bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel prognostic model for diagnosing atypical bile duct hyperplasia in patients with intrahepatic lithiasis
Authors: Lu Hongcheng , Yang Hao , Wu Linquan , Liao Wenjun , He Xianping , Li Enliang , Wu Rongshou , Shi Shidai , Yang Zhilong 
Published: April 2019

Abstract
There is no specific method for the preoperative diagnosis of atypical bile duct hyperplasia, which is a precursor of cholangiocarcinoma. This study aimed to create a new model for diagnosing atypical bile duct hyperplasia based on routine laboratory tests in patients with intrahepatic lithiasis.
The new diagnostic model was developed with a derivation cohort that included 375 patients with intrahepatic lithiasis. Clinical and pathological data were retrospectively collected. Prognostic factors were evaluated with univariate and logistic regression analyses. The validation cohort included 136 patients who were retrospectively screened to quantify the model's predictive value.
Age and Carbohydrate Antigen 19-9 (CA-199) were revealed to be diagnostic indicators of atypical bile duct hyperplasia in patients with intrahepatic lithiasis. The new diagnostic model was created with the formula: −6.612 + (0.002 × CA-199) + (0.072 × Age). The area under the receiver operating curve of the model was 0.721. With 0.25 as the cutoff point, the sensitivity and specificity of this model in the derivation cohort were 13.9% and 95.9%, respectively. In the validation cohort, these values were 28.5% and 88.7%, respectively. The novel model has an acceptable and stable ability to predict atypical hyperplasia in the intrahepatic bile duct.
This novel model provides a simple system for diagnosing atypical bile duct hyperplasia before surgery in patients with intrahepatic lithiasis.
Effects of different interventions on animal models of ischemic stroke
Authors: Zhang Yan , Yu Hui-Jin , Shi Shu-Zhen , Wang Jian-Cheng 
Published: April 2019

Abstract

Background:
Ischemic stroke often leads to lifelong disability or death in stroke patients. It is one of the most common causes of death and disability worldwide, so it is a global health problem. The objective of this protocol is to provide the methods for using overview and network meta-analysis to identify the more effective intervention for infarct volume and neurobehavioral score in animal models of ischemic stroke.

Methods:
A systematic literature search will be conducted in PubMed and Embase to obtain relevant systematic reviews on December 11, 2018. Assessing the Methodological Quality of Systematic Reviews (AMSTAR2) and SYRCLE's risk of bias tool will be used to assess quality of the included reviews and risk of bias of randomized controlled trials (RCTs) for animal studies. Infarct volume and neurobehavioral score will be chosen as primary and secondary outcomes. The relative effect size of the treatment will be calculated using the standardized mean difference (SMD) and 95% confidence interval (CI). R 3.5.1 through the GEMTC package will be used to perform a network meta-analysis to synthesize direct and indirect evidence.

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

Conclusion:
Our study can provide a reference for further clinical practice and can be compared with clinical trial results to obtain a more credible therapeutic effect of this intervention.

Ethics and communication:
Formal ethical approval is unnecessary, because this study is based on published researches.

PROSPERO registration number:
CRD42019126811
Scapula chondrosarcoma
Authors: Qiang Shuai , Ma Xin-Nan , Wang Hong-Wei , Lv Song-Cen 
Published: April 2019

Abstract

Rationale
Chondrosarcoma is a malignant mesenchymal tumor originating from cartilage. The pelvis, ribs, femur, and humerus are the most frequently affected sites, and scapula involvement is relatively rare. The aim of the present study was to report a case of chondrosarcoma in the scapula.

Patient concerns
A 42-year-old woman presented with a 3-month history of a painful mass in the right scapula.

Diagnoses and intervention
The patient underwent tumor resection. The post-operative pathological diagnosis was scapula chondrosarcoma.

Outcomes
Following resection, the patient continued to receive routine follow-up care. There was no recurrence or tumor metastasis at a follow-up of 5 years.

Conclusions
Surgery remains the primary therapy for chondrosarcoma. One of the greatest challenges in the management of chondrosarcoma is to accurately assess tumor grade before surgical intervention. Chemotherapy and radiotherapy have been applied without success. Chemo- and radioresistance have been examined beyond classic phenotypic properties to identify more efficient therapeutic strategies. Therefore, development of future novel therapies is contingent upon elucidating the molecular mechanisms of chondrosarcoma.
General anesthesia for patient with Fahr's syndrome
Authors: Park Suyong , Jee Dae-Lim , Kim Hyuckgoo 
Published: April 2019

Abstract

Rationale:
Fahr's syndrome (FS) is a rare neurological and psychiatric disorder characterized by bilateral brain calcifications when a secondary cause of the calcification is found.

Patient concerns:
A 53-year-old female patient diagnosed with FS for laminectomy because of ossification of posterior longitudinal ligament. She had a history of generalized tonic-clonic (GTC) seizure and medication with anticonvulsant drugs. She had gait disturbance, spasticity, bradykinesia, and diffuse calcifications in the basal ganglia, thalamus, cerebellum, and cerebral hemispheres on the brain computed tomography. On the preoperative examination, the serum and ionized calcium (Ca) were decreased to 3.7 and 2.22 mg/dL. Hypomagnesemia is combined with hypocalcemia. Furthermore, the level of parathyroid hormone was decreased to 2.18 pg/mL.

Diagnoses:
Due to the radiologic findings and laboratory test results, she was diagnosed with FS with primary hypoparathyroidism.

Interventions:
The Ca and magnesium (Mg) had been corrected before surgery but the electrolytes revealed low level at the intraoperative period. The 300 mg of calcium chloride was administered at 2 times and 1200 mg of it were infused for 1 hour during intraoperative periods. In addition, total 4 g of Mg sulfate intravenously administered. We used rocuronium as a neuromuscular block and checked neuromuscular function by train-of-four monitoring.

Outcomes:
Residual neuromuscular blockade was reversed with pyridostigmine and her muscle power completely recovered. The patient was extubated successfully and no unpredictable events occurred. On the day following transfer, serum electrolytes remained low, and although Ca was continuously supplied, serum Ca did not recover to a normal level. The patient was medicated with anticonvulsant drugs but experienced GTC seizure 2 weeks after surgery.

Lessons:
We presume that the pathophysiology of FS was related to primary hypoparathyroidism and hypomagnesemia. FS raises concerns associated with neuromuscular problems, spasticity, and seizure, and concerns of hypotension, heart failure, cardiac arrhythmia, and cerebrovascular attack during perioperative periods, among anesthesiologists because of hypocalcemia and vessel calcification. During the perioperative period, Ca levels should be closely monitored, and titrated Ca replacement therapy is recommended. The simultaneous correction of hypomagnesemia is of considerable importance when correcting hypocalcemia.
Identifying the superior antibiotic prophylaxis strategy for breast surgery
Authors: Guo Tao , Chen Baiyang , Rao Fengying , Wu Ping , Liu Pengpeng , Liu Zhisu , Li Zhen 
Published: April 2019

Abstract

Background:
The clinical roles of different antibiotic prophylaxis strategies for breast surgery remains large unknowns. The aim of this study is to evaluate different antibiotic prophylaxis strategies based on a network meta-analysis.

Methods:
We initially retrieved literature from globally recognized databases, namely, MEDLINE, EMBASE and Cochrane Central, to address relative randomized controlled trials (RCTs) investigating the antibiotic prophylaxis strategies for breast surgery. Relative postoperative infection rates were quantitatively pooled and estimated based on the Bayesian theorem. Values of surface under the cumulative ranking curve (SUCRA) probabilities were calculated and ranked. Additional pairwise meta-analyses were performed to validate differences between the respective strategies at the statistical level for further explanations.

Results:
After a detailed review, a total of 14 RCTs containing 6 different strategies were included for the network meta-analysis. The results indicated that the application of antibiotics administered during pre- plus post- plus intraoperative periods possessed the highest possibility of having the best clinical effects (SUCRA, 0.40), followed by intraoperative administration alone (SUCRA, 0.35) and pre- plus intraoperative administrations (SUCRA, 0.20). Moreover, an additional pairwise meta-analysis determined that pre- and intraoperative-related strategies significantly reduced postoperative infections at a statistical level.

Conclusion:
Based on the current evidence, we concluded that application of antibiotics administered during pre- plus post- plus intraoperative periods seemed to reveal superior benefits. However, the essential roles of pure intraoperative and postoperative application were still need to be further validated.
Primary nasal diffuse large B-cell lymphoma with synchronous pulmonary involvement
Authors: Hao Shuhong , Sun Yan , Hu Chunmei , Zhi Yunhui , Xiao Han , Li Yarong 
Published: April 2019

Abstract

Rationale:
Diffuse large B-cell lymphoma (DLBCL) is the most commonly occurring type of non-Hodgkin's lymphoma, which may be found at various extranodal sites. The nose is not a common site for DLBCL as compared with natural killer/T-cell lymphoma, and synchronous pulmonary involvement is even rarer. We report a case of primary nasal DLBCL who presented with a mass in the left lower lobe, mimicking primary lung carcinoma.

Patient concerns:
A 62-year-old Chinese female visited the Ear-Nose-Throat Department of our hospital with nasal congestion and rhinorrhea for 2 months.

Diagnosis:
Computed tomography scan revealed a mass with soft tissue density in the left vestibule and nasal cavity. Histopathological examination revealed a large number of lymphoma cells, and immunohistochemistry confirmed the diagnosis of DLBCL.

Interventions:
The patient was treated with 6 cycles of R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisone, and rituximab).

Outcomes:
The treatment was well tolerated and led to complete remission for the patient. There was no sign of relapse over the 3-year close follow-up

Lessons:
DLBCL can be present at various extranodal sites and clinicians irrespective of their specialty must be vigilant for the synchronous mode of presentation of such lesions. Immunohistochemical techniques play a vital role in the diagnosis, because clinical characteristics may be misleading.
Plasmacytoma of the skull mimicking an epidural hematoma
Authors: Chen Zupeng , Li Xu 
Published: April 2019

Abstract

Rationale:
Plasmacytoma as the 1st presentation of skull tumors is a rare disorder. When it is combined with brain trauma or dramatic changes in intracranial pressure, patients are more prone to misdiagnosis.

Patient concerns:
A 67-year-old woman complaining of a headache presented with a history of head trauma for the past 1 hour. Emergency head computed tomography initially suggested an epidural hematoma.

Diagnosis:
Emergency surgery was performed to remove the intracranial hematoma, but a tumor-like mass was found during surgery, and pathologic assessment confirmed plasmacytoma. Surgery was difficult because of bleeding. The tumor was radically removed.

Interventions and outcomes:
The patient underwent whole-brain radiotherapy and chemotherapy. She died 40 months after the surgery.

Lessons:
Epidural lesions found after a head injury may be assumed to be an epidural hematoma, leading to unnecessary surgery. Diseases such as hematomas, meningiomas, eosinophilic granulomas, bone metastases, and osteosarcomas must be considered.
Craniosynostosis: A Reversible Pathology?
Authors: Säljö Karin , Maltese Giovanni , Tarnow Peter , Kölby Lars 
Published: April 2019

Abstract
The formation of the cranial sutures, in utero, occurs when the ossification of the skull bones reaches predestined positions around gestational week 15 to 20. Craniosynostosis, and the consequent skull shape deformities, is treated with surgery including osteotomies of the fused sutures. The occasional appearance of a new suture in the osteotomy lines has previously been described as sporadic events. In this retrospective study, a 4-year consecutive series of osteotomies combined with springs for craniosynostosis were systematically analysed regarding the appearance of neosutures. In total, 84 patients were included and in 16 patients (19%) a new radiologically normal suture appeared in a part of the suture that was completely closed preoperatively. Additionally, in 7 patients (8%) a new suture appeared in a part of the suture that had a discernible suture prior to surgery.
In conclusion, in this consecutive and well-defined patient cohort operated for craniosynostosis, the formation of a neosuture is not a rare, and speculatively not a random, event. The appearance of a new suture long after the normal time period for suture formation in utero indicates that the craniosynostosis may just as well be caused by disturbed formation of the suture as actual premature closure.
Potential Patient Education of YouTube Videos Related to Wisdom Tooth Surgical Removal
Authors: Özdal Zincir Özge , Bozkurt Aylin Paşaoğlu , Gaş Selin 
Published: April 2019

Abstract
This present study aimed to evaluate the education of YouTube videos about wisdom tooth surgical removal for viewers. In this study, the term “wisdom tooth surgical removal” was searched on YouTube. After excluding duplicates, irrelevant videos, non-English-language videos; 92 relevant videos in English were independently examined by 3 reviewers. The videos were categorized as ‘poor’, ‘moderate’ and ‘excellent’ by scoring 9 points in order to evaluate the information they provided to the audience. Chi-square test was performed for categorical variables and differences between groups were compared with ANOVA-Kruskal Wallis. Correlations were analyzed using Pearson and Spearman test. Statistical significance was set P < 0.05. Majority of the videos (63%, n = 58) were uploaded by layperson for sharing personal experience, 19.6%, (n = 18) healthcare professionals (dentist, orthodontist, surgeon). There were 64 (69.6%) not useful videos, 19 (20.7%) moderately useful videos, and 9 (9.8%) very useful videos. There is no significant correlation between efficiency ratio and source of upload (P > 0.05). There is a significant relationship between efficiency ratio and interaction index (P = 0.019 < 0.05). Interaction indexes of poor useful videos are more than others. There is a significant relationship between the type of video and video demographics (all data’ significant values < 0.05). Mean values of patient's experience are more than others. Healthcare professionals should be aware of the accuracy of information on the internet in order to guide patients.
Single-Cell Analysis Reveals Regional Reprogramming during Adaptation to Massive Small Bowel Resection in Mice
Authors: Seiler Kristen M. , Waye Sarah E. , Kong Wenjun , Kamimoto Kenji , Bajinting Adam , Goo William H. , Onufer Emily J. , Courtney Cathleen , Guo Jun , Warner Brad W. , Morris Samantha A. 
Published: April 2019

AbstractBackground & AimsThe small intestine (SI) displays regionality in nutrient and immunological function. Following SI tissue loss (as occurs in short gut syndrome, or SGS), remaining SI must compensate, or ‘adapt’; the capacity of SI epithelium to reprogram its regional identity has not been described. Here, we apply single-cell resolution analyses to characterize molecular changes underpinning adaptation to SGS.MethodsSingle-cell RNA-sequencing was performed on epithelial cells isolated from distal SI of mice following 50% proximal small bowel resection (SBR) vs. sham surgery. Single-cell profiles were clustered based on transcriptional similarity, reconstructing differentiation events from intestinal stem cells (ISCs) through to mature enterocytes. An unsupervised computational approach to score cell identity was used to quantify changes in regional (proximal vs distal) SI identity, validated using immunofluorescence, immunohistochemistry, qPCR, western blotting, and RNA-FISH.ResultsUniform Manifold Approximation and Projection-based clustering and visualization revealed differentiation trajectories from ISCs to mature enterocytes in sham and SBR. Cell identity scoring demonstrated segregation of enterocytes by regional SI identity: SBR enterocytes assumed more mature proximal identities. This was associated with significant upregulation of lipid metabolism and oxidative stress gene expression, which was validated via orthogonal analyses. Observed upstream transcriptional changes suggest retinoid metabolism and proximal transcription factorCreb3l3drive proximalization of cell identity in response to SBR.ConclusionsAdaptation to proximal SBR involves regional reprogramming of ileal enterocytes toward a proximal identity. Interventions bolstering the endogenous reprogramming capacity of SI enterocytes—conceivably by engaging the retinoid metabolism pathway—merit further investigation, as they may increase enteral feeding tolerance, and obviate intestinal failure, in SGS.SynopsisHere, single-cell RNA sequencing reveals interactions between the retinoid metabolism pathway and ‘regional reprogramming’ of distal small intestinal epithelium to a proximal identity following proximal small bowel resection. This provides novel insight into physiological adaptation to short gut syndrome.
A lipophilicity-based energy function for membrane-protein modelling and design
Authors: Weinstein Jonathan Yaacov , Elazar Assaf , Fleishman Sarel Jacob 
Published: April 2019

AbstractMembrane-protein design is an exciting and increasingly successful research area which has led to landmarks including the design of stable and accurate membrane-integral proteins based on coiled-coil motifs. Design of topologically more complex proteins, such as most receptors, channels, and transporters, however, demands an energy function that balances contributions from intra-protein contacts and protein-membrane interactions. Recent advances in water-soluble all-atom energy functions have increased the accuracy in structure-prediction benchmarks. The plasma membrane, however, imposes different physical constraints on protein solvation. To understand these constraints, we recently developed a high-throughput experimental screen, called dsTβL, and inferred apparent insertion energies for each amino acid at dozens of positions across the bacterial plasma membrane. Here, we express these profiles as lipophilicity energy terms in Rosetta and demonstrate that the new energy function outperforms previous ones in modelling and design benchmarks. Rosetta ab initio simulations starting from an extended chain recapitulate two-thirds of the experimentally determined structures of membrane-spanning homo-oligomers with <2.5 Å root-mean-square deviation within the top-predicted five models. Furthermore, in two sequence-design benchmarks, the energy function improves discrimination of stabilizing point mutations and recapitulates natural membrane-protein sequences of known structure, thereby recommending this new energy function for membrane-protein modelling and design.
Predictability of salient distractor increases top-down control in healthy younger and older adults
Authors: Haupt Marleen , Napiórkowski Natan , Sorg Christian , Müller Hermann J. , Finke Kathrin 
Published: April 2019

AbstractYounger adults are able to shield attentional selection against distractors when they have preknowledge about the upcoming distractor location. For older adults, who suffer from an overall decrease in attentional capacity and who are, in addition, particularly prone to attentional capture, such an adaptive shielding ability would be of particular importance. However, it is an open question whether healthy older adults can utilise the predictability of distractor locations to improve top-down controlled selection to the same degree as younger adults. The theory of visual attention (TVA) framework provides a systematic way to measure an individual’s efficiency of top-down control. The present study combined a TVA-based partial-report paradigm with abrupt-onset cues rendering the indicated location highly salient in a bottom-up fashion. Experiment 1, in which (on cued trials) the cue was invariably followed by a distractor at the cued location, showed that the cueing increased the weight of the distractor in the competition for selection compared to uncued distractors (on trials without a cue). In Experiment 2, the probability with which the abrupt-onset cue indicated the upcoming distractor location (1/3 vs. 2/3 of trials) was manipulated between experimental blocks. Participants were able to learn these statistical contingencies and exert top-down control more efficiently in blocks with highly valid distractor location cues, as compared to low-validity blocks. This finding suggests that, even though abrupt-onset spatial cues increase the attentional weights of distractors, participants can acquire and use pre-knowledge about the likelihood that a distractor will appear at an indicated location to down-weight the bottom-up attentional-capture signal. This ability turned out to be comparable across age groups, suggesting that efficient use of predictive information to shield against distracting information is preserved in normal ageing.
Conditions for synaptic specificity during the maintenance phase of synaptic plasticity
Authors: Huertas Marco A. , Sacktor Todd Charlton , Shouval Harel Z. 
Published: April 2019

AbstractActivity-dependent modifications of synaptic efficacies are a cellular substrate of learning and memory. Experimental evidence shows that these modifications are synapse-specific and that the long-lasting effects are associated with the sustained increase in concentration of specific proteins like PKMζ. However, such proteins are likely to diffuse away from their initial synaptic location and spread out to neighboring synapses, potentially compromising synapse-specificity. In this paper we address the issue of synapse-specificity during memory maintenance. Assuming that the long-term maintenance of synaptic plasticity is accomplished by a molecular switch we perform simulations using the reaction-diffusion package in NEURON and analytical calculations to determine the limits of synaptic-specificity during maintenance. Moreover, we explore the effects of the diffusion and degradation rates of proteins and of the geometrical characteristics of dendritic spines on synapse specificty. We conclude that the necessary conditions for synaptic specificity during maintenance require that protein synthesis occurs in dendritic spines and that the activated dendritic spines exhibit small neck diameters.