bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical analysis of 12 cases of ovarian cystic mature teratoma with malignant transformation into squamous cell carcinoma
Authors: Wang Xiangyu , Li Wenjing , Kong Yan , Liu Xiangyu , Cui Zhumei 
Published: February 2021

Objective This study aimed to examine the clinicopathological characteristics, treatment, and prognostic factors in 12 cases of malignant transformation of mature cystic teratoma of the ovary (MCTO). Methods We performed a retrospective study of 12 patients with malignant transformation of MCTO who were admitted to the Affiliated Hospital of Qingdao University from 2003 to 2019. We examined case records, clinical parameters, and biological assessments. Results The median age of the patients was 56.5 years and seven of them were postmenopausal. The average tumor size was 18.5 cm. All patients had pelvic masses at their first hospital visit. Nine of the patients had discomfort in the lower abdomen, two presented with a lower abdominal palpable mass, and three were complicated by fever. The median follow-up time was 73 months (12‒193 months). Ten patients survived with a disease-free status and two died. Conclusions There is a low incidence of malignant transformation of MCTO, and its most common histological type is squamous cell carcinoma. Age and tumor size are important factors in malignant transformation of teratomas. While there is a lack of treatment guidelines for malignant transformation of MCTO, early diagnosis and treatment may be beneficial for these patients.
Cervical malignant teratoma masquerading as a hematoma: a case report
Authors: Lin Han-Jie , Hsu Chao-Yu , Tsai Stella Chin-Shaw 
Published: February 2021

Background Post-pubertal teratomas, which mostly occur at 20 to 40 years old, are more likely to be found at a metastatic site in up to 20% of cases and may be inadvertently overlooked. We present a case of cervical malignant teratoma that masqueraded as a hematoma. Case presentation: A 24-year-old man presented to our institution with a 4-month history of a progressively relapsing painless mass in the neck, despite conservative treatments with oral medications. A huge space-occupying mass was identified with almost total occlusion of the left internal jugular vein. The likely diagnosis was an organized hematoma or congenital cystic tumor with internal hemorrhage. Surgical excisional biopsy of the mass lesion was conducted and a malignant teratoma was found. A whole-body positron emission tomography scan showed a left inguinal mass, bilateral intra-abdominal lymphadenopathies, and abdominal metastases. Histopathology further suggested the diagnosis of an immature testicular teratoma with multiple lymph node metastases. The patient received adjuvant chemotherapy with a bleomycin, etoposide, and cisplatin regimen. During follow-up, salvage second-line chemotherapy was required with a paclitaxel, ifosfamide, and cisplatin regimen. Conclusion Although uncommon, cervical teratoma should be taken into consideration once a painless and non-remitting mass lesion is found in a young adult.
In vitro and in vivo assessment of the protective effect of sufentanil in acute lung injury
Authors: Gao Qi , Chang Ningqing , Liu Donglian 
Published: February 2021

Objectives To investigate the mechanisms underlying the protective effect of sufentanil against acute lung injury (ALI). Material and Methods Rats were administered lipopolysaccharide (LPS) by endotracheal instillation to establish a model of ALI. LPS was used to stimulate BEAS-2B cells. The targets and promoter activities of IκB were assessed using a luciferase reporter assay. Apoptosis of BEAS-2B cells was evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling. Results Sufentanil treatment markedly reduced pathological changes in lung tissue, pulmonary edema and secretion of inflammatory factors associated with ALI in vivo and in vitro. In addition, sufentanil suppressed apoptosis induced by LPS and activated NF-κB both in vivo and in vitro. Furthermore, upregulation of high mobility group box protein 1 (HMGB1) protein levels and downregulation of miR-129-5p levels were observed in vivo and in vitro following sufentanil treatment. miR-129-5p targeted the 3ʹ untranslated region and its inhibition decreased promoter activities of IκB-α. miR-129-5p inhibition significantly weakened the protective effect of sufentanil on LPS-treated BEAS-2B cells. Conclusion Sufentanil regulated the miR-129-5p/HMGB1 axis to enhance IκB-α expression, suggesting that sufentanil represents a candidate drug for ALI protection and providing avenues for clinical treatment.
Treatment of small and medium retinoblastoma tumors with Iris diode laser
Authors: Reynolds Margaret M , Sein Julia , Hayashi Robert , Lueder Gregg 
Published: February 2021

Purpose: Differing techniques have been reported for focal laser therapy for patients with small and medium retinoblastoma. We report the technique used at our center; and report the functional and anatomical outcomes for small and medium retinoblastomas treated with focal laser therapy with or without systemic chemotherapy. Methods: A retrospective case study was conducted including pediatric patients with macular retinoblastoma treated with systemic chemotherapy and laser ablation from July 1990 to July 2015 at Washington University School of Medicine/Saint Louis Children’s Hospital. Results: Fourteen eyes (11 patients) with small and medium retinoblastoma tumors were treated with repetitive indirect laser hyperthermia and seven of those patients were treated with systemic chemotherapy as well. Using the International Retinoblastoma classification, one eye was stage A, 10 eyes were stage B, and three eyes were stage C. The mean follow-up time was 7.7 years. There were no recurrences of tumor in the patients. Final visual acuity outcomes were 20/20 to 20/50 in four eyes, 20/60 to 20/200 in four eyes, and 20/400 or less in six eyes. None of the patients developed metastatic disease. Conclusions: The evidence for systemic chemotherapy and diode laser therapy is limited to case series and retrospective reviews, but evidence suggests that it is an effective treatment for small and medium sized retinoblastoma tumors involving the macula with the potential for good visual outcomes.
Understanding the role of self-determination in shaping university experiences for autistic and typically developing students in the United Kingdom
Authors: Lei Jiedi , Russell Ailsa 
Published: February 2021

With more autistic students enrolling in higher education, little is known about how autistic students can actively and effectively shape their own university experience through self-determination. This study explores how both autistic ( n = 18) and typically developing students and recent graduates ( n = 18) perceive their self-determination during their transition into, through and out of university in the United Kingdom. Students reported many shared and unique aspects of autonomy, competence and relatedness underlying self-determination. Many autistic students also discussed autism-related strengths facilitating academic pursuit at university, though found coping with transitional changes more difficult than typically developing students. Using strength-based approaches to help autistic students to actively adapt to routine changes might facilitate their self-determination during transition to university. Lay abstract Prior research suggests that autistic students in higher education might struggle with developing autonomy, competence and establish relatedness due to their executive functioning and social communication difficulties. We interviewed 18 autistic and 18 typically developing students to explore how students perceived themselves to be in control of their university experience. Both groups provided anecdotal examples that supported similar perceptions of self-determination in shaping the academic, daily living and socialisation aspects of university life. Autistic students reflected on their cognitive strengths such as attention to detail, persistence and ability to tailor their academic studies towards their interest. Varying degrees of sociability were noted, with some autistic students preferring to focus their self-determination efforts on academic success, while others treasured the novel social experiences including peer support and friendship at university. Compared to greater flexibility endorsed by typically developing students, autistic students perceived establishing a routine at university to be a necessity and were self-determined in maintaining stability amid a sea of change. Recognising strengths and self-determination efforts in autistic students can help stakeholders support their personal development towards independent living and self-sufficiency in adulthood and to successfully transition into, through and out of university.
The Effect of Intimate Partner Violence on the Physical Health and Health-Related Behaviors of Women: A Systematic Review of the Literature
Authors: Stubbs Anita , Szoeke Cassandra 
Published: February 2021

Aim: The long-term effects of intimate partner violence (IPV) on physical health outcomes and health-related behaviors are underresearched in comparison to the effects on mental health and pregnancy. This systematic review examines the recent research in this area from 2012 through 2019. Methods: SCOPUS, PubMed, EBSCOhost, and gray literature were searched using the key words “intimate partner violence” and “health.” To meet inclusion criteria, studies needed to be original research and focus on IPV during adulthood and its effects on the physical health or health-related behaviors of women. Fifty-two studies were qualitatively analyzed, with results grouped into broad categories of effects, including cardiovascular, endocrine, infectious diseases, and health screening. Results: IPV was shown to have negative effects on physical health outcomes for women, including worsening the symptoms of menopause and increasing the risk of developing diabetes, contracting sexually transmitted infections, engaging in risk-taking behaviors including the abuse of drugs and alcohol, and developing chronic diseases and pain. It also has significant effects on human immunodeficiency virus outcomes, worsening CD4+ cell depletion. Results varied regarding the effects of IPV on cardiovascular health outcomes. Conclusion: The result of this review demonstrates that women who have experienced violence and abuse are at significantly increased risk of poor health outcomes in a variety of areas and so require specialized and tailored primary care. This review highlights significant gaps in this field of research, particularly in relation to cardiovascular disease, endocrine dysfunction, and neurological symptoms and conditions. It demonstrates a need for additional long-term studies in this field to better inform the health care of women who have experienced IPV and to establish the physiological mediators of these outcomes.
Medical Tent Usage From Bank of America Chicago Marathon 2015-2017
Authors: Parker Brendan , Thaker Poonam , Chan Shu , Chiampas George 
Published: February 2021

Background: As mass participation events continue to increase in popularity, the need for medical care continues to increase. Our objective was to evaluate the course medical tent usage throughout the Bank of America Chicago Marathon course. Our second objective was to evaluate emergency medical services (EMS) utilization during the event. Hypothesis: We hypothesize that as the race progresses, medical tents will see more participants and EMS will have an increase in utilization. Level of Evidence: Level 4. Methods: This study was a retrospective analysis of data collected by the medical staff from 2015 to 2017. Documented patient encounters were analyzed from each course medical tent. Twenty medical tents were spaced roughly 1.2 miles apart depending on location and ease of EMS access to the medical tent location. Results: From 2015 to 2017, the course medical tents saw 2973 patients, with a 96.3% discharge rate. The data showed a linear increase of 5.69 patients seen per mile until mile 20 (linear regression P < 0.01). After mile 20, the number of patients seen per mile was about the same. The data also showed an increase in EMS utilization every 5 miles as the race progressed ( P = 0.04) and an increase in ratio of patients transported to the hospital compared with patients transferred to the main medical tents up to mile 20 ( P = 0.02). Conclusion: Course medical tents saw a statistically significant linear increase in patients per mile until mile 20. Total EMS utilization showed a statistically significant increase in usage as the race progressed and a statistically significant increase in ratio of transports to transfers as the race progressed until mile 20. Clinical Relevance: This study has the potential to influence medical tent and EMS placement for endurance events with increasing patient encounters and hospital transports as the mileage of the endurance event increases.
Long-term survival in a cat with tonsillar squamous cell carcinoma treated with surgery and chemotherapy
Authors: Treggiari Elisabetta , Romanelli Giorgio , Ferro Silvia , Roccabianca Paola 
Published: February 2021

Case summary A 13-year-old neutered female domestic shorthair cat was presented for further investigation of a right-sided cervical mass. Oral cavity examination revealed a unilateral, right tonsillar mass. Following a contrast-enhanced CT scan of head, thorax and abdomen, which showed no clear evidence of distant metastasis, cytology of the cervical mass was consistent with a metastatic retropharyngeal lymph node, and the patient underwent tonsillectomy and lymphadenectomy. The tumour was histopathologically confirmed to be a well-differentiated squamous cell carcinoma with lymph node metastasis, and sequential chemotherapy treatments with carboplatin were administered. The cat underwent a second surgery to treat local recurrence and chemotherapy was continued. Subsequently, multiple lymphadenectomies to remove additional metastatic lymph nodes were performed, followed by adjuvant treatment with doxorubicin. Restaging procedures, performed every 3-6 months did not document any local recurrence nor any local or distant metastasis. The patient was euthanased after developing neoplastic pleural effusion 965 days following tonsillectomy. Relevance and novel information Tonsillar tumours are rare in cats, but clinical presentation can be similar to that in dogs. Treatment with surgery and chemotherapy, and more importantly multiple lymphadenectomies, may delay the onset of distant metastasis and it should be considered in similar cases to possibly prolong survival.
Evaluation of the Clinical Role of Strain Elastography in Patients Diagnosed With Congenital Torticollis
Authors: Özkan Elif Özyazici , Ozkan Mehmet Burak , İsik İshak Abdurrahman 
Published: February 2021

Objective: The objective of this study was to determine the elasticity of sternocleidomastoid muscle (SCM) in patients with congenital muscular torticollis (CMT). Methods: In all, 41 patients and 22 controls were included in the study, and the elasticity of the patients’ SCM was measured. Echogenicity, thickness, and strain values of the SCM were also obtained. Results: The thickness and strain values of the SCM were higher in the patient group than in the control group ( P = .02 and P = .15). For median values, there was no difference in echogenicity and strain. In the strain elastography evaluation of the receiver operating curve (ROC) for muscle echogenicity in the isoechoic muscle group, the specificity and sensitivity were determined to be 100% and 22%, respectively, for the area under the curve (AOC) value of 0.558 (95% confidence interval [CI], 0.424–0.6686), and the cutoff value was <1.4. In the hyperechoic muscle group, the ROC for AUC values was found to be 0.542 (95% CI, 0.411–0.6686), and the cutoff value was >1.4 with 100% sensitivity and 20.75 specificity. Conclusions: The strain elastography technique can be used in the diagnosis of CMT.
The Function and Autophagy Regulation of PLEKHA8 in T Cell Acute Lymphoblastic Leukemia
Authors: Yuan Tian , Shi Ce , Tian Chen , You M. James 
Published: February 2021

Introduction:T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematological malignancy. Over the past 20 years, several oncogenic drivers and crucial signaling pathways have been unraveled in this disease. However, most T-ALL patients are still treated with high dose multiagent chemotherapy due to limited targeted treatment. To further investigate the pathogenesis and develop the new therapeutic targets of T-ALL, we previously developed a mouse genetic model of T-ALL that is deficient forPtentumor suppressor gene. We identified PLEKHA8, a Golgi protein, is highly expressed in thePtenconditional knockout mouse T-ALL. We have verified the high expression of PLEKHA8 in patients' T-ALL samples. PLEKHA8 has the pleckstrin homology (PH) domain binding to phosphatidylinositol 4-monophosphate (PI4P) at the Golgi, is important in lipid metabolism and transport. The Golgi complex regulates the production and delivery of proteins and lipids, and is a site of lipid metabolism needed for autophagy, in particular PI(4)P. We hypothesized that PLEKHA8 affects the cell function and plays a role in the autophagy of human T-ALL via lipid metabolism.
Methods:PLEKHA8 was knocked down in T-ALL cell lines using a lentivirus-based vector with shRNAs to assess its effect on cell function. CCK8 assay was employed to detect the cell proliferation. Cell cycle was analyzed using 5-bromo-2'-deoxyuridine (BrdU) and flow cytometry. Autophagy proteins were monitored by western blot. PI(4)P was tested by confocal fluorescence microscopy.
Results:T-ALL cells underwent lower cell proliferation and sub-G1 cell accumulation after knocking down PLEKHA8 gene by using shRNA systems. The autophagy marker LC3, Beclin 1 and ATG 5 were markedly increased while P62 decreased after the downregulation PLEKHA8 in T-ALL cells. In addition, PLEKHA8 knocking down in T-ALL cells led to the accumulation of PI(4)P in cytoplasm as observed by confocal fluorescence microscopy.
Conclusion:Our data indicate that PLEKHA8 facilitates cell growth in T-ALL cells. Decreased expression of PLEKHA8 inhibits cell proliferation and accumulate sub-G1 phase of T-ALL cells. Decreased PLEKHA8 expression increases the autophagy of T-ALL cells, which could be based on the PI(4)P pathway of autophagy. Our studies provide a new insight into the pathogenesis and potential targeted therapy of T-ALL.

Disclosures
No relevant conflicts of interest to declare.
Efficacy and Safety of New Anti-CD20 Monoclonal Antibodies Versus Rituximab for Induction Therapy of CD20+ B-Cell Non-Hodgkin Lymphomas: A Systematic Review and Meta-Analysis
Authors: Luo Chengxin , Li Xi , Xu Shuangnian , Chen Jieping 
Published: February 2021

Rituximab combined with chemotherapy is the first-line induction therapy of CD20positive B-cell non-Hodgkin lymphomas (CD20+ B-NHL). Recently new anti-CD20 monoclonal antibodies (mAbs) have been developed, but their efficacy and safety compared with rituximab are still controversial. We aimed to assess the efficacy and safety of new anti-CD20 mAbs compared with rituximab in the induction therapy of CD20+ B-NHL with a systematic review and meta-analysis. We searched MEDLINE, Embase, and Cochrane Library for eligible randomised controlled trials (RCTs) that compared new anti-CD20 mAbs with rituximab in induction therapy of B-NHL. The primary outcomes are progression-free survival (PFS) and overall survival (OS), additional outcomes include event-free survival (EFS), disease-free survival (DFS), overall response rate (ORR), complete response rate (CRR) and incidences of adverse events (AEs). Time-to-event data were pooled as hazard ratios (HRs) using the generic inverse-variance method and dichotomous outcomes were pooled as odds ratios (ORs) using the Mantel-Haenszel method with their respective 95% confidence interval (CI). Eleven RCTs comprising 5,261 patients with CD20+ B-NHL were included. Compared with rituximab, obinutuzumab significantly prolonged PFS (HR 0.84, 95% CI 0.73-0.96, P = 0.01), had no improvement on OS, ORR, and CRR, but increased the incidences of serious AEs (OR 1.29, 95%CI 1.13-1.48, P &lt; 0.001). Ofatumumab was inferior to rituximab in consideration of ORR (OR 0.73, 95% CI 0.55-0.96, P = 0.02), and had no significant differences with rituximab in regard to PFS, OS and CRR. 131I-tositumomab yield similar PFS, OS, ORR and CRR with rituximab. 90Y-ibritumomab tiuxetan increased ORR (OR 3.07, 95%CI 1.47-6.43, P = 0.003), but did not improve PFS, DFS, OS and CRR compared with rituximab. In conclusion, compared with rituximab in induction therapy of CD20+ B-NHL, obinutuzumab can significantly improves PFS but with higher incidence of AEs, ofatumumab decrease ORR, 90Y-ibritumomab tiuxetan increase ORR.

Disclosures
No relevant conflicts of interest to declare.
Elucidating Barriers to Advance Care Planning in Malignant Hematology Clinics: A Single Centre Experience in Ontario, Canada
Authors: Motalo Oksana , Hillis Christopher M. 
Published: February 2021

Introduction: Advance care planning (ACP) is a patient-centered process with clear benefits for patients. Despite the widespread recognition of ACP as an integral part of quality cancer care,compliance with ACP provision remains suboptimal especially in malignant hematology. Many barriers to end-of-life discussions among hematologists have been identified in the literature. This study aims to describe a baseline rate of ACP with hematology outpatients at the end-of-life and the local barriers to ACP, which could inform future quality improvement (QI) initiatives in this area.
Setting/participants: Malignant hematologists (n = 10), hematology fellows (n=2), and hematology clinic nurses (n=4) of the Juravinski Cancer Centre (JCC) in Hamilton, Ontario, Canada participated in this study.
Methods: A retrospective chart audit was undertaken to establish the baseline rate of ACP for the target population at our centre. Subsequently, key stakeholder interviews were held with our local multiple myeloma (MM) specialists to document barriers to ACP from their perspectives. The emerging themes were synthesized using a Fishbone diagram and validated by the JCC hematology clinic staff through multivoting.
Results: The baseline rate of ACP with hematology outpatients at the end-of-life at our centre is 40%. The are three main local barriers to ACP with the target population: 1) lack of patient initiative; 2) time/scheduling constraints; and 3) competing priorities.
Discussion: Patients who participate in ACP are much more likely to have their end-of-life wishes followed than those who do not. Malignant hematology patients are at the greatest risk of not having ACP discussions with their clinicians due to several patient, provider, and system barriers. Patient- and system-level barriers have been identified as the most prevalent at the JCC, necessitating a tailored QI initiative to achieve the standard of care.

Disclosures
Hillis: Roche: Honoraria.