bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic and clinicopathological significance of kinesin family member C1 in various cancers
Authors: Sun Yuting , Zhang Yi , Lang Zhiquan , Huang Junfu , Zou Zhenhong 
Published: October 2019

Abstract

Background:
Kinesin family member C1 (KIFC1), a C-type kinesin motor protein, plays important roles in centrosome assembly and intracellular transport. Numerous studies have focused on the prognostic value of KIFC1 in malignant tumors and the relationship between KIFC1 expression and clinicopathological traits of cancer patients, but the studies remain controversial. And no meta-analysis has yet shown the association between KIFC1 and various cancers.

Methods:
Systematic retrieval was carried out within several databases, including PubMed, Embase, Web of Science, Wanfang and China National Knowledge Infrastructure (CNKI). In addition, hazard ratios (HR) and relative risks (RR) with 95% confidence intervals (CIs) were calculated to examine the risk or hazard correlation by Stata SE15.1.

Results:
Eleven studies with the overall 2424 participants were included in this research. High KIFC1 expression was remarkably correlated with worse OS (HR = 1.33, 95% CI = 1.07–1.60) and poorer relapse-free survival (HR = 2.28, 95% CI = 1.75–2.80). In subgroup analysis, high KIFC1 expression was a negative predictor for OS in patients with ovarian cancer (P < .001), breast cancer (P < .001), hepatocellular carcinoma (P < .001), and non-small cell lung cancer (P < .001), but not for esophageal squamous cell carcinoma (P = .246). Moreover, high levels of KIFC1 were related with positive lymph node metastasis (RR = 1.23, 95% CI = 1.01–1.50, P = .041) and advanced tumor node metastasis (TNM) stage (RR = 1.55, 95% CI = 1.27–1.89, P < .001).

Conclusions:
KIFC1 overexpression indicates poor prognosis and more serious clinicopathological characteristics in kinds of malignancies. Thus, we conclude that KIFC1 could be a target for clinical diagnosis and treatment of various cancers.
Association between palliative care and end-of-Life care for patients with hematological malignancies
Authors: Chiang Jui-Kun , Lee Yang-Cheng , Kao Yee-Hsin 
Published: October 2019

Abstract
To date, few studies have examined the end-of-life (EOL) care for patients with hematological malignancies (HMs). We evaluated the effects of palliative care on the quality of EOL care and health care costs for adult patients with HMs in the final month of life.
We conducted a population-based study and analyzed data from Taiwan's Longitudinal Health Insurance Database, which contains claims information for patient medical records, health care costs, and insurance system exit dates (our proxy for death) between 2000 and 2011.
A total of 724 adult patients who died of HMs were investigated. Of these patients, 43 (5.9%) had received only inpatient palliative care (i-Pal group), and 19 (2.6%) received home palliative care (h-Pal group). The mean health care costs during the final month of life were not significantly different between the non-Pal and Pal groups (p=0.315) and between the non-Pal, i-Pal, and h-Pal groups (p=0.293) either. By the multivariate regression model, the i-Pal group had lower risks of chemotherapy, ICU admission, and receipt of CPR, but higher risks of at least two hospitalizations and dying in hospital after adjustments. The h-Pal group had the similar trends as the i-Pal group but lower risk of dying in hospital after adjustments.
Patients with HMs who had received palliative care could benefit from less aggressive EOL cancer care in the final month of life. However, 8.6% patients with HMs received palliative care. The related factors of more hospitalizations and dying in hospital warrant further investigation.
Clinical application of low-dose misoprostol in the induced labor of 16 to 28 weeks pathological pregnancies (a STROBE-compliant article)
Authors: Yang Yan , Wang Yan , Du Xin , Duan Jie , Huang Yan-ming 
Published: October 2019

Abstract
Oral mifepristone combined with rivanol lactate (rivanol) is commonly used in second-trimester pregnancy termination. However, rivanol is not suitable to premature rupture of membranes and oligohydramnios because amniocentesis is difficult. Mifepristone combined with misoprostol is suitable for the patients with oligohydramnios. In accordance with the misoprostol dosing recommendations by the International Federation of Gynecology and Obstetrics (FIGO), the incidences of uterine rupture and cervical laceration are relatively high in Chinese pregnant women. The aim of our study was to optimize misoprostol dosing regimen in terms of efficacy and safety in Chinese pregnant women.
We modified the Bishop Score, and then gave patients low-dose misoprostol according to the modified Bishop score. Based on the amniotic fluid volume (AFV) indicated by type-B ultrasonic instrument, the cases with AFV ≤2 cm receiving low-dose misoprostol combined with mifepristone and the cases with amniocentesis failure followed by receiving low-dose misoprostol combined with mifepristone were enrolled into study group, and the cases with AFV >2 cm receiving rivanol combined with mifepristone were enrolled into control group. The start time of uterine contractions, time of fetal expulsion, birth process, hospital day, successful induced labor rate, complete induced labor rate, and incomplete induced labor rate were observed and compared between the 2 groups.
There were significant differences in the start time of uterine contractions, time of fetal expulsion, birth process, and hospital day between the control group and the study group (all P < .05). The successful induced labor rate, complete induced labor rate, and incomplete induced labor rate were also significantly different between the 2 groups (all P < .05).
In the induced labor of 16 to 28 weeks pathological pregnancy, low-dose misoprostol can markedly improve the successful induced labor rate and complete induced labor rate, shorten the birth process and hospital day, and decrease uterine curettage rate and uterine rupture risk. Low-dose misoprostol combined with mifepristone is suitable to the induced labor of 16 to 28 weeks pathological pregnancy in Chinese women.
The optimal timing of laparoscopic cholecystectomy in patients with mild gallstone pancreatitis
Authors: Zhong Fu-ping , Wang Kai , Tan Xue-qin , Nie Jian , Huang Wen-feng , Wang Xiao-fang 
Published: October 2019

Abstract

Background:
The optimal timing of laparoscopic cholecystectomy (LC) in patients with mild acute gallstone pancreatitis (MAGP) is controversial. The aim of this study was to systematically evaluate and compare the safety and efficacy of early laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC) in patients with MAGP.

Methods:
A strict search was conducted of the electronic databases, including PubMed, MEDLINE Embase, the ISI Web of Science, and Cochrane Library for all relevant English literature and RevMan5.3 software for statistical analysis was used.

Results:
A total of 19 studies comprising 2639 patients were included. There was no significant difference in intraoperative complications [risk ratio (RR) = 1.46; 95% confidence interval (CI) = 0.88–2.41; P = .14)], postoperative complications (RR = 0.81; 95% CI = 0.58–1.14; P = .23), rate of conversion to open cholecystectomy (RR = 1.00; 95% CI = 0.75–1.33; P = .99), operative time (MD = 1.60; 95% CI = −1.36–4.56; P = .29), and rate of readmission (RR = 0.63; 95% CI = 0.19–2.10; P = .45) between the ELC and DLC groups. However, the ELC group was significantly correlated with lower length of hospital stay (MD = −2.01; 95% CI = −3.15 to −0.87; P = .0006), fewer gallstone-related events rates (RR = 0.17; 95% CI = 0.07–0.44; P = .0003), and lower endoscopic retrograde cholangiopancreatography (ERCP) usage (RR = 0.83; 95% CI = 0.71–0.97; P = .02) compared with the DLC group.

Conclusion:
Early laparoscopic cholecystectomy is safe and effective for patients with MAGP, but the indications and contraindications must be strictly controlled.
Scavenger receptor class a, member 3 is associated with severity of hand, foot, and mouth disease in a case-control study
Authors: Tian Ye , Zhou Kai , Hu Jing , Shan Ming-Feng , Chen Hong-Jian , Cheng Shan , Liu Li-Fei , Mei Xiao-Li 
Published: October 2019

Abstract
Hand, foot, and mouth disease (HFMD) spreads rapidly and has been recognized as a public health problem in recent years in China. Unfortunately, there is no effective vaccine or antiviral drug currently for EV71 infection. In this study, we aim to identify biomarker which are associated with for severity of EV71 infection cases using high-throughput RNA sequencing approach.
RNA sequencing of samples from severe HFMD (S) patients group (n = 10) and control HFMD (C) patients group (n = 10) were performed and the results were verified by qPCR. mRNA with the highest expression level was selected to be validated in an independent cohort comprising of 45 severe EV71 infected patients and 45 control by qPCR assay.
Seventeen significant differentially expressed genes were identified. Scavenger receptor class A, member 3 (SCARA3) was one of the significantly upregulated genes with the highest expression level and was selected for validation. The mean relative expression levels in severe HFMD and control HFMD patients were 10.1-fold and 5.0-fold, respectively, P value <.001.
We found that SCARA3 is associated with severity of HFMD, and it may be a potential prognostic marker to predict the HFMD progression in EV71 infected patients.
Associations between FDG-PET and Ki 67-index in head and neck cancer
Authors: Meyer Hans-Jonas , Gundermann Peter , Surov Alexey 
Published: October 2019

Abstract

Background:
FDG-PET might be able to reflect histopathology features of tumors. Ki 67 in head and neck carcinomas (HNSCC). The present study sought to elucidate the association between Ki 67 index and SUVmax based upon a large patient sample.

Methods:
PubMed database was screened for studies analyzed the relationship between Ki 67 and SUV in HNSCC. Nine studies comprising 211 patients were suitable for analysis.

Results:
SUVmax increased with tumor grade and was statistically significant different between G1, G2, and G3 tumors. The ROC analysis for discrimination between G1/G2 and G3 tumors revealed an area under curve of 0.71. In the overall patient sample, SUVmax correlated statistically significant with Ki 67 index (r = 0.154, P = .032).

Conclusion:
The present study identified a weak correlation between SUV values and proliferation index Ki 67 index in HNSCC in a large patient sample. Therefore, SUVmax cannot be used as surrogate parameter for proliferation activity in HNSCC.
Association of striatal dopaminergic neuronal integrity with cognitive dysfunction and cerebral cortical metabolism in Parkinson’s disease with mild cognitive impairment
Authors: Kim Heeyoung , Oh Minyoung , Oh Jungsu S. , Moon Hyojeong , Chung Sun Ju , Lee Chong Sik , Kim Jae Seung 
Published: October 2019

Objectives
Cognitive impairment is a common non-motor feature of Parkinson’s disease (PD). However, the underlying pathophysiology of cognitive decline is unclear. We investigated the association of striatal dopamine transporter (DAT) loss with cognitive function and cerebral cortical metabolism in PD.

Methods
Twenty-eight patients (63.1 ± 7.1 yrs, M:F = 15:13) with advanced stage of PD were enrolled, including 15 (53.6%) diagnosed with mild cognitive impairment (MCI). All patients underwent FP-CIT PET/CT, neuropsychological tests, and FDG PET/CT within a 2-week interval. We calculated the specific to non-specific binding ratio on FP-CIT PET images in 12 striatal subregional VOIs, using one occipital VOI template as a reference. Age-adjusted normalized specific to non-specific binding ratios (%BRs) of striatal subregions were compared in two groups: PD with MCI versus PD (without cognitive impairment).

Results
There were no statistical differences in age, age at onset, disease duration, motor symptoms, or level of education between the two groups. The PD with MCI had lower %BRs in all striatal subregions (P < 0.05) except the posterior putamen, compared with the PD. Striatal DAT availability correlated with frontal/executive function (r = 0.567, P = 0.003) and visuospatial function (r = 0.614, P = 0.001) but not with memory function. Dopamine transporter binding of striatal subregions also correlated with posterior cortical metabolism.

Conclusion
This study suggest that DAT loss in the striatum, except in the posterior putamen, is associated with cognitive dysfunction, specifically frontal/executive function and visuospatial function in PD subjects.
Performance of a Clinical Decision Support Tool to Identify PICU Patients at High Risk for Clinical Deterioration*
Authors: Dewan Maya , Muthu Naveen , Shelov Eric , Bonafide Christopher P. , Brady Patrick , Davis Daniela , Kirkendall Eric S. , Niles Dana , Sutton Robert M. , Traynor Danielle , Tegtmeyer Ken , Nadkarni Vinay , Wolfe Heather 
Published: October 2019

Objectives:
To evaluate the translation of a paper high-risk checklist for PICU patients at risk of clinical deterioration to an automated clinical decision support tool.

Design:
Retrospective, observational cohort study of an automated clinical decision support tool, the PICU Warning Tool, adapted from a paper checklist to predict clinical deterioration events in PICU patients within 24 hours.

Setting:
Two quaternary care medical-surgical PICUs—The Children’s Hospital of Philadelphia and Cincinnati Children’s Hospital Medical Center.

Patients:
The study included all patients admitted from July 1, 2014, to June 30, 2015, the year prior to the initiation of any focused situational awareness work at either institution.

Interventions:
We replicated the predictions of the real-time PICU Warning Tool by retrospectively querying the institutional data warehouse to identify all patients that would have flagged as high-risk by the PICU Warning Tool for their index deterioration.

Measurements and Main Results:
The primary exposure of interest was determination of high-risk status during PICU admission via the PICU Warning Tool. The primary outcome of interest was clinical deterioration event within 24 hours of a positive screen. The date and time of the deterioration event was used as the index time point. We evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of the performance of the PICU Warning Tool. There were 6,233 patients evaluated with 233 clinical deterioration events experienced by 154 individual patients. The positive predictive value of the PICU Warning Tool was 7.1% with a number needed to screen of 14 patients for each index clinical deterioration event. The most predictive of the individual criteria were elevated lactic acidosis, high mean airway pressure, and profound acidosis.

Conclusions:
Performance of a clinical decision support translation of a paper-based tool showed inferior test characteristics. Improved feasibility of identification of high-risk patients using automated tools must be balanced with performance.
Research Collaboration in Pediatric Critical Care Randomized Controlled Trials: A Social Network Analysis of Coauthorship*
Authors: Duffett Mark , Brouwers Melissa , Meade Maureen O. , Xu Grace M. , Cook Deborah J. 
Published: October 2019

Objectives:
Clinical research is a collaborative enterprise; researchers benefit from the expertise, experience, and resources of their collaborators. We sought to describe the extent and patterns of collaboration among pediatric critical care trialists, and to identify the most influential individuals, centers, and countries.

Design:
Social network analysis of coauthorship.

Data Sources:
Publications of pediatric critical care randomized controlled trials (1986–2018).

Data Extraction:
We manually extracted the names of all authors and their affiliations. We used productivity (number of randomized controlled trials), influence (number of citations), and four measures of prominence in the social network (degree, betweenness, closeness, and eigenvector centrality) to identify the most influential individuals.

Measurements and Main Results:
From 415 randomized controlled trials in pediatric critical care, we identified 2,176 trialists from 377 centers in 43 countries. The coauthorship network is highly disconnected and dominated by a single large cluster of trialists publishing 142 (34%) of the randomized controlled trials. However, 119 (29%) of the randomized controlled trials were published by 28 smaller clusters—a median (interquartile range) of 3 (2–4) randomized controlled trials each. The remaining 154 (37%) randomized controlled trials were coauthored by researchers publishing a single randomized controlled trial each. This overall structure has remained constant with the publication of new randomized controlled trials over 33 years. The most influential trialists and centers varied according to the metric we used; only one trialist and three centers ranked in the top 10 for all measures of influence. Thirty-five of the 40 trialists (88%) ranking in the top 10 of any of the measures were from the United States, the United Kingdom, and Canada.

Conclusions:
Pediatric critical care has made considerable progress in the number of trialists and randomized controlled trials, but the research enterprise remains highly clustered and fragmented, particularly geographically. Efforts to further increase the quantity and quality of research in the field should include steps to increase the level and range of collaboration.
Early Enteral Nutrition Is Associated With Improved Clinical Outcomes in Critically Ill Children: A Secondary Analysis of Nutrition Support in the Heart and Lung Failure-Pediatric Insulin Titration Trial
Authors: Srinivasan Vijay , Hasbani Natalie R. , Mehta Nilesh M. , Irving Sharon Y. , Kandil Sarah B. , Allen H. Christine , Typpo Katri V. , Cvijanovich Natalie Z. , Faustino E. Vincent S. , Wypij David , Agus Michael S. D. , Nadkarni Vinay M. 
Published: October 2019

Objectives:The impact of early enteral nutrition on clinical outcomes in critically ill children has not been adequately described. We hypothesized that early enteral nutrition is associated with improved clinical outcomes in critically ill children.Design:Secondary analysis of the Heart and Lung Failure-Pediatric Insulin Titration randomized controlled trial.Setting:Thirty-five PICUs.Patients:Critically ill children with hyperglycemia requiring inotropic support and/or invasive mechanical ventilation who were enrolled for at least 48 hours with complete nutrition data.Interventions:Subjects received nutrition via guidelines that emphasized enteral nutrition and were classified into early enteral nutrition (enteral nutrition within 48 hr of study randomization) and no early enteral nutrition (enteral nutrition after 48 hr of study randomization, or no enteral nutrition at any time).Measurements and Main Results:Of 608 eligible subjects, 331 (54%) received early enteral nutrition. Both early enteral nutrition and no early enteral nutrition groups had similar daily caloric intake over the first 8 study days (median, 36 vs 36 kcal/kg/d;p= 0.93). After controlling for age, body mass indexzscores, primary reason for ICU admission, severity of illness, and mean Vasopressor-Inotrope Score at the time of randomization, and adjusting for site, early enteral nutrition was associated with lower 90-day hospital mortality (8% vs 17%;p= 0.007), more ICU-free days (median, 20 vs 17 d;p= 0.02), more hospital-free days (median, 8 vs 0 d;p= 0.003), more ventilator-free days (median, 21 vs 19 d;p= 0.003), and less organ dysfunction (median maximum Pediatric Logistic Organ Dysfunction, 11 vs 12;p< 0.001).Conclusions:In critically ill children with hyperglycemia requiring inotropic support and/or mechanical ventilation, early enteral nutrition was independently associated with better clinical outcomes.
Greater Occipital Nerve Block for the Treatment of Chronic Migraine Headaches: A Systematic Review and Meta-Analysis
Authors: Shauly Orr , Gould Daniel J. , Sahai-Srivastava Soma , Patel Ketan M. 
Published: October 2019

Background:
Few treatment options exist for chronic migraine headaches, with peripheral nerve blocks having long been used to reduce the frequency and severity of migraines. Although the therapeutic effects have been observed in clinical practice, the efficacy has never been fully studied. In the past decade, however, several randomized controlled clinical trials have been conducted to assess the efficacy of greater occipital nerve block in the treatment of chronic migraine headaches.

Methods:
A systematic review of the literature was performed in the citation databases PubMed, Embase, MEDLINE, and the Cochrane Library. The initial search of databases yielded 259 citations, of which 33 were selected as candidates for full-text review. Of these, nine studies were selected for inclusion in this meta-analysis.

Results:
Studies were analyzed that reported mean number of headache days per month in both intervention and control groups. A total of 417 patients were studied, with a pooled mean difference of −3.6 headache days (95 percent CI, −1.39 to −5.81 days). This demonstrates that greater occipital nerve block intervention significantly reduced the frequency of migraine headaches compared with controls (p < 0.00001). Pooled mean difference in pain scores of −2.2 (95 percent CI, −1.56 to −2.84) also demonstrated a significant decrease in headache severity compared with controls (p < 0.0121).

Conclusions:
Greater occipital nerve blocking should be recommended for use in migraine patients, particularly those that may require future surgical intervention. The block may act as an important stepping stone for patients experiencing migraine headache because of its usefulness for potentially assessing surgical candidates for nerve decompression.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Twenty-Four–Hour Ex Vivo Perfusion with Acellular Solution Enables Successful Replantation of Porcine Forelimbs
Authors: Krezdorn Nicco , Macleod Fiona , Tasigiorgos Sotirios , Turk, M.D. Marvee , Wo Luccie , Kiwanuka, B.A. Harriet , Lopdrup, B.I.D. Rachel , Kollar Branislav , Edelman Elazer R. , Pomahac Bohdan 
Published: October 2019

Background:
A critical barrier to successful limb replantation and allotransplantation is the maximum allowable limb ischemia time of 4 to 6 hours. The current gold standard is to preserve amputated limbs on an ice slurry. Experimental machine perfusion has yielded promising results as an alternative. In particular, hypothermic acellular perfusion has enabled preservation of amputated limbs for up to 12 hours thus far.

Methods:
Amputated forelimbs of Yorkshire pigs were preserved on static cold storage at 4°C for 4 hours (static cold storage group) or perfused at 8°C for 24 hours (perfusion group) with oxygenated modified STEEN Solution perfusate before replantation. Animals were followed up for 7 days after replantation.

Results:
Eight animals underwent replantation (cold storage group, n = 4; perfusion group, n = 4). Seventy-five and 100 percent of animals in the static cold storage and perfusion groups survived for 7 days, respectively. Glycogen and adenosine triphosphate remained stable throughout perfusion. Heart and respiratory rate after replantation were increased in the static cold storage group. There was increased damage in muscle biopsy specimens obtained from animals in the static cold storage group after 7 days when compared with those from animals in the perfusion group.

Conclusions:
Hypothermic acellular ex vivo perfusion of limbs for up to 24 hours enables tissue preservation comparable to that obtained with conventional static cold storage for 4 hours and may reduce muscle damage and systemic reactions on limb replantation. Translation to human limbs may help improve limb replantation and allotransplantation outcomes.