bluuebunny/crossref_metadata_2025_split huggingface dataset:
Solutions to stuck tunneled cuffed catheters in patients undergoing maintenance hemodialysis
Authors: Yongchun He , Hua Jiang , Xiaohan Huang , Jianghua Chen , Ping Zhang 
Published: June 2020

Objective: To study and discuss treatments for stuck tunneled cuffed catheter in patients undergoing maintenance hemodialysis. Method: Retrospectively analyzing clinical data of 13 patients with stuck tunneled cuffed catheter in the Kidney Disease Center of the First Affiliated Hospital, College of Medicine, Zhejiang University in the period between September 2012 and October 2018. All patients failed to remove hemodialysis catheters by regular technique. The stuck catheters were treated by thoracotomy, endoluminal percutaneous transluminal angioplasty with blunt dissection or embedded and left in situ. Results: In 13 patients, one was successfully treated by thoracotomy, one failed to remove the catheter by regular technique and blunt dissection, and the stump of the catheter was clamped and buried in the subcutaneous fascia of the neck, and the other 11 were treated by endoluminal percutaneous transluminal angioplasty with blunt dissection. The average time of catheter removal procedure is 25 min, the overall success rate is 92.3%, and the success rate of percutaneous transluminal angioplasty is 100%. Conclusion: Thoracotomy is an efficient way to treat stuck catheter but is limited by its high risk and complications. Leaving part of catheter in situ may increase the risk of central vein stenosis. Comparing to the former two, endoluminal percutaneous transluminal angioplasty is a safe, efficient, and practical way for stuck catheters and should be recommended as the first choice.
Severe hemodialysis access-induced distal ischemia may be associated with poor survival
Authors: Gerrickens Michael W M , Yadav Reshabh , Wouda Rosanne , Beerenhout Charles H , Scheltinga Marc R M 
Published: June 2020

Background: Some hemodialysis patients develop hemodialysis access-induced distal ischemia due to insufficient loco-regional perfusion pressure and consequent poor arterial flow. We hypothesized that patients with severe hemodialysis access-induced distal ischemia had worse survival compared with patients with mild or no hemodialysis access-induced distal ischemia. Methods: This single-center retrospective observational cohort study included three groups of prevalent hemodialysis patients with an upper extremity vascular access between 2006 and 2018. Symptomatic patients had signs and symptoms of hemodialysis access-induced distal ischemia and low digital brachial indices (<60%) and were divided into a mild (Grade I–IIa) and a severe hemodialysis access-induced distal ischemia (IIb–IV) group. The control group consisted of hemodialysis patients without signs of hemodialysis access-induced distal ischemia with digital brachial indices ≥60%. Factors potentially related to 4-year survival were analyzed. Results: Mild hemodialysis access-induced distal ischemia-patients displayed higher digital brachial indices ( n = 23, 41%, ±3) compared with severe hemodialysis access-induced distal ischemia-patients ( n = 28, 24%, ±4), whereas controls had the highest values ( n = 48, 80%, ±2; p < .001). A total of 44 patients (44%) died during follow-up. Digital brachial index (hazards ratio 0.989 [0.979–1.000] p = .046) was related to overall mortality following correction for presence of arterial occlusive disease (hazards ratio 2.28 [1.22–4.29], diabetes (hazards ratio 2.00 [1.07–3.72], and increasing age (hazards ratio 1.03 [1.01–1.06] as was digital pressure (hazards ratio 0.990 [0.983–0.998], p = .011). Overall survival was similar in mild hemodialysis access-induced distal ischemia and controls (2-year, 79% ±5; 4-year, 57% ±6, p = .818). In contrast, 4-year survival was >20% lower in patients with severe hemodialysis access-induced distal ischemia (2-year 62%± 10; 4-year 34% ± 10; p = .026). Conclusion: Presence of severe hemodialysis access-induced distal ischemia may be associated with poorer survival in hemodialysis patients. Lower digital brachial index values are associated with higher overall mortality, even following correction for other known risk factors.
Molecular tracking of pathogens in central venous catheter
Authors: Lara Maristela Oliveira , Lucas Thabata Coaglio , kalapothakis Evanguedes , Thomasini Ronaldo Luis , Machado Carla Jorge 
Published: June 2020

Background: Central venous catheter–related bloodstream infection is an important adverse event in health care. Molecular methods are not yet substitutive of microbiological in the detection of the pathogens responsible for the infection, but they can help in the epidemiological characterization. Aim: To detect bacteria by polymerase chain reaction, from material extracted from the tip of central catheters of patients suspected of infection at the intensive care unit. Methods: Catheters (n = 34) of patients suspected of central venous catheter–related infection were analyzed by polymerase chain reaction. The findings were compared with culture of catheter tip and blood cultures performed by the hospital. Findings: The prevalence of bacteria was Staphylococcus aureus (50%), Enterococcus faecalis (41.2%), Klebsiella pneumoniae (32.4), Pseudomonas aeruginosa (20.6%), Acinetobacter baumannii (38.2%), Escherichia coli (2.9%), and Enterobacter cloacae (0%). No blood culture showed bacterial growth, the culture of catheter tip revealed bacteria in 21 (61.8%) and the polymerase chain reaction had positivity in 31 (91.2%) of the catheters. The mean central venous catheter time was 11 days, and the jugular vein was the site of insertion. Conclusion: The molecular method identified more bacteria than microbiological methods and revealed colonization of the catheters. The most commonly found bacteria are in the environment and in the microbiota of the skin, which suggests contamination by the hands of health professionals and points out the need for more efforts in preventive strategies.
Prolonged Pyrexia: Kikuchi-Fujimoto Disease in a Patient With Hb H-Constant Spring Thalassemia
Authors: Kasinathan Ganesh 
Published: June 2020

Introduction: Haemoglobin H (Hb H) disease is an alpha thalassemia characterised by either 3 alpha-globin gene deletions (deletional type) or 2 alpha-globin gene deletions with 1-point mutation (nondeletional type). Haemoglobin H-Constant Spring thalassemia is the most common Hb H disease in Asia. Kikuchi-Fujimoto disease (KFD) is an important cause of prolonged fever in thalassemia and is often self-limiting. Case Presentation: A 30-year-old women of Malay ethnicity presented to the thalassemia unit with a month history of prolonged fever, headache, and painful enlarged neck lymph nodes. She is known to have Hb H-Constant Spring thalassemia, in which she is on 3-monthly blood transfusion. Physical examination revealed persistent pyrexia of 38°C. She had multiple tender bilateral cervical lymphadenopathies with the largest measuring 4 × 4 cm. The complete blood count revealed hypochromic microcytic anaemia with leucopenia and a normal platelet count. She had hyperferritinemia of 3500 ng/mL. The DNA analysis of alpha-globin gene showed heterozygosity for alpha zero thalassemia South East Asian deletion with termination codon mutation (TAA-CAA) which was consistent with Hb H-Constant Spring thalassemia. Numerous investigations for her prolonged fever including cultures did not yield any positive results. Whole-body computed tomography (CT) imaging showed diffuse lymphadenopathies and hepatosplenomegaly. Finally, a left cervical lymph node biopsy was performed which was consistent with KFD. She was treated with oral prednisolone which was gradually tapered based on response. Currently, she is asymptomatic and is in complete remission. Conclusion: Kikuchi-Fujimoto disease should be considered as a cause for prolonged pyrexia in a patient with thalassemia. An early diagnosis of KFD would avoid an unnecessary battery of investigations. This case highlights the importance of clinicopathological correlation in managing patients with thalassemia as these patients often have other associated morbidities.
Hyper-articulation effects in Korean glides by heritage language learners
Authors: Chang Seung-Eun , Weiss-Cowie Samuel 
Published: June 2020

Aims and objectives: Hyper-articulation effects in glide sounds and heritage production are unexplored areas. Thus, this study examines how the Korean glide /we/ is phonetically implemented in hyper-articulated speech by English-speaking heritage learners of Korean. Language-specific fundamental frequency (F0) patterns and methodological issues involving inconsistent data in heritage research are also addressed. Methodology: Korean-American students enrolled in an intermediate-low Korean language course for Korean heritage students at a university in the US read four isolated sentences, once in casual speech and once in hyper-articulated (or clear) speech. They repeated this sequence five times. Data and analysis: The syllable duration of the glide more than doubled and the upward transitional feature of /w/ was significantly expanded with a steeper slope in clear speech compared to casual speech. The expansion of vowel space of /e/ in clear speech was also attested for second formant (F2). Although pitch did not vary between the two speaking styles at syllable onset or vowel midpoint, it exhibited a significant increase at syllable offset in clear speech. The strong intra- and inter-speaker variations frequently observed in heritage language research were not found in this study. Conclusions: The results generally echo the hyper-articulated speech changes observed in native Korean speakers. The pitch pattern outcomes suggest that heritage learners’ enhancement corresponds more to that of their heritage language than their dominant language. Although the data generally supports the idea that heritage learners’ enhancement strategies emulate those of native speakers in terms of exaggerated acoustic features, the same is not true regarding absolute acoustic values; their acoustic values are more exaggerated than native speakers’ in clear speech. Originality and implications: The findings present new hyper-articulation effects regarding glide sounds and an additional enhancement strategy of end-of-syllable pitch raising in hyper-articulated speech. This study also suggests that controlling for confounding population variables mitigates the methodological challenges of heritage language research.
Contemporary management of an orthodontic-orthognathic patient with limited time availability in an orthodontic office setting: Case report
Authors: Kau Chung How , Wang Zhendong , Wang Jue , Krishnan Deepak G 
Published: June 2020

Introduction: This case report describes the treatment of a 21-year-old man who presented in an orthodontic office for treatment but lived in a city 100 miles away and wanted the orthognathic surgery in another state in America. The patient presented with an anterior open bite and skeletal Class III relationship. Methods: The treatment plan included: (1) effective and careful communication of the treatment plan with the patient, orthodontist and oral and maxillofacial surgeon; (2) pre-surgical alignment and levelling of the teeth in both arches with Invisalign; (3) a long-distance communication between the orthodontist and the surgeon for surgical plan with virtual surgical planning (VSP Orthognathics; 3D Systems, www.3Dsystem.com ) online; (4) maxillary advancement (LeFort I osteotomy) with mandibular set-back (bilateral sagittal split osteotomy); (5) postsurgical correction of the malocclusion with clear brackets and aligners; and (6) retention and final small tooth movement adjustments with aligners/clear retainers. Results: The anterior open bite was treated, crowding was eliminated in the upper and lower anterior segment, correction of skeletal and dental Class III malocclusion was obtained, mandibular plane angle was reduced and facial profile improved. Conclusions: The results suggest that aesthetic and functional results can be achieved with long-distance communication of two specialties and with the combined use of clear aligners and clear fixed appliances.
When access is denied: Conducting an interview through letter writing
Authors: Burtt Emma 
Published: June 2020

Access to prisons in England and Wales is becoming ever more restricted to researchers and all projects must have sufficient links to Her Majesty’s Prison and Probation Service (HMPPS) priorities to be considered. What are the alternatives when there is no such link or when access has otherwise been denied? This article focuses on one possible solution – conducting a qualitative interview via letter. Drawing on my own experience of conducting such interviews with prisoners maintaining innocence, I document how the method can work in practice. Although not without difficulty, written interviews are capable of producing rich, qualitative data and provide benefits to both the researcher and researched when compared to traditional face-to-face interviews. I ultimately demonstrate how interviews via letter offer a valuable alternative when interacting with people, not only in prison but across all secure estates.
MiR-590 Suppresses Proliferation and Induces Apoptosis in Pancreatic Cancer by Targeting High Mobility Group A2
Authors: Wang Ya-Dong , Mao Jia-Ding , Wang Jun-Feng , Xu Mao-Qi 
Published: June 2020

Background: Pancreatic ductal adenocarcinoma is a common malignancy with high morbidity. MicroRNAs have been demonstrated to be critical posttranscriptional regulators in tumorigenesis. This study aimed to investigate the effect of microRNA-590 on the proliferation and apoptosis of pancreatic ductal adenocarcinoma. Material and Methods: The expression of microRNA-590 and high mobility group AT-hook 2 were examined in clinical pancreatic ductal adenocarcinoma tissues. Pancreatic ductal adenocarcinoma cell line Capan-2 was employed and transfected with microRNA-590 mimics or inhibitor. The correlation between microRNA-590 and high mobility group AT-hook 2 was verified by luciferase reporter assay. Cell viability and apoptosis were detected by MTT and flow cytometry assay. The protein level of high mobility group AT-hook 2, AKT, p-AKT, mTOR, and phosphorylated mTOR were analyzed by Western blotting. Results: MicroRNA-590 was found to be negatively correlated with the expression of high mobility group AT-hook 2 in pancreatic ductal adenocarcinoma tissues. Further studies identified high mobility group AT-hook 2 as a direct target of microRNA-590. Moreover, overexpression of microRNA-590 downregulated expression of high mobility group AT-hook 2, reduced cell viability, and promoted cell apoptosis, while knockdown of miR-590 led to an inverse result. MicroRNA-590 also suppressed the phosphorylation of AKT and mTOR without altering total AKT and mTOR levels. Conclusion: Our study indicated that microRNA-590 negatively regulates the expression of high mobility group AT-hook 2 in clinical specimens and in vitro. MicroRNA-590 can inhibit cell proliferation and induce cell apoptosis in pancreatic ductal adenocarcinoma cells. This regulatory effect of microRNA-590 may be associated with AKT signaling pathway. Therefore, microRNA-590 has the potential to be used as a biomarker for predicting the progression of pancreatic ductal adenocarcinoma.
DCK is an Unfavorable Prognostic Biomarker and Correlated With Immune Infiltrates in Liver Cancer
Authors: Hu Shu Fang , Lin Xia , Xu Lv Ping , Chen Hong Gang , Guo Ju Feng , Jin Li 
Published: June 2020

Background: The biological function of deoxycytidine kinase in tumor is not yet clear, and there are a few studies relating to the correlation of deoxycytidine kinase gene with the occurrence and development of liver cancer. Methods: The messenger RNA expression of deoxycytidine kinase was analyzed with the use of the UALCAN and GEPIA database. Moreover, we assessed the function of deoxycytidine kinase on clinical prognosis with Kaplan-Meier plotter database. The relationship between deoxycytidine kinase and cancer immune infiltrates was investigated via Tumor Immune Estimation Resource site. Furthermore, Tumor Immune Estimation Resource was also used to evaluate the correlations between the expression of deoxycytidine kinase and gene marker sets of immune infiltrates. Results: The deoxycytidine kinase messenger RNA level significantly upregulated in patients with liver cancer compared to normal liver samples. Moreover, the increased expression of deoxycytidine kinase messenger RNA was closely associated with reduced overall survival and disease-free survival in all liver cancers. In addition, deoxycytidine kinase expression displayed a strong correlation with infiltrating levels of macrophages, neutrophils, and dendritic cells in liver cancer, and deoxycytidine kinase expression was positively correlated with diverse immune marker sets in liver cancer. Conclusions: All the above findings suggested that increased expression of deoxycytidine kinase was significantly related to unfavorable prognosis in patients with liver cancer. And deoxycytidine kinase is correlated with immune infiltrating levels, including those of B cells, macrophages, neutrophils, and dendritic cells in patients with liver cancer. These findings suggest that deoxycytidine kinase can be used as a prognostic biomarker for determining prognosis and immune infiltration in liver cancer. And deoxycytidine kinase is a potential target for liver cancer therapy, and these preliminary findings require further study to determine whether deoxycytidine kinase-targeting reagents might be developed for clinical application in liver cancer.
Prognostic Role of IL-18 in Various Human Cancers and Radiation Injuries: A Meta-Analysis
Authors: Yao Zhen , Zhao Minyan , Gao Guangyu , Yang Jiawen , Wang Zhenzhen , Liu Yulong 
Published: June 2020

Background: In recent years, more and more studies have shown that various inflammatory factors have predictive effects on the prognosis of various human tumors. However, the prognostic role of interleukin 18 (IL-18) remains controversial. Furthermore, its role in radiation-induced injuries relating to radiotherapy (RT) is also unclear. In this study, we conducted the meta-analysis to clarify its roles in prognosis of human tumors and radiation-induced injuries relating to RT. Methods: We comprehensively searched PubMed, Embase, and Cochrane Library to identify studies published before November 2019 involving patients with cancer expressing IL-18 and which reported overall survival (OS) during the follow-up period. Results: A total of 1376 samples from 16 studies showed that high expression of IL-18 is closely related to prognosis and OS for patients with carcinoma (hazard ratio [HR]: 2.12; 95% CI: 1.81-2.49; P = .04; random-effect model). In addition, subgroup analysis proved that high expression of IL-18 was related to poor OS of hematologic tumor (HR: 2.03, 95% CI: 1.44-2.86, P < .00001), hepatocellular carcinoma (HR: 1.99, 95% CI: 1.38-2.86, P = .0002), and gastric cancer (HR: 2.00, 95% CI: 1.12-3.57, P = .02). Conclusions: High expression of IL-18 is related with poor prognosis of carcinoma.
Systemic lupus erythematosus diagnosis impacts clinical outcomes of arteriovenous fistulas in comparison to other end-stage renal disease etiologies
Authors: Cuen-Ojeda Cesar , Pascual-Ramos Virginia , Contreras-Yáñez Irazú , Anaya-Ayala Javier E , Elenes-Sanchez Erika , Rosas-Rios Casandra , Mendez-Sosa Miguel A , Lozano-Corona Rodrigo , Hinojosa Carlos A 
Published: June 2020

Objectives Arteriovenous fistulas primary patency at one-year occurs in 43–85% of the patients with end-stage renal disease. The diagnosis attributable to end-stage renal disease has been suggested to impact arteriovenous fistulas outcomes. The objective was to compare primary patency at one week, 1, 3, 6, and 12 months of follow-ups, among systemic lupus erythematosus patients and two control groups; additionally, we evaluated the impact of systemic lupus erythematosus to predict early patency loss. Methods A retrospective review of charts from arteriovenous fistulas created between 2008 and 2017 was performed. One-hundred thirty-four patients were identified and classified according to end-stage renal disease attributable diagnosis as: systemic lupus erythematosus cases ( N = 14), control-group-1 (91 patients with primarily diabetes and hypertension), and control-group-2 (29 patients with idiopathic end-stage renal disease). A case–control matched design (1:2:1) was proposed. Logistic regression analysis and Kaplan–Meier curves were used. Institutional Review Board approval was obtained. Results More systemic lupus erythematosus patients lost primary patency at 3 (28.6%) and 12 months (71.4%) than patients from control-groups-1 (vs. 3.6% and 35.7%, respectively) and -2 (vs. 0% and 14.3%, respectively), ( p ≤ 0.011 for both). Days of primary patency survival were shorter in systemic lupus erythematosus patients ( p = 0.003). Systemic lupus erythematosus diagnosis was the only factor associated with early patency loss, HR: 3.141, 95%CI: 1.161–8.493 (systemic lupus erythematosus diagnosis vs. control-group-1) and HR: 12.582, 95%CI: 1.582–100.035 (systemic lupus erythematosus diagnosis vs. control-group-2). Conclusions Diagnosis attributable to end-stage renal disease has a major impact on arteriovenous fistula outcomes in patients. Systemic lupus erythematosus patients have an increased risk of arteriovenous fistulas patency loss within the first six months of follow-up. Patients with idiopathic end-stage renal disease had an excellent one year arteriovenous fistula patency survival.
A pilot study of next generation sequencing–liquid biopsy on cell-free DNA as a novel non-invasive diagnostic tool for Klippel–Trenaunay syndrome
Authors: Palmieri Maria , Pinto Anna Maria , di Blasio Laura , Currò Aurora , Monica Valentina , Sarno Laura Di , Doddato Gabriella , Baldassarri Margherita , Frullanti Elisa , Giliberti Annarita , Mussolin Benedetta , Fallerini Chiara , Molinaro Francesco , Vaghi Massimo , Renieri Alessandra , Primo Luca 
Published: June 2020

Objectives Somatic mosaicism of PIK3CA gene is currently recognized as the molecular driver of Klippel–Trenaunay syndrome. However, given the limitation of the current technologies, PIK3CA somatic mutations are detected only in a limited proportion of Klippel–Trenaunay syndrome cases and tissue biopsy remains an invasive high risky, sometimes life-threatening, diagnostic procedure. Next generation sequencing liquid biopsy using cell-free DNA has emerged as an innovative non-invasive approach for early detection and monitoring of cancer. This approach, overcoming the space-time profile constraint of tissue biopsies, opens a new scenario also for others diseases caused by somatic mutations. Methods In the present study, we performed a comprehensive analysis of seven patients (four females and three males) with Klippel–Trenaunay syndrome. Blood samples from both peripheral and efferent vein from malformation were collected and cell-free DNA was extracted from plasma. Tissue biopsies from vascular lesions were also collected when available. Cell-free DNA libraries were performed using Oncomine™ Pan-Cancer Cell-Free Assay. Ion Proton for sequencing and Ion Reporter Software for analysis were used (Life Technologies, Carlsbad, CA, USA). Results Cell-free circulating DNA analysis revealed pathogenic mutations in PIK3CA gene in all patients. The mutational load was higher in plasma obtained from the efferent vein at lesional site (0.81%) than in the peripheral vein (0.64%) leading to conclude for a causative role of the identified variants. Tissue analysis, available for one amputated patient, confirmed the presence of the mutation at the malformation site at a high molecular frequency (14–25%), confirming its causative role. Conclusions Our data prove for the first time that the cell-free DNA-next generation sequencing–liquid biopsy, which is currently used exclusively in an oncologic setting, is indeed the most effective tool for Klippel–Trenaunay syndrome diagnosis and tailored personalized treatment.