bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute proximal left anterior descending thrombosis manifested by persistent hiccups
Authors: Gao Hanxiang , Zhang Bo , Song Li , Yao Suyu , Zhang Zheng , Bai Ming 
Published: November 2019

AbstractIntroduction:Hiccup is usually a benign and self-limited phenomenon. Therefore, if hiccups do not resolve by themselves and even last for a long time, it may be the marker of serious medical conditions.Patient concerns:We encountered a case presenting with recurrent abdominal discomfort. Diffuse ST-segment elevation in V2-V6 and elevated Troponin I was identified. He had complained about constipation and incomplete intestinal obstruction was ever suspected. Four days later, he exhibited persistent hiccups.Diagnosis:He was diagnosed with acute anterior wall myocardial infarction. And elective coronary angiography showed that proximal left anterior descending (LAD) was occluded by fresh thrombus with TIMI 1 flow.Interventions:The lesion in proximal LAD was dilated with low pressure. Interestingly, the hiccups reduced. And after stent implantation the hiccup disappeared in 24 hours.Outcomes:The patient was discharged in good general condition, with maintenance therapy and a follow-up protocol.Conclusion:Hiccup is only rarely described in the context of acute proximal LAD thrombosis. However, if this special symptom occurs intractably during disease progression, thrombus is revealed to be the probable cause, prompt opening of the criminal vessel should be performed besides strengthening of anticoagulant and antiplatelet.
Radiological analysis of breast lymphoma
Authors: Zhou Changyu , Lv Kun , Lin Dongya , Yu Yinxing , Xu Maosheng , Bu Yangyang 
Published: November 2019

Abstract
This retrospective study aimed to improve the diagnostic accuracy of breast lymphoma (BL) by analyzing the findings of BL on mammography and magnetic resonance imaging (MRI).
Fifteen patients with breast lymphoma (BL, Primary/Secondary: 13/2) were confirmed by pathology. The imaging findings of those patients were analyzed by 2 senior radiologists.
BL commonly showed significant enhancement with penetrating vessels and septation in masses on dynamic contrast-enhanced MRI (DCE-MRI). Diffusion limitation of BL is more pronounced than breast cancer on diffusion weighted imaging.
The study suggests that the penetrating vessels and diffusion restriction of lesions are helpful for the diagnosis and differential diagnosis of BL.
Development and validation of a rheumatologist satisfaction with practice scale
Authors: Sheth Khushboo , Valenzuela Antonia , Shoor Stanford , Ritter Philip Lloyd , Lorig Kate 
Published: November 2019

Abstract
There is a paucity of succinct measures of physician satisfaction. As part of a Performance Improvement Project, we developed and piloted a simple questionnaire to determine rheumatologists satisfaction.
Thirty 5 rheumatologists in the academic or private setting were sent opened-ended questions to determine the factors that made them satisfied or dissatisfied with respect to their rheumatology practice. From the responses we formed 14 questions 1 to 10 scale centering on satisfaction and dissatisfaction that was piloted in 30 rheumatologists and subsequently validated in 173 rheumatologists within the US and Latin America.
Our combined sample included 173 rheumatologists (55 English and 118 Spanish-speaking respondents). The mean satisfaction for the combined sample was 6.92 (standard deviation=1.1, range 4.08–9.62). The strongest contributors to physician satisfaction were “Seeing interesting and challenging cases” (8.6 ± 1.5) and “The ability to make a difference in patient's life” as well as “Establishing long term relationship with patients” (8.39 ± 1.5). The strongest contributors to physician dissatisfaction were “Getting inappropriate referrals not in the scope of practice” (4.3 ± 2.13) and “Time spent on documentation” (4.5 ± 2.59). The scale had good reliability, relatively normal distribution, and little or no redundancy among items.
A simple and practical questionnaire to measure physician satisfaction, in particular rheumatologists satisfaction, was developed, piloted and successfully validated on a predominately academic sample of rheumatologists within the US and Latin America. This scale will serve as a means to identifying potential barriers to the implementation of performance improvement projects in the practice of Rheumatology.
Gastric mucormycosis complicated by a gastropleural fistula
Authors: Uchida Tomohisa , Okamoto Momoko , Fujikawa Keita , Yoshikawa Daisuke , Mizokami Akinari , Mihara Tomo , Kondo Akira , Ohba Kazuo , Kurohama Kazuhiro , Nakashima Masahiro , Sekine Ichiro , Nakamura Shigeki , Miyazaki Yoshitsugu , Kawakami Atsushi 
Published: November 2019

Abstract

Rationale:
Mucormycosis is a rare opportunistic fungal infection with poor prognosis. The incidence of mucormycosis has been increasing, and it is a threat to immunocompromised hosts. We present a case of gastric mucormycosis complicated by a gastropleural fistula during immunosuppressive treatment for adult-onset Still disease (AOSD).

Patient concerns:
An 82-year-old woman diagnosed with AOSD who developed gastric ulcers during the administration of an immunosuppressive therapy with corticosteroids, cyclosporine, and tocilizumab complained of melena and epigastralgia. Esophagogastroduodenoscopy showed multiple ulcers covered with grayish or greenish exudates.

Diagnoses:
The patient diagnosed with mucormycosis based on culture and biopsy of the ulcers, which showed nonseptate hyphae branching at wide angles. Mucor indicus was identified using polymerase chain reaction.

Interventions and outcomes:
Although liposomal amphotericin B was administered, gastric mucormycosis was found to be complicated by a gastropleural fistula. The patient died because of pneumonia due to cytomegalovirus infection, and autopsy revealed the presence of Mucorales around the fistula connecting the stomach and diaphragm.

Lessons:
Gastric mucormycosis is refractory to treatment and fatal. Surgical resection, if possible, along with antifungal drugs can result in better outcomes.
Crossed-fused renal ectopia with renal calculi
Authors: Cao Yalei , Zhang Yinan , Kang Weiting , Suo Ning , Cui Zilian , Luo Yuanman , Jin Xunbo 
Published: November 2019

Abstract

Rationale:
Crossed renal ectopia (CRE) is a rare congenital anomaly that is frequently associated with gastrointestinal, cardiovascular, genital and bone malformations. To the best of our knowledge, only 35 cases of crossed renal ectopia involving calculi and 30 cases of CRE associated with renal carcinoma have been reported to date.

Patient concerns:
Here, we present 2 cases of crossed renal ectopia. A 59-year-old woman with diabetes presented to our hospital with abdominal pain. The second patient was a 24-year-old woman who complained with abdominal pain with a duration of 1 day.

Diagnoses:
On the basis of abdominal ultrasonography, we suspected a solitary kidney both in the two patients. Combined with retrograde pyelography and 3D computed tomography, case 1 was diagnosed as an S-shaped right-to-left crossed-fused ectopic kidney with many stones in the left (normal) renal pelvis and case 2 was confirmed to have lump right-to-left crossed-fused renal ectopia with two 3-mm stones in the renal pelvis of the 2 kidneys.

Interventions:
Case 1 underwent percutaneous nephrolithotomy while case 2 refused to undergo surgery and underwent conservative treatment for pain relief.

Outcomes:
Two patients have been followed up and have no stones recurrence.

Lessons:
Crossed fused renal ectopia is easily misdiagnosed as a solitary kidney. CRE is so rare that the recognition of the disease needs to be improved and effective treatment should be taken timely. According to the two cases and literature review, minimally invasive surgery has become increasingly common to treat CRE with stones and carcinoma.
Umbilical artery thrombosis
Authors: Li Huanxi , Qufeng Wu , Wei Wei , Lin Xueyan , Zhang Xueqin 
Published: November 2019

Abstract

Rationale:
The umbilical cord is the way to exchange gas, supply nutrients, excrete metabolized. Thrombosis of the umbilical cord leads to fetal hypoxia, which jeopardizes fetal health and can cause fetal death. Umbilical vessel thrombosis, which is rarely reported, is difficult to detect prenatally.

Patient concerns:
Both pregnant women had an unremarkable pregnancy course until a routine ultrasound scan in the third trimester showed a single umbilical artery. However, one umbilical vein and 2 umbilical arteries were seen during an ultrasound examination at 32 weeks. Case 2 had a better pregnancy outcome because of the timely discovery of this complication.

Diagnosis:
Both cases were diagnosed as umbilical artery thrombosis.

Interventions:
The first patient received no interventions until they reported decreased fetal movements and gradually disappear. The second patient underwent an emergency cesarean section.

Outcomes:
In Case 1, an emergency ultrasound examination showed intrauterine fetal death, and the patient vaginally delivered a stillborn child weighing 3300 g in a day. In Case 2, a female neonate weighing 2860 g was delivered by cesarean section, and exhibited Apgar scores of 10 and 10 at 1 and 5 minutes.

Conclusion:
In the late-term abortions, obstetricians should be vigilant if ultrasound imaging shows suspected umbilical vascular thrombosis or shows 1 umbilical artery when there had previously been 2. The fetus should be closely monitored and interventions implemented as early as possible to improve the prenatal detection rate of umbilical vessel thrombosis and avoid adverse pregnancy outcomes.
Spontaneous rupture of unscarred uterus in the third trimester after in vitro fertilization-embryo transfer because of bilateral salpingectomy
Authors: Sun Yan , Huang Jing , Kong Hong-Fang 
Published: November 2019

Abstract

Rationale:
Rupture of an unscarred uterus after in vitro fertilization–embryo transfer (IVF-ET) in a primiparous woman is rare. Assisted reproductive technology (ART)-induced rupture of an unscarred uterus is usually attributable to increased dizygotic twinning rates. Salpingectomy can result in cornual scarring and increase the risk of uterine rupture as well as the mortality rate in a subsequent ectopic pregnancy. Here, we present the first reported case of a spontaneous, third-trimester, uterine rupture in a primiparous woman after IVF-ET due to a history of bilateral salpingectomy because of bilateral oviduct and ovarian cysts; the patient did not have an ectopic pregnancy or any cornual or other uterine scarring during this pregnancy after IVF-ET.

Patient concerns:
A 24-year-old woman with a history of IVF-ET and bilateral salpingectomy was admitted to our hospital with unexplained acute upper abdominal pain during the third trimester.

Diagnosis:
The fetal heart rate was abnormal. Abdominal ultrasonography was negative. Computed tomography revealed a small amount of abdominal and pericardial effusion. Laboratory tests revealed increased white blood cells. A diagnosis of pregnancy complicated by acute abdomen was considered. Emergent exploratory laparotomy revealed a uterine rupture at the right fundus adjacent to the right cornual area.

Interventions:
The patient was successfully managed with simultaneous exploratory laparotomy and lower-segment cesarean section. The rupture site was repaired.

Outcomes:
Two live infants were uneventfully delivered. Follow-up assessments of the mother and the female baby on the 42nd postpartum day yielded normal results. The male infant was diagnosed with left hydronephrosis and required an operation.

Lessons:
We conclude that the ART-associated increase in dizygotic twinning rates may be a neglected risk factor for spontaneous rupture of the unscarred uterus, especially in patients who have undergone salpingectomy. Uterine rupture should be considered in a patient with multiple pregnancy following IVF-ET who presents with acute abdominal pain and abnormal fetal heart rate. Timely exploratory laparotomy is the key to a good prognosis.
The expression and prognostic significance of Drp1 in lung cancer
Authors: Yu Lingling , Xiao Zuke , Tu Hongying , Tong Bo , Chen Shengsong 
Published: November 2019

Abstract

Background:
Dynamin-related protein 1 (Drp1) plays important roles in tumorigenesis, including lung cancer. However, the effect of Drp1 in lung cancer remains unclear. The present study was aimed to investigate the clinical significance and effect of Drp1 on prognosis of lung cancer.

Methods:
Oncomine and The Cancer Genome Atlas (TCGA) databases were selected to predict the differential expression levels of Drp1 in lung cancer. Then, 70 cases of lung cancer and normal tissues were collected and immunohistochemistry was used to detect the expression of Drp1. In addition, Kaplan–Meier Plotter database and TCGA database were used to verify the correlation between Drp1 expression and the clinical prognosis in lung cancer patients.

Results:
Drp1 was significantly overexpressed in lung cancer tissues based on Oncomine and TCGA databases (P < .05). Moreover, results from immunohistochemistry showed that Drp1 protein level in lung cancer was also significantly higher than that in the matched normal tissues (P < .05). Prognostic analysis from Kaplan–Meier Plotter database with the chosen probe IDs of 203105_s_at suggested that Drp1 was negatively correlated to overall survival (OS) of lung cancer patients (HR = 1.16, 95% CI: 1.02–1.31; P = .025), but not in the probe IDs of 226154_at (HR = 0.86, 95% CI: 0.73–1.01; P = .069). However, prognosis from TCGA database showed inconsistent results in which high expression of Drp1 was correlated with worse survival probability of all, male, female in lung adenocarcinoma (P < .05), but not in LUSC (P > .05).

Conclusion:
Drp1 was highly expressed in lung cancer based on bioinformatics analysis and tissue microarray, but there was a lot of inconsistency in prognosis depending on different levels of Drp1 from the bioinformatics analysis.
Optimizing Time to Antibiotic Administration in Children with Possible Febrile Neutropenia through Quality Improvement Methodologies
Authors: Burns Beech , Hartenstein Melinda , Lin Amber , Langley Denise , Burns Erin , Heilman James , Tanski Mary , Stork Linda , Ma O. John 
Published: November 2019

Introduction:
Febrile neutropenia is a potentially life-threatening complication of chemotherapy in pediatric oncology patients. Prompt initiation of antibiotic therapy may minimize morbidity and mortality associated with this condition, and time to antibiotic (TTA) administration <60 minutes is used as a quality benchmark by many institutions. We implemented a quality improvement initiative to achieve TTA < 60 minutes in >80% of eligible patients in the pediatric emergency department.

Methods:
After collecting baseline data, we employed consecutive PDSA cycles to (i) reduce time to antibiotic order after patient arrival; (ii) expedite the preparation of antibiotic by pharmacy; and (iii) enable antibiotic ordering before patient arrival. Statistical process control methodologies were used for key outcome measures to compare pre-intervention, post-intervention, and maintenance periods.

Results:
Comparing pre-intervention and post-intervention years, mean TTA decreased from 64 to 53 minutes and the percentage of patients receiving antibiotics in <60 minutes increased from 59% to 84%. Improvements were sustained in the maintenance period of the project, with mean TTA administration of 44 minutes and 85% of patients receiving antibiotics within our stated goal.

Conclusion:
Through a series of PDSA cycles, we decreased TTA and increased the percentage of febrile neutropenia patients receiving antibiotics in <60 minutes.
Kidney Donor Profile Index Is a Reliable Alternative to Liver Donor Risk Index in Quantifying Graft Quality in Liver Transplantation
Authors: Scheuermann Uwe , Truong Tracy , Seyferth Elisabeth R. , Freischlag Kyle , Gao Qimeng , Yerxa John , Ezekian Brian , Davis Robert P. , Schroder Paul M. , Peskoe Sarah B. , Barbas Andrew S. 
Published: November 2019

Background.
The most established metric for estimating graft survival from donor characteristics in liver transplantation is the liver donor risk index (LDRI). The LDRI is calculated from donor and transplant-related variables, including cold ischemic time. Because cold ischemic time is unknown at the time of organ offer, LDRI is not available for organ acceptance decisions. In contrast, the kidney donor profile index (KDPI) is derived purely from donor variables known at the time of offer and thus calculated for every deceased donor in the United States. The similarity in donor factors included in LDRI and KDPI led us to hypothesize that KDPI would reliably approximate LDRI in estimating graft survival in liver transplantation.

Methods.
The United Network of Organ Sharing registry was queried for adults who underwent deceased donor liver transplantation from 2002 to 2016. The cohort was divided into quintiles of KDPI and LDRI, and graft survival was calculated according to Kaplan Meier. Hazard ratios for LDRI and KDPI were estimated from Cox proportional hazards models, and Uno’s concordance statistic was compared.

Results.
In our analysis of 63 906 cases, KDPI closely approximated LDRI in estimating liver graft survival, with an equivalent concordance statistic of 0.56.

Conclusions.
We conclude that KDPI can serve as a reasonable alternative to LDRI in liver acceptance decisions.
Reserve in Alzheimer's disease: update on the concept, functional mechanisms and sex differences
Authors: Ewers Michael 
Published: November 2019

Purpose of review
Epidemiological evidence suggests that higher reserve significantly delays the dementia onset in Alzheimer's disease. Yet, confusion in terminology of reserve and related concepts exists and the lack of quantitative measures and unclear neural substrates of reserve have hampered progress. We review here the latest advances in the concept, measures and functional brain mechanisms of reserve, as well as their moderating factors including sex and gender.

Recent findings
The definition of reserve has been revised towards a more simplified concept, and the development of quantitative measurements of a cognitive advantage in disease has been advanced. Functional MRI and FDG-PET studies have provided for the first time converging evidence for the involvement of the cognitive control and salience network and temporal pole in reserve. Women tend to show lower resilience than men at advanced stages of AD.

Summary
Neuroimaging studies have provided substantial evidence for putative brain mechanisms supporting reserve in Alzheimer's disease. However, the findings are still somewhat disparate and call for the development of unifying and testable theory of functional and structural brain properties that subserve reserve. Sex differences emerged as a moderating factor of reserve in Alzheimer's disease and need to be made a major research focus in Alzheimer's disease.
Can computers understand words like humans do? Comparable semantic representation in neural and computer systems
Authors: Zhang Linmin , Wang Lingting , Yang Jinbiao , Qian Peng , Wang Xuefei , Qiu Xipeng , Zhang Zheng , Tian Xing 
Published: November 2019

AbstractSemantic representation has been studied independently in neuroscience and computer science. A deep understanding of human neural computations and the revolution to strong artificial intelligence appeal for a joint force in the language domain. We investigated comparable representational formats of lexical semantics between these two complex systems with fine temporal resolution neural recordings. We found semantic representations generated from computational models significantly correlated with EEG responses at an early stage of a typical semantic processing time window in a two-word semantic priming paradigm. Moreover, three representative computational models differentially predicted EEG responses along the dynamics of word processing. Our study provided a finer-grained understanding of the neural dynamics underlying semantic processing and developed an objective biomarker for assessing human-like computation in computational models. Our novel framework trailblazed a promising way to bridge across disciplines in the investigation of higher-order cognitive functions in human and artificial intelligence.
Standardizing Human Brain Parcellations
Authors: Lawrence Ross M. , Bridgeford Eric W. , Myers Patrick E. , Arvapalli Ganesh C. , Ramachandran Sandhya C. , Pisner Derek A. , Frank Paige F. , Lemmer Allison D. , Nikolaidis Aki , Vogelstein Joshua T. 
Published: November 2019

AbstractUsing brain atlases to localize regions of interest is a requirement for making neuroscientifically valid statistical inferences. These atlases, represented in volumetric or surface coordinate spaces, can describe brain topology from a variety of perspectives. Although many human brain atlases have circulated the field over the past fifty years, limited effort has been devoted to their standardization. Standardization can facilitate consistency and transparency with respect to orientation, resolution, labeling scheme, file storage format, and coordinate space designation. Our group has worked to consolidate an extensive selection of popular human brain atlases into a single, curated, open-source library, where they are stored following a standardized protocol with accompanying metadata, which can serve as the basis for future atlases. The repository containing the atlases, the specification, as well as relevant transformation functions is available at https://github.com/neurodata/neuroparc.
Messinian vegetation and climate of the intermontane Florina-Ptolemais-Servia Basin, NW Greece inferred from palaeobotanical data: How well do plant fossils reflect past environments?
Authors: Bouchal Johannes M. , Güner Tuncay H. , Velitzelos Dimitrios , Velitzelos Evangelos , Denk Thomas 
Published: November 2019

AbstractThe late Miocene is marked by pronounced environmental changes and the appearance of strong temperature and precipitation seasonality. Although environmental heterogeneity is to be expected during this time, it is challenging to reconstruct palaeoenvironments using plant fossils. We investigated leaves and dispersed spores/pollen from 6.4–6 Ma strata in the intermontane Florina-Ptolemais-Servia Basin (FPS) of northwestern Greece. To assess how well plant fossils reflect the actual vegetation of the FPS, we assigned fossil-taxa to biomes providing a measure for environmental heterogeneity. Additionally, the palynological assemblage was compared to pollen spectra from modern lake sediments to assess biases in spore/pollen representation in the pollen record. We found a close match of the Vegora assemblage with modernFagus–Abiesforests of Turkey. Using taxonomic affinities of leaf fossils, we further established close similarities of the Vegora assemblage with modern laurophyllous oak forests of Afghanistan. Finally, using information from sedimentary environment and taphonomy, we distinguished local and distantly growing vegetation types. We then subjected the plant assemblage of Vegora to different methods of climate reconstruction and discussed their potentials and limitations. Leaf and spore/pollen records allow accurate reconstructions of palaeoenvironments in the FPS, whereas extra-regional vegetation from coastal lowlands is likely not captured.