bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraventricular neuroepithelial tumors: Surgical outcome, technical considerations and review of literature
Authors: Aftahy Amir Kaywan , Barz Melanie , Krauss Philipp , Liesche Friederike , Wiestler Benedikt , Combs Stephanie E. , Straube Christoph , Meyer Bernhard , Gempt Jens 
Published: October 2020

Abstract
Background: Intraventricular neuroepithelial tumors (IVT) are rare lesions and comprise different pathological entities such as ependymomas, subependymomas and central neurocytomas. The treatment of choice is neurosurgical resection, which can be challenging due to their intraventricular location. Different surgical approaches to the ventricles are described. Here we report a large series of IVTs, its postoperative outcome at a single tertiary center and discuss suitable surgical approaches. Methods: We performed a retrospective chart review at a single tertiary neurosurgical center between 03/2009-05/2019. We included patients that underwent resection of an IVT emphasizing on surgical approach, extent of resection, clinical outcome and postoperative complications.Results: 45 IVTs were resected from 03/2009 to 05/2019, 13 ependymomas, 21 subependymomas, 10 central neurocytomas and one glioependymal cyst. Median age was 52,5 years with 55.6% (25) male and 44.4% (20) female patients. Gross total resection was achieved in 93.3% (42/45). 84.6% (11/13) of ependymomas, 100% (12/21) of subependymomas, 90% (9/10) of central neurocytomas and one glioependymal cyst were completely removed. Postoperative rate of new neurological deficits was 26.6% (12/45). Postoperative new permanent cranial nerve deficits occurred in one case with 4th ventricle subependymoma and one in 4th ventricle ependymoma. Postoperative KPSS was 90% (IR 80-100). 31.1% of the patients improved in KPSS, 48.9% remained unchanged and 20% declined. Postoperative adverse events rate was 20.0%. Surgery-related mortality was 2.2%. The rate of shunt/cisternostomy-dependent hydrocephalus was 13.3% (6/45). 15.4% of resected ependymomas underwent adjuvant radiotherapy. Mean follow-up was 26,9 (±30.1) months.Conclusion: Our surgical findings emphasize satisfactory complete resection throughout all entities. Surgical treatment can remain feasible, if institutional experience is given. Satisfying long-term survival and cure is possible by complete removal. Gross total resection should always be performed under function-remaining aspects due to mostly benign or slow growing nature of IVTs. Further data is needed to evaluate standard of care and alternative therapy options in rare cases of tumor recurrence or in case of patient collective not suitable for operative resection.
A novel “Three-port” trocar placement technique for laparoscopic radical prostatectomy
Authors: Xu Ben , Peng Yi-ji , Ma Guo-Zhong , Zhang Qian 
Published: October 2020

Abstract
Background: To introduce a novel “three-port” trocar placement technique for laparoscopic radical prostatectomy (LRP) in prostate cancer (PCa) patients.Methods: We retrospectively reviewed 300 patients with PCa who received surgical treatment between November 2010 and June 2015 at our institution. They were divided into group A: three-port LRP, group B: conventional four-five port LRP, group C: open RP (ORP) and group D: robotic-assisted RP (RARP). A learning curve was analyzed by dividing patients of group A into the early and late stages.Results: All groups were comparable with regard to the preoperative characteristics except for the relatively smaller prostate volume in group A. The three-port LRP operations were performed successfully with only 8 cases conversion to the conventional LRP. None of any severe complications or conversion to ORP occurred. In group A, the mean operative time (OT) duration was 113.8min, the mean estimated blood loss (EBL) was 94.2ml, the mean drainage days was 4.0d, the mean hospitalization was 5.1d, and 27.8% of the prostate specimen margins (PSM) were positive. The differences of OT, EBL, drainage days, hospitalization and transfusion in group A were statistically significant among the majority of the other groups (p<0.05). After undergoing the early stages of a learning curve analysis in three-port LRP, the EBL was obviously decreased.Conclusions: Three-port LRP is a novel technique that exhibits superior intraoperative advantages to the conventional LRP. Due to its less OT, EBL, drainage days, hospitalization and transfusion with a shorter learning curve, it should be recommended and popularized in the clinical practice!
Understanding the barriers to using oral anticoagulants among long-term aspirin users with atrial fibrillation – A qualitative study
Authors: Ng Vanessa WS , Siu Chung-Wah , Chiu Patrick KC , Kng Carolyn PL , Jamieson Elizabeth , Wong Ian CK , Lam May PS 
Published: October 2020

Abstract
Background: Despite international treatment guidelines currently advocating oral anticoagulants (OACs) as the only appropriate stroke prevention therapy for patients with atrial fibrillation (AF) and evidence that OACs can greatly reduce the risk of stroke with similar risk of bleeding compared with aspirin, the underuse of OACs in patients with AF is common globally, especially in Asia. This study aimed to identify the barriers to prescribing and using OACs among long-term aspirin users with AF.Method: Face-to-face interviews were conducted with fourteen eligible patients with AF using a semi-structured interview guide. The interview recordings were transcribed verbatim and data was analyzed according to the principles of thematic analysis.Results: Five themes were developed: awareness of AF symptoms and diagnosis; knowledge and understanding of AF and stroke prevention therapy; role of decision-making in prescribing; willingness to switch from aspirin to OACs; and impact of OAC regimen on daily living. The majority of the patients were not aware of the symptoms and diagnosis of AF and only had a vague understanding of the illness and stroke prevention therapy, leading to their minimal involvement in decisions relating to their treatment. Some patients and their caregivers were particularly concerned about the bleeding complications from OACs and perceived aspirin to be a suitable alternative as they find the adverse effects from aspirin manageable and so preferred to remain on aspirin if switching to OACs was not compulsory. Lastly, the lifestyle modifications required when using warfarin, e.g. alternative dosing regimen, diet restriction, were seen as barriers to some patients and caregivers.Conclusion: The findings revealed patients’ knowledge gap in AF management which may be targeted using educational interventions to improve patients’ understanding of AF and its management and hence encourage active participation in the decision-making of their treatment in the future.
Dose- and time-dependent effects of hyaluronidase on structural cells and the extracellular matrix of the skin
Authors: Buhren Bettina , Schrumpf Holger , Gorges Katharina , Reiners Oliver , Boelke Edwin , Fischer Jens , Homey Bernhard , Gerber Arne 
Published: October 2020

Abstract
Hyaluronic acid (hyaluronan; HA) is an essential component of the extracellular matrix (ECM) of the skin. The HA-degrading enzyme hyaluronidase (HYAL) is critically involved in the HA-metabolism. Yet, only little information is available regarding the skin´s HA-HYAL interactions on the molecular and cellular levels.OBJECTIVE To analyze the dose- and time-dependent molecular and cellular effects of HYAL on structural cells and the HA-metabolism in the skin.MATERIALS AND METHODS Chip-based, genome-wide expression analyses (Affymetrix® GeneChip PrimeView™ Human Gene Expression Array), quantitative real-time PCR analyses, enzyme-linked immunosorbent assay (ELISA), immunohistochemistry (DAB), and in vitro wound healing assays were performed to assess dose-dependent and time-kinetic effects of HA and HYAL (bovine hyaluronidase, Hylase “Dessau”) on normal human dermal fibroblasts (NHDF), primary human keratinocytes in vitro and human skin samples ex vivo.RESULTS Genome-wide expression analyses revealed an upregulation of HA synthases (HAS) up to 1.8-fold change in HA- and HYAL-treated NHDF. HA and HYAL significantly accelerated wound closure in an in vitro model for cutaneous wound healing. HYAL induced HAS1 and HAS2 mRNA gene expression in NHDF. Interestingly, low concentrations of HYAL (0.015 U/ml) resulted in a significantly higher induction of HAS compared to moderate (0.15 and 1.5 U/ml) and high concentrations (15 U/ml) of HYAL. This observation corresponded to increased concentrations of HA measured by ELISA in conditioned supernatants of HYAL-treated NHDF with the highest concentrations observed for 0.015 U/ml of HYAL. Finally, immunohistochemical analysis of human skin samples incubated with HYAL for up to 48 h ex vivo demonstrated that low concentrations of HYAL (0.015 U/ml) led to a pronounced accumulation of HA, whereas high concentrations of HYAL (15 U/ml) reduced dermal HA-levels.CONCLUSION HYAL is a bioactive enzyme that exerts multiple effects on the HA-metabolism as well as on the structural cells of the skin. Our results indicate that HYAL promotes wound healing and exerts a dose-dependent induction of HA-synthesis in structural cells of the skin. Herein, interestingly the most significant induction of HAS and HA were observed for the lowest concentration of HYAL.
A cross-sectional study on the burden and impact of migraine on work productivity and quality of life in selected workplaces in the Philippines
Authors: Haw Nel Jason , Cabaluna Ian Theodore , Kaw Germaine Erika , Cortez Joanna Feliz , Chua Maria Pamela , Guce Kristel 
Published: October 2020

Abstract
Background: Migraine imposes a substantial personal and economic burden to many working age individuals. This study aimed to evaluate the burden and impact of migraine on work productivity in selected workplaces in the Philippines. Methods: A cross-sectional survey was conducted among employees suspected or diagnosed with migraine February to May 2020. Volunteer employees were screened for migraine using the ID-Migraine™ test. Eligible employees were tested for migraine severity and impact on work productivity using the Migraine Disability Assessment (MIDAS) questionnaire. Quality of life was measured using the Short Form-36 (SF-36) questionnaire and additional questions on triggers, coping mechanisms, workplace assistance, and health care utilization were asked. Multiple logistic regression was used to identify significant predictors of migraine disability (high – MIDAS Grade III/IV vs. low – MIDAS Grade I/II). Differences in quality of life scores by migraine disability were measured using multiple linear regression. Productivity costs lost to migraine disability were calculated as the number of days lost to migraine multiplied by the self-reported wage rate, and costs according to migraine severity were measured using a two-part model (logistic then generalized linear model). Results: From around 24,000 employees who were invited to participate in the survey, 954 respondents provided consent and attempted to respond to the survey resulting to a response rate of around 4.1%. A total of 511 positive migraine screens were included in the final sample. Females comprised two-thirds of all positive migraine screens and were more likely to have high migraine disability (odds ratio: 1.60, 95% CI: 1.03 - 2.49) than males. Those with high migraine disability scored lower on role limitations compared to those with low migraine disability. Stress and looking at computer screens were cited as the top trigger for migraine, while sleeping enough hours and getting a massage were cited as top coping mechanisms. Three in four (77%) visited their company clinic within the past three months, which meant that most doctors seen for migraine-related symptoms were general practitioners. Five in six (85%) took medication for migraine, almost all of which were over-the-counter medications. Mean annual productivity costs lost due to migraine disability were PHP27 794 (USD556) per person. Conclusion: Migraine poses a significant threat to work productivity in the Philippines. Many opportunities, such as disease management and introduction of alternative options for migraine treatment, may be introduced to help address these issues.
A Rare Primary Intraosseous Schwannoma of the Tibia
Authors: Liu Xueqing , Ding Yunlong , Shen Yanling , Yang Wensheng 
Published: October 2020

Abstract
Background: Primary intraosseous schwannoma is a rare benign tumor derived from schwanncells that cover myelinated nerve fibers, accounting for less than 0.2% of all primary bone tumors. Because of its rarity, the new World Health Organization classification of bone tumors has deleted it.Case presentation: A 29-year-old woman presented with a history of intermittent pain on her right ankle over three years. Radiological examination revealed a multilocular cystic and lytic lesion in the distal tibia. Histologically, the tumor was composed of spindle shaped cells, similar to soft tissue neurilemmoma. The patient underwent a surgical resection of the intraosseous lesion. After a 38-month follow-up, the symptoms were significantly relieved and there was no clinical or radiological recurrence.Conclusion: Primary intraosseous schwannoma is a rare benign bone tumor. The pathologists should be aware of the incidence of the tumor, although WHO has deleted it.
Updated evaluation of clinicopathologic landscape in histopathologic subtypes of endometrial carcinoma with MMR gene mutation
Authors: Wang Aifen , Hu Weidong , Zhang Qinfu , Ren Hongjiu , Zhao Zihan , Zhang Ziyue , Chen Youguo 
Published: October 2020

Abstract
Background: This study aimed to identify an optimal screening strategy to detect mismatch repair (MMR) mutation for each histologic subtype of endometrial carcinoma. Methods:We performed a comparative analysis of the demographic, clinical, pathologic, and molecular data for 562 patients from The Cancer Genome Atlas database, stratified by tumor histologic subtype.Results: Molecular data, including MLH1, MLH3, PMS1, PMS2, MSH2, MSH3, MSH6, and EPCAM, was available for 562 patients, of which 162 (28.8%) had tumors that were positive for MMR gene mutations. Of these tumors, the penetrate rate of grade 3 endometrioid endometrial carcinoma (84/184, 45.7%) was significantly higher than that of uterine serous carcinoma (35/156, 22.4%) (p < 0.001), grade 2 endometrioid endometrial carcinoma (26/129, 20.2%) (p < 0.001), and grade 1 endometrioid endometrial carcinoma (17/93, 18.3%) (p < 0.001). Of 562 endometrial carcinomas, alterations in MSH2 (n = 55), MSH6 (n = 54), and MSH3 (n = 50) were the most frequent mutations. There were no differences in overall survival and progression-free interval (PFI) between MMR mutation carriers and nonmutation carriers (p >0.05) except that PFI with MMR gene mutation was higher than with MMR proficiency in grade 3 endometrioid endometrial carcinoma (p = 0.014). Conclusions: Grade 3 endometrioid endometrial carcinoma harbored more MMR mutations than grade 1 endometrioid endometrial carcinoma, grade 2 endometrioid endometrial carcinoma, and uterine serous carcinoma. Besides MLH1, MSH2, MSH6, PMS2, and EPCAM mutation, MLH3, MSH3, and PMS1 mutation may be necessary to be screened in patients with newly diagnosed endometrial carcinoma.
How Large is The Burden of Depression in A Medical School? A Cross-Sectional Study Among Medical Students in Nigeria
Authors: Ossai Edmund Ndudi , Eze Irene Ifeyinwa , Onyenakazi Rejoice Chinecherem , Ugebe Elias Ifeyinwa , Eze Basil C , Obasi Obinna C 
Published: October 2020

Abstract
Background: Mental health of students deteriorate when they begin studies in a medical school and remains poor throughout the period of training. Notwithstanding that medical students of today are the physicians of tomorrow who need to have stable mental health for effective performance, mental status of this group have not been adequately explored in the Nigeria context. The study aimed to determine the prevalence of depression and associated factors among medical students in Nigeria. Methods: A cross-sectional study was carried out on all matriculated medical students of Ebonyi state University Abakaliki, Nigeria. Information was obtained from 522 medical students that were eligible to participate in the study using self-administered structured questionnaire. Becks Depression Inventory was used to determine the prevalence of depression. Chi square test was used in the analysis to ascertain association between variables. Level of statistical significance was determined by a p value of <0.05.Results: Mean age of the students was 23.2±3.3 years and majority, 60.2% were males. Prevalence of depression was 17.4%. Third-year class (major examination class) had the highest proportion of students who were depressed, 24.2% while final year class had the least, 8.8%. Coping mechanisms for low moods included sleeping, 50.4% and having interactions with colleagues, 46.9%. Factors associated with depression included being <25 years, (p=0.008), being in clinical school, (p=0.023) and being afraid some students may not graduate from medical school, (p=0.030).Conclusions: Burden of depression was high among the students and most pronounced among third year students. There is need for proper orientation of newly admitted medical students on the medical curriculum by authorities of the university. Medical students preparing for major examinations should be well supported and encouraged by their colleagues and efforts should be made to decrease undue anxiety among the students. Adequate measures should be put in place for early detection and prompt management of cases of depression among the students.
Applying Deep Learning for Genome Detection of Coronavirus
Authors: Rani Geeta , Oza Meet Ganpatlal , Dhaka Vijaypal Singh , Pradhan Nitesh , Verma Sahil , Rodrigues Joel J. P. C. 
Published: October 2020

Abstract
Amidst the global pandemic and catastrophe created by ‘COVID-19’, every research institution and scientists are doing their best efforts to invent or find the vaccine or medicine for the disease. The objective of this research is to design and develop a deep learning model for finding the degree of similarity of the genome of the Severe Acute Respiratory Syndrome-Coronavirus 2 (‘SARS-CoV-2’) with a given genome. This research also aims at detecting the genome of ‘SARS-CoV-2’ in the host human beings. The experimental results on the dataset publicly available at National Centre for Biotechnology Information, show that the model is effective in predicting the similarity score of the genomic sequence of ‘SARS-CoV-2’ and other prevalent viruses such as Severe Acute Respiratory Syndrome-Coronavirus, Middle East Respiratory Syndrome Coronavirus, Human Immunodeficiency Virus, and Human T- cell Leukaemia Virus. This is successful in detecting the genome of ‘SARS-CoV-2’ in the host genome with an accuracy of 99.27%. It may prove a useful tool for doctors to quickly classify the infected and non-infected genomes. It can also be useful in finding the most effective drug from the available drugs for the treatment of ‘COVID-19’.
Positive Feedback Regulation between USP15 and ERK2 Promotes Cartilage Repair Through the TGF-β/SMAD2 signaling
Authors: Wang Wenjuan , Zhu Yanhui , Sun Zhenyu , Jin Chen , Wang Xiang 
Published: October 2020

Abstract
The transforming growth factor-β (TGF-β) signaling pathway plays an essential role in maintaining homeostasis in joints affected by osteoarthritis (OA). Here, we detected that overexpression of USP15, rather than USP15 C269S (a USP15 mutant), activated p-SMAD2 in ATDC5 cells, which also went down by USP15 knocked out followed by the latest gene editing technology Crispr/Cas9. And we established rat knee OA models through anterior cruciate ligament transection and partial medial meniscectomy (ACLT+pMMx) after 8 weeks and conducted the corresponding Adeno-associated virus (AAV) intraarticular injections. Next, experimental data including immunohistochemical staining, HE/Safranin-O fast green staining, histological evidence analysis, relevant Osteoarthritis Research Society International (OARSI) scores, expression of molecules involved in cartilage anabolism and so on indicated that USP15 can reduce damaged cartilage by activating TGF-β signaling pathway in vivo. We further observed that ERK2 of non-SMAD signaling can maintain the cartilage phenotype by regulating the TGF-β signaling pathway through USP15 in vitro and in vivo. Most importantly, USP15 is required during this process and can form a complex with ERK2 to regulate ubiquitination of ERK2. Specifically, USP15, instead of USP15 C269S, deubiquitinates and activates ERK2, followed by translocation of phosphorylated ERK2 from the cytoplasm to the nucleus. Taken together, our study revealed a positive feedback regulation between USP15 and ERK2, which plays a critical role in the interaction of SMAD and non-SMAD signaling pathways to promote cartilage repair in experimental OA. Therefore, this specific mechanism can guide clinical treatments of OA.
Apolipoprotein L1 Risk Genotypes in Ghanaian Systemic Lupus Erythematosus Patients: A Prospective Cohort Study
Authors: Blazer Ashira , Dey Ida Dzifa , Nwaukoni Janet , Reynolds Margret , Ankrah Festus , Algasas Huda , Ahmed Tasneem , Divers Jasmin 
Published: October 2020

Abstract
Objective: Two Apolipoprotein L1 (APOL1) risk variants (RV) are enriched in sub-Saharan African populations due to a conferred resistance to Trypanosoma brucei. This comes at the cost of progressive renal disease by multiple causes including systemic lupus erythematosus (SLE). In African Americans, APOL1 high-risk genotypes have emerged as an important risk factor for progressive lupus nephritis. Despite emerging reports that SLE is common in Ghana, where APOL1 variant allelic frequencies are high, the regional contribution to SLE outcomes has not been described. Accordingly, this prospective longitudinal cohort study tested the associations between APOL1 high-risk genotypes and kidney outcomes, organ damage accrual, and death in 100 Ghanaian SLE patients.Methods: A prospective cohort of 100 SLE outpatients met four 1982 American College of Rheumatology SLE criteria. Patients were assessed for demographics, SLE activity, and organ injury as measured by the Systemic Lupus International Collaborating Clinics Damage Index (SDI) at baseline and every 6 months for 1 year. Serum, plasma, and saliva samples were taken for serologic testing and APOL1 genotyping. Outcomes of interest were kidney function, SDI, and case fatality. Results: Assuming a recessive model of inheritance, the APOL1 high-risk genotype (2RV) associated with developing end stage renal disease (ESRD) at an odds ratio of 14 (p=0.008). These patients accrued more SDI points particularly in renal, neurologic, and cardio/pulmonary domains. The SDI was 81.3% higher in 2RV patients compared to 0RV or 1RV patients despite no difference in SLE activity (p=0.02). After a 12 month period of observation, 3/12 (25%) of the 2RV patients died compared to 2/88 (2.3%) of the 0RV or 1RV carriers (odds ratio=13.6, p=0.01). Deaths were due to end stage kidney disease and heart failure. Conclusion: Our results suggest that in Ghanaian SLE patients, APOL1 risk variants are heritable risk factors for morbidity and mortality. Despite no appreciable differences in SLE severity, APOL1 high-risk patients exhibited progressive renal disease, organ damage accrual, and a 13-fold higher case fatality rate.