bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adenoid cystic carcinoma of the breast in a male
Authors: Pang Wenyang , Wang Zhengyi , Jin Xiaoyan , Zhang Qiang 
Published: August 2019

Abstract

Rationale:
Adenoid cystic carcinoma (ACC) of the breast is an infrequent neoplasm, and the occurrence in males is rare. Therefore, diagnostic and therapeutic challenges are inevitable.

Patient concerns:
Herein, we present a case of a 44-year-old man with a tumor on his right breast that he had known about for 6 years.

Diagnoses:
The patient underwent a lumpectomy, and the histological examination confirmed a diagnosis of ACC.

Interventions:
Modified radical mastectomy was subsequently conducted in the patient. No positive lymph nodes were observed in the postoperative pathological examination. Following the surgery, the patient received adjuvant chemotherapy.

Outcomes:
The patient remained recurrence-free at 26 months.

Lessons:
Compared to female breast ACC, male breast ACC may behave differently biologically and have a different prognosis. Our case will provide more diagnostic and treatment experience to deal with this disease.
The relationship of plasma fibrinogen with clinicopathological stages and tumor markers in patients with non-small cell lung cancer
Authors: Bian Nan-Nan , Shi Xin-Yu , Qi Hong-Yu , Hu Xin , Ge Yang , An Guang-Yu , Feng Guo-Sheng 
Published: August 2019

Abstract
Numerous studies have shown that the blood of cancer patients are generally in hypercoagulable statement. The aim of the present research is to study the relationships of plasma fibrinogen (Fbg) levels with clinicopathological stages (CS) and tumor markers of non-small cell lung cancer (NSCLC).
Baseline information, plasma Fbg levels, CS, and expression level of tumor markers were collected from medical records retrospectively. Unitary linear regression was used to analyze the relationships between continuous variables and Fbg, and multiple linear regression was used to analyze the relationships between categorical variables and Fbg. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (Version 4) for NSCLC were adopted to evaluate CS.
A total of 652 NSCLC patients were included. Compared with the females, male patients had higher mean plasma Fbg levels (P < .001). The later the N stages (P = .002), M stages (P = .002), and CS (P = .001) were, the higher the average plasma Fbg levels were. The levels of squamous cell carcinoma antigen (P = .001), carbohydrate antigen 125 (P = .041), and neuron-specific enolase (P < .001) were positively correlated with plasma Fbg concentration. The plasma level of Fbg in lung adenocarcinoma patients (P < .001) was the lowest, while that of lung squamous cell carcinoma patients (P < .001) was the highest in NSCLC patients.
The plasma Fbg concentration is related to gender, CS, and tumor markers in patients with NSCLC.
Procalcitonin-guided antibiotic therapy in acute exacerbation of chronic obstructive pulmonary disease
Authors: Li Zhuying , Yuan Xingxing , Yu Ling , Wang Bingyu , Gao Fengli , Ma Jian 
Published: August 2019

Abstract

Background:
The benefit of a procalcitonin (PCT)-guided antibiotic strategy in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains uncertain.

Objectives:
This updated meta-analysis was performed to reevaluate the therapeutic potential of PCT-guided antibiotic therapy in AECOPD.

Data sources:
We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov up to February 2019 to identify randomized controlled trials (RCTs) investigating the role of PCT-guided antibiotic strategies in treating adult patients with AECOPD. Relative risk (RR) or mean differences (MD) with accompanying 95% confidence intervals (CIs) were calculated with a random-effects model.

Results:
Eight RCTs with a total of 1376 participants were included. The results suggested that a PCT-guided antibiotic strategy reduced antibiotic prescriptions (RR: 0.55; 95% CI: 0.39–0.76; P = .0003). However, antibiotic exposure duration (MD: −1.34; 95% CI: −2.83–0.16; P = .08), antibiotic use after discharge (RR: 1.61; 95% CI: 0.61–4.23; P = .34), clinical success (RR: 1.02; 95% CI: 0.96–1.08; P = .47), all-cause mortality (RR: 1.05; 95% CI: 0.72–1.55; P = .79), exacerbation at follow-up (RR: 0.97; 95% CI: 0.80–1.18; P = .78), readmission at follow-up (RR: 1.12; 95% CI: 0.82–1.53; P = .49), length of hospital stay (MD: −0.36; 95% CI: −1.36–0.64; P = .48), and adverse events (RR: 1.33; 95% CI: 0.79–2.23; P = .28) were similar in both groups.

Implications of key findings:
A PCT-guided antibiotic strategy is associated with fewer antibiotic prescriptions, and has similar efficacy and safety compared with standard antibiotic therapy in AECOPD patients.
Serum magnesium levels during magnesium sulfate infusion at 1 gram/hour versus 2 grams/hour as a maintenance dose to prevent eclampsia in women with severe preeclampsia
Authors: Pascoal Ana C. F. , Katz Leila , Pinto Marcela H. , Santos Carina A. , Braga Luana C. O. , Maia Sabina B. , Amorim Melania M. R. 
Published: August 2019

Abstract

Background:
Magnesium sulfate is the ideal drug for the prevention and treatment of eclampsia. Nevertheless, the best regimen for protection against eclampsia with minimal side effects remains to be established. This study aimed to compare serum magnesium levels during intravenous infusion of magnesium sulfate at 1 gram/hour versus 2 grams/hour as a maintenance dose to prevent eclampsia in pregnant and postpartum women with severe preeclampsia.

Methods:
A randomized, triple-blind clinical trial was conducted, comparing serum magnesium levels during the intravenous infusion of magnesium sulfate at 1 gram/hour versus 2 grams/hour as a maintenance dose for the prevention of eclampsia in 62 pregnant and postpartum women with severe preeclampsia, 31 in each group. An intravenous loading dose of 6 grams of magnesium sulfate was administered over 30 minutes in both groups. The patients were then randomized to receive a maintenance dose of either 1 or 2 grams/hour for 24 hours. Primary outcomes consisted of serum magnesium levels at the following time points: baseline, 30 minutes, every 2 hours until the end of the first 6 hours, and every 6 hours thereafter until the termination of magnesium sulfate infusion. Side effects, maternal complications, and neonatal outcomes were the secondary outcomes.

Results:
Serum magnesium levels were higher in the 2-gram/hour group, with a statistically significant difference from 2 hours after the beginning of the magnesium sulfate infusion (P <.05). Oliguria was the most common complication recorded in both groups, with no significant difference between the 2 regimens (RR 0.88; 95% CI: 0.49–1.56; P = .65). No cases of eclampsia occurred. Side effects were more common in the 2-gram/hour group (RR 1.89; 95% CI: 1.04–3.41; P = .02); however, all were mild. There were no differences between the 2 groups regarding neonatal outcomes, except for admission to neonatal intensive care, which was more frequent in the 1-gram/hour group (25% vs 6.3%; P = .04).

Conclusion:
Magnesium sulfate therapy at the maintenance dose of 1 gram/hour was just as effective as the 2-gram maintenance dose, with fewer side effects.
Effectiveness of electrical stimulation for postoperative pain in patients with osteosarcoma
Authors: Yu Tao , Tang Hua-yu , Wang Tian-shu , Wei Wei 
Published: August 2019

Abstract

Background:
This study aims to investigate the effectiveness and safety of electrical stimulation (ES) for postoperative pain (PPP) in patients with osteosarcoma systematically.

Methods:
We will systematically search the following electronic databases from inception to the May 1, 2019: MEDILINE, Cochrane Library, EMBASE, Web of Science, Springer, and CNKI without language restrictions. All literatures of randomized controlled trials (RCTs) and case-controlled studies (CCSs) of ES for PPP in patients with osteosarcoma will be included. RevMan 5.3 software (Cochrane Community; London, UK) and STATA 15.0 software (StataCorp; College Station) will be used for statistical analysis. Cochrane risk of bias will be used for methodological quality assessment for RCTs and Newcastle-Ottawa Scale will be utilized for CCSs.

Results:
This study will assess the clinical effectiveness and safety of ES for PPP in patients with osteosarcoma through assessing primary outcome of pain intensity and secondary outcomes of frequency of rescue analgesic use, cumulative morphine consumption, quality of recovery, as well as adverse events.

Conclusion:
This study will provide latest evidence on effectiveness and safety of ES for PPP in patients with osteosarcoma, and may also provide guidance for both clinician and further studies.

Dissemination and ethics:
This study does not require ethical approval, because it will not analyze the individual patient data. Its results are expected to be published in peer-reviewed journals.

Systematic review registration:
PROSPERO CRD42019135790.
Emotional problems in mothers of autistic children and their correlation with socioeconomic status and the children's core symptoms
Authors: Zhou Wensu , Liu Dan , Xiong Xiyue , Xu Huilan 
Published: August 2019

Abstract
To investigate the emotional problems (depressive and anxiety symptoms) of mothers of children with autism spectrum disorder (ASD) and explore the role of the mother's socioeconomic status (SES) and the core symptoms of the child on the mother's emotional problems.
This cross-sectional survey was performed in 180 mothers of children with ASD in Chang Sha city of China. The 7-item Generalized Anxiety Disorder Scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) were used to assess the anxiety and depressive symptoms of the mothers of the autistic children. The education level and annual family income, as well as occupation, were be selected as components of the mother's SES. Autism Behaviour Checklist (ABC) and Social Responsiveness Scale (SRS) were used for the evaluation of the core symptoms of the children. A general information questionnaire was also used. The ordinal regression was used to examine the effect of the SES and children's core symptoms on maternal emotional problems.
The valid response rate was 92.7% (167 of 180 questionnaires were returned). Of the mothers studied, 72.5% and 80.2% had depressive and anxiety symptoms, respectively, and 67.1% suffered from both symptoms. Mother's SES was observed to be unrelated to maternal anxiety symptoms (P >.05). Only 1 component of the SES (junior high school education level) was related to depressive symptoms (OR = 0.31, 95% CI 0.12–0.80). SRS score under 115 (OR = 0.38, 95% CI 0.16–0.93) of autistic children was a protective factor against maternal anxiety symptoms. The borderline and mild behavioral problems (OR = 0.43, 95% CI 0.19–0.99; OR = 0.45, 95% CI 0.22–0.94, respectively) of autistic children were protective factors against maternal depressive symptoms.
Mothers of autistic children generally exhibited high levels of anxiety and depressive symptoms. The core symptoms of the autistic children were observed to be strongly associated with both maternal anxiety and depressive symptoms. Improvements in the core symptoms of children with ASD may help reduce maternal anxiety and depressive symptoms to some extent.
Adipogenesis for soft tissue reconstruction
Authors: Karagoz Huseyin , Zor Fatih , Goktas Esra , Gorantla Vijay S. 
Published: August 2019

Purpose of review
It has been increasingly common to use adipose tissue for regenerative and reconstructive purposes. Applications of autologous fat transfer and different stem cell therapies have significant limitations and adipose tissue engineering may have the potential to be an important strategy in the reconstruction of large tissue defects. A better understanding of adipogenesis will help to develop strategies to make adipose tissue more effective for repairing volumetric defects.

Recent findings
We provide an overview of the current applications of adipose tissue transfer and cellular therapy methods for soft tissue reconstruction, cellular physiology, and factors influencing adipogenesis, and adipose tissue engineering. Furthermore, we discuss mechanical properties and vascularization strategies of engineered adipose tissue, and its potential applications in the clinical settings.

Summary
Autologous fat tissue transfer is the standard of care technique for the majority of surgeons; however, high resorption rates, poor perfusion within a large volume fat graft and widely inconsistent graft survival are the main limitations. Adipose tissue engineering is a promising field to reach the first goal of producing adipose tissue which has more predictable survival and higher graft retention rates. Advancements of scaffold and vascularization strategies will contribute to metabolically and functionally more relevant adipose tissue engineering.
Congenital Heart Disease: Prenatal Diagnosis and Genetic Associations
Authors: Hopkins Maeve K. , Dugoff Lorraine , Kuller Jeffrey A. 
Published: August 2019

Importance
Congenital heart disease (CHD) is a common cause of neonatal morbidity and mortality. Several genetic abnormalities have been linked to congenital cardiac disease. When diagnosed prenatally, appropriate evaluation can help optimize neonatal outcomes.

Objective
The objective of this review is to identify appropriate prenatal genetic testing when congenital cardiac defects are identified antenatally. This review also identifies specific congenital cardiac defects that are associated with fetal aneuploidy and genetic syndromes.

Evidence Acquisition
A MEDLINE search of “genetic testing” or “microarray” and “congenital heart disease” and specific conditions reported in the review was performed.

Results
The evidence cited in this review includes case reports or case series (4) textbooks (3), systematic reviews (1), expert committee opinions (10), and 37 additional peer-reviewed journal articles that were original research or expert summaries.

Conclusions and Relevance
When CHD is identified through prenatal screening, patients should be referred for genetic counseling and offered appropriate genetic testing. Prenatal diagnosis of genetic syndromes related to CHD and close communication between obstetric, genetic, and pediatric providers can help optimize outcomes for both mother and baby.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this activity, physicians should be better able to distinguish the appropriate genetic screening and testing when congenital cardiac defects are diagnosed; assess associated risks of genetic abnormality with a diagnosed congenital cardiac defect; refer patients to genetic counselors for appropriate indication(s); describe the risks, benefits, and limitations of antenatal genetic testing and educate patient regarding these risks, benefits, and limitations; and identify indications for screening fetal echocardiography.
A Cost Minimization Analysis of Treatment Options for Postmenopausal Women With Dysuria
Authors: Bradley Megan S. , Beigi Richard H. , Shepherd Jonathan P. 
Published: August 2019

(Abstracted from Am J Obstet Gynecol 2019; doi: 10.1016/j.ajog.2019.04.031)
The most common type of bacterial infection seen in an outpatient setting is urinary tract infection (UTI). In the United States, the overall lifetime prevalence of UTIs in women is greater than 50%.
Neurodevelopmental Outcome of Children With Spina Bifida Aperta Repaired Prenatally vs Postnatally: Systematic Review and Meta-analysis
Authors: Inversetti A. , Van der Veeken L. , Thompson D. , Jansen K. , Van Calenbergh F. , Joyeux L. , Bosteels J. , Deprest J. 
Published: August 2019

(Abstracted from Ultrasound Obstet Gynecol 2019;53:293–301)
Spina bifida aperta is characterized by a congenital defect in the vertebral arches, with protrusion of the meninges and, in the case of myelomeningocele, protrusion of the spinal cord as well. In the majority of cases, spina bifida is not lethal in the neonatal period, although it is associated with higher mortality than in the normal population (44,000 deaths in 150,000 affected newborns per year worldwide).
Maternal Telomere Length Is Shorter in Intrauterine Growth Restriction Versus Uncomplicated Pregnancies, But Not in the Offspring or in IVF-Conceived Newborns
Authors: Perales-Puchalt Alfredo , Soberón Nora , Monterde Mercedes , Hervas-Marin David , Foronda Miguel , Desantes Domingo , Soler Inmaculada , Perales-Marin Alfredo , Pellicer Antonio , Blasco Maria A. 
Published: August 2019

(Abstracted from Reprod Biomed Online 2019;38(4):606–612)
Telomeres are protective nucleoprotein structures found at the end of chromosomes that progressively shorten with each round of DNA replication during cell division. Telomere shortening is associated with physiological aging, and short telomeres have been found to be an early indicator of cardiovascular disease.
System Factors Influencing the Use of a Family-Centered Rounds Checklist
Authors: Kelly Michelle M. , Xie Anping , Li Yaqiong , Cartmill Randi , Cox Elizabeth D. , Brown Roger L. , Wetterneck Tosha , Carayon Pascale 
Published: August 2019

Introduction:
Checklists are used to operationalize care processes and enhance patient safety; however, checklist implementation is difficult within complex health systems. A family-centered rounds (FCR) checklist increased physician performance of key rounding activities, which were associated with improved parent engagement, safety perceptions, and behaviors. To inform FCR checklist implementation and dissemination, we assessed physician compliance with this checklist and factors influencing its use.

Methods:
Guided by a recognized human factors and systems engineering approach, rounding observations and ad hoc resident and attending physician interviews were conducted at a tertiary children’s hospital. Rounding observers documented 8-item checklist completion (nurse presence, family preference, introductions, assessment/plan, discharge goals, care team questions, family questions, and read back orders) and then interviewed physicians to elicit their perceptions of challenges and facilitators to FCR checklist use. We performed a directed content analysis of interview notes, iteratively categorizing data into known hospital work system components.

Results:
Of 88 individual patient rounds observed after checklist implementation, 90% included the nurse, and 77% occurred at the bedside. In an average patient rounding session, staff performed 82% of checklist items. Factors influencing checklist use were related to all hospital work system components, eg, physician familiarity with checklist content (people), visibility of the checklist (environment), providing schedules for rounding participants (organization), and availability of a mobile computer during rounds (technology).

Conclusions:
Multiple factors within hospital systems may influence FCR checklist use. Strategies, such as providing rounding schedules and mobile computers, may promote optimal engagement of families during rounds and promote pediatric patient safety.
A Quality Improvement Approach to Increase Exercise Assessment in Survivors of Childhood Leukemia
Authors: Coven Scott L. , Bibart Mindy , Frost Randall , Gallagher Travis , Guinipero Terri , Valasek Amy E. , Olshefski Randal 
Published: August 2019

Introduction:
Survivors of childhood cancer are at increased risk of treatment-related cardiovascular disease, the severity of which is impacted by the level of regular exercise. Exercise assessments (EAs) are not a routine component of follow-up care.

Methods:
We incorporated a quantitative EA tool into the clinic triage during follow-up visits for survivors of acute lymphoblastic leukemia. The nursing staff was surveyed on the use of the EA tool to gauge understanding and level of comfort with addressing patient questions.

Results:
Over 27 months, the percentage of off-therapy acute lymphoblastic leukemia patients with documented EA increased from 0% to 80%. We noted degradation in EA completions in the last 6 months of the project, which we attributed to project nursing staff transition and failure to maintain education. Interventions that improved the percentage of completed EA included the incorporation the assessment tool into the electronic medical record and weekly reminders of scheduled eligible patients. A nurse incentive plan did not impact project success. Survey results revealed that the nursing staff were comfortable with the EA and did not view the new process as hurting patient flow.

Conclusion:
Implementation of an EA tool into routine clinic follow-up was successful. We met the project goal of assessing greater than 50% of the follow-up patients. This work will serve as the foundation for the next phase of the project, which will be to provide education on the importance of exercise and earlier intervention when a sedentary lifestyle is identified.
From correlation towards causality: modulating brain rhythms of pain using transcranial alternating current stimulation
Authors: Hohn Vanessa D. , May Elisabeth S. , Ploner Markus 
Published: August 2019

Abstract

Introduction:
Accumulating evidence suggests that neural oscillations at different frequencies and their synchrony between brain regions play a crucial role in the processing of nociceptive input and the emergence of pain. Most findings are limited by their correlative nature, however, which impedes causal inferences.

Objective:
To move from correlative towards causal evidence, methods that allow to experimentally manipulate oscillatory brain activity are needed.

Results:
Transcranial alternating current stimulation (tACS) is a noninvasive brain stimulation technique designed to modulate neural oscillations in a frequency specific manner and as such a suitable method to investigate the contribution of oscillatory brain activity to pain. Despite its appeal, tACS has been barely applied in the field of pain research. In the present review, we address this issue and discuss how tACS can be used to gather mechanistic evidence for the relationship between pain and neural oscillations in humans.

Conclusions:
Transcranial alternating current stimulation holds great potential for the investigation of the neural mechanisms underlying pain and the development of new treatment approaches for chronic pain if necessary methodological precautions are taken.
Neuroimaging-based pain biomarkers: definitions, clinical and research applications, and evaluation frameworks to achieve personalized pain medicine
Authors: Mackey Sean , Greely Henry T. , Martucci Katherine T. 
Published: August 2019

Abstract:
One of the key ambitions of neuroimaging-based pain biomarker research is to augment patient and clinician reporting of clinically relevant phenomena with neural measures for prediction, prognosis, and detection of pain. Despite years of productive research on the neuroimaging of pain, such applications have seen little advancement. However, recent developments in identifying brain-based biomarkers of pain through advances in technology and multivariate pattern analysis provide some optimism. Here, we (1) define and review the different types of potential neuroimaging-based biomarkers, their clinical and research applications, and their limitations and (2) describe frameworks for evaluation of pain biomarkers used in other fields (eg, genetics, cancer, cardiovascular disease, immune system disorders, and rare diseases) to achieve broad clinical and research utility and minimize the risks of misapplication of this emerging technology. To conclude, we discuss future directions for neuroimaging-based biomarker research to achieve the goal of personalized pain medicine.