bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound characteristics of cervical lesions in patients with radioiodine refractory differentiated thyroid cancer
Authors: Gao Luying , Lin Yansong , Jiang Yuxin , Li Hui , Gao Qiong , Xi Xuehua , Wang Ying , Yang Xiao , Lai Xingjian , Zhu Shenling , Zhang Xiaoyan , Zhao Ruina , Zhang Bo 
Published: November 2019

Abstract
Radioiodine refractory (RAIR) is the major cause of thyroid cancer-related death. In order to avoid needless Radioiodine (RAI) therapy, recognizing the RAIR cases in time is important for the patients to obtain more time for the effective therapy.
Evaluate the ultrasound features of cervical metastatic lymph node in patients with RAIR differentiated thyroid cancer (DTC).
Seventeen adult patients with histologically confirmed locally advanced or metastatic RAIR-DTC were prospectively enrolled. The ultrasound (US) characteristics of cervical lesions in patients with the RAIR-DTC were compared with cervical lymph node metastasis from 59 non RAIR-DTC cases.
Among the 17 patients, cervical lymph node metastasis was found in 15 patients (88.3%). The cervical lesions of RAIR-DTC (mean size, 2.0 cm) were larger than that in non RAIR-DTC group (mean size, 1.30 cm). More multiple lesions and more lesions with visible flow were found in the RAIR Group, while fewer hyperechogenic punctuations were found in RAIR group (P < .05). The distant metastasis rates showed that RAIR-DTC led to a poorer prognosis than those of patients in the non RAIR Group (P < .01).
Ultrasound can help distinguish metastasized cervical lymph nodes of RAIR-DTC patients from non RAIR-DTC patients. For RAIR-DTC patients, a long-term US evaluation should be performed.
Carbapenem-resistant Klebsiella pneumoniae infection causing rupture of graft artery in solid organ recipients
Authors: Cai Yun-Shi , Xiao Heng , Zhang Shu , Li Mao , Liang Si-Min , Shi Zheng-Rong , Du Cheng-You 
Published: November 2019

Abstract

Rationale:
Donor-derived bacterial infection is a rare cause of morbidity after solid organ transplantation (SOT) but associated with significant morbidity and mortality, deaths caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) infection account for a considerable proportion of postoperation mortality rate in liver and kidney recipients. The arterial rupture as a result of fungal arteritis is occasionally described, while the rupture of graft vascular anastomosis after SOT due to donor-derived CRKP infection is rarely reported.

Patients concerns:
We reported 1 patient with donor-derived CRKP infection following liver transplantation and 2 patients following renal transplantation (1 liver and 2 kidneys were from the same donor), who experienced sudden abdominal pain and abdominal hemorrhage almost at the same time after organ transplantation.

Diagnosis:
The patients were diagnosed as graft arteries rupture due to corrosion caused by CRKP infection based on computed tomography scan, blood culture, laparotomy, and pulse-field gel electrophoresis.

Interventions:
Anti-shock treatment, exploratory laparotomy, broad-spectrum antibiotics, and abdominal puncture and drainage were given.

Outcomes:
The liver recipient survived as well as the liver graft, still under treatment of multiple abdominal infections. The 2 renal recipients were alive after resection of the renal grafts and underwent hemodialysis.

Lessons:
Rupture of graft artery should be foreseen when donor-derived CRKP infection was confirmed and broad-spectrum antibiotics and other interventions need to be considered.
Association between asymmetry in lower extremity lean mass and functional mobility in older adults living in the community
Authors: Lee Eun Jeong , Lee Seung Ah , Soh Yunsoo , Kim Yong , Won Chang Won , Chon Jinmann 
Published: November 2019

Abstract
The asymmetry in lower extremity strength is known to be related to the functional mobility in older adults living in the community. However, little is known about the association between lower extremity lean mass asymmetry and functional mobility in this patient group. Hence, this study aimed to determine whether asymmetry in lower extremity muscle mass has a significant relationship with functional mobility in older adults living in the community.
This cross-sectional study analyzed the pre-existing data from the Korean Frailty and Aging Cohort Study. A total of 435 older people (aged 70–84 years) were divided into the following groups according to their Limb Asymmetry Index (LAsI): low, intermediate, and high asymmetric groups. LAsI is calculated using lower extremity lean mass, and comparisons between groups were conducted. The participants were also further divided into better and worse mobility groups based on their physical performance test results (Timed Up and Go and Short Physical Performance Battery), and comparisons between groups were conducted. Comparisons between fallers and non-fallers were also conducted. In addition, this study investigated the factors that had a significant effect on gait speed and fall experience within the past year among older adults living in the community.
The LAsI was significantly associated with gait speed in older adults living in the community. Older adults in the highest tertile of the LAsI had a slower gait speed than those in the lowest tertile of the LAsI. However, no significant difference was observed in the LAsI between the better mobility group and worse mobility group. Moreover, the LAsI was not a significant predictor of falls.
Asymmetry in lower extremity lean mass was significantly associated with gait speed in older adults living in the community.
Impact of prenatal ultrasound diagnosis for fetal renal abnormalities
Authors: Chen Ying , Liu Wei 
Published: November 2019

Abstract

Background:
This study will evaluate diagnostic accuracy and management outcome studies involving patients assessed with prenatal ultrasound diagnosis (PUD) for fetal renal abnormalities (FRA).

Methods:
We will search the following electronic databases of MEDLINE, EMBASE, Cochrane Library, Web of Science, Springer, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure for diagnostic accuracy studies from inceptions to the present without language restrictions. Two authors will independently screen studies, collect data, and assess methodological quality.
We will use RevMan V.5.3 and Stata V.12.0 software for data pooling and statistical analysis.

Results:
In this study, we will assess sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio to determine the diagnostic accuracy of PUD for the treatment of patients with FRA.

Conclusion:
This study will provide latest evidence for the diagnostic accuracy of PUD for FRA.

Systematic review registration:
PROSPERO CRD42019151306.
A retrospective study of antibacterial iodine-coated implants for postoperative infection
Authors: Shirai Toshiharu , Tsuchiya Hiroyuki , Terauchi Ryu , Tsuchida Shinji , Mizoshiri Naoki , Mori Yuki , Takeuchi Akihiko , Hayashi Katsuhiro , Yamamoto Norio , Ikoma Kazuya , Kubo Toshikazu 
Published: November 2019

Abstract
Postoperative infection is one of the most serious complications in orthopedic surgery. We have developed and use iodine-coated implants to prevent and treat postoperative infection in compromised hosts. This study evaluated outcomes using iodine-coated implants for postoperative infections.
We treated 72 postoperative infected patients using iodine-coated implants. Of these, 38 were males and 34 were females, with a mean age of 59.3 years. The mean follow-up period was 5.6 years. The patients included 23 with an infection following total knee arthroplasty, 20 following total hip arthroplasty, 11 following osteosynthesis, 11 following spine surgery, 6 following tumor excision, and 1 following osteotomy. Of these, 37 underwent single-stage surgery and 35 underwent staged revision surgery. We performed staged surgery in any case with active infection. The survival of iodine-coated implants was determined using Kaplan-Meier analysis. White blood cell (WBC) and C-reactive protein (CRP) levels were measured pre- and postoperatively. To evaluate the systemic effects of iodine, serum thyroid hormone levels were examined.
Five patients underwent re-revision surgery. In 3 patients, periprosthetic infection recurred at an average of 18 months after surgery. The reinfection rate was 4.2%. These patients recovered following reimplantation of iodine-coated prostheses. No patients required amputation. The survival rate of iodine-coated implants was 91%. There were no signs of infection at the latest follow-up. The median WBC level was nearly in the normal range, and CRP levels returned to normal within 4 weeks after surgery. No abnormalities of thyroid gland function were detected.
Iodine-coated titanium implants can be very effective in the treatment of postoperative infections. An iodine coating can be safely applied to infected regions.
Differentiation of testicular seminoma and nonseminomatous germ cell tumor on magnetic resonance imaging
Authors: Liu Renwei , Lei Zhengxian , Li Aibo , Jiang Yixiang , Ji Jiayin 
Published: November 2019

Abstract
Magnetic resonance imaging (MRI) has excellent soft tissue resolution, as well as multidirectional and multisequence scanning technology, making it an important supplementary method in the diagnosis of testicular tumor.
To explore the utility of preoperative MRI for the differential diagnosis of testicular seminoma and nonseminomatous germ cell tumors (NSGCTs).
The medical records from 39 patients with testicular tumors that were examined preoperatively with MRI and treated with urologic surgery at our institution between January 2015 and March 2019 were retrospectively reviewed. Testicular tumors were confirmed by pathology and classified as seminoma (n = 20) or NSGCT (n = 19). Two radiologists analyzed the testicular tumors on preoperative MRI for morphology: multiple nodules or a single mass; presence/absence of a capsule; signal compared to the normal contralateral testicle (isointense, hypointense, hyperintense, or mixed); enhancement; septa; and hemorrhagic or cystic degeneration. Characteristics of seminomas and NSGCT were compared using the Chi-square or Fischer exact test.
MRI showed that the majority (95%; 19/20) of seminomas were nodular. There were significant differences in the presence/absence of a capsule (P = .001), T1-weighted imaging (T1WI) signal intensity (P = .047), T2-weighted imaging (T2WI) signal intensity (P < .001), septa (P < .001), and hemorrhagic or cystic degeneration (P < .001) between seminomas and NSGCT.
Seminomas were more likely to have no capsule, isointensity on T1WI, hypointensity on T2WI, and had narrow obviously enhanced fibrovascular septa without hemorrhagic or cystic degeneration; NSGCT was more likely to have a capsule, a mainly mixed signal on T1WI and T2WI, most of them had no fibrovascular septa, and hemorrhagic or cystic degeneration was common in malignant NSGCT.
This study suggests that preoperative MRI can distinguish seminoma from NSGCT. We propose that preoperative MRI of the scrotum is an effective technique that should be widely adopted for the management of scrotal disease.
Predictors of Reopening the Sternum in Children After Cardiac Surgery
Authors: Shaath Ghassan A. , Jijeh Abdulraouf M. Z. , Ismail Sameh R. , Hijazi Omar , Abu Sulaiman Riyadh , Almadani Wedad , Hamadah Mohammed Husam , Najm Hani K. , Kabbani Mohamed S. 
Published: November 2019

Objectives:
Capillary leak syndrome can be severe in children after open-heart surgery which may hinder sternum closure and described as mediastinal tamponade. Reopening the sternum postoperatively may help maintaining hemodynamics and respiratory function. We looked for predictors that indicate the need for reopening the sternum.

Design:
A retrospective cohort study.

Setting:
A single cardiac center experience from 2009 to end of 2015.

Patients:
All children who required emergent reopening the sternum in the pediatric cardiac ICU after cardiac surgery were grouped as index cases and matched to a control group for age, body weight, cardiac diagnosis, and type of repair (single vs biventricular).

Interventions:
Emergent reopening the sternum.

Measurements and Main Results:
With a ratio of two control cases for each index case, variables related to cardiac output (predictors) were collected in a time line of 12, 6 hours, and just before reopening the sternum. Morbidities and mortality were also reviewed. Thirty-three index cases were compared with 63 control cases. Hospital stay and hospital-acquired infections were the same between the groups. Ventilation hours were longer in the index cases. Temperature gap more than 3°C, inotropic score more than 14, and acute kidney injury indicated by doubled blood urea nitrogen and creatinine were higher in the index group 6 hours before reopening the sternum. Mortality was more in the reopening sternum group with higher risk when extracorporeal membrane oxygenation was needed.

Conclusions:
Low cardiac output after cardiac surgery in children in form of temperature gap more than 3°C, inotropic score more than 14, and acute kidney injury may predict the need of reopening the sternum. Rate of mortality was higher in the reopening sternum group when extracorporeal membrane oxygenation was needed.
The Prognostic Value of Somatosensory Evoked Potentials in Children After Cardiac Arrest: The SEPIA Study
Authors: McDevitt William M. , Rowberry Tracey A. , Davies Paul , Bill Peter R. , Notghi Lesley M. , Morris Kevin P. , Scholefield Barnaby R. 
Published: November 2019

Purpose:
Absent cortical somatosensory evoked potentials (SSEPs) reliably predict poor neurologic outcome in adults after cardiac arrest (CA). However, there is less evidence to support this in children. In addition, targeted temperature management, test timing, and a lack of blinding may affect test accuracy.

Methods:
A single-center, prospective cohort study of pediatric (aged 24 hours to 15 years) patients in which prognostic value of SSEPs were assessed 24, 48, and 72 hours after CA. Targeted temperature management (33–34°C for 24 hours) followed by gradual rewarming to 37°C was used. Somatosensory evoked potentials were graded as present, absent, or indeterminate, and results were blinded to clinicians. Neurologic outcome was graded as “good” (score 1–3) or “poor” (4–6) using the Pediatric Cerebral Performance Category scale 30 days after CA and blinded to SSEP interpreter.

Results:
Twelve patients (median age, 12 months; interquartile range, 2–150; 92% male) had SSEPs interpreted as absent (6/12) or present (6/12) <72 hours after CA. Outcome was good in 7 of 12 patients (58%) and poor in 5 of 12 patients (42%). Absent SSEPs predicted poor outcome with 88% specificity (95% confidence interval, 53% to 98%). One patient with an absent SSEP had good outcome (Pediatric Cerebral Performance Category 3), and all patients with present SSEPs had good outcome (specificity 100%; 95% confidence interval, 51% to 100%). Absence or presence of SSEP was consistent across 24-hour (temperature = 34°C), 48-hour (t = 36°C), and 72-hour (t = 36°C) recordings after CA.

Conclusions:
Results support SSEP utility when predicting favorable outcome; however, predictions resulting in withdrawal of life support should be made with caution and never in isolation because in this very small sample there was a false prediction of unfavorable outcome. Further prospective, blinded studies are needed and encouraged.
Specific Symptom Profiles are Associated with Distinct Changes in Amygdala Connectivity in Youth
Authors: Stoddard Joel , Kircanski Katharina , Haller Simone P. , Hinton Kendra E. , Sharif-Askary Banafsheh , Brotman Melissa A. 
Published: November 2019

AbstractComplex clinical presentations are common in youth seeking mental health treatment, complicating attempts to identify specific biological underpinnings to guide precision psychiatry. We defined four classes of such youth based on their symptom profiles and identified unique patterns of amygdala functional connectivity in each class.Subjects were 215 youth who varied along major symptom dimensions commonly associated with pediatric affective psychopathology: depression, irritability, anxiety, and attention-deficit/hyperactivity (ADHD). We used latent profile analysis to identify classes of symptom patterns. Functional MRI data were obtained while subjects completed a gender identification task of face-emotions that varied in emotion type and intensity. We used generalized psychophysiological interaction analysis to examine associations between the probability of being in each symptom class and amygdala functional connectivity.The likelihood of being in the class with high parent-reported irritability and ADHD symptoms was associated with amygdala connectivity to the insula and superior temporal gyrus while processing high-intensity angry and fearful faces; to the precuneus while processing intensity across emotions; and to the ventrolateral prefrontal cortex across all task conditions. The likelihood of being in the class with high anxious and depressive symptoms was negatively associated with amygdala-thalamic connectivity across task conditions.This is the first study to identify distinct associations between symptom profile classes and amygdala connectivity in a transdiagnostic sample of youth. These neural correlates provide external validity to latent classes derived from symptom clusters. This is an essential first step toward identifying the biological basis of common transdiagnostic symptom presentations in youth.
Neonatal white matter tract microstructure and 2-year language outcomes after preterm birth
Authors: Dubner Sarah E. , Rose Jessica , Feldman Heidi M. , Travis Katherine E. 
Published: November 2019

AbstractAimTo determine whether variability in diffusion MRI (dMRI) white matter tract metrics, obtained in a cohort of preterm infants prior to neonatal hospital discharge, would be associated with language outcomes at age 2 years, after consideration of age at scan and number of major neonatal complications. Method: 30 children, gestational age 28.9 (2.4) weeks, underwent dMRI at mean post menstrual age 36.4 (1.4) weeks and language assessment with the Bayley Scales of Infant Development–III at mean age 22.2 (1.7) months chronological age. Mean fractional anisotropy (FA) and mean diffusivity (MD) were calculated for 5 white matter tracts. Hierarchical linear regression assessed associations between tract FA, moderating variables, and language outcomes. Results: FA of the left inferior longitudinal fasciculus accounted for 17% (p = 0.03) of the variance in composite language and FA of the posterior corpus callosum accounted for 19% (p = 0.02) of the variance in composite language, beyond that accounted for by post menstrual age at scan and neonatal medical complications. The number of neonatal medical complications moderated the relationship between language and posterior corpus callosum FA but did not moderate the association in the other tract. Conclusion: Language at 2 is associated with white matter metrics in early infancy in preterm children. The different pattern of associations by fiber group may relate to the stage of brain maturation and/or the nature and timing of medical complications related to preterm birth. Future studies should replicate these findings with a larger sample size to assure reliability of the findings.
Somatic genetic drift and multi-level selection in modular species
Authors: Yu Lei , Boström Christoffer , Franzenburg Sören , Bayer Till , Dagan Tal , Reusch Thorsten B.H. 
Published: November 2019

AbstractCells in multicellular organisms are genetically heterogeneous owing to somatic mutations. The accumulation of somatic genetic variation in species undergoing asexual (or clonal) reproduction (termed modular species) may lead to phenotypic heterogeneity among modules. However, abundance and dynamics of somatic genetic variation under clonal growth, a widespread life history in nature, remain poorly understood. Here we show that branching events in a seagrass clone or genet leads to population bottlenecks at the cellular level and hence the evolution of genetically differentiated modules. Studying inter-module somatic genetic variation, we uncovered thousands of SNPs that segregated among modules. The strength of purifying selection on mosaic genetic variation was greater at the intra-module comparing with the inter-module level. Our study provides evidence for the operation of selection at multiple levels, of cell population and modules. Somatic genetic drift leads to the emergence of genetically unique modules; hence, modules in long-lived clonal species constitute an appropriate elementary level of selection and individuality.
A reservoir of rituximab-resistant splenic memory B cells contributes to relapses after B-cell depletion therapy
Authors: Crickx Etienne , Chappert Pascal , Weller Sandra , Sokal Aurélien , Azzaoui Imane , Vandenberghe Alexis , Bonnard Guillaume , Rossi Geoffrey , Fadeev Tatiana , Storck Sébastien , Galicier Lionel , Meignin Véronique , Rivière Etienne , Godeau Bertrand , Michel Marc , Weill Jean-Claude , Reynaud Claude-Agnès , Mahévas Matthieu 
Published: November 2019

AbstractImmune thrombocytopenia (ITP) is an autoimmune disease mediated by pathogenic antibodies directed against platelet antigens, including GPIIbIIIa. Taking advantage of spleen samples obtained from ITP patients, we characterized by multiples approaches the onset of disease relapses occurring after an initial complete response to rituximab. Analysis of splenic B cell immunoglobulin heavy chain gene repertoire at bulk level and from single anti-GPIIbIIIa B cells revealed that germinal centers were fueled by B cells originating from the ongoing lymphopoiesis, but also by rituximab-resistant memory B cells, both giving rise to anti-GPIIbIIIa plasma cells. We identified a population of splenic memory B cells that resisted rituximab through acquisition of a unique phenotype and contributed to relapses, providing a new target in B cell mediated autoimmune diseases.
Signal processing in auditory cortex underlies degraded speech sound discrimination in noise
Authors: Town Stephen M. , Wood Katherine C. , Bizley Jennifer K. 
Published: November 2019

AbstractThe ability to recognize sounds in noise is a key part of hearing, and the mechanisms by which the brain identifies sounds in noise are of considerable interest to scientists, clinicians and engineers. Yet we know little about the necessity of regions such as auditory cortex for hearing in noise, or how cortical processing of sounds is adversely affected by noise. Here we used reversible cortical inactivation and extracellular electrophysiology in ferrets performing a vowel discrimination task to identify and understand the causal contribution of auditory cortex to hearing in noise. Cortical inactivation by cooling impaired task performance in noisy but not clean conditions, while responses of auditory cortical neurons were less informative about vowel identity in noise. Simulations mimicking cortical inactivation indicated that effects of inactivation were related to the loss of information about sounds represented across neural populations. The addition of noise to target sounds drove spiking activity in auditory cortex and recruitment of additional neural populations that were linked to degraded behavioral performance. To suppress noise-related activity, we used continuous exposure to background noise to adapt the auditory system and recover behavioral performance in both ferrets and humans. Inactivation by cooling revealed that the benefits of continuous exposure were not cortically dependent. Together our results highlight the importance of auditory cortex in sound discrimination in noise and the underlying mechanisms through which noise-related activity and adaptation shape hearing.