bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pancreatic plasticity: epigenetic mechanisms and connections to neoplasia
Authors: David Charles J. 
Published: November 2019

Abstract
To counterbalance cellular losses due to age or injury, adult tissues must produce replacement cells appropriate in type and number. In different tissues, evolution has arrived at distinct solutions to this problem, depending on the nature of the tissue. Tissues with a large amount of cell turnover, such as the intestine, harbor a dedicated pool of stem cells dedicated to the constant replenishment of lost cells. In contrast, the pancreas is a relatively quiescent organ that lacks a clear population of resident stem cells. Instead, occasional self-duplication appears to be the major form of cellular replacement in the normal pancreas. Upon injury, however, the epigenetic barriers between cell types begin to fall, resulting in cell identity interconversion between multiple cell types in the pancreas. The epigenetic basis for these transdifferentiation events, involves the down-regulation of lineage-determining transcription factors specifying 1 cell fate and their replacement with factors specifying the alternate cell fate. The signals that underpin the switching of transcriptional programs are beginning to be unraveled. One important form of pancreatic plasticity, acinar-to-ductal metaplasia, occurs in response to injury-induced inflammatory stimuli. This form of metaplasia is associated with pancreatitis, a known risk factor for pancreatic cancer. The resulting ductal structures reactivate signaling pathways associated with embryonic pancreatic progenitors, and have been proposed to contribute to pancreatic regeneration. Consistent with a progenitor-like phenotype, in the presence of oncogenic stimuli, these metaplastic ducts are highly sensitive to neoplastic transformation, for reasons that are beginning to come to light.
Providing effective asthma care at a pediatric patient-centered medical home
Authors: Kennedy Christopher M. , Jolles Diana R. 
Published: November 2019

ABSTRACT

Background:
A recent assessment of the national annual burden of the cost of asthma among school-aged children was nearly $6 million. In a Midwestern county, the incidence of childhood asthma was 15.8%, which was above both state and national levels.

Local problem:
Effective asthma care was not being provided at a rural, pediatric patient-centered medical home due to a lack of standardization. This quality improvement (QI) initiative aimed to increase the mean effective asthma care score to 78% for patients with asthma over the course of 90 days.

Methods:
This right care initiative was implemented using a rapid-cycle Plan-Do-Study-Act methodology. Tests of change in the areas of team engagement, patient engagement, and two process measures were analyzed through chart audits and run charts over four cycles. Likert scale surveys were used to analyze qualitative data.

Interventions:
Interventions included developing the Asthma Patient Identification Tool, implementing an asthma education protocol with teach-back, creating standardized smart phrases for effective documentation, and initiating asthma care huddles.

Results:
The delivery of effective asthma care increased to 84%. The number of patients receiving the asthma education protocol increased to 65%, with 80% of the patients participating in effective teach-back sessions. The mean effective documentation score increased to 92%.

Conclusions:
A standardized approach to asthma care grounded in evidence-based guidelines positively affected the delivery of care. Nurse practitioners are effective team leaders for clinical QI initiatives.
Preoperative platelet morphology parameters as prognostic predictors for endometrial malignant carcinoma stage and progesterone receptor
Authors: Song Jianrong , Lai Xiaohong , Zhang Yulong , Zheng Xiangqin , Su Jiangcheng 
Published: November 2019

Abstract
To investigate preoperative platelet morphology parameters and other whole blood cells in patients of malignant endometrial carcinoma compared with benign disease.
Retrospective analysis was performed through collecting patients’ hematological parameters before performing total abdominal/vaginal hysterectomy and standard radical surgery due to benign and malignant endometrial disease between 2006 and 2017. Parameters required included white blood cell (WBC), hemoglobin, platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet thrombocytocrit (PCT). And neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated. For malignant carcinoma, Ki-67 percentage and progesterone receptor (PR) status were further collected.
A total of 288 patients were included with 145 benign cases and 143 malignant cases. Patients of confirmed endometrial carcinoma showed a significant lower value of PDW (55.21 ± 4.72 vs 49.54 ± 5.89, P < .001), meanwhile significant higher values of MPV (7.12 ± 1.56 vs 8.89 ± 1.67, P < .001) and PCT (24.18 ± 6.89 vs 27.93 ± 8.93, P = .003). Further analysis of endometrial carcinoma patients showed that no significant difference in platelet parameters was found between patients with stage I to II and stage III to IV (P > .05), while increased value in PDW and reduced value in MPV was found in PR negative compared with positive patients.
Preoperative platelet morphology parameters seemed to be used as one kind of predictive factors to discriminate malignant and benign endometrial disease. Limited by present study design, further prospective studies are required to support this finding.
Contrast enhancement on 100- and 120 kVp hepatic CT scans at thin adults in a retrospective cohort study
Authors: Masuda Takanori , Nakaura Takeshi , Funama Yoshinori , Sato Tomoyasu , Higaki Toru , Matsumoto Yoriaki , Yamashita Yukari , Imada Naoyuki , Kiguchi Masao , Baba Yasutaka , Yamashita Yasuyuki , Awai Kazuo 
Published: November 2019

Abstract

Purpose:
To assess the probability of achieving optimal contrast enhancement in 100 kVp and 120 kVp-protocol on hepatic computed tomography (CT) scans.

Materials and methods:
We enrolled 200 patients in a retrospective cohort study. Hundred patients were scanned with 120 kVp setting, and other 100 patients were scanned with 100 kVp setting. We measured the CT number in the abdominal aorta and hepatic parenchyma on unenhanced scans and hepatic arterial phase (HAP)-, and portal venous phase (PVP). The aortic enhancement at HAP and the hepatic parenchymal enhancement at PVP were compared between the two scanning protocols. Bayesian inference was used to assess the probability of achieving optimal contrast enhancement in each protocol.

Results:
The Bayesian analysis indicated that when 100 kVp-rotocol was used, the probability of achieving optimal aortic enhancement (>280 HU) was 98.8% ± 0.6%, whereas it was 88.7% ± 2.5% when 120 kVp-protocol was used. Also, the probability of achieving optimal hepatic parenchymal enhancement (>50 HU) was 95.3% ± 1.5%, whereas it was 64.7% ± 3.8% when 120 kVp-protocol was used.

Conclusion:
Bayesian inference suggested that the post-test probability of optimal contrast enhancement at hepatic dynamic CT was lower under the 120 kVp than the 100 kVp-protocol
Oral steroid decreases the progression of joint destruction of large joints in the lower extremities in rheumatoid arthritis
Authors: Doi K. , Ito H. , Tomizawa T. , Murata K. , Hashimoto M. , Tanaka M. , Murakami K. , Nishitani K. , Azukizawa M. , Okahata A. , Saito M. , Mimori T. , Matsuda S. 
Published: November 2019

Abstract
To identify the risk factors for destruction of large joints in the lower extremities in patients with rheumatoid arthritis (RA) during a 4-year follow-up period in a prospective study.
We enrolled consecutive patients who participated in both 2012 and 2016. Clinical data, disease activity, and types of medication were collected in 2012. Standard anteroposterior radiographs of weight-bearing joints (hips, knees, and ankles) were taken in 2012 and 2016. Radiographic progression was defined as progression in the Larsen grade or the need for joint arthroplasty or arthrodesis. The association between baseline characteristics and the incidence of radiographic progression was statistically assessed.
A total of 213 patient were enrolled, and, after exclusion, 186 patients were analyzed. Sixty 9 patients (37.1%) showed radiographic progression in 1 of the large joints in the lower extremities. Multivariate regression analysis showed that radiographic progression was associated with older age, higher disease activity, and the presence of radiographic destruction at the baseline. The lower dosage of oral prednisolone was a significant risk factor compared with higher dosage when used.
Patients with the risk factors should be followed closely to limit the progression of large joint destruction in the lower extremities.
A comparison of sotagliflozin therapy for diabetes mellitus between week 24 with week 52
Authors: Zhang Nie , Gu Zhi-Qun , Ding Yun-Long , Yang Liu , Chen Mao-Bing , Zheng Qi-Han 
Published: November 2019

Abstract

Background:
According to the centers for disease control and prevention, 14% of American adults have diabetes – 10% know it, and more than 4% go undiagnosed. Sotagliflozin is a new type of diabetes drug This study is to compare the efficacy of Sotagliflozin therapy for Diabetes Mellitus (DM) between week 24 with week 52.

Methods and analysis:
Through to October 2019, Web of Science, PubMed Database, Cochrane Library, EMBASE, Clinical Trials and CNKI will be searched to identify randomized controlled trials (RCTs) exploring SOTA therapy for DM. Strict screening and quality evaluation will be performed on the obtained literature independently by 2 researchers; outcome indexes will be extracted. The bias risk of the included studies will be evaluated based on Cochrane assessment tool. Meta-analysis will be performed on the data using Revman 5.3 software. We will provide practical and targeted results assessing the lost efficacy of SOTA therapy for DM from week 24 to week 52, to provide reference for clinicians.

Ethics and dissemination:
The stronger evidence about the lost efficacy of SOTA for DM from week 24 to week 52 will be provided for clinicians.

Trial registration number:
PROSPERO CRD42019133027.

Strengths and limitations of this study:
Whether the efficacy of SOTA could last for a long time is still inconclusive, high quality research is still lacking, and this study attempts to explore this issue; The efficacy of SOTA at different times will be compared by direct comparisons and indirect comparisons, this can lead to more accurate and reliable results; The quality of the included literatures are uneven, and some data might be estimated by calculation, which may affect the quality of this study.
One-stage posterior debridement with transverse process strut as bone graft in the surgical treatment of single-segment thoracic tuberculosis
Authors: Liang Xin-Jie , Zhong Weiyang , Tang Ke , Quan Zhengxue , Luo Xiao-Ji , Jiang Dian-Ming 
Published: November 2019

Abstract
This retrospective study investigated the effect of the novel bone graft transverse process strut (TPS) in single segmental thoracic spinal tuberculosis (TB) with the one-stage posterior approach of debridement, fusion, and internal instrumentation. Thirty patients treated in our department from March 2014 to October 2016 were retrospectively analyzed. Surgical time, blood loss, hospitalization time, drainage volume, and follow-up (FU) duration were recorded. The visual analog scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), American Spinal Injury Association (ASIA) grade, segmental angle, and bone fusion were compared between preoperative and final FU. All the patients were followed for a mean 50.10 ± 25.10 months; the mean age, surgical time in minutes, blood loss, hospitalization time, and drainage volume were 46.23 ± 17.20 years, 195.08 ± 24.0 minutes, 280.77 ± 189.90 mL, 17.31 ± 4.23 days, 436.92 ± 193.81 mL, respectively. VAS and ODI scores were significantly improved at the final FU. The ESR and CRP returned to normal. All patients achieved bony fusion with a mean time of 5.85 ± 1.82 months and a mean segmental angle of 18.77 ± 2.49° preoperatively, which significantly decreased to 9.31 ± 1.54° at the final FU (P < .05). No complications, such as bone graft failure, pleural effusion, fistula, or wound infection were recorded except for cerebrospinal fluid leakage (one case), water electrolyte imbalance (5 cases), superficial infection (1 case), and mild intestinal obstruction (1 case). TPS as a bone graft is reliable, safe, and effective for segmental stability reconstruction for surgical management of single-segment thoracic spinal TB.
Cardiac sarcoidosis: worse pulmonary function due to left ventricular ejection fraction?
Authors: Martusewicz-Boros Magdalena M. , Boros Piotr W. , Wiatr Elżbieta , Zych Jacek , Kempisty Anna , Kram Marek , Piotrowska-Kownacka Dorota , Wesołowski Stefan , Baughman Robert P. , Roszkowski-Sliż Kazimierz 
Published: November 2019

Abstract
Dyspnea and exercise intolerance are usually attributed to pulmonary disease in sarcoidosis patients. However, cardiac involvement may also be responsible for these symptoms. Data regarding the impact of heart involvement on lung function in cardiac sarcoidosis (CS) is limited.
The aim of study was to compare the results of pulmonary function tests (PFTs) in patients with and without heart involvement. We performed a retrospective analysis of PFTs in a group of sarcoidosis patients both with and without heart involvement evaluated by cardiovascular magnetic resonance (CMR) study. The study was performed in the period between May 2008 and April 2016.
We included data of sarcoidosis patients who underwent testing for possible CS (including CMR study) at a national tertiary referral center for patients with interstitial lung diseases. All patients had histopathologicaly confirmed sarcoidosis and underwent standard evaluation with PFTs measurements including spirometry, plethysmography, lung transfer factor (T
L,CO), and 6-minute walking test (6MWT) assessed using the most recent predicted values.
We identified 255 sarcoidosis patients (93 women, age 42 ± 10.7 y): 103 with CS and 152 without CS (controls). CS patients had significantly lower left ventricular ejection fraction (LVEF; 56.9 ± 7.0 vs 60.4 ± 5.4, P < .001). Any type of lung dysfunction was seen in 63% of CS patients compared with 31% in the controls (P = .005). Ventilatory disturbances (obstructive or restrictive pattern) and low T
L,CO were more frequent in CS group (52% vs 23%, P < .001 and 38% vs 18% P < .01 respectively). CS (OR = 2.13, 95% CI: 1.11–4.07, P = .02), stage of the disease (OR = 3.13, 95% CI: 1.4–7.0, P = .006) and LVEF (coefficient = –0.068 ± 0.027, P = .011) were independent factors associated with low FEV1 but not low T
L,CO. There was a significant correlation between LVEF and FEV1 in CS group (r = 0.31, n = 89, P = .003). No significant difference in 6MWD between CS patients and controls was observed.
Lung function impairment was more frequent in CS. Lower LVEF was associated with decreased values of FEV1. Relatively poor lung function may be an indication of cardiac sarcoidosis.
Conservative interventions for the treatment of pelvic organ prolapse
Authors: Sun Yuanjie , Chen Huan , Liu Yan , Jiao Ruimin , Yuan Jingxue , Zhang Xuecheng , Liu Zhishun 
Published: November 2019

Abstract

Background:
Pelvic organ prolapse (POP) is the downward descent of vaginal walls, affecting the health of 32% to 76% female patients. Conservative interventions are considered as priority before seeking help from surgery. We plan to make the systematic review to assess the effectiveness of conservative intervention for adult women with POP.

Methods:
Studies will be searched in PubMed, EMBASE, and the Cochrane Library from inception to July 2017. Primary outcomes are specific POP-related symptom, severity of prolapse, Prolapse-related, and general health-related quality of life and other non-POP-specific symptoms.

Results:
The data will be synthesized if possible using MD, SMD or RR. A descriptive analysis will be made if the data cannot be synthesized.

Discussion:
The systematic review might provide solid evidence for the treatment of POP by conservative intervention.
Inverted internal limiting membrane flap technique and an autologous platelet concentrate to treat an Nd:YAG laser-induced macular hole
Authors: Yang Young Hoon , Chung Young Taek , Kim Bu Ki , Moon Jun Hyung , Mun Su Joung 
Published: November 2019

Abstract

Rationale:
Nd:YAG laser-induced macular holes (MHs) feature more extensive anatomical defects and worse functional outcomes than idiopathic MHs. Although new treatment options for large refractory MHs have been suggested, the current literature on Nd:YAG laser-induced MHs suggests only conventional pars plana vitrectomy combined with internal limiting membrane (ILM) peeling, which is the same treatment as for idiopathic MHs.

Patient concerns:
A 40-year-old dermatologist was referred to us because of a sudden decrease in visual acuity following exposure to a floor-tile-reflected single-shot Nd:YAG laser beam while not wearing protective goggles.

Diagnoses:
An Nd:YAG laser-induced MH was diagnosed based on fundoscopy and optical coherence tomography (OCT).

Interventions:
Pars plana vitrectomy using an inverted ILM flap technique and autologous platelet concentrate (APC) was performed.

Outcomes:
Postoperative spectral domain OCT and en-face OCT showed “U-shaped” closure of the MH and a decreased ellipsoid zone defect, while the best-corrected visual acuity improved from 20/500 to 20/25.

Lessons:
The inverted ILM flap technique combined with APC is an effective option to achieve successful MH closure and visual improvement in patients with an Nd:YAG laser-induced MH.
Compatibility of [99mTc]Tc-EDDA/HYNIC-TOC and [68Ga] Ga-DOTA-TOC in a syringe for intravenous administration
Authors: Chaib Sarah , Hallouard François , Chennell Philip , Darcissac Caroline , Morelec Isabelle , Rioufol Catherine , Sautou Valérie , Fraysse Marc 
Published: November 2019

Objective
Drug quality in medical devices is not evaluated during the marketing authorization of radiopharmaceuticals. Therefore, the extemporaneous change of packaging made for preparation of patient unit doses in a syringe is the responsibility of radiopharmacists. The present study aimed to determine the impact of packaging and storage in a polypropylene syringe on the quality of hydrophilic drugs [99mTc]Tc-EDDA/HYNIC-TOC (Tektrotyd) and [68Ga]Ga-DOTA-TOC (Somakit-TOC).

Methods
Appearance, pH, radiochemical purity, sterility, and endotoxin tests were performed according the current European Pharmacopoeia. Subvisible and visible particles tests of the European Pharmacopoeia were adapted due to limited preparation volume (<25 ml). Sorption tests were performed according to the literature.

Results
After 2 h storage in a syringe, drug sorption of Tektrotyd and Somakit-TOC was of less than 2.5% and similar to other 99mTc-radiopharmaceuticals (range: from 1.1 ± 0.5% to 4.2 ± 0.6%). For Tektrotyd, this sorption phenomenon was positively influenced by the drug concentration and a short contact with the medical device (4.8 ± 0.2% up to 5 s vs. 2.3 ± 0.2%, n = 4; P < 0.001). For Somakit-TOC, the duration of contact with syringe had no impact (1.6 ± 0.2% up to 5 s vs. 1.7 ± 0.6%; P = 1.000). No drug radiolysis or alteration of microbiological aspects were observed. No impurity from a 3-piece-syringe was observed according to drug aspect, pH, and subvisible and visible particles, which remained within specification of the current European Pharmacopoeia.

Conclusion
This study found that drug sorption to packaging was compatible with clinical use and absence of drug alteration of Tektrotyd and Somakit-TOC after repackaging in a syringe in polypropylene and prolonged storage during 2 h.
Sequential PET/diffusion-weighted imaging in the evaluation of myocardial perfusion and viability in coronary artery disease: a preliminary study
Authors: Ling Xueying , Chen Jianxin , Shang Jingjie , Tang Yongjin , Cheng Yong , Xu Hao 
Published: November 2019

Objectives
To evaluate the utility of sequential F-18 fluorodeoxyglucose PET/diffusion-weighted imaging in assessing myocardial perfusion and viability in coronary artery disease.

Methods
Fourteen coronary artery disease patients and five non-coronary artery disease subjects underwent sequential cardiac F-18 fluorodeoxyglucose PET/diffusion-weighted imaging using a trimodality PET/computed tomography-MRI system. The perfusion data were acquired by measuring low b-values apparent diffusion coefficient using diffusion-weighted imaging. Regional myocardial viability was determined by perfusion/metabolism patterns. The perfusion/metabolism patterns obtained by low b-values apparent diffusion coefficient/fluorodeoxyglucose uptake were analyzed and compared with the results from the combination of rest 99mmethoxyisobutylisonitrile (99mTc-MIBI) myocardial perfusion single-photon emission computed tomography with F-18 fluorodeoxyglucose PET/computed tomography.

Results
Ten coronary artery disease patients and five non-coronary artery disease subjects were included in the final analysis. Low b-values apparent diffusion coefficient defects involved with 25 myocardial regions were demonstrated in nine coronary artery disease patients, while 99mTc-MIBI defects involved with 21 myocardial regions were shown in the same patients. The agreement between low b-values apparent diffusion coefficient and MIBI uptake was good in coronary artery disease patients (κ = 0.627, P < 0.001) and was better still in the whole subjects (κ = 0.733, P < 0.001). Low b-values apparent diffusion coefficient/fluorodeoxyglucose uptake demonstrated mismatch patterns in six coronary artery disease patients and MIBI/fluorodeoxyglucose uptake revealed mismatch patterns in seven coronary artery disease patients. Agreement in the evaluation of regional myocardial viability between low b-values apparent diffusion coefficient/fluorodeoxyglucose uptake and MIBI/fluorodeoxyglucose uptake was high in coronary artery disease patients (κ = 0.627, P < 0.001) and all subjects (κ = 0.728, P < 0.001).

Conclusions
Low b-values apparent diffusion coefficient/fluorodeoxyglucose uptake is comparable to MIBI/fluorodeoxyglucose uptake in assessing perfusion/metabolism patterns, indicating that microperfusion might dominate the diffusion signal at low b-values and sequential PET/diffusion-weighted imaging might be useful to evaluate myocardial viability in coronary artery disease patients.