bluuebunny/crossref_metadata_2025_split huggingface dataset:
Platelet Count Variation and Risk for Coronary Artery Abnormalities in Kawasaki Disease
Authors: Ae Ryusuke , Abrams Joseph Y. , Maddox Ryan A. , Schonberger Lawrence B. , Nakamura Yosikazu , Shindo Asuka , Kuwabara Masanari , Makino Nobuko , Matsubara Yuri , Kosami Koki , Sasahara Teppei , Belay Ermias D. 
Published: December 2019

Background:
Platelet count is considered as a biomarker for the development of coronary artery abnormalities (CAAs) among Kawasaki disease (KD) patients. However, previous studies have reported inconsistent results. We addressed the controversial association of platelet count with CAAs using a large-scale dataset.

Methods:
A retrospective cohort study was conducted using KD survey data from Japan (2015–2016; n = 25,448). Classifying patients by intravenous immunoglobulin (IVIG) responsiveness, we described the trends in platelet count using the lowest and highest values along with the specific illness days. Multivariate logistic regression analysis was performed to evaluate the association between platelet count and CAAs, adjusting for relevant factors.

Results:
Platelet counts rapidly decreased from admission, reached the lowest count at 6–7 days, and peaked after 10 days. Platelet counts in IVIG non-responders decreased with a lower minimum value than IVIG responders, but subsequently rebounded toward a higher maximum. Compared with patients with normal platelet counts (150–450 × 109/L), patients with abnormally high platelet counts (>450 × 109/L) were more likely to have CAAs at admission (adjusted odds ratio: IVIG responders, 1.50 [95% confidence interval 1.20–1.87] and non-responders, 1.46 [1.01–2.12]). By contrast, IVIG non-responding patients whose counts were below normal (<150 × 109/L) after hospitalization were at higher risk for developing CAAs (2.27 [1.44–3.58]).

Conclusions:
Platelet count varied widely by illness day and was confounded by IVIG responsiveness, which might have contributed to previous inconsistent findings. KD patients with abnormally high platelet counts at admission or abnormally low counts after hospitalization were at higher risk for CAAs.
Nursing Care Practices for Patients With Pulmonary Embolism Undergoing Treatment With Ultrasound-Assisted Thrombolysis: An Integrative Review
Authors: Herriott Bethann , Mion Lorraine C. 
Published: December 2019

Background
Pulmonary embolism (PE) remains a common and life-threatening event. The use of ultrasound-assisted thrombolysis (USAT) for the delivery of thrombolytic agents to the clot has developed in the last 10 years. A search yielded no evidence-based practice guidelines for the nursing care of the patient with PE during and post USAT treatment and specifically when using the EKOS machine.

Objective
The objective of this integrative review was to explore the literature and web for any information on the use of USAT for adults with PE both during and post treatment. Our goal was to examine nurse-specific practices to develop appropriate protocols.

Methods
We conducted a search of PubMed, Web of Science, EBSCOhost, CINAHL, Google Scholar, and Google for any guidelines, observational studies, or experimental studies using USAT for PE in adults. Nurse authors independently reviewed the articles using a standardized data coding form. Information abstracted included sample and setting characteristics, access characteristics, medication, sheath removal, compression, and bleeding events.

Results
Twenty-two articles, published in 2008–2019, met the eligibility criteria. Most studies were small retrospective studies at single sites. Variation existed on the clinician, the clinical area for placement, the amount and duration of delivery of medication, and where care was provided during the infusion. Few studies noted sheath removal or compression procedures. Fifteen studies reported 1 fatal, 12 major, 4 moderate, and 36 minor bleeding events at the catheter insertion sites.

Conclusion
There is lack of sufficient information for the development of nursing practice guidelines for this new technology.
Sudden cardiac death in the Kazakh and Han peoples of Xinjiang, China
Authors: Zhang Jianghua , Zhou Xianhui , Xing Qiang , Li Yaodong , Zhang Ling , Zhou Qina , Lu Yanmei , Zhai Meiling , Bao Jianfu , Tang Baopeng 
Published: December 2019

Abstract
Sudden cardiac death (SCD) is a major cause of mortality in China. This study collected reference data for future programs of prevention of SCD among the ethnic Kazakh and Han populations in Xinjiang, China.
From January 1, 2015 to December 31, 2015, 2 monitoring locations in northern Xinjiang China were utilized. These locations were selected based on the geographic, economic, and administrative structures of the ethnic Kazakh settlements in Xinjiang. Investigators were trained to investigate SCDs in Kazakh and Han people, a study population totaling more than 400,000. The populations were compared for SCD incidence.
The average age of the Han population was significantly higher than that of the Kazakh. During the year 2015, there were 135 SCDs, specifically 67 and 68 in the Han and Kazakh populations, respectively, incidences of 37.94 and 36.2 per 100,000. After standardizing for age, the incidence in these populations was 29.36 and 51.85 per 100,000. Among those who experienced SCD, the prevalence of hypertension was higher in the Kazakh group than in the Han. The multivariate analysis of populations with SCD showed that, among the patients with coronary heart disease, the Kazakh were more likely to have SCD than the Han (odds ratio: 3.58, confidence interval: 1.18–10.95).
Among the elderly, the incidence of SCD was much higher in the Kazakh population than in the Han population. Basic medical services and health education should be strengthened in the Kazakh pastoral areas.
The value of MGMT promote methylation and IDH-1 mutation on diagnosis of pseudoprogression in patients with high-grade glioma
Authors: Zhou Min , Niu Chaoshi , Jia Li , He Hu 
Published: December 2019

Abstract

Objective:
To date, there are several published studies on the value of IDH-1 (isocitrate dehydrogenase-1) mutation and MGMT (O6-Methylguanine-DNA methyltransferas) promoter methylated status on the diagnosis of pseudoprogression (PSP) and true tumor progression after or within chemo-radiotherapy of high grade glioma (HGG). We performed a meta-analysis about the significant value of these 2 molecular markers on the diagnosis of PsP in high- grade glioma.

Methods:
We searched the eligible studies from PubMed, Medline, Embase, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI) and Wan Fang Database. The relevant studies published before October 2018 were identified. ORs (odds ratios) with 95%CIs (confidence intervals) were used to evaluate the value using fixed- or random-effect model.

Results:
Thirteen studies about MGMT promoter methylated status and 4 studies about IDH-1 mutations were found eligible for this present meta-analysis. Significant value of MGMT promoter methylation status (OR = 4.02, 95%CI = 2.76–5.87, P < .001) and IDH-1 mutations (OR = 12.78, 95%CI = 3.86–42.35, P < .001) were observed.

Conclusions:
This meta-analysis provided evidences that MGMT promoter methylation status and IDH-1 mutations could distinguish PSP from true tumor progression.
Association of obesity with the clinicopathological features of thyroid cancer in a large, operative population
Authors: Zhao Sitong , Jia Xiaomeng , Fan Xiaojing , Zhao Ling , Pang Ping , Wang Yajing , Luo Yukun , Wang Fulin , Yang Guoqing , Wang Xianling , Gu Weijun , Zang Li , Pei Yu , Du Jin , Ba Jianming , Dou Jingtao , Mu Yiming , Lyu Zhaohui 
Published: December 2019

Abstract
We aimed to investigate the association between excess body mass index (BMI) and papillary thyroid cancer (PTC) in an operative population, and the impact of higher BMI on clinicopathological aggressiveness of PTC.
Charts of 10,844 consecutive patients with thyroid nodules undergoing partial or total thyroidectomy between 1993 and 2015 were reviewed. Patients diagnosed with PTC were stratified in 4 groups: BMI < 18.5 (underweight), 18.5 ≤ BMI < 24 (normal-weight), 24 ≤ BMI < 28 (overweight) and BMI ≥ 28(obese). The impacts of high BMI on prevalence and clinicopathological parameters of PTC were retrospectively analyzed in both univariate and multivariate binary logistic regression analysis.
For every 5-unit increase in body mass, the odds of risk-adjusted malignance increased by 36.6%. The individuals who were obese and overweight were associated with high risk of thyroid cancer [odds ratio (OR)= 1.982, P < .001; OR= 1.377, P < .001; respectively] compared to normal weight patients, and this positive association was found in both genders. Obesity was independent predictors for tumors larger than 1 cm (OR = 1.562, P < .001) and multifocality (OR = 1.616, P < .001). However, there was no difference in cervical lymph node (LN) metastasis among BMI groups. Crude analysis showed BMI was associated with advanced tumor-node-metastasis (TNM) stage (relative risk, approximately 1.23 per 5 BMI units, P < .001), but this association disappeared after adjusting for confounding factors.
Obesity was significantly associated with the risk of PTC in a large, operative population. Higher BMI was significantly associated with larger tumor size and multifocal tumor.
Cardiopulmonary function after robotic exoskeleton-assisted over-ground walking training of a patient with an incomplete spinal cord injury
Authors: Jang Yun-Chol , Park Hyeng-Kyu , Han Jae-Young , Choi In Sung , Song Min-Keun 
Published: December 2019

Abstract

Rationale:
Spinal cord injury (SCI) patients who experience difficulties with independent walking use gait-assistive devices such as a cane, walker, or wheelchair. Few studies have explored gait patterns or cardiopulmonary function in chronic SCI patients after powered exoskeleton training. We investigated whether the cardiopulmonary function of a patient with an incomplete chronic cervical SCI and a hemiplegic gait pattern could be improved by walking training using a powered exoskeleton (Angelegs).

Patient concerns:
A 57-year-old male was diagnosed with an SCI at C3-C4. The right upper and lower limb motor functions differed when evaluated before entry into the program. Motor function was good in the right leg but poor in the left one. Before program entry, the patient could walk for about 10 m using a cane. He did not have a history of severe medical or psychological problems and was not cognitively impaired.

Diagnosis:
The patient was tetraplegia with incomplete SCI at C3-C4.

Interventions:
The patient was trained for 6 weeks using a powered exoskeleton. The training program consisted of sit-to-stand and stand-to-sit movements, maintenance of balanced standing for 5 minutes, and walking for 15 minutes.

Outcomes:
After 6 weeks of training, gait speed improved in the timed up-and-go test, and cardiac function was enhanced as measured by the metabolic equivalent and VO2 tests.

Lessions:
Walking training using a powered exoskeleton can facilitate the effective rehabilitation and improve the gait speed and cardiopulmonary function of patients with chronic SCIs or strokes.
Can preoperative neutrophil to lymphocyte, lymphocyte to monocyte, or platelet to lymphocyte ratios differentiate glioblastoma from brain metastasis?
Authors: Baran Oguz , Kemerdere Rahsan , Korkmaz Taha Sukru , Kayhan Ahmet , Tanriverdi Taner 
Published: December 2019

Abstract
This retrospective analysis of patients aims to show the blood levels of preoperative inflammatory markers in patients with glioblastoma and brain metastasis and to provide the diagnostic accuracy of the neutrophil–lymphocyte (NLR), lymphocyte–monocyte (LMR), and platelet–lymphocyte (PLR) ratios between the 2 groups of patients.
The retrospective reviews of the neutrophil, lymphocyte, monocyte, and platelet counts were analyzed in 80 patients with newly diagnosed glioblastoma and 70 patients with brain metastasis. The NLR, LMR, and PLR were calculated in each group. The differences in all the parameters were compared between the 2 groups.
Although the neutrophil, monocyte, and platelet counts were higher and the lymphocyte count was lower in patients with metastasis, the difference was not significant. A significantly higher PLR (P = .004) and a lower LMR (P = .01) were found in patients with brain metastasis. Although both PLR and LMR had diagnostic accuracy in differentiating glioblastoma from brain metastasis, LMR showed the highest diagnostic accuracy. NLR showed no diagnostic accuracy.
Systemic inflammation is more severe in glioblastoma than in brain metastasis, and LMR is more sensitive and/or specific than PLR in differentiating glioblastoma from brain metastasis. Therefore, LMR (less likely PLR) can be used as an index for differentiating between glioblastoma and brain metastasis before surgery.
The number of stents was an independent risk of stent restenosis in patients undergoing percutaneous coronary intervention
Authors: Tang Long , Cui Qian-Wei , Liu Dan-Ping , Fu Ying-Ying 
Published: December 2019

Abstract
Percutaneous coronary intervention (PCI) is one of the most effective therapies for coronary artery disease, but stent restenosis remains an important clinical challenge. The studies about the independent effect of the number of stents on stent restenosis were limited.
The purpose was to identify the independent effect of the number of stents on stent restenosis.
A retrospective cohort study of data reuse.
From July 2009 to August 2011, a total of 2338 cases met the inclusion and exclusion criteria.
The univariate analysis showed that the number of stents was a risk of stent restenosis, the OR value was 1.30 (95% CI:1.15 to 1.47, P < .001). The multi-factor regression analysis also showed that the number of stents was an independent risk of stent restenosis, the adjusted OR value was 1.38 (95% CI: 1.15 to 1.66, P < .001).Compared with 1–2 stents, the adjusted OR values of 3–5 stents and more than 6 stents were respectively 2.20 (95% CI: 1.24 to 3.90, P = .007) and 5.33 (95% CI: 1.89 to 15.08, P = .002), and the trend adjusted OR values was 2.26 (95% CI: 1.43 to 3.59, P < .001).The subgroup analysis of multi-factor regression analysis showed that when patients with the following conditions: 50 < Age, female, non-DES or SES, the risk of stent restenosis increased obviously.
The number of stents was an independent risk of stent restenosis in patients undergoing PCI, especially for patients with the following conditions: 2<the number of stents, 50 < age, female, Non-DES (Drug-eluting stents) or SES (sirolimus-eluting stent).
Beta wave enhancement neurofeedback improves cognitive functions in patients with mild cognitive impairment
Authors: Jang Jung-Hee , Kim Jieun , Park Gunhyuk , Kim Haesook , Jung Eun-Sun , Cha Ji-yun , Kim Chan-young , Kim Siyeon , Lee Jun-Hwan , Yoo Horyong 
Published: December 2019

Abstract

Background:
Mild cognitive impairment (MCI) is a symptom characterizing cognitive decline and a transitional state between normal aging and dementia; however, there is no definitive diagnosis and treatment for MCI. Neurofeedback (NF), which is a training mechanism that employs operant conditioning to regulate brain activity, has been increasingly investigated concerning its beneficial effects for dementia and MCI.

Methods:
This study investigated cognitive improvement and hemodynamic changes in the prefrontal cortex (PFC) following NF training in patients with MCI. Five patients with MCI received NF training for enhanced beta band activity in the dorsolateral PFC—16 sessions for 8 weeks—with each session divided into 9 5-minute trials. The primary outcome measure was a cognitive assessment tool: the Korean version of the Montreal Cognitive Assessment. The secondary outcome measures were the Central Nervous System Vital Signs for neurocognitive testing, hemodynamic changes using functional near-infrared spectroscopy in the PFC during a working-memory task, and Beck Depression Inventory scores.

Results:
After completing the training, patients’ cognitive function significantly improved in domains such as composite memory, cognitive flexibility, complex attention, reaction time, and executive function. Increased electroencephalogram beta power was observed over NF training sessions (Spearman rank correlation test: r = 0.746, P = .001). The threshold value for gaining positive feedback from pre-NF baseline on beta power significantly increased (Spearman rank correlation test: r = 0.805, P = .001). Hemodynamic response in PFC changed after NF training, and individual differences were identified. Specifically, hypoactivation of the hemodynamic response by emotional distraction recovered following NF training.

Conclusion:
We suggest that patients’ cognitive processing efficiency was improved by the NF training. These beneficial results suggest that NF training may have potential therapeutic applications to prevent the progression from MCI to dementia.
Trial registration number: Clinical Research Information Service (KCT0003433).
Late puerperal hemorrhage of a patient with Klippel–Trenaunay syndrome
Authors: Zhang Jian , Wang Kana , Mei Jie 
Published: December 2019

Abstract

Introduction:
The Klippel–Trenaunay syndrome (KTS) is a rare congenital disorder. The obstetric course of women with KTS varies. Complications include bleeding, disseminated intravascular coagulation (DIC), thromboembolic events, etc.

Patient concerns:
Here, we report a case of late puerperal hemorrhage of a Chinese puerpera with KTS. The repeating severe hemorrhage, the DIC, and the Kasabach–Merrit syndrome made the treatment more difficult.

Diagnosis:
KTS is a mixed malformation with a vascular component that is characterized by abnormal development of veins, capillaries, and lymphatics. Our patient was first diagnosed with KTS at the last trimester of pregnancy.

Interventions:
Massive infusion of blood products, two laparotomies, as well as bilateral internal iliac artery embolization was carried out.

Outcomes:
Although the patient survived from the life-threatening hemorrhage, she lost her uterus forever.

Conclusion:
An interdisciplinary cooperation of obstetrician, anesthesiologist, vascular surgeon, and intensive care physician is highly recommended. Prophylactic anticoagulation is generally advised in the gestational and postpartum period.
Cellular angiofibroma in the hypopharynx
Authors: Liu Ya , Xu Yaping , Wang Qinying , Chen Qiongqiong 
Published: December 2019

Abstract

Rationale:
Cellular angiofibroma is a rare benign mesenchymal tumor which mostly occurs in the superficial soft tissues of the genital region. Occurrence in the head and neck region is extremely rare. To our knowledge, this is the first case of cellular angiofibroma arising in the hypopharynx.

Patient's concerns:
A 54-year-old male complained of a mass moving through his throat for 1 month. A tumor was found in the right lateral wall of the pharyngeal at the level of the epiglottis by laryngoscope. Magnetic resonance imaging confirmed the presence of a mass in the right lateral pharyngeal area. A benign tumor was suspected based on the clinical symptoms and imaging findings.

Diagnosis:
A supporting laryngoscope was performed under general anesthesia and the lesion was resected. Immunohistochemical analysis revealed cellular angiofibroma.

Interventions:
The patient underwent surgical excision of the lesion.

Outcomes:
Thus far, no recurrence has been observed 6 months after excision.

Lessons:
Cellular angiofibroma located in the lateral pharyngeal is rare; however, immunohistochemical staining is helpful for its diagnosis. Treatment is relatively simple and requires local excision and follow-up.
Prognostic effect of different etiologies in patients with gastric cardia cancer
Authors: Kim Yeon-Ji , Chung Woo Chul , Cho Ik Hyun , Kim Jaeyoung , Kim Seonhoo 
Published: December 2019

Abstract
There are still many controversies about the characteristics and prognosis of gastric cardia cancer. We aimed to evaluate the clinical characteristics and outcome between cardia and noncardia cancer. Also, we evaluated the clinical outcome according to etiologic factors.
We performed a retrospective cohort study of 92 patients with gastric cardia cancer from January 2003 to December 2013. The patients with noncardia cancer were selected as age- and sex-matched control.
The frequencies of gastroesophageal reflux disease (GERD) and negative Helicobacter pylori infection without atrophy were significantly higher in gastric cardia cancers, but there was no difference in the frequency of obesity. The frequency of early gastric cancers was 40.0%, which was significantly lower than that of noncardia cancer. The rate of recurrence, disease-free survival, and overall survival duration were significantly lower in gastric cardia cancers (P < .01), even though there was no significant difference in the rate of curative resection (R0). In terms of the etiologic factors, there were no differences of disease prognosis, regardless of the presence of GERD, obesity, and H pylori infection with associated gastritis.
Gastric cardia cancer showed distinct clinical characteristics and a negative prognostic impact compared with gastric noncardia cancer.
Continuity of Care and Mental Health Service Use Among Medicaid-enrolled Youths
Authors: Pennap Dinci , Zito Julie M. , Santosh Paramala J. , Tom Sarah E. , Onukwugha Eberechukwu , Magder Laurence S. 
Published: December 2019

Background:
Recent reports of increased national estimates of pediatric psychiatric emergency department (ED) visits and psychiatric hospitalizations emphasize the need to research these utilization patterns.

Objectives:
To assess the patient-provider continuity of care (CoC) and compare the risk of psychiatric ED visits or hospitalization according to the CoC level.

Research Design:
A cohort design was applied to Medicaid administrative claims data (2007–2014) for 3–16-year olds with a first psychiatric diagnosis between 2009 and 2013 (n=38,825).

Subjects:
Continuously enrolled youths with (1) ≥1 outpatient psychiatric visits and (2) ≥4 pediatric outpatient visits in the prior 24 months.

Measures:
The authors assessed CoC in the 24 months before the first psychiatric outpatient visit and quantified CoC using the Alpha Index. The authors assessed patient-provider CoC before first psychiatric diagnosis and the odds of psychiatric ED visits or psychiatric hospitalizations in the year after diagnosis.

Results:
Of the 38,825 youths, 88.9% received a first psychiatric diagnosis by age 14. The odds of ED visits were significantly higher among youths with low CoC [6.63%, adjusted odds ratio (AOR), 1.27; 95% confidence interval (CI), 1.13–1.41] or moderate CoC (5.76%; AOR, 1.14; 95% CI, 1.02–1.27) compared with those with high CoC (4.96%). Greater odds of psychiatric hospitalization related to low (7.53%; AOR, 1.17; 95% CI, 1.06–1.29) or moderate CoC (7.01%; AOR, 1.15; 95% CI, 1.03–1.27) compared with high CoC (6.06%).

Conclusions:
The odds of potentially disruptive clinical management and costly psychiatric ED visits or hospitalizations were lower for youths with high CoC. The findings support the need to research the impact of CoC on long-term pediatric mental health service use.