bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rare case report of fungal esophagitis combined with giant gastric ulcer in an immunocompetent patient
Authors: Liang Ma , Liwen Zhang , Juan Dai , Yun Zhuang , Yanbo Ding , Jianping Chen 
Published: January 2019

Abstract

Rationale:
Fungal infection of gastrointestinal (GI) tract is usually seen in immunocompromised patients, but can rarely occur in immunocompetent people in whom no permissive factor is present.

Patient concerns:
We describe a 68-year-old male immunocompetent patient presenting with simultaneous fungal esophagitis and giant gastric ulcer.

Diagnoses:
Repeated endoscopic biopsies were taken from the giant gastric ulcer edge and base and histology demonstrated granulation tissue and pseudohyphal fungal forms.

Interventions:
The patient was treated with fluconazole and omeprazole for 8 weeks.

Outcomes:
After antifungal treatment with fluconazole, the patient's clinical symptoms gradually disappeared with the healing of gastric ulcer, which never recurred in this patient until 3 months after follow-up.

Lessons:
Nonhealing gastroesophageal ulcers highlights the importance of repeated endoscopies and biopsies.
Effect of orbital decompression on dysthyroid optic neuropathy
Authors: Liang Qiao-Wen , Yang Huasheng , Luo Wenjing , He Jian-Feng , Du Yi 
Published: January 2019

Abstract
In this study, we try to explore the effect of orbital decompression treatment on severe dysthyroid optic neuropathy.
We retrospectively collected demographic and clinical characteristics of thyroid eye disease patients who performed orbital decompression. Then we analyzed the change of best-corrected visual acuity and exophthalmometry after surgery and the correlations among clinical parameters.
A total of 22 cases (30 eyes) were included in the study. After orbital decompression, visual acuities improved in 16 eyes, declined in 8 eyes, and had no change in 5 eyes. Best-corrected visual acuity was significantly improved (0.1 vs 0.4, P = .039) and exophthalmometry was significantly declined (22.0 mm vs 16.5 mm, P = .001) after orbital decompression. Better postoperative best-corrected visual acuity was significantly correlated with better preoperative best-corrected visual acuity (r = 0.718, P < .05), and with normal optic disc (r = 0.568, P < .05), but not with age, exophthalmometry, keratopathy, and clinical activity score.
These results showed that orbital decompression is a useful approach to manage dysthyroid optic neuropathy. The optimal time for surgery should be chosen based on clinical parameters, such as visual acuity and degree of crowding of orbital apex.
Relapsing granulomatosis with polyangiitis provoked by trauma
Authors: Deng Shan , Xing Yida , Wang Hongjiang , Kong Xiaodan 
Published: January 2019

Abstract

Rationale:
The precise cause of granulomatosis with polyangiitis (GPA) remains unclear. Herein we present a case of refractory GPA occurring after trauma.

Patient concerns:
A 43-year-old man suffered fractures of the left orbital in an accident, and then received surgical repair. At a postoperative follow-up, he developed maxillary sinusitis. Seven months later, he was hospitalized with symptoms of cough, high-grade fever, and loss of weight.

Diagnosis:
He was diagnosed with GPA based on the symptoms of upper and lower respiratory tract involvement, granulomas in a lung biopsy specimen, and presence of PR3-ANCA.

Interventions:
Initially the patient responded well to the treatment of glucocorticoids and cyclophosphamide (CYC). Forty days later, he was hospitalized again with symptoms of fever, cephalgia, and recurrent ulcerated subcutaneous nodules, due to the vasculitic manifestations of GPA. This time he was treated with cyclophosphamide and glucocorticoids with no improvement, and then switched to rituximab.

Outcomes:
After 4 doses of rituximab, the symptom of cephalgia disappeared and subcutaneous ulcerations and conjunctival congestion diminished.

Lessons:
Trauma may act as an inflammatory stimulus to affect the course of disease in GPA. The combination of glucocorticoids and cyclophosphamide is the standard therapy for GPA. Nevertheless, patients who have no response to CYC, especially with predominantly vasculitic manifestations, could resort to rituximab.
Delayed malposition of a double-lumen hemodialysis catheter that caused hemorrhage and hypovolemic shock
Authors: Chen I-Chen , Yang Shih-Chia , Liu Kuan-Ting , Wu Yen-Hung 
Published: January 2019

Abstract

Rationale:
Double-lumen hemodialysis catheters are commonly used as temporary hemodialysis routes. Complications include infection, thrombosis, cardiac arrhythmia, entrapped guide wire, and malposition. We report a rare complication of delayed hemodialysis catheter malposition that caused retroperitoneal hemorrhage and hypovolemic shock during hemodialysis.

Patient concerns:
A 72-year-old female patient who was receiving hemodialysis was referred to our emergency department because of general discomfort and decreased blood pressure (BP) after her regular hemodialysis. She had undergone surgery for a left forearm arteriovenous pseudoaneurysm and received a temporary hemodialysis catheter insertion via the left femoral vein 2 weeks before. The initial blood examination revealed a mildly decreased baseline hemoglobin level (7.2 g/dL) and hyperkalemia (5.9 mmol/L). Her BP recovered after fluid resuscitation. She was administered hemodialysis again, following which her BP reduced and a change in consciousness developed.

Diagnosis:
Chest and abdominal computed tomographies were performed to exclude acute vascular problems and showed a hemodialysis catheter tip protruding from the left iliac vein and hematoma in the left retroperitoneal space and pelvic cavity.

Interventions:
Intubation, fluid resuscitation, vasopressor administration, and blood transfusion were performed. She was admitted to the intensive care unit. The left femoral hemodialysis catheter was removed.

Outcomes:
Follow-up computed tomography revealed resolution of the retroperitoneal space hematoma. She was transferred to the ordinary ward 18 days later with a stable hemodynamic status. Unfortunately, she developed hospital-acquired pneumonia and arteriovenous shunt infection, and died from respiratory failure and sepsis on the 34th day in our hospital.

Lessons:
Femoral double-lumen catheter malposition is rare and potentially fatal. Emergency physicians should be aware of situations wherein a patient's BP declines markedly soon after a hemodialysis initiation.
Ultrasound-guided placement of a midline catheter in a patient with extensive postburn contractures
Authors: Yokota Taisuke , Tokumine Joho , Lefor Alan Kawarai , Hasegawa Ayako , Yorozu Tomoko , Asao Takayuki 
Published: January 2019

Abstract

Rationale:
Obtaining venous access in a patient with extensive postburn scar contractures is a challenge.

Patient concerns:
A 39-year-old woman suffered a burn 2 years previously with a total body surface area burn of 93%, and a burn index of 85. Reconstructive surgery was previously performed 39 times. Split-thickness skin grafting to the neck was planned. She had no accessible peripheral veins.

Diagnosis:
Difficult venous access due to excessive burn scar contractures.

Interventions:
Central venous catheterization was considered impossible even with ultrasound guidance. We placed a midline catheter for intraoperative venous access in a patient with extensive burn scar contractures. The midline catheter is a peripheral venous catheter placed in an arm vein.

Outcomes:
We successfully placed a midline catheter in the right brachial vein. This catheter was used for 24 days without difficulty.

Lessons:
The midline catheter is a viable choice in patients with difficult vascular access due to extensive postburn scar contractures.
Elastography detected solid organ stiffness increased in patients with acromegaly
Authors: Bankir Mehmet , Sumbul Hilmi Erdem , Koc Ayse Selcan , Demirtas Derya , Acibucu Fettah 
Published: January 2019

Abstract
Elastography is a method to examine the increase in solid organs stiffness (SOS), and there is no data in the literature regarding to its use in patients with acromegaly. In this study, we aimed to investigate the change of SOS in patients with acromegaly and to determine the parameters closely related to SOS in same patient groups.
We included 40 subjects with acromegaly and 40 healthy control subjects. In addition to routine renal, liver and thyroid ultrasonography (USG), SOS for 3 solid organs were measured by elastography. The participants of the study were divided into 3 groups as the control (Group-I), acromegaly patients with remission (Group-II), and acromegaly patients without remission (Group-III).
Insulin growth factor-1 (IGF-1) level significantly increased from Group-I to Group-III. Glucose, creatinine, albuminuria, alkaline phosphatase, TSH, and growth factor levels were highest in Group-III and statistically significance was found only between Group-I and Group-III. Liver, kidney and thyroid size and echogenicity were increased from Group-I to Group-III. Liver and renal stiffness and thyroid gland strain ratio significantly increased from Group-I to Group-III and these parameters were statistically different between all groups. In linear regression analysis, IGF-1 levels were independent determinants of SOS.
SOS values of acromegaly patients with active disease were significantly increased compared to both the control group and the acromegaly patients in remission phase. Serum IGF-1 levels were independently associated with SOS in these patients. SOS measurement should be part of a routine USG examination in patients with acromegaly, especially in patients during active disease.
Physiotherapy Versus Physiotherapy Plus Cognitive Training on Cognition and Quality of Life in Parkinson Disease
Authors: Barboza Natália Mariano , Terra Marcelle Brandão , Bueno Maria Eduarda Brandão , Christofoletti Gustavo , Smaili Suhaila Mahmoud 
Published: January 2019

Objective
The aim of the study was to verify the effectiveness of physiotherapy associated with cognitive training to improve cognition and quality of life in individuals with Parkinson disease.

Design
This is a randomized clinical trial involving 58 individuals with mild to moderate Parkinson disease, randomly distributed into two groups: motor group and cognitive-motor group. Both groups were assessed for cognition and quality of life at the beginning of the study, at the end of the intervention protocols, and 3 mos after the end of the intervention. The following instruments were used to assess cognition and quality of life: Mini-Mental State Examination, Montreal Cognitive Assessment, Verbal fluency test, Rey Auditory Verbal Learning Test, Cognitive and perceptual assessment by pictures, Trail Making Test, Clock Drawing Executive Test, and Parkinson Disease Quality of Life Questionnaire. The motor group engaged in motor physiotherapy, whereas the cognitive-motor group underwent combined motor physiotherapy with cognitive training.

Results
The intragroup analysis revealed that both groups presented improved cognition (memory and visuospatial function domains) and quality of life after execution of the protocols, but without statistically significant intergroup differences.

Conclusions
When comparing the intervention moments, the two treatment approaches used were effective for the outcomes: memory, visuospatial function, and quality of life in both groups.
Debunking a Surgical Myth: Do Not Touch the Temporalis
Authors: Bennett Katelyn G. , Ettinger Russell E. , Liang Fan , Beck Peter C.C. , Stoldt Meike K. , McNeely Molly M. , Nabi Syed R. , Vercler Christian J. , Buchman Steven R. 
Published: January 2019

Background:
A longstanding dictum exists to avoid surgical manipulation of the temporalis muscle out of concern for an exceedingly high rate of muscle atrophy and recurrent temporal hollowing. The authors challenge this surgical myth, considering such advice to be erroneous. The authors hypothesize that elevation of the temporalis muscle, if performed using standard muscle flap principles, will demonstrate excellent results.

Methods:
To assess temporalis response to surgical manipulation, the authors reviewed patients who underwent calvarial vault remodeling by the senior author for craniosynostosis between 1988 and 2011. Nonsyndromic patients with single-suture synostosis and 5 years of follow-up were eligible for inclusion. The medical record was used to measure rates of reoperation, recurrent temporal hollowing, and persistent temporalis overcorrection.

Results:
Of the cohort reviewed, 196 patients met inclusion criteria. Ten patients (5.1%) exhibited recurrent bitemporal constriction. One patient (0.5%) underwent a revision temporalis turnover flap, and 2 patients (1.0%) underwent soft tissue augmentation. The overall reoperation rate was 1.5%. Temporalis overcorrection, in an attempt to prophylactically rectify the expected atrophy after temporalis manipulation, persisted in 11 patients (5.6%). Three of these patients required treatment with steroid injections, Botox injections, or operative muscle debulking. The overall reoperation rate for temporalis overcorrection was 1.5%.

Conclusions:
The authors’ low reoperation rates for recurrent deformity, in combination with persistent temporalis overcorrection in 5.6% of patients, should dispel the myth that manipulation of the temporalis invariably results in atrophy. The muscle may be surgically manipulated, as long as plastic surgery principles are followed.
Analysis of Surgical Approaches to Skull Base Tumors Involving the Pterygopalatine and Infratemporal Fossa
Authors: Chung Hyo Jin , Moon In Seok , Cho Hyung-Ju , Kim Chang-Hoon , Sharhan Salma Saud Al , Chang Jung Hyun , Yoon Joo-Heon 
Published: January 2019

Abstract
Selecting an appropriate surgical approach for resection of huge skull base tumors involving pterygopalatine and infratemporal fossa is challenging because of their rarity and high possibility of vital anatomical structure injuries. To suggest the guidance of selecting the appropriate approach by analyzing outcomes and satisfactions of known surgical approaches with our previous experience, the authors retrospectively analyzed skull base tumor cases experienced for 24 years, and condensed to 4 well-known surgical approaches: maxillary swing, infratemporal fossa type C, transzygomatic, and a combined transzygomatic–midfacial degloving approach: to review indications, advantages, and limitations of these approaches. Maxillary swing approach was useful in large-sized tumors as it provided wide surgical field; however, inevitable facial scar was the main drawbacks, especially in adolescents. Infratemporal fossa approach type C was helpful in the involvement of vital vascular structures; however, long incision scar with temporal area depression and permanent conductive hearing loss were the factors of patients’ dissatisfaction. Transzygomatic approach could be the good alternative to the infratemporal fossa approach type C; however, en bloc tumor resection was impossible due to its limited operative space. To overcome limitations of these approaches, transzygomatic approach was combined with midfacial degloving approach, and it enabled lateral and anterior access without prominent facial scar and/or deformity while providing wide surgical space. Based on our 24 years of surgical experience in managing huge skull base tumors, the authors recommend the combined transzygomatic–midfacial degloving approach, which enables complete resection with short postoperative healing periods and no disfiguring facial incisions.
Atraumatic Delayed Orbital Hematoma Sixteen Years After Orbital Floor Fracture Repair With Porous Polyethylene Implant
Authors: Slentz Dane Harper , Rajjoub Lamise , Domanski Mark 
Published: January 2019

Abstract
Porous alloplastic materials such as titanium mesh and porous polyethylene allow for the ingrowth of fibrovascular tissues into the implant; stabilizing the implant and reducing the risk of extrusion and extrusion-related complications (such as hematoma formation). The literature contains 2 specific reports of delayed atraumatic orbital hematomas occurring 8 months and 3 years after orbital floor reconstruction with porous polyethylene implants. In this study, an atraumatic orbital hematoma occurring 16 years after orbital floor reconstruction with a porous polyethylene implant was presented. The hematoma was evacuated and the implant was removed without replacement of a secondary implant. The remaining fibrovascular tissue on the underside of the implant provided enough support of the orbital soft tissues to achieve excellent anatomic and physiologic outcomes.
Prevention of heart failure in hypertension – disentangling the role of evolving left ventricular hypertrophy and blood pressure lowering: the ALLHAT study
Authors: Johnson Kyle , Oparil Suzanne , Davis Barry R. , Tereshchenko Larisa G. 
Published: January 2019

AbstractBackgroundHypertension (HTN) is a known risk factor for heart failure (HF), possibly via the mechanism of cardiac remodeling and left ventricular hypertrophy (LVH). We studied how much blood pressure (BP) change and evolving LVH contribute to the effect that lisinopril, doxazosin, amlodipine have on HF compared to chlorthalidone.MethodsWe conducted causal mediation analysis of Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) data. ALLHAT participants with available serial ECGs and BP measurements were included (n=29,892; mean age 67±4 y; 32% black; 56% men): 11,008 were randomized to chlorthalidone, 5,967 – to doxazosin, 6,593 – to amlodipine, and 6,324 – to lisinopril. Evolving ECG-LVH, and BP-lowering served as mediators. Incident symptomatic HF was the primary outcome. Linear regression (for mediator) and logistic regression (for outcome) models were adjusted for mediator-outcome confounders (demographic and clinical characteristics known to be associated both with both LVH/HTN and HF).ResultsA large majority of participants (96%) had ECG-LVH status unchanged; 4% developed evolving ECG-LVH. On average, BP decreased by 11/7 mmHg. In adjusted Cox regression analyses, progressing ECG-LVH [HR 1.78(1.43-2.22)], resolving ECG-LVH [HR 1.33(1.03-1.70)], and baseline ECG-LVH [1.17(1.04-1.31)] carried risk of incident HF. After full adjustment, evolving ECG-LVH mediated 4% of the effect of doxazosin on HF. Systolic BP-lowering mediated 12% of the effect of doxazosin, and diastolic BP-lowering mediated 10% effect of doxazosin, 7% effect of amlodipine, and borderline 9% effect of lisinopril on HF.ConclusionsEvolving ECG-LVH and BP change account for 4-13% of the mechanism by which antihypertensive medications prevent HF.
Prevalence and risk factors of postpartum depression within one year after birth in urban slums of Dhaka, Bangladesh
Authors: Azad Rashidul , Fahmi Rukhshan , Shrestha Sadichhya , Joshi Hemraj , Hasan Mehedi , Khan Abdullah Nurus Salam , Chowdhury Mohiuddin Ahsanul Kabir , Arifeen Shams El , Billah Sk Masum 
Published: January 2019

AbstractPostpartum depression (PPD) is a serious pubic health concern and known to have the adverse effects on mother’s perinatal wellbeing; an d child’s physical and cognitive development. There were limited literatures on PPD in Bangladesh, especially in urban slum context. The aim of this study was to assess the burden and risk factors of PPD among the urban slum women. A cross-sectional study was conducted between November-December 2017 in three urban slums on 376 women within first 12 months of postpartum. A validated Bangla version of Edinburgh Postnatal Depression Scale was used to measure the depression status. Respondent’s socio-economic characteristics and other risk factors were collected with structured validated questionaire by trained interviewers. Unadjusted Prevalence Ratio (PR) and Adjusted Prevalence Ratio (APR) were estimated with Generalized Linear Model(GLM) and Generalized Estimating Equation (GEE) respectively to identify the risk factors of PPD. The prevalence of PPD was 39.4% within first 12 months following the child birth. Job involvement after child delivery (APR=1.9, 95% CI= 1.1, 3.3), job loss due to pregnancy (APR=1.5, 95% CI= 1.0, 2.1), history of miscarriage or still birth or child death (APR=1.4, 95% CI= 1.0, 2.0), unintended pregnancy (APR=1.8, 95% CI= 1.3, 2.5), management of delivery cost by borrowing, selling or mortgaging assets (APR=1.3, 95% CI= 0.9, 1.9), depressive symptom during pregnancy (APR=2.5, 95% CI= 1.7, 3.8) and intimate partner violence (APR=2.0, 95% CI= 1.2, 3.3), were identified as risk factors. PPD was not associated with poverty, mother in law and any child related factors. The burden of postpartum depression was high in the urban slum of Bangladesh. Maternal mental health services should be integrated with existing maternal health services. Research is required for the innovation of effective, low cost and culturally appropriate PPD case management and preventive intervention in urban slum of Bangladesh.
Tracking the popularity and outcomes of all bioRxiv preprints
Authors: Abdill Richard J. , Blekhman Ran 
Published: January 2019

AbstractResearchers in the life sciences are posting work to preprint servers at an unprecedented and increasing rate, sharing papers online before (or instead of) publication in peer-reviewed journals. Though the increasing acceptance of preprints is driving policy changes for journals and funders, there is little information about their usage. Here, we collected and analyzed data on all 37,648 preprints uploaded to bioRxiv.org, the largest biology-focused preprint server, in its first five years. We find preprints are being downloaded more than ever before (1.1 million tallied in October 2018 alone) and that the rate of preprints being posted has increased to a recent high of 2,100 per month. We also find that two-thirds of preprints posted before 2017 were later published in peer-reviewed journals, and find a relationship between journal impact factor and preprint downloads. Lastly, we developed Rxivist.org, a web application providing multiple ways of interacting with preprint metadata.
BigMPI4py: Python module for parallelization of Big Data objects
Authors: Ascension Alex M. , Araúzo-Bravo Marcos J. 
Published: January 2019

AbstractBig Data analysis is a discipline with a growing number of areas where huge amounts of data is extracted and analyzed. Parallelization in Python integrates Message Passing Interface via mpi4py module. Since mpi4py does not support parallelization of objects greater than 231bytes, we developed BigMPI4py, a Python module that wraps mpi4py, supporting object sizes beyond this boundary. BigMPI4py automatically determines the optimal object distribution strategy, and also uses vectorized methods, achieving higher parallelization efficiency. BigMPI4py facilitates the implementation of Python for Big Data applications in multicore workstations and HPC systems. We validated BigMPI4py on whole genome bisulfite sequencing (WGBS) DNA methylation ENCODE data of 59 samples from 27 human tissues. We categorized them on the three germ layers and developed a parallel implementation of the Kruskall-Wallis test to find CpGs with differential methylation across germ layers. We observed a differentiation of the germ layers, and a set of hypermethylated genes in ectoderm and mesoderm-related tissues, and another set in endoderm-related tissues. The parallel evaluation of the significance of 55 million CpG achieved a 22x speedup with 25 cores. BigMPI4py is available athttps://gitlab.com/alexmascension/bigmpi4pyand the Jupyter Notebook with WGBS analysis athttps://gitlab.com/alexmascension/wgbs-analysis