bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of early wound leakage as a risk factor for prosthetic joint infection
Authors: Kremers Keetie , Leijtens Borg , Camps Simone , Tostmann Alma , Koëter Sander , Voss Andreas
Published: February 2019

Background and purpose:

Prosthetic joint infection (PJI) is a serious complication resulting from total knee arthroplasty (TKA) or total hip arthroplasty (THA). In this study, patients with a PJI are compared with patients with an uncomplicated postoperative course to identify relevant risk factors for PJI.

Methods:

A matched case–control study was performed with patients undergoing fast-track, elective unilateral TKA or THA. The following data were collected: demographics, surgery-related characteristics (perioperative blood loss, use of cement, body temperature), and postoperative characteristics (hematoma formation, wound leakage, blood transfusion, length of stay [LOS]).

Conclusions:

When the PJI group was compared with the control group, there was significantly more wound leakage during hospital stay (88% vs. 36%, p = .001) and early wound dressing changes in the first 3 days after surgery (88% vs. 40%, p = .002). Hematoma formation was observed more in the PJI patients group (44% vs. 10%, p = .005). A trend test revealed a significant association between the total number of wound dressing changes and development of PJI (p < .001); 72% of PJI patients had a length of stay of ≥4 days compared with 34% of controls (odds ratio 10.5; 95% CI [2.1–52.3]; p = .004).

Implications for practice:

Early postoperative wound drainage and hematoma formation directly correlate with PJI. This resulted in a significantly higher number of dressing changes and longer LOS. The nurse practitioner has a central role in postoperative care and is the first to recognize signs of an adverse postoperative clinical course.
Conditioned Pain Modulation (CPM) is Reduced in Irritable Bowel Syndrome
Authors: Marcuzzi Anna , Chakiath Rosemary J. , Siddall Philip J. , Kellow John E. , Hush Julia M. , Jones Michael P. , Costa Daniel S.J. , Wrigley Paul J.
Published: February 2019

This systematic review summarises evidence assessing endogenous pain inhibition in people with irritable bowel syndrome (IBS) compared with healthy controls using conditioned pain modulation (CPM) and offset analgesia (OA). Evidence regarding the role of psychological variables is also examined. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Four electronic databases were searched to retrieve studies assessing CPM or OA in adults diagnosed with IBS according to the ROME II/III criteria. Standardized mean differences were calculated for each study and a random effects model was used for meta-analysis. Eleven studies were included, 5 of which reported results on the relationship between CPM and psychological variables. None of the studies assessed OA. The risk of bias assessment found a lack of assessor blinding in all studies. The pooled effect estimate was 0.90 (95% CI, 0.40-1.40) indicating a significantly lower CPM effect in people with IBS compared with controls. This effect was reduced to 0.51 when 1 outlier was excluded from the analysis. In addition, reduced CPM responses were significantly correlated with higher anxiety (r=0.17 to 0.64), stress (r=0.63), and pain catastrophizing (r=0.38) in people with IBS; however, the evidence available was limited and the strength of these associations variable. Depression was not found to be associated with CPM in these IBS cohorts. The results of this review suggest that people with IBS, as a group, demonstrate reduced pain inhibition measured by CPM. The preliminary evidence about the association between psychological factors and CPM warrants further investigations.
Association between prognosis and SEMA4D/Plexin-B1 expression in various malignancies
Authors: Yang Yibo , Wang Jing , Li Hui , Liu Lihong , Yao Maojin , Xiao Tao
Published: February 2019

Introduction:

SEMA4D and its high affinity receptor Plexin-B1 showed a promising prognosis prediction for carcinoma patients in recent studies, we performed a meta-analysis to evaluate the prognostic role of them in various malignancies.

Methods:

A systematic literature search was performed in PubMed, Embase, Web of Science, and CNKI from inception till July 2017. Eligible studies were identified by different reviewers. Hazard ratios (HRs)/related ratios (RRs) and their corresponding 95% confidence intervals (CIs) were extracted to investigate the relevance between malignancies prognosis and SEMA4D/Plexin-B1.

Results:

Around 2638 patients from 14 studies were included in this meta-analysis. High expression of SEMA4D was significantly associated with overall survival (OS) and disease-free survival/progression-free survival/recurrence-free survival (DFS/PFS/RFS) in tumors (respectively, HRos = 2.05, 95%CI: 1.68–2.50, P < .001; HRdfs/pfs/rfs = 1.59, 95%CI = 1.27–1.98, P < .001). However, the relationship between SEMA4D expression and prognosis of breast cancer patients was failed to find (HR = 0.76, 95%CI = 0.32–1.82, P = .539). Plexin-B1 level showed a significant positive correlation both with OS and DFS of Caucasian breast cancer patients (respectively, HRos = 0.56, 95%CI: 0.39–0.79, P = .001; HRdfs = 0.68, 95%CI = 0.51–0.90, P = .008)

Conclusions:

SEMA4D could be a prospective biomarker for prognostic prediction of various malignancies except breast cancer. For Caucasian breast cancer patients, SEMA4D's high affinity receptor Plexin-B1 showed a significant positive correlation with survival.
Status and factors related to posttraumatic growth in patients with lung cancer
Authors: Peng Xingchen , Su Yonglin , Huang Wenxia , Hu Xiaolin
Published: February 2019

Post-traumatic growth in cancer patients refers to perceived positive changes following cancer diagnosis and treatment. Little is known about the status and factors related to posttraumatic growth among Chinese patients with lung cancer.

To investigate the status and factors of posttraumatic growth among Chinese patients with lung cancer.

A cross-sectional design was adopted in this study. Patients (N = 173) from the oncology unit at one teaching hospital in Sichuan were recruited. Posttraumatic growth, depression, anxiety, and coping style were self-reported by the patients. Multiple linear regression analysis was to examine factors related to posttraumatic growth.

Posttraumatic growth was a common exit in Chinese lung cancer patients. Time since cancer diagnosis, patient depression, and coping strategies are factors that affect the experience of posttraumatic growth.

Reducing depression, providing available support, and improving active coping strategies are areas to facilitate posttraumatic growth.
Is perioperative colloid infusion more effective than crystalloid in preventing postoperative nausea and vomiting?
Authors: Kim Hyun Jung , Choi Seung Ho , Eum Darhae , Kim Seung Hyun
Published: February 2019

Background:

Adequate intravenous fluid replacement is recommended as an effective nonpharmacologic strategy for reducing postoperative nausea and vomiting (PONV), one of the most common and stressful complications of general anesthesia. We aimed to evaluate the effect of hydration, according to the type of fluid, on PONV as previous studies have reported inconsistent results.

Methods:

We performed a systemic review and meta-analysis of randomized controlled trials (RCTs) comparing infusion of colloid with that of crystalloid in terms of PONV incidence and the need for rescue antiemetic therapies for 24 hours after surgery under general anesthesia. The effect of fluid infusion according to the duration of anesthesia was also examined. A literature search was performed, using MEDLINE, Excerpta Medica Database, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus, up to February 2018.

Results:

We included 8 RCTs. Compared with the crystalloid infusion, perioperative colloid infusion did not reduce PONV incidence, with a relative risk of 0.87 (95% confidence interval [CI], 0.60–1.25). However, subgroup analysis by duration of anesthesia showed a statistically significant subgroup effect (P = .04, I

2
 = 77.4%), suggesting that the effect of colloid differed from that of crystalloid depending on the duration of anesthesia. In the subgroup that underwent anesthesia for more than 3 hours, in which the patients had mostly undergone abdominal surgeries, colloid infusion significantly reduced the incidence of PONV compared with crystalloid infusion (RR, 0.69; 95% CI, 0.53–0.89). In the subgroup that underwent anesthesia for <3 hours, colloid infusion did not reduce the incidence of PONV compared with crystalloid infusion (RR, 1.32; 95% CI, 0.76–2.27). The requirement for antiemetics was comparable between colloid and crystalloid infusions, with an RR of 0.93 (95% CI, 0.55–1.58).

Conclusion:

Colloid administration had a more preventive effect on PONV than crystalloid administration in patients undergoing abdominal surgery under general anesthesia for more than 3 hours but did not show a preventive effect in patients undergoing anesthesia for <3 hours.
Solitary nasopharynx metastasis from hepatocellular carcinoma after liver transplantation
Authors: Lou Li-Li , Zhang Ying , Huang Xu , Zhang Li-Xia , Ji Hui-Fan , Li Xu , Guo Xiao-Lin
Published: February 2019

Rationale:

Hepatocellular carcinoma (HCC) is the fifth most common cancer and third leading cause of cancer-related deaths worldwide. Nasopharyngeal metastasis of hepatocellular carcinoma is very rare. This is the first report of posttransplantation nasopharyngeal metastasis.

Patient concerns:

A 45-year-old man with a history of hepatitis B related hepatocellular carcinoma (HCC) in the right segment of the liver received an orthotopic liver transplant. Two year after the transplantation, he suffered from severe headache, and head contrast enhanced CT scans did not show clues for brain or skull metastasis. Then he developed hoarseness and dysphagia.

Diagnosis:

The nasopharyngeal cancer was confirmed to be metastatic tumor from liver histologically according to biopsy.

Interventions:

This patient underwent radiotherapy (RT) of the metastatic nasopharyngeal tumor, and there was significant symptomatic relief.

Outcomes:

The patient died 3 months after nasopharyngeal metastasis was diagnosed.

Lessons:

Recurrence of hepatocellular carcinoma with metastasis of nasopharyngeal carcinoma after liver transplantation is rare, but the prognosis is very poor. Close follow-up of patients should be paid attention to prevent the occurrence of such diseases.
Kawasaki disease complicating bilateral facial nerve palsy and giant coronary artery aneurysms
Authors: Yu Xia , Liu Xiaoxia , Wang Yongchun , Lu Na , Wang Mengjiao , Sun Li
Published: February 2019

Rationale:

Kawasaki disease (KD), which is also known as mucocutaneous lymphnode syndrome, is a vasculitic disease and involves multi-system disorder with various clinical manifestations. KD is specific predilection for the coronary arteries and is the most common cause of childhood-acquired heart disease in developed countries. KD is rarely complicated by cranial nerve VII palsy.

Patient concerns:

This report described a 7-month-old infant who suffered from bilateral infranuclear facial nerve palsy (FNP) and multiple coronary artery aneurysms (CAAs) in parallel with KD. The patient had an intermittent fever for 18 days and had a medical history of bilateral conjunctival injection, strawberry tongue, reddened lips, and perianal excoriation. Physical examinations revealed fever (38.5°C), fingertips desquamation of the skin, and left cervical lymphadenopathies.

Diagnosis:

The diagnosis of KD is based on the presence of clinical features of persistent fever (≥5 days) together with polymorphous exanthema, cervical lymphadenopathy, non-purulent conjunctival injection, changes of the lips, oral cavity, and extremities. An echocardiogram has showed a beaded sample dilatation of all coronary arteries, in addition to aneurysms of the middle of the right coronary artery (6.2 mm in diameter; 14.5 Z score), and the left coronary artery (5.4 mm in diameter; 9.4 Z score). The physical examinations revealed incomplete closure of both eyes and bilateral drooping of the mouth, suggesting a bilateral infranuclear FNP.

Interventions:

The patient received intravenous immunoglobulin (IVIG) (2 g/kg) with high-dose aspirin according to the clinical guidelines.

Outcomes:

Her fever finally resolved after 2 days’ IVIG. All inflammatory indexes returned to normal or near-normal levels prior to discharge. However, the echocardiogram remained unchanged and the patient's facial nerve palsies had not recovered.

Lessons:

FNP in KD is uncommon. Yet, it may be a marker of disease progression. One should be aware of the diagnosis of KD when children suffer from high fever, FNP, and even with incomplete clinical features.
High concentrations of serum interleukin-6 and interleukin-8 in patients with bipolar disorder
Authors: Lu Yun-Rong , Rao Ying-Bo , Mou Yu-Jian , Chen Yan , Lou Han-Fen , Zhang Yu , Zhang Dan-Xuan , Xie Hai-Yan , Hu Li-Wei , Fang Ping
Published: February 2019

Immune system dysregulation plays a key role in the physiopathology of bipolar disorder (BD) and major depressive disorder (MDD). However, whether interleukins might be biomarkers to distinguish these 2 affective disorders is unclear. Here, we assessed the differences in serum levels of interleukin 6 (IL-6) and interleukin 8 (IL-8) as well as C-reactive protein (CRP) in patients with MDD and BD. In total, we enrolled 21 MDD patients, 26 BD patients, and 20 healthy controls. We collected a total of 35 samples from BD patients in 3 different phases, depression phase, manic phase, and remission stage, and 27 samples from MDD patients in acute and remission phases. Serum IL-6 and IL-8 levels were assessed with solid phase sandwich ELISA-based quantitative arrays, and CRP levels were determined with an automatic analyzer. Both serum IL-6 and IL-8 levels were elevated in BD patients but not MDD patients. Subgroup analysis indicated elevated serum IL-6 in both the depression and manic phases in BD patients. The serum CRP levels did not change in either BD or MDD patients. However, sex differences in CRP concentrations were observed in healthy controls. Furthermore, there were linear correlations between the CRP levels and Bech-Rafaelsen Mania Rating Scale (BRMS) scores in BD patients. IL-6 and IL-8 levels may serve as biomarkers to differentiate between MDD and BD patients, even when the clinical manifestations are atypical. IL-6 may be used for the differential diagnosis of MDD and depressive episodes in BD.
The effects of aging on the profile of the cervical spine
Authors: Liu Jingpei , Liu Peng , Ma Zikun , Mou Jianhui , Wang Zhaolin , Sun Dong , Cheng Jie , Zhang Dengwei , Xiao Jianlin
Published: February 2019

The study aims to investigate the effects of aging on the cervical spine.

Outpatients in the study were grouped by age. The cervical spine image in the sagittal plane from participants in the supine position was acquired with MRI. Thoracic inlet angle (TIA), T1 slope (T1S), neck tilt (NT), and cervical angle (CC2–7) were measured.

NT and TIA measured 41.84 ± 9.26 and 64.15 ± 10.72 in participants younger than 40, and 53.02 ± 9.52 and 72.09 ± 10.49 in participants older than 40 (P < .01). CC2–7 measured 6.11 ± 9.88 in participants younger than 40, significantly lower compared with participants older than 40, which measured 10.89 ± 11.02 (P = .003). TIS did not differ significantly between the 2 groups (P = .087). No significant difference was found in all measurements between the female and male participants. Age was moderately correlated with NT (r = 0.466, P < .01) and TIA (r = 0.512, P < .01), but weakly correlated with CC2–7 (r = 0.315, P < .01) and TIS (r = 0.210, P = .005). TIA showed a strong correlation with NT (r = 0.748, P < .01) and a moderate correlation with T1S (r = 0.458, P < .01). Lastly, T1S was strongly correlated with CC2–7 (r = 0.701, P < .01).

The result showed that NT, CC2–7, and TIA, but not T1S, increased with age.
The efficacy of the new medical internship management network system
Authors: Xia Oudong , Ye Jiaqi , Lin Anqi , Chen Yating , Guo Wenjie , Fong Tszhei , Qian Ruolan , Luo Peng , Zeng Zhirong
Published: February 2019

With the increasing number of medical students and scattered host hospitals, the traditional clinical internship management system has been falling behind. Thus, we have independently developed a new clinical practice management system based on the browser/server structure.

We aim to evaluate the efficacy of the new medical management system on the quality of the internship and survey the users’ satisfaction.

This study was conducted on the students of Second Clinical Medical College of Southern Medical University, including 672 interns (non-user group) who had not used the system and 315 users (user group). We analyzed the scores of their theoretical knowledge and clinical skills before and after the internship, which served as the quantitative standards for evaluating the efficacy of the system. User satisfaction surveys were also conducted, including by interns, clinical teachers, and teaching administrators.

An analysis of scores showed that the user group had more significant improvement in both clinical knowledge and skills than the non-user group after the internship. Significant improvement was found in the user group, while there was a slight difference in the non-user group. A total of 310 students responded to the satisfaction questionnaires effectively, most of whom agreed with the system's benefits of learning theoretical knowledge (98.1%, n = 304) and clinical skills (93.9%, n = 291). Additionally, 115 clinical teachers and 27 teaching administrators were selected using a random sampling method for the survey. The results showed that 96.3% of the teachers considered the system to be helpful for improving teaching quality, and 92.6% administrators thought it was useful for implementing management. Over 90% of the participants in the 3 user groups reported a strong satisfaction of the system.

With high level of user satisfaction, this system helps to strengthen the management for interns and improves the medical knowledge and skills of interns. Hence, it could be widely used in medical colleges and even in other fields.
Effect of segmental muscle vibration on upper extremity functional ability poststroke
Authors: Annino Giuseppe , Alashram Anas R. , Alghwiri Alia A. , Romagnoli Cristian , Messina Giuseppe , Tancredi Virginia , Padua Elvira , Mercuri Nicola Biagio
Published: February 2019

Background:

Upper extremity functional impairments are common consequences of stroke. Therefore, continuous investigation of effective interventions for upper extremity functions after stroke is a necessity. Segmental muscle vibration (SMV) is one of the interventions that incorporate sensory stimulation to improve motor cortical excitability. The aim of this study was to investigate the influence of 5-minute SMV application along with supervised physical therapy (SPT) on improving activities of daily living and motor recovery on the hemiparetic upper extremity in patients with stroke.

Methods:

A sample of 37 patients poststroke (29 males) was randomly allocated to either SPT control group (n = 18) or SPT and SMV (SPT-SMV) experimental group (n = 19). All patients received 3 sessions per week of SPT for 8 weeks. The SPT-SMV experimental group received SMV at the end of each SPT session. Outcome measures used were Barthel index (BI), modified Ashworth scale, manual muscle testing, and goniometry for range of motion (ROM) assessment.

Results:

Thirty-four patients completed the study. Patients in both groups improved significantly after treatment in BI, elbow ROM, and elbow muscles strength. However, muscle tone in elbow joint of the hemiplegic upper extremity improved significantly after SMV only in the experimental group (SPT-SMV).

Conclusion:

The SPT intervention can improve functional outcomes of upper extremity in people after stroke. However, using SMV may have superior effect on improving muscle tone after stroke.
Body posture and physical activity in children diagnosed with asthma and allergies symptoms
Authors: Brzęk Anna , Knapik Andrzej , Sołtys Jacek , Gallert-Kopyto Weronika , Famuła-Wąż Anna , Plinta Ryszard
Published: February 2019

Asthma and body posture abnormalities in children and young people are major epidemiological problems worldwide. Asthma among children and adolescents, its relations with physical activity (PA) and PA relations with body posture were and are still being investigated.

The aim of this study was to investigate how body posture is shaped in children diagnosed with asthma symptoms and whether body posture is associated with PA. The study involved 192 children. The main group consisted of 90 children diagnosed with asthma and allergies symptoms age 9 to 12 years old (x = 10.75 ± 1.08). The control group included 102 healthy children at the similar age (x = 10.64 ± 1.1). The level of activity has been assessed on the basis of a questionnaire and body posture assessments were done using a plumb line, pediscoliometer, digital inclinometer.

Comparison of percentage of respondents fitting into body posture norms clearly indicates higher value in the group classified as active. In the group of participants diagnosed with asthma, percentage differences of participants with good body posture (without postural defects) were statistically significant. Among healthy children, percentages of the participants were higher in active children than in inactive children.

Body posture is directly related to PA and the lack of activity affects disturbances within posturometric parameters. Prevention of body posture abnormalities is worth promoting in groups of children, also with various diseases including asthma and allergies symptoms.
Emphysema quantification using hybrid versus model-based generations of iterative reconstruction
Authors: Martin Steve P. , Gariani Joanna , Feutry Grégoire , Adler Dan , Karenovics Wolfram , Becker Christoph D. , Montet Xavier
Published: February 2019

To compare 2 incompatible generations of iterative reconstructions from the same raw dataset based on automatic emphysema quantification and noise reduction: a hybrid algorithm called sinogram affirmed iterative reconstruction (SAFIRE) versus a model-based algorithm called advanced modeled iterative reconstruction (ADMIRE).

Raw datasets of 40 non-contrast thoracic computed tomography scanners obtained from a single acquisition on a SOMATOM Definition Flash unit (Siemens Healthcare, Forchheim) were reconstructed with 3 levels of SAFIRE and ADMIRE algorithms resulting in a total of 240 datasets. Emphysema index (EI) and image noise were compared using repeated analysis of variance (ANOVA) analysis with a P value <.05 considered statistically significant.

EI and image noise were stable between both generations of IR when reconstructed with the same level (P ≥0.31 and P ≥0.06, respectively).

SAFIRE and ADMIRE perform equally in terms of emphysema quantification and noise reduction.
Integrating traditional Chinese medicine healthcare into dementia care plan by reducing the need for special nursing care and medical expenses
Authors: Lin Shun-Ku , Lo Pei-Chia , Chen Wang-Chuan , Lai Jung-Nien
Published: February 2019

Reducing the need for advanced nursing care and medical expenses is an essential concern of dementia care. We investigated the impact of traditional Chinese medicine (TCM) on advanced nursing care and medical costs.

We used Longitudinal Health Insurance Database to implement a cohort study of patients with dementia between 1997 and 2012 in Taiwan. Data from the onset of dementia to 1st advanced nursing care for the endotracheal tube, urinal indwelling catheterization, and nasogastric tube were assessed using Cox regression proportional hazards model, and independent t test was used to determine the difference of hospitalization costs and days. We also used ANOVA test to compare the hospital cost, hospital stay, and numbers according to different duration of TCM.

We assessed 9438 new diagnosed patients with dementia without advanced nursing care were categorized into 2 groups: 4094 (43.4%) TCM users, and 5344 (56.6%) non-TCM users. In the TCM groups, 894 (21.8%) patients were declared as advanced nursing care, while 1683 (31.5%) patients were in non-TCM group. Cox proportional hazard regression indicated that using TCM may decrease the need for advanced nursing care (adjusted hazard ratio (aHR) = 0.61, 95% confidence interval [95% CI]: 0.56–0.66) compared to non-TCM. The TCM users have lower hospitalization costs and hospitalization time compared to non-TCM users.

Integrating TCM healthcare into dementia care was found to be associated with a lower need for advanced nursing care, hospitalization costs, and admission time with more benefits from longer durations of TCM use.
Risk of subsequent health disorders among living kidney donors
Authors: Lin Shih-Yi , Lin Cheng-Li , Sung Fung-Chang , Chang Chao-Hsiang , Wu His-Chin , Chen Wen-Chi , Wang I-Kuan , Chen Chao-Jung , Chou An-Kuo , Kao Chia-Hung
Published: February 2019

Few studies have investigated the risk of physiological sequelae in living kidney donors (KDs). We conducted a population-based cohort study using the National Health Insurance Research Database of Taiwan, which covers more than 99% of citizens.

We comprehensively investigated the risk of medical disorders after kidney donation in living KDs using a maximum follow-up of 13 years. From January 1997 to December 2010, 1081 living KDs and 1082 age- and sex-matched non-KDs were eligible. Primary outcomes comprised end-stage renal disease, chronic kidney disease, stroke, cancer, acute myocardial infarction, acute renal failure (ARF), and diabetes.

The adjusted hazard ratios (HRs) for developing ARF, diabetes, hyperlipidemia, hypertension, cancer, end-stage renal disease, acute myocardial infarction, and stroke were similar between the KD and non-KD cohorts (P > .05). Although differences in the adjusted HRs of ARF were nonsignificant, the cumulative incidence rate of ARF 13 years after donation was 7.48 per 1000 person-years in the KD cohort compared with 3.46 in the matched non-KD cohort. The incidence rate ratio for ARF between donors and nondonors significantly increased to 2.16 (95% confidence interval, 1.61–2.71).

Living KDs experienced no significant health disorders following kidney donation but should be alert to the higher incidence rate of ARF.
Long-term efficacy of different procedures for treatment of varicose veins
Authors: Guo Liqin , Huang Rong , Zhao Dunyong , Xu Guilian , Liu Hui , Yang Jian , Guo Tao
Published: February 2019

Background:

Various procedures for the treatment of varicose veins have been shown to have long-term effectiveness, but research has yet to identify the most effective procedure. The aim of this study was to investigate the long-term efficacy of different procedures based on Bayesian network meta-analysis and to rank therapeutic options for clinical decision-making.

Methods:

Globally recognized databases, namely, MEDLINE, Embase, and Cochrane Central, were searched for randomized controlled trials (RCTs). Quantitative pooled estimation of successful treatment rate (STR) and recurrence rate (RR) was performed to assess the long-term efficacy of each procedure with more than a 1-year follow-up. The surface under the cumulative ranking (SUCRA) probabilities of the P values regarding STR and RR were calculated to rank various procedures. Grades of Recommendations Assessment, Development and Evaluation (GRADE) criteria were utilized for the recommendation of evidence from pairwise direct comparisons.

Results:

A total of 39 RCTs encompassing a total of 6917 limbs were eligible and provided relative raw data. After quantitative analysis, the CHIVA procedure was determined to have the best long-term efficacy, as it had the highest STR (SUCRA, 0.37). Additionally, the results revealed that CHIVA possessed the highest probability of achieving the lowest long-term RR (SUCRA, 0.61). Moreover, the sensitivity analysis with inconsistency approach clarified the reliability of the main results, and the evidence of most direct comparisons was ranked as high or moderate.

Conclusion:

CHIVA seemed to have superior clinical benefits on long-term efficacy for treating varicose veins. However, the conclusion still needs additional trials for supporting evidence.
Alterations in fecal short-chain fatty acids in patients with irritable bowel syndrome
Authors: Sun Qinghua , Jia Qiong , Song Lijin , Duan Liping
Published: February 2019

Background:

Recent studies indicate that gut microbiota disorders potentially contribute to the pathogenesis of irritable bowel syndrome (IBS), which can be partly reflected by fecal short-chain fatty acids (SCFAs) generated from gut microbiota. Previous studies on SCFA alterations in patients with IBS have yielded conflicting results. No prior systematic review has been conducted on the alterations in fecal SCFAs in IBS patients.

Aims:

We performed a meta-analysis to explore and clarify alterations in fecal SCFAs in IBS patients.

Methods:

Case-control studies, randomized controlled trials (RCTs), and self-controlled studies were identified through electronic database searches. The standardized mean difference (SMD) with 95% confidence interval (CI) in fecal SCFA levels between different groups was calculated.

Results:

The proportion of fecal propionate in patients with IBS was significantly higher than in healthy controls (HCs) (SMD = 0.44, 95% CI = 0.12, 0.76). A subgroup analysis showed that the concentration of fecal propionate (SMD = −0.91, 95% CI = −1.41, −0.41) and butyrate (SMD = −0.53, 95% CI = −1.01, −0.04) in patients with constipation-predominant IBS (IBS-C) was significantly lower than that in HCs, and the concentration of fecal butyrate in patients with diarrhea-predominant IBS (IBS-D) was higher than that in HCs (SMD = 0.34, 95% CI = 0.00, 0.67). Finally, we found that restricted diets correlated with fecal butyrate reduction in IBS (SMD = −0.26, 95% CI = −0.51, −0.01).

Conclusions:

In terms of fecal SCFAs, there were differences between patients with IBS and HCs. In IBS-C patients, propionate and butyrate were reduced, whereas butyrate was increased in IBS-D patients in comparison to HCs. Propionate and butyrate could be used as biomarkers for IBS diagnosis.
Incidence of surgical-site infection following open reduction and internal fixation of a distal femur fracture
Authors: Bai Yanbin , Zhang Xiong , Tian Ye , Tian Dehu , Zhang Bing
Published: February 2019

Surgical-site infection (SSI) is a common complication in orthopedic surgery; however, SSI after surgically managed distal femur fractures was not well studied. The aim of this study was to investigate the incidence of SSI and identify some modifiable and nonmodifiable risk factors.

The patients’ electronic medical records (EMRs) were reviewed to identify those who sustained a distal femur fracture and treated by open reduction and internal fixation (ORIF) between March 2014 and February 2018. SSI was defined based on the Centers for Disease Control criteria and confirmed according to the descriptions in EMR. Univariate and multivariate logistic regression models were used to determine the independent risk factors associated with SSI.

Totally, EMRs of 665 patients who underwent ORIF of distal femur fractures were reviewed and 24 SSIs were found, indicating the overall incidence of SSI was 3.6%. The rate of deep SSI was 1.2% and superficial SSI was 2.4%. Staphylococcus aureus was the most common causative pathogen, either alone (7/15, 46.7%) or as a mixed infection (3/15, 20%), followed by mixed bacterial (4/15, 26.7%) and S epidermidis (2/15, 13.3%) and others. Patients with SSI had approximately twice the length of hospital stay as those without SSIs (29.0 vs 16.0 days, P < .001). Open fracture, temporary use of external fixation, obesity, smoking, diabetes mellitus, and preoperative reduced albumin level were identified as independent risk factors associated with SSI, and current smoking and preoperative reduced albumin level were the true modifiable factors.

Patients should be encouraged to cease smoking as early as possible and increase the good-quality protein intake to reduce or prevent the occurrence of SSI. An explanation of the nonmodifiable risk factors should be included when patients are counseled about their increased risk of SSI.
Assessment of the diagnostic value of using serum CA125 and GI-RADS system in the evaluation of adnexal masses
Authors: Zheng Heng , Tie Yan , Wang Xi , Yang Yang , Wei Xiawei , Zhao Xia
Published: February 2019

Cancer antigen 125 (CA125) is a valuable tumor marker for ovarian cancer. Gynecology Imaging Reporting and Data System (GI-RADS) is proved to be effective at identifying the adnexal masses. We investigated whether the combination of these two methods can improve the diagnostic accuracy of ovarian cancer.

We retrospectively analyzed preoperative data of 325 patients diagnosed with suspected adnexal mass, 196 patients with benign ovarian masses and 129 with malignant ovarian cancer (stage I: 34, II: 16, III: 61, IV: 18). CA125 was analyzed using the ARCHITECT system, GI-RADS was evaluated according to the International Ovarian Tumor Analysis consensus nomenclature and definitions. Sensitivities and specificities were also calculated for GI-RADS, CA125 and the combinations.

The sensitivity, specificity and accuracy of CA125, GI-RADS were 75.97%, 79.59%, 78.15%, and 90.70%, 90.82%,90.77%, the combination data were 94.79%, 96.00%,95.53%. The AUC of combined diagnostic methods was the largest and significantly better compared with each method alone, P < .001). For stage I-II malignancy, GI-RADS as a single method was superior to CA125.

Combined use of serum CA 125 and GI-RADS system improved the identification of adnexal masses at high risk of malignancy and could be used for clinical decision-making.
How Much Does Medication Nonadherence Cost the Medicare Fee-for-Service Program?
Authors: Lloyd Jennifer T. , Maresh Sha , Powers Christopher A. , Shrank William H. , Alley Dawn E.
Published: February 2019

Background:

Medication adherence is associated with lower health care utilization and savings in specific patient populations; however, few empirical estimates exist at the population level.

Objective:

The main objective of this study was to apply a data-driven approach to obtain population-level estimates of the impact of medication nonadherence among Medicare beneficiaries with chronic conditions.

Research Design:

Medicare fee-for-service (FFS) claims data were used to calculate the prevalence of medication nonadherence among individuals with diabetes, heart failure, hypertension, and hyperlipidemia. Per person estimates of avoidable health care utilization and spending associated with medication adherence, adjusted for healthy adherer effects, from prior literature were applied to the number of nonadherent Medicare beneficiaries.

Subjects:

A 20% random sample of community-dwelling, continuously enrolled Medicare FFS beneficiaries aged 65 years or older with Part D (N=14,657,735) in 2013.

Measures:

Avoidable health care costs and hospital use from medication nonadherence.

Results:

Medication nonadherence for diabetes, heart failure, hyperlipidemia, and hypertension resulted in billions of Medicare FFS expenditures, millions in hospital days, and thousands of emergency department visits that could have been avoided. If the 25% of beneficiaries with hypertension who were nonadherent became adherent, Medicare could save $13.7 billion annually, with over 100,000 emergency department visits and 7 million inpatient hospital days that could be averted.

Conclusion:

Medication nonadherence places a large resource burden on the Medicare FFS program. Study results provide actionable information for policymakers considering programs to manage chronic conditions. Caution should be used in summing estimates across disease groups, assuming all nonadherent beneficiaries could become adherent, and applying estimates beyond the Medicare FFS population.
New and Emerging Biomarkers in Endocrine Pathology
Authors: Papathomas Thomas G. , Nosé Vania
Published: February 2019

Significant advances in genomics and molecular genetics in recent years have reshaped the practice of endocrine pathology. Pan-genomic studies, including the pioneering ones on papillary thyroid carcinoma, phaeochromocytoma/paraganglioma, and adrenal cortical carcinoma from the Cancer Genome Atlas (TCGA) project, provided a comprehensive integrated genomic analysis of endocrine tumors into distinct molecularly defined subtypes. Better understanding of the molecular landscape and more accurate definition of biological behavior has been accordingly achieved. Nevertheless, how any of these advances are translated into routine practice still remains a challenge in the era of precision medicine. The challenge for modern pathology is to keep up the pace with scientific discoveries by integrating novel concepts in tumor classification, molecular genetics, prognostication, and theranostics. As an example, pathology plays a role in the identification of hereditary disease, while it offers the tools for complementing molecular genetics, for example, validation of variants of unknown significance deriving from targeted sequencing or whole exome/genome sequencing approach. Immunohistochemistry has arisen as a cost-effective strategy in the evaluation either of somatic mutations in tumors and/or germline mutations in patients with familial cancer syndromes. Herein, a comprehensive review focusing on novel and emerging biomarkers is presented in order pathologists and other endocrine-related specialists to remain updated and become aware of potential pitfalls and limitations in the field of endocrine pathology.
Mycetocola zhujimingii sp. nov., isolated from faeces of Tibetan antelopes (Pantholops hodgsonii)
Authors: Li Junqin , Yang Jing , Lu Shan , Jin Dong , Lai Xin-He , Zhang Gui , Tian Zhi , Pu Ji , Wu Xiaomin , Huang Ying , Wang Suping , Xu Jianguo
Published: February 2019

Strains 449T and 622 are both aerobic, Gram-stain-positive, short, rod-shaped bacilli that were recently isolated from the faeces of Tibetan antelopes on the Qinghai–Tibet Plateau in China. Their 16S rRNA gene sequences were most similar to those of

Mycetocola zhadangensis

ZD1-4T(97.9–98.0 %) and

Mycetocola miduiensis

CGMCC 1.11101T(97.3–97.4 %). Phylogenetic analysis of the 16S rRNA gene sequences further suggested that strains 449T and 622 represent a new lineage within the genus

Mycetocola
. The G+C content of strain 449T is 64.9 mol%. Optimal growth was achieved at pH 7.0 and 28 °C. Cells contained anteiso-C15 : 0 as the major cellular fatty acid, MK-10 and MK-11 as predominant menaquinones, diphosphatidylglycerol and phosphatidylglycerol as major polar lipids, and lysine as the diagnostic diamino acid. The DNA–DNA hybridization values of strains 449T and 622 were below the 70 % cut-off with respect to known strains of the genus

Mycetocola

. Based on these genotypic, phenotypic and biochemical characteristics, it seems rational to conclude that strains 449T and 622 belong to the genus

Mycetocola

and thus represent a novel species, for which the name

Mycetocola
zhujimingii sp. nov. is proposed. The type strain is 449T (=CGMCC 1.16372T=DSM 106173T).
Comparative genomics of Parolsenella catena and Libanicoccus massiliensis: Reclassification of Libanicoccus massiliensis as Parolsenella massiliensis comb. nov.
Authors: Sakamoto Mitsuo , Ikeyama Nao , Murakami Takumi , Mori Hiroshi , Yuki Masahiro , Ohkuma Moriya
Published: February 2019

Previous analyses based on 16S rRNA and hsp60 genes indicated that Parolsenella catena and Libanicoccus massiliensis were closely related to each other and formed a monophyletic cluster independent of the related

Olsenella

species. To clarify the relationship of these two species, we determined the genome sequence of

P. catena

JCM 31932T and compared it with that already sequenced for

L. massiliensis

Marseille-P3237T. Phylogenetic trees based on the concatenated 37 single-copy ribosomal proteins or RpoB robustly supported the relationship observed in the previous studies. Digital DNA–DNA hybridization and average nucleotide identity (ANI) values between

P. catena

JCM 31932T and

L. massiliensis

Marseille-P3237T were 32.6 and 87.8 %, respectively, indicating that

P. catena

JCM 31932T and

L. massiliensis

Marseille-P3237T are independent species. Alignment fraction and ANI values between the two genomes were 0.75 and 88.84 %, respectively, thus indicating that the two species should be classified into the same genus. The number of putative orthologous genes shared between the two genomes was 1321, which was significantly larger than those (482–928) reported between

L. massiliensis

Marseille-P3237T and other closely related species. In addition, the genome of

P. catena

JCM 31932T had a high degree of synteny conservation with that of

L. massiliensis

Marseille-P3237T. On the basis of these findings, we propose that

L. massiliensis

should be reclassified as Parolsenella massiliensis comb. nov.; the type strain is Marseille-P3237T (=JCM 33000T=CCUG 71182T).
녹차 추출물의 민물장어 과산화 억제효과
Authors: Song Hee-Sun
Published: February 2019

장어의 과산화 억제를 위해 녹차의 물추출물과 시판소주(30°)를 용매로 추출한 녹차 주정추출물을 장어 전처리용 시료로 사용하였다. 장어 80 g에 녹차 추출액 150 mL에 1시간 담근 후 세척하여 장어를 전처리하였다. 추출물의 항산화활성은 DPPH 및 ABTS 소거활성, 반건조 장어의 산가, 과산화물가, 카보닐가, TBA가, 리놀레산 및 장어유 과산화 지연반응을 통해 확인하였다. 녹차 주정추출물이 DPPH 및 ABTS 소거에서 가장 높은 활성을 보였고, 비타민 C 10 mM와 유사한 활성을 보였다(p<0.05). 장어에 녹차 물 및 주정 추출물을 전처리한 후 21일간 냉장저장 하면서 장어의 산화정도를 측정하였다. 녹차 추출물을 처리한 경우, 산가, 과산화물가, 카보닐가, TBA가를 무처리한 경우보다 낮추어 과산화 억제에 효과가 있는 것으로 판단되었다. 또한 리놀레산 및 장어유의 과산화 유도기간을 지연시켜 과산화를 억제하는 효과가 있었다. 특히 녹차 주정 추출물은 vitamin C 10 mM과 유사한 항산화 효과가 있는 것으로 나타났다. 본 연구의 결과를 종합해 볼 때, 장어에 녹차 주정(30° 소주)추출물로 전처리하는 것은 장어의 냉장보관 중의 과산화를 억제시키는 데 효과가 있는 것으로 판단되었다.
Memory enhancing activity of extract of new citrus cultivar ‘Shinyegam’in mice
Authors: Kim Sang Suk , Park Ji Yong , Lee Won Chang , Park Chang-Yong , Ko Bong-Hyon , Jeon Yoon-A , Park Kyung Jin , An Hyun Joo , Kang Seok Beom , Yun Su Hyun , Choi Young Hun , Lee Young Jae
Published: February 2019

A new mandarin hybrid cultivar called ‘Shinyegam’ was developed from a cross between ‘Kiyomi’ (Citrus unshiu × C. sinensis) and ‘Wilking’ (Citrus reticulata) at the Citrus Research Institute of the National Institute of Horticultural and Herbal Science in 2012. The ‘Shinyegam’ was extracted with 70% ethanol (SYGE), and polyphenol content was measured to assess total antioxidant activity of flavonoids. Radical scavenging activities of the extracts were examined using a-a-diphenyl-β-picrylhydrazyl (DPPH), 2,2-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid (ABTS), and ferric reducing antioxidant power (FRAP) assays. SYGE showed high polyphenol and flavonoid content as well as strong DPPH, ABTS, and FRAP radical scavenging activity. We used a mouse model to assess the memory enhancing properties of SYGE and its ameliorating activities on learning and memory impairments. Drug-induced amnesia was initiated by scopolamine treatment (2 mg/kg, interperitoneal). SYGE administration (25 mg/kg, oral) significantly enhanced cognitive function and attenuated scopolamine-induced cognitive impairments as determined by novel object recognition, passive avoidance and Y-maze tasks. In addition, SYGE increased brain-derived neurotrophic factor (BDNF) expression in the hippocampus. These results suggest that SYGE enhances learning and memory in normal states and attenuates memory loss caused by cholinergic dysfunction.
96 Eyes: Parallel Fourier Ptychographic Microscopy for high-throughput screening
Authors: Chan Antony C. S. , Kim Jinho , Pan An , Xu Han , Nojima Dana , Hale Christopher , Wang Songli , Yang Changhuei
Published: February 2019

We report the implementation of a parallel microscopy system (96 Eyes) that is capable of simultaneous imaging of all wells on a 96-well plate. The optical system consists of 96 microscopy units, where each unit is made out of a four element objective, made through a molded injection process, and a low cost CMOS camera chip. By illuminating the sample with angle varying light and applying Fourier Ptychography, we can improve the effective brightfield imaging numerical apertuure of the objectives from 0.23 to 0.3, and extend the depth of field from ±5 μm to ±15 μm. The use of Fourier Ptychography additionally allows us to computationally correct the objectives’ aberrations out of the rendered images, and provides us with the ability to render phase images. The 96 Eyes acquires raw data at a rate of 0.7 frame per second (all wells) and the data are processed with 4 cores of graphical processing units (GPUs; GK210, Nvidia Tesla K80, USA). The system is also capable of fluorescence imaging (excitation = 465 nm, emission = 510 nm) at the native resolution of the objectives. We demonstrate the capability of this system by imaging S1P1-eGFP-Human bone osteosarcoma epithelial (U2OS) cells.
Potato genotypes differentially alter the expression of Phytophthora infestans effectors during PAMP-mediated resistance induction
Authors: Thomas Cécile , Boulch Pauline Le , Andrivon Didier , Val Florence
Published: February 2019

Pathogen recognition by plants via pathogen-associated molecular patterns leads to PAMP-triggered immunity. However, pathogens can modulate it via the secretion of effectors. We hypothesize that in potato, induced defense triggered by a Phytophthora infestans concentrated culture filtrate (CCF) could alter both effector expression and disease severity.

CCF was sprayed onto three potato genotypes with different resistance levels, before inoculation with P. infestans. Symptoms were scored visually at 1-4 dpi, while the expression of defense and effector genes was assessed by qRT-PCR.

CCF induced most defense genes in Désirée (PRs, EIN3) and Bintje (PRs, PAL and POX), but repressed most defense genes in Rosafolia. On the contrary, CCF induced most effector genes in Rosafolia (Pi03192, Avrblb2, Avr3a, EPIC2B and SNE1). INF1 was over-expressed in Bintje, despite its earlier expression in both Désirée and Rosafolia compared to unsprayed controls. Pi03192 was repressed in Désirée, and was expressed earlier in Rosafolia than in controls. However, induced defense responses by CCF significantly reduced lesion areas at 3 dpi only in Désirée.

The effectiveness of induced defense thus depends on host genotypes. It results from differential interactions and kinetics of defense and effector genes expressions.
Comprehensive network analysis reveals alternative splicing-related lncRNAs in hepatocellular carcinoma
Authors: Wang Junqing , Chen Yixin , Xu Keli , Mo Yin-yuan , Zhou Yunyun
Published: February 2019

A number of recent studies have highlighted the findings that certain lncRNAs are associated with alternative splicing (AS) in tumorigenesis and progression. Although existing work showed the importance of linking certain misregulations of RNA splicing with lncRNAs, a primary concern is the lack of genome-wide comprehensive analysis for their associations.

We analyzed an extensive collection of RNA-seq data, quantified 198,619 isoform expressions, and found systematic isoform usage changes between hepatocellular carcinoma (HCC) and normal liver tissue. We identified a total of 1375 splicing switched isoforms and further analyzed their biological functions.

To predict which lncRNAs are associated with these AS genes, we integrated the co-expression networks and epigenetic interaction networks collected from text mining and database searching, linking lncRNA modulators such as splicing factors, transcript factors, and miRNAs with their targeted AS genes in HCC. To model the heterogeneous networks in a single framework, we developed a multi-graphic random walk (RWMG) network method to prioritize the lncRNAs associated with AS in HCC. RWMG showed a good performace evaluated by ROC curve based on cross-validation and bootstrapping strategy.

As a summary, we identified 31 AS-related lncRNAs including MALAT1 and HOXA11-AS, which have been reported before, as well as some novel lncRNAs such as DNM1P35, HAND2-AS1, and DLX6-AS1. Survival analysis further confirmed the clinical significance of identified lncRNAs.