bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors That Predict Institutional Adoption of Professional Physical Therapist Education Programs
Authors: Dickson Tara , Taylor Barrett J
Published: March 2019

Background

Between 1995 and 2015, the number of accredited physical therapist education programs in the United States rose from 127 to 224. Colleges and universities have been known to develop new programs in an effort to generate revenues through student tuition.

Objective

In the present study, sources of institutional revenue and expenditures were used as predictors for the adoption of physical therapist education programs.

Design

Yearly data from the Integrated Postsecondary Education Data System for 1731 higher education institutions were combined with dates from the Commission on Accreditation in Physical Therapy Education for physical therapist education program accreditation from 1995 to 2015.

Methods

A retrospective event history analysis of yearly institutional data was used to calculate the hazard of an institution adopting a physical therapist education program on the basis of institutional revenues and expenditures.

Results

Private institutions were 62% less likely to adopt a physical therapist education program when they experienced a 1% increase in total revenue per full-time–equivalent student. Conversely, a given private institution was 2.71 times more likely to adopt a physical therapist education program for every 1% increase in total expenditures per full-time–equivalent student. Both public and private institutions experienced an increased chance of adopting an entry-level (professional) physical therapist education program when instructional expenditures rose. They were also more than twice as likely to adopt physical therapist education programs when they experienced a 1% increase in the number of students.

Limitations

Causation between professional physical therapist education program adoption and the variables studied cannot be determined through observational analysis alone.

Conclusions

The more revenue a private institution generated, the less likely it was to add a program in the search for further revenues. As expenses rose, the chance of adoption trended upward beyond increases in institutional revenues for both public and private not-for-profit institutions.
Evaluation complacency or evaluation inertia? A study of evaluative metrics and research practices in Irish universities
Authors: Ma Lai , Ladisch Michael
Published: March 2019

Evaluative metrics have been used for research assessment in most universities and funding agencies with the assumption that more publications and higher citation counts imply increased productivity and better quality of research. This study investigates the understanding and perceptions of metrics, as well as the influences and implications of the use of evaluative metrics on research practices, including choice of research topics and publication channels, citation behavior, and scholarly communication in Irish universities. Semi-structured, in-depth interviews were conducted with researchers from the humanities, the social sciences, and the sciences in various career stages. Our findings show that there are conflicting attitudes toward evaluative metrics in principle and in practice. The phenomenon is explained by two concepts: evaluation complacency and evaluation inertia. We conclude that evaluative metrics should not be standardized and institutionalized without a thorough examination of their validity and reliability and without having their influences on academic life, research practices, and knowledge production investigated. We also suggest that an open and public discourse should be supported for the discussion of evaluative metrics in the academic community.
‘To Be Shut Up’: New Evidence for the Development of Quarantine Regulations in Early-Tudor England
Authors: Roger Euan C
Published: March 2019

On 13 January 1518, a series of ordinances to regulate plague outbreaks were proclaimed in London. These have previously been thought to have been the first set of quarantine measures issued in England; part of an ambitious new social policy led by the King’s chief minister, Cardinal Thomas Wolsey, and intended to bring England in line with the leading Renaissance states in Europe. The discovery of two previously unknown documents from the archives of St George’s College, Windsor—which predate the London ordinances—requires a reconsideration of this narrative. The article argues that demands for plague quarantine regulations were driven primarily by Henry VIII’s personal and pronounced fear of infection and considers the factors that may have led to such a fear. In doing so, it introduces new evidence for the death of Henry’s grandmother, Elizabeth Woodville, and explores the ways in which medical ideas travelled across Europe.
Genome Sequence Resources for Four Phytopathogenic Fungi from the Colletotrichum orbiculare Species Complex
Authors: Gan P. , Tsushima A. , Narusaka M. , Narusaka Y. , Takano Y. , Kubo Y. , Shirasu K.
Published: March 2019

Colletotrichum orbiculare species complex fungi are hemibiotrophic plant pathogens that cause anthracnose of field crops and weeds. Members of this group have genomes that are remarkably expanded relative to other Colletotrichum fungi and compartmentalized into AT-rich, gene-poor and GC-rich, gene-rich regions. Here, we present an updated version of the C. orbiculare genome, as well as draft genomes of three other members from the C. orbiculare species complex: the alfalfa pathogen C. trifolii, the prickly mallow pathogen C. sidae, and the burweed pathogen C. spinosum. The data reported here will be important for comparative genomics analyses to identify factors that play a role in the evolution and maintenance of the expanded, compartmentalized genomes of these fungi, which may contribute to their pathogenicity.
Eight Species of Fusarium Cause Root Rot of Corn (Zea mays) in South Dakota
Authors: Okello Paul N. , Petrović Kristina , Kontz Brian , Mathew Febina M.
Published: March 2019

Fusarium root rot of corn (Zea mays L.) is yield-limiting in the United States, but there is no information available on the disease in South Dakota. In 2015, corn seedlings with discolored roots were arbitrarily sampled from 50 South Dakota fields, and 198 isolates were recovered. Eight species (F. acuminatum, F. boothii, F. equiseti-incarnatum complex, F. graminearum, F. oxysporum, F. proliferatum, F. solani, and F. subglutinans) were identified by morphology and translation elongation factor 1-α gene sequencing. F. graminearum (26.8%) was the most common fungus, and F. boothii (0.5%) was the least recovered. Fourteen isolates, representing the eight species, were evaluated for their pathogenicity on 2-week-old seedlings of inbred ‘B73’ using the inoculum layer method in the greenhouse. Fourteen days postinoculation, root rot severity was evaluated on a 1-to-5 rating scale and expressed as relative treatment effects (RTEs). F. proliferatum isolate P2 caused significantly greater RTE (based on 95% confidence intervals) on seedlings than the other isolates and the noninoculated control, except F. graminearum isolate FG23. This study indicates that the eight species of Fusarium are aggressive root rot pathogens of corn in South Dakota, and this information will help evaluate strategies for producers to manage these pathogens in their fields.
Effects of Anaerobic Soil Disinfestation on Sclerotinia sclerotiorum in Paraguay
Authors: Sanabria-Velazquez Andres D. , Testen Anna L. , Enciso Guillermo A. , Soilan Laura C. , Miller Sally A.
Published: March 2019

The effects of anaerobic soil disinfestation (ASD) on Sclerotinia sclerotiorum sclerotia viability was tested in four field trials in Paraguay. Plots were amended with wheat bran (20.2 Mg/ha), molasses (10.1 Mg/ha), or wheat bran (20.2 Mg/ha) plus molasses (10.1 Mg/ha), saturated with water, and covered with black plastic mulch for 3 weeks. Control plots were not amended but were saturated and either covered (anaerobic control) or maintained uncovered (aerobic control). Tubes painted with iron oxide paint were placed in soils to assess soil reducing conditions. Sclerotia were buried 6 cm deep in treated and control soils along with temperature data loggers. After 3 weeks, the viability of sclerotia was significantly lower in all ASD-treated soils (4 to 52%) compared with the aerobic control soil (100%), regardless of the carbon source used. Sclerotial viability was also significantly reduced compared with anaerobic controls at three sites, depending on the carbon source used. A significant negative correlation between soil reducing conditions and sclerotia viability was observed at all sites. Wheat bran and molasses are widely available and inexpensive in Paraguay, and ASD with these carbon sources provides smallholder South American vegetable farmers with a new option for sustainable management of Sclerotinia and potentially other soilborne pathogens.
Acute compartment syndrome
Authors: Harding Margaret Meyer
Published: March 2019

Acute compartment syndrome (ACS) is a true orthopedic emergency. NPs in all settings should be able to recognize ACS to ensure swift surgical intervention is not delayed. This article highlights a systematic approach to exam and diagnosis.
An Interdisciplinary, Multi-Institution Telehealth Course for Third-Year Medical Students
Authors: Jonas Christopher E. , Durning Steven J. , Zebrowski Catherine , Cimino Francesca
Published: March 2019

Problem

The American Medical Association has called for telehealth to become a core competency of medical students. Studies indicate that a principal reason physicians do not practice telehealth is lack of training, yet patient interest in and satisfaction with telehealth are high. No comprehensive U.S. undergraduate medical education curriculum teaching telehealth principles has been published.

Approach

In February 2018, the Uniformed Services University of the Health Sciences (USU) provided an innovative telehealth training experience for third-year medical students. USU led an interinstitutional, interprofessional learner-centered course including six segments: (1) multiple-choice pretest; (2) asynchronous lectures covering telehealth history, applications, ethics, safety, military uses, etiquette, and patient considerations; (3) in-person interactive telehealth instruction including patient selection, current uses, and risk management; (4) faculty-supervised mock patient telehealth encounters; (5) hands-on diagnosis and advanced surgical procedures using telehealth equipment; and (6) multiple-choice posttest.

Outcomes

This course was piloted with 149 third-year medical students. Students’ improvement in telehealth knowledge was demonstrated through (1) 10.1% average improvement between pre- and posttest scores, (2) completion of competency-based checklists, and (3) postcourse preceptor and student feedback. Faculty feedback indicated that technology use was novel and effective based on student input. Faculty noted that students enjoyed engaging via videoconference. Of participating medical students, 119 (80%) indicated future plans to practice telehealth; several requested to be part of future telehealth courses.

Next Steps

Telehealth will be integrated into clinical rotations in collaboration with other institutions. As the telehealth curriculum is taught at other institutions, lessons learned will inform enhancements at USU.
Near-infrared Spectroscopy–derived Cerebral Autoregulation Indices Independently Predict Clinical Outcome in Acutely Ill Comatose Patients
Authors: Rivera-Lara Lucia , Geocadin Romegryko , Zorrilla-Vaca Andres , Healy Ryan , Radzik Batya R. , Palmisano Caitlin , White Mirinda A. , Sha Dhaval , Ponce-Mejia Luciano , Brown Charles , Hogue Charles , Ziai Wendy C.
Published: March 2019

Objective:

Outcome prediction in comatose patients with acute brain injury remains challenging. Regional cerebral oxygenation (rSO2) derived from near-infrared spectroscopy (NIRS) is a surrogate for cerebral blood flow and can be used to calculate cerebral autoregulation (CA) continuously at the bedside from the derived cerebral oximetry index (COx). We hypothesized that COx derived thresholds for CA are associated with outcomes in patients with acute coma from neurological injury.

Methods:

A prospective cohort study was conducted in 88 acutely comatose adults with heterogenous brain injury diagnoses who were continuously monitored with COx for up to 3 consecutive days. Multivariable logistic regression was performed to investigate association between averaged COx and short (in-hospital and 3 mo) and long-term (6 mo) outcomes.

Results:

Six month mortality rate was 62%. Median COx in nonsurvivors at hospital discharge was 0.082 [interquartile range, IQR: 0.045 to 0.160] compared with 0.042 [IQR: −0.005 to 0.110] in survivors (P=0.012). At 6 months, median COx was 0.075 [IQR: 0.27 to 0.158] in nonsurvivors compared with 0.029 [IQR: −0.015 to 0.077] in survivors (P=0.02). In the multivariable logistic regression model adjusted for confounders, average COx ≥0.05 was associated with both in-hospital mortality (adjusted odds ratio [OR]=2.9, 95% confidence interval [CI]=1.15-7.33, P=0.02), mortality at 6 months (adjusted OR=4.4, 95% CI=1.41-13.7, P=0.01), and severe disability (modified Rankin Score ≥4) at 6 months (adjusted OR=4.4, 95% CI=1.07-17.8, P=0.04). Area under the receiver operating characteristic curve for predicting mortality and severe disability at 6 months were 0.783 and 0.825, respectively.

Conclusions:

Averaged COx ≥0.05 is independently associated with short and long-term mortality and long-term severe disability in acutely comatose adults with neurological injury. We propose that COx ≥0.05 represents an accurate threshold to predict long-term functional outcome in acutely comatose adults.
Bone Conduction Amplification in Children: Stimulation via a Percutaneous Abutment versus a Transcutaneous Softband
Authors: Pittman Andrea L.
Published: March 2019

Objectives:

Research suggests that the speech perception of children using bone conduction amplification improves if the device is coupled to an implanted abutment rather than to a softband. The purpose of the present study was to determine if the benefit of direct stimulation via an abutment is limited to small improvements in speech perception or if similar or greater benefits occur for other auditory tasks important for learning and communication.

Design:

Fourteen children (7 to 15 years of age) with bilateral conductive and three children with unilateral conductive or sensorineural hearing loss were enrolled. Each child completed four tasks while using a bone conduction device coupled to an implanted abutment and with the device coupled to a softband. The two devices were worn at the same time and activated one at a time for testing. The children completed four tasks under each coupling condition: (a) a traditional word recognition task, (b) an auditory lexical decision task in which the children repeated aloud, and indicated the category of, real and nonsense words, (c) a nonsense-word detection task which required the children to identify nonsense words within short sentences, and (d) a rapid word learning task in which the children learned to associate nonsense words with novel images.

Results:

Regression analyses revealed that age, duration of device use, in-situ hearing thresholds, or device output did not account for a significant portion of the variability in performance for any of the four tasks. Repeated-measures analysis of variance revealed significant increases in word recognition with the abutment as well as significantly better performance for the lexical decision and word learning tasks. The data indicated that the children with the poorest performance with the softband tended to benefit most with the abutment. Also, the younger children showed improved performance for more tasks with the abutment than the older children. No difference between coupling conditions was observed for nonsense-word detection.

Conclusions:

The improved recognition of familiar words, categorization and repetition of nonsense words, and speed of word learning with the abutment suggests that direct stimulation provides a higher-quality signal than indirect stimulation through a softband. Because these processes are important for vocabulary acquisition and language development, children may experience long-term benefits of direct stimulation for academic, social, and vocational purposes in addition to immediate improvement in communication.
An Ig Transmembrane Domain Motif Improves the Function of TCRs Transduced in Human T Cells: Implications for Immunotherapy
Authors: D’Apice Luciana , Cuccaro Fausta , Varriale Sonia , Cipria Deborah , Sartorius Rossella , Circosta Paola , Cignetti Alessandro , Salerno Massimiliano , Coscia Maria R. , Oreste Umberto , Marzullo Vincenzo M. , Martini Giuseppe , Acuto Oreste , De Berardinis Piergiuseppe
Published: March 2019

Adoptive transfer of T lymphocytes (ACT) engineered with T-cell receptors (TCRs) of known antitumor specificity is an effective therapeutic strategy. However, a major constraint of ACT is the unpredictable interference of the endogenous TCR α and β chains in pairing of the transduced TCR. This effect reduces the efficacy of the genetically modified primary T cells and carries the risk of generating novel TCR reactivities with unintended functional consequences. Here, we show a powerful approach to overcome these limitations. We engineered TCR α and β chains with mutations encompassing a conserved motif (FXXXFXXS) required to stabilize the pairing of immunoglobulin heavy chain transmembrane domains. Molecular modeling supported the preferential pairing of mutated TCR and impaired pairing between mutated and wild-type TCRs. Expression of the mutated TCR was similar to wild type and conferred the expected specificity. Fluorescence resonance energy transfer analysis in mouse splenocytes transduced with mutated or wild-type TCRs showed a higher proximity of the former over the latter. Importantly, we show that mutated TCRs effectively outcompete endogenous TCRs and improve in vitro antitumor cytotoxicity when expressed in ex vivo isolated human T cells. This approach should contribute to improving current protocols of anticancer immunetherapy protocols.
Nurses' Perspectives on Spiritual Caregiving
Authors: Janzen Kyla C. , Reimer-Kirkham Sheryl , Astle Barbara
Published: March 2019

This qualitative secondary analysis explored the narratives of 14 nurses from various practice settings. Data analysis identified that although nurses share responsibility for spiritual caregiving for their patients, the ability to provide this care is greatly influenced by intrinsic and the extrinsic factors. Spiritual caregiving was seen as both a discrete act that facilitated patients' spiritual practices and, in other situations, took the form of integrative spiritual caregiving that was part of the interpersonal connection in the nurse–patient relationship.
Crescentic Modification to Island Pedicle Rotation Flaps for Defects of the Distal Nose
Authors: Howe Nicole M. , Chen David L. , Holmes Todd E.
Published: March 2019

BACKGROUND

Island pedicle flaps based on a lateral sling of the nasalis have difficulty reaching distal nasal defects due to tethering of the muscle to its insertion point. The authors hypothesized that reach could be improved by modifying a crescentic flap to rotate around a pivot point equidistant to the flap and the defect.

OBJECTIVE

To describe the design, execution, and results with a modified crescentic island pedicle rotation flap for repair of distal nasal defects after Mohs micrographic surgery.

METHODS

The authors performed a retrospective analysis of patients who had distal nasal defects repaired with a modified crescentic island pedicle rotation flap over an 8-year period. All charts and photographs were examined. Sex and age of the patient, type of cutaneous carcinoma, location and size of the defect, and complications were recorded.

RESULTS

Forty-eight patients were included. The flap was used to successfully reconstruct defects on the distal nose ranging in size from 0.25 cm2 to 3.8 cm2. Complications involved one wound infection and one episode of postoperative bleeding.

CONCLUSION

The authors' modifications to the island pedicle flap may be reliably used to reconstruct small- to medium-sized defects of the distal nose in a single stage with minimal risk of complications.
Shear Wave Elastography in the Evaluation of Facial Skin Stiffness After Focused Ultrasound Treatment
Authors: Paluch Lukasz , Ambroziak Marcin , Pietruski Piotr , Noszczyk Bartlomiej
Published: March 2019

BACKGROUND

No objective method for the evaluation of facial aesthetic procedures has been proposed thus far. The authors hypothesized that shear wave elastography may be an appropriate method to evaluate the outcomes of some aesthetic treatments.

OBJECTIVE

The aim of the study was to compare elastographic parameters of facial skin, subcutaneous fat, and superficial musculoaponeurotic system before high-intensity focused ultrasound treatment and 60 days after this procedure.

METHODS AND MATERIALS

The study included 57 female patients aged 51.5 ± 7.3 years. Shear wave elastography of facial skin was performed before the aesthetic procedure and 2 months thereafter.

RESULTS

Baseline stiffness of all examined layers correlated inversely with patients' age. Sixty days after the aesthetic treatment, the stiffness of all tissues improved significantly. The extent of the improvement correlated inversely with patients' body mass index.

CONCLUSION

Shear wave elastography can accurately assess the outcomes of facial treatment with high-intensity focused ultrasound. Using this method, the authors documented improved stiffness of facial skin as early as 60 days after the procedure. The beneficial effect of the aesthetic treatment was observed regardless of patients' age but was less evident in women with excess body weight.
Orbital Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma: An Ongoing Diagnostic Challenge Further Confounded by Small-Cell Predominance
Authors: Wolkow Natalie , Jakobiec Frederick A. , Habib Larissa A. , Freitag Suzanne K.
Published: March 2019

Purpose:

To highlight the histopathologic diagnostic challenges of small-cell predominant extranodal nasal-type natural killer/T-cell lymphoma (ENTNKT) of the orbit.

Methods:

Retrospective chart review and histopathologic study with immunohistochemistry and in situ hybridization of 3 cases.

Results:

Three cases of ENTNKT presented to the Mass Eye and Ear emergency room as orbital cellulitis over 1 year. The first case was unusual in that there was a predominance of small cells, giving the ENTNKT the histopathologic appearance of a nonmalignant inflammatory process. This challenging case is juxtaposed alongside 2 other cases, which exhibited the more typical lymphomatous microscopic appearance.

Discussion:

ENTNKT can extend into the orbit from the adjacent sinuses or rarely arise primarily in the orbit. A diagnosis is typically made with a biopsy. Occasionally, however, the histopathologic diagnosis can be elusive when a predominance of small lymphomatous cells that are virtually indistinguishable from non-neoplastic inflammatory cells is present. Demonstration of CD56 positivity by immunostaining and in situ hybridization for Epstein–Barr virus are essential in confirming the diagnosis.

Conclusions:

ENTNKT should be considered both in the clinical and histopathologic differential diagnoses of orbital infections and idiopathic inflammations (pseudotumor).
Occult Nasolacrimal Duct Obstruction Secondary to IgG4-Related Ophthalmic Disease
Authors: Alsoudi Amer , Copperman Thomas S. , Idowu Oluwatobi O. , Kersten Robert C.
Published: March 2019

A 68-year-old man with known history of IgG4-related disease presented with a 1-year history of mucoid discharge OD and progressive proptosis OS. MRI showed diffuse enlargement of the left lacrimal gland along with prolonged infiltrative changes involving the left extraocular muscles, supraorbital nerve, and infraorbital nerve. No identifiable masses were noted in either nasolacrimal drainage system on MRI. Due to clinical evidence of nasolacrimal duct obstruction, a right external dacryocystorhinostomy was performed along with biopsies of the right lacrimal sac and left lacrimal gland. Immunohistochemical stains identified IgG4-positive plasma cells in the biopsy of the right lacrimal sac indicative of secondary acquired nasolacrimal duct obstruction despite the absence of mass forming lesions on exam and nasolacrimal imaging. This report is the first to describe nasolacrimal drainage system IgG4-related ophthalmic disease involvement in an otherwise clinically and radiographically normal appearing tear drainage system.
Early Mobilization of Patients With External Ventricular Drains: Does Therapist Experience Matter?
Authors: Stout Kristen , Ankam Nethra S. , Athar M. Kamran , Bu Paula , Dabbish Nooreen S. , Leiby Benjamin E. , Melnyk Sara , Shah Syed Omar , Tarkiainen Ashley
Published: March 2019

Objective:

Growing evidence supports the benefits and safety of early mobilization of patients in intensive care units. Frequently cited barriers to early mobilization are insufficient staffing and training. This study examines the number of professionals and years of physical therapy or occupational therapy experience needed to mobilize patients in neuro-intensive care units with external ventricular drains (EVDs).

Design:

The study was a retrospective review of a prospective quality improvement database, which includes 185 encounters with 90 patients with EVDs from June 2014 through July 2015.

Results:

Ninety-five percent of encounters required at most 2 professionals for mobilization. No evidence of association between number of people required to mobilize and highest activity achieved was found. Neither the number of people to mobilize patients nor the primary therapist's years of experience were associated with the type of activity achieved or the occurrence of an adverse event.

Conclusion:

This analysis suggests that patients with EVDs in the neuro-intensive care unit can be safely and efficiently mobilized by physical therapists and occupational therapists of varying levels of clinical experience. Early mobilization of patients with EVDs may demand fewer staff resources than perceived by clinicians.
Red Plaques on Knees
Authors: Ivey Lauren A. , Wahjudi Ingrid , Jacob Sharon E.
Published: March 2019

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. This is a teledermatology case of an annular, papular eruption on both knees, ankles, and knuckles.
Burning Red Face
Authors: Amin Mina , Jacob Sharon E.
Published: March 2019

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. This is a teledermatology case of a burning red face.
Surgical Flaps in Mohs Micrographic Surgery
Authors: Goddard Lindsey , Ivey Lauren , Seeburger Jack
Published: March 2019

Skin cancer can be broadly categorized into melanoma and nonmelanoma skin cancer (NMSC). Squamous cell carcinoma and basal cell carcinoma are the most common subtypes of NMSC. When a patient presents with a skin finding suspect for NMSC, a confirming skin biopsy is performed. On the basis of the biopsy results, patient factors, and clinical characteristics of the cancer, an appropriate form of treatment is selected. Mohs micrographic surgery (or Mohs) is a tissue-sparing surgical approach, utilizing frozen section margin control. Once removal of the NMSC has been assured by Mohs surgery, the resultant skin defect is evaluated for repair. The choice of repair should maintain or restore function and aesthetic form while minimizing skin tension. Using a skin flap may be the best choice of repair to achieve these goals. Here, we describe both rotation and advancement flaps. Rotation flaps are constructed using an arciform incision adjacent to the original wound. Advancement flaps describe the movement of skin and tissue directly forward to close the wound, employing no rotational movement. There are three main subtypes of advancement flaps: unidirectional, bidirectional, and island pedicle or V-to-Y flaps.
Effect of Korean medicine as add-on therapy to phototherapy for psoriasis
Authors: Lee Sam-Ro , Kim Sungha , Park Chul-Eun , Lee Jun-Hwan , Lee Dong-Hyo
Published: March 2019

Rationale:

Psoriasis is a common chronic, immune-mediated inflammatory skin disease. Here, we describe 2 patients who presented with psoriasis to illustrate the potential efficacy of Korean medicine treatment combined with phototherapy.

Patient concerns:

A 33-year-old female (Case 1) and a 37-year-old male (Case 2) presented at the clinic with symptoms of itching, erythema, and scaliness.

Diagnosis:

Both patients were diagnosed with psoriasis based on the locations of erythema, as well as the appearance of circumscribed scaly papules and plaques.

Interventions:

Patients underwent 5 months (Case 1) and 8 months (Case 2) of treatments with acupuncture, herbal medicine, probiotics, and phototherapy.

Outcomes:

After treatment, the patients improved in Psoriasis Area and Severity Index score from 7 to 1.2 (Case 1), and 23.2 to 2.2 (Case 2).

Lessons:

These outcomes suggest that Korean medicine therapies combined with phototherapy may be effective for resolution of psoriasis; however, further research is needed to confirm these findings.
Tranexamic acid can reduce blood loss in patients undergoing intertrochanteric fracture surgery
Authors: Jiang Wenming , Shang Liyong
Published: March 2019

Background:

This meta-analysis aimed to assess whether administration tranexamic acid (TXA) could reduce blood loss and transfusion requirements in patients undergoing intertrochanteric fracture surgery.

Methods:

We performed an electronic search of PubMed (1950–October 2018), EMBASE (1974–October 2018), the Cochrane Library (October 2018 Issue 3), the Google database (1950–October 2018), and the Chinese Wanfang database (1950–October 2018). Studies were included in accordance with Population, Intervention, Comparison, Outcomes, and Setting (PICOS) including criteria. Intertrochanteric fracture patients prepared for surgery were selected. Administration with TXA and the placebo or no interventions were considered as an intervention and comparators, respectively. Measures related to total blood loss, blood loss in drainage, hemoglobin on postoperative day were analyzed. A fixed/random-effects model was used according to the heterogeneity assessed by the I
2 statistic. Data analysis was performed using Stata 12.0 software.

Results:

A total of five RCTs with 584 patients (TXA group = 289, control group = 298) were included in the meta-analysis. Based on the results, administration of TXA was associated with a reduction in total blood loss, blood loss in drainage, need for transfusion, length of hospital stay, and occurrence of hematoma (P < .05). Administration of TXA increased the hemoglobin level at 3 days after surgery (P < .05). There were no significant differences between the two groups in terms of the occurrence of deep venous thrombosis, pulmonary embolism, or infection (P > .05).

Conclusion:

Administration of TXA is associated with reduced total blood loss, postoperative hemoglobin decline, and transfusion requirements in patients with intertrochanteric fractures. Additional high-quality RCTs should be conducted in the future.
Transhepatic-intrahepatic branches of the portal vein catheterization for ex vivo liver resection and autotransplantation
Authors: Kong Junjie , Shen Shu , Yang Xianwei , Wang Wentao
Published: March 2019

Rationale:

There has been increased use of ex vivo liver resection and autotransplantation (ERAT) for treatment of end-stage hepatic alveolar echinococcosis (HAE). Rapid perfusion of the autograft in bench resection is always required to reduce the warm ischemia time (WIT) and to protect the function of the remnant liver. Nevertheless, the severe invasion of the portal hepatis sometimes makes it impossible to find a usable inflow rapidly and the process of perfusion could be delayed.

Patient concerns:

Two patients diagnosed with end-stage HAE combined with severe portal hepatis invasion were selected to undergo ERAT at our center.

Diagnosis:

Besides the large HAE lesions, the CT imaging of patient 1 showed that part of the intra- and extrahepatic portal vein (PV) had disappeared. Patient 2 had severe invasion of both of the right and left branches of the PV.

Interventions:

We introduced a new approach for perfusing the liver in ERAT using transhepatic-intrahepatic branches of the PV catheterization. Afterward, ERAT was successfully performed.

Outcomes:

For patient 1, the WIT was 2 minutes and the cold ischemia time (CIT) was 296 minutes. For patient 2, the WIT was 2 minutes and the CIT was 374 minutes. Patient 1 suffered stenosis of the common bile duct on postoperative day 14, and patient 2 recovered uneventfully. Both of the 2 patients were discharged from the hospital with normal laboratory values on postoperative day 31 and 15, respectively. The laboratory values for both patients at recent follow-up were normal.

Lessons:

Transhepatic-intrahepatic branches of the PV catheterization is useful for decreasing WIT and facilitating the management of ERAT. It is a useful technical variant that could be used in ERAT for treating patients with severe portal hepatis invasion.
Comparison of the psychometric properties of the EQ-5D-3L and SF-6D in the general population of Chengdu city in China
Authors: Zhao Longchao , Liu Xiang , Liu Danping , He Yan , Liu Zhijun , Li Ningxiu
Published: March 2019

The EQ-5D-3L and SF-6D are the most commonly used economic evaluation instruments. Data comparing the psychometric properties of the instruments are scarce in the Chinese population. This study compared the psychometric properties of these measures in the Chinese general population in Chengdu.

From October to December 2012, 2186 respondents (age ≥18) were selected from urban and rural areas of Chengdu, China, via multistage stratified cluster sampling. Correlations, scatter plots and Bland-Altman plots were used to explore the relationships between the 2 measures. Ceiling and floor effects were used to analyze the score distribution. The known-groups method was used to evaluate discriminant validity.

Among 2186 respondents, 2182 completed the questionnaire, and 2178 (18–82 years old, mean 46.09 ± 17.49) met the data quality requirement. The mean scores for the EQ-5D-3LCN, EQ-5D-3LUK, and SF-6DUK were 0.95 (Std: 0.11), 0.93 (Std: 0.15), and 0.79 (Std: 0.12), respectively. The correlations between domains ranged from 0.16 to 0.51. The correlation between the EQ-5D-3LCN and SF-6DUK and between the EQ-5D-3LUK and SF-6DUK was 0.46. The scatter plots and Bland-Altman plots demonstrated poor agreement between the EQ-5D-3L and SF-6D. The floor and ceiling effects were respectively 0.05% and 74.60% for the EQ-5D-3L and 0.05% and 2.53% for the SF-6DUK. The EQ-5D-3LCN, EQ-5D-3LUK and SF-6D have good discriminant validity in different sociodemographic and health condition groups. The SF-6D has higher level of discriminant validity in moderately healthy groups in the EQ-5D-3L full-health population.

Both the EQ-5D-3L and SF-6D are valid economic evaluation instruments in the Chinese general population in Chengdu but do not seem to be interchangeable. The EQ-5D-3L has a higher ceiling effect and higher level of discriminant validity among different sociodemographic groups, and the SF-6D has a lower ceiling effect and higher level of discriminant validity in health condition groups. Users may consider the evidence in the choice of these instruments.
Discussion on operative skills in the embolization of hydrosalpinx by hysteroscopic placement of a microcoil
Authors: Cai Hua-Lei , Pan Le-Yun , Wang Shun-Fang , Tian Yu , Zheng Xiao-Zhu , Yang Yan , Li Kun
Published: March 2019

This study aims to discuss the operative skills of hysteroscopic tubal embolization and reduce the occurrence of complications.

Ninety-four patients were divided into group A and group B. The main surgical technique in group A: when the inner sleeve is sent to the fallopian tube and no longer accessible (but no >3 cm), remove the guide wire and put into the microcoil. But in group B, there are four major surgical techniques. First, the depth at which the guide wire enters the tube was controlled at 2 cm. Second, the inner diameter of the fallopian tube must be explored to determine the type and shape of the coils. Third, saline should be used to separate the catheter. Fourth, it is to control the release speed of the coils. The superiority of the improved operation method was confirmed by comparing the surgical failure rate, incidence of complications, and cost of surgery before and after the procedure.

The reoperation rate of group A was 10% (3/30), while that of group B was 2.68% (3/112). The ectopic microcoils rate of group A was 6.67% (2/30), while that of group B was 0.89% (1/112). The microcoil damages rate of group 23.33% (7/30), while that of group B was 8.04% (9/112). All P values were <.01, and the difference was statistically significant.

Hysteroscopic tubal embolization is currently a new surgical procedure to block the fallopian tubes and prevent the reverse flow of fluid in the fallopian tubes into the uterine cavity. After we improved surgical techniques, the surgical failure rate, complication rate, and operation cost of fallopian tube embolization were significantly lower than before the improved method was applied. The improved techniques led to a higher success rate.
Massive hemoperitoneum and upper gastrointestinal hemorrhage following liver rupture secondary to gallbladder perforation
Authors: Lan Xiang , Xiang Yuanyuan , Liu Fei , Li Bo , Wei Yonggang , Zhang Hua
Published: March 2019

Rationale:

Available literature states that the common reasons for non-traumatic spontaneous liver rupture are hepatocellular carcinoma, macronodular cirrhosis, hemangioma, and other tumors; gallbladder perforation is not cited as a cause.

Patient concerns:

The patient presented with sudden-onset right upper quadrant pain with tarry stool for 3 days after eating with dysphoria and increasing thirst; gradually, hemorrhagic shock developed. He had no history of trauma, no background of chronic hepatitis, and no cirrhosis.

Diagnosis:

Hemorrhage secondary to spontaneous rupture of intrahepatic cholangiocarcinoma.

Interventions:

Left hemihepatectomy, cholecystectomy, and common bile duct exploration were performed.

Outcomes:

The patient was diagnosed with massive hemoperitoneum accompanying upper gastrointestinal hemorrhage following liver rupture secondary to gallbladder perforation. The postoperative course was uneventful and the patient was discharged after 10 days of hospitalization.

Lessons:

If patients present with non-traumatic spontaneous liver rapture accompanying cholelithiasis and gallbladder hematoma, gallbladder perforation should be considered as a differential diagnosis. Misdiagnosis can lead to incorrect treatment.
Hepatitis C virus infection is a risk factor for non-Hodgkin lymphoma
Authors: Zhu Xiaofeng , Jing Li , Li Xiaoming
Published: March 2019

Previous studies have reached conflicting results regarding the possibility that hepatitis C virus (HCV) infection may increase the risk of non-Hodgkin lymphoma (NHL). We performed a meta-analysis to clarify the relationship between HCV infection and development of NHL. The PubMed, Web of Science, and Embase databases were searched for relevant studies estimating the association between HCV infection and NHL risk through October 31, 2017. Fixed effects or random effects models were used to calculate the pooled odds ratio (OR) and its 95% confidence interval (CI). A total of 18 studies met the inclusion criteria. We found a positive association between HCV infection and NHL (pooled OR 1.69, 95% CI 1.40–2.03, P < .05). In conclusion, our meta-analysis suggested that HCV infection was associated with increased risk of developing NHL.
Single nucleotide polymorphism of rs2596542 and the risk of hepatocellular carcinoma development
Authors: Kuang Xue-Jun , Mo Dun-Chang , Qin Yan , Ahir Bhavesh K. , Wang Jian-Jun , Peng Zhao , Deng Zu-Liang
Published: March 2019

Background:

Major histocompatibility complex class I-related chain A (MICA) is considered as a tumor antigen, and its expression is affected by its genetic polymorphisms. However, the relationship between rs2596542 polymorphisms in MICA promoter region and hepatocellular carcinoma (HCC) is not fully elucidated so far. This study aims to explore the relationship between single nucleotide polymorphism of rs2596542 and the risk of HCC development through meta-analysis.

Methods:

MEDLINE, Web of Science, and EMBASE databases were systematically searched to identify relevant studies. A meta-analysis was performed to examine the association between MICA rs2596542 polymorphism and susceptibility to HCC. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.

Results:

Fourteen case–control studies involving 4,900 HCC cases and 19,519 controls were included. The MICA rs2596542C allele was significantly associated with decreased risk of HCC based on allelic contrast (OR = 0.76, 95% CI = 0.69–0.83, P 
< .001), homozygote comparison (OR = 0.57, 95% CI = 0.48–0.69, P 
< .001), and a recessive genetic model (OR = 0.77, 95% CI = 0.65–0.91, P 
< .001), whereas patients carrying the MICA rs2596542TT genotype had significantly higher risk of HCC than those with the CT or CC genotype (TT vs CT + CC, OR = 1.57, 95% CI = 1.36–1.81, P 
< .001). Subgroups analyses based on the ethnic or the source of control groups found very similar findings.

Conclusion:

The C allele in MICA rs2596542 is a protective factor for hepatocarcinogenesis, whereas the T allele is a risk factor. Further large and well-designed studies are needed to confirm this conclusion.
Comparison between video-assisted thoracoscopic lung cancer resection and robot-assisted lung cancer resection
Authors: Chai Tianci , Lin Yuhan , Shen Zhimin , Chen Sui , Zhang Zhenyang , Lin Wenwei , Zhang Peipei , Kang Mingqiang , Lin Jiangbo
Published: March 2019

Background:

Video-assisted thoracoscopic surgery (VATS) has developed rapidly and a variety of feasible technical methods have been formed. VATS is the main way of lung cancer resection nowadays with minor surgical incision and less bleeding. Robot-assisted thoracic surgery (RATS) is a revolution in surgical procedures and robotic pulmonary resection has been put to use by an increasing quantity of hospitals around the world. However, the widespread adoption of robot-assisted lung cancer resection is controversial. We aimed to evaluate quality metrics of these 2 different approaches of operation by this review and meta-analysis.

Methods and Analysis:

We will search Medline, Embase, Pubmed, Google Scholar, and the Cochrane Central Register of Controlled Trials for related literature published in any language before February 28, 2019. Propensity score matched comparative studies, prospective cohort studies; randomized controlled trials (RCTs) will be included. If sufficient data are available, we will perform subgroup analysis in different operative types of lung cancer resection.

Results:

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

Conclusion:

To our knowledge, this will be the first time to use meta-analysis to assess quality metrics of video-assisted thoracoscopic lung cancer resection and robot-assisted lung cancer resection. The results of this study will provide more proofs for researchers, clinicians, and patients with lung cancer to choose a suitable surgical procedure. There is not enough high-quality evidence of RCTs to be included, due to the characteristics of interventions. We will try to include some non-randomized controlled trials, small sample trails. Although our team has experience in carrying out a systematic review and meta-analysis, there may be high heterogeneity and low reliability of evidence, which is the limitation of this study.
The value of 18F-FDG PET/CT in the diagnosis of different size of solitary pulmonary nodules
Authors: Tang Kun , Wang Ling , Lin Jie , Zheng XiangWu , Wu Yiwei
Published: March 2019

This study aimed to evaluate the diagnostic value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for solitary pulmonary nodules (SPNs) with different diameters.

One hundred eighty two consecutive patients with SPN who underwent 18F-FDG PET/CT examination were retrospectively studied. Patients were categorized into 3 groups according to the diameter of nodules: Group A with the diameter of greater than or equal to 6 mm and less than or equal to 10 mm; Group B with diameter greater than 10 mm and less than or equal to 20 mm; Group C with diameter greater than 20 mm and less than or equal to 30 mm. The efficiency of PET/CT, PET and CT in the diagnosis of benign and malignant SPNs and different subgroup of SPNs was calculated. Receiver operating characteristic curves (ROCs) were drawn and area under the curves (AUCs) were compared between different groups.

The age, diameter, mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax) of benign and malignant nodules were significantly different (P < .05). For overall SPNs, the sensitivity, specificity, accuracy, PPV, and NPV of PET/CT were 98.35%, 77.05%, 91.21%, 89.47%, and 95.92%, respectively. The AUC of PET/CT was significantly larger than that of SUVmean, SUVmax, and CT (P < .05). For different size of SPNs, the AUC of PET/CT in group A was higher than that in group B and group C, but there was no significant difference with CT (P > .05). In group B, the accuracy of PET/CT in the diagnosis of SPN was significantly higher than that of CT (P < .05).

18F-FDG PET/CT demonstrated excellent performance in identifying different size of SPNs, especially for those with diameter between 11 and 20 mm, the diagnostic value of 18F-FDG PET/CT is significantly higher than other methods.
The association between socioeconomic status and prevalence of chronic kidney disease
Authors: Shen Quanquan , Jin Wei , Ji Shuiyu , Chen Xiaoying , Zhao Xiang , Behera Tapas Ranjan
Published: March 2019

To investigate the prevalence of chronic kidney disease (CKD) among eastern Chinese rural residents and analyze the relationship between socioeconomic conditions and CKD.

A cross-sectional survey of 1713 adults, enrolled from 4 villages in the north-central part of Zhejiang province in eastern China was conducted by collecting data on socioeconomic status, physical examination, and laboratory investigations. CKD was defined as estimated glomerular filtration rate < 60 mL/min per 1.73 m2 or urinary albumin/creatinine ratio more than 30 mg/g. The crude and adjusted prevalence of CKD was estimated and the association of socioeconomic status was analyzed by logistic regression.

A total of 1654 adults (96.53%) completed the screening, and 1627 (98.37%) of them had complete questionnaire and test information. The standardized prevalence of CKD adjusted by age and sex was 9.21% (95% confidence interval, 7.8–10.63). People with hypertension, hyperglycemia, hyperuricemia, high fasting blood glucose, and high body mass index had higher risk for CKD. Socioeconomic status was found to be partly related to CKD, especially educational level and occupational nature.

A high prevalence of CKD was observed among rural residents in north-central Zhejiang province in eastern China. Socioeconomic statuses were partly related to the prevalence of CKD.