bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term response on letrozole for gastric cancer
Authors: Iida Yuuki , Hongo Kumiko , Onoda Takanobu , Kita Yusuke , Ishihara Yukio , Takabayashi Naoki , Kobayashi Ryo , Kuriki Ken , Hiramatsu Takeyuki 
Published: May 2021

Abstract

Rationale:
Hormone therapies, particularly those targeting estrogen and its receptors, are a key treatment modality for patients with estrogen receptor (ER)-positive breast or ovarian cancer. Some gastric cancers (GCs) express ERs, and preclinical studies suggest the potential of estrogen-targeting hormone therapy on GC; however, the clinical relevance of this hormone therapy on GC treatment has not been well elucidated.

Patient concerns:
An 80-year-old female was admitted to our department with hypogastric pain and vomiting. Computed tomography demonstrated small bowel obstruction, and laparotomy after bowel decompression revealed peritoneal dissemination consisting of a poorly-differentiated adenocarcinoma. Intestinal bypass between the ileum and transverse colon was performed.

Diagnoses:
The tumor was ER- and mammaglobin-positive, indicating that it originated from a breast cancer. Diagnostic imaging revealed no evidence of breast cancer; however, right axillary ER- and mammaglobin-positive lymphadenopathy was found.

Interventions:
The patient received hormone therapy using letrozole based on a clinical diagnosis of occult breast cancer with peritoneal dissemination and right axillary lymph node metastasis.

Outcomes:
The patient remained disease free until 37 months but deceased at 53 months from the onset of disease. An autopsy revealed no tumor cells in the right breast tissue; however, there was a massive invasion of cancer cells in the stomach.

Lessons:
A patient with ER positive GC with peritoneal dissemination and right axillary lymph node metastasis presented remarkable response to letrozole. The long-term survival obtained using letrozole for a patient with GC with distant metastasis suggests the potential of estrogen targeting hormone therapies for GC.
Transapical off-pump mitral valve repair following prior mitral valve surgery
Authors: Blessberger Hermann , Kellermair Joerg , Kammler Juergen , Steinwender Clemens , Zierer Andreas F. 
Published: May 2021

Abstract

Rationale:
Redo surgeries after mitral valve repair are technically demanding. Procedures applying the NeoChord device (NeoChord Inc, St. Louis Park, MN) have proven to be safe and feasible in selected patients requiring mitral valve repair due to a leaflet prolapse or flail. However, its use for redo procedures after conventional surgical repair has not been well established yet.

Patient concerns:
We report the case of a 57-year-old man who presented with dyspnea upon exertion. The patient had undergone a minimally invasive surgical mitral valve repair because of a flail leaflet of the segments segment 2 of the posterior mitral valve leaflet (P2)/segment 3 of the posterior mitral valve leaflet (P3) 4 years before.

Diagnoses:
Transesophageal echocardiography identified a relapse of severe mitral valve regurgitation. The recurring regurgitant jet was caused by a flail leaflet due to newly ruptured native chords.

Interventions:
After discussion in an interdisciplinary heart team, we performed a minimally invasive off-pump redo procedure applying the NeoChord device under three-dimensional transesophageal echocardiographic guidance.

Outcomes:
The echocardiographic result with only trivial residual mitral regurgitation as well as the further clinical course of the patient were favorable.

Lessons:
As redo surgery after minimally invasive mitral valve repair is challenging, the NeoChord device represents a novel treatment option that does not require cardiopulmonary bypass.
Breast and cervical cancer mortality in the western Amazon
Authors: Leitão Francisco Naildo Cardoso , Bezerra Italla Maria Pinheiro , de Lima Marcos Vinicius Malveira , Pimentel Renata Macedo Martins , Jr Hugo Macedo , Morais Mauro José de Deus , Machado Ana Paula Araújo , Abreu Luiz Carlos de 
Published: May 2021

Abstract
Among the main types of neoplasms in the female population, breast and cervical cancers are the most important due to their high morbidity and mortality rates. The mortality has been proportionally higher in developing countries. Analysis of the trend of cancer mortality in Brazil revealed a considerable difference in the pattern of deaths between the regions.
To analyze the trend of mortality due to breast and cervical cancers in women.
Retrospective study of a series of death cases, using secondary data from the mortality information system (SIM) of the Ministry of Health. The deaths were identified as the underlying cause of breast and cervical cancers, including malignant neoplasms of the uterus without other specifications, occurring from 1980 to 2014. Thus, the annual standardized age-specific mortality rates by the world population were applied. For trend analysis, regression models were utilized in which the mortality rates were considered dependent variables and years the independent variable. Polynomial regression models and a Prais–Winsten regression model were adopted.
Cervical cancer presented a mortality rate ranging from 2.15 to 10.69 per 100,000 women from 1980 to 2014, with a tendency for stability.
Breast cancer mortality rate varied from 3.81 to 11.47 per 100,000 women from 1981 to 2014, indicating a growing trend.
There is a significant increase in the mortality rate for breast cancer and stability of cervical cancers in the State of Acre from 1980 to 2014, evidencing a concern in their care and monitoring. Above all, guaranteed access, especially to the population of women at social risk, and the search for effective screening should be emphasized in the formation of the care line and the Health Care Network in the State of Acre.
Musculoskeletal pain among male faculty members of the College of Medicine and College of Dentistry
Authors: Aldhafian Osama R. , Alsamari Faisal A. , Alshahrani Naif A. , Alajmi Mohammed N. , Alotaibi Abdulelah M. , Nwihadh Naif Bin , Saleh Ayman K. 
Published: May 2021

Abstract
We aimed to establish the local prevalence of musculoskeletal pain among faculty members in Saudi Arabia and describe the patient's risk factors and preventive measures that may reduce its burden.
An observational, quantitative, cross-sectional study was carried out to evaluate the prevalence of musculoskeletal pain and its risk factors among male faculty members in the College of Medicine and Dentistry, using a designed questionnaire based on the Standardized Nordic Musculoskeletal Questionnaire. Chi-square testing at a significance level of P < .05, was used for comparative analysis. SPSS version 26 was used for all analyses.
Ninety responders participated in the survey analysis. The prevalence of musculoskeletal pain among faculty members was 77.8%, and the most common site of musculoskeletal pain occurred at two different sites of the three (low back, neck, and shoulder), with a prevalence of 38.9%. As for risk factors of musculoskeletal pain, only age group showed a significant correlation with the site of musculoskeletal pain (P = .024), where patients in the younger age group (25–35 years old) were at higher risk of lower back pain, while participants in the older age group (36 to 44 years old and 45 years or older) were at higher risk of musculoskeletal pain in two different sites.
Musculoskeletal pain affects more than two-thirds of faculty members. In particular, low back pain is a common problem among faculty members. Age is a significant risk factor for the occurrence of musculoskeletal pain, with more than one site involvement in older age.
Predictive variables for peripheral neuropathy in treated HIV type 1 infection revealed by machine learning
Authors: Tu Wei , Johnson Erika , Fujiwara Esther , Gill M. John , Kong Linglong , Power Christopher 
Published: May 2021

Objective:
Peripheral neuropathies (PNPs) in HIV-infected patients are highly debilitating because of neuropathic pain and physical disabilities. We defined prevalence and associated predictive variables for PNP subtypes in a cohort of persons living with HIV.

Design:
Adult persons living with HIV in clinical care were recruited to a longitudinal study examining neurological complications.

Methods:
Each patient was assessed for symptoms and signs of PNP with demographic, laboratory, and clinical variables. Univariate, multiple logistic regression and machine learning analyses were performed by comparing patients with and without PNP.

Results:
Three patient groups were identified: PNP (n = 111) that included HIV-associated distal sensory polyneuropathy (n = 90) or mononeuropathy (n = 21), and non-neuropathy (n = 408). Univariate analyses showed multiple variables differed significantly between the non-neuropathy and PNP groups including age, estimated HIV type 1 (HIV-1) duration, education, employment, neuropathic pain, peak viral load, polypharmacy, diabetes, cardiovascular disorders, AIDS, and prior neurotoxic nucleoside antiretroviral drug exposure. Classification algorithms distinguished those with PNP, all with area under the receiver operating characteristic curve values of more than 0.80. Random forest models showed greater accuracy and area under the receiver operating characteristic curve values compared with the multiple logistic regression analysis. Relative importance plots showed that the foremost predictive variables of PNP were HIV-1 duration, peak plasma viral load, age, and low CD4+ T-cell levels.

Conclusion:
PNP in HIV-1 infection remains common affecting 21.4% of patients in care. Machine-learning models uncovered variables related to PNP that were undetected by conventional analyses, emphasizing the importance of statistical algorithmic approaches to understanding complex neurological syndromes.
Placental Vascular Abnormalities in Association With Prenatal and Long-Term Health Characteristics Among HIV-Exposed Uninfected Adolescents and Young Adults
Authors: Fourman Lindsay T. , Mueller Sarah B. , Boutin Autumn , Zheng Isabel , Pan Chelsea S. , Gerard Marisa E. , Stanley Takara L. , Roberts Drucilla J. 
Published: May 2021

Background:
HIV-exposed uninfected (HEU) individuals are predisposed to adverse health outcomes, which in part may stem from the influence of an altered intrauterine milieu on fetal programming. The placenta serves as a readout for the effects of the maternal environment on the developing fetus and may itself contribute to the pathogenesis of disease.

Setting:
US academic health system.

Methods:
We leveraged a previously established registry-based cohort of HEU adolescents and young adults to identify 26 subjects for whom placental histopathology was available. We further obtained placental tissue from 29 HIV-unexposed pregnancies for comparison. We examined differences in placental histopathology between the groups and related villous vascularity in the HEU group to prenatal maternal characteristics and long-term health outcomes.

Results:
Placentas from HEU pregnancies demonstrated a higher blood vessel count per villus as compared with controls (5.9 ± 1.0 vs. 5.4 ± 0.8; P = 0.05), which was independent of maternal prenatal age, race, body mass index, smoking status, hemoglobin, and gestational age. Furthermore, within the HEU group, lower CD4+ T-cell count during pregnancy was associated with greater placental vascularity (r = −0.44; P = 0.03). No significant relationships were observed between placental blood vessel count per villus and body mass index z-score or reactive airway disease among HEU individuals later in life.

Conclusions:
Placentas from HEU pregnancies demonstrated increased villous vascularity compared with HIV-unexposed controls in proportion to the severity of maternal immune dysfunction. Further studies are needed to examine intrauterine exposure to hypoxia as a potential mechanism of fetal programming in HIV.
Gonadotropin-Secreting Pituitary Macroadenoma Complicated With Hemorrhagic Apoplexy in 18F-FDG PET/CT
Authors: Dejust Sebastien , Decoudier Benedicte , Higel Brigitte , Litre Claude-Fabien , Morland David 
Published: May 2021

Abstract
We report the case of 69-year-old man referred for a stage IV pulmonary adenocarcinoma and presenting a decrease in visual acuity. An 18F-FDG PET/CT showed an intense and heterogeneous uptake of a mass in the sellar region. An MRI showed a pituitary macroadenoma associated with a large cyst on the left side, with necrosis zones and fluid level, compressing the optic chiasma. Endocrine testing showed a panhypopituitarism, and pathology confirmed a pituitary apoplexy in a gonadotropin-secreting macroadenoma. No malignant cells were detected. Molecular imaging could have an important role in the detection and characterization of pituitary tumors.
Skeletal Muscle Metastases in HCC Revealed by 18F-Choline PET/CT
Authors: Evangelista Laura , Giacomuzzi Francesco , Di Gregorio Fernando , Rensi Marco 
Published: May 2021

Abstract
We present a case of a 68-year-old woman undergoing 18F-choline PET/CT due to a history of hepatocellular cancer treated with multimodal therapies and with a rapid increase in α-fetoprotein. 18F-Choline PET/CT showed multiple uptakes in the skeletal muscles compatible with the recurrence of disease. The interpretation of 18F-choline PET/CT in this cancer should be careful and discussed in a multidisciplinary team.
Increased 68Ga-FAPI Uptake in Neurofibromatosis in a Patient With Pleomorphic Rhabdomyosarcoma
Authors: Wu Junhao , Wang Yingwei , Zhang Chunyin 
Published: May 2021

Abstract
A 48-year-old man presented with a painless enlarging mass on his right thigh for 2 months. He had a history of neurofibromatosis. MRI showed a mass in his right thigh. Malignant tumor was suspected. He was enrolled in the clinical trial of 68Ga-FAPI in solid tumors. Multiple increased FAPI uptake was observed in the right thigh mass, lung, and mediastinal lymph nodes, which were confirmed being pleomorphic rhabdomyosarcoma by biopsy. In addition, widespread metabolic activity was also observed in his cutaneous fibroma nodules. This case showed that benign neurofibromatosis can cause FAPI uptake.
68Ga-DOTATATE PET/CT Distinguishes Neuroendocrine Tumor Mesenteric Lymph Node Metastasis From an Extensive IgG4-Positive Fibrosis Surrounding It
Authors: Ahmadi Bidakhvidi Niloefar , Cuyle Pieter-Jan , Sagaert Xavier , Ballaux Florence , Deroose Christophe M. 
Published: May 2021

Abstract
A 56-year-old woman presented with right iliac fossa pain. Abdominal CT showed a mesenteric mass in the right iliac fossa, adjacent to the vena cava inferior and right ureter. Biopsy of the mass revealed a well-differentiated neuroendocrine tumor. 68Ga-DOTATATE PET/CT showed strong somatostatin receptor expression only within in a small, central area of this mesenteric mass, with faint 68Ga-DOTATATE uptake in the majority of this mesenteric mass. Pathology revealed an IgG4-positive storiform fibrosis surrounding a mesenteric adenopathy. 68Ga-DOTATATE PET/CT discriminates between neuroendocrine tumor lymph node metastases and fibrosis, hereby avoiding potential sampling error of tumor biopsies and guiding surgical approach.
Treatment of Glucagonoma-Related Necrolytic Migratory Erythema With Peptide Receptor Radionuclide Therapy
Authors: Mavi Mehmet Emin , Tuncel Murat 
Published: May 2021

Abstract
Glucagonomas are rare types of pancreatic neuroendocrine tumors. They may present with a clinical entity called glucagonoma syndrome, which includes necrolytic migratory erythema as a skin component. Here we present a 26-year-old woman experiencing ongoing skin lesions, excessive weight loss, and nausea. She was diagnosed with metastatic glucagonoma. Her 68Ga-DOTATATE PET/CT showed increased uptake at the primary pancreatic lesion and hepatic metastases. She received 2 cycles of peptide receptor radionuclide therapy and had a partial response with a near-complete regression of her skin lesions.
Mechanistic Studies of DNase I Activity: Impact of Heparin Variants and PAD4
Authors: Sohrabipour Sahar , Muniz Valdirene S. , Sharma Neha , Dwivedi Dhruva J. , Liaw Patricia C. 
Published: May 2021

ABSTRACT

Background:
Excessive production of neutrophil extracellular traps (NETs) in sepsis contributes to vascular occlusion by acting as a scaffold and stimulus for thrombus formation. Removal of extracellular DNA, the major structural component of NETs, by DNase I may reduce host injury.

Objectives:

Methods:
DNA–histone complexes were treated with DNase I ± heparin variants and visualized via agarose gels. We compared the ability of DNase I ± heparin variants to digest NETs released by phorbol 12-myristate 13-acetate-stimulated neutrophils versus DNA–histone complexes released by necrotic HEK293 cells. Plasma DNA and DNase I levels were measured longitudinally in 76 septic patients.

Results:
Heparin enhances DNase I-mediated digestion of DNA–histone complexes in a size-dependent manner that does not require the antithrombin-binding region. In contrast, DNase I alone was able to degrade the DNA–histone component of NETs presumably due to peptidylarginine deiminase 4 (PAD4)-mediated histone citrullination that weakens DNA–histone interactions. In purified systems, PAD4 treatment of DNA–histone complexes enhanced the ability of DNase I to degrade histone-bound DNA. In septic patients, endogenous DNase I levels remained persistently low over 28 days, and there were no significant correlations between DNA and DNase I levels.

Conclusion:
Heparin enhances DNA-mediated digestion of DNA–histone complexes in a size-dependent manner that is independent of its anticoagulant properties. Citrullination of histones by PAD4 renders DNA–histone complexes susceptible to DNase I digestion. Endogenous DNase I levels are persistently decreased in septic patients, which supports the potential utility of DNase I as a therapy for sepsis.
Lose Weight to Donate: Development of a Program to Optimize Potential Donors With Hepatic Steatosis or Obesity for Living Liver Donation
Authors: Rose John T. , Vargas Paola , Seay Tara , Pesch Arthur J. , Williams Tessa , Sites Anita , Henry Zachary , Northup Patrick G. , Pelletier Shawn J. , Oberholzer Jose , Argo Curtis K. , Goldaracena Nicolas 
Published: May 2021

Background.
Living donor liver transplantation offers an attractive option to reduce the waitlist mortality. However, in recent years, the rising prevalence of obesity and nonalcoholic fatty liver disease has posed a serious threat to the donor pool while simultaneously increasing demand for liver transplant. To our knowledge, there have been no major published studies in the United States documenting a diet and exercise intervention to expand the living donor pool. Hereby, we established a pilot program called “Lose Weight to Donate” and present our initial experience.

Methods.
Our center instituted a remotely monitored diet and exercise pilot program to increase eligibility for living liver donation. Potential donors with any of the following were included: body mass index >30 kg/m2, hepatic steatosis >5% on screening MRI, or isolated hypertension.

Results.
Over 19 mo, 7 individuals enrolled in the program of remote monitoring for at least 6–8 wk. Initial and follow-up abdominal MRI was performed in 5 of these individuals to assess steatosis, anatomy, and volume. Initial steatosis was highly variable (fat signal fraction range, 8%–26%). Follow-up MRI fat signal fraction values and hepatic volume all decreased to varying degrees. Ultimately, 2 of 7 individuals donated, whereas a third was approved, but the intended recipient was transplanted in the interim.

Conclusions.
These results indicate the feasibility of a remotely monitored program to expand donation in light of the rising incidence of hepatic steatosis and obesity.
Deep Covid - Covid Diagnosis Using Deep Neural Networks and Transfer Learning
Authors: Sagar Abhinav 
Published: May 2021

AbstractCoronavirus is a global emergency as of May 2021. If not acted upon by drugs at the right time, coronavirus may result in the death of individuals. Hence early diagnosis is very important along the progress of the disease. This paper focuses on coronavirus detection using x-ray images, for automating the diagnosis pipeline using convolutional neural networks and transfer learning. This could be deployed in places where radiologists are not easily available in order to detect the disease at very early stages. In this study we propose our deep learning architecture for the classification task, which is trained with modified images, through multiple steps of preprocessing. Our classification method uses convolutional neural networks and transfer learning architecture for classifying the images. Our findings yield an accuracy value of 91.03%, precision of 89.76 %, recall value of 96.67% and F1 score of 93.09%.
Umbilical Cord Blood DNA Methylation in Children Who Later Develop Type 1 Diabetes
Authors: Laajala Essi , Ullah Ubaid , Grönroos Toni , Rasool Omid , Halla-aho Viivi , Konki Mikko , Kattelus Roosa , Mykkänen Juha , Nurmio Mirja , Vähä-Mäkilä Mari , Kallionpää Henna , Lietzén Niina , Ghimire Bishwa R. , Laiho Asta , Hyöty Heikki , Elo Laura L. , Ilonen Jorma , Knip Mikael , Lund Riikka J. , Orešič Matej , Veijola Riitta , Lähdesmäki Harri , Toppari Jorma , Lahesmaa Riitta 
Published: May 2021

ABSTRACTDistinct DNA methylation patterns have recently been observed to precede type 1 diabetes in whole blood collected from young children. Our aim was to determine, whether perinatal DNA methylation could be associated with later progression to type 1 diabetes. Reduced representation bisulfite sequencing (RRBS) analysis was performed on umbilical cord blood samples collected within the Type 1 Diabetes Prediction and Prevention (DIPP) study. Children later diagnosed with type 1 diabetes and/or testing positive for multiple islet autoantibodies (N=43) were compared to control individuals (N=79), who remained autoantibody-negative throughout the DIPP follow-up until 15 years of age. Potential confounding factors related to the pregnancy and the mother were included in the analysis. No differences in the cord blood methylation patterns were observed between these cases and controls.
Automatic Electrocardiogram Detection of Suspected Hypertrophic Cardiomyopathy: Application to Wearable Heart Monitors
Authors: Denis Max , Bachoro Mulatu , Gebreslassie Winta , Oladunni Timothy 
Published: May 2021

AbstractIn this work, an automatic detection algorithm for hypertrophic cardiomyopathy (HCM) is presented. Of particular interest is the algorithm’s ability to differentiate HCM subjects and healthy volunteers from a single lead ECG dataset. Suspected HCM subjects are identified by the primary clinical abnormality associated with HCM, left ventricular hypertrophy (LVH). In total, n=43 human subjects ECG datasets are investigated: n=21 healthy volunteers and n=22 left ventricular hypertrophy (LVH) patients. Significant differences of p-value 0.01 and 0.04 were found for the respective ECG parameters, S-wave amplitude and ST-segment, when differentiating between the LVH patients and healthy human volunteers.