bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of grain moxibustion in hemiplegia
Authors: Chen Guoming , Huang Chuyao , Liu Yunyun , Zhang Zhaoping , Qi Xiangjun , Shi Peiyu , Li Dan , Lv Huiye , Zhang Bin 
Published: April 2019

Abstract

Background:
The increasing morbidity of stroke brings enormous social and economic pressure to the countries. Hemiplegia is the common sequela of stroke patients, which affects their physical activities and daily life, and its optimal treatment is still an urgent problem. In Asian countries, moxibustion therapy is widely combined with rehabilitation in poststroke hemiplegia. Among them, grain moxibustion, due to its concentration on stimulating the acupoints and deep heat penetration, can promote neurorehabilitation after stroke. Therefore, based on the current literatures, the effectiveness and safety of grain moxibustion were systematically evaluated to provide possible alternative therapy for the rehabilitation of hemiplegia.

Methods:
Studies search for eligible randomized controlled trials (RCTs) that use grain moxibustion as the sole treatment for hemiplegia and their data extraction will be done by two researchers. Mean difference (MD) or relative risk (RR) with fixed or random effect model in terms of 95% confidence interval (CI) will be adopted for the data synthesis. To evaluate the risk of bias, the Cochrane's risk of bias assessment tool will be utilized. The sensitivity or subgroup analysis will also be conducted when meeting high heterogeneity (I
2 > 50%).

Results:
This meta-analysis will provide an authentic synthesis of the grain moxibustion's effect for hemiplegia.

Conclusion:
The findings of the review offer updated evidence and identify whether grain moxibustion can be an effective treatment for hemiplegia.

PROSPERO registration number:
PROSPERO CRD 42018117765
Challenges in management of unusual acquired factor V deficiency
Authors: Takemoto Kiyoshi , Hamada Osamu , Kitamura Koichi , Fujiwara Naoki , Miyakawa Yoshitaka 
Published: April 2019

Abstract

Rationale:
Acquired inhibitors of coagulation are antibodies that either inhibit the activity or increase the clearance of a clotting factor. Acquired factor V deficiency is a rare coagulation disorder, and it can sometimes be life threatening.

Patient concerns:
We describe a case of a 90-year-old Japanese male with acquired factor V deficiency. He was previously misdiagnosed with congenital factor V deficiency when he presented with hemoptysis and a negative factor V inhibitor test result at a different hospital 5 years earlier. Coagulopathy recurred with ecchymosis when he sustained a bruise after falling on a bush.

Diagnosis:
Although the factor V inhibitor test result was negative and a mixing study suggested a deficiency pattern, we diagnosed the patient with acquired factor V deficiency on the basis of no history of bleeding diathesis, a lack of response to multiple fresh frozen plasma transfusion, and clinical response to corticosteroid therapy.

Interventions:
Intravenous methylprednisolone was administered at 500 mg/day for 3 days, followed by oral prednisolone at 1 mg/kg/day.

Outcomes:
Coagulation test results improved and symptoms resolved 2 weeks after corticosteroid administration.

Lessons:
This case report suggests that clearance-facilitating antibodies exist without the presence of neutralizing inhibitors. When patients present with coagulation factor V deficiency in the absence of coagulation inhibitors, acquired factor V deficiency should also be considered.
Acute parkinsonism as an unexpected consequence of pituitary adenoma resection
Authors: Ho Pei-Lin , Chen Yin-Chun , Teng Chun-hsin , Wu Chiao-Chuan , Huang Poyin 
Published: April 2019

Abstract

Introduction:
Transsphenoidal resection of pituitary tumors is a surgery performed through the nose and sphenoid sinus to remove pituitary tumors. Disorders of sodium balance are common after transsphenoidal surgery involving the pituitary gland. Here, we report the clinical features of an original case of acute onset parkinsonism later confirmed to be secondary to transsphenoidal resection of pituitary adenoma.

Patient concerns:
A 36-year-old female had received transsphenoidal pituitary resection for pituitary adenoma. Eight days after the surgery, she suffered from acute onset general weakness and nausea/vomiting. She was diagnosed with hyponatremia for which she was treated. Acute onset ataxia, bilateral hand tremor, and dysarthria were then noted on the 4th day of hyponatremia treatment.

Diagnosis:
Based on history, clinical manifestation, and MRI brain images, a diagnosis of acute parkinsonism caused by isolated extrapontine myelinolysis (EPM) was made.

Interventions:
Patient was treated with levodopa/carbidopa.

Outcomes:
Patient's symptoms and signs improved gradually and 2 month follow-up MRI brain showed significant resolution of the bilateral lentiform nuclei hyperintensities on the T2-weighted images. Her neurological deficits had subsided completely.

Lessons:
This case highlights an unexpected association between transsphenoidal resection of pituitary tumors and acute parkinsonism which is a treatable manifestation of EPM. Correction of hyponatremia following transsphenoidal pituitary resections should be preceded cautiously because even gradual correction of hyponatremia can produce myelinolysis.
Middle cerebral artery stenosis is associated with the increased risk of intracerebral hemorrhage in Chinese
Authors: Shen Lin , Zhou Huchuan , Wei Fei , Shuai Jie 
Published: April 2019

Abstract
Intracerebral hemorrhage (ICH) is a major cause of morbidity and mortality throughout the world. It is reported that the incidence of deep ICH and intracranial artery stenosis (ICAS) are higher in Asian countries. Thus, there are concerns regarding a potential relationship between ICAS and ICH. This study was aimed to investigate this potential relationship between intracranial artery (middle cerebral artery, MCA) stenosis and ICH in the lateral lenticulostriate artery (LLA) territory in Chinese. Totally, 973 in-hospital subjects were retrospectively enrolled including subjects with the diagnosis of ICH, acute ischemic stroke (IS), and prior IS and subjects without cerebral diseases. These subjects were divided into four groups: ICH, acute IS, prior IS, and normal group (without cerebral diseases). Multiple logistic regression analysis showed that severe MCA stenosis was associated with the increased risk of ICH (OR = 5.070) and acute IS (OR = 5.406) in the LLA territory. The moderate MCA stenosis was associated with the increased risk of ICH (OR = 9.899) and was not associated with acute IS in the LLA territory. The increased perfusion pressure to the LLA may be the cause. In conclusion, MCA stenosis, especially moderate MCA stenosis, is associated with ICH in the LLA territory in Chinese.
Glomerulocystic kidney identified in older patients by magnetic resonance imaging
Authors: Amano Yasuo , Omori Yuko , Yanagisawa Fumi , Takagi Ryo 
Published: April 2019

Abstract
Glomerulocystic kidney (GCK) is often associated with genetic disorders and identified in children or adolescents. However, there are some case reports describing sporadic adult GCK identified by magnetic resonance imaging (MRI). The purpose of this study was to evaluate relationship of GCK identified by MRI in older patients to renal function and renal corticomedullary differentiation (CMD) assessed by MRI.
GCK was identified in 16 older patients (mean age, 79.2 years) by T2-weighted imaging. The cysts of GCK were numerous, homogeneously small, and located in the renal cortex on T2-weighted images. Ten of the 16 patients with GCK had renal impairment (estimated glomerular filtration rate <60 ml/min/1.73 m2). Six patients who had GCK, chronic liver disease, and renal impairment showed moderate or good CMD.
GCK identified by MRI may be related to renal impairment in some older patients, including those with preserved CMD as a result of chronic liver diseases.
Effectiveness comparisons of acupuncture for psoriasis
Authors: Xie Zhi-yin , Zhou Yu , Deng Sheng , Ding Wei , Duan Xing-wu , Yang Li-rong 
Published: April 2019

AbstractBackground:Psoriasis is an immune-mediated polygenic hereditary skin disease quality of the patients’ life because of the great trouble it causes to patients. Whereas there is variability when we regard the selection of acupuncture treatments in practice and most choices are made based on personal experience or preference of clinician. This study uses network meta-analysis to compare the effectiveness of different forms of acupuncture for psoriasis and assesses the evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Methods:We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to April 2019. The quality of the included RCTs will be evaluated by the risk of bias (ROB) tool and the evidence will be evaluated by GRADE. STATA 13.0 and WinBUGS 1.4.3 through the GeMTC package will be used to perform a network meta-analysis to synthesize direct and indirect evidence.Results:The results of this network meta-analysis (NMA) will be submitted to a peer-reviewed journal for publication.Trial registration number:PROSPERO CRD42019123437
Third Trimester Vitamin D Status Is Associated With Birth Outcomes and Linear Growth of HIV-Exposed Uninfected Infants in the United States
Authors: Sudfeld Christopher R. , Jacobson Denise L. , Rueda Noé M. , Neri Daniela , Mendez Armando J. , Butler Laurie , Siminski Suzanne , Hendricks Kristy M. , Mellins Claude A. , Duggan Christopher P. , Miller Tracie L. ,   for the Pediatric HIV/AIDS Cohort Study
Published: April 2019

Background:
Vitamin D status in pregnancy may influence the risk of prematurity, birth size, and child postnatal growth, but few studies have examined the relationship among pregnant women living with HIV.

Methods:
We conducted a prospective cohort study of 257 HIV-infected mothers and their HIV-exposed uninfected infants who were enrolled in the 2009–2011 nutrition substudy of the Surveillance Monitoring for ART Toxicities (SMARTT) study. HIV-infected pregnant women had serum 25-hydroxyvitamin D (25(OH)D) assessed in the third trimester of pregnancy, and their infants' growth and neurodevelopment were evaluated at birth and approximately 1 year of age.

Results:
The mean third trimester serum 25(OH)D concentration was 35.4 ± 14.2 ng/mL with 15% of women classified as vitamin D deficient (<20 ng/mL) and 21% as insufficient (20–30 ng/mL). In multivariable models, third trimester vitamin D deficiency and insufficiency were associated with −273 g [95% confidence interval (CI): −450 to −97] and −203 g (95% CI: −370 to −35) lower birth weights compared with vitamin D sufficient women, respectively. Maternal vitamin D deficiency was also associated with shorter gestation (mean difference −0.65 weeks; 95% CI: −1.22 to −0.08) and lower infant length-for-age z-scores at 1 year of age (mean difference: −0.65; 95% CI: −1.18 to −0.13). We found no association of vitamin D status with infant neurodevelopment at 1 year of age.

Conclusion:
Third trimester maternal vitamin D deficiency was associated with lower birth weight, shorter length of gestation, and reduced infant linear growth. Studies and trials of vitamin D supplementation in pregnancy for women living with HIV are warranted.
Heating Injection Drug Preparation Equipment Used for Opioid Injection May Reduce HIV Transmission Associated With Sharing Equipment
Authors: Ball Laura J. , Venner Colin , Tirona Rommel G. , Arts Eric , Gupta Kaveri , Wiener Joshua C. , Koivu Sharon , Silverman Michael S. 
Published: April 2019

Background:
London, Canada, experienced an HIV outbreak among persons who inject drugs despite widespread distribution of harm reduction equipment. Hydromorphone controlled-release (HMC) is the local opioid of choice. Injection drug preparation equipment (IDPE; ie, cookers and filters) is often shared and reused because of the perception that there is residual HMC in the IDPE after use. The purpose of this study was to investigate the mechanisms of HIV transmission in this context.

Methods:
Residual hydromorphone, (controlled-release or immediate-release), remaining in the IDPE, was measured with liquid chromatography–tandem mass spectrometry, in conditions replicating persons who inject drug use. HIV was added to IDPE in the presence HMC, hydromorphone immediate-release, or microcrystalline cellulose (an HMC drug excipient). HIV viral persistence was measured by reverse transcriptase activity and infectivity of indicator Tzm-bl cells.

Results:
Forty-five percent of HMC remained in the IDPE after the first aspiration of solution, with no change after heating. HIV persistence and infectivity were preserved in the presence of HMC, and less so with microcrystalline cellulose. Heating the IDPE rapidly inactivated HIV.

Conclusions:
Sharing of IDPE is a potential means of HIV transmission. HMC encourages IDPE sharing because of the residual drug in the IDPE, and the HMC excipients preserve HIV viability. Heating IDPE before aspiration of the opioid may be a harm reduction strategy.
Adipofascial Radial Forearm Free Flap for Anterior Skull Base Reconstruction in Complicated Forebrain Oncological Surgery
Authors: Pangrazi Pier Paolo , De Francesco Francesco , Di Rienzo Alessandro , Riccio Michele 
Published: April 2019

Background:Radical resections of ethmoidal tumors with intracranial extension present highly complex surgical and reconstructive problems. The purpose of report is to describe the authors’ use of adipofascial radial forearm free flaps following unsuccessful anterior cranial fossa oncological surgery.Methods:Adipofascial radial forearm free flaps were used to treat 3 similar cases of cutaneous fistula following bone resorption with communication to anterior cranial fossa and nasal cavity.Results:No flap loss, no deaths, and no postoperative complications were observed. All patients underwent a nasal endoscopy, revealing adequate vitality and integration of the free flaps. One of the patients consented to additional surgery to improve outcome.Conclusions:Meticulous preoperative selection and an experienced interdisciplinary team are required to achieve the best surgical outcomes in complex cases. Free adipofascial forearm flaps could be an excellent therapeutic option in the reconstruction of the anterior skull base, notably in cases involving major postoperative complications.
Epidemiology of Incontinence-Associated Dermatitis and Intertriginous Dermatitis (Intertrigo) in an Acute Care Facility
Authors: Arnold-Long Mary , Johnson Emily 
Published: April 2019

PURPOSE:
The purpose of this study was to measure the prevalence of incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD) upon admission, and the incidence of hospital-acquired IAD and ITD in a sample of acutely ill adults.

DESIGN:
This was a descriptive, retrospective-cohort observational study.

SUBJECTS AND SETTING:
The sample comprised 417 adults admitted to an urban community hospital licensed for 249 acute and 52 acute rehabilitation beds in Charleston, South Carolina, and referred to WOC nurses for evaluation and treatment.

METHODS:
Prevalence and incidence rates were calculated from data previously collected for quality improvement purposes from January 1, 2014, to December 31, 2016, by the WOC nurses and documented in a secure, password-protected electronic spreadsheet. The prevalence of IAD/ITD was calculated as the proportion of patients diagnosed with IAD/ITD on admission to our facility. The incidence of IAD and ITD was calculated as percentage of patients who developed IAD/ITD during the course of their hospital stay. All units in the hospital were included.

RESULTS:
The mean prevalence of IAD present on admission was 16%; the prevalence decreased over the data collection period; it was 21% in 2014, 15% in 2015, and 13% in 2016. The mean incidence of hospital-acquired IAD during the data collection period was 23%; the highest rate (26%) occurred in 2016. Patients classified as normal weight from their body mass index and patients 60 years and older had the highest incidence of hospital-acquired IAD. The mean prevalence of ITD for patients admitted to the hospital was 40% for the 3-year time; annual rates varied from a low of 36% in 2015 to a high of 42% in 2016. The mean incidence of hospital-acquired ITD was 33% over the data collection period; mean incidence rates were 32% in 2014, 39% in 2015, and 29% in 2016. The incidence of ITD was higher in patients classified as obese based on body mass index in patients 60 years and older. The most common location was the gluteal cleft.

CONCLUSIONS:
The prevalence of IAD fell within the range of prior epidemiologic studies, but the facility-acquired IAD incidence rates were higher than other studies based in the acute care setting. The prevalence of ITD was higher than rates reported in prior studies; we searched the literature and found no previous reports of ITD occurrences over the course of a hospital stay. Additional research regarding IAD prevention and ITD in the gluteal cleft is needed. Data collection regarding IAD and ITD prevalence and incidence could be incorporated into the data collection tool used for pressure injury data collection for the National Database of Nursing Sensitive Indicators.
Targeting the trypanosome kinetochore with CLK1 protein kinase inhibitors
Authors: Saldivia Manuel , Rao Srinivasa P.S. , Fang Eric , Myburgh Elmarie , Brown Elaine , Wollman Adam J. M. , Ritchie Ryan , Lakhsminarayana Suresh B , Chen Yen Liang , Patra Debjani , Koh Hazel X. Y. , Williams Sarah , Supek Frantisek , Paape Daniel , Bower-Lepts Christopher , Leake Mark C. , McCulloch Richard , Kaiser Marcel , Barrett Michael P. , Jiricek Jan , Diagana Thierry T. , Mottram Jeremy C. 
Published: April 2019

ABSTRACTThe kinetochore is a macromolecular structure that assembles on the centromeres of chromosomes and provides the major attachment point for spindle microtubules during mitosis. In Trypanosoma brucei the proteins that make up the kinetochore are highly divergent, with the inner kinetochore comprising at least 20 distinct and essential proteins (KKT1-20) that include four protein kinases, CLK1 (KKT10), CLK2 (KKT19), KKT2 and KKT3. We performed a phenotypic screen of T. brucei bloodstream forms with a Novartis kinase-focused inhibitor library, which identified a number of selective inhibitors with potent pan-kinetoplastid activity. Deconvolution of an amidobenzimidazole series using a selection of 37 T. brucei mutants that over-express known essential protein kinases identified CLK1 as the primary target. Biochemical studies show that the irreversible competitive inhibition of CLK1 is dependent on a Michael acceptor forming an irreversible bond with C215 in the ATP binding pocket, a residue that is not present in human CLK1, thereby providing selectivity. Chemical inhibition of CLK1 impairs inner kinetochore recruitment and compromises cell cycle progression, leading to cell death. We show that KKT2 is a substrate for CLK1 and identify phosphorylation of S508 to be essential for KKT2 function and for kinetochore assembly. We propose that CLK1 is part of a novel signalling cascade that controls kinetochore function via phosphorylation of the inner kinetochore protein kinase KKT2. This work highlights a novel drug target for trypanosomatid parasitic protozoa and a new chemical tool for investigating the function of their divergent kinetochores.
ELIMÄKI locus is required for mechanosensing and proprioception in birch trees
Authors: Alonso-Serra Juan , Shi Xueping , Peaucelle Alexis , Rastas Pasi , Bourdon Matthieu , Immanen Juha , Takahashi Junko , Koivula Hanna , Eswaran Gugan , Muranen Sampo , Help-Rinta-Rahko Hanna , Smolander Olli-Pekka , Su Chang , Safronov Omid , Gerber Lorenz , Salojärvi Jarkko , Hagqvist Risto , Mähonen Ari-Pekka , Nieminen Kaisa , Helariutta Ykä 
Published: April 2019

AbstractThe remarkable vertical and radial growth observed in tree species, encompasses a major physical challenge for wood forming tissues. To compensate with increasing size and weight, cambium-derived radial growth increases the stem width, thereby supporting the aerial body of trees. This feedback appears to be part of a so-called “proprioception” (1, 2) mechanism that controls plant size and biomass allocation. Yet, how trees experience or respond to mechanical stress derived from their own vertical loading, remains unknown. Here, we combined two strategies to dissect the proprioceptive response in birch. First, we show that in response to physical loading, trees promote radial growth with different magnitudes along the stem. Next, we identified a mutant cultivar (B. pubescens cv. Elimäki) in which the main stem shows normal vertical development, but collapses after three months. By inducing precocious flowering, we generated a backcrossed population (BC1) by producing two generations in 4 years. In his scheme, we uncovered a recessive trait (eki) that segregates and genetically maps with a Mendelian monogenic pattern. Unlike WT,ekiis resistant to vertical mechanical stimulation. However,ekiresponds normally to the gravitropic stimulus by making tension wood. Before the collapse, cell size inekiis compromised resulting in radial growth defects, depending on stem height. Cell walls of developing xylem and phloem tissues have delayed differentiation ineki, and its tissues are softer compared to WT as indicated by atomic force microscopy (AFM). The transcriptomic profile ofekihighlighted the overlap with that of theArabidopsisresponse to touch. Taken together, our results suggest that the mechanical environment and cell wall properties of developing woody tissues, can significantly affect the growth responses to vertical loading thereby compromising their proprioceptive capacity. Additionally, we introduce a fast forward genetics strategy to dissect complex phenotypes in trees.
The RhoGEF Cysts couples apical polarity proteins to Rho and myosin activity at adherens junctions
Authors: Silver Jordan T. , Wirtz-Peitz Frederik , Simões Sérgio , Pellikka Milena , Yan Dong , Binari Richard , Nishimura Takashi , Li Yan , Harris Tony J. C. , Perrimon Norbert , Tepass Ulrich 
Published: April 2019

AbstractThe spatio-temporal regulation of small Rho GTPases is crucial for the dynamic stability of epithelial tissues. However, how RhoGTPase activity is controlled during development remains largely unknown. To explore the regulation of Rho GTPases in vivo we analyzed the Rho GTPase guanine nucleotide exchange factor (RhoGEF) Cysts, the Drosophila orthologue of mammalian p114RhoGEF, GEF-H1, p190RhoGEF, and AKAP-13. Loss of Cysts causes a phenotype that closely resemble the mutant phenotype of the apical polarity regulator Crumbs. This phenotype can be suppressed by the loss of basolateral polarity proteins suggesting that Cysts in an integral component of the apical polarity protein network. Cysts activates Rho at adherens junctions to promote junctional enrichment of myosin II, which requires the RhoGEF domain and the coiled-coil domain containing C-terminal region of Cysts. Cysts recruitment to the apico-lateral cortex depends on Crumbs and Bazooka/Par3 and requires multiple domains within Cysts including the C-terminal region. Together, our findings indicate that Cysts links apical polarity proteins to Rho1 and myosin activation at adherens junctions to support junctional and epithelial integrity in the Drosophila ectoderm.