Western blotting, and RT-qPCR.

Results
miR-874 was downregulated in GC cell lines and tissues. miR-874 overexpression in GC cells led to inhibition of cell proliferation and induction of apoptosis. Moreover, SPAG9 was identified as a direct miR-874 target, the expression of which was suppressed by miR-874. SPAG9 overexpression markedly promoted GC cell proliferation.

Conclusions
miR-874 inhibited cell proliferation and induced apoptosis in GC cells. SPAG9 downregulation was crucial for the tumor-suppressive effects of miR-874. Hence, the miR-874/SPAG9 axis could serve as a novel therapeutic target in GC.
Activity of PD1 inhibitor therapy in advanced sarcoma: a single-center retrospective analysis
Authors: Quiroga Dionisia , Liebner David A. , Philippon Jennifer S. , Hoffman Sarah , Tan Yubo , Chen James L. , Lenobel Scott , Wakely Paul E. , Pollock Raphael , Tinoco Gabriel 
Published: June 2020

Abstract
Background
Sarcomas constitute a heterogeneous group of tumors with different clinical behaviors and variable responses to systemic therapies. Recent immunotherapy studies with PD1 inhibitors (PD1i) show promising results with use in certain soft-tissue sarcomas; however, the clinical and molecular features that best predict response to PD1i remain unclear.

Methods
Demographic, imaging, histologic, and genetic sequencing data was collected for sarcoma patients who received nivolumab or pembrolizumab (PD1i) treatment at our institution between January 1st 2015 and April 23rd 2018. The primary objective was to determine progression-free survival (PFS) in patients with advanced sarcomas receiving PD1i. Secondary objectives included determining overall survival (OS) and assessment of characteristics associated with response to PD1i. Fifty-six patients who were treated with PD1i therapy met inclusion criteria for this study.

Results
Partial response towards PD1i treatment was seen in 3 in 26 evaluable patients, but no complete responses were observed (overall response rate 11.5%). Within this group of patients, the 90 day PFS was found to be 48.8%. In patients in whom PD1 expression was known, there was a statistically significant positive correlation between expression of PD1 and longer PFS and OS rates. Patients that were treated with more than four cycles of PD1i therapy were also more likely to have a greater OS.

Conclusions
This study suggests activity of PD1i in a pretreated cohort of advanced sarcoma patients, particularly for the subset of patients with PD1 positive tumors. Our results highlight the importance of further research to better target the optimal patient population and markers of response.
Meeting psychosocial needs to improve health: a prospective cohort study
Authors: Snowden Austyn , Young Jenny , Savinc Jan 
Published: June 2020

AbstractBackgroundCancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention.MethodProspective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3 L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, median 84 days later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models with heteroscedasticity-consistent standard errors.ResultsParticipants were White British with median age between 50 and 64 years. Cancer type and stage were varied. EQ-5D utility scores improved at follow-up by 0.121 [0.0891–0.153],p < .001, and VAS scores improved by 7.81 [5.88–9.74],p < .001. The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status.ConclusionThis study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants had both a statistically significant and clinically meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants, this study has shown for the first time that it is possible to capture a clinically meaningful improvement as a function of reducing someone’s personally identified concerns.
Risk factors for excessive postoperative exo-drift after unilateral lateral rectus muscle recession and medial rectus muscle resection for intermittent exotropia
Authors: Morisawa Shin , Hamasaki Ichiro , Shibata Kiyo , Shimizu Takehiro , Kono Reika , Miyata Manabu , Furuse Takashi , Hasebe Satoshi , Ohtsuki Hiroshi , Morizane Yuki , Shiraga Fumio 
Published: June 2020

Abstract
Background
To detect significant factors associated with excessive postoperative exo-drift in young patients with intermittent exotropia who had undergone unilateral lateral rectus muscle recession and medial rectus muscle resection.

Methods
We retrospectively examined the records of 64 consecutive patients < 18 years old who underwent surgery between April 2004 and December 2011. We sought risk factors for excessive postoperative exo-drift among patients’ demographic and clinical characteristics using univariate and multivariable linear regression analysis.

Results
Younger patients (P = 0.007), and those with larger preoperative exo-deviation at distance (P = 0.033), a lower incidence of peripheral fusion at distance (P = 0.021) or a greater postoperative initial eso-deviation (P = 0.001), were significantly more likely to have an excessive postoperative exo-drift (> 20 prism diopters). Univariate analysis revealed significant associations between excessive postoperative exo-drift and age at surgery (P = 0.004), preoperative exo-deviation at distance (P = 0.017) and postoperative initial eso-deviation at distance (P < 0.001). Multivariable linear regression analysis showed that postoperative initial eso-deviation at distance (P = 0.008) was significantly associated with postoperative exo-drift.

Conclusions
Postoperative exodrift in unilateral RR is predicted by the initial postoperative eso-deviation, which may offset the overcorrection. However, the exo-drift is greater in cases with a large preoperative exo-deviation and/or at a younger age, and should be followed carefully.
Minoxidil induced central serous Chorioretinopathy treated with oral Eplerenone – a case report
Authors: Venkatesh Ramesh , Pereira Arpitha , Jain Kushagra , Yadav Naresh Kumar 
Published: June 2020

Abstract
Background
Minoxidil solution has routinely been used for decades for the treatment of androgenic alopecia. Central serous chorioretinopathy (CSCR) is a rare side-effect noted following prolonged topical minoxidil therapy for androgenic alopecia. In this report, we describe a case of a 41-year-old young man who developed CSCR following prolonged therapy with topical Minoxidil solution and was treated with oral eplerenone.

Case presentation
A 41-year-old male presented to the retina clinic with complaints of seeing a black spot, blurred vision and metamorphopsia involving the right eye for the past 4 months. He was on treatment for androgenic alopecia with topical 5% Minoxidil application on scalp two times a day. He noticed the symptoms 8 months after starting the treatment and had stopped the medication since the past 2 months. On examination, best-corrected visual acuity was 20/20 in both eyes. Fundoscopic examination of the right eye with +78D lens on slit lamp revealed the presence of subretinal fluid and few focal spots of retinal pigment epithelial alterations. Optical coherence tomography scan evaluation showed the presence of subretinal fluid (SRF) and pachychoroid supporting the diagnosis of CSCR. Indocyanine green angiography revealed dilated hyperpermeable choroidal vasculature on the nasal side of the fovea in the early and later phases of the angiogram. The patient was diagnosed with CSCR as a possible consequence of the topical minoxidil solution. Patient was asked to avoid future use of Minoxidil and was started on oral eplerenone therapy 50 mg/day for 4 consecutive weeks. One month later, there was complete resolution of his symptoms and SRF. At the final follow-up visit, 2 months after starting the therapy, there was no recurrence of SRF.

Conclusion
CSCR is a rare side-effect noted following prolonged topical minoxidil therapy for androgenic alopecia. While we found oral eplerenone to be safe and effective, further studies would be required before it can be routinely used in the population.
Tübingen hip flexion splints for developmental dysplasia of the hip in infants aged 0–6 months
Authors: Zhou You , Li Rong , Li Chuan , Zhou Ping , Li Yan , Ke You-hao , Jiang Fei , Kang Xiao-peng 
Published: June 2020

Abstract
Background
Developmental dysplasia of the hip (DDH) is a common disorder in infants. The present study aimed to evaluate the efficacy and safety of the Tübingen hip flexion splints in treating DDH in infants aged 0–6 months.

Methods
This is a retrospective study analyzing 259 hips in 195 infants with DDH of Graf type IIc or worse classifications treated between January 2015 and December 2017. Patients were followed up for at least 6 months. Avascular necrosis of the femoral head was diagnosed using plain radiographs at the last follow-up visit according to the Bucholz-Ogden classification. Successful treatment was defined as an improvement of the Graft classification to type I, or an improvement of the International Hip Dysplasia Institute classification to type I in patients aged > 6 months.

Results
Treatment was deemed successful in 128 patients (83.7%). Avascular necrosis occurred in 3 patients (3 hips). Univariate analysis showed that late treatment initiation, family history of DDH, Graf type IV and bilateral involvement were independent risk factors for treatment failure (p < 0.05). The receiver operating characteristic curve showed a cut-off value of 12 weeks for age at treatment initiation regarding successful treatment. Logistic regression analysis showed that gender, breech presentation, firstborn, swaddling, birth weight > 3.5 kg, oligohydramnios, foot deformity and torticollis did not affect the success rate of treatment (p > 0.05).

Conclusions
The Tübingen splint showed good efficacy and safety in treating DDH in infants aged 0–6 months. Family history of DDH, Graf classification of type IV, bilateral involvement and treatment initiation after 12 weeks of age are risk factors of treatment failure.

Trial registration
N/A
Examining the autistic traits in children and adolescents diagnosed with attention-deficit hyperactivity disorder and their parents
Authors: Okyar Esra , Görker Işık 
Published: June 2020

Abstract
Background
Attention-Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two of the most frequently-observed neurodevelopmental disorders. Autistic traits are detected frequently in children who have ADHD. This study aimed to examine autism symptoms in children diagnosed with ADHD and their parents; and also, to investigate parental risk factors that increase autistic traits in children. Besides the risk factors related to pregnancy, birth and developmental history were examined.

Methods
Two groups were created consisting of 66 children diagnosed with ADHD and 33 children not diagnosed with ADHD and their parents. Autism symptoms were screened with the Autism Behavior Checklist (ABC) in children, and Autism Spectrum Quotient (AQ) in parents. Also, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale and Wender Utah Rating Scale (WURS) were used to determine ADHD symptoms in parents.

Results
It was determined that there were more autism symptoms in children who were diagnosed with ADHD than in the control group without ADHD. There were more autistic symptoms in boys and the presence of Oppositional Defiant Disorder (ODD). Although there were more ADHD symptoms in the parents of children diagnosed with ADHD, it was determined that they did not differ from parents in the control group in terms of autism symptoms. It was also determined that maternal and paternal ADHD symptoms were predictive for autism symptoms in children. It was also shown that maternal smoking during pregnancy is associated with more autistic traits.

Conclusion
ASD and ADHD show high levels of comorbidity. The etiology remains unclear. Both ADHD and ASD show strong hereditary transition. We found that maternal and paternal ADHD symptoms predict autism symptoms in children with ADHD. However, more studies are needed to reveal the etiology.
Participation in the Child and Adult Care Food Program is associated with fewer barriers to serving healthier foods in early care and education
Authors: Zaltz Daniel A. , Hecht Amelie A. , Pate Russell R. , Neelon Brian , O’Neill Jennifer R. , Benjamin-Neelon Sara E. 
Published: June 2020

AbstractBackgroundEarly care and education (ECE) is an important setting for influencing young children’s dietary intake. There are several factors associated with barriers to healthy eating in ECE, and recent evidence suggests that participation in the Child and Adult Care Food Program (CACFP), the primary national food assistance program in ECE, may be associated with fewer barriers to serving healthier foods. However, no prior studies have examined differences between CACFP participants and non-participants across a large, multi-state sample. This is the first study to examine the association between CACFP participation and barriers to serving healthier foods in ECE using a random sample of directors from two regions across the country.MethodsWe conducted a cross-sectional survey among a random sample of child care center directors from four states (Massachusetts, North Carolina, Rhode Island, and South Carolina). We conducted logistic and Poisson regression to calculate the odds and incidence rate ratios of reporting 1) no barriers, 2) specific barriers (e.g., cost), and 3) the total number of barriers, by CACFP status, adjusting for covariates of interest.ResultsWe received 713 surveys (36% response rate). About half (55%) of centers participated in CACFP. The most prevalent reported barriers to serving healthier foods were cost (42%) and children’s food preferences (19%). Directors from CACFP centers were twice as likely to report no barriers, compared to directors from non-CACFP centers (OR 2.03; 95% CI [1.36, 3.04];p < 0.01). Directors from CACFP centers were less likely to report cost as a barrier (OR = 0.46; 95% [CI 0.31, 0.67];p < 0.001), and reported fewer barriers overall (IRR = 0.77; 95% CI [0.64, 0.92];p < 0.01), compared to directors from non-CACFP centers.ConclusionsCACFP directors reported fewer barriers to serving healthier foods in child care centers. Still, cost and children’s food preferences are persistent barriers to serving healthier foods in ECE. Future research should evaluate characteristics of CACFP participation that may alleviate these barriers, and whether barriers emerge or persist following 2017 rule changes to CACFP nutrition standards.
Use and importance of different information sources among patients with rare diseases and their relatives over time: a qualitative study
Authors: Litzkendorf Svenja , Frank Martin , Babac Ana , Rosenfeldt Daniel , Schauer Franziska , Hartz Tobias , Graf von der Schulenburg J.-Matthias 
Published: June 2020

Abstract
Background
Finding reliable information on one of more than 7000 rare diseases is a major challenge for those affected. Since rare diseases are defined only by the prevalence criterion, a multitude of heterogeneous diseases are included. Common to all, however, are difficulties regarding information access. Even though various quantitative studies have analyzed the use of different information sources for specific rare diseases, little is known about the use of information sources for different rare diseases, how users rate these information sources based on their experiences, and how the use and importance of these information sources change over time.

Methods
Fifty-five patients with a variety of rare diseases and 13 close relatives participated in qualitative interviews. For these interviews, a semi-structured guideline was developed, piloted, and revised. Data analysis involved a qualitative content analysis developed by Philipp Mayring.

Results
The participants considered internet as the most important and widespread information source, especially for early information. Although patients have difficulty dealing with information obtained online, they consider online searching a quick and practical option to gather information. During the course of the disease, personal contact partners, especially self-help associations and specialized doctors, become more important. This is also because information provided online is sometimes insufficiently detailed to answer their information needs, which can be complemented by information from doctors and self-help.

Conclusions
People rarely use just one type of source, but rather refer to different sources and informants. The source used depends on the type of information sought as well as other person-related factors such as preexisting knowledge and the disease stage. To improve people’s information searching and connect them with medical specialists in rare diseases, a central information portal on rare diseases might be a suitable access point to provide free and quality assured information for patients, caregivers, and physicians. This would allow not only patients but also doctors to find quality assured information on symptoms and therapies as well as patient associations and specialized doctors.