bluuebunny/crossref_metadata_2025_split huggingface dataset:
S172. GLUTAMATE RELATED CONNECTIVITY DISTURBANCES OF THE SALIENCE AND DEFAULT MODE NETWORKS IN PSYCHOSIS
Authors: McCutcheon Rob , Pillinger Toby , Jauhar Sameer , Pepper Fiona , Rogdaki Maria , Howes Oliver 
Published: May 2020

Abstract

Background
Cortical dysconnectivity and dysfunctional glutamatergic signalling are both implicated in the pathophysiology of psychotic illness. The relationship between these two systems, and the relevance to psychotic disorders remains unknown.

Methods
50 individuals with a psychotic disorder and 54 healthy controls received baseline imaging using 1H-MRS to measure anterior cingulate glutamate concentrations, and resting state MRI to characterise functional brain networks. These measures were subsequently repeated following 3 days treatment with either the glutamatergic regulator riluzole (N=36), or a dopamine antagonist (N=14). The network-based statistic was used to examine relationships between glutamate concentrations and connectivity of the salience and default mode networks in patients and controls, and to investigate how this changed following pharmacological manipulation.

Results
In healthy controls higher baseline anterior cingulate glutamate concentrations were associated with reduced salience network connectivity, particularly for interhemispheric connections. This pattern was not seen in patients, and the greater the divergence from the relationship observed in controls, the greater the severity of negative symptoms. Default mode-salience internetwork connectivity was greater in patients compared to controls, and inversely correlated with baseline glutamate concentrations. Furthermore, riluzole associated changes in glutamate concentrations were associated with an inverse change in internetwork connectivity suggesting a causal relationship.

Discussion
Individuals with a psychotic disorder showed marked alterations in the relationship between anterior cingulate cortex glutamate concentration and connectivity of the salience and default mode networks. A pharmacological challenge with a glutamate regulating agent modulated this association, highlighting that the relationship is potentially malleable.
S201. HIPPOCAMPAL SUBFIELD VOLUMES AND CHANGE IN BODY MASS OVER 12 MONTHS OF TREATMENT IN FIRST-EPISODE SCHIZOPHRENIA SPECTRUM DISORDERS
Authors: Du Plessis Stéfan , Luckhoff Hilmar , Kilian Sanja , Asmal Laila , Scheffler Frederika , Phahladira Lebogang , Olivier Riaan , Emsley Robin 
Published: May 2020

Abstract

Background
In this study, we explored the relationship between hippocampal subfield volumes and change in body mass over 12 months of treatment in 90 first-episode schizophrenia spectrum disorder patients (66 males, 24 females; mean age= 24.7±6.8 years).

Methods
Body mass index was assessed in patients at baseline, and at months 3, 6, 9 and 12. Hippocampal subfields of interest were assessed using a segmentation algorithm included in the FreeSurfer 6.0 software program.

Results
Linear regression analysis showed a significant interactive effect between sex and anterior hippocampus size as a predictor of change in body mass over 12 months, adjusting for age, substance use, treatment duration, and posterior hippocampal volumes. In an exploratory sub-analysis, partial correlations revealed a significant association between weight gain and smaller CA1, CA3 and subiculum volumes in females, but not males, adjusting for age and substance use, with similar trends evident for the CA4 and presubiculum subfields.

Discussion
In conclusion, our findings suggest that smaller anterior hippocampal subfields are associated with the development of weight gain over the course of treatment in first-episode schizophrenia spectrum disorders in a sex-specific fashion, and may partly explain the more severe and ongoing increase in body mass evident for female patients.
Combined vascularized bone graft and scaphocapitate fusion in the treatment of stage III(b) Kienböck’s disease: a cohort study involving 11 patients
Authors: Safoury Yasser , Atteya Amr 
Published: May 2020

Background:
The purpose of this study was to evaluate the results of combined scaphocapitate fusion and revascularization of the lunate for patients with stage III(b) Kienböck’s disease.

Methods:
Eleven patients with stage III(b) (Lichtman classification) Kienböck’s disease were identified. The inclusion criteria were stage III(b) Kienböck’s disease according to the Lichtman classification, with no previous surgical interventions, no radiocarpal arthritis, and intact lunate articular surfaces proven by plain radiographs, MRI, and intraoperative wrist arthroscopy. All patients were scheduled for scaphocapitate fusion and lunate revascularization. Intraoperative wrist arthroscopy was mandatory for the plan of treatment.

Results:
In all patients there was radiographic evidence of union and bone consolidation at the carpal fusion site at a mean of 8 wk. MRI was obtained 1 yr after the procedure and showed revascularization of the lunate in all patients. Postoperative serial radiographs showed improvement and maintenance of the lunate height and diameter. Postoperatively, wrist extension range of motion showed a mean improvement of 11.3%, while wrist flexion range of motion showed a mean improvement of 24.32%. Mean improvement in grip strength was 106.33%. VIsual analog scale (VAS) for pain showed a mean improvement of 71.02%. Disability of the Arm, Shoulder, and Hand (DASH) score showed a mean improvement by 77.67%.

Conclusions:
Revascularization and restoration of lunate anatomy together with an unloading procedure gives better results in the treatment of stage III(b) Kienböck’s disease. This technique prevents further collapse of the lunate with satisfactory long term results. Intraoperative wrist arthroscopy is mandatory to prove the intact lunate articular surface.

Level of Evidence:
Level IV.
Perils of Antithrombotic Transitions: Effect of Oral Factor Xa Inhibitors on the Heparin Antifactor Xa Assay
Authors: Ahuja Tania , Yang Irene , Huynh Quy , Papadopoulos John , Green David 
Published: May 2020

Background:
Oral factor Xa inhibitors (OFXais) may interfere with the heparin antifactor Xa (antiXa) assay. The best method to measure heparin activity during the transition from an OFXai to intravenous (IV) unfractionated heparin (UFH) remains unknown. This study aimed to assess the safety and effectiveness of transitioning from an OFXai to UFH.

Methods:
A retrospective analysis was conducted of patients with supratherapeutic antiXa levels on UFH who received either apixaban or rivaroxaban within 72 hours before UFH initiation at NYU Langone Health. The primary objective was to identify the incidence of interference on the heparin antiXa assay due to OFXai exposure in the previous 72 hours. The secondary outcomes included the indication for transition to UFH and the rate of thromboembolic and bleeding events.

Results:
A total of 93 patients with supratherapeutic antiXa activity levels with prior OFXai use were reviewed. Moderate renal impairment, defined as creatinine clearance less than 49 mL/min, was present in 67 (72%) patients. The primary indication for transition from OFXai to UFH was in anticipation for a procedure, and it occurred in 37 (40%) patients. There were 3 major bleeding events and 3 clinically relevant nonmajor bleeding events. No thromboembolic events occurred.

Conclusions:
This study assessed the prevalence of supratherapeutic antiXa levels and clinical outcomes during the transition from OFXais to UFH. Health care systems should develop guidelines to assist clinicians in monitoring antiXa activity in patients undergoing a transition from an OFXai to UFH. It is also important to assess the patient's underlying thromboembolic and bleeding risks.
Short-term Safety of a Silicone Gel–filled Breast Implant: A Manufacturer-sponsored, Retrospective Study
Authors: Yoon Seanhyuck , Chang Jae-Hoon 
Published: May 2020

Background:
Currently, 8 different brands of a silicone gel–filled breast implant are commercially available in Korea. But the superiority of short-term safety has not been established.

Methods:
A total of 709 patients (1,418 breasts) received an implant-based augmentation mammaplasty. We compared a 1-year incidence of complications and complication-free survival among the breast implants. Moreover, we performed a subgroup analysis of the patient cohorts by excluding cases associated with a periareolar incision, revision or reoperation, and anatomic implants.

Results:
In our series, 1-year incidences of complications were 0.55% (1/182), 3.14% (5/159), 5.19% (7/135), and 6.58% (10/152) in patients receiving the BellaGel/BellaGel SmoothFine, the Mentor CPG, the Matrix, and the Motiva Ergonomix, respectively. Moreover, the incidence of capsular contracture was 0.55%, 0.63%, 1.32%, and 3.70% in patients receiving the BellaGel/BellaGel SmoothFine, the Mentor CPG, the Motiva Ergonomix, and the Matrix, respectively. Furthermore, a complication-free survival was 24.82 ± 0.18, 22.23 ± 1.09, 22.15 ± 0.77, and 22.12 ± 1.07 months in patients receiving the BellaGel/BellaGel SmoothFine, the Motiva Ergonomix, the Mentor CPG, and the Matrix, respectively, except for the 2 other remaining products used for a smaller number of patients. However, a subgroup analysis showed no significant differences in a 1-year incidence of complication and complication-free survival among the BellaGel SmoothFine, the Motiva Ergonomix, and the Naturgel.

Conclusion:
It is impossible to draw a definite conclusion about the superiority of the short-term safety among the silicone gel–filled breast implants that are commercially available in Korea.
Local and Systemic Inflammation and Oxidative Stress After a Single Bout of Maximal Walking in Patients With Symptomatic Peripheral Artery Disease
Authors: Andrade-Lima Aluisio , da Silva Junior Natan , Chehuen Marcel , Miyasato Roberto , Souza Rodrigo W.A. , Leicht Anthony S. , Brum Patricia C. , de Oliveira Edilamar M. , Wolosker Nelson , Forjaz Claudia L.M. 
Published: May 2020

Objective
The aim of this study was to assess the effects of a single bout of maximal walking on blood and muscle nitric oxide (NO) bioavailability, oxidative stress, and inflammation in symptomatic peripheral artery disease (PAD) patients.

Methods
A total of 35 men with symptomatic PAD performed a graded maximal exercise test on a treadmill (3.2 km/h, 2% increase in grade every 2 minutes). Plasma samples and gastrocnemius muscle biopsies were collected preexercise and postexercise for assessment of NO bioavailability (plasma NO and muscle, endothelial NO synthase), oxidative stress and antioxidant function (lipid peroxidation [LPO], catalase [CAT], and superoxide dismutase), and inflammation (interleukin-6, C-reactive protein, tumor necrosis factor-α, intercellular adhesion molecules, and vascular adhesion molecules). The effects of the walking exercise were assessed using paired t tests or Wilcoxon tests.

Results
After maximal walking, plasma NO and LPO were unchanged (P > .05), plasma CAT decreased, and all blood inflammatory markers increased (all P ≤ .05). In the disease-affected skeletal muscle, endothelial NO synthase, CAT, LPO, and all inflammatory markers increased, whereas superoxide dismutase decreased (all P ≤ .05).

Conclusion
In patients with symptomatic PAD, maximal exercise induces local and systemic impairments, which may play a key role in atherogenesis. Exercise strategies that avoid maximal effort may be important to reduce local and systemic damage and enhance clinical benefits.
Estimating the Impact of Verification Bias on Celiac Disease Testing
Authors: Hujoel Isabel A. , Jansson-Knodell Claire L. , Hujoel Philippe P. , Hujoel Margaux L.A. , Choung Rok Seon , Murray Joseph A. , Rubio-Tapia Alberto 
Published: May 2020

Goal:
The goal of this study was to estimate the impact of verification bias on the diagnostic accuracy of immunoglobulin A tissue transglutaminase (IgA tTG) in detecting celiac disease as reported by an authoritative meta-analysis, the 2016 Comparative Effectiveness Review (CER).

Background:
Verification bias is introduced to diagnostic accuracy studies when screening test results impact the decision to verify disease status.

Materials and Methods:
We adjusted the sensitivity and specificity of IgA tTG reported by the 2016 CER with the proportion of IgA tTG positive and negative individuals who are referred for confirmatory small bowel biopsy. We performed a systematic review from January 1, 2007, to July 19, 2017, to determine these referral rates.

Results:
The systematic review identified 793 articles of which 9 met inclusion criteria (n=36,477). Overall, 3.6% [95% confidence interval (CI): 1.1%-10.9%] of IgA tTG negative and 79.2.2% (95% CI: 65.0%-88.7%) of IgA tTG positive individuals were referred for biopsy. Adjusting for these referral rates the 2016 CER reported sensitivity of IgA tTG dropped from 92.6% (95% CI: 90.2%-94.5%) to 57.1% (95% CI: 35.4%-76.4%) and the specificity increased from 97.6% (95% CI: 96.3%-98.5%) to 99.6% (95% CI: 98.4%-99.9%).

Conclusions:
The CER may have largely overestimated the sensitivity of IgA tTG due to a failure to account for verification bias. These findings suggest caution in the interpretation of a negative IgA tTG to rule out celiac disease in clinical practice. More broadly, they highlight the impact of verification bias on diagnostic accuracy estimates and suggest that studies at risk for this bias be excluded from systematic reviews.
Association between interleukin-10-819T/C polymorphism and risk of ischemic stroke
Authors: Zuo Shuang , Zheng Tingting , Li Haishan 
Published: May 2020

Abstract

Background:
The interleukin-10 (IL-10)-819T/C polymorphism has been indicated to be correlated with ischemic stroke susceptibility, but this relationship remains controversial. A meta-analysis was conducted to investigate the potential association between IL-10-819T/C polymorphism and ischemic stroke risk.

Methods:
Databases including Pubmed, Embase, and CNKI were searched. Data were extracted and odds ratios (OR) with 95% confidence intervals (CI) were calculated.

Results:
Eight case-control studies with 1832 cases and 1520 controls were included in this meta-analysis. IL-10-819T/C polymorphism may decrease the risk of ischemic stroke (C vs T: OR = 1.01, 95% CI: 0.91–1.12; CC vs TT: OR = 0.91, 95% CI: 0.73–1.14; CT vs TT: OR = 1.10, 95% CI: 0.95–1.28; CC + CT vs TT: OR = 1.06, 95% CI: 0.92–1.22; CC vs CT + TT: OR = 0.91, 95% CI: 0.75–1.11). In the stratified analysis by sample size, and case-control matched status, significant associations were still not observed in all genetic models. In the subgroup meta-analysis based on source of controls, IL-10-819T/C polymorphism had decreased ischemic stroke risk for recessive model in population-based controls’ subgroup (CC vs CT + TT: OR = 0.69, 95% CI: 0.50–0.95), but not in the hospital-based controls’ subgroup. In the stratified analysis based on ethnicity, IL-10-819T/C polymorphism had decreased ischemic stroke risk for recessive model in Asian populations (CC vs CT + TT: OR = 0.78, 95% CI: 0.62–0.99), but not in Caucasian populations.

Conclusions:
In conclusion, the results suggest that the IL-10-819T/C polymorphism is not associated with ischemic stroke risk. Larger scale studies are needed for confirmation.
The cost-effectiveness of empirical antibiotic treatments for high-risk febrile neutropenic patients
Authors: Tori Katerina , Tansarli Giannoula S. , Parente Diane M. , Kalligeros Markos , Ziakas Panayiotis D. , Mylonakis Eleftherios 
Published: May 2020

Abstract

Purpose:
Febrile neutropenia has a significant clinical and economic impact on cancer patients. This study evaluates the cost-effectiveness of different current empiric antibiotic treatments.

Methods:
A decision analytic model was constructed to compare the use of cefepime, meropenem, imipenem/cilastatin, and piperacillin/tazobactam for treatment of high-risk patients. The analysis was performed from the perspective of U.S.-based hospitals. The time horizon was defined to be a single febrile neutropenia episode. Cost-effectiveness was determined by calculating costs and deaths averted. Cost-effectiveness acceptability curves for various willingness-to-pay thresholds (WTP), were used to address the uncertainty in cost-effectiveness.

Results:
The base-case analysis results showed that treatments were equally effective but differed mainly in their cost. In increasing order: treatment with imipenem/cilastatin cost $52,647, cefepime $57,270, piperacillin/tazobactam $57,277, and meropenem $63,778. In the probabilistic analysis, mean costs were $52,554 (CI: $52,242-$52,866) for imipenem/cilastatin, $57,272 (CI: $56,951-$57,593) for cefepime, $57,294 (CI: $56,978-$57,611) for piperacillin/tazobactam, and $63,690 (CI: $63,370-$64,009) for meropenem. Furthermore, with a WTP set at $0 to $50,000, imipenem/cilastatin was cost-effective in 66.2% to 66.3% of simulations compared to all other high-risk options.

Discussion:
Imipenem/cilastatin is a cost-effective strategy and results in considerable health care cost-savings at various WTP thresholds. Cost-effectiveness analyses can be used to differentiate the treatments of febrile neutropenia in high-risk patients.
Anlotinib combined with etoposide for platinum-resistant recurrent ovarian cancer
Authors: Sun Li , Yang Meng , Zhang Xuan , Li Hua , Wu Lingying , Zhang Yuzi , Cai Shangli 
Published: May 2020

Abstract

Introduction:
Platinum-resistant ovarian cancer is characterized by its poor prognosis and limited treatment options. Angiogenesis plays a fundamental role in the development of drug-resistance in ovarian cancer. Anlotinib, a novel oral multi-targeted tyrosine kinase inhibitor which targets a board spectrum of angiogenesis-associated growth factor receptors, has shown promising anti-tumor efficacy in clinical trials. Herein, we report a case of ovarian cancer treated with anlotinib plus etoposide after secondary cytoreductive surgery.

Patient concerns:
A 45-year-old female with primary platinum-resistant ovarian cancer who progressed rapidly after the first cytoreductive surgery, the second cytoreductive surgery, and several lines of treatment. The patient refused to receive intravenous chemotherapy any more.

Diagnosis:
Primary platinum-resistant ovarian cancer.

Interventions:
The oral combination treatment of anlotinib (12 mg, qd) and etoposide (100 mg, qd) were delivered.

Outcomes:
Finally, the patient was responsive to the orally treatment of anlotinib combined with etoposide. The patient has been alive with no evidence of disease progression for 18 weeks.

Conclusion:
Our case suggests that oral treatment of anlotinib combined with etoposide which is acceptable and convenient, may be an additional option for the management of platinum-resistant ovarian cancer.
Exercise or sport activities for patients with cancer
Authors: Wang Fang-fang , Yuan Yang , Song Yu-jun , Wu Yan-qiong , He Yun , Deng Xiu-xiu , Wu Shui-lin , Dai Ding-mei , Wang Min 
Published: May 2020

Abstract

Objective:
We plan to review all published systematic reviews (SRs) and meta-analyses (MAs) of exercise or sport activities for patients with cancer. The aim of this study is to combine and reanalyze related data and to provide more comprehensive and higher-level evidence.

Methods:
We plan to search four English databases and four Chinese databases from inception to June 2019. Patients who were treated by all of exercise or sport activities such as running, gymnastics, taichi, and qigong, will be included. The following information will be extracted from each included SR: first author, year of publication, country of origin, number of primary study; the number of patients enrolled, participant characteristics, duration of cancer diagnosis, cancer types. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and A Measurements Tool to Assess Systematic Reviews 2 (AMSTAR-2) will be used to assess the reporting and methodological quality of SRs/MAs. The characteristics of included SRs/MAs and their quality will be descriptively summarized using systematically structured tables. The network MA approach and narrative synthesis will be used to examine data when applicable. Odds ratio and (standardized) mean difference with their 95% confidence intervals will be used as summary statistics. Stata 13.0 software will be used to analyze and pool data.

Results:
The results of the overview will be submitted to a peer-reviewed journal for publication.

Ethics and dissemination:
The study is not a clinical study, and we will search and evaluate existing sources of literature. So, ethical approval is not required.
The effects of physical activity on physiological markers in breast cancer survivors
Authors: Kang Xin-Yao , Xu Qun-Ying , Yu Ze , Han Shu-Fang , Zhu Yu-Fang , Lv Xin 
Published: May 2020

Abstract

Background:
To systematically evaluate the effects of physical activity on physiological markers in breast cancer survivors.

Methods:
A systematic search of the PubMed, Wed of Science, Medline, CNKI and Wanfang Database was performed to identify eligible randomized controlled trials to explore physical activity on physiological markers in breast cancer survivors. STATA version 13.0 (Stata Corp LP, College Station, TX) was used for all statistical analyses.

Results:
A total of 11 articles with 941 cases were eligible in this meta-analysis. The results of the meta-analysis showed that physical activity could decrease the levels of insulin (SMD = −1.90, 95%CI: −3.2 to −0.60; I2 = 92.3%, P < .001), insulin-like growth factor 1 (IGF-I) (WMD = −4.67, 95%CI: −23.14 to 13.79; I2 = 96.2%, P < .001), insulin-like growth factor binding protein-3 (IGFBP-3) (WMD = −20.09, 95%CI: −47.15 to 6.97; I2 = 93.3%, P < .001). However, compared with the control group, there was not the significant change of insulin-like growth factor 2 (IGF-II), insulin-like growth factor binding protein-1 (IGFBP-1), leptin, adiponectin, glucose, C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-ɑ) levels after the intervention.

Conclusions:
Physical activity could improve the insulin function that might be associated with decreasing the levels of IGF-I, IGFBP-3 and insulin in breast cancer survivors.