bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late-onset bronchopleural fistula after lobectomy and adjuvant chemotherapy for lung cancer
Authors: Zhang Chu , Pan Yong , Zhang Rui-Mei , Wu Wen-Bin , Liu Dong , Zhang Miao 
Published: June 2019

Abstract

Rationale:
Late-onset bronchopleural fistula (BPF) induced by chemotherapy after lobectomy for lung cancer is rarely reported, lacking reliable preventive approaches. A timely identification and individualized treatment is essential for prognosis.

Patient concerns:
A 52-year-old female patient complained of fever, productive cough, and fatigue 1 week after adjuvant chemotherapy following right lower lobectomy and systemic mediastinal lymph node dissection. Chest computed tomography (CT) indicated pneumothorax and thick-walled empyema cavity within her right-sided thorax.

Diagnoses:
The patient was diagnosed as late-onset BPF based on clinical manifestation and chest radiography.

Interventions:
In addition to antibiotics, a chest tube was reinserted under CT guidance, and vacuum suction was utilized for continuous drainage. Next cycle of adjuvant chemotherapy was terminated.

Outcomes:
The empyema cavity was gradually closed in 1 month after conservative treatment, and the patient survived with good condition up to now.

Lessons:
Late-onset BPF should be kept in mind when the patient suffered from productive cough and chills during postoperative chemotherapy. And a prompt conservative management might be effective.
Comparative study of lactobacilli and bifidobacteria in vaginal tract of individual with bacterial vaginosis and healthy control by quantitative PCR
Authors: Bakhshi Ashraf , Safayi Delouyi Zahra , Taheri Shiva , Alivandi Azadeh , Mohammadzadeh Nima , Dabiri Hossein 
Published: June 2019

Background:
Bacterial vaginosis is characterized by a disequilibrium in vaginal microflora with the distinguishing feature of decrease in lactobacilli. The current study aimed to study lactobacilli and bifidobacteria in the vaginal tract of individual with bacterial vaginosis.

Methods:
For this purpose, vaginal swabs of 108 women, including 92 patients with clinical symptoms of bacterial vaginosis and 16 healthy cases were collected. After extraction of DNA from vaginal samples, quantitative PCR was performed for detect the bacterial load and 16SrRNA gene. PCR was performed for the detection of microorganisms related to sexually transmitted infections, which all samples harboring any of such microorganisms was excluded from study.

Results:
There was a positive link between the quantitation of Lactobacillus spp. and Bifidobacterium spp. among patients with bacterial vaginosis and healthy group. Quantitative PCR analysis illustrates that the frequency of Lactobacillus spp. and Bifidobacterium spp. are significantly lower in patients with bacterial vaginosis compared with healthy individuals.

Conclusion:
The current study promotes our understanding about the vaginal Lactobacillus spp. and Bifidobacterium spp. among patients and healthy individuals in Iran. Confirming the link between the frequency of lactobacilli and bacterial vaginosis could help us develop new prebiotics and probiotics for this disorder.
Critical Trio Exome Benefits In-Time Decision-Making for Pediatric Patients With Severe Illnesses*
Authors: Wu En-Ting , Hwu Wuh-Liang , Chien Yin-Hsiu , Hsu Ching , Chen Ting-Fu , Chen Nai-Qi , Chou Hung-Chieh , Tsao Po-Nien , Fan Pi-Chuan , Tsai I-Jung , Lin Shuan-Pei , Hsieh Wu-Shiun , Chang Tung-Ming , Chen Chi-Nien , Lee Chen-Hao , Chou Yen-Yin , Chiu Pao-Chin , Tsai Wen-Hui , Hsiung Hann-Chang , Lai Feipei , Lee Ni-Chung 
Published: July 2019

Objectives:
Critical illnesses caused by undiagnosed genetic conditions are challenging in PICUs. Whole-exome sequencing is a powerful diagnostic tool but usually costly and often fail to arrive at a final diagnosis in a short period. We assessed the feasibility of our whole-exome sequencing as a tool to improve the efficacy of rare diseases diagnosis for pediatric patients with severe illness.

Design:
Observational analysis.

Method:
We employed a fast but standard whole-exome sequencing platform together with text mining-assisted variant prioritization in PICU setting over a 1-year period.

Setting:
A tertiary referral Children’s Hospital in Taiwan.

Patients:
Critically ill PICU patients suspected of having a genetic disease and newborns who were suspected of having a serious genetic disease after newborn screening were enrolled.

Interventions:
None.

Measurements and Main Results:
Around 50,000 to 100,000 variants were obtained for each of the 40 patients in 5 days after blood sampling. Eleven patients were immediately found be affected by previously reported mutations after searching mutation databases. Another seven patients had a diagnosis among the top five in a list ranked by text mining. As a whole, 21 patients (52.5%) obtained a diagnosis in 6.2 ± 1.1 working days (range, 4.3–9 d). Most of the diagnoses were first recognized in Taiwan. Specific medications were recommended for 10 patients (10/21, 47.6%), transplantation was advised for five, and hospice care was suggested for two patients. Overall, clinical management was altered in time for 81.0% of patients who had a molecular diagnosis.

Conclusions:
The current whole-exome sequencing algorithm, balanced in cost and speed, uncovers genetic conditions in infants and children in PICU, which helps their managements in time and promotes better utilization of PICU resources.
Effects of Whole-Body Vibration on Motor Impairments in Patients With Neurological Disorders
Authors: Alashram Anas R. , Padua Elvira , Annino Giuseppe 
Published: July 2019

Objective
This systematic review was conducted to examine the effects of whole-body vibration training on motor impairments among patients with neurological disorders and to investigate which the whole-body vibration training parameters induced improvement in motor impairments.

Design
PubMed, SCOPUS, PEDro, REHABDATA, and Web of Science were searched for randomized controlled trials and pseudo-randomized controlled trials investigated the effect of whole-body vibration on motor impairments in patients with neurological disorders. The methodological quality was rated using the Cochrane Collaboration’s tool.

Results
Twenty studies were included in this systematic review. Four studies included patients with multiple sclerosis, cerebral palsy (n = 2), stroke (n = 9), Parkinson disease (n = 3), spinal cord injuries (n = 1), and spinocerebellar ataxia (n = 1). The results showed different evidence of benefits and nonbenefits for whole-body vibration training in motor impairments outcomes.

Conclusions
There is weak evidence for a positive effect of short-term whole-body vibration training on spasticity of lower limbs, mobility, balance, and postural control. Besides, positive effect of the long-term effect of whole-body vibration training on mobility in patients with neurological disorders. The optimal whole-body vibration training parameters in treating patients with neurological disorders remain unclear.
The Usefulness of Basic Movement Scale in Hip Fracture Patients
Authors: Goto Ryutaro , Toyama Shogo , Sawada Koshiro , Takamuku Kiyoshi , Kubo Toshikazu , Takahashi Tai 
Published: July 2019

Objective
The aim of the study was to investigate the validity of using total score and to examine the constitution and characteristics of the Basic Movement Scale in postsurgery patients with hip fracture.

Design
The dimensionality and the threshold difficulty intervals between each score and item difficulty hierarchy of the Basic Movement Scale were examined using factor analysis and Rasch analysis in 37 patients admitted to our hospital between April and November 2015.

Results
For factor analysis, the contribution ratio of the first factor was 78.9%, that of the second factor was 6.5%, and there were no items that fit the Rasch analysis. The threshold was reversed at 6 of the 48 locations. The difficulty of the 12 Basic Movement Scale items was distributed roughly evenly among all 9 lots, with some deviation. There was one very easy item, and there were some items almost overlapping in difficulty.

Conclusions
The results showed a unidimensional association between the items and evaluation index. The difficulty threshold of each score was approximated to the interval scale. Therefore, the Basic Movement Scale has evident construct validity and enables quantitative evaluation of physical ability, assessment of the effects of daily training, and general predictions of the feasibility of patients' clinical goals.
Peripheral nerve pathology in sickle cell disease mice
Authors: Sadler Katelyn E. , Lewis Tylor R. , Waltz Tyler B. , Besharse Joseph C. , Stucky Cheryl L. 
Published: June 2019

AbstractIntroduction:Many patients with sickle cell disease (SCD) suffer from chronic pain, which is often described as neuropathic in nature. Although vascular and inflammatory pathology undoubtedly contribute to the SCD pain experience, the nociceptive signals that ultimately drive symptoms are detected and transmitted by peripheral sensory neurons. To date, no systematic histological examination of peripheral nerves has been completed in patients or mouse models of SCD to diagnose disease-related neuropathy.Objectives:In this brief report, we compared peripheral nerve morphology in tissues obtained from Berkeley transgenic SCD mice and control animals.Methods:Sciatic nerves were visualized using light and transmission electron microscopy. Myelin basic protein expression was assessed through Western blot. Blood–nerve barrier permeability was measured using Evan's blue plasma extravasation.Results:Peripheral fibers from SCD mice have thinner myelin sheaths than control mice and widespread myelin instability as evidenced by myelin sheath infolding and unwrapping. Deficits are also observed in nonmyelinating Schwann cell structures; Remak bundles from SCD nerves contain fewer C fibers, some of which are not fully ensheathed by the corresponding Schwann cell. Increased blood–nerve barrier permeability and expression of myelin basic protein are noted in SCD tissue.Conclusions:These data are the first to characterize Berkeley SCD mice as a naturally occurring model of peripheral neuropathy. Widespread myelin instability is observed in nerves from SCD mice. This pathology may be explained by increased permeability of the blood–nerve barrier and, thus, increased access to circulating demyelinating agents at the level of primary sensory afferents.
Neurological Involvement in Patients With Primary Sjögren’s Syndrome
Authors: Fan Guihua , Dai Fan , Chen Shiju , Sun Yuechi , Qian Hongyan , Yang Guomei , Liu Yuan , Shi Guixiu 
Published: July 2019

Background/Objective
The neurological involvement associated with primary Sjögren’s syndrome (pSS) can be life threatening. However, the specific characteristics of pSS-related neurological involvement remain obscure. This study aimed at determining the clinical characteristics of this neurological involvement in patients with pSS.

Methods
The clinical data of 205 patients with pSS who were admitted to our department between January 2015 and June 2017 were studied. Characteristics and laboratory findings of pSS patients with neurological abnormalities were compared with pSS patients without.

Results
Forty of the 205 patients with pSS exhibited neurological abnormalities (19.51%); of these, 13 patients exhibited central nervous system (CNS) involvement only, 20 patients exhibited peripheral nervous system (PNS) involvement only, and 7 patients exhibited both, yielding a total of 20 (9.76%) patients with CNS involvement and 27 (13.17%) patients with PNS involvement. The titers of anti-Sjögren’s syndrome type A (SSA) antibodies were significant higher while the presence of anti-Sjögren’s syndrome type B (SSB) antibodies was significant lower in patients with vs. without neurological involvement. Similar results were found in patients with CNS involvement. No significant differences between patients with and without neurological involvement were found for the other clinical parameters examined.

Conclusions
Neurological involvement in patients with pSS is common and needs to be carefully evaluated. Patients with pSS with a high titer of anti-SSA and low presence of anti-SSB antibodies might have a relatively high risk of developing neurological involvement. Future studies should focus on identifying biomarkers that may aid in the early diagnosis of neurological involvement in patients with pSS.
Cerebrospinal Fluid Leak Following Nasal Packing for Epistaxis
Authors: Sireci Federico , Immordino Vincenzo , Galletti Francesco , Galletti Bruno , Cimino Giovanni , Sbacchi Claudio 
Published: July 2019

Abstract
Anterior epistaxis is commonly treated with Merocel nasal packing insertion. A 63-year-old male patient showed a cerebrospinal fluid rhinorrhea and pneumocephalus immediately after insertion of a Merocel tampon used for spontaneous right anterior epistaxis. He later developed fever and headache. This clinical report is to highlight how the nasal merocel should be positioned by specialized personnel and to describe how to manage this type of complication.
Long-term Outcomes of Laparoscopy-assisted Gastrectomy for T4a Advanced Gastric Cancer: A Single-center Retrospective Study
Authors: Zhang Luyang , Zang Lu , Sun Jing , Dong Feng , Feng Bo , Lu Ai-guo , Wang Ming-liang , Zheng Min-hua , Ma Jun-jun , Hu Wei-guo 
Published: June 2019

Background:
Laparoscopy-assisted gastrectomy (LAG) has been proven to be feasible and oncologically safe for early gastric cancer. Despite the rapid increase in the number of LAG cases, there are few reports on the long-term outcomes of T4a (serosalinvasion) gastric cancer after LAG. The aim of the present study was to evaluate the long-term clinical outcomes in patients with stage T4a gastric cancer after laparoscopic gastrectomy.

Materials and Methods:
A total of 578 patients with gastric cancer were treated with LAG between February 2004 and December 2014. Among these patients, 224 patients were pathologically confirmed with T4a advanced gastric cancer. The clinical and follow-up data were retrospectively analyzed, the survival rates were estimated using the Kaplan-Meier method, and the risk factors for overall and disease-free survival (DFS) were evaluated by Cox regression.

Results:
Among these 224 patients, 129 patients were above 60 years old, and the male-to-female ratio was 157:67. Furthermore, among these patients, 125 patients received laparoscopy-assisted distal gastrectomy, whereas 99 patients received laparoscopy-assisted total gastrectomy. Forty (17.90%) patients experienced postoperative complications according to the Clavien-Dindo classification. Median follow-up time was 32 months. Recurrence was observed in 99 (44.20%) patients. The cumulative 5-year overall survival (OS) and DFS rates were 47.20% and 43.60%, respectively. The 5-year OS and DFS rates were 72.50% and 70.00% for stage N0, 57.00% and 53.90% for stage N1, 41.60% and 37.00% for stage N2, and 23.30% and 21.30% for stage N3, respectively. In the univariate analysis, tumor size, tumor location, N stage and metastatic lymph node ratio (MLR) were correlated with OS and DFS. The MLR was identified as an independent predictor for OS (P<0.05; hazard ratio=1.828; 95% confidence interval, 1.353-2.469) and DFS (P<0.05; hazard ratio=1.197; 95% confidence interval, 0.945-1.516).

Conclusions:
The long-term outcomes of LAG for T4a (M0) gastric cancer were acceptable, compared with previous reports. Therefore, this treatment could be considered as an alternative operative approach for T4a gastric cancer. The MLR was an independent predictor for OS and DFS.
A Novel Approach on dTMS Coil Design Based on Tractography and Neural Cable Theory
Authors: Jafari Ali Mohtadi , Abdolali Ali 
Published: June 2019

AbstractDeep transcranial magnetic stimulation (dTMS) plays a useful role in the treatment of many diseases. In previous designs, it is only desired to maximize the absolute value of the electric field in the target zone. Whereas due to the nerve cable equation (NCE), the membrane potential of a nerve cell is changed due to the rate of change in the tangential electric field . In this paper, the criterion of the design is to maximize along the nerve cell fiber and simultaneously minimize the absolute value of the electric field. The direction of the nerve fibers is obtained using Tractography. Then, the specifications of source and coils such as position and spatial angles are determined in such a way that every two coils cancel the absolute value of the electric field of each other by using reciprocity theorem. This happened whereas the is maximized. For better comparison, a 20-coil array is designed for stimulation of cingulum region of the brain. Results of this array are compared with results of the FO8-Halo coil and it is shown that with the same value for , an absolute value of the induced field in the brain for the 20-coil array is much smaller than the FO8-Halo coil. Also, designed coil array requires smaller sources. So, the array can stimulate the target zone more accurately and with higher efficiency. This new technique can solve the problem of stimulation of the large areas of the brain and stimulate the desired target zone with more accuracy.
Inhibition Controls Receptive Field Size, Sensitivity, and Response Polarity of Direction Selective Ganglion Cells Near the Threshold of Vision
Authors: Yao Xiaoyang , Field Greg D. 
Published: June 2019

AbstractInformation about motion is encoded by direction-selective retinal ganglion cells (DSGCs). These cells reliably transmit this information across a broad range of light levels, spanning moonlight to sunlight. Previous work indicates that adaptation to low light levels causes heterogeneous changes to the direction tuning of ON-OFF (oo)DSGCs and suggests that superior-preferring ON-OFF DSGCs (s-DSGCs) are biased toward detecting stimuli rather than precisely signaling direction. Using a large-scale multi-electrode array, we measured the absolute sensitivity of ooDSGCs and found that s-DSGCs are ten-fold more sensitive to dim flashes of light than other ooDSGCs. We measured their receptive field sizes and found that s-DSGCs also have larger receptive fields than other ooDSGCs, however, the size difference does not fully explain the sensitivity difference. Using a conditional knockout of gap junctions and pharmacological manipulations, we demonstrate that GABA-mediated inhibition contributes to the difference in absolute sensitivity and receptive field size at low light levels, while the connexin36-mediated gap junction coupling plays a minor role. We further show that GABA-mediated inhibition masks the OFF response of ooDSGCs under scotopic conditions, restricting their responses to increases in light. These results reveal that GABAergic inhibition controls and differentially modulates the responses of ooDSGCs under scotopic conditions.Significance StatementLight adaptation and parallel processing are two major functions of retina. Here we show that parallel processing is differentially regulated between photopic and scotopic conditions across DSGCs. This differential adaptation alters the absolute sensitivity and RF size of s-DSGCs relative to other ooDSGC types. These results point to novel mechanisms and possibly new circuit elements that shape retinal processing of motion under rod-mediated light levels.
Circadian control of intrinsic heart rate via a sinus node clock and the pacemaker channel
Authors: Wang Yanwen , Olieslagers Servé , Johnsen Anne Berit , Mastitskaya Svetlana , Ni Haibo , Zhang Yu , Black Nicholas , Anderson Cali , Cox Charlotte , Bucchi Annalisa , Wegner Sven , Bano-Otalora Beatriz , Petit Cheryl , Gill Eleanor , Logantha Sunil Jit , Ashton Nick , Hart George , Zhang Henggui , Cartwright Elizabeth , Wisloff Ulrik , Da Costa Martins Paula , DiFrancesco Dario , Dobrzynski Halina , Piggins Hugh D. , Boyett Mark R. , D’Souza Alicia 
Published: June 2019

ABSTRACTIn the human, there is a circadian rhythm in the resting heart rate and it is higher during the day in preparation for physical activity. Conversely, slow heart rhythms (bradyarrhythmias) occur primarily at night. Although the lower heart rate at night is widely assumed to be neural in origin (the result of high vagal tone), the objective of the study was to test whether there is an intrinsic change in heart rate driven by a local circadian clock. In the mouse, there was a circadian rhythm in the heart rate in vivo in the conscious telemetrized animal, but there was also a circadian rhythm in the intrinsic heart rate in denervated preparations: the Langendorff-perfused heart and isolated sinus node. In the sinus node, experiments (qPCR and bioluminescence recordings in mice with a Per1 luciferase reporter) revealed functioning canonical clock genes, e.g. Bmal1 and Per1. We identified a circadian rhythm in the expression of key ion channels, notably the pacemaker channel Hcn4 (mRNA and protein) and the corresponding ionic current (funny current, measured by whole cell patch clamp in isolated sinus node cells). Block of funny current in the isolated sinus node abolished the circadian rhythm in the intrinsic heart rate. Incapacitating the local clock (by cardiac-specific knockout of Bmal1) abolished the normal circadian rhythm of Hcn4, funny current and the intrinsic heart rate. Chromatin immunoprecipitation demonstrated that Hcn4 is a transcriptional target of BMAL1 establishing a pathway by which the local clock can regulate heart rate. In conclusion, there is a circadian rhythm in the intrinsic heart rate as a result of a local circadian clock in the sinus node that drives rhythmic expression of Hcn4. The data reveal a novel regulator of heart rate and mechanistic insight into the occurrence of bradyarrhythmias at night.
The story so far-digital preservation in institutional repositories
Authors: Adjei Emmanuel , Mensah Monica , Amoaful Eric Amponsah 
Published: June 2019

PurposeThe purpose of this study is to examine the standards, strategies, support and challenges of digital preservation in institutional repositories in academic libraries in Ghana.Design/methodology/approachThe research was qualitative. Data used for analysis were drawn from interviews with respondents selected purposively from eight Ghanaian academic libraries.FindingsA key finding of the study was that although the academic libraries had operational directions for digital preservation activities in the institutional repositories, available standards and practices for ensuring long-term preservation seem to be unsuitable.Research limitations/implicationsRecommendations based on findings included development of comprehensive digital preservation policies to provide mandate and direction to preservation of the libraries digital collections, development of disaster plans, adequate funding, staff development and support from management.Originality/valueThe study has demonstrated the need for academic libraries in Ghana to have and develop good digital preservation standards for sustaining the institutional repositories to help in realizing its benefits.