bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motivational Counseling to Reduce Sedentary Behaviors and Depressive Symptoms and Improve Health-Related Quality of Life Among Women With Metabolic Syndrome
Authors: Chiang Li-Chi , Heitkemper Margaret McLean , Chiang Shang-Lin , Tzeng Wen-Chii , Lee Meei-Shyuan , Hung Yi-Jen , Lin Chia-Huei 
Published: March 2019

Background
Motivational interviewing, as a counseling approach, could promote not only behavioral changes but also individuals' psychological adaptation. Previous studies provide evidence that motivational interviewing focused on increasing physical activity decreases the risk of metabolic syndrome in women. Its effects on sedentary behaviors, depressive symptoms, and health-related quality of life (HRQL) remain unknown.

Objectives
The aim of this study was to evaluate whether a 12-week motivational counseling program reduces sedentary behaviors and depressive symptoms and improves HRQL in Taiwanese women.

Methods
A randomized controlled study was conducted. Participants (n = 115) were randomly assigned into 3 groups: experimental group (received a brochure on lifestyle modification combined with 12 weeks of motivational counseling), comparison group (received a lifestyle modification brochure), and usual care group (UCG). Outcome variables were measured at baseline and at 12 weeks post intervention by the International Physical Activity Questionnaire, Beck Depression Inventory, and Medical Outcomes Short Form-36 Health Survey. Generalized estimating equations were applied to analyze the intervention effects of groups by interaction of group and time.

Results
Women in the experimental group not only reduced (P < .001) weekly sitting time by 374 minutes but also decreased (P < .05) depressive symptoms, as well as had greater overall HRQL including 8 subscales as compared with the UCG. As compared with the UCG, the women in the comparison group had no change in sedentary behaviors, but they had reduced depressive symptoms and improvement on some HRQL subscales.

Conclusions
Motivational counseling that incorporates behavioral change principles is effective in reducing sedentary behaviors and depressive symptoms and improving HRQL for women with metabolic syndrome.
A Randomized, 8-Week Study of the Effects of Extended-Release Paliperidone and Olanzapine on Heart Rate Variability in Patients With Schizophrenia
Authors: Pu Zheng-Ping , Li Guo-Rong , Zou Zhan-Ping , Tao Feng , Hu Shao-Hua 
Published: March 2019

Abstract

Purpose
This study aimed to explore the effect of extended-release paliperidone (paliperidone ER) and olanzapine on heart rate variability (HRV) in patients with schizophrenia.

Methods
A total of 106 patients with schizophrenia diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) were randomly divided into the paliperidone ER group or the olanzapine group for an 8-week clinical trial, with 53 patients in each group. The time domain and frequency domain analyses including the SD of all the R-R intervals in 24 hours (SDNN), the SD of the mean value of all the normal R-R intervals in every 5-minute interval within 24 hours (SDANN index), the mean value of the SD of all the normal R-R intervals in every 5-minute interval within 24 hours (SDNN index), the root mean square of successive R-R differences, the percentage of adjacent R-R intervals that differ by more than 50 milliseconds, high-frequency power (HF), low-frequency power (LF), and LF/HF were adopted to assess the HRV of patients at baseline and after treatment for 8 weeks in each group. The Positive and Negative Symptom Scale was used to evaluate the clinical efficacy. The incidence rates of adverse reactions were also calculated.

Results
In total, 48 patients in the paliperidone ER group and 45 patients in the olanzapine group completed the entire 8-week treatment. The SDNN, SDNN index, and SDANN index in the olanzapine group were significantly lower than those in the paliperidone ER group (P < 0.05) after treatment for 8 weeks, whereas their mean LF level was higher than that in the paliperidone ER group (P < 0.05) after completion of treatment. Patients in the olanzapine group showed a significant decrease in the SDNN, SDANN index, and SDNN index as well as a statistical increase in the LF and LF/HF in comparison with the pretreatment values (P < 0.05), whereas patients in the paliperidone ER group showed a decrease in the SDANN index and a statistical increase in the LF in comparison with the pretreatment values (P < 0.05).

Conclusion
The HRV of patients with schizophrenia changes when they are administered with paliperidone ER or olanzapine, and more attention should be paid to their cardiac autonomic function when using these 2 antipsychotics.
Prevalence of cervical cancer and pre-cancerous lesions among unscreened Women in Kumasi, Ghana
Authors: Donkoh Emmanuel Timmy , Agyemang-Yeboah Francis , Asmah Richard Harry , Wiredu Edwin K. 
Published: March 2019

Abstract
Ghana does not have a universal population-based cervical cancer screening program and there is very limited information about the distribution of cervical epithelial cell lesions. This study provides evidence that a moderately high prevalence of cervical cancer and precancerous lesions exists among unscreened women in Kumasi.
The prevalence of cervical epithelial cell abnormalities among a cross-section of women attending cervical cancer screening for the first time in a suburb of Ghana from 2011 to 2014 was studied. Cervical smears were prepared and examined independently by 2 cytotechnologists and confirmed by a pathologist. Cervical lesions were classified according to the Bethesda System for cervical cytology 2001.
Out of the 592 women for whom a Pap smear was available for evaluation, 555 (93.8%) were negative for intraepithelial lesion or malignancy. Eight women (1.4%) showed atypical squamous cells of undetermined significance (ASCUS), 9 (1.4%) low-grade squamous intraepithelial lesions, and 2 (0.3%) high-grade squamous intraepithelial lesions. A total of 15 (2.5%) smears were unsatisfactory for cervical cytology. Additionally, 3 women (0.5%) had squamous cell carcinoma, giving an overall rate of 3.7% for epithelial cell abnormalities.
Cervical cancer and precursor epithelial cell abnormalities are common among women in Kumasi for a disease that can be prevented by early detection through routine screening and management. This study provides adequate background data to recommend the implementation of cervical cancer screening in all eligible women in Ghana.
The clinical significance of microRNA-122 in predicting the prognosis of patients with hepatocellular carcinoma
Authors: Zhang Yanfang , Li Yongguo , Jiang Wenhui , Li Qian , Lan Yinghua 
Published: March 2019

Abstract

Background:
Although the prognostic value of microRNA-122 (miR-122) for hepatocellular carcinoma (HCC) patients have been evaluated by numerous studies, the results of them were not completely consistent. The present study aims to comprehensively evaluate the predicting value of miR-122 on the prognosis of patients with HCC based on all eligible literatures.

Methods:
Numerous electronic databases (MEDLINE, Embase, Pubmed, Google Scholar, and China Biology Medicine disc) were applied to retrieve relevant studies. Overall survival (OS) and progression-free survival (PFS) were used as primary endpoints. All statistical analyses were performed by RevMan software version 5.3.5 and STATA software version 14.1. In addition, the results of this meta-analysis were validated by an independent dataset from the Cancer Genome Atlas (TCGA).

Results:
A total of 11 studies containing 1124 patients were included in this meta-analysis. The pooled results showed that low miR-122 expression in HCC tissues significantly associated with unfavorable OS (hazard ratio [HR] = 1.48, 95% confidence interval [CI] 1.22–1.80, P < .001) and PFS (HR = 1.54, 95% CI 1.28–1.85, P < .001) in patients with HCC. However, the expression level of miR-122 in blood did not have the ability in predicting OS (HR = 0.75, 95% CI 0.44–1.28, P = .29) and PFS (HR = 0.84, 95% CI 0.58–1.20, P = .33) of HCC. Subgroup analysis further indicated that low expression of miR-122 in tumor tissues predicted poor OS in HCC patients who received curative liver resection (HR = 2.00, 95% CI 1.08–3.70, P = .03). Analysis using TCGA dataset suggested that low miR-122 expression in HCC tissues was significantly associated with OS (HR = 1.61, 95% CI 1.13–2.27, P = .008) other than PFS (HR = 1.30, 95% CI 0.96–1.75, P = .09).

Conclusion:
Low miR-122 expression in HCC tissues was a reliable indicator for predicting the OS of HCC patients who underwent curative resection. Owing to the disagreement between this meta-analysis and the TCGA dataset, the predictive value of miR-122 in tissues for PFS needs to be verified by future well-designed studies with large sample size.
Risk factors for acquisition and mortality of multidrug-resistant Acinetobacter baumannii bacteremia
Authors: Zhou Hua , Yao Yake , Zhu Bingquan , Ren Danhong , Yang Qing , Fu Yiqi , Yu Yunsong , Zhou Jianying 
Published: March 2019

Abstract
Bloodstream infection caused by Acinetobacter baumannii has become a major clinical concern, especially multidrug-resistant A baumannii (MDRAB). The aim of this study was to identify the risk factors of nosocomial acquired MDRAB bacteremia and to determine the risk factors related to the mortality of patients with MDRAB bacteremia. Patients with nosocomial acquired A baumannii bacteremia were enrolled between January, 2013 and December, 2017 at the First Affiliated Hospital, School of Medicine, Zhejiang University. Medical records were reviewed, and the clinical and microbial characteristics were collected. Among the 338 patients suffering from A baumannii bacteremia, 274 patients were infected with MDRAB bacteremia. Bacteremia-related mortality was 46.4% for the overall sample; 56.2% for MDRAB bacteremia patients, 4.7% for non-MDRAB bacteremia patients. The identified risk factors for developing MDRAB bacteremia were previous exposure to carbapenems [odds ratio (OR) 5.78, P = .005] and penicillins+β-lactamase inhibitors (OR 4.29, P = .009). Primary bacteremia tended to develop non-MDR bacteremia (OR 0.10, P = .002). The risk factors for MDRAB bacteremia-related mortality were old age (OR 1.02, P = .036), a high Pitt bacteremia score (OR 1.32, P < .001), bacteremia occurring after severe pneumonia (OR 8.66, P < .001), while catheter-related infection (OR 0.47, P = .049) and operations for treating infection (OR 0.51, P = .043) may have a better outcome. Patients with MDRAB had a higher mortality rate. Patients with previous carbapenems and penicillins+β-lactamase inhibitor exposure are at an increased risk of MDRAB bacteremia, whereas patients with primary bacteremia tended to develop non-MDR bacteremia. The risk factors for MDRAB bacteremia-related mortality were old age, a high Pitt bacteremia score, and bacteremia occurring after severe pneumonia, whereas catheter-related infection and operations for the treatment of infection may have a better outcome.
HMG CoA reductase expression as a prognostic factor in Korean patients with breast cancer
Authors: Kim Hyojeong , Seol Young Mi , Choi Young Jin , Shin Ho-Jin , Chung Joo Seop , Shin Nari , Kim Ahrong , Kim Jee Yeon , Kim Keun Young , Bae Youngtae 
Published: March 2019

Abstract
There are many preclinical and epidemiological reports suggesting a correlation between 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoAR) or HMG-CoAR inhibitor (statin) treatment and prognosis in breast cancer. This study aimed to investigate the expression of HMG-CoAR in Korean patients with breast cancer.
The expression of HMG-CoAR on tissue microarrays from 191 patients who underwent resection from 2005 to 2006 in the Pusan National University Hospital was assessed by immunohistochemistry (IHC). The IHC assessment by a board-certified pathologist included areas of both carcinoma and peritumoral tissue of the breast. The scores of cancer-specific staining were adjusted by the scores of peritumoral staining.
The patients were followed for a median 9.1 years. Disease-free survival (DFS) was shorter in patients with a positive adjusted HMG-CoAR score by log-rank test (not reached vs 11.6 years, P = .011). After adjusting for age, T stage, N stage, pathological grade, perioperational chemotherapy, adjuvant radiotherapy, estrogen receptor positivity, progesterone receptor positivity, human epidermal growth factor receptor-2 positivity, and high Ki-67 (>10%), a positive adjusted HMG-CoAR IHC score was also associated with shorter DFS (hazard ratio = 2.638, 95% confidence interval [CI] 1.112–6.262, P = .028).
The expression of HMG-CoAR might be an independent prognostic factor in breast cancer. There are established drugs targeting HMG-CoAR, and further studies on its potential as a predictive marker are needed.
Serum ATX as a novel biomarker for breast cancer
Authors: Shao Yingbo , Yu Yang , He Yaning , Chen Qi , Liu Hui 
Published: March 2019

Abstract
Recent accumulating evidence indicates the biological actions of Autotaxin-Lysophosphatidic acid (ATX-LPA) signaling axis in malignant tumors. However, the role of Autotaxin-Lysophosphatidic acid signaling axis in breast cancer has not been reported. The present study aims to examine the alterations of serum autotaxin in breast cancer and discuss whether serum autotaxin could be useful as a novel parameter of breast cancer.
Serum autotaxin antigen was measured in 112 patients with breast cancer and 50 healthy volunteers by ELISA. The association of serum autotaxin antigen levels with clinicopathological parameters and outcomes of breast cancer was analyzed.
Serum autotaxin antigen was significantly higher in breast cancer patients than healthy volunteers (291.32 ± 38.02 ng/ml vs 254.04 ± 21.03 ng/ml, respectively; P < .0001). Serum autotaxin measurement successfully discriminated breast cancer patients from normal and healthy controls (AUC = 0.798, 95% CI: 0.732–0.864) with an optimal cut-off value of 267.34 ng/ml (sensitivity = 0.741, specificity = 0.800). Increased serum autotaxin was associated with breast cancer nodal status (P = .007), Tumor-Node- Metastasis (TNM) stage (P = .009) and Ki-67 index (P = .004). Univariate and multivariate Cox regression analysis revealed that elevated serum autotaxin showed an independent prognostic value for poor Disease-free survival.
Our present study confirmed the elevation, potential diagnostic, and independent prognostic value of serum autotaxin for breast cancer. Serum autotaxin could serve as a reliable novel biomarker for breast cancer.
Radical modular pancreatoduodenectomy for pancreatic head cancer using a combination of multiple artery-first approaches technique
Authors: Leng Kai-Ming , Zhong Xiang-Yu , Tai Sheng , Kang Peng-Cheng , Wan Ming , Jiang Xing-Ming , Wang Hao , Xu Yi , Wang Zhi-Dong , Cui Yun-Fu 
Published: March 2019

Abstract
The aim of this study was to describe and assess the efficacy of a combination of multiple artery-first approaches (CMAFA) in pancreatoduodenectomy (PD) depending on the tumor location from an embryonic point of view.
Between January 2011 and December 2016, seventy-nine consecutive patients with pancreatic head cancer (PHC) underwent PD with curative intent. Patients were classified into two groups according to the surgical procedure: CMAFA-PD group (n = 38) and conventional PD (Co-PD) group (n = 41). Clinicopathlogical variables and clinical outcomes were compared among the two groups.
The CMAFA technique demonstrated an improved rate of R0 resection (89.5% vs. 70.7%, P = .038) and a higher median lymph node yield (24 vs.20, P = .034). The CMAFA-PD group was associated with reduced blood loss (450 vs. 600 ml, P = .049), lower rate of blood transfusion (23.7% vs. 46.3%, P = .035), and shorter length of hospital stay (19 vs. 26 days, P < .001). The rates of 90-day mortality, major morbidity, and readmission were comparable among the two groups.
This study demonstrates that CMAFA is a feasible and efficient technique with acceptable perioperative and oncological outcomes in treating patients with PHC.
Dramatic effect in passive ROM exercise under sedation in a patient with intractable complex regional pain syndrome (type I)
Authors: Oh Hyun-Min , Kim Chul-Hyun , Kim Ae-Ryoung 
Published: March 2019

Abstract

Rationale:
Complex regional pain syndrome (CRPS) usually occurs after trauma and surgery but can also occur spontaneously. There are various known pathophysiology and treatment protocols for CRPS. However, there is no established treatment guideline. Although physical therapy is known as the first line treatment for CRPS, performing physical therapy is difficult due to severe pain. This case reports the first case with positive effect of physical therapy under sedation that allowed early physical therapy.

Patient concerns:
A 19-year old female had her right elbow area slightly hit by someone else, after which it began to swell and become more painful. Active and passive range of motion (ROM) of the right upper extremity gradually decreased through 3 months, and pain and edema worsened.

Diagnoses:
She had allodynia, nonpitting edema, temperature asymmetry, and trophic change in fingernails in the right upper extremity, which met the diagnostic criteria for CRPS. In the 3-phase bone scan, which is a specific tool to diagnose CRPS, there was trace uptake increase in the right elbow and wrist, indicating possibility of CRPS.

Interventions:
Despite conventional treatments such as pharmacologic and interventional therapies, neither pain nor edema subsided. Pain was so severe that it was impossible to apply physical therapy. Therefore, the patient underwent passive ROM exercise in the right upper extremity under sedation for 30 minutes, which was relatively easier due to decreased pain. After 2 days of passive ROM exercise under sedation, the patient was able to receive passive ROM exercise twice daily without sedation for 18 days.

Outcomes:
After 20 days of passive ROM exercise, including 2 days of passive ROM exercise under sedation, the circumference of her right hand decreased by 5 cm, wrist 2 cm, and elbow 6 cm compared to the initial measurement. Numeric pain rating scale improved from 9 to 3, and her manual muscle test marked fair plus from trace, Jebsen–Taylor hand function test score 43 from 0.

Lessons:
This case suggests that passive ROM exercise under sedation may be a successful alternative as a treatment when exercise, currently known as a treatment to CRPS, is impossible.
Novel treatment of severe radial artery spasm using “homemade sheathless technique”
Authors: Zhang Zaiyong , Xie Qiang 
Published: March 2019

Abstract

Rationale:
Transradial access (TRA) is common for cardiac catheterization, but radial artery spasm (RAS) is suggested to be highlighted. Severe radical artery spasm could be solved by a relative novel approach called “sheathless technique,” using a Tiger diagnostic catheter.

Patient concerns:
A 73-year-old woman presented to our institution with a recurrent feeling of discomfort in her chest. Her electrocardiogram showed ST segment depression. Her medical history indicated arterial hypertension, diabetes, and chronic renal failure. She was on hemodialysis for 5 years for the management of renal problems. Five stents were implanted from femoral access in another hospital via 2 percutaneous coronary interventions. The patient agreed to angiography this time and wanted a more comfortable solution.

Diagnosis:
Recurrent exertional angina was confirmed based on the chief complaint, electrocardiogram, and history.

Interventions:
After a successful radial artery puncture, a 6F arterial sheath pipe and a 5F Tiger diagnostic ductus could only advance slightly because of the RAS. Glonoin and verapamil functioned with the help of the radial sheath, and systemic nitroglycerin was applied later but had a negative outcome. Warm covers were positioned on the antebrachium, but no relief was reported.
The “homemade sheathless technique” was applied. The 5F tube was held, and the 6F sheath was withdrawn. A blade was used to damage the sheath in reverse, and the excess sheath tube was removed.

Outcomes:
The diagnostic catheter was successfully advanced to the ascending aorta, enabling left main and right coronary engagement and angiography. No significant coronary lesion was observed. The patient was discharged 3 days after angiography. Moreover, no complications were observed. A follow-up for 1 month after discharge also showed no complications.

Lessons:
Severe RAS causing failure of TRA is frequent in the transradial catheterization procedure. The sheathless technique may be useful in relieving spasm when other measures fail.
Does the use of proton pump inhibitors increase the risk of hypomagnesemia
Authors: Liao Shengtao , Gan Li , Mei Zhechuan 
Published: March 2019

Abstract

Background:
Proton pump inhibitors (PPIs) are commonly used in the treatment of acid-related diseases; however, the association between the use of PPIs and potential risk of hypomagnesemia is controversial.

Methods:
In the present study, databases including PubMed, EMBASE, MEDLINE, PsycINFO, CINAHL, the Cochrane Library, and 4 Chinese databases were searched since the inception until April 2018. Previous observational studies on the incidence of hypomagnesemia in individuals exposed to PPIs were included.

Results:
This systematic review involved 15 studies including 129,347 participants, and the sample size varied from 52 to 95,205. Meta-analysis of 14 studies indicated that the use of PPIs increased the risk of hypomagnesemia [RR, 1.44, 95% CI, 1.13–1.76; I2, 85.2%]. Subgroup analysis revealed that the use of PPI was not associated with the incidence of hypomagnesemia in outpatients [RR, 1.49; 95% CI, 0.83–2.14; I2, 41.4%] and hospitalized patients [RR, 1.05; 95% CI, 0.81–1.29; I2, 62.1%], respectively. The use of PPIs was not related to the risk of hypomagnesemia based on the cut-off values of 1.8 mg/dL [RR, 1.73; 95% CI, 0.87–2.58; I2, 65.2%], 1.7 mg/dL [RR, 1.48; 95% CI, 0.90–2.06; I2, 87.6%], and 1.6 mg/dL [RR, 0.98; 95% CI, 0.69–1.27; I2, 67.9%].

Conclusion:
The association between the exposure to PPI and the incidence of hypomagnesemia remained unclear. Due to the remarkable heterogeneity in previous studies, a definitive conclusion could not be drawn. Further research should be conducted to investigate the relationship between the use of individual PPI and potential risk of hypomagnesemia, and a dose-response analysis may be required.
Primary hepatic mucosa-associated lymphoid tissue lymphoma
Authors: Xie Huazhi , Lv Jian , Ji Yong , Du Xinjian , Yang Xin 
Published: March 2019

Abstract

Rationale:
Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease, and there is no consensus yet on the treatment modalities. Here, we report a new case of MALT lymphoma and review the current literature on this disease.

Patient concerns:
A 73-year-old man was admitted to our department following the incidental finding of a solitary 1.8-cm diameter mass in the liver.

Diagnosis:
Microscopic findings identified the mass as a tumor with infiltration of diffuse atypical B lymphocytes. Immunohistochemical analysis showed positivity for CD20 and CD79a, and negativity for CD3 and CD5. These collective data led to the diagnosis of primary hepatic MALT lymphoma.

Interventions:
The tumor was removed by surgical resection. The patient refused additional treatment after the surgery.

Outcomes:
At the time of writing this report, the patient has been disease free for 6 months postsurgery.

Lessons:
Review of the previously published case reports on this rare tumor type indicates that in addition to chronic liver inflammation due to infection or other reasons, genetic aberrations can also contribute to the development of hepatic MALT lymphoma. Additionally, IgH rearrangement is a good genetic hallmark of this tumor. Owing to no specific clinical or radiologic features to define the disease profile for diagnosis, surgery may be a good choice for both diagnosis and therapy if the patient's condition permits.