bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of early menopause with angiographically-derived SYNTAX score
Authors: Yan Liqiu , Cao Xufen , Zeng Saitian , Yu Jing , Li Zhe , Lian Zheng , Lv Fengfeng , Wang Jiawang 
Published: December 2018

Abstract
Association of early menopause with increased risk of cardiovascular events has been confirmed in previous studies. SYNTAX score (SX-score) can comprehensively quantify severity of coronary artery disease (CAD) and predict the outcomes of patients with CAD. However, the association of early menopause with SX-score has never been reported.
We prospectively included 1875 consecutive postmenopausal patients who underwent coronary angiography (CAG) and were angiographically diagnosed with CAD from January 2011 to December 2013. SX-score was calculated using the SX-score algorithm based on diagnostic angiogram. Ordinal logistic regression analysis was used to investigate the association between early menopause and SX-score.
Patients with early menopause were more likely to have a history of hypertension, diabetes, hyperlipidemia, and less likely to smoking. Besides, they have higher fasting glucose, hemoglobin A1C (HbA1c), total cholesterol (TC), low-density lipoprotein (LDL), triglyceride (TG), and body mass index (BMI) compared with the patients without early menopause. Moreover, patients with early menopause have higher SX-score and multi-vessel diseases. Ordinal logistic regression analysis showed that age, hypertension, diabetes, and early menopause exerted independent influences on SX-score. The patients undergone oophorectomy, early menopause was highly associated with SX-score.
Early menopause was an independent predictor of SX-score in postmenopausal patients with CAD.
Pneumomediastinum caused by occult paraquat poisoning
Authors: Deng Peng , Chen Yao , Li Hong , Wan Zhi 
Published: December 2018

Abstract

Rationale:
Paraquat is a widely applied contact herbicide that is highly poisonous. About 20% of patients with paraquat poisoning develop pneumomediastinum as a complication with a mortality rate of almost 100%.

Patient concerns:
A 15-year-old boy presented with a 1-month history of retrosternal chest pain with no obvious cause. High-resolution computed tomography showed pneumomediastinum.

Diagnoses:
After all likely causes of pneumomediastinum were eliminated, the diagnosis of occult paraquat poisoning was made when serum paraquat concentration was revealed at 467.40 ng/mL, despite the patient's denial of ingestion or contact.

Interventions:
Hemoperfusion, intravenous glucocorticoid, and ulinastatin was administered for 3 days with other routine treatment against paraquat poisoning. The serum paraquat concentration decreased to zero.

Outcomes:
Despite the general high mortality and poor prognosis of paraquat poisoning, the patient recovered and was completely asymptomatic at his 3-month follow-up.

Lessons:
Paraquat poisoning should be suspected as a differential diagnosis when patients present with pneumomediastinum without recognizable cause.
VEGF overexpression is associated with optic nerve involvement and differentiation of retinoblastoma
Authors: Wu Qizheng , Sun Xiao , Zheng Guangying 
Published: December 2018

Abstract

Background:
Vascular endothelial growth factor (VEGF) plays an important role in the pathogenesis of cancer. Although numerous studies have investigated the association between VEGF expression and pathogenesis of retinoblastoma, the results remained inconsistent. To illuminate the association, we performed a meta-analysis study.

Methods:
According to the PRISMA guideline, eligible studies were searched in the Medicine, Embase, Web of Science, Chinese National Knowledge Infrastructure, and Wanfang databases. Stata 14.0 software was used to calculate the relevant statistical parameters.

Results:
Seventeen studies with 296 controls and 470 patients with retinoblastoma were included from 17 eligible literatures. Overall, significant association between VEGF overexpression and susceptibility of retinoblastoma was observed in Chinese population (odds ratio [OR] = 21.67, 95% confidence interval [CI] = 13.96–33.62). Subgroup analysis based on control sample type showed that VEGF overexpression was significantly associated with the risk of retinoblastoma (Normal retina tissue, OR = 23.97, 95% CI = 9.67–59.42; retinoblastoma adjacent tissue, OR = 20.85, 95% CI = 12.64–34.37). Significant associations of VEGF overexpression with optic nerve involvement and differentiation of retinoblastoma were found (Optic nerve involvement, OR = 6.90, 95% CI = 4.01–11.88; Differentiation, OR = 0.18, 95% CI = 0.12–0.28). In addition, only 1 study was included to analyze the role of VEGF protein expression in the prognosis of retinoblastoma, and the result showed that VEGF expression was significantly associated with the prognosis of retinoblastoma, which should be verified in the future studies.

Conclusions:
Our findings demonstrated that VEGF overexpression was significantly associated with the risk of retinoblastoma. Besides, the results suggested that VEGF overexpression might have a crucial effect on the optic nerve involvement and differentiation of retinoblastoma.
The efficacy of cervical spine phantoms for improving resident proficiency in performing ultrasound-guided cervical medial branch block
Authors: Kwon So Young , Kim Jong-Woan , Cho Min Ji , Al-Sinan Abdullah Hussain , Han Yun-Joung , Kim Young Hoon 
Published: December 2018

Abstract

Background:
Few studies have been conducted on the utility of cervical spine phantoms for practicing cervical procedures. Here, we describe a simple method for creating a cervical spine phantom and investigate whether the use of a gelatin-based phantom is associated with improved proficiency in performing ultrasound-guided cervical medial branch block.

Methods:
A cervical spine phantom was prepared using a cervical spine model immersed in a mixture of gelatin and psyllium husk. In total, 27 participants, inexperienced in spinal ultrasonography, were enrolled and allocated to 1 of 2 groups (training group, n = 18; control group, n = 9). All participants were tested (test-1) following an introductory course of basic ultrasonography. Participants in the control group were tested again after 1 week (test-2). Those in the training group received a further individual 3-hour training session, and were tested again after 1 week (test-2).

Results:
The mean performance score in test-1 was 62.5 ± 10.1 points in the training group and 62.3 ± 4.1 points in the control group [95% confidence interval (95% CI) −5.5 to 5.8; P = .954]. In test-2, the mean score was 86.8 ± 6.5 points and 59.9 ± 4.4 points in the training and control groups, respectively (95% CI 21.9–31.8; P < .001). The mean time required to complete test-1 was 84.6 ± 26.6 seconds in training group and 90.7 ± 43.9 seconds in the control group (95% CI −34.0 to 21.7; P = .653); in test-2, the time required was 56.6 ± 27.9 and 91.2 ± 43.8 seconds (95% CI −63.0 to −6.2; P = .019), respectively. Interobserver reliability showed excellent agreement based on the intraclass correlation coefficient, and moderate to almost perfect agreement by kappa statistics.

Conclusion:
Training using a gelatin-based cervical spine phantom helps novices acquire the skills necessary to perform ultrasound-guided cervical medial branch blocks.
Is the transdermal fentanyl patch an efficient way to achieve acute postoperative pain control?
Authors: Jang Ji Su , Hwang Sung Mi , Kwon Youngsuk , Tark Hyunjin , Kim Young Joon , Ryu Byoung Yoon , Lee Jae Jun 
Published: December 2018

Abstract

Backgroupd:
This study investigated the plasma fentanyl concentration and efficacy of transdermal fentanyl patch (TFP) (25 μg/h) in the management of acute postoperative pain.

Methods:
Patients undergoing laparoscopic cholecystectomy were randomly allocated to 2 groups. The TFP group (n = 30) received a single TFP 25 μg/ h to the anterior chest wall 14 h before operation. The IV group (n = 30) received a placebo patch. After the operation, intravenous fentanyl infusion (25 μg/h) was begun with loading dose 25 μg in the IV group and only normal saline in the TFP group. Plasma fentanyl levels were measured at admission, 1, 6, 12, 24, and 48 h postoperatively. Pain severity and adverse effects were evaluated too.

Results:
The fentanyl level peaked 1 h after operation in the TFP group (3.27 ± 0.34 ng/mL) and 24 h postoperatively in the IV group (2.9 ± 0.42 ng/mL). Pain scores and the use of rescue analgesics were not significantly different between 2 groups. Respiratory depression was not happened in both groups.

Conclusions:
The TFP (25 μg/h) affixed 14 h before surgery reached a higher constant concentration than the same dose setting of a constant IV infusion of fentanyl after surgery. Although the concentration of fentanyl was higher than those of previous researches, there was no respiratory depression. But, there was no advantage of reducing pain score and the use of rescue analgesics. Clinical trial registration: (available at: http://cris.nih.go.kr, KCT0002221).
Combined therapy and antivascular endothelial growth factor monotherapies for polypoidal choroidal vasculopathy
Authors: Zhang Yun , Li Xun , Chen Xiaoye , Cai Zhaolun , Zhang Zirong , Tang You , Chang Tiancong , Chen Misha , Zhang Meixia 
Published: December 2018

Abstract

Background:
Different antivascular endothelial growth factor (VEGF) monotherapy regimens and photodynamic therapy (PDT) combined with anti-VEGF therapy are available for patients with polypoidal choroidal vasculopathy (PCV). However, the comparative efficacy and safety of different anti-VEGF monotherapy regimens and combined therapy with PDT and anti-VEGF remains unknown. The aim of our study is to evaluate the efficacy and safety of anti-VEGF monotherapies and combined therapy in patients with PCV.

Methods:
We will systematically search PubMed, Embase, and the Cochrane library for eligible studies. The Cochrane Collaboration's tool for assessing the risk of bias in a randomized trial and the ROBINS-I tool will be used to assess the risk of bias in the included studies. The primary outcome is the mean change in best corrected visual acuity from baseline. The secondary outcomes are the mean change in central retinal thickness from baseline and the number of serious adverse events.

Results:
The result will generate a comprehensive suggestion for the treatment of PCV.

Conclusion:
The results of the network meta-analysis will be submitted in a peer-reviewed journal for publication.

Ethics and dissemination:
The study does not involve human subjects and requires no ethical approval or patient consent. The results of the network meta-analysis will be submitted in a peer-reviewed journal for publication and generate a comprehensive suggestion for the treatment of PCV.
Removal of an intraorbital metallic foreign body following double-penetrating ocular injury
Authors: Cui Yan , Li Ziwei , Wang Yuwei , Shi Long 
Published: December 2018

Abstract

Rationale:
Open eye injury is one of the commonest ophthalmic emergencies, and when accompanied by intraorbital foreign bodies, the condition carries a poor prognosis.

Patient concerns:
A 28-year-old man presented to the emergency department of our hospital complaining of sudden painful loss of vision in the left eye after he hammered an iron plate.

Diagnosis:
The ocular examination revealed a 4-mm full thickness scleral laceration with prolapsed uveal tissue, a traumatic cataract. Computed tomography (CT) demonstrated an orbital foreign body in the retrobulbar area.

Interventions:
The patient underwent emergency scleral suturing, severance of medial rectus muscle, and removal of the orbital foreign body. Twelve days after the emergency operation, pars plana lensectomy and pars plana vitrectomy were performed.

Outcomes:
After 3 months of follow-up, there was no immune response. Visual acuity in the left eye was the perception of hand motion. The retina remained mostly attached with normal intraocular pressure, and good cosmetic appearance. The globe anatomy was maintained, but the vision could not be restored due to the grave nature of the trauma.

Lessons:
Transconjunctival approach extraocular muscle severance may thus be a suitable approach to the removal of intraorbital metallic foreign body.
Prediction of novel target genes and pathways involved in tall cell variant papillary thyroid carcinoma
Authors: Xia Fada , Jiang Bo , Chen Yong , Du Xin , Peng Yao , Wang Wenlong , Wang Zhuolu , Li Xinying 
Published: December 2018

AbstractBackground:Tall cell variant papillary thyroid carcinoma (TCPTC) is reportedly associated with aggressive clinicopathological parameters and poor outcomes; however, the molecular mechanisms underlying TCPTC remain poorly understood.Methods:The gene mutation types and mRNA expression profiles of patients with TCPTC were obtained from The Cancer Genome Atlas (TCGA) database. Differentially expressed genes (DEGs) were identified. Pathways in the interaction network and the diagnostic approaches of candidate markers for TCPTC were investigated.Results:BRAFmutation was particularly prevalent in TCPTC with a mutation frequency of 78%. TCPTC was associated with a patient age >45 years, tumor multifocality, extrathyroidal extension, a higher T stage, advanced AJCC TNM stages,BRAFV600E mutation, and poor disease-free survival. We identified 4138 TCPTC-related DEGs and 301 TCPTC-specific DEGs. Intriguingly, the gene expression pattern revealed that the dysregulated levels of both putative oncogenes and tumor suppressors in TCPTC were higher than those in classical/conventional variant PTC (cPTC). Functional enrichment analyses revealed that these DEGs were involved in several cancer-related pathways. A protein-protein interaction (PPI) network was constructed from the 301 TCPTC-specific DEGs, and 3 subnetworks, and 8 hub genes were verified. Receiver operating characteristic (ROC) analyses revealed that 6 hub genes, includingCOL5A1,COL1A1,COL10A1,COL11A1,CCL20, andCXCL5, could be used not only for the differential diagnosis of PTC from normal samples, but also for the differential diagnosis of TCPTC from cPTC samples.Conclusions:Our study might provide further insights into the investigations of the tumorigenesis mechanism of TCPTC and assists in the discovery of novel candidate diagnostic markers for TCPTC.
Association between thermal threshold abnormalities and peripheral artery disease in patients with type 2 diabetes
Authors: Sheen Yi-Jing , Li Tsai-Chung , Lin Jiann-Liang , Tsai Wen-Chen , Kao Chuen-Der , Bau Cho-Tsan , Sheu Wayne H.-H. 
Published: December 2018

Abstract
Both diabetic peripheral neuropathy and peripheral arterial disease (PAD) cause foot ulcers and often result in non-traumatic amputations in patients with type 2 diabetes. This study aimed to evaluate the association between clinical variables, PAD, and subclinical diabetic small fiber peripheral neuropathy detected by abnormal thermal thresholds of the lower extremities in patients with type 2 diabetes.
We investigated 725 consecutive patients with type 2 diabetes (male/female: 372/353; mean age, 67 ± 11 years) who did not have apparent cardiovascular disease (including coronary artery disease, arrhythmia, and stroke) and who underwent the quantitative sensory test for thermal (warm and cold) thresholds of the lower limbs and ankle-brachial index (ABI)/toe-brachial index (TBI) examinations in 2015. The analyses included glycated hemoglobin, estimated glomerular filtration rate, and other characteristics.
In total, 539 (74.3%) patients showed an abnormality of at least 1 thermal threshold in their feet. All patients with an abnormal ABI (<0.9) had concurrent impaired thermal thresholds, and 93% (87/94) of patients with an abnormal TBI experienced abnormal thermal thresholds in the lower limbs. Age- and sex-adjusted TBI and estimated glomerular filtration rate were significantly correlated to abnormal thermal thresholds. In the multivariate analysis, fasting plasma glucose, and glycated hemoglobin were independently associated with abnormal thermal thresholds in the lower extremities.
Subclinical thermal threshold abnormalities of the feet are significantly associated with PAD and nephropathy in patients who have type 2 diabetes without cardiovascular disease.
Coagulation markers and echocardiography predict atrial fibrillation, malignancy or recurrent stroke after cryptogenic stroke
Authors: Ellis Deandrea , Rangaraju Srikant , Duncan Alexander , Hoskins Michael , Raza Syed Ali , Rahman Haseeb , Winningham Melanie , Belagaje Samir , Bianchi Nicolas , Mohamed Ghada A. , Obideen Mahmoud , Sharashidze Vera , Belair Trina , Henriquez Laura , Nahab Fadi 
Published: December 2018

Abstract
We evaluated the utility of left atrial volume index (LAVI) and markers of coagulation and hemostatic activation (MOCHA) in cryptogenic stroke (CS) patients to identify those more likely to have subsequent diagnosis of atrial fibrillation (AF), malignancy or recurrent stroke during follow-up.
Consecutive CS patients who met embolic stroke of undetermined source (ESUS) who underwent transthoracic echocardiography and outpatient cardiac monitoring following stroke were identified from the Emory cardiac registry. In a subset of consecutive patients, d-dimer, prothrombin fragment 1.2, thrombin-antithrombin complex and fibrin monomer (MOCHA panel) were obtained ≥2 weeks post-stroke and repeated ≥4 weeks later if abnormal; abnormal MOCHA panel was defined as ≥2 elevated markers which did not normalize when repeated. We assessed the predictive abilities of LAVI and the MOCHA panel to identify patients with subsequent diagnosis of AF, malignancy, recurrent stroke or the composite outcome during follow-up.
Of 94 CS patients (mean age 64 ± 15 years, 54% female, 63% non-white, mean follow-up 1.4 ± 0.8 years) who underwent prolonged cardiac monitoring, 15 (16%) had new AF. Severe LA enlargement (vs normal) was associated with AF (P < .06). In 42 CS patients with MOCHA panel testing (mean follow-up 1.1 ± 0.6 years), 14 (33%) had the composite outcome and all had abnormal MOCHA. ROC analysis showed LAVI and abnormal MOCHA together outperformed either test alone with good predictive ability for the composite outcome (AUC 0.84).
We report the novel use of the MOCHA panel in CS patients to identify a subgroup of patients more likely to have occult AF, occult malignancy or recurrent stroke during follow-up. A normal MOCHA panel identified a subgroup of CS patients at low risk for recurrent stroke on antiplatelet therapy. Further study is warranted to evaluate whether the combination of an elevated LAVI and abnormal MOCHA panel identifies a subgroup of CS patients who may benefit from early anticoagulation for secondary stroke prevention.
Differential Gene Expression in Erlotinib-Treated Fibroblasts
Authors: Wickersham Karen E. , Hodges Theresa K. , Edelman Martin J. , Song Yang , Nan Mintong , Dorsey Susan G. 
Published: December 2018

Background
Therapies targeting the epidermal growth factor receptor (EGFR) result in a painful rash, the most common and debilitating toxicity among patients with non-small cell lung cancer (NSCLC) who take EGFR tyrosine kinase inhibitor (TKI) therapy; however, predicting the development and the severity of the rash is difficult.

Objective
The aim of this study was to examine how erlotinib—an EGFR TKI that NSCLC patients take to stop or slow tumor growth—altered the transcriptome of dermal fibroblasts.

Methods
Dermal fibroblasts (ATCC PCS-201-012) were seeded in cell culture flasks, grown under standard conditions, and transferred to cell culture dishes. Cells were treated once daily for 3 days with erlotinib 100 nM (n = 5), erlotinib 1 μM (n = 5), vehicle 1 μM (dimethyl sulfoxide) (n = 5), or no treatment (n = 5). Total RNA was extracted using a standard TRIzol method and hybridized using Affymetrix GeneChip Human Genome U133 Plus 2.0 arrays. Raw intensities generated from the arrays were normalized using a Robust Multiarray Average method and analyzed using analysis of variance in Limma R software. Differentially expressed genes were analyzed using Ingenuity Pathway Analysis to identify canonical or noncanonical signaling pathways enriched in this dataset.

Results
We selected genes for investigation based on their potential role in wound healing (AQP3), rash development (CCL2), fibroblast activation (PALLD), cancer and cancer progression (GDF-15, SLC7A11, MMP12, and DIRAS3), and cell cycle control (CDC6). We were able to validate four of these genes by both Western blot analysis and quantitative polymerase chain reaction (MMP12, CCL2, CDC6, and SLC7A11).

Discussion
If found predictive of rash in future studies using patient samples, our findings may help to identify those at risk for severe rash so that (a) the dose of EGFR TKI therapy may be adjusted; (b) additional treatments for the rash can be developed; and/or (c) precise, patient-centered interventions can be developed so that patients with cancer can better self-manage their rash and adhere to EGFR TKI treatment.
Perception of frequency modulation is mediated by cochlear place coding
Authors: Whiteford Kelly L. , Kreft Heather A. , Oxenham Andrew J. 
Published: December 2018

AbstractNatural sounds convey information via frequency and amplitude modulations (FM and AM). Humans are acutely sensitive to the slow rates of FM that are crucial for speech and music. This sensitivity has been thought to rely on precise stimulus-driven auditory-nerve spike timing (time code), whereas a coarser code, based on variations in the cochlear place of stimulation (place code), represents faster FM. Here we test this longstanding theory in listeners with normal and impaired hearing, resulting in widely varying place-coding fidelity. Contrary to predictions, FM detection thresholds at slow and fast rates are highly correlated and closely related to the fidelity of cochlear place coding. We support this conclusion with additional data showing that place-based coding degrades at high modulation rates and in high spectral regions in ways that were previously interpreted as reflecting the limits of fine neural timing. The results suggest a unitary place-based neural code for FM.
Updating the in silico human surfaceome with meta-ensemble learning and feature engineering
Authors: Bojar Daniel 
Published: December 2018

AbstractNext to being targeted by most available drugs, human proteins located in the plasma membrane are also responsible for a plethora of essential cellular functions, ranging from signaling to transport processes. In order to target and study these transmembrane proteins, their plasma membrane location has to be established. Yet experimental validation of the thousands of potential plasma membrane proteins is laborious and technically challenging. A recent study performed machine learning to classify surface and non-surface transmembrane proteins in human cells based on curated high-quality training data from the Cell Surface Protein Atlas (CSPA) and other databases, reporting a cross-validation prediction accuracy of 93.5% (1). Here, we report an improved version of the surfaceome predictor SURFY, SURFY2, using the same training data with a meta-ensemble classification approach involving feature engineering. SURFY2 yielded predictions with an accuracy score of 95.5% on a test dataset never seen before by the classifier. Importantly, we found several high-confidence re-classifications of disease-relevant proteins among the discrepant predictions between SURFY and SURFY2. To rationalize the prediction mechanism of SURFY2 and analyze differently classified transmembrane proteins we investigated classifier feature importances and data distributions between prediction sets. SURFY2 exhibited both an increased precision as well as recall compared to SURFY and delivers the best in silico human surfaceome up to now. This updated version of the surfaceome will instigate further advances in drug targeting and research on cellular signaling as well as transport processes.