bluuebunny/crossref_metadata_2025_split huggingface dataset:
Warthin-Like Mucoepidermoid Carcinoma: A Case Series Addressing the Need for Diagnostic Criteria Manuscript type: Case series
Authors: Agrawal Tushar , Patil Asawari , Mittal Neha , Rane Swapnil , Rabade Katha , Bal Munita 
Published: April 2024

Abstract

Warthin-like Mucoepidermoid carcinoma(WLMEC) is a newly described rare variant of Mucoepidermoid carcinoma(MEC). Rarity, coupled with potential misdiagnoses as the benign Warthin tumor necessitates careful examination and understanding of clinical and histological features. Lack of defining criteria in the current classification adds to the conundrum.
Cases of WLMEC were retrieved from the archives of Department of Pathology from 2017-2022. Clinical and imaging data were obtained from the Electronic medical record system.
A total of three cases, in two males and one female, aged 25, 49, and 64 years were diagnosed based on the proposed diagnostic criteria. A longstanding painless swelling in all cases, and lymphadenopathy in one case was seen at presentation. Imaging, in all cases, showed a hypodense mass with a mean diameter of 2 cm (range 1.1-2.9cm), involving the superficial lobe of parotid. Histomorphology, only superficially reminiscent of Warthin’s tumor at low power, was of a circumscribed tumour with disorganised cuboidal epithelium instead of oncocytic lining, with epithelial to lymphoid ratio varying from 0.4 to 0.9. Admixed areas with classic MEC morphology were seen (100% cases) comprising 5%, 15% and 25% of the tumour respectively. Atypical mitoses, lymphovascular invasion and perineurial invasion was not seen in any case. Immunohistochemistry for CK7 and P40 was diffusely positive in all. Mucicarmine stain highlighted interspersed mucous cells. As per MSKCC, AFIP and Brandwein systems, all these tumours were low grade, which corroborated with the prognosis as no recurrence or distant metastases was seen in a mean follow-up period of 12 months.
Low power resemblance of WLMEC to Warthin tumor can lead to an erroneous diagnosis with prognostic implications, which may be obviated by using the proposed diagnostic criteria. Awareness of occurrence in younger age, presence of goblet cells, and areas with classic MEC morphology in a thoroughly sampled tumor might help avoid this pitfall.
Mid-term outcomes of robotic-assisted versus video-assisted invasive minimally esophagectomy for esophageal cancer: A retrospective propensity-matched analysis of 842 patients
Authors: Huang Jiang-shan , Zhu Jia-fu , Zhong Qi-hong , Guo Fei-long , Lin Yu-kang , Zhang Zhen-yang , Lin Jiang-Bo 
Published: April 2024

Abstract

Aim: The purpose of this study is to compare the safety, effectiveness, and mid-term survival rates of robot-assisted minimally invasive esophagectomy (RAMIE) and video-assisted minimally invasive esophagectomy(VAMIE) using propensity score matching (PSM) analysis.
Methods: A total of 842 patients undergoing minimally invasive esophagectomy at our department from January 2019 and October 2023 were analyzed, including 694 patients in VAMIE group and 148 in RAMIE group. PSM analysis was applied to generate matched pairs for further comparison. Operative outcomes and postoperative complications were compared between all patients in matched groups. Mid-term outcomes consisting of overall survival (OS) and disease-free survival (DFS) were compared.
Results: After 1:4 PSM, 148 patients in the RAMIE and 592 patients in the VAMIE. Compared to VAMIE, RAMIE exhibited earlier removal of chest (P < 0.001) and neck (P < 0.001) drainage tubes, shorter postoperative hospital stays (P = 0.003), and a higher number of lymph node dissections. However, the surgical duration of RAMIE was longer than that of VAMIE. There were no significant differences between RAMIE group and VAMIE group in postoperative complications. There was no statistically significant difference in the 3-year OS (VAMIE:70.9% and RAMIE:75%) and DFS (VAMIE:56.1% and RAMIE:54.9%) between the two groups.
Conclusion: Compared to VAMIE, RAMIE emerges as a viable and safe surgical approach. The mid-term survival outcomes between the two procedures are comparable, suggesting RAMIE as a potential alternative to minimally invasive esophagectomy.
Bile-derived cfDNA of syncytin-1 and SLC7A11 as a potential molecular marker for early diagnosis of cholangiocarcinoma
Authors: He Jing , Qian Jingrong , Li Xin , Zhao Xiaoyue , Meng Weiwei , Zhuang Xuewei 
Published: April 2024

Abstract

Background: Bile circulating free DNA (cfDNA) as a novel liquid biopsy method for the early clinical diagnosis of cholangiocarcinoma (CCA) has been less reported.
Methods: We collected bile samples from 51 patients with CCA and 48 patients with gallstones at Shandong Provincial third Hospital from September 2022 to December 2023. We quantified bile cfDNA of syncytin-1 and SLC7A11,calculated the correlation bySpearman rank correlation, plotted Receiver Operating Characteristic (ROC) curves, and compared the Area Under Curve (AUC) values to explored early diagnostic utility in patients.
Results: We first found the bile cfDNA of syncytin-1 and SLC7A11 levels in CCA were higher than in gallstones (p < 0.001; p < 0.001). And there was significant correlation between syncytin-1 and SLC7A11 expression (Spearman ’r = 0.458, p < 0.001). The AUC of bile cfDNA of syncytin-1 was 0.891(specificity of 90.2% and sensitivity of 75.0%), the AUC of bile cfDNA of SLC7A11 was 0.793 (specificity of 80.4% and sensitivity of 72.9%), and combination of bile cfDNA of syncytin-1/SLC7A11/CA19-9 markers improved diagnostic efficiency in CCA patients (AUC:0.901, p < 0.001).
Conclusion: The bile cfDNA of syncytin-1 and SLC7A11 was high expression in cholangiocarcinoma, which may be used as a novel biomarker for early diagnosis.
Human papillomavirus type-specific distribution in cervical intraepithelial neoplasia and cancer in The Gambia prior to HPV immunization programme: A baseline for monitoring the quadrivalent vaccine
Authors: Bah Haddy , Ceesay Foday , Leigh Ousman , Bah Haddy Tunkara , Savage Ahmad Tejan , Kimmitt Patrick.T. 
Published: April 2024

Abstract

Background: Persistent infection with the high-risk human papillomavirus (HR-HPV) is associated with causing nearly 95% of cervical cancer and remains a worldwide concern. In the Gambia, cervical cancer is the leading cause of cancer deaths in women. Current estimates indicate that 286 women are annually diagnosed with cervical cancer with a fatality rate of 70%. In an attempt to address this, in 2019 the quadrivalent HPV vaccine was incorporated into the Gambia’s expanded programme on Immunisation. The aim of the study was to retrospectively assess the prevalence and distribution of high-risk HPV genotype in archived, formalin fixed paraffin embedded cervical biopsy tissues diagnosed with cervical cancer in the Gambia from year 2013 -2022.
Method: A total of 223 samples with histologically diagnosis of cervical cancer with adequate tissues were sectioned and deparaffinised, followed by HPV DNA extraction and the detection of HR-HPV by real-time multiplex PCR. The internal housekeeping gene was amplified in 119 samples, which were subsequently tested for HPV DNA.
Results: HPV prevalence was found to be 87% (104 /119) in cervical cancer cases, 15 (12.6%) samples tested negative for HPV DNA. In single infections, HPV 16 genotype was the most frequent type in cervical cancer cases accounting for 53% (56/104), followed by other high risk HPV genotypes 17% (18/104), and HPV genotype 18 was found in 15% (16/104) of cervical cancer cases. HPV related cervical cancer was most common in the 32 -42 year (28.8%, 30/104) aged women. A significant association between age and diagnosis with cervical cancer (p = 0.023), and HPV genotype (p = 0.038) was observed.
Conclusion: There was no difference in the distribution of HPV 16 and 18 genotypes in cervical cancer cases in The Gambia in comparison with the global distribution. However, the high prevalence of single infections with other HR-HPV, and multiple infections with HPV 16 and other HR-HPV genotypes seen in this study, clearly shows that the nonavalent HPV vaccine could be more beneficial for The Gambia. This study provides The Gambia with a baseline data to use in policy decisions regarding future evaluation of the quadrivalent HPV vaccine in the country.
Retention of patients in HIV/AIDS care at the healthcare facility level in Ethiopia: Same-day antiretroviral initiation status
Authors: Chachu Kidanu Hurisa , Maboe KEFILOE ADOLPHINA 
Published: April 2024

Abstract

Background
To meet the ambitious goal of eradicating the HIV epidemic by 2030, the Joint United Nations Programme on HIV/AIDS has set 95-95-95 targets. These targets aim for 95% of HIV-infected individuals to know their status, 95% to initiate antiretroviral therapy (ART), and 95% to achieve virologic suppression by 2030. In Ethiopia, progress towards these targets has been made, but challenges persist. This study aims to evaluate same-day ART initiation status regarding retention of patients in HIV/AIDS care at the healthcare facility level in Ethiopia.
Methods
A cross-sectional study design was conducted involving retrospective document analysis of 332 clinical records. The study included clinical records of patients initiated on same-day ART from the 1st of October 2017 until the 30th of October 2019. Data was analyzed quantitatively, descriptive and inferential statistical analyses were performed using Statistical Package for Social Science (SPSS) version 28.0 software. Data analysis involved conducting logistic regression to examine the relationships between factors associated with retention in HIV care.
Results
The results indicated varying retention rates over different time intervals: 35% at 6 months (n = 49), 81% at 12 months (n = 50), 89% from 13 to 18 months (n = 63), and 94% at 24 months (n = 34), with an overall retention in HIV/Care at 59% (n = 196). The study’s logistic regression analysis revealed that gender has a significant effect on retention (β = 2.890, p < 0.01), tertiary education was 0.2 times greater than no formal education, that is, (β = 0.212, p < 0.05), tertiary education was 0.13 times more than a secondary education, which is (β = 0.131, p < 0.01), patients who reside in urban areas were more likely to be retained than those who reside in rural areas, that is, (β = 0.467, p < 0.05), patients with a good level of adherence were 0.1 times more likely to be retained in comparison to those with a fair level of adherence (β = 0.092, p < 0.01).
Conclusion
The study underscores the importance of same-day ART initiation in enhancing retention rates among patients in HIV/AIDS care in Ethiopia. Factors such as gender, education level, urban residence, adherence, functional status, and WHO stage significantly influence retention. Addressing these factors through targeted interventions is crucial for achieving sustained improvements in HIV care and advancing towards epidemic eradication goals by 2030.
The association between the Health Promotion Levy and employment in South Africa: an interrupted time series analysis
Authors: Dare Chengetai , Boachie Micheal Kofi , Goldstein Susan , Thsehla Evelyn 
Published: April 2024

Abstract

Background
The production and consumption of sugar-sweetened beverages (SSBs) have been increasing over the past years, globally. However, there is overwhelming evidence linking SSBs to the rising prevalence in obesity and its comorbidities. In South Africa, the prevalence of overweight and obesity is high and is among the highest in Sub-Saharan Africa. In response to rising prevalence in obesity and its comorbidities, on 1 April 2018 the South African government introduced an SSB tax, known as the Health Promotion Levy (HPL). However, the levy has been opposed by the sugar industry, claiming that it leads to jobs losses. Against this backdrop, this study seeks to investigate the association between the HPL and employment in the sugar industry.
Methods
We employed single-group interrupted time series analyses using the Quarterly Labour Force Survey data from Statistics South Africa.
Results
Our results show that the HPL has not been associated with job losses (or generation) in the sugar-related industries in South Africa. These findings are consistent with the findings on the effects of SSB taxes on employment in other jurisdictions.
Conclusions
Considering that the HPL does not impede employment, and the overwhelming evidence on the effectiveness of SSB taxes, together with the relatively low tax burden, it is imperative that the government raises the HPL from the current 8% of the retail price to the WHO-recommended 20% threshold. The government should also consider expanding the HPL to fruit juices. Such strategies are important in encouraging people to reduce the intake of SSBs, while enabling the government to raise additional revenue for the fiscus.
Insights into the taxonomy and virulence-related genetic profiles in Cupriavidus by comparative genomic analysis
Authors: Chen Shenglei , Wang Xiaoyu , Zhang Leilei 
Published: April 2024

Abstract

Background: Cupriavidusspecies have significant potential for environmental and industrial applications. Some have been recognized as opportunistic pathogens and are increasingly reported to be related to human infections. However, the taxonomic classification of Cupriavidus at the species level remains challenging. This may partly limit the understanding of pathogenesis in Cupriavidus.Here, we aim to clarify the Cupriavidus taxonomy and elucidate virulence-related genetic profiles using comparative genomic analysis.
Results:This study used eight Cupriavidus species to investigate the taxonomy of Cupriavidus. Of these, C. alkaliphilus, C. basilensis, C. gilardii, C. oxalaticus, C. necator, and C. taiwanensis are species complex, and the first four species are first reported as the species complex. More importantly, C. alkaliphilus and part of C. taiwanensis mixed, suggesting that some strains of these two species were probably mislabeled. The open pan-genome and prevalence of mobile genetic elements indicated high genetic variation in Cupriavidus. A total of 47 genes related to virulence factors were identified in Cupriavidus. Virulence factors in almost all Cupriavidus strains were related to the antimicrobial activity (acrB), biofilm (adeG, algU), stress survival (clpP, katA, sodB, ureA, ureB, and ureG), adherence (htpB,kdsA) and others (icl); the opportunistic pathogens, C. gilardii, and C. metallidurans, contained extra virulence genes (plc-2). Furthermore, six types of secretion systems (T1SS-T6SS) were identified in Cupriavidus. T2SS was conserved across all eight species; the other secretion systems presented diverse distribution. Interestingly, C. gilardii possesses two different T3SS clusters. Finally, emre, responsible for the efflux pump of aminoglycoside antibiotics, is a major antibiotic resistance gene of Cupriavidus strains. Other genes related to aminoglycosides, β-lactam, fosfomycin, and multidrug resistance are species-specific among opportunistic pathogens individually.
Conclusions: This study for the first time investigated the taxonomic classification ofCupriavidus andvirulence-related genetic profiles by comparative genomic analysis. Findings from this study lead us to propose updating the taxonomy of the six identified Cupriavidusspecies containing species complex. The virulence-related information, including virulence factors, secretion systems, and antibiotic resistance genes, provides insights into understanding the pathogenesis of Cupriavidus and may facilitate the diagnosis of infections caused by pathogenic Cupriavidus spp.
Impact on members and retail pharmacies of China's Urban Employee Basic Medical Insurance medicine purchasing reforms: Case studies in Wuhan
Authors: Xu Zhihao , Nicholas Stephen , Maitland Elizabeth , Wang Jian , Li Jie , Lv Shenghao , Tan Jialong 
Published: April 2024

Abstract

Background
In 2023, local health authorities implemented prescription medicine purchases from retail pharmacies by urban employee basic medical insurance (UEBMI) members. Using case studies from Wuhan, we assess the impact of the 2023 medicine purchasing reform on the medicine buying behavior; evaluate the benefits of the changes to UEMBI members; and provide insights into China’s retail pharmacies’ business model.
Methods
Daily UEBMI claim data was collected at two Wuhan pharmacies from March 2022 to December 2023, including data on customer age, sex, employment state and claim type before and after the implementation of the 2023 policy. The impact of the new retail pharmacy purchasing policy on medicines purchasing behavior, such as the number of medicine purchasers, the total expenditure per capita, and the medical savings accounts expenditure per capita, were quantitatively evaluated using descriptive statistics and interrupted time series analysis (ITSA).
Results
The characteristics of medicine purchasers were not significantly affected by the new policy. Retired UEBMI members benefited more from allowing UEBMI funds for prescription purchases from retail pharmacies than currently employed UEBMI members. The number of UEBMI member medicine purchasers from retail pharmacies showed a significant upward trend, increasing the benefits to UEBMI members, without medicine over-use or risk of fraud. The benefit to members was measured by the absence of any significant upward per capita total expenditure trend and a significant decrease in the proportion of medicine expenditures from members personal medical savings accounts.
Conclusions
The 2023 reforms allowed UEBMI members to purchase medicine from retail pharmacies, providing medicine accessibility and affordability for members, especially retired members; did not trigger an increase in members’ medicine consumption; attenuated the over-use of hospital pharmacies; and transformed pharmacies’ business model away from a singular focus on price competition towards a combination of price competition and health services.
B cells infiltration potentially responded better to systemic corticoids in oral lichen planus and oral lichenoid lesions
Authors: Feng Ming-hua , Lai Yi-rao , Deng Yi-wen , Li Xi-ye , Pan Lei , Tian Zhen , Wang Yu-feng , Tang Guo-yao 
Published: April 2024

Abstract

Background: Oral lichen planus (OLP) and oral lichenoid lesion (OLL) are common chronic inflammation in the oral mucosa. B cells infiltration in OLP and OLL, however, little is known about these cells in OLP and OLL.
Objectives: To analyze the function and infiltrating features of B lymphocytes in OLP and OLL, and to preliminarily evaluate their correlation with clinical outcomes.
Methods: Tissue samples were collected from OLP, OLL, and healthy mucosa. The phenotypes and amounts of B cells in tissues were analyzed by single-cell sequencing. Their proportion and infiltrating features in tissues were examined by immunohistochemistry and immunofluorescence. With the systemic medication of corticoids, the correlation between B cells infiltrating characteristics and the clinical outcomes were evaluated.
Results: A quantified proportion increase of B cells was shown in both OLP and OLL. B cells in OLP demonstrated heightened activation and enhanced regulation in immune response. A cohort of 100 patients with OLP/OLL and 13 healthy controls were examined to investigate the B cells infiltration pattern. B cells were distributed in the superficial layer of lamina propria in 92.9% and 41.9% of OLP and OLL, respectively(P<0.01); focally distributed in 25.0% and 62.9% of OLP and OLL, respectively(P<0.01). With the systemic medication of corticoids, the cases with B cell infiltration (B+) in OLP and OLL groups showed a statistically significant reduction in REU scores before and after treatment (P<0.01)
Conclusions: B cells are widely present in OLP and OLL, and B cell infiltration in OLP and OLL are related to the better therapeutic effect of oral corticoids.
Natural foraging selection and gut microecology of two subterranean rodents from the Eurasian Steppe in China
Authors: Sz Zhenghaoni , Fu Heping , Yuan Shuai , Chen Kai , Han Tingting , Bu Fan , Sun Shanshan , Zhu Na , Man Duhu 
Published: April 2024

Abstract

As the most abundant group of mammals, rodents possess a very rich ecotype, which makes them ideal for studying the relationship between diet and host gut microecology. Zokors are specialized herbivorous rodents adapted to living underground. Unlike more generalized herbivorous rodents, they feed on the underground parts of grassland plants. There are two species of the genus Myospalax in the Eurasian steppes in China: one is Myospalax psilurus, which inhabits meadow grasslands and forest edge areas, and the other is M. aspalax, which inhabits typical grassland areas. How are the dietary choices of the two species adapted to long-term subterranean life, and what is the relationship of this diet with gut microbes? Are there unique indicator genera for their gut microbial communities? Relevant factors such as the ability of both species to degrade cellulose are not yet clear. In this study, we analysed the gut bacterial communities and diet composition of two species of zokors using 16S amplicon technology combined with macro-barcoding technology. We found that the diversity of gut microbial bacterial communities in M. psilurus was significantly higher than that in M. aspalax and that the two species of zokors possessed different gut bacterial indicator genera. Based on the results of Mantel analyses, the gut bacterial community of M. aspalax showed a significant positive correlation with the creeping-rooted type food, and there was a complementary relationship between the axis root type food and the rhizome type food dominated (containing bulb types and tuberous root types) food groups. Functional prediction based on KEGG found that M. psilurus possessed a stronger degradation ability in the same cellulose degradation pathway. Neutral modelling results showed that the gut flora of the M. psilurus has a wider ecological niche compared to that of the M. aspalax. This provides a new perspective for understanding how rodents living underground in grassland areas respond to changes in food conditions.