bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and validation of a noninvasive diagnostic criteria for biliary atresia in infants based on the STROBE compliant
Authors: Liu Xiaoguai , Peng Xiaokang , Huang Yanxia , Shu Chang , Liu Pan , Xie Weike , Dang Shuangsuo 
Published: February 2019

Abstract
It is difficult for clinicians to distinguish biliary atresia (BA) from other causes of neonatal cholestasis (NC) at an early stage. The aim of this study was to design and validate noninvasive diagnostic criterion for early diagnosis of BA in infants.
In this retrospective cohort study, a total of 482 medical records of patients with NC were recruited to design diagnostic criteria. Parameters showing a significant difference between BA (n = 166) and non-BA (n = 316) patients were analyzed by logistic regression to predict the occurrence of BA, and then a nomogram scoring system was designed and validated in another cohort that included 190 cases of NC.
A prediction diagnostic criterion with parameters including direct bilirubin, total bilirubin, globulin, albumin, gamma glutamyl transpeptidase, cholesterol, total bile acid, hepatobiliary scintigraphy, birth weight, and stool color was established; the sensitivity and specificity of this diagnostic criterion was 89% and 84%, respectively. The accuracy was 86% and the AUC was 0.91 [95% CI (0.88–0.97)]. The total score ranged from 0 to 402, with a cut-off value of ≥254 discriminating BA from other causes of NC. By applying this score in the validation set with age <60 days, the accuracy was 95.3%, the sensitivity was 93.8% and the specificity was 96.0%, respectively.
This prediction diagnostic criterion could facilitate clinicians to distinguish infants with and without BA based on a particular series of parameters, reducing treatment burden and enhancing therapeutic efficiency.
Association of SENPs single-nucleotide polymorphism and breast cancer in Chinese population
Authors: Cai Jiaqin , Wei Xiaoxia , Zhang Guifeng , Sui Yuxia , Zhuang Jie , Liu Zhenhua , Sun Hong 
Published: February 2019

Abstract
SUMO-specific Cysteine Proteases (SENPs) have involvement in the initiation and progression of human cancers. In the present study, we evaluated the association of SENPs polymorphism with susceptibility as well as clinicopathologic features and patients’ response of breast cancer (BC) in a Chinese population.
We genotyped SENP1 (rs61918808), SENP2 (rs6762208), SENP7 (rs61697963) by sequencing in a case–control study including 210 BC patients and 225 healthy volunteers. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assume the association strength.
No significant association was found between polymorphism of the 3 SENPs and BC susceptibility. However, SENP1 rs61918808 (C>T) and SENP7 rs61697963 (A>C) was associated with HER-2 expression (P < .05). SENP2 rs6762208(C>A) was correlated with increasing risk of lymph node metastases (P < .05). Among the patients who received neoadjuvant chemotherapy, T allele and TT genotype of SENP1 rs61918808 were less likely to achieve pCR (P < .05).
We first reported SENPs variants were not associated with BC risk in Chinese population, but presented specific effect on clinicopathological features of BC. Moreover, SENP1 rs61918808 may be a predictor for the clinical response in local advanced BC patients who received neoadjuvant chemotherapy.
Tobramycin/dexamethasone eye drops as a better choice for lacrimal duct probing in persistent congenital nasolacrimal duct obstruction
Authors: Xiang Qin , Hu Dan , Gao Xu 
Published: February 2019

Abstract

Background:
Congenital nasolacrimal duct obstruction (CNLDO) is common and. lacrimal duct probing is the major treatment. But persistent CNLDO in older children makes the success rate rapidly decreased due to long-term chronic inflammation. To improve the success rate, probing combined with tobramycin/dexamethasone ointment is considered effective. But in practice, we found a lot of problems in using the ointment. So we tried tobramycin/dexamethasone eye drops as a replacement. The results is surprising, so we hope to do some further research in order to prove it is worth to clinical application.

Objective:
To evaluate the effect of lacrimal duct probing combined with tobramycin/dexamethasone eye drops or ointment on persistent CNLDO in children older than 1-year-old.

Methods:
This randomized controlled study included 409 subjects (496 eyes) older than 1-year-old with persistent CNLDO in southwest China, and classified into 3 groups: 96 cases (123 eyes) were the tobramycin/dexamethasone eye drops group (drops group), 88 cases (104 eyes) were the tobramycin/dexamethasone ointment group (ointment group), and 225 cases (269 eyes) were control group which probing with normal saline (NS group). The data of age, sex, and laterality were analyzed through pairwise comparison. Then the 3 groups were divided into 2 subgroups by age, 12 to 24 months and 25 to 36 months. The surgical findings and success rate in two subgroups were compared.

Results:
The success rates in the tobramycin/dexamethasone eye drops group in both 2 age subgroups were significantly higher than that in the ointment group and NS group (P < .05).

Conclusions:
Probing combined with tobramycin/dexamethasone eye drops was effective and easy-to-perform in the clinic, and it may be a better choice for persistent CNLDO.
Heart rate variability based machine learning models for risk prediction of suspected sepsis patients in the emergency department
Authors: Chiew Calvin J. , Liu Nan , Tagami Takashi , Wong Ting Hway , Koh Zhi Xiong , Ong Marcus E. H. 
Published: February 2019

Abstract
Early identification of high-risk septic patients in the emergency department (ED) may guide appropriate management and disposition, thereby improving outcomes. We compared the performance of machine learning models against conventional risk stratification tools, namely the Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), and our previously described Singapore ED Sepsis (SEDS) model, in the prediction of 30-day in-hospital mortality (IHM) among suspected sepsis patients in the ED.
Adult patients who presented to Singapore General Hospital (SGH) ED between September 2014 and April 2016, and who met ≥2 of the 4 Systemic Inflammatory Response Syndrome (SIRS) criteria were included. Patient demographics, vital signs and heart rate variability (HRV) measures obtained at triage were used as predictors. Baseline models were created using qSOFA, NEWS, MEWS, and SEDS scores. Candidate models were trained using k-nearest neighbors, random forest, adaptive boosting, gradient boosting and support vector machine. Models were evaluated on F1 score and area under the precision-recall curve (AUPRC).
A total of 214 patients were included, of whom 40 (18.7%) met the outcome. Gradient boosting was the best model with a F1 score of 0.50 and AUPRC of 0.35, and performed better than all the baseline comparators (SEDS, F1 0.40, AUPRC 0.22; qSOFA, F1 0.32, AUPRC 0.21; NEWS, F1 0.38, AUPRC 0.28; MEWS, F1 0.30, AUPRC 0.25).
A machine learning model can be used to improve prediction of 30-day IHM among suspected sepsis patients in the ED compared to traditional risk stratification tools.
ZNF582 methylation as a potential biomarker to predict cervical intraepithelial neoplasia type III/worse
Authors: Li Na , He Ya , Mi Peng , Hu Yuanjing 
Published: February 2019

Abstract

Objective:
DNA methylation markers have been assessed as potential biomarkers for early cervical cancer detection. Herein, we evaluated the diagnostic performance of zinc finger protein 582 (ZNF582) methylation for cervical cancer detection.

Methods:
Eligible studies were systematically searched from the electronic databases. The quality of enrolled studies was evaluated using the second version of the check list for Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). The bivariate meta-analysis model was employed to plot the summary receiver operator characteristic (SROC) curve using Stata 14.0 software. Cochran's Q test and I2 statistics were applied to assess heterogeneity among studies. Publication bias was evaluated by the Deeks’ funnel plot asymmetry test.

Results:
Seven studies composed of 1749 patients were eventually included. The pooled sensitivity of ZNF582 methylation was estimated to be 0.71 [95% confidence interval (CI): 0.67–0.75] in differentiating patients with cervical intraepithelial neoplasia type III/worse (CIN3+), corresponding to a specificity of 0.81 (95% CI: 0.79–0.83) and area under the curve (AUC) of 0.85. Our stratified analysis suggested that sequential combined of HPV DNA and ZNF582 methylation test (AUC, sensitivity, and specificity of 0.876, 0.75, and 0.87, respectively) achieved higher diagnostic accuracy than single HPV DNA testing test (AUC, sensitivity and specificity of 0.669, 0.96, and 0.41, respectively).

Conclusions:
ZNF582 methylation has a prospect to be an auxiliary biomarker for cervical cancer screening. A new strategy of co-testing HPV DNA and ZNF582 methylation test in cervical scrapings confers an improved diagnostic accuracy than single HPV DNA testing.
Integrative analysis reveals driver long non-coding RNAs in osteosarcoma
Authors: Luo Zhenguo , Xiao Li , Li Jing , Dong Buhuai , Wang Chunsheng 
Published: February 2019

Abstract
Transcriptome profiling of osteosarcoma (OS) by next generation sequencing technology (NGS) has been broadly performed by previous researches, which uncovers a large number protein-coding driver genes, facilitates our understanding of the molecular mechanisms of OS formation, progression and metastasis. Recently, more and more researchers realize the importance of long non-coding RNAs (lncRNAs) on the development of OS. However, few studies focus on discovering driver lncRNAs.
Here we collected somatic copy number alterations (SCNAs) and gene expression profiles of 84 samples from Therapeutically Applicable Research to Generate Effective Treatments (TARGET) project. The RNA sequencing data detected 13,903 expressed lncRNAs, 157 of which were previously reported to be associated with cancer based on the annotations from Lnc2Cancer database.
By analyzing the SNP array data, several significant SCNAs were detected, such as the amplifications on chromosomes 1q, 4q, 17p, 17q, and 19q, and deletions on 1q, 3q, 9p, 10q, and 15q. With the SCNA and gene expression profiles, we identified 167 driver genes by integrative analysis, including 162 novel driver lncRNAs, 2 lncRNAs reported to be associated with OS, and another 3 associated with other cancers. Furthermore, functional characterization and survival analysis revealed that RP11-241F15.10 may function as a tumor suppressor in OS, and loss of function may contribute to activation of Wnt signaling pathway.
This study not only facilitates our understanding of the oncogenic or tumor-suppressor role of lncRNAs in OS, but also provides potential therapies for the patients with OS with metastasis or relapse.
A prospective comparative study of intravenous alendronate and ibandronate for the treatment of osteoporosis
Authors: Horikawa Akira , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Kodama Hiroyuki , Shimada Yoichi 
Published: February 2019

Abstract

Rationale:
Few comparative studies have evaluated the differences between intravenous alendronate (ALN) and ibandronate (IBN) in patients with osteoporosis. This study was to compare the effects of these 2 drugs on bone mineral density (BMD), bone metabolic markers, and adverse events in patients with osteoporosis.

Patient concerns:
Seventy-eight subjects were assigned to the ALN group and 66 to the IBN group.

Diagnoses:
The diagnosis of osteoporosis was based on BMD values of the femoral neck or lumbar spine less than −2.5 SD below the reference values.

Interventions:
This study was designed as a 52-weeks, prospective, non-randomized study involving a parallel-group comparison between intravenous ALN and intravenous IBN in elderly women with osteoporosis.

Outcomes:
The non-switched-IBN subgroup showed significant decrease in serum collagen type I cross-linked telopeptide (NTX) at 6 and 12 months compared with baseline, and the decrease in NTX were significantly greater in the non-switched-IBN subgroup than in the non-swithed-ALN subgroup. BMD in the lumbar spine in the non-switched-IBN subgroup showed a significant increase at 12 months and the increase in BMD were significantly larger than in the non-switched-ALN subgroup.

Lessons:
Intravenou IBN might result in a significantly greater increase of BMD and decrease in NTX, but it had a higher incidence of adverse drug reactions than ALN.
Blastic plasmacytoid dendritic cell neoplasm with unusual extracutaneous manifestation
Authors: Lee Seung Eun , Park Ha Young , Kwon Dohee , Jeon Yoon Kyung , Kim Wook Youn 
Published: February 2019

Abstract

Rationale:
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy. This disease almost always presents with cutaneous involvement.

Patient concerns:
The 1st patient was a 16-year-old girl who presented with recurrent epistaxis. The 2nd patient was a 17-year-old female who presented with nasal obstruction and voice change for a month.

Diagnoses:
In the 1st patient, sinonasal computed tomography (CT) revealed a 2.9-cm sized, polypoid mass in the nasal cavity. In the 2nd patient, CT scans revealed a large enhancing nasopharyngeal mass involving adenoid and several small indeterminate lymph nodes at the neck. Cutaneous examination was unremarkable for either patient. Biopsy of these 2 masses and bone marrow biopsy were performed. Histologic diagnosis of the 2 cases was BPDCN.

Interventions:
Both patients were treated with induction chemotherapy and received allogenic peripheral blood stem-cell transplant.

Outcomes:
No relapse was observed in the 2 patients for 14 and 11 months, respectively, after transplantation. Interestingly, they had no skin lesions at initial diagnosis or during the course of their illness.

Lessons:
We 1st identified nasal cavity as an unusual site of BPDCN. BPDCN should be considered in differential diagnosis of blastic leukemia with an undifferentiated and ambiguous immunophenotype despite the absence of skin lesions.
Associations between short-term efficacy and clinical characteristics of infantile hemangioma treated by propranolol
Authors: Wu Changhua , Guo Lei , Wang Liang , Li Jing , Wang Changfeng , Song Dan 
Published: February 2019

Abstract
Propranolol is the mainstay of treatment for infantile hemangiomas (IHs) benefited from its low complication in the present study. However, it has an uncertainty treating period with cumbersome methods which may be related to clinical features. This study sought to considered possible influences of short-term efficacy to medication.
Retrospective analysis of 82 patients with IHs treated by propranolol was performed. The patients were grouped according to effect (excellent, good and fair/poor). ANOVA or t test was used to assess the relationships between effect and clinical features of IHs.
Twenty-seven patients were males and 55 were females. The median age of treatment initiation was 3.5 (±2.11) months. Mean follow-up time for the group was 6.2 months (1.5–16 months). There were no significant associations between short-term efficacy and gender, time points of treatment, diameter of tumor and multifocality. However, tumor thickness was associated with short-term efficacy (P = .013). Moreover, an obvious difference of short-term efficacy has been found when tumor thickness <1.2 cm.
In the present study, tumor thickness was associated with the short-term efficacy in patients with IHs. Propranolol may be gets a better outcome when tumor thickness <1.2 cm at a short time.
Manifestations of and risk factors for acute myocardial injury after acute organophosphorus pesticide poisoning
Authors: Chen Kai-Xiang , Zhou Xin-Hua , Sun Cheng-Ai , Yan Pei-Xia 
Published: February 2019

Abstract
This study aimed to explore the risk factors for acute myocardial injury (AMI) caused by acute organophosphorus pesticide poisoning (AOPP).
The clinical data of 98 patients, who were treated in our hospital due to oral AOPP from April 2013 to April 2017, were retrospectively analyzed. These patients were divided into two groups: AMI group and control group. The incidence of AMI was analyzed. Furthermore, the dosage forms and dose of the pesticide, and the interval between pesticide taking and doctor visit were compared between these two groups. Moreover, their clinical symptoms were observed; the serum cholinesterase levels, myocardial injury, and heart failure markers were detected, and the occurrence of arrhythmia and the structure and function of the heart were investigated through continuous electrocardiographic monitoring and transthoracic echocardiography.
Among these 98 AOPP patients, 51 patients were complicated with AMI, and the incidence was 52.0%. The main manifestations of these 51 patients with AMI were as follows: the serum levels of myocardial injury markers (creatine kinase-Mb [CK-Mb] and cardiac troponin I [cTnI]) and heart failure markers (N-terminal pro B-type natriuretic peptide [NT-pro BNP]) were significantly higher, when compared with the control group (P < .001), and the incidence of arrhythmia (FVPB, P = .02; RAA, P = .03; RVA, P = .02; ST-T changes, P = .01) and heart failure (P = .04) was also significantly higher when compared with the control group. With regard to dosage forms of the pesticides, the number of patients taking the pesticides with solvents containing aromatic hydrocarbons was significantly higher in the AMI group than in the control group (P = .001). And the number of patients taking over 100 mL of pesticides was also significantly higher in the AMI group than in the control group (P < .001). Significantly more patients in the AMI group had an interval of over 1 h between pesticide taking and doctor visit than in the control group (P < .001).
Risk factors for AMI after AOPP may include the dose and dosage form of the pesticide, and the interval between pesticide taking and doctor visit.
Analyzing maternal mortality rate in rural China by Grey-Markov model
Authors: Wang Yawen , Shen Zhongzhou , Jiang Yu 
Published: February 2019

Abstract
Maternal mortality rate (MMR) in China has reduced during a decade but still higher than many countries around the world. Rural China is the key region which affects over all maternal death. This study aims to develop a suitable model in forecasting rural MMR and offer some suggestions for rural MMR intervention. Data in this study were collected through the Health Statistical Yearbook (2017) which included the overall MMR in China and urban and rural mortality rate. A basic grey model (GM(1,1)), 3 metabolic grey models (MGM), and a hybrid GM(1,1)–Markov model were presented to estimate rural MMR tendency. Average relative error (ARE), the post-test ratio (C), and small error probability (P) were adopted to evaluate models’ fitting performance while forecasting effectiveness was compared by relative error.
The MMR in rural China reduced obviously from 63.0 per 100,000 live births in 2005 to 21.1 per 100,000 live births in 2017. One basic GM(1,1) model was built to fit the rural MMR and the expression was X^((1)) (k + 1) = 553.80e^0.0947k – 550.00 (C = 0.0456, P > .99). Three MGM models expressions were X^((1)) (k + 1)  = 548.67e^0.0923k – 503.17 (C = 0.0540, P > .99), X^((1)) (k + 1) = 449.39e^0.0887k – 408.09 (C = 0.0560, P > .99), X^((1)) (k + 1) = 461.33e^0.0893k – 425.23(C = 0.0660, P > .99). Hybrid GM(1,1)–Markov model showed the best fitting performance (C = 0.0804, P > .99). The relative errors of basic GM(1,1) model and hybrid model in fitting part were 2.42% and 2.03%, respectively, while 5.35% and 2.08%, respectively, in forecasting part. The average relative errors of MGM were 2.07% in fitting part and 17.37% in forecasting part.
Data update was crucial in maintain model's effectiveness. The hybrid GM(1,1)–Markov model was better than basic GM(1,1) model in rural MMR prediction. It could be considered as a decision-making tool in rural MMR intervention.
Assessment of cholestasis in drug-induced liver injury by different methods
Authors: Xing Mindan , Zhai Lu , Li Jia , Li Qian , Gao Min , Wen Jun , Xu Zengli 
Published: February 2019

Abstract
Cholestasis in drug-induced liver injury (DILI) can be assessed by biochemical and pathologic methods, but the agreement between the 2 methods remains unclear.
The aim of this study was to identify the accurate method for assessment of cholestasis in DILI.
The DILI standard established and revised by the Council for International Organizations of Medical Sciences (CIOMS) (R values were calculated by liver function at different time points), cholestatic liver disease guideline (European Association for the Study of the Liver, EASL), and liver pathology were used to assess, compare, and analyze the cholestasis in 133 patients with DILI.
The R values at different time points in CIOMS standard had no statistical difference for the assessment of cholestatic DILI (a = 0.05, χ2 = 1.51, P = .679). There were statistical differences among the results of CIOMS, EASL, and pathology (a = 0.05, χ2 = 99.97, P < .001). EASL standard had no statistical difference with pathology (a = 0.003, χ2 = 8.00, P = .005).
CIOMS and EASL standards based on biochemical parameters underestimated cholestatic DILI, as compared to liver pathology.
Comparative efficacy and safety of lipid-lowering agents in patients with hypercholesterolemia
Authors: Zhao Zonglei , Du Song , Shen Shuxin , Luo Ping , Ding Shoukun , Wang Guanggong , Wang Lixia 
Published: February 2019

Abstract

Background:
The comparative efficacy and safety of PCSK9 inhibitors, statins, and ezetimibe to lower lipid levels in patients with hypercholesterolemia remain unknown. We aimed to investigate the benefits and harms of the lipid-lowering agents in these patients.

Methods:
PubMed, Embase, and the Cochrane Library were searched from January 1, 2000 to June 1, 2018 for relevant randomized controlled trials (RCTs). Frequentist network meta-analysis was used to pool all estimates. Ranking probabilities were used to rank the comparative effects of all drugs against placebo.

Results:
Eighty-four RCTs enrolled 246,706 patients were included. Most of the included were assessed as low risk of bias. The probabilities of PCSK9 inhibitors that ranked first in improving lipid outcomes were all 100%. The probability of statins that ranked first in reducing the risk of cardiovascular (CV) events was 60.6%, and the probability of PCSK9 inhibitor was 37.1%, while no significant difference of efficacy in reducing CV events was observed between the 2 agents (odds ratios [OR] 0.98, 95% CI 0.87–1.11). Statin ranked first in reducing all-cause and CV death. Compared with placebo, statins were associated with reduced risks of all-cause (OR 0.90, 95% CI 0.85–0.96) and CV death (OR 0.83, 95% CI 0.75–0.91) while PCSK9 inhibitors and ezetimibe were not. No agents caused adverse events (including neurocognitive events), except that statins therapy significantly increases the levels of alanine aminotransferase (ALT) (OR 1.89, 95% CI 1.42–2.51) and creatine kinase (CK) (OR 1.45, 95% CI 1.09–1.93) and the incidence of diabetes (OR 1.13, 95% CI 1.02–1.26).

Conclusions:
PCSK9 inhibitors were the most effective lipid-lowering agents in improving lipid levels. Furthermore, PCSK9 inhibitors achieved similar CV benefits like statins, while PCSK9 inhibitors were not associated with any increased risk of statin-related side-effects. Thus, PCSK9 inhibitors may also be recommended as promisingly first-line lipid-lowering treatment for patients with hypercholesterolemia, especially for these with statins intolerance or resistance.