bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of lesions on magnetic resonance imaging in multiple sclerosis: practical guidelines
Authors: Filippi Massimo , Preziosa Paolo , Banwell Brenda L , Barkhof Frederik , Ciccarelli Olga , De Stefano Nicola , Geurts Jeroen J G , Paul Friedemann , Reich Daniel S , Toosy Ahmed T , Traboulsee Anthony , Wattjes Mike P , Yousry Tarek A , Gass Achim , Lubetzki Catherine , Weinshenker Brian G , Rocca Maria A
Published: May 2019

MRI has improved the diagnostic work-up of multiple sclerosis, but inappropriate image interpretation and application of MRI diagnostic criteria contribute to misdiagnosis. Some diseases, now recognized as conditions distinct from multiple sclerosis, may satisfy the MRI criteria for multiple sclerosis (e.g. neuromyelitis optica spectrum disorders, Susac syndrome), thus making the diagnosis of multiple sclerosis more challenging, especially if biomarker testing (such as serum anti-AQP4 antibodies) is not informative. Improvements in MRI technology contribute and promise to better define the typical features of multiple sclerosis lesions (e.g. juxtacortical and periventricular location, cortical involvement). Greater understanding of some key aspects of multiple sclerosis pathobiology has allowed the identification of characteristics more specific to multiple sclerosis (e.g. central vein sign, subpial demyelination and lesional rims), which are not included in the current multiple sclerosis diagnostic criteria. In this review, we provide the clinicians and researchers with a practical guide to enhance the proper recognition of multiple sclerosis lesions, including a thorough definition and illustration of typical MRI features, as well as a discussion of red flags suggestive of alternative diagnoses. We also discuss the possible place of emerging qualitative features of lesions which may become important in the near future.
BEEF SPECIES–RUMINANT NUTRITION CACTUS BEEF SYMPOSIUM: Maternal immune modulation prior to embryo arrival in the uterus is important for establishment of pregnancy in cattle1
Authors: Gifford Craig A , Aloqaily Bahaa H , Hernandez Gifford Jennifer A
Published: May 2019

In 1953, Sir Peter Medawar first recognized the allogeneic properties of a developing conceptus and rationalized that an “immune-tolerant” physiological state must exist during pregnancy. Early theories speculated that the conceptus evaded the maternal immune system completely, but 40 yr after Medawar’s observations, Wegmann proposed that the maternal immune system shifts the cytokine profile away from inflammatory cytokine production when an embryo is present. The economic consequences and production losses of subfertile animals have been well documented in studies evaluating calving distribution. Despite advances in understanding infertility or subfertility, few technologies exist to identify subfertile animals or improve fertility beyond hormonal intervention associated with synchronization protocols. Work in rodents and some livestock species indicates that the uterine immune cell population shifts dramatically after copulation and these early immune-modulated events establish a receptive uterine environment. Clearly, as evident in embryo transfer, the presence of a conceptus is sufficient to establish communication for pregnancy establishment but does not rule out the importance of other physiological events to prime the maternal immune system prior to blastocyst arrival in the uterus. In support of this concept, work in our laboratory and by others has demonstrated that autologous intrauterine transfer of peripheral immune cells prior to embryo transfer can increase pregnancy rates and accelerate conceptus development in women and cattle. Understanding aberrant immune regulation in subfertile animals may provide markers for subfertility or targets for clinical intervention to enhance fertility, particularly when using reproductive technologies.
Characterization of an Amphetamine Interference from Gabapentin in an LC–HRMS Method
Authors: Muñoz-Muñoz Ana Celia , Pekol Teresa , Schubring Dana , Hyland Robin , Johnson Charlene , Andrade Lawrence
Published: May 2019

An amphetamine interference was observed during the development of an liquid chromatography–high-resolution mass spectrometry (LC–HRMS) multi-class confirmation method for the determination of 47 drugs and metabolites in urine. The interference passed all qualitative criteria for amphetamine leading to potential false-positive results. Upon investigation, it was found that the amphetamine interference was correlated with the presence of high levels of gabapentin. Gabapentin is routinely detected in patient urine specimens at levels in excess of 1 mg/mL as it is widely prescribed at high doses and does not undergo significant metabolism. The source of the interference was identified as a gabapentin in-source fragment isomeric with protonated amphetamine. Here we describe the characterization of this interference and how its effect was mitigated in the LC–HRMS method.
Development and Field Evaluation of a Novel, Inexpensive Passive Trap for Monitoring Dispersal of Necrophagous Dipteran Larvae
Authors: Oliveira Diego Leandro , Barbosa Taciano Moura , Maia Artur C D , Vasconcelos Simão Dias
Published: May 2019

Techniques for the survey of necrophagous dipterans are frequently designed for adult flies and often neglect forensically important information, such as the postfeeding larval dispersal following carcass colonization. In this study, we propose and test a novel trap design for the collection of dipteran larvae at the postfeeding stage. The Trap for Dispersing Larvae (TDL) consists of two semiindependent parts: 1) a 2-liter PET bottle, containing the attractant (carcass); and 2) a plastic box, which selectively captures postfeeding dispersing larvae. Based on a field test in a dry forest fragment in Brazil, the TDL trap captured ca. 1,500 larvae of 13 species of Calliphoridae, Muscidae, Fanniidae, and Sarcophagidae. The species richness of dispersing larvae recorded in our study was ca. 60% of that previously recorded in this area. As the TDL trap can assess larval dispersal without interfering with carcass decomposition, we demonstrate that it can be used to assess temporal variation in the dynamics of colonization. In the present study, most larval dispersal occurred at 5-d postexposure, but the traps remained efficient until 7 d, by which time rat carcasses had skeletonized. We conclude that the TDL trap captures the dispersing dipteran larvae with little interference in carcass decomposition processes. The trap also provides a representative sample of species and is simple to use and of low cost.
The cold-induced transcription factor bHLH112 promotes artemisinin biosynthesis indirectly via ERF1 in Artemisia annua
Authors: Xiang Lien , Jian Dongqin , Zhang Fangyuan , Yang Chunxian , Bai Ge , Lan Xiaozhong , Chen Min , Tang Kexuan , Liao Zhihua
Published: May 2019

Basic helix-loop-helix (bHLH) proteins are the second largest family of transcription factors (TFs) involved in developmental and physiological processes in plants. In this study, 205 putative bHLH TF genes were identified in the genome of Artemisia annua and expression of 122 of these was determined from transcriptomes used to construct the genetic map of A. annua. Analysis of gene expression association allowed division of the 122 bHLH TFs into five groups. Group V, containing 15 members, was tightly associated with artemisinin biosynthesis genes. Phylogenetic analysis indicated that two bHLH TFs, AabHLH106 and AabHLH112, were clustered with Arabidopsis ICE proteins. AabHLH112 was induced by low temperature, while AabHLH106 was not. We therefore chose AabHLH112 for further examination. AabHLH112 was highly expressed in glandular secretory trichomes, flower buds, and leaves. Dual-luciferase assays demonstrated that AabHLH112 enhanced the promoter activity of artemisinin biosynthesis genes and AaERF1, an AP2/ERF TF that directly and positively regulates artemisinin biosynthesis genes. Yeast one-hybrid assays indicated that AabHLH112 could bind to the AaERF1 promoter, but not to the promoters of artemisinin biosynthesis genes. Overexpression of AabHLH112 significantly up-regulated the expression levels of AaERF1 and artemisinin biosynthesis genes and consequently promoted artemisinin production.
The nuclear-localized PPR protein OsNPPR1 is important for mitochondrial function and endosperm development in rice
Authors: Hao Yuanyuan , Wang Yunlong , Wu Mingming , Zhu Xiaopin , Teng Xuan , Sun Yinglun , Zhu Jianping , Zhang Yuanyan , Jing Ruonan , Lei Jie , Li Jingfang , Bao Xiuhao , Wang Chunming , Wang Yihua , Wan Jianmin
Published: May 2019

Pentatricopeptide repeat (PPR) proteins constitute one of the largest protein families in land plants. Recent studies revealed the functions of PPR proteins in organellar RNA metabolism and plant development, but the functions of most PPR proteins, especially PPRs localized in the nucleus, remain largely unknown. Here, we report the isolation and characterization of a rice mutant named floury and growth retardation1 (fgr1). fgr1 showed floury endosperm with loosely arranged starch grains, decreased starch and amylose contents, and retarded seedling growth. Map-based cloning showed that the mutant phenotype was caused by a single nucleotide substitution in the coding region of Os08g0290000. This gene encodes a nuclear-localized PPR protein, which we named OsNPPR1, that affected mitochondrial function. In vitro SELEX and RNA-EMSAs showed that OsNPPR1 was an RNA protein that bound to the CUCAC motif. Moreover, a number of retained intron (RI) events were detected in fgr1. Thus, OsNPPR1 was involved in regulation of mitochondrial development and/or functions that are important for endosperm development. Our results provide novel insights into coordinated interaction between nuclear-localized PPR proteins and mitochondrial function.
The plant Mediator complex and its role in jasmonate signaling
Authors: Zhai Qingzhe , Li Chuanyou
Published: May 2019

The Mediator complex is an essential, multisubunit transcriptional coactivator that is highly conserved in eukaryotes. Mediator interacts with gene-specific transcription factors, the RNA polymerase II transcriptional machinery, as well as several other factors involved in transcription, and acts as an integral hub to regulate various aspects of transcription. Recent studies of the plant Mediator complex have established that it functions in diverse aspects of plant development and fitness. Jasmonate (JA) is an oxylipin-derived plant hormone that regulates plant immunity and development. The basic helix–loop–helix transcription factor MYC2, which is a master regulator of JA signaling, orchestrates genome-wide transcriptional reprogramming of plant cells to coordinate defense- and growth-related processes. Here, we review the function of the plant Mediator complex in regulating JA signaling. We focus on the multifunctional Mediator subunit MED25, which emerges as an integrative hub for the transcriptional regulation of jasmonate signaling.
Grieg As Storyteller: The Poetics of the Ballade in G Minor, Op. 24
Authors: Martin Gregory
Published: May 2019

Critical discussion of Edvard Grieg’s Ballade has tended to dwell on more superficial aspects of its formal layout, rather than investigate the unique poetics that underlies its trajectory. This essay contends that in 1875, when he chose to write a song ‘so people will see / that even the North can be beautiful’, Grieg turned to the most profound and personal of Norway’s literary inheritances, the sagas and Eddas, for formal, structural, and aesthetic inspiration. The juxtaposition of ancient folksong and late-Romantic harmony fuels a dynamic interaction that not only creates the effect of a great abyss of time, but also serves as the dramatic impetus for Grieg’s narrative, one that gradually purges the theme of its chromaticism and transforms it into a barbaric final dance. Grieg’s engagement with his material may be seen as something analogous to the oral poet, illuminating aspects of storytelling sometimes unfamiliar in the Western tradition.
Cross-border enforcement of tax debts: trustee issues in the UK and offshore
Authors: Gunson Hugh , Klemme Thomas
Published: May 2019

This article considers the effect of recent international tax cooperation alongside the established principle in India v Taylor and the extent to which trustees can now be potentially liable for foreign tax claims and judgments against them.
Nonsexually Transmitted Genital Ulcer Secondary to Hand, Foot, and Mouth Disease
Authors: Wong Jennifer , Langford Andrea , Howard David L.
Published: May 2019

BACKGROUND:

Genital ulcers that are not the result of sexually transmitted infections (STIs) are uncommon, and case reports predominantly feature pubertal girls.

CASE:

A 38-year-old monogamous, nulliparous woman acutely developed painful vaginal ulcers 7 days after babysitting a child who was subsequently diagnosed with hand, foot, and mouth disease. The patient developed nonspecific systemic symptoms followed by painful and rapidly expanding genital ulcers. Laboratory test results for herpes, syphilis, human immunodeficiency virus, gonorrhea, chlamydia, and Epstein-Barr virus were all negative. The patient was treated with brief inpatient observation, oral prednisone, meticulous wound care, and debridement. The ulcers resolved over a 3-week period.

CONCLUSION:

Although typically associated with pubertal girls, genital ulcers that are not the result of STIs can affect adults as well. The cornerstone of management regardless of age is supportive care, debridement and wound care, and treatment with steroids.
Potential Consequences of Minimum-Volume Standards for Hospitals Treating Women With Ovarian Cancer
Authors: Wright Jason D. , Huang Yongmei , Melamed Alexander , Tergas Ana I. , St. Clair Caryn M. , Hou June Y. , Khoury-Collado Fady , Ananth Cande V. , Neugut Alfred I. , Hershman Dawn L.
Published: May 2019

OBJECTIVE:

To assess the potential effects of implementing minimum hospital volume standards for ovarian cancer on survival and access to care.

METHODS:

We used the National Cancer Database to identify hospitals treating women with ovarian cancer from 2005 to 2015. We estimated the number of patients treated by each hospital during the prior year. Multivariable models were used to estimate the ratio of observed/expected 60-day, and 1-, 2- and 5-year mortalities. The mean predicted observed/expected ratio of hospitals was plotted based on prior year volume. The number of hospitals that would be restricted if minimum-volume standards were implemented was modeled.

RESULTS:

A total of 136,196 patients treated at 1,321 hospitals were identified. Increasing hospital volume was associated with decreased 60-day (P=.004), 1-year (P<.001), 2-year (P<.001) and 5-year (P=.008) mortality. In 2015, using a minimum-volume cutpoint of one case in the prior year would eliminate 144 (13.6%) hospitals (treated 2.6% of all patients); a cutpoint of three would eliminate 364 (34.5%) hospitals (treated 7.7% of the patients). The mean observed/expected ratios for hospitals with a prior year volume of 1 was 1.14 for 60-day mortality, 1.06 for 1-year mortality, 1.12 for 2-year mortality, and 1.08 for 5-year mortality. Among hospitals with a prior year volume of one, 49.2% had an observed/expected ratio for 2-year mortality of at least 1 (indicating worse than expected performance), and 50.8% had an observed/expected ratio of less than 1 (indicating better than expected performance). The mean observed/expected ratios for hospitals with a prior year volume of two or less were 1.11 for 60-day mortality, 1.09 for 1-year mortality, 1.08 for 2-year mortality, and 1.07 for 5-year mortality. Implementing a minimum-volume standard of one case in the prior year would result in one fewer death for every 198 patients at 60 days, for every 613 patients at 1 year, and for every 62 patients at 5 years.

CONCLUSION:

Implementation of minimum hospital volume standards could restrict care at a significant number of hospitals, including many centers with better-than-predicted outcomes.
Systolic Hypertension, Preeclampsia-Related Mortality, and Stroke in California
Authors: Judy Amy E. , McCain Christy L. , Lawton Elizabeth S. , Morton Christine H. , Main Elliott K. , Druzin Maurice L.
Published: May 2019

OBJECTIVE:

To describe the clinical characteristics of stroke and opportunities to improve care in a cohort of preeclampsia-related maternal mortalities in California.

METHODS:

The California Pregnancy-Associated Mortality Review retrospectively examined a cohort of preeclampsia pregnancy-related deaths in California from 2002 to 2007. Stroke cases were identified among preeclampsia deaths, and case summaries were reviewed with attention to clinical variables, particularly hypertension. Health care provider– and patient-related contributing factors were also examined.

RESULTS:

Among 54 preeclampsia pregnancy-related deaths that occurred in California from 2002 to 2007, 33 were attributed to stroke. Systolic blood pressure exceeded 160 mm Hg in 96% of cases, and diastolic blood pressure was 110 or higher in 65% of cases. Hemolysis, elevated liver enzymes, and low platelet count syndrome was present in 38% (9/24) of cases with available laboratory data; eclampsia occurred in 36% of cases. Headache was the most frequent symptom (87%) preceding stroke. Elevated liver transaminases were the most common laboratory abnormality (71%). Only 48% of women received antihypertensive treatment. A good-to-strong chance to alter outcome was identified in stroke cases 66% (21/32), with delayed response to clinical warning signs in 91% (30/33) of cases and ineffective treatment in 76% (25/33) cases being the most common areas for improvement.

CONCLUSION:

Stroke is the major cause of maternal mortality associated with preeclampsia or eclampsia. All but one patient in this series of strokes demonstrated severe elevation of systolic blood pressure, whereas other variables were less consistently observed. Antihypertensive treatment was not implemented in the majority of cases. Opportunities for care improvement exist and may significantly affect maternal mortality.
The dilemma of treating hepatitis C virus-associated cryoglobulinemia
Authors: Roccatello Dario , Fenoglio Roberta , Sciascia Savino
Published: May 2019

Purpose of review

The present review focuses on the new therapeutic opportunities offered by the combination of biological drugs, mainly Rituximab, with direct-acting antiviral agents (DAAs).

Recent findings

Hepatitis C virus (HCV) is known to be the etiologic agent in the majority of patients with mixed cryoglobulinemia syndrome. Clinical research has been focused on antiviral drugs and, more recently, on the new, highly potent DAAs. New DAAs assure sustained virologic response (SVR) rates greater than 90% with relief of mild-to-moderate symptoms.

Mixed cryoglobulinemia may present with multiorgan vasculitis involving kidneys, joints, skin, and peripheral nerves. Data on DAAs efficacy in HCV-associated cryoglobulinemic vasculitis are disappointing possibly because of the inability of these drugs to suppress the immune-mediated process once it has been triggered. Immunosuppression has often been employed in the past as a first-line therapy in cryoglobulinemic vasculitis despite the potential risk of the infection exacerbation. However, more manageable Rituximab-based therapeutic approaches have been more recently used without increase of viral load. Rituximab substantially changed the outcome of HCV-associated cryoglobulinemic vasculitis by providing long-term remission. A combination schedule of DAAs and Rituximab may result in eradication of both cryoglobulinemic vasculitis and HCV infection.
Precision Medicine Applications to Manage Multiply Injured Patients With Orthopaedic Trauma
Authors: McKinley Todd O. , Lisboa Felipe A. , Horan Annamarie D. , Gaski Greg E. , Mehta Samir
Published: May 2019

Precision medicine offers potential for improved outcomes by tailoring interventions based on patient-specific demographics and disease-specific data. Precision methods are relatively unexplored in trauma patients. New research is being looked at for precision methods to treat patients with large extremity wounds, nonunions, and fractures associated with polytrauma. Precision-based clinical decision tools are being validated to optimize timing for open wound definitive closure. Early patient-specific biomarkers to stratify nonunion risk within 1 week of fracture are being explored. Patient-specific data to stage timing of major fracture interventions in multiply injured patients are being interrogated.
Patient Outcomes in Orthopaedic Trauma: How to Evaluate if Your Treatment Is Really Working?
Authors: Nauth Aaron , Wasserstein David , Tornetta Paul , Cole Peter A. , Obremskey William T. , Attum Basem , Slobogean Gerard P.
Published: May 2019

Outcomes are critical to gauge the success of our treatments and, in particular, surgical interventions in orthopaedic trauma. Patient-reported outcomes have evolved to become the primary measurement of success in surgery. This article reviews the concepts relevant to understanding these outcomes including general health outcomes, extremity- and disease-specific outcomes, minimum clinically important difference, economic analysis of treatment cost/benefit, and the impact of psychosocial factors on outcomes. An understanding of these concepts is important to allow for effective interpretation and critical analysis of the literature as well as to facilitate the practice of evidence-based medicine.
Cell-Based Therapies for the Treatment of Fractures
Authors: Borrelli Joseph , Della Rocca Gregory J. , Schneider Prism , Pape Hans-Christoph , Cinelli Paolo , Weil Yoram , Khoury Amal , Liebergall Meir , Watson Tracy
Published: May 2019

Ongoing studies investigating fracture healing have uncovered and allowed investigators to gain a better understanding of where the variety of cells, which participate in this process, originate, and how they communicate as well as how they can be enhanced to successfully heal a fracture when the process has slowed or failed completely. This brief review will highlight some of the recent findings regarding the role the immune system in fracture healing and how these cells communicate with each other during the healing process. In addition, two 2 methods that have recently been shown to be promising techniques in supporting fracture when it stalls or reversing the process, when the fracture has failed to heal, will also be described.
Home-Based Cardiac Rehabilitation
Authors: Thomas Randal J. , Beatty Alexis L. , Beckie Theresa M. , Brewer LaPrincess C. , Brown Todd M. , Forman Daniel E. , Franklin Barry A. , Keteyian Steven J. , Kitzman Dalane W. , Regensteiner Judith G. , Sanderson Bonnie K. , Whooley Mary A.
Published: May 2019

Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible patients participating in CR in the United States. New delivery strategies are urgently needed to improve participation. One potential strategy is home-based CR (HBCR). In contrast to center-based CR services, which are provided in a medically supervised facility, HBCR relies on remote coaching with indirect exercise supervision and is provided mostly or entirely outside of the traditional center-based setting. Although HBCR has been successfully deployed in the United Kingdom, Canada, and other countries, most US healthcare organizations have little to no experience with such programs. The purpose of this scientific statement is to identify the core components, efficacy, strengths, limitations, evidence gaps, and research necessary to guide the future delivery of HBCR in the United States. Previous randomized trials have generated low- to moderate-strength evidence that HBCR and center-based CR can achieve similar improvements in 3- to 12-month clinical outcomes. Although HBCR appears to hold promise in expanding the use of CR to eligible patients, additional research and demonstration projects are needed to clarify, strengthen, and extend the HBCR evidence base for key subgroups, including older adults, women, underrepresented minority groups, and other higher-risk and understudied groups. In the interim, we conclude that HBCR may be a reasonable option for selected clinically stable low- to moderate-risk patients who are eligible for CR but cannot attend a traditional center-based CR program.
Genetics of neurodegenerative diseases for the advanced practice provider
Authors: Alexander Sheila A.
Published: May 2019

Neurodegenerative diseases are more common in older individuals and are progressively debilitating. Due to the aging of the American population, the burden of neurodegenerative diseases on the health care infrastructure will likely significantly increase in the near future. Genetic science has advanced our understanding of the pathology driving these diseases thereby informing new, individualized care paradigms. Although translation into clinical practice is slow, there are a few examples of instances where precision medicine is making a difference in the care of patients with neurodegenerative diseases that may be driven by genetic background. This article provides a brief overview of the current knowledge of genetic influences on two common neurodegenerative diseases, Alzheimer Disease and Parkinson Disease, as well as ways this knowledge is being tested for a precision medicine approach to care.
Revascularization strategies in cardiogenic shock after acute myocardial infarction
Authors: Desch Steffen
Published: May 2019

Purpose of review

Coronary revascularization compared with medical treatment alone leads to improved survival in patients with myocardial infarction (MI) and cardiogenic shock. Percutaneous coronary intervention (PCI) is the predominant mode of revascularization in clinical practice. This review discusses several aspects relevant to mechanical revascularization such as general indication, the roles of PCI and bypass surgery, percutaneous access site choice, strategy in multivessel disease and adjunctive antithrombotic therapy.

Recent findings

The recently published CULPRIT-SHOCK trial provided the first randomized evidence that in the vast majority of patients with infarct-related cardiogenic shock PCI should be confined to the culprit lesion, whereas nonculprit lesions should not be routinely treated in the emergency setting. Although randomized data are not available, a primary radial access for PCI is becoming more popular in the shock population. Cardiac surgery plays an indispensable, yet quantitatively only minor role in the management of infarct-related cardiogenic shock.

Coronary revascularization remains the cornerstone in the early management of patients with acute MI and cardiogenic shock. In patients with multivessel disease, a strategy of culprit lesion only PCI is the default approach.
Yixinshu capsule combined with conventional treatment for chronic heart failure
Authors: Cai Yinhe , Zhang Qingsong , Huang Cihui , Lu Ke , Chen Baishu , Liu Cuiling
Published: May 2019

Background:

Yixinshu Capsule is widely utilized in Asia for the treatment of chronic heart failure (CHF) as a conventional drug, but a comprehensive conclusion is lacking. Here, we will provide a protocol to perform a meta-analysis and trial sequential analysis to evaluate the efficacy of Yixinshu Capsule combined with conventional treatment for chronic heart failure.

Methods:

We will conduct a thorough search in six databases, PubMed, EMBASE, Cochrane Library Database, Chinese National Knowledge Infrastructure (CNKI), Chinese Science Journal Database (VIP), and Chinese Biomedical and Medical Database (CBM). Inclusion criteria will be randomized control trials (RCTs) with one group receiving Yixinshu Capsule based on conventional treatment and another group receiving conventional treatment alone. Modified Jadad scale and Cochrane's risk of bias assessment will be used to assess methodological quality. Only studies with modified Jadad scale score ≥3 will be included in meta-analysis for efficacy, which will be defined as moderate methodological quality. The total effective rate will be considered as the primary outcome and the secondary outcome will include mortality, rehospitalized rate, left ventricular ejection fraction (LVEF), 6-minute walking distance, E/A, left ventricular end-diastolic diameter (LVEDD), BNP, and NT-proBNP. We will conduct trial sequential analysis to evaluate the reliability of the primary outcome.

Results:

This study will provide a rational synthesis of current evidences for Yixinshu Capsule on chronic heart failure.

Conclusion:

The conclusion of this study will provide evidence for judging the efficacy of Yixinshu Capsule on chronic heart failure.

Registration:

PROS-PERO CRD42019119612.
Right anterior section graft for living-donor liver transplantation
Authors: Navarro Jonathan Geograpo , Choi Gi Hong , Kim Myoung Soo , Jung Yoon Bin , Lee Jae Geun
Published: May 2019

Rationale:

In living-donor liver transplantation (LDLT), the right lobe graft is commonly utilized to prevent small-for-size syndrome, despite the considerable donor morbidity. Conversely, the feasibility of the left lobe graft and the right posterior section graft in smaller-sized recipients is now commonly employed with comparable outcomes to right lobe grafts. The efficacy of the right anterior section graft has rarely been reported.

Patient concerns:

A 56-year-old man, a heavy alcoholic beverage drinker for 20 years, presented in the emergency department with massive ascites and lethargy. He was previously admitted twice due to bleeding esophageal varices.

Diagnosis:

He was diagnosed with hepatic encephalopathy coma due to alcoholic liver cirrhosis. The Child–Turcotte–Pugh score was 11 (class C), and the Model for End-stage Liver Disease score was 21.62.

Intervention:

A LDTL was offered to the patient as the best treatment option available. The patient's 26-year-old son was found to be the only donor-compatible candidate for the LDTL.

Preoperatively, the right lobe of the donor occupied 76.2% of the total liver volume exposing the donor to a small residual liver volume. The right posterior section and left lobe volumes were insufficient, providing a graft-to-recipient weight ratio of 0.42% and 0.38%, respectively. However, the right anterior section could fulfill an acceptable GRWR of 0.83%. Thus, a living donor right anterior sectionectomy was performed.

Outcomes:

Clinical signs and symptoms and liver function improved following anterior section graft transplantation without complications.

Lesson:

The procurement of anterior section graft is technically feasible in selected patients, especially in high-volume liver centers.
GRIK4 and GRM7 gene may be potential indicator of venlafaxine treatment reponses in Chinese of Han ethnicity
Authors: Sun Qianqian , Yuan Fan , Yuan Ruixue , Ren Decheng , Zhu Yuhao , Bi Yan , Hu Jiaxin , Guo Zhenming , Xu Fei , Niu Weibo , Ma Gaini , Wu Xi , Yang Fengping , Wang Lu , Li Xingwang , Yu Tao , He Lin , He Guang
Published: May 2019

Venlafaxine is one of commonly prescribed antidepressants for major depressive disorder (MDD). Accumulated evidence implicates the involvement of glutamatergic receptors in the pathophysiology of MDD and antidepressant treatment.

By using 193 MDD patients who have been taking venlafaxine for 6 weeks, we investigated whether single nucleotide polymorphisms (SNPs) in glutamate ionotropic receptor kainate type subunit 4 (GRIK4), glutamate ionotropic receptor AMPA type subunit 1 (GRIA1) and glutamate metabotropic receptor 7 (GRM7) were associated with treatment response. 14 SNPs were selected randomly depended on association studies. Efficacy of treatment was determined by 17-item of Hamilton Rating Scale. Allele and genotype frequencies were compared between responders and non-responders.

After adjusting by the false discovery rate (FDR), rs6589847 and rs56275759 in GRIK4 and rs9870680 in GRM7 showed associating with venlafaxine treatment response at week 6. (FDR: P = .018, P = .042, and P = .040, respectively).

Our results indicated that genetic variants in the GRIK4 and GRM7 may associate with the treatment response in MDD patients treated by venlafaxine.
Prognostic value of IGF-1R in lung cancer
Authors: Xu Jun , Bie Fenglong , Wang Yadong , Chen Xiaowei , Yan Tao , Du Jiajun
Published: May 2019

Background:

Insulin-like growth factor receptor 1 (IGF-1R) is a key player in a wide array of pathological processes, while the prognostic role of IGF-1R in lung cancer remains controversial.

Methods:

We conducted a meta-analysis to evaluate the prognostic value of IGF-1R in lung cancer. We searched for recent studies on the expression of IGF-1R and extracted prognostic lung cancer data from the articles.

Results:

Eventually, 22 studies with 3859 patients were analyzed in our meta-analysis. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were used to quantify the ability of IGF-1R to predict survival. The results indicated that IGF-1R positive expression was associated with an unfavorable disease-free survival (DFS) in non-small cell lung cancer (NSCLC) patients on univariate analysis (HR = 1.24, 95% CI: 1.00–1.55, P = .054) and multivariate analysis (HR = 1.49, 95% CI: 1.01–2.21, P = .045), but there was no significant difference in the relationship between IGF-1R positive expression and overall survival (OS) on univariate analysis (HR = 1.04, 95% CI: 0.86–1.25, P = .712) and multivariate analysis (HR = 0.89, 95% CI: 0.57–1.39, P = .602). IGF-1R mRNA expression related to OS was obtained in 2 studies, with the pooled HR being 1.663 (95% CI: 1.071–2.583, P = .024). For IGF-1R expression and small cell lung cancer (SCLC), the conclusion was not statistically significant, with the pooled HR being 1.22 (95% CI: 0.66–2.27, P = .524).

Conclusions:

Our results indicate that high expression of IGF-1R predicts poor DFS in NSCLC, yet it does not predict poor OS in NSCLC and SCLC. IGF-1R may be a useful predictor of outcomes in patients with NSCLC.
Comparison of value of biomarkers in diagnosing lung cancer
Authors: Wu Fanqi , Wang Hong , Tao Hongyan , Huang Huirong , Zhang Longguo , Wu Di , Wan Yixin
Published: May 2019

Background:

In both sexes combined, lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death. Furthermore, the incidence rate is increasing in many countries. Many lung cancer patients have a poor prognosis because they are usually diagnosed at an advanced stage. Therefore, there is an urgent need to develop effective methods for early diagnosis of lung cancer. Some systematic reviews have evaluated the value of biomarkers for diagnosing lung cancer. However, it remains unclear which biomarker has superior performance for early and accurate detection of lung cancer. This overview aims to assess the methodological and reporting quality of available systematic reviews and to find an optimal biomarker for diagnosing lung cancer.

Methods:

We searched PubMed, Embase.com, the Cochrane Library of Systematic Reviews, and Web of Science to identify relevant systematic reviews including randomized controlled trials, cross-sectional studies, case-control studies, or cohort studies that reported the value of biomarkers for diagnosing lung cancer. The methodological quality will be assessed using AMASAR-2 checklist, and the reporting quality will be assessed using PRISMA-DTA checklist. Bubble plot will be generated to map the biomarkers, methodological and reporting quality. The pairwise meta-analysis and indirect comparisons will be performed using STATA 13.0.

Results:

The results of this study will be published in a peer-reviewed journal

Conclusion:

This overview will provide comprehensive evidence of different biomarkers for the diagnosis of lung cancer.

Ethics and dissemination:

Ethics approval and patient consent are not required as this study is an overview based on published systematic reviews.
Predictive value of posterior cranial fossa morphology in the decompression of Chiari malformation type I
Authors: Liu Zheng , Hao Zheng , Hu Si , Zhao Yeyu , Li Meihua
Published: May 2019

Posterior fossa decompression (PFD) is the standard procedure for the treatment of Chiari malformation type I (CMI). Although most patients have satisfactory surgical outcomes, some show no improvement or even a worsening of symptoms. Patient selection is thought to account for these different surgical outcomes. Our aim was to evaluate the predictive value of the preoperative posterior cranial fossa (PCF) morphology on the efficacy of PFD.

Data from 39 CMI patients with CMI-related symptoms who underwent occipital foramen enlargement + C-1 laminectomy + enlarged duraplasty were retrospectively collected from January 2011 to May 2018. The patients were divided into improved and unimproved groups according to the modified Chicago Chiari Outcome Scale. Demographic information and clinical history, including preoperative comorbidities and clinical manifestations, were recorded for the 2 groups and compared. PCF morphology was assessed based on 13 linear, 8 angular, 4 areal parameters and 4 ratios related to these liner and areal parameters. The data were then analyzed statistically.

Of the 39 patients with CMI, 24 showed improvement after PFD (61.5%), whereas the remaining 15 patients showed no improvement (38.5%). The preoperative symptoms lasted 1 to 240 months, with a median of 24 months. The follow-up period ranged from 2 to 82 months, with a median of 27 months. The improved and unimproved groups differed significantly with regard to upper limb numbness (OR = 10, P = .02) and upper limb weakness (OR = 4.86, P = .02). The 2 groups did not differ significantly with regard to any morphological parameters such as tonsillar descent, syrinx size.

Preoperative upper limb numbness and upper limb weakness are unfavorable factors that influence the outcome of PFD in patients with CMI. However, the morphology of PCF cannot predict the response to PFD in patients with CMI.
Characterization of atypical acute promyelocytic leukaemia
Authors: Wang Xiaoxue , Wang Jing , Zhang Lijun
Published: May 2019

Rationale:

The vast majority of acute promyelocytic leukemia (APL) is characterized with a specific chromosomal translocation t (15, 17) (q22, q21), which fuses PML-RARα leading to a good response to all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). However, there are few cases of atypical APL, including PLZF-RARα, F1P1L1-RARα, STAT5b-RARα, et al. Neither PLZF-RARα nor STAT5b-RARα are sensitive to ATRA and ATO, and the prognosis is poor.

Patient concerns:

Here we have 3 cases (PLZF-RARα, n = 2; STAT5b-RARα, n = 1). Case A, A 53-year-old Chinese female had suffered ecchymosis in both legs for 3 days. Case B, A 44 years old male suffered pain from lower limbs and hip. Case C, 52-year-old male patient presented with fever for 3 weeks invalid to antibiotics and gingival bleeding for 1 week.

Diagnoses:

With RT-PCR and karyotype, Case A is diagnosed with STAT5b-RARα-positive APL.

Case B, C are diagnosed with PLZF-RARα-positive APL.

Interventions:

In case A, ATO, and ATRA were used for induction treatment. In Case B, ATO, and chemotherapy with DA were given in the first induction treatment. In Case C, ATRA, and ATO were used immediately, subsequently, chemotherapy was added with DA, ATRA, and CAG combination treatment, and medium-dose cytarabine with daunorubicin were given regularly.

Outcomes:

In Case A, the patient refused the following treatment and discharged on day 25. In Case B, the patient got the disseminated intravascular coagulation (DIC).In Case C, the patient has survived for 7 months and remains CR.

Lessons:

Both STAT5b-RARα-positive APL and PLZF-RARα-positive APL appear to be resistant to both ATRA and ATO, so combined chemotherapy and allo-HSCT should be considered. Since the prognosis and long-term outcome are poor, more clinical trials, and researches should be taken.
The association and diagnostic value of red blood cell distribution width in colorectal cancer
Authors: Shi Cheng , Xie Mingzhi , Li Lihua , Li Kezhi , Hu Bang-Li
Published: May 2019

Red blood cell distribution width (RDW) is associated with several diseases. However, the diagnostic value of RDW and its related factors remain unclear in colorectal cancer (CRC).

This single-center retrospective study evaluated 211 Chinese CRC patients and 103 healthy controls. The association of RDW with the clinical parameters of CRC, as well as its correlations with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were analyzed. The diagnostic value of RDW alone or combined with CEA and CA19-9 was evaluated using receiver operating characteristic curve analysis. A meta-analysis was also performed to combine our data with previously published data to enhance our findings.

In the CRC patients, RDW was clearly elevated and was significantly associated with CRC tumor location, histological type, T status (but not N or M status), and clinical stage. However, RDW was not significantly correlated with CEA or CA19-9 levels. Using RDW to diagnose CRC provided a sensitivity of 53.1% and specificity of 77.7%. The diagnostic accuracy of RDW was enhanced by combining RDW with CEA and CA19-9 levels. We identified 5 previous studies with 633 CRC patients and 1050 controls, which were combined with our cases and controls. The meta-analysis revealed an overall sensitivity of 69%, specificity of 70%, and an area under the curve of 0.74.

In CRC cases, RDW was associated with tumor location, histological type, T status, and clinical stage. Furthermore, RDW had a moderate value for diagnosing CRC and might be useful in this setting.
Proposed safe apnea test using positive end-expiratory pressure valve and short-term blood gas analysis
Authors: Park Jin , Lee Young-Joo , Hong Kyung Sook
Published: May 2019

The apnea test is an essential examination for the determination of brain death; however, hypotension, hypoxemia, and other complications during the apnea test can affect the stability of brain-dead patients, as well as organ function for recipients. Therefore, it is necessary to establish standard guidelines for apnea testing.

The modified apnea test (MAT) comprises delivery of 100% oxygen through the endotracheal tube connected to manual resuscitator (Ambu bag) with the positive end-expiratory pressure (PEEP) valve after disconnection of the mechanical ventilator for maintenance of PEEP. Forty-nine instances of the conventional apnea test (CAT) were performed in 25 brain-dead patients; 77 instances of the MAT were performed in 39 brain-dead patients.

The mean duration of the apnea test was 3.5 ± 1.4 minutes in the CAT group and 3.0 ± 1.2 minutes in the MAT group. There were no significant changes in PaCO2, PaO2, or pH between the CAT and MAT groups (P = .341, .593, and .503, respectively). In overweight patients (body mass index ≥ 23 kg/m2), MAT prevented dramatic reductions in PaO2 and SaO2 (P < .05 for both). In the patients who had hypoxic brain injury due to hanging, differences in PaO2 and SaO2 in the MAT group were significantly smaller than in the CAT group (P < .05).

Although MAT, which was invented to maintain PEEP, was not efficient for all brain-dead patients, it could be helpful in selected patient groups, such as overweight patients or those who had hypoxic injury due to hanging. And clinicians should consider short-term apnea test to avoid unnecessarily prolonged hypoxemia.
Androgen receptor variant 7 (AR-V7) in sequencing therapeutic agents for castratrion resistant prostate cancer
Authors: Sciarra Alessandro , Gentilucci Alessandro , Silvestri Ida , Salciccia Stefano , Cattarino Susanna , Scarpa Susanna , Gatto Antonio , Frantellizzi Viviana , Von Heland Magnus , Ricciuti Gian Piero , Del Giudice Francesco , Maggi Martina
Published: May 2019

Background:

androgen receptor variant 7 (AR-V7) has been suggested as potential marker for treatment selection in men with metastatic castration-resistant prostate cancer (mCRPC). The aim of the present review is to critically analyze: frequency of the AR-V7 expression in mCRPC cases—impact of AR-V7 expression on abiraterone, enzalutamide, and taxane therapy.

Methods:

we searched in the Medline and Cochrane Library database from the literature of the past 10 years. We critically evaluated the level of evidence according to the European Association of Urology (EAU) guidelines.

Results:

12 clinical trials were selected. The determination of AR-V7 in peripheral blood using circulating tumor cells mRNA seems to be the preferred method. At baseline, the mean percentage of cases with AR-V7 positivity was 18.3% (range 17.8%–28.8%). All data on mCRPC submitted to enzalutamide or abiraterone reported a significantly (P <.05) lower clinical progression-free survival (CPFS) and overall survival (OS) in AR-V7+ than AR-V7− cases (CPFS hazard ratio [HR]: 2.3; 95% CI 1.1–4.9; OS HR: 3.0; 95% CI 1.4–6.3). In mCRPC cases submitted to chemotherapies data are not homogeneous and some studies showed no association between CPFS or OS and AR-V7 status (OS HR 1.6; 95% CI 0.6–4.4; P = .40).

Conclusions:

the suggestion is that taxane therapy is more efficacious than abiraterone or enzalutamide for men with AR-V7+ CRPC. On the contrary, clinical outcomes did not seem to differ significantly on the basis of the type of therapy used among AR-V7− cases.
Influence of speed and heel-to-toe drop in running shoes for female recreational runners
Authors: Gijon-Nogueron Gabriel , Soler-Crespo Francisco Jose , Sanchez-Rodriguez Raquel , Cabello-Marique David , Lopezosa-Reca Eva , Ortega-Avila Ana Belen
Published: May 2019

In recent years, the popularity of running has boomed and the number of women runners has risen sharply. However, little research has been conducted into the running cycle as concerns female runners. The aim of this study is to analyse, in women runners, the relationships between spatiotemporal parameters in the running cycle, the heel drop in running shoes and a progressive increase in training speed, when running on a treadmill.

Thirty-eight female runners were recruited from the Malaga University Athletics Club and Nerja Athletics Club. All were at least 18 years old, recreationally active (3–4 running sessions per week) and able to run 5 km in less than 25 min. Their running performance on a treadmill was recorded and spatiotemporal parameters assessed using the OptoGait system.

As the running speed increased (8–12–15 km/h) the spatiotemporal parameters of the running cycle altered: the flight time increased (P < .001) and the contact time decreased (P = .05). Heel drop (4–12 mm) was not significantly associated with any of the parameters (phase 1: P = .198; phase 2: P = .191; phase 3: P = .242).

A progressive increase in training speed on a treadmill directly influences the spatiotemporal parameters of the running cycle in women runners.