bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative Opioid Consumption After Scheduled Compared With Unscheduled Cesarean Delivery
Authors: Prabhu Malavika , Dolisca Sarah , Wood Rachel , James Kaitlyn , Bateman Brian T. , Barth William H. , Wylie Blair J. 
Published: January 2019

OBJECTIVE:
To identify characteristics associated with high inpatient daily opioid consumption after cesarean delivery.

METHODS:
This is a retrospective cohort study of all cesarean deliveries performed under neuraxial anesthesia with neuraxial morphine, at a single institution from January 1, 2015, to December 31, 2015. Women with preoperative opioid use disorder or chronic opioid use were excluded. Sociodemographic data, medical comorbidities, use of anxiolytics or antidepressants, smoking history, nonopioid substance use, intrapartum and cesarean delivery characteristics, and opioid consumption data (converted to morphine milligram equivalents) were abstracted. We defined high opioid use as a mean daily opioid consumption, standardized to the postoperative length of stay (excluding the first 24 postoperative hours to account for neuraxial morphine), greater than the 75th percentile of all opioid consumption. We used multivariable Poisson regression, stratified by whether or not cesarean delivery was scheduled, to identify characteristics associated with high opioid consumption.

RESULTS:
Among 949 women who underwent cesarean delivery, the mean (SD) and median (interquartile range) daily opioid consumption was 48.6 (22.8) and 44.6 (36.6–66.6) morphine milligram equivalents, respectively. Among those women with high opioid consumption, the mean (SD) and median (interquartile range) daily opioid consumption was 78.8 (8.5) and 78.3 (72.9–83.5) morphine milligram equivalents, respectively. Daily opioid consumption among those with high consumption was similar among women with scheduled compared with unscheduled cesarean delivery. Sociodemographic characteristics were similar among women with and without high opioid consumption. No sociodemographic, antepartum, or intrapartum characteristics were associated with high opioid consumption for either women having unscheduled or scheduled cesarean deliveries.

CONCLUSION:
For a quarter of women undergoing cesarean delivery, daily consumption of opioids is equivalent to 10 tablets of oxycodone 5 mg daily. No characteristics were associated with high opioid use for women having a scheduled or unscheduled cesarean delivery. Understanding opioid consumption after cesarean delivery is critical to managing women's postoperative pain while decreasing opioid exposure and risks of long-term opioid use disorder.
Scrambler therapy: what's new after 15 years? The results from 219 patients treated for chronic pain
Authors: Ricci Marianna , Fabbri Laura , Pirotti Sara , Ruffilli Nicola , Foca Flavia , Maltoni Marco 
Published: January 2019

Abstract
Chronic pain is often difficult to treat, requiring a comprehensive multidisciplinary therapeutic intervention and a high level of management expertise.
This is particularly true for patients who are unresponsive to standard treatments for chronic pain, for which Scrambler Therapy (ST) is indicated. The aim of the present study was to evaluate the impact of ST on patient-reported moderate to severe chronic pain.
This was a prospective trial on 219 patients affected by chronic pain from April 2010 to March 2016. The study consisted of 2 consecutive weeks of treatment with ST (one 30-min daily session, 5 days a week) (T0, T1, T2) and a 2-week follow-up (T3, T4). Patients were asked to describe the pain using the Numeric Rating Scale (NRS) immediately prior to and after the treatment.
Two hundred nineteen patients were treated for chronic pain of different nature with mean values of 6.44 (± 2.11) at T0, 3.22 (± 2.20) at T2, and 3.19 (± 2.34) at T4. A reduction in the symptomatology from T0 to T2 was maintained throughout T4 (P value < .0001). Of the 219 patients treated with ST, 83 (37.9%) had cancer pain and 136 (62.1%) had non-cancer pain. No adverse events were reported.
Future research should focus on individual response, retreatment, and maintenance therapy. The data showed a statistically significant impact of ST, which was maintained during follow-up, on patients suffering from chronic pain of different nature.
The impact of SimMan on resident training in emergency skills
Authors: Liu Yu , Zhang Yanshu , Zhang Lei , Bai Hongliang , Wang Gang , Guo Litao 
Published: January 2019

Abstract
The purpose of this study was to analyze the role of SimMan in resident training of emergency skills.
Forty-five 1st year medical residents were selected for this study. All participants were divided into groups and each participant performed different roles during training. Clinical cases were selected using the tutor mode/auto mode in the SimMan computer system in order to train and assess each group. A pre-test was administered to the 45 residents before emergency medical technician (EMT) skill training. Finally, a post-test was conducted with SimMan after training. Tutors scored the student's performance and recorded the overall time for the procedure.
Before training, the overall qualification rate was 44.44%. The average score of the 9 groups was 62.78 ± 8.84 and the average 1st aid duration was 519.22 ± 34.35 seconds. After the training, the overall qualification rate was 100%. The average score of the 9 groups was 80.89 ± 7.39. The average 1st aid duration was 453.56 ± 24.40 seconds. The P values in comparing pre- and post-training data were .009, <.001 and <.001.
An integrated learning approach using SimMan as a tool for training and examination can help training residents develop emergency skills, teamwork, and communication.
Grip strength can be used to evaluate postoperative residual neuromuscular block recovery in patients undergoing general anesthesia
Authors: Pei Da-Qing , Zhou Hong-Mei , Zhou Qing-He 
Published: January 2019

Abstract

Background:
Residual postoperative neuromuscular blockade is an important clinical issue. Neuromuscular monitoring is usually used to evaluate neuromuscular recovery in patients undergoing general anesthesia. However, this procedure is inconvenient and not widely adopted. We aimed to examine the correlation between grip strength and train-of-four ratio (TOFr) to examine whether assessing grip strength can be used clinically to monitor residual neuromuscular blockade.

Methods:
One hundred twenty patients with ASA I or II scheduled for laparoscopic cholecystectomy under general anesthesia were enrolled in this study. All patients were randomly selected to receive standard anesthesia induction with either 0.6 mg·kg−1 rocuronium or 0.2 mg·kg−1 cisatracurium. Grip strength was tested in all patients using an electronic device before anesthesia and when TOFr values of 0.7, 0.8, and 0.9, and an hour later of TOFr value of 0.25. The time required for a change in TOFr values from 0.25 to 0.75 and 0.9 was evaluated. Spearman rank correlation analysis was performed to determine correlations between grip strength and TOFr.

Results:
Spearman rank correlation analysis indicated that there was a significant correlation between grip strength and TOFr during patient recovery from general anesthesia (correlation coefficient for grip strength recovery [r
s] = 0.886). Subgroup analysis revealed that there were no differences in mean maximum grip value recovery between patients treated with rocuronium and those treated with cisatracurium when TOFr was 0.7, 0.8, and 0.9 or when the TOFr was 0.25 after 60 minutes (all P
>.05). Recovery of TOFr from 0.25 to 0.75 and from 0.25 to 0.9 was longer in patients treated with rocuronium than in those treated with cisatracurium (both P <.001).

Conclusion:
There was a strong correlation between grip strength and TOFr during recovery from general anesthesia. Evaluation of grip strength can be used as an additional strategy to evaluate postoperative residual neuromuscular blockade.
Predictive models composed by radiomic features extracted from multi-detector computed tomography images for predicting low- and high- grade clear cell renal cell carcinoma
Authors: He Xiaopeng , Zhang Hanmei , Zhang Tong , Han Fugang , Song Bin 
Published: January 2019

Abstract
To evaluate the values of conventional image features (CIFs) and radiomic features (RFs) extracted from multi-detector computed tomography (MDCT) images for predicting low- and high-grade clear cell renal cell carcinoma (ccRCC).
Two hundred twenty-seven patients with ccRCC were retrospectively recruited. Five hundred seventy features including 14 CIFs and 556 RFs were extracted from MDCT images of each ccRCC. The CIFs were extracted manually and RFs by the free software—MaZda. Least absolute shrinkage and selection operator (Lasso) was applied to shrink the high-dimensional data set and select the features. Five predictive models for predicting low- and high-grade ccRCC were constructed by the selected CIFs and RFs. The 5 models were as follows: model of minimum mean squared error (minMSE) of CIFs (CIF-minMSE), minMSE of cortico-medullary phase (CMP) of kidney (CMP-minMSE), minMSE of parenchyma phase (PP) of kidney (PP-minMSE), the combined model of CIF-minMSE and CMP-minMSE (CIF-CMP-minMSE), and the combined model of CIF-minMSE and PP-minMSE (CIF-PP-minMSE). The Lasso regression equation of each model was constructed, and the predictive values were calculated. The receiver operating characteristic (ROC) curves of predictive values of the 5 models were drawn by SPSS19.0, and the areas under the curves (AUCs) were calculated.
According to Lasso regression, 12, 19 and 10 features were respectively selected from the CIFs, RFs of CMP image and that of PP images to construct the 5 predictive models. The models ordered by their AUCs from large to small were CIF-CMP-minMSE (AUC: 0.986), CIF-PP-minMSE (AUC: 0.981), CIF-minMSE (AUC: 0.980), CMP-minMSE (AUC: 0.975), and PP-minMSE (AUC: 0.963). The maximum diameter of the largest axial section of ccRCC had a maximum weight in predicting the grade of ccRCC among all the features, and its cutoff value was 6.15 cm with a sensitivity of 0.901, a specificity of 0.963, and an AUC of 0.975.
When combined with CIFs, RFs extracted from MDCT images contributed to the larger AUC of the predictive model, but were less valuable than CIFs when used alone. The CIF-CMP-minMSE was the optimal predictive model. The maximum diameter of the largest axial section of ccRCC had the largest weight in all features.
Efficacy of perampanel for anti-N-methyl-D-aspartate receptor encephalitis
Authors: Akiyama Hisanao , Sasaki Rie , Hasegawa Yasuhiro 
Published: January 2019

Abstract

Rationale:
We report this 1st case because perampanel may be effective against the seizures and abnormal behavior that occur in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

Patient concerns:
The patient was a healthy 26-year-old woman who suddenly developed seizures and exhibited abnormal behavior.

Diagnoses:
NMDAR encephalitis was diagnosed based on positive NMDAR antibody on cerebrospinal fluid analysis.

Interventions:
Treatment with anticonvulsants and sedatives was started immediately, along with steroid pulse therapy and plasmapheresis, but these measures did not adequately control the repeated seizures and abnormal behavior. However, with the addition of oral perampanel, an α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, the seizures and abnormal behavior promptly disappeared.

Outcomes:
The patient was transferred to the rehabilitation hospital and returned to her job.

Lessons:
It appears that perampanel rapidly eliminated these clinical features by inhibiting inflow of abnormal glutamic acid and attenuating nerve hyperexcitability by acting as a selective and noncompetitive antagonist of AMPA receptors that had increased in the postsynaptic membrane due to anti-NMDAR encephalitis. To the best of our knowledge, there are no other reports showing that perampanel was effective against anti-NMDAR encephalitis. This case suggests that perampanel may be effective against the seizures and abnormal behavior that occur in anti-NMDAR encephalitis.
Exercise training as an adjunctive therapy to montelukast in children with mild asthma
Authors: Zhang Yan-Feng , Yang Lin-Dong 
Published: January 2019

Abstract

Background:
This study investigated the effectiveness and safety of exercise training (ET) as an adjunctive therapy to montelukast for children with mild asthma (MA).

Methods:
A total of 72 children, ages 4 to 12 years with MA were randomly assigned to a treatment group or a control group at a ratio of 1:1. The subjects in the treatment group received ET plus montelukast, while the participants in the control group received montelukast alone. The primary endpoint was lung function, as measured by forced expiratory volume in 1 second (FEV1) and ratio between FEV1 and forced vital capacity (FEV1/FVC). The secondary endpoints included the symptom improvements, as measured by clinical assessment score, and quality of life (QoL), as assessed with Paediatric Allergic Disease Quality of Life Questionnaire (PADQLQ) scores. In addition, adverse events were also assessed during the period of this study. All outcomes were measured at baseline, at the end of 6-week treatment and 2-week follow-up after the treatment.

Results:
After 6-week treatment and 2-week follow-up, although ET plus montelukast did not show better effectiveness in improving lung function, as evaluated by the FEV1 (P > .05) and FEV1/FVC (P > .05) than montelukast alone, significant relief in clinical symptoms (P < .01), and improvement in QoL (P < .01) have achieved. Additionally, both groups had similar safety profile.

Conclusion:
The results of this study showed that ET as an adjunctive therapy to montelukast may benefit for children with MA. Further studies are still needed to warrant the results of this study.
Top 100 cited articles on infection in orthopaedics
Authors: Jiang Yu , Hu Renjing , Zhu Guoxing 
Published: January 2019

Abstract

Purpose:
The infection is an essential problem in the clinical practice in orthopedics. The bibliometric analysis was conducted to evaluate the top 100 cited articles on infection in orthopaedics.

Methods:
The Web of Science (WoS) Core Database was comprehensively searched from 1975 to 2017, and the literature search was limited in Science Citation Index Expanded (SCI-E). The subject terms included “infection”, “infectious”, and “infect∗”. All retrieved articles were filtrated by selecting the subspecialty of “Orthopedics”. The searching results were listed by citation times to identify the top 100 cited articles. Significant information was elicited, including the authors, journals, countries, institutions, published year, and types of publication.

Results:
A significant increase was observed in the number of annual publications focusing on infection in orthopedics worldwide. Each of the top 100 cited articles was cited more than 150 times. Total citation times was positively associated with citation times in 2016 (P <.01) and mean citation times per year (P <.01). Conversely, age of the article was negatively associated with citation times in 2016 (P <.01) and mean citation times per year (P <.01). Besides, citation times in 2016 was positively related to mean citation times per year (P <.01). The United States was the most productive country, surgery was the most popular subspecialty and Journal of Bone and Joint Surgery American Volume was the most popular journal.

Conclusion:
Infection in orthopaedics has attracted more and more researchers’ concern. As for the top 100 cited articles, there were significant relationships among total citation times, citation times in 2016 and mean citation times per year as well as age of the article. The United States was the most productive country, surgery was the most popular subspecialty and Journal of Bone and Joint Surgery American Volume was the most popular journal.
A survey on the perception and attitude change of first-line healthcare providers after child abuse education in South Korea
Authors: Paek So Hyun , Kwak Young Ho , Noh Hyun , Jung Jin Hee 
Published: January 2019

Abstract
We had designed an educational program for early reporting of suspected child abuse for healthcare providers in South Korea. The purpose of study was to evaluate the effectiveness of education program for health care providers as pilot study. The educational program consisted of two 2-hour-long didactic lectures and was held at 15 hospitals between July and December 2016. We conducted a survey study with physicians, nurses, emergency medical technicians, and other hospital staff. Participants completed survey questionnaires before and after the lecture and 3 months later. The questionnaire contained 3 sections: practical knowledge regarding child abuse, confidence in reporting, and willingness to report. A 10-point Likert scale was used to evaluate the responses. A total of 1103 participants working in 15 different hospitals attended the educational program. In all, 663 participants (75.5%) completed the survey with nurses at 61.7% and physicians at 22%. 26.4% had previously received education about child abuse and reporting methods, and 227 (34.2%) had experience with reporting (direct and indirect) child abuse. The score about knowledge improved from 5.28 points before to 8.03 after the educational program, and was 7.1 after 3 months (P < .001), using a 10-point Likert scale. The confidence increased from 4.76 before the program to 7.59 after it, and was 6.6 after 3 months (P < .001). The willingness to report increased from 7.46 before the program to 8.68 after it, and was 8.14 after 3 months (P < .001). Participants’ satisfaction with the education program was 8.3 points immediately after education and 7.6 points after 3 months. The recommendation index of curriculum was 8.4 points before program and 8.1 points after 3 months. The educational program on the assessment of child abuse and reporting methods increased healthcare professionals’ knowledge and confidence and improved their willingness to report suspected child abuse in a low-perception environment.
Deletion of Lats 1 and 2 in mouse pancreatic acinar cells induces pancreatic fibrosis and inflammation
Authors: Gao Ming , Liu Jun , Nipper Michael , Sharkey Francis E. , Johnson Randy L. , Crawford Howard C. , Chen Yidong , Wang Pei 
Published: January 2019

AbstractObjectiveThe Hippo signaling pathway is known for regulating proliferation, differentiation, organ size, and tumorigenesis. Large tumor suppressor kinase 1 and 2 (LATS1&2) are the core kinases of this pathway, whose functions in both the normal pancreas and pancreatic diseases are unclear. We studied the function of LATS1&2 specifically in pancreatic acinar cells of adult mice.DesignWe generated mice with adult pancreatic acinar cell–specific deletion ofLats1&2genes by using CreER/LoxP. Pancreata were analyzed by histological examination, immunostaining, western blot, and RNA-sequencing.ResultsDeletion ofLats1&2genes in adult pancreatic acinar cells resulted in rapid development of pancreatic inflammation and fibrosis. Loss of Lats1&2 did not directly induce acinar cell proliferation or apoptosis, but resulted in pancreatic stellate cell (PSC) activation followed by immune cell infiltration and acinar-to-ductal metaplasia. These effects were mediated by the Hippo downstream effectors YAP1/TAZ. By using neutralizing antibody to block CTGF, a YAP1/TAZ target, the inflammation and fibrosis were reduced. Our RNA-sequencing data identified upregulation of fibroinflammatory genes inLats1&2null pancreata, which may play important roles in stimulating PSC activation and promoting pancreatic fibrosis, as well as inflammation.ConclusionsDeletion of theLats1&2genes from adult acinar cells leads to the YAP1/TAZ dependent upregulation of a fibroinflammatory program. Our results emphasize the critical role of Lats1&2 in regulating PSC activation. Our findings identify new strategies for controlling pancreatic inflammation and fibrosis in diseases such as pancreatitis and pancreatic cancer.
Relevance of the iron-responsive element (IRE) pseudotriloop structure for IRP1/2 binding and validation of IRE-like structures using the yeast three-hybrid system
Authors: Chen Shih-Cheng , Olsthoorn René C.L. 
Published: January 2019

AbstractIron-responsive-elements (IREs) are ~35-nucleotide (nt) stem-loop RNA structures located in 5′ or 3′ untranslated regions (UTRs) of mRNAs, and mediate post-transcriptional regulation by their association with IRE-binding proteins (IRPs). IREs are characterized by their apical 6-nt loop motif 5′-CAGWGH-3′ (W = A or U and H= A, C or U), the so-called pseudotriloop, of which the loop nts C1 and G5 are paired, and the none-paired C between the two stem regions. In this study, the yeast three-hybrid (Y3H) system was used to investigate the relevance of the pseudotriloop structure of ferritin light chain (FTL) for the IRE-IRP interaction and the binding affinities between variant IRE(-like) structures and the two IRP isoforms, IRP1 and 2. Mutational analysis of FTL IRE showed that deletion of the bulged-out U6 of the pseudotriloop does not significantly affect its binding to either IRP1 or 2, but substitution with C enhances binding of both IRPs. In addition, IRP1 was found more sensitive toward changes in the pseudotriloop-stabilizing C1-G5 base pair than IRP2, while mutation of the conserved G3 was lowering the binding of both IRPs. In comparison to FTL IRE other variant IREs, IRE of 5′-aminolevulinate synthase 2 (ALAS2), SLC40A1 (also known as Ferroportin-1), and endothelial PAS domain protein 1 (EPAS1) mRNA showed slightly higher, similar, and slightly weaker affinity for IRPs, respectively, while SLC11A2 IRE exhibited very weak binding to IRP1 and medium binding to IRP2, indicating the different binding modes of IRP1 and 2. Notably, α-Synuclein IRE showed no detectable binding to either IRP1 or 2. Our results indicate that Y3H represents abona fidesystem to characterize binding between IRPs and various IRE-like structures.
Incorporating prior information into signal-detection analyses across biologically informed gene-sets
Authors: Zhang Mengqi , Gelfman Sahar , McCarthy Janice , Goldstein David B. , Allen Andrew S. 
Published: January 2019

ABSTRACTSignal detection analyses are used to assess whether there is any evidence of signal within a large collection of hypotheses. For example, we may wish to assess whether there is any evidence of association with disease among a set of biologically related genes. Such an analysis typically treats all genes within the sets similarly, even though there is substantial information concerning the likely importance of each gene within each set. For example, deleterious variants within genes that show evidence of purifying selection are more likely to substantially affect the phenotype than genes that are not under purifying selection, at least for traits that are themselves subject to purifying selection. Here we improve such analyses by incorporating prior information into a higher-criticism-based signal detection analysis. We show that when this prior information is predictive of whether a gene is associated with disease, our approach can lead to a significant increase in power. We illustrate our approach with a gene-set analysis of amyotrophic lateral sclerosis (ALS), which implicates a number of gene-sets containing SOD1 and NEK1 as well as showing enrichment of small p-values for gene-sets containing known ALS genes.