bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel mutation in the conserved sequence of vascular endothelial growth factor receptor 3 leads to primary lymphoedema
Authors: Dai Ting , Li Bohan , He Bo , Yan Liwei , Gu Liqiang , Liu Xiaolin , Qi Jian , Li Ping , Zhou Xiang 
Published: June 2018

Objective To investigate whether lymphoedema in a Chinese family showed the hereditary and clinical characteristics of Milroy disease, an autosomal dominant form of congenital lymphoedema, typically characterized by chronic lower limb tissue swelling due to abnormal lymphatic vasculature development, and to perform mutational analyses of vascular endothelial growth factor receptor ( VEGFR)3. Methods Individuals from a three-generation family affected by congenital lymphoedema were clinically assessed for Milroy disease. Mutation analysis of VEGFR3 was performed using DNA from family members and healthy controls. Results Out of 20 family members, eight were diagnosed with hereditary lymphoedema. Mutation analyses revealed a novel mutation site for c.3163 G>A, resulting in a p.1055D>N mutation in the second tyrosine kinase domain of VEGFR3, which was present in affected individuals only (absent in all unaffected family members and 130 healthy controls). Computed functional analyses showed the mutation may lead to structural alterations with a probability of 0.99999 of being disease causing. Conclusion A novel mutation associated with Milroy disease was identified in a Chinese family, expanding our knowledge of VEGFR3 gene function and providing a potential molecular target for treating hereditary lymphoedema.
A case of a patient with severe renal failure on hemodialysis treated with vismodegib for relapsing basal cell carcinoma
Authors: Sbrana Andrea , Antonuzzo Andrea , Galli Luca , Biasco Elisa , Musettini Gianna , Paolieri Federico , Ricci Sergio 
Published: June 2018

Introduction: Basal cell carcinoma (BCC) is the most common skin cancer. Treatment options for metastatic or locally advanced BCC inappropriate for surgery or radiotherapy were poor until vismodegib was approved for use in this setting. This drug can be safely used in patients with mild to moderate renal impairment, but limited data are available for its use in case of severe kidney failure. We present the case of a patient with severe renal failure on hemodialysis treated with vismodegib. Case description: An 83-year-old patient with relapsing BCC of both auricles and severe renal failure on hemodialysis was treated with vismodegib for 7 months. The treatment proved to be effective with a striking reduction of the tumor masses. The patient was on therapy with vismodegib for 7 months and no severe adverse event was observed. Conclusion: Vismodegib could be used in patients with severe renal impairment, but these patients must be attentively followed and strict cooperation among healthcare professionals, such as nephrologists, dermatologists, and medical oncologists, is required.
Prognostic factors for outcome of microvascular decompression in trigeminal neuralgia: A prospective systematic study using independent assessors
Authors: Heinskou Tone Bruvik , Rochat Per , Maarbjerg Stine , Wolfram Frauke , Brennum Jannick , Olesen Jes , Bendtsen Lars 
Published: June 2018

Introduction There is a lack of high-quality prospective, systematic studies using independent assessors of outcome of microvascular decompression as treatment for trigeminal neuralgia. Methods Clinical characteristics and outcome data were recorded prospectively from consecutive classical trigeminal neuralgia patients, using standardized interviews. Degree of neurovascular contact was evaluated by a 3.0 Tesla MRI blinded to symptomatic side. Patients were assessed before and 12 months after surgery by a neurologist. Results Twenty-six men and 33 women completed 12 months follow-up. Forty-one patients (69%) had an excellent outcome (no pain, no medication). Ten (18%) patients had a good outcome. Eight (12%) patients had no improvement or had worsening of pain. MRI showed neurovascular contact with morphological changes in 34 patients (58%). Odds ratio between neurovascular contact with morphological changes and excellent outcome was 4.4 (Cl 1.16–16.26), p = 0.029. Odds ratio between male sex and excellent outcome was 11.38 (Cl 2.12–59.52), p = 0.004. No significant association was found between excellent outcome and concomitant persistent pain, current age or disease duration. Conclusion Neurovascular contact with morphological changes and male sex are positive predictive factors for outcome of microvascular decompression. The findings enable clinicians to better inform patients before surgery.
Forearm Flexor Injuries Among Major League Baseball Players: Epidemiology, Performance, and Associated Injuries
Authors: Hodgins Justin L. , Trofa David P. , Donohue Steve , Littlefield Mark , Schuk Michael , Ahmad Christopher S. 
Published: June 2018

Background: Despite evidence highlighting the importance of the forearm flexor muscles of elite baseball players, no studies have reported on the epidemiology of flexor strains and their associated outcomes. Purpose: To examine the incidence, associated injuries, and outcomes associated with forearm flexor injuries among major and minor league baseball players. Study Design: Cohort study; Level of evidence, 3. Methods: Injury data attributed to forearm flexor injuries among Major League Baseball (MLB) and minor league teams between 2010 and 2014 were obtained from the professional baseball Health and Injury Tracking System. This analysis included the number of players injured, seasonal timing of injury, days spent on the disabled list (DL), preinjury performance data, and subsequent injuries. Results: A total of 134 and 629 forearm flexor injuries occurred in MLB and the minor leagues, respectively. The mean player age was 28.6 and 22.8 years in the MLB and minor leagues, respectively. The mean time spent on the DL for MLB players was 117.0 days, as opposed to 93.9 days in the minor leagues ( P = .272). Interestingly, pitcher performance declined in all categories examined leading up to the season of injury, with significant differences in walks plus hits per inning pitched ( P = .04) and strike percentage ( P = .036). Of MLB players with a forearm injury, subsequent injuries included 50 (37.3%) shoulder, 48 (35.8%) elbow, and 24 (17.9%) forearm injuries. Among injured minor league players, subsequent injuries included 170 (27.0%) shoulder, 156 (24.8%) elbow, and 83 (13.2%) forearm injuries. These rates of subsequent injuries were significantly higher compared with the rates of injuries sustained among players without forearm injuries in both leagues ( P < .001). Finally, 26 (19.4%) MLB and 56 (8.9%) minor league players required an ulnar collateral ligament reconstruction, rates that were significantly higher compared with players without a flexor strain ( P < .001). Conclusion: Flexor-pronator injuries are responsible for considerable time spent on the DL for elite players in MLB and the minor leagues. The most significant findings of this investigation illustrate that a flexor strain may be a significant risk factor for subsequent upper extremity injuries, including an ulnar collateral ligament tear.
Prolonged veno-arterial extracorporeal life support for cardiac failure
Authors: Guenther Sabina PW , Shudo Yasuhiro , Hiesinger William , Banerjee Dipanjan 
Published: June 2018

Objectives: In intractable cardiogenic shock, extracorporeal life support frequently is the last treatment option. Outcomes of prolonged veno-arterial extracorporeal life support for cardiac failure are poorly defined. Methods: We retrospectively analyzed 10 patients (4 females, age = 36 ± 16 years) who underwent prolonged extracorporeal life support (≥7 days) from December 2015 to March 2017 for cardiogenic shock. The primary endpoint was survival to hospital discharge. Results: Etiologies included ischemic cardiomyopathy with non ST-segment elevation myocardial infarction (n = 1), dilated (n = 3), hypertrophic (n = 1), postpartum cardiomyopathy (n = 1), and others (n = 4). Heart failure was left or biventricular in 80.0% (left ventricular ejection fraction = 15.6 ± 5.5%). Among the 10 patients, 80.0% underwent femoral and 20.0% central cannulation, 40.0% required changes in the cannulation strategy, and 80.0% underwent left ventricular venting. No technical malfunctions occurred, but 50.0% required circuit exchanges for thrombus formation. 80.0% suffered from infections. 60.0% could be decannulated after 717 ± 830 (168–2301) h of support, and survival to hospital discharge was 40.0%. Longest follow-up available is 160 ± 175 (12–409) days after discharge, with 30.0% alive and in satisfying functional condition. Conclusion: Prolonged veno-arterial extracorporeal life support for cardiac failure is feasible with low technical complication rates. Survival rates are acceptable, yet inferior to short-term support. We observed a shift from initial shock-related complications to infections during prolonged support. Since recovery and thus weaning is rather unlikely after a prolonged need for extracorporeal life support, this form of support should be limited to centers offering the full spectrum of interdisciplinary cardiac care including ventricular assist device implantation and transplantation.
Breast cancer mortality and screening mammography in New Zealand: Incidence-based and aggregate analyses
Authors: Taylor Richard , Gregory Marli , Sexton Kerry , Wharton Jessica , Sharma Nisha , Amoyal Georgina , Morrell Stephen 
Published: June 2018

Objective To investigate trends in breast cancer mortality in New Zealand women, to corroborate or negate a causal association with service screening mammography. Method Cumulated mortality rates from breast cancer deaths individually linked to incident cases diagnosed before and after screening commencement were compared, in women aged 50–64 (from 2001) and aged 45–49 and 65–69 (from 2006). Trends and differences in aggregate invasive breast cancer mortality (1975–2013) were assessed in relation to introduction of mammography screening targeting women aged 50–64 and 45–69. Joinpoint analysis was also undertaken. Results The reduction in incidence-based cumulated breast cancer mortality before and after the introduction of screening was −15% (p = 0.006) for women aged 45–69, and 17% (p = 0.005) for those aged 50–64. Aggregate mortality declined by −34% (2005–13 compared with 1992–98) in the age group 50–64, and by –28% among women aged 45–49 and –25% among women aged 65–74. For women aged 50–64 the 2-joinpoint model shows a 1990 turning point, from prior rising mortality to a mean −1.8% decline per annum, coinciding with improvements in primary treatment of breast cancer; and a steepening of the decline (−3.0% p.a.) from the late 1990s, coinciding with the introduction of service mammography screening. Conclusion Breast cancer mortality declines occurring since the advent of screening mammography in New Zealand are consistent with other incidence-based and aggregate studies of screening mammography in populations, individual-based cohort studies, and randomized controlled trials.
Integrating a Serious Game Into Case-Based Learning
Authors: Addy Tracie M. , Dube Derek , Croft Catherine , Nardolilli Jonathan O. , Paynter Orville C. , Hutchings Michelle L. , Honsberger Michael J. , Reeves Philip M. 
Published: June 2018

Background. Gaming can augment case-based learning (CBL) when students play the role of characters in the accompanying narrative and apply their knowledge. Aim. This article describes how an educational game was integrated into a CBL activity aimed to teach students the immunological basis behind how the Ebola virus evades the immune response. Method. The CBL activity and game were co-developed to align with learning objectives relative to basic immunology. The exercise was implemented during a rigorous summer enrichment program with US domestic and international high school students. Quasi-experimental and exploratory correlational research designs were employed to assess student engagement and learning gains, and relationships to various factors including game playing attributes and goal orientations. Results. Students found the CBL activity to be engaging and improve their understanding of the material. Comparison of pre-/post-test knowledge scores corroborated such findings. Increased student frequency of playing the game was associated with higher post-knowledge scores. Various student attributes were associated with increased learning and game play. Conclusions. Gaming integrated within case studies has the potential to enhance students’ engagement and learning by allowing learners to explore challenging biological processes in a digital environment.
Chemokine Expression Is Involved in the Vascular Neogenesis of Ewing Sarcoma: A Preliminary Analysis of the Early Stages of Angiogenesis in a Xenograft Model
Authors: Giner Francisco , López-Guerrero José A , Fernández-Serra Antonio , Machado Isidro , Mayordomo-Aranda Empar , Peydró-Olaya Amando , Llombart-Bosch Antonio 
Published: June 2018

Background Ewing sarcoma (EWS) is the second most common bone cancer in pediatric patients. Angiogenesis is a major factor for tumor growth and metastasis. Our aim was to carry out a histological, immunohistochemical, and molecular characterization of the neovascularization established between xenotransplanted tumors and the host during the initial phases of growth in nude mice in three angiogenesis experiments (ES2, ES3, and ES4). Methods The original human EWS were implanted subcutaneously on the backs of three nude mice. Tumor pieces 3 mm–4 mm in size from early passages of Nu432, Nu495, and Nu471 were also implanted subcutaneously on the backs of three sets (ES2, ES3, and ES4) of athymic Balb-c nude mice (n = 14 each). The animals were sacrificed at 24, 48, and 96 hours and at 7, 14, 21, and 28 days after implantation to perform histological, immunohistochemical, and molecular studies (neovascularization experiments). Results We observed histological, ultrastructural, and immunohistochemical changes in the xenografted tumor at different times after implantation. Chemokine ligand expression peaked twice, once during the first 48 hours and again in the second week. We observed that tumor cells in contact with murine peritumoral stroma presented higher expression of chemokine ligands as well as more tumor cells around the capillary vessels. Mouse serum vascular endothelial growth factor levels peaked twice, once in the first hours and then in the second week after tumor implantation. Conclusion Chemokines and other angiogenic factors may be relevant in the angiogenic mechanism during tumor growth. This model provides information on the early stages of the angiogenic process and could be a useful tool in researching anti-angiogenic drugs for new therapeutic strategies in EWS.
How does maternal education influence the linguistic environment supporting bilingual language development in child second language learners of English?
Authors: Sorenson Duncan Tamara , Paradis Johanne 
Published: June 2018

Aims: In monolingual situations, mothers with higher levels of education are more likely to provide their children with enriched linguistic input. However, in bilingual situations, the relationship between maternal education and input is more complex because education may have occurred in one, but not both, of the languages. This study details this complexity by examining the relationship between maternal education and linguistic input in a group of children learning English as a second language (L2). Method: Participants were 89 immigrant/refugee children, living in Canada with diverse first languages (L1s). They completed a story-telling task in their L2 and parent reports provided a measure of L1 development. Parents also answered detailed questionnaires about family demographics and linguistic input within the family. Results: Regression modeling revealed that cumulative exposure to the L2 in school, maternal L2 fluency, relative quantity of L1/L2 use by the mother (input) and by the child (output) all influenced children’s L1 and L2 development. Relative quantity of input and maternal L2 fluency were, in turn, influenced by the amount of education mothers had completed and the language in which that education occurred. In instances where mothers were educated primarily in the L1, higher levels of education were associated with relatively more L1 input. For mothers who were educated predominantly in the L2, higher levels of education were associated with relatively more L2 input. Across both groups, mothers with higher levels of education had higher L2 fluency. Conclusion: This study revealed a complex relationship between the amount of education a mother has, the language in which that education occurred and the linguistic input she provides to her children. This complexity highlights that monolingual studies about input and environment may not offer a sufficiently nuanced perspective to account for the greater levels of variability found in bilingual situations. Originality: Previous research has offered valuable insights into the relationship between individual difference factors and bilingual acquisition. This study moves the field forward through the consideration of the interaction between factors in shaping bilingual acquisition.
Cortisol, cortisone, and 4-methoxyphenylacetic acid as potential plasma biomarkers for early detection of non-small cell lung cancer
Authors: Xiang Chengcheng , Jin Shidai , Zhang Juan , Chen Minjian , Xia Yankai , Shu Yongqian , Guo Renhua 
Published: June 2018

Background: Lung cancer is the most common cause of cancer-related deaths in men and women worldwide. Novel diagnostic biomarkers are urgently required to enable the early detection and treatment of lung cancer, and using novel methods to explore tumor-related biomarkers is a hot topic in lung cancer research. The purpose of this study was to use ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS) metabolomics analysis technology combined with multivariate data processing methods to identify potential plasma biomarkers for non-small cell lung cancer (NSCLC). Methods: Plasma samples from 99 NSCLC patients and 112 healthy controls were randomly divided into the screening group and the validation group, respectively. UPLC-MS metabolomics analysis technology combined with multivariate data processing methods were used to identify potential plasma biomarkers for NSCLC. Results: A total of 254 metabolites were detected and validated in plasma. Orthogonal Projections to Latent Structures Discriminant Analysis (OPLS-DA) modeling indicated that 28 endogenous metabolites were present at significantly different levels in patients with NSCLC than healthy controls (variable importance in projection (VIP)>1 and P<0.001 (independent samples t-test) in both the screening group and the validation group). Further analysis revealed that cortisol, cortisone, and 4-methoxyphenylacetic acid had high sensitivity and specificity values as biomarkers for discriminating between NSCLC and healthy controls. Significant associations between specific plasma metabolites and the pathological type or stage of NSCLC were also observed. Conclusions: Metabolomics has the potential to distinguish between NSCLC patients and healthy controls, and may reveal new plasma biomarkers for the early detection of NSCLC.
Ultrasound-guided fine-needle aspiration cytology of lesions in the head and neck performed without local anaesthesia – An analysis of pain perception
Authors: Drage Nicholas , Greenall Christopher , Farnell Damian JJ 
Published: June 2018

Introduction Ultrasound-guided fine-needle aspiration cytology is commonly carried out in the head and neck. The aim was to examine the amount of pain experienced by patients undergoing this procedure carried out without the use of local anaesthetic. Methods A questionnaire was given to 109 consecutive patients undergoing ultrasound-guided fine-needle aspiration cytology containing a visual analogue scale. Patients were asked to mark with a vertical line on the 100 mm horizontal scale amount of pain they experienced during the biopsy. The pain was subsequently categorised as ‘no pain’, ‘mild pain’, ‘moderate pain’ or ‘severe pain’ based on previous pain studies. Results Hundred patients completed the visual analogue scale section of the questionnaire satisfactorily. Twenty-one patients experienced no pain, 62 experienced mild pain and 17 experienced moderate pain. No patients experienced severe pain. Further analysis showed that females had significantly higher visual analogue scale scores (Mann–Whitney test: U = 925.5, z = 2.211, P = 0.027). Patients who were aware that they were going to have a biopsy had significantly lower visual analogue scale scores than those who were not aware (Mann–Whitney test: U = 859.5, z = 2.263, P = 0.024). Conclusions Ultrasound-guided fine-needle aspiration cytology is generally a well-tolerated procedure with pain scores being higher in females. It is advised that patients are told by the referring clinician the need for biopsy as this reduces the amount of pain experienced.
Patients’ perceptions of patient–provider communication and diabetes care: A systematic review of quantitative and qualitative studies
Authors: Peimani Maryam , Nasli-Esfahani Ensieh , Sadeghi Roya 
Published: June 2018

Objectives To explore the association between patients’ perceptions of communication quality with their provider and a range of patients’ outcomes in T2DM. Also, to identify barriers and facilitators to effective communication from the patients’ perspective. Methods English and Persian papers published from 2000 to 2017 were searched in Web of Science, Pubmed, Scopus, Embase and SID, IranMedex, and MAGIRAN databases using appropriate search terms. Twenty-two studies complied the inclusion criteria. Each study was assessed for the focus of the study, study design (cross-sectional or qualitative study), population, outcome measures, patients’ outcomes, and methodological quality. Results The quality of most studies was moderate to high based on the JBI Critical Appraisal Checklists. Higher perceived quality of provider–patient communication in patients with T2DM was associated with improved self-management, adherence to diabetes care and greater well-being, perceived personal control, self-efficacy, and less diabetes distress. Factors that patients with T2DM perceived as important factors in facilitating or hampering effective communication were more related to the provision of emotional support. Discussion The limited evidence shows patient-perceived communication quality is a significant modifiable approach for improving a range of outcomes in patients with T2DM. Due to socio-cultural differences, further high-quality research is needed for deciding the best communication style in various societies.