bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of acupuncture on postoperative recovery and extubation time
Authors: Kwon Seungwon , Jin Chul , Jeong Aram , Yang Seung-Bo 
Published: January 2021

Abstract

Background:
This systematic review protocol aims to provide evidence of the efficacy and safety of acupuncture on postoperative recovery and extubation time.

Methods:
The following 11 electronic databases will be searched from inception: The Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, AMED, CINAHL, 1 Chinese database (CNKI), and 5 Korean databases (OASIS, DBpia, RISS, KISS, NDSL). Only randomized controlled trials of acupuncture treatment for postoperative recovery after surgery will be included for review. The selection of the studies, data extraction, and management will be performed independently by 3 researchers. Methodological quality, including the risk of bias, will be assessed using the Cochrane risk of bias assessment tool.

Results and Conclusions:
Our systematic review will provide evidence of the efficacy of acupuncture on postoperative recovery and extubation time. This evidence will provide useful information to practitioners and patients in the field of surgery and complementary medicine.

PROSPERO registration number:
2020 CRD42020168411
Predicting 72-h mortality in patients with extremely high random plasma glucose levels
Authors: Watanabe Tamami , Sugawara Hitoshi , Saito Kai , Ishii Akira , Fukuchi Takahiko , Omoto Kiyoka 
Published: January 2021

Abstract
The risk factors associated with 72-hours mortality in patients with extremely high levels of random plasma glucose (RPG) remain unclear.
To explore the risk factors predictive of 72-hours mortality in patients with extremely high RPG under heterogenos pathophysiological conditions.
Retrospective, single-center, case-controlled cross-sectional study.
University teaching hospital.
Adults over age 18 were selected from the medical records of patients at the Saitama Medical Center, Japan, from 2004 to 2013.
Extremely high RPG (≥500 mg/dl).
Mortality at 72 hours following the RPG test, regardless of hospitalization or in an outpatient setting. Multivariate logistic regression analysis was performed with adjustment for age, sex, body mass index (BMI), and RPG level. The final prediction model was built using the logistic regression model with a higher C-statistic, specificity, and sensitivity.
A total of 351 patients with RPG ≥500 mg/dl were identified within the 10-year period. The 72-hours mortality rate was 16/351 (4.6%). The C-statistics of the 72-hours mortality prediction model with serum albumin (ALB) and creatine kinase (CK) was 0.856. The probability of 72-hours mortality was calculated as follows: 1/[1 + exp (−5.142 + 0.901log (CK) −1.087 (ALB) + 0.293 (presence (1) or absence (0) of metastatic solid tumor)]. The sensitivity and specificity of this model was 75.5%.
The independent risk factors associated with 72-hours mortality in patients with RPG ≥500 mg/dl are hypoalbuminemia, elevated CK, and presence of a metastatic solid tumour. Further research is needed to understand the mechanisms and possible interventions to prevent mortality associated with extremely high RPG.
Prognostic significance of ANO1 expression in cancers
Authors: Zhang Congxiao , Li Haini , Gao Jing , Cui Xiaoqing , Yang Shengmei , Liu Zongtao 
Published: January 2021

Abstract

Background:
Anoctamin-1 (ANO1) plays a pivotal role in cancer progression. A meta-analysis was conducted to assess the potential prognostic role of ANO1 in cancers.

Methods:
A total of 1760 patients from 7 eligible studies were included into the analysis. Pooled hazard ratios or odds ratios were extracted and calculated with a random-effects model, and analyses of heterogeneity bias were conducted.

Results:
Our results showed that over expression of ANO1 was significantly correlated with poor overall survival in all cancers (HR = 1.52; 95% CI: 1.19–1.92; P = .0006). Subgroup analysis indicated that there was a significant association between over expression of ANO1 and poor prognosis breast cancer (HR = 3.24; 95% CI: 1.74–6.04), head and neck squamous cell carcinoma (HR = 1.14; 95% CI: 1.00–1.30), esophageal squamous cell carcinoma (HR = 1.93; 95% CI: 1.07–3.50), gastric cancer (HR = 1.62; 95% CI: 1.12–2.34) and colorectal cancer (HR = 1.38; 95% CI: 1.03–1.85). In addition, over expression of ANO1 was not associated with TNM stage, histological grade, lymph node metastasis, tumor size, age and gender. However, ANO1 was significantly associated with human epidermal growth factor receptor 2, but not associated with progesterone receptor or estrogen receptor in breast cancer.

Conclusions:
Our results indicate that ANO1 can be a predictive factor for prognosis of cancer.
Enoxaparin Dose Requirements to Achieve Therapeutic Low–molecular-weight Heparin Anti-factor Xa Levels in Infants and Young Children
Authors: Wysocki Emma L. , Kuhn Alexis , Steinbrenner Jenny , Tyrrell Laura , Abdel-Rasoul Mahmoud , Dunn Amy , Cloyd Colleen 
Published: January 2021

Introduction:
Enoxaparin is commonly used to treat pediatric thrombosis. Several small retrospective studies have suggested that infants and young children require higher enoxaparin doses to achieve therapeutic anti-factor Xa levels compared with adults.

Materials and Methods:
This is a retrospective study of hospitalized children who received enoxaparin for the treatment of thrombosis at a free-standing children’s hospital. The primary objective was to ascertain the enoxaparin dose required to achieve an anti-factor Xa level of 0.5 to 1.0 U/mL among 4 age groups in a large cohort of infants and young children between 60 days and 5 years of age.

Results:
A total of 176 infants and children were evaluated. The majority of patients were less than 1 year of age (n=104). An inverse relationship between enoxaparin dose needed to achieve therapeutic anti-factor Xa levels and patient age was noted, particularly in the first year of life. Patients who were 60 days to less than 7 months at the time of enoxaparin initiation (n=73) required the highest mean dose among the age groups at 1.73 mg/kg subcutaneously every 12 hours (P<0.0001).

Conclusion:
Infants and young children require higher doses of enoxaparin to achieve therapeutic anti-factor Xa levels compared with adults.
Stratification of Bleeding Risk Using Thromboelastography in Children on Extracorporeal Membrane Oxygenation Support*
Authors: Sleeper Lynn A. , Mulone Michelle , Diallo Fatoumata , Nasr Viviane G. , Thiagarajan Ravi R. , Emani Sitaram , Emani Sirisha 
Published: January 2021

Objectives:
Patients undergoing extracorporeal membrane oxygenation are at high risk for bleeding and thrombotic complications. Current laboratory methods for assessing the coagulation system may be imprecise and complicate clinical decision-making. We hypothesize that thromboelastography may be more strongly associated with bleeding events than traditional methods and can aid extracorporeal membrane oxygenation coagulation management.

Design:
In a retrospective study, 40 patients with congenital heart disease requiring extracorporeal membrane oxygenation support yielded a total of 159 patient days of data for thromboelastography analysis.

Setting:
Pediatric cardiac ICU at a single institution.

Subjects:
Pediatric patients (≤ 18 yr) with congenital heart disease requiring extracorporeal membrane oxygenation support.

Interventions:
None.

Methods:
Thromboelastography was performed on whole blood samples collected 6–12 hours following extracorporeal membrane oxygenation initiation and daily for the duration of extracorporeal membrane oxygenation. Bleeding during each 24-hour period was defined as need for re-exploration or need for blood transfusion. Associations between thromboelastography variables and bleeding over each 24-hour period (bleeding vs nonbleeding days) were assessed using mixed effects logistic regression and classification and regression tree analysis.

Measurements and main results:
Bleeding occurred in 25 patients (63%), contributing 87 bleeding days (55% extracorporeal membrane oxygenation days) for analysis. The probability of bleeding within the 24-hour period was not associated with activated partial thromboplastin time (p = 0.6) or anti-Xa levels (p = 0.3) on that day. The strongest correlate of bleeding was a maximum amplitude less than 55.4 mm on thromboelastography (odds ratio, 3.28; 95% CI, 1.63–6.60; p < 0.001). Bleeding occurred on 73% versus 35% of extracorporeal membrane oxygenation days for maximum amplitude less than 55.4 mm versus greater than or equal to 55.4 mm, respectively. Bleeding occurred on all days when a combination of maximum amplitude less than 55.4 mm and a reaction time greater than 12.9 minutes was present. The lowest risk of bleeding (28% of patient days) was associated with maximum amplitude greater than or equal to 55.4 mm and plasma fibrinogen greater than 345 mg/dL.

Conclusions:
Thromboelastography-derived variables maximum amplitude and reaction time, along with plasma fibrinogen levels, can help predict bleeding events in children on extracorporeal membrane oxygenation support. Research based on larger patient samples is needed to confirm the specific thresholds identified for bleeding risk stratification for extracorporeal membrane oxygenation anticoagulation management.
Diagnostic Value of Monocyte-to-Lymphocyte Ratio Against Other Biomarkers in Children With Appendicitis
Authors: Duman Levent , Karaibrahimoğlu Adnan , Büyükyavuz Behçet İlker , Savaş Mustafa Çağri 
Published: January 2021

Objectives
This study aimed to investigate diagnostic value of monocyte-to-lymphocyte ratio as a novel biomarker in children with appendicitis and to compare with other biomarkers.

Methods
A total of 683 children were included in this retrospective study. Patients were categorized as acute appendicitis (AA, n = 254), perforated appendicitis (PA, n = 82), nonspecific abdominal pain (NAP, n = 197), and control (n = 150). The groups were compared for demographics, duration of symptoms, monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), white blood cell count, neutrophil percentage (NP), C-reactive protein (CRP), mean platelet volume, and sodium level.

Results
There was a significant difference between all groups for MLR, PLR, and CRP. White blood cell count, NP, and NLR were significantly increased in patients with appendicitis, but there was no significant difference in the differential diagnosis between PA and AA. Sodium levels significantly decreased in patients with appendicitis. No statistically significance was determined between all groups in term of mean platelet volume. Among the biomarkers, MLR showed the highest diagnostic value (area under the receiver operator characteristic curve = 0.798) for AA, while CRP showed excellent diagnostic value (area under the receiver operator characteristic curve = 0.897) for PA.

Conclusions
To our knowledge, this is the first study showing that MLR is a valuable parameter to differentiate patients with and without appendicitis. White blood cell, NP, and NLR are also useful parameters. On the other hand, an increased CRP level and hyponatremia are indicators of PA.
Pediatric Train Injuries
Authors: Pennell Christopher , Lindholm Erika , Latreille Jacob , Kadakia Shreeja , Nanassy Autumn , Ciullo Sean , Arthur L. Grier , Grewal Harsh , Prasad Rajeev 
Published: January 2021

Objectives
Trains can cause severe injuries in pediatric patients requiring significant resource utilization. We sought to review train injuries in Pennsylvania to determine the burden of these injuries on the pediatric trauma system.

Methods
We queried the Pennsylvania Trauma Outcomes Study Database to identify patients younger than 18 years injured by trains between 2007 and 2016. Demographics, hospital course, outcomes, and resource utilization were reviewed.

Results
Thirty-five children from 17 Pennsylvania counties were included. Three counties accounted for 48.6% of injured children. The median age was 15.0 years, and most patients were White (60.0%) and male (77.1%). The median length of stay was 8.0 days and overall mortality 8.6%. Intensive care unit admission was required for 65.7%. The median Injury Severity and Functional Status at Discharge scores were 14.0 and 18.0, respectively. Major orthopedic injuries (fracture or amputation) were the most common (57.1%) followed by traumatic brain injury (45.7%), pneumothorax (14.3%), and solid organ injury (14.3%). Operative management was common with 65.7% undergoing surgery.

Conclusions
Injuries caused by trains can be severe and are most commonly orthopedic or traumatic brain injuries. Targeted safety interventions may be possible given the common mechanisms and geographic clustering of these injuries.
Occult Bone Metastases From Hepatocellular Carcinoma Detected on 68Ga-PMSA PET/CT
Authors: Usmani Sharjeel , Rasheed Rashid , Al Kandari Fareeda , Ahmed Najeeb 
Published: January 2021

Abstract

68Ga-PSMA is an excellent radiotracer for both staging and detection of recurrence in prostate cancer, but it can also be useful in other solid tumors due to tumor-associated angiogenic factors and endothelial cell sprouting. We report a case of an 82-year-old man with hepatocellular carcinoma who presented with rising tumor marker but stable CT findings 6 months after transarterial chemoembolization. 68Ga-PSMA PET/CT showed high PSMA-expressing hyperneovascular hepatic lesions (primary tumor), additional multifocal hepatic lesions, and with unexpected multiple bone metastases. 68Ga-PSMA expression in hepatocellular carcinoma can influence patient management and potentially guide radionuclide legend therapy.
18F-FDG PET/CT Monitoring of Response to Programmed Death Protein 1 Blockade in Metastatic Basal Cell Carcinoma
Authors: Jadvar Hossein , In Gino K. 
Published: January 2021

Abstract
A 73-year-old woman with history of metastatic basal cell carcinoma presented with a large spinal mass demonstrating a high mutational burden of 111 mutations/Mb. She underwent T12 corpectomy and T10–L3 posterior spinal fusion followed by adjuvant radiation. After 2 years of surveillance, FDG PET/CT and a contrast-enhanced MRI revealed recurrence, prompting salvage therapy with the hedgehog signaling pathway inhibitor, sonidegib, which only transiently stabilized the disease. An off-label treatment with the programmed death protein 1 inhibitor, pembrolizumab, was initiated. Serial FDG PET/CT showed gradual decline in tumor metabolism over the next 12 months, leading to complete metabolic response.
Narrative Discourse Intervention After Traumatic Brain Injury
Authors: Steel Joanne , Elbourn Elise , Togher Leanne 
Published: January 2021

Purpose:
Narrative discourse (e.g., telling anecdotes or relating personal events) comprises a key part of social interaction and is commonly affected after traumatic brain injury (TBI). Research over the past decades has enabled improved characterization of discourse impairment after TBI, but a critical lack of research into discourse intervention approaches remains.

Methods:
This systematic review examined empirical research on narrative discourse intervention after TBI. Searches were conducted on EMBASE, CINAHL, PsycINFO, and PubMed for original research on spoken narrative discourse treatment, where at least 50% of the study participants were adults with TBI.

Results:
Of 519 screened articles, six studies met criteria: three single case studies and three case series studies. Interventions incorporated metacognitive and metalinguistic theoretic principles, with a focus on understanding the structure and elements of narratives. Active components of treatments are discussed and compared in relation to existing narrative discourse treatment programs for other neurological communication disorders.

Conclusions:
Although all studies reported gains on some measures for treated narratives following intervention, there were mixed results for effect generalization and/or maintenance. The INCOG guidelines recommend that interventions after TBI should be contextualized and involve personally relevant materials, and this was not evident in the reviewed intervention approaches. Directions are suggested for clinical practice and future research in treating narratives.
Measuring Change at the Discourse-Level Following Conversation Treatment
Authors: DeDe Gayle , Hoover Elizabeth 
Published: January 2021

Purpose:
This article reviews four discourse measures and examines whether they are sensitive to impairments in people with both mild and severe aphasia. We also ask whether these measures were sensitive to effects of conversation treatment in two case examples.

Method:
Two people with aphasia, one mild and fluent and the other severe and nonfluent, served as case studies. Both case studies had participated in conversation treatment, in which individualized goals were targeted in the context of naturalistic conversation-based interactions. Picture descriptions were analyzed using three discourse measures: core lexicon, words per minute, and correct information units. In addition, words per minute and conversation turns were examined in personal narratives produced by the individual with severe nonfluent aphasia in a conversational context.

Results:
For the individual with mild aphasia, both words per minute and core lexicon were sensitive to the presence of aphasia and treatment changes. For the individual with severe aphasia, all measures were sensitive to the presence of aphasia, but only words per minute and number/type of conversation turns were sensitive to effects of treatment.

Discussion/Conclusions:
Discourse measures capture relevant aspects of communication that may not be seen on standardized measures of discrete language skills. Given different aphasia profiles and individual communication goals, clinicians need to choose the most relevant, reliable, and informative measures.
Making Sense of Right Hemisphere Discourse Using RHDBank
Authors: Minga Jamila , Johnson Melissa , Blake Margaret Lehman , Fromm Davida , MacWhinney Brian 
Published: January 2021

Purpose:
Right hemisphere brain damage (RHD) commonly causes pragmatic language disorders that are apparent in discourse production. Specific characteristics and approaches to assessment, diagnosis, and treatment of these disorders are not well-defined. RHDBank, a shared database of multimedia interactions for the study of communication using discourse, was created to address these gaps. The database, materials, and related analysis programs are free resources to clinicians, researchers, educators, and students.

Method:
A standard discourse protocol was developed to elicit multiple types of discourse: free speech, conversation, picture description, storytelling, procedural discourse, and question-asking. Testing included measures of cognition, unilateral neglect, and communicative participation. Language samples were video-recorded and transcribed in CHAT format. Currently, the database includes 24 adults with RHD and 24 controls.

Results:
Illustrative analyses show how RHDBank can facilitate research using micro- and macrolinguistic discourse analysis techniques both within this population and across populations. Educational resources, such as the Grand Rounds tutorial, were developed using case studies from the database.

Conclusions:
RHDBank is a shared database of resources that can facilitate educational and research efforts to address the gaps in knowledge about RHD communication and improve the clinical management of individuals with RHD.
Obesity and Oxidative Stress in Older Adults At Risk for Dementia
Authors: Turner Ashlee , Hoyos Camilla , Mowszowski Loren , LaMonica Haley , Lagopoulos Jim , DeMayo Marilena M. , Ireland Catriona , Hickie Ian B. , Naismith Sharon L. , Duffy Shantel L. 
Published: January 2021

Objective:
This study aimed to investigate the relationship between obesity and oxidative stress in older adults at risk for dementia. It also aimed to explore the influence of physical activity on the relationship between obesity and oxidative stress in this at risk cohort.

Methods:
Older adults at risk for dementia underwent comprehensive medical, neuropsychological, and psychiatric assessment. At risk was defined as participants with subjective or mild cognitive impairment. Glutathione was assessed by magnetic resonance spectroscopy in the left hippocampus and the anterior and posterior cingulate cortex. Body mass index (BMI) was calculated and classified as healthy (BMI <25 kg/m2) or overweight/obese (BMI ≥25 kg/m2).

Results:
Sixty-five older adults (mean age=66.2 y) were included for analysis. The overweight/obese group had significantly greater glutathione in the hippocampus compared with the healthy weight group (t=−2.76, P=0.008). No significant difference in glutathione was observed between groups in the anterior or posterior cingulate. In the overweight/obese group, a higher BMI was associated with a diabetes diagnosis and lower total time engaging in physical activity (r=−0.36, P=0.025), however, glutathione did not correlate with activity levels across groups.

Conclusion:
This study demonstrates that changes in in vivo markers of oxidative stress are present in overweight/obese older adults at risk for dementia. Future research should explore the relationship with diabetes and the longitudinal relationship between BMI and oxidative stress, and response to therapeutic interventions.
Seq-Scope: Submicrometer-resolution spatial transcriptomics for single cell and subcellular studies
Authors: Cho Chun-Seok , Xi Jingyue , Park Sung-Rye , Hsu Jer-En , Kim Myungjin , Jun Goo , Kang Hyun-Min , Lee Jun Hee 
Published: January 2021

AbstractSpatial barcoding technologies have the potential to reveal histological details of transcriptomic profiles; however, they are currently limited by their low resolution. Here we report Seq-Scope, a spatial barcoding technology with a resolution almost comparable to an optical microscope. Seq-Scope is based on a solid-phase amplification of randomly barcoded single-molecule oligonucleotides using an Illumina sequencing-by-synthesis platform. The resulting clusters annotated with spatial coordinates are processed to expose RNA-capture moiety. These RNA-capturing barcoded clusters define the pixels of Seq-Scope that are approximately 0.5-1 μm apart from each other. From tissue sections, Seq-Scope visualizes spatial transcriptome heterogeneity at multiple histological scales, including tissue zonation according to the portal-central (liver), crypt-surface (colon) and inflammation-fibrosis (injured liver) axes, cellular components including single cell types and subtypes, and subcellular architectures of nucleus, cytoplasm and mitochondria. Seq-scope is quick, straightforward and easy-to-implement, and makes spatial single cell analysis accessible to a wide group of biomedical researchers.