bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pilot Study of Self-care Breath Training Exercise for Reduction of Chronic Dyspnea
Authors: Deng Gary , Feinstein Marc B. , Benusis Lara , Tin Amy L. , Stover Diane E. 
Published: November 2018

Purpose:
Dyspnea related to chronic pulmonary disorders is difficult to manage. In this single-arm study, we evaluated feasibility and potential efficacy of a self-care breath training program to reduce dyspnea that persists despite standard treatments in patients with chronic lung disease.

Methods:
Adult patients with a chronic pulmonary disorder and stable moderate dyspnea received one 30-min training on specific breathing techniques, followed by audio-guided at-home practice 15 min twice daily for 6 wk, supported with weekly telephone monitoring/coaching. The feasibility endpoints, Baseline and Transition Dyspnea Indexes, 6-min walk test, Hospital Anxiety and Depression Scale, and oxygen saturation at rest and exercise were evaluated at baseline and wk 6.

Results:
Of the 23 patients enrolled over 2 yr, 19 completed the study. A majority (74%; 95% CI, 49%-91%) completed at least 75% of the home practice sessions. Significant objective improvements in physical performance, defined as distance walked, were observed after 6 wk of intervention. On average, patients walked significantly further in the 6-min walk test (59 ft; 95% CI, 18-99; P = .007). In addition, 53% reported clinically significant (20%, defined a priori) subjective improvement in the Transition Dyspnea Index, although the difference was not statistically significant (0.7; 95% CI, −0.8 to 2.3; P = .3). No significant differences were seen in the Hospital Anxiety and Depression Scale or oxygen saturation.

Conclusions:
A low-burden, low-cost, self-care breath training program improved distance walked by patients with chronic dyspnea after 6 wk of home practice. Promising data suggest that a randomized trial of this breath training program is warranted.
The US Transuranium and Uranium Registries (USTUR): A Five-Decade Follow-Up Of Plutonium and Uranium Workers
Authors: Kathren Ronald L. , Tolmachev Sergei Y. 
Published: November 2018

Abstract
Dedication: The research of the US Transuranium and Uranium Registries relies heavily upon postmortem autopsy findings and radiochemical analysis of tissues. The enormous debt owed to those now-deceased registrants who unselfishly voluntarily participated in the US Transuranium and Uranium Registries program through postmortem donation of their tissues and to those still-living registrants who have volunteered to be future postmortem tissue donors is hereby acknowledged with gratitude. The scientific findings derived from postmortem analysis of these tissues have been instrumental in advancing our understanding of the actinide elements in humans and have led to refinement, validation, and confidence in safety standards for those who work with these elements as well as for the general public. To these generous and anonymous persons who made this ultimate contribution, this paper is dedicated with great thanks and admiration.
High unmet need in severe chronic pruritus in the United States: results from a survey of practicing community dermatologists
Authors: Sedlack Stuart , Yosipovitch Gil , Kerby Matthew B. , Nagle Paul C. , Ständer Sonja 
Published: November 2018

Introduction:
Chronic pruritus (CP) is a symptom of many diseases, but there is a scarcity of data on this condition in the US.

Methods:
We surveyed practicing, community-based US dermatologists about aspects of CP, including the number of patients seen annually, patient characteristics, treatments, and level of unmet need. US dermatologists who responded to a screening survey and reported managing ≥10 patients with CP per year were administered a 55-question web-based survey. The survey was conducted from March 27 to April 10, 2015.

Results:
A total of 212 survey responses were included in the analysis. The prevalence of CP in the dermatologists’ practices in the previous year was reported as 4.8%. Of 9 dermatologic conditions in the survey, CP was rated as having the highest level of unmet need (8.6 on a 10-point scale). Respondents reported that 32.7% of their patients had CP classified as severe/very severe, with 53.7% of patients having CP lasting for >1 year. Most dermatologists prescribed antihistamines (77.5%) or corticosteroids (76.1%) as first-line therapy to their patients with severe/very severe CP, and 36.3% of their patients did not respond to currently available treatments.

Discussion:
The combined prevalence of CP and its high level of unmet need necessitate the development of effective/tolerable treatments for this patient population.
Clinicopathological and prognostic significance of GLUT1 in breast cancer
Authors: Deng Yu , Zou Jialing , Deng Ting , Liu Junying 
Published: November 2018

Abstract

Background:
Previous studies examining the prognostic value of glucose transporter 1 in breast cancer have yielded inconsistent results. We, therefore, performed a meta-analysis to clarify this issue.

Methods:
The research was reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Relevant studies were retrieved from PubMed, Web of Science, EMBASE, and Cochrane library.

Results:
A total of 7 reports with 1861 patients were finally chosen. GLUT1 overexpression was found to be associated with high histological grade (OR = 3.74, 95% CI = 2.45–5.69, P < .001), negative PR status (OR = 0.33, 95% CI = 0.22–0.49, P < .001), and negative estrogen receptor (ER) status (OR = 0.27, 95% CI = 0.17–0.42, P < .001). However, no significant correlation was seen between GLUT1 levels and presence of lymph node metastasis, tumor size or the status of human epidermal growth factor receptor 2 (HER2). Overexpression of GLUT1 also correlated with a poor overall survival (hazard ratio [HR] = 1.65, 95% confidence interval [CI] = 1.17–2.31, P = .004) and disease-free survival (HR = 2.35, 95% CI = 1.4–3.94, P < .001). No evidence of significant publication bias was found.

Conclusion:
This meta-analysis indicates that GLUT1 expression is associated with poor prognostic and a series of clinicopathological features in breast cancer. GLUT1 might be a potential biomarker and therapeutic target in breast cancer.
Resistance profile to antimicrobial agents in the main circulating bacteria isolated from acute periodontal and endodontic infections in Latin America (MICROBE- DENT)
Authors: Abe Flávia Casale , Bergamaschi Cristiane de Cássia , Figueiró Mabel Fernandes , Lopes Luciane Cruz 
Published: November 2018

Abstract

Background:
Antimicrobial resistance is currently considered the main risk to global health. A variety of microbial species have been isolated from endodontic and periodontal infections. However, clinical endodontic and periodontics bacterial isolates have not been sufficiently characterized with regard to their capacity for antibiotic resistance. We aim to assess the existing evidence to estimate the prevalence of the main antimicrobial resistance and multidrug resistant organisms in endodontics and periodontics and to describe their geographic distribution in Latin America.

Methods:
All types of designs and will be restricted to Latin American studies will be included in this systematic review. MEDLINE, Embase, CINAHL, BVS (LILACS, BBO - bvsalud.org), IBECS (bases.bireme.br), Google Scholar, Cochrane Central Register of Controlled Trials, and Web of Science databases will be searched from 2013 to December 31, 2018 for all types of study designs that report microbial infection in endodontics and periodontics and their resistance and that define the microbiological methods used to identify microorganisms. The selection of articles for inclusion will be performed by 2 reviewers using predefined eligibility criteria. The Cochrane and ROBINS-I risk of bias assessment tools will be used to assess the methodological quality of randomized control trials. The Newcastle–Ottawa scale will be used to assess the quality of methodology in observational studies. The overall quality of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) using the same principles and domains applied in the quality assessment of prognostic studies. The heterogeneity of the findings will be assessed using both the χ2 test and the I
2 statistic. Sensitivity analysis will be performed by subgroup analyses and meta-regression to investigate the effect of study-level characteristics, such as age, gender, and methodological quality score, whenever possible. Publication bias across studies will be evaluated by visual inspection of the funnel plots and Begg's test for the results covered in 10 or more studies.

Results:
The evidence derived by this study will inform best practices for patients with endodontic and periodontal problems receiving antimicrobial agents.

Conclusion:
Successful completion will significantly impact clinical practice and contribute to improved prescribing competency.

Protocol registration:
PROSPERO—CRD42018077810.
Clinical significance of prognostic nutritional index in patients with glioblastomas
Authors: Ding Jin-Duo , Yao Kun , Wang Peng-Fei , Yan Chang-Xiang 
Published: November 2018

Abstract
Preoperative prognostic nutritional index (PNI) has been proven to be associated with clinical outcomes in patients with malignancies. However, data regarding the role of PNI in human glioblastomas (GBMs) is lacking. We, therefore, aimed to investigate the association between PNI and clinical parameters and survival in GBM patients.
This retrospective analysis included 300 GBM patients who were surgically treated at our institute from 2008 to 2017. PNI was calculated as albumin (g/L) + 5×total lymphocyte count (109/L). SPSS 22.0, GraphPad Prism 5, and X tile were the primary tools used for data analysis, figuring drawing, and calculating optimal cutoffs, respectively.
Mean albumin value, lymphocyte count, and PNI were 42.13 ± 4.43 g/L, 1.73 ± 0.71 × 109/L, and 50.80 ± 6.01, respectively. PNI was increased in patients aged ≤60 years and in men. Moreover, PNI ≥44 was associated with improved overall survival in younger patients and women. PNI was not associated with isocitric dehydrogenase (IDH)-1R132H mutations or predicted survival in GBM patients without such mutations. Univariate analysis showed that a high preoperative Karnofsky performance score, gross total resection, completed chemoradiotherapy, IDH-1R132H mutations, and higher PNI levels were associated with favorable outcomes. Multivariate analysis showed that only completed chemoradiotherapy and IDH-1R132H mutations were independent prognostic factors.
Our results indicated that PNI is associated with age and sex in GBM patients but fails to provide independent prognostic values.
Efficacy of levetiracetam compared with phenytoin in prevention of seizures in brain injured patients
Authors: Zhao Lin , Wu Yu-Peng , Qi Jin-Long , Liu Yong-Qiang , Zhang Kai , Li Wen-Ling 
Published: November 2018

Abstract

Background:
Early and/or late onset in patients with brain injury (BI) is associated with a poorer prognosis, and phenytoin (PHT) is standard of care to prevent seizures. Levetiracetam (LEV), an alternative antiepileptic drug, is associated with less cognitive disruption. The purpose of this study was to evaluate the safety and efficacy of LEV in the prevention of brain traumatic seizures with the standard drug PHT.

Methods:
Search the publications on comparison the safety and efficacy of LEV against the standard agent PHT in prevention of traumatic seizures in BI to January 2018. After rigorous reviewing on quality, the data were extracted from eligible trials. All trials analyzed the summary hazard ratios of the endpoints of interest.

Results:
LEV was found not more effective than PHT in terms of overall seizure (odds ratio [OR] = 0.73; 95% confidence interval [CI] = 0.51–1.05; P = .09), and late seizure (OR = 0.64; 95% CI = 0.34–1.19; P = .16) occurrence. However, there is significant difference in terms of early seizure (OR = 0.63; 95% CI = 0.40–0.99; P = .04). Moreover, there were no significant differences in terms of mortality (OR = 0.67; 95% CI = 0.43–1.05; P = .08), or side effects (OR = 1.31; 95% CI = 0.80–2.15; P = .29) between groups.

Conclusion:
The meta-analysis showed that LEV prevention of seizures was associated with early seizure rates that were lower than the PHT-prolonged course of treatment. There is no statistically significant difference in the efficacy and safety profile of PHT and LEV in cases of traumatic BI.
Associations of anthropometric adiposity indexes with hypertension risk
Authors: Deng Guijuan , Yin Lu , Liu Weida , Liu Xiaoyun , Xiang Quanyong , Qian Zhenzhen , Ma Juntao , Chen Hui , Wang Yang , Hu Bo , Li Wei , Jiang Yu 
Published: November 2018

AbstractBackground and objective:The association between hypertension and obesity has been confirmed, while no agreement has been reached about which anthropometric adiposity index is the best. This meta-analysis aimed to perform a systematic review and meta-analysis on the associations of hypertension risk with body mass index (BMI), waist circumstance (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), and a prospective urban and rural epidemiology study from China (PURE-China) was added into this meta-analysis as an individual study.Methods:Systematic literature searching was conducted to identify relevant articles published up to September 2018 in CNKI, WANFANG Data, Web of Science, SinoMed, PubMed, MEDLINE, EMBASE, Cochrane Library and cross-referencing. Literature reporting the association of hypertension risk with BMI, WC, WHR, and WHtR were defined as eligible. PURE-China data were analyzed and included as 1 eligible study into meta-analyses. Summary odds ratio (OR) and area under receiver operating characteristic curve (AUC) were pooled using meta-analysis methods. Heterogeneity and publication bias were evaluated. Subgroups based on gender, country and study design were conducted as well.Results:Thirty-eight original articles including PURE-China were included into meta-analyses, involving 309,585 subjects. WHtR had the strongest association with hypertension risk (OR, 1.68; 95% confidence interval, [CI]:1.29–2.19) and prediction ability (AUC, 70.9%; 95% CI: 67.8%–74.2%), which were also confirmed in subgroup analyses based on gender and country. However, BMI was found to have the highest prediction ability in adjusted models of PURE-China and followed WC, both of which were superior to WHtR (73.7% and 73.4% vs 73.2%).Conclusions:Our overall meta-analysis further confirmed WHtR as a good indicator at discriminating those individuals at increased risk of hypertension, and in some cases, it is better than BMI, WC, and WHR.
Transverse testicular ectopia associated with persistent Müllerian duct syndrome treated by transseptal orchiopexy
Authors: Chung Ho Seok , Kim Sun-Ouck , Yu Ho Song , Kim Sung-Sun , Kwon Dong Deuk 
Published: November 2018

Abstract

Rationale:
Persistent Müllerian duct syndrome (PMDS) is rare form of male pseudohermaphroditism characterized by the presence of uterus and fallopian tubes with normal external genitalia and secondary sexual characteristics. Transverse testicular ectopia (TTE) is also a rare form of testicular ectopia that may be associated with PMDS.

Patient concerns:
We present a 2-year-old boy who presented with bilateral non-palpable testes with left inguinal mass.

Diagnosis:
TTE with PMDS.

Interventions:
On exploration, both testes were present in the left inguinal region. Uterus and fallopian tubes were located between the testes. A hysterectomy was perfomed with resection of the underdeveloped fallopian tubes. Bilateral orchiopexy was performed by placing both gonads into subdartos pouches in each scrotum with transseptal approach.

Outcomes:
Both testes were palpable in both the scrotum at 1-year postoperative follow-up and we are planning a regular follow-up.

Lessons:
In case of TTE with PMDS, optimal surgical approach with orchiopexy and excision of Müllerian duct should be needed. A long-term postoperative follow-up is necessary for assessment of malignant transformation and infertility.
Study on the incidence and risk factor of silent cerebrovascular disease in young adults with first-ever stroke
Authors: Fan Huimin , Hao Xuezeng , Yang Shuna , Li Yue , Qin Wei , Yang Lei , Yuan Junliang , Hu Wenli 
Published: November 2018

Abstract
Silent cerebrovascular diseases, including silent brain infarcts (SBI), white matter hyperintensity (WMH), and cerebral microbleed, are closely correlated with stroke progression. The purpose of this study was to investigate the prevalence and potential risk factors of SBI and WMH in young patients with first-ever stroke.
A total of 400 young patients with first-ever stroke were included in this study and received magnetic resonance imaging test. The distributions of stroke subtypes were analyzed based on patients’ age and gender. The prevalence of SBI and WMH was evaluated in different age groups and stroke subtypes. Independent risk factors for SBI and WMH were identified using logistic regression analysis.
The distribution of stroke subtypes was not correlated with patients’ age or gender in our study. The incidence of SBI and WMH among all of the young stroke patients was 14.50% and 8.75%, respectively, which showed an upward tendency with age. The percentages of both SBI and WMH were significantly higher in small-vessel disease patients than in cases with other subtype diseases (all P < .05). Hypertension (odds ratio [OR] = 2.645, 95% confidence interval [CI] = 1.429–4.896, P = .002 for SBI; OR = 5.474, 95% CI = 2.319–12.921, P = .000 for WMH; OR = 39.988, 95% CI = 3.988–400.949, P = .002 for SBI and WMH) and homocysteine (OR = 4.033, 95% CI = 2.191–7.425, P = .000 for SBI; OR = 5.989, 95% CI = 2.637–13.602, P = .000 for WMH; OR = 4.068, 95% CI = 1.207–13.715, P = .024 for SBI and WMH) might be potential risk factors for SBI and WMH.
The prevalence of silent cerebrovascular disease was elevated with age. Hypertension and elevated homocysteine levels were 2 risk factors for silent cerebrovascular disease in young stroke patients.
Treatment of persistent postoperative hiccups with stellate ganglion block
Authors: Lee A Ran , Cho Young Woo , Lee Jae Min , Shin Yong Joon , Han Il Sang , Lee Hyung Kwan 
Published: November 2018

Abstract

Rationale:
Although persistent postoperative hiccups can cause various problems (such as sleep disorders, depression, fatigue) for the patient, there has been little research on this topic. The purpose of this study is to determine the effectiveness of treating persistent postoperative hiccups with a stellate ganglion block (SGB), an injection of local anesthetic in the sympathetic nerve tissue of the neck.

Patient concerns and diagnoses:
Three patients each developed persistent hiccups within 3 days of abdominal surgery, lasting for 3 to 6 days. The patients were diagnosed as having persistent hiccups based on the hiccup duration.

Interventions and outcomes:
The 3 patients were treated with an SGB. After the procedure, the frequency and intensity of hiccups decreased and then the hiccups stopped completely.

Conclusion:
An SGB is an effective method that can be considered in conjunction with other treatments for persistent hiccups. Clinicians should be mindful of the negative effects that persistent hiccups can exert on patients.
Percutaneous endoscopic lumbar discectomy by transfacet joint approach
Authors: Ning Cong , Wang Yuanyi , Xu Feng , Zhang Wenjing , Liu Wei , Lv Zhenshan , Liu Yadong , Fu Changfeng 
Published: November 2018

Abstract

Rationale:
The accurate and smooth establishment of a working cannula guarantees rapid and minimally invasive treatment effects using percutaneous endoscopic lumbar discectomy (PELD) for lumbar disc herniation (LDH). With anatomic variations such as a hyperplastic superior articular process (SAP), the conventional transforaminal approach cannot achieve an ideal result.

Patient concerns:
A 48-year-old male patient suffered waist and left lower limb pain, with exacerbation of symptoms after exertion.

Diagnoses:
L5-S1 disc herniation, hyperplastic SAP of S1.

Interventions:
To demonstrate the segment responsible for compression, a lumbar nerve root block was carried out. This was followed by PELD via a transfacet joint approach at L5-S1.

Outcomes:
The patient experienced an improved quality of life postoperatively (i.e., visual analog score for pain = 1 and Oswestry disability index  = 88). Lumbar function and stability were preserved as of the 1-month postoperative follow-up.

Lessons:
The transfacet joint approach could extend the indications for PELD and present an alternative option in selected cases. A new concept of “subsidence foramen” is raised to characterize this anatomic variation, and it may guide working access establishment of PELD. In addition, reading imaging results carefully and individualizing treatments promote the use of PELD as minimally invasive surgery.
NRAGE is a potential diagnostic biomarker of hepatocellular carcinoma
Authors: Zou Wenshuang , Cui Junfeng , Ren Zhong , Leng Yan 
Published: November 2018

Abstract
Hepatocellular carcinoma (HCC) is one of the most common cancers and a leading cause of cancer-related deaths worldwide. Early diagnosis of HCC remains a great challenge in clinic. Novel and effective biomarkers are in urgent need in early diagnosis of HCC.
Serum levels of neurotrophin-receptor-interacting melanoma antigen-encoding gene homolog (NRAGE) were measured for 107 patients with HCC, 98 patients with benign liver diseases, and 89 healthy controls using quantitative real-time polymerase chain reaction. Receiver operating characteristic curve was applied to evaluate the diagnostic capacity of serum NRAGE in HCC.

NRAGE expression was significantly higher in patients with HCC than in controls (all, P < .05). Moreover, its expression was tightly correlated with TNM stage (P = .004). NRAGE could distinguish patients with HCC from healthy controls with the area under the curve (AUC) of 0.874, yielding a sensitivity of 81.3% and a specificity of 78.7%. Additionally, in differentiation between benign liver diseases and HCC, the AUC value of NRAGE was 0.726, with a sensitivity of 63.6% and a specificity of 73.5%. Meanwhile, alpha-fetoprotein also could distinguish patients with HCC from benign liver disease cases, with an AUC of 0.677, a sensitivity of 64.4%, and a specificity of 60.2%.

NRAGE could be a potential biomarker for HCC early diagnosis.