bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incorporation of biochemical factors for survival analysis of transarterial chemoembolization in patients with hepatocellular carcinoma: A retrospective cohort study
Authors: Chan Wen-Hui , Huang Song-Fong , Lee Chao-Wei , Wu Tsung-Han , Pan Kuan-Tse , Lin Shi-Ming , Yu Ming-Chin , Hung Chien-Fu 
Published: August 2019

Introduction Hepatocellular carcinoma (HCC) is a common gastrointestinal cancer that occurs worldwide, and conventional transarterial chemoembolization (cTACE) is one of the first treatment choices for advanced HCC. However, biochemical factors and comorbidity have seldom been reported in the long-term outcomes. Methods This retrospective cohort study included 444 HCC patients who underwent cTACE-based therapy in 2010 to 2012. Survival outcomes were analyzed using a Kaplan–Meier curve and Cox regression analysis. Results The mean age was 62.1 ± 12.5 years, and 74.3% were men. Analysis of the mean biochemical values indicated that the presence of portal vein thrombosis, α-fetoprotein (AFP) >200 ng/mL, AJCC 7th stage III, diabetes, albumin <3 g/dL, and hemoglobin were significantly and independently associated with poorer long-term outcomes. Discussion The presence of venous thrombus and elevation of AFP levels are the most important factors in cTACE treatment. The host factors, including metabolic status and liver damage, should be evaluated in these patients.
Changes of aldosterone levels in patients with type 2 diabetes complicated by moderate to severe obstructive sleep apnea–hypopnea syndrome before and after treatment with continuous positive airway pressure
Authors: Zhang Jie , Tian Lin , Guo Lixin 
Published: August 2019

Objective Both obstructive sleep apnea–hypopnea syndrome (OSAHS) and type 2 diabetes mellitus (T2DM) are closely related to the renin-angiotensin-aldosterone system. We investigated whether hyperaldosteronemia is found in patients with OSAHS complicated by T2DM and whether continuous positive airway pressure (CPAP) treatment can significantly reduce the aldosterone level. Methods Patients with T2DM were classified into an OSAHS group [apnea–hypopnea index (AHI) of ≥15] and a control group (without OSAHS; AHI of <5). The OSAHS group was exposed to CPAP for 7 days (7 h/day). Results The plasma aldosterone, plasma renin, and urinary aldosterone levels were higher in the OSAHS than control group. The plasma aldosterone and renin levels were significantly lower after than before treatment in the OSAHS group, but they were still higher than the baseline levels in the control group. The post-treatment urinary aldosterone level was significantly higher in the OSAHS than control group. No correlation was found between the AHI and plasma renin, plasma aldosterone, and 24-hour urinary aldosterone levels. The blood glucose level in the OSAHS group did not significantly change after treatment. Conclusions The plasma and urine aldosterone levels are increased in patients with concurrent T2DM and OSAHS and are significantly reduced by CPAP. Trial registration: ChiCTR-ION-16009837
Popliteal artery entrapment syndrome as a cause of failed treatment of a false popliteal aneurysm
Authors: Song Xitao , Zhou Mengxin , Tang Lei , Liu Zhili , Zheng Yuehong , Chen Yuexin 
Published: August 2019

Objective Popliteal artery entrapment syndrome is a rare cause of popliteal artery aneurysms. We present a rare case of a false aneurysm associated with popliteal artery entrapment syndrome that was treated with endovascular repair that initially failed. Case report A 60-year-old man with a false popliteal artery aneurysm and limb ischemia was treated with endovascular repair that initially failed. The popliteal artery was suspected to be compressed by an abnormal bundle of muscle according to the findings of a subsequent magnetic resonance imaging examination. The popliteal artery was entrapped by an abnormal slip of the medial gastrocnemius muscle head. Parts of the popliteus muscle were also involved in compression of the popliteal artery, which was not distinguished on preoperative magnetic resonance imaging. Thus, the patient was diagnosed with a mixed type of popliteal artery entrapment syndrome (types III and IV). Bypass with the small saphenous vein was then performed. The patient was finally discharged with satisfactory relief of his ischemic symptoms. Conclusion Popliteal artery entrapment syndrome should be considered before treating popliteal artery aneurysms, especially atypical pseudoaneurysms without significant atherosclerosis. Definitive surgical management rather than endoluminal treatment is required unless combined with open decompressive surgery to correct the musculotendinous anatomy.
Correlation of FGFR2 rs2981582 polymorphisms with susceptibility to breast cancer: a case-control study in a Chinese population
Authors: Shu Jin , Hui Xuelian , Zheng Xin , Zhao Juan , Xu Zhaochen , Chen Yingpu , Lu Chao , Li Junling 
Published: August 2019

Objective Breast cancer (BC) is a common malignancy among women worldwide. Fibroblast growth factor receptor 2 (FGFR2) rs2981582 is reported to play a vital role in BC development. However, the relationship between them remains unclear. Methods Ninety-five patients and 140 healthy controls were enrolled in the study. Plasma DNA was genotyped by the MassARRAY method. A meta-analysis was conducted to clarify the effect of FGFR2 polymorphism on BC risk. Results Our case-control study results revealed a significant difference in CC, TC, and TT genotypes between patients and controls. Logistic regression analysis showed that TT and TC genotype and the dominant mode were significantly correlated with BC development [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.050–2.27; OR = 1.81, 95% CI: 1.24–2.73; OR = 2.15, 95% CI: 1.25–5.31, respectively], even after adjusting for age, body weight, drinking, smoking, and estrogen receptor status. A meta-analysis of 15 studies showed significant differences among the dominant, recessive, heterozygote, and homozygote models between patients and controls. Conclusions Our results showed an association of FGFR2 rs2981582 polymorphism with BC in an Asian population. However, a more comprehensive study of the relationship between the polymorphism and BC is still needed.
Somatic symptoms and their association with anxiety and depression in Chinese patients with cardiac neurosis
Authors: Zheng Feng , Duan Yinglong , Li Jingle , Lai Lin , Zhong Zhuqing , Hu Manhui , Ding Siqing 
Published: August 2019

Objective We sought to investigate somatic symptoms detected by the Somatic Self-rating Scale and to evaluate whether they were associated with the psychological symptoms of anxiety and depression in patients with cardiac neurosis. Methods A total of 180 patients with cardiac neurosis at the Third Xiangya Hospital, Changsha, China, were surveyed from January 2017 to July 2018. Participants completed a general information questionnaire, the Somatic Self-rating Scale, the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder Scale-7. Results The mean (±standard deviation) somatic symptom score in patients with cardiac neurosis was 40.83 ± 7.12. The most severe symptoms were cardiovascular symptoms, fatigue and muscle soreness. A total of 90 patients (46.4%) had anxiety and 80 (50.0%) had depression. Multiple stepwise regression analysis showed that somatic symptoms in patients with cardiac neurosis were associated with both anxiety and depression. Conclusion Somatic symptoms in patients with cardiac neurosis were associated with both anxiety and depression. Therefore, it is important to provide effective emotional interventions to promote patient rehabilitation.
Psychometric assessment of the Italian version of the melanoma module (SCNS-M12-Ita) of the Supportive Care Needs Survey (SCNS-SF34)
Authors: Miniotti Marco , Zeneli Anita , Bassino Stefania , Pavan Sara , Ribero Simone , Leombruni Paolo 
Published: August 2019

Introduction: This study examines the validity and the reliability of the translated-into-Italian version of the SCNS-SF34 melanoma module (SCNS-M12-Ita) for a sample of patients with melanoma ( n = 268). Methods: Content validity was analyzed by examining the redundancy of items. Floor/ceiling effects were investigated via frequency tables. Factor structure was studied through principal component analysis. Internal consistency was evaluated with Cronbach α. Test–retest reliability was analyzed using intraclass correlation coefficients (ICCs). Convergent–discriminant validity was studied by calculating Pearson correlations. Construct validity was investigated by comparing subgroups of patients through multivariate analysis of variance. Results: Content validity of the SCNS-M12-Ita was satisfactory. The floor effect ranged from 24.3% to 82.5%. The 2-factor solution explained 61.4% of the total variance. Internal consistency was excellent for component 1 (α = 0.92) and questionable (α = 0.58) for component 2. Test–retest reliability was excellent for component 1 (ICC = 0.92) and poor for component 2 (ICC = 0.58). Except for component 2, item-total correlations were greater than 0.60. Construct validity was confirmed, as the expected correlations ( r < 0.40) were observed and 60% of the postulated hypotheses about between-group differences were confirmed. Conclusions: The study demonstrated that the SCNS-M12-Ita is a valid and reliable instrument for assessing the supportive care needs of patients with melanoma.
Equipoise in Appropriate Initial Volume Resuscitation for Patients in Septic Shock With Heart Failure: Results of a Multicenter Clinician Survey
Authors: Wardi Gabriel , Joel Ian , Villar Julian , Lava Michael , Gross Eric , Tolia Vaishal , Seethala Raghu R. , Owens Robert L. , Sell Rebecca E. , Montesi Sydney B. , Rahaghi Farbod N. , Bose Somnath , Rai Ashish , Stevenson Elizabeth K. , McSparron Jakob , Tolia Vaishal , Beitler Jeremy R. 
Published: August 2019

Purpose: International clinical practice guidelines call for initial volume resuscitation of at least 30 mL/kg body weight for patients with sepsis-induced hypotension or shock. Although not considered in the guidelines, preexisting cardiac dysfunction may be an important factor clinicians weigh in deciding the quantity of volume resuscitation for patients with septic shock. Methods: We conducted a multicenter survey of clinicians who routinely treat patients with sepsis to evaluate their beliefs, behaviors, knowledge, and perceived structural barriers regarding initial volume resuscitation for patients with sepsis and concomitant heart failure with reduced ejection fraction (HFrEF) <40%. Initial volume resuscitation preferences were captured as ordinal values, and additional testing for volume resuscitation preferences was performed using McNemar and Wilcoxon signed rank tests as indicated. Univariable logistic regression models were used to identify significant predictors of ≥30 mL/kg fluid administration. Results: A total of 317 clinicians at 9 US hospitals completed the survey (response rate 47.3%). Most respondents were specialists in either internal medicine or emergency medicine. Substantial heterogeneity was found regarding sepsis resuscitation preferences for patients with concomitant HFrEF. The belief that patients with septic shock and HFrEF should be exempt from current sepsis bundle initiatives was shared by 39.4% of respondents. A minimum fluid challenge of ∼30 mL/kg or more was deemed appropriate in septic shock by only 56.4% of respondents for patients with concomitant HFrEF, compared to 89.1% of respondents for patients without HFrEF ( P < .01). Emergency medicine physicians were most likely to feel that <30 mL/kg was most appropriate in patients with septic shock and HFrEF. Conclusions: Clinical equipoise exists regarding initial volume resuscitation for patients with sepsis-induced hypotension or shock and concomitant HFrEF. Future studies and clinical practice guidelines should explicitly address resuscitation in this subpopulation.
Effects of Pharmacist-Conducted Medication Reconciliation at Discharge on 30-Day Readmission Rates of Patients With Chronic Obstructive Pulmonary Disease
Authors: Singh Divita , Fahim Germin , Ghin Hoytin Lee , Mathis Scott 
Published: August 2019

Purpose: To analyze effect of pharmacist-conducted medication reconciliation on 30-day readmission rates in chronic obstructive pulmonary disease (COPD) and identify common medication errors among patient with readmissions. Methods: Pharmacists were educated on discharge medication reconciliation for patients with COPD. A retrospective chart review was conducted on patients who underwent pharmacist-conducted discharge medication reconciliation to determine 30-day readmissions. Medication errors analyzed included medication omissions and dose or frequency errors. Previously collected internal research without pharmacist-conducted medication reconciliation served as the control. Results: There were 65 patients in the control group and 50 in the intervention group. About 25% of patients in the control group and 26% of patients in the intervention group had any cause readmissions within 30 days of discharge ( P = .87). Both the control and the intervention group had similar COPD-related readmissions of 12.3% and 12.6%, respectively. Medication dose or frequency errors consisted of 68.9% and 46.7% of total errors in the control and the intervention groups, respectively. Long-acting muscarinic antagonist (LAMA) or long-acting beta 2-agonist (LABA) were the most common drug classes to be incorrectly dosed or omitted at discharge. In the intervention group, 30 errors were identified. Due to inability to coordinate discharges, pharmacists intervened on 13 errors, 7 of which were accepted by the prescriber. Conclusion: Pharmacist-conducted medication reconciliation at discharge did not affect 30-day readmission rates of patients with COPD. Confounding factors included a small sample size, passive pharmacist education, and discharge issues. The most common medication errors at discharge were dosing or frequency errors of LABAs or LAMAs.
‘I Too Am a Human’: The Political Psychology of Pakistan’s Former President General Pervez Musharraf
Authors: Conley Ross F. 
Published: August 2019

This study explores the political psychology of General Pervez Musharraf, Pakistan’s most recent military dictator. It categorises his ‘operational code’—a collection of general political beliefs assessed from spoken and/or written statements—over four periods of his nine years of power. By analysing word choices in 55 interviews and press conferences, the findings suggest that Musharraf maintained stable beliefs of a friendly political universe and a preference for cooperative strategies to achieve his goals. The largest changes in his beliefs came immediately after 9/11. Before, Musharraf expressed his strongest beliefs of a friendly political universe and favour for cooperation. After 9/11, these beliefs decreased, but they remained overall friendly and cooperative. Additionally, 9/11 appears to have had the largest influence on Musharraf’s beliefs on how he should operate to meet his goals (instrumental beliefs), not on his beliefs of others in the political environment (philosophical beliefs). Applied today, this can be useful when engaging Pakistan’s leaders. With Musharraf as an example, the long-held, philosophical beliefs of Pakistan’s leaders may not easily change. Foreign officials may find more success accepting these beliefs and focusing on shared goals that align with Pakistan’s political worldview.
Differences in the Tensor Veli Palatini Muscle and Hearing Status in Children With and Without 22q11.2 Deletion Syndrome
Authors: Perry Jamie L. , Kotlarek Katelyn J. , Spoloric Kelly , Baylis Adriane , Kollara Lakshmi , Grischkan Jonathan M. , Kirschner Richard , Bates David Gregory , Smith Mark , Findlen Ursula 
Published: August 2019

Purpose:To investigate the dimensions of the tensor veli palatini (TVP) muscle using high image resolution 3-dimensional magnetic resonance imaging (MRI) of the soft palate among children with normal velopharyngeal and craniofacial anatomy and to compare values to individuals with a diagnosis of 22q11.2 deletion syndrome (22q11DS). We also sought to determine whether there is a relationship between hypoplasia of the TVP and severity of middle ear dysfunction and hearing loss.Methods:Three-dimensional MRI were used to collect and analyze data obtained across 53 children between 4 and 12 years of age, including 40 children with normal velopharyngeal and craniofacial anatomy and 13 children with a diagnosis of 22q11.2 DS. Tensor veli palatini muscle length, thickness, and volume as well as bihamular distance were compared among participant groups.Results:A Welch’s t-test revealed that the TVP in participants with 22q11DS is significantly shorter ( P = .005, 17.3 vs 19.0 mm), thinner ( P < .001, 1.1 vs 1.8 mm), and less voluminous ( P < .001, 457.5 vs 667.3 mm3) than participants without 22q11DS. Participants with 22q11DS also had a greater ( P = .006, 27.7 vs 24.7 mm) bihamular distance than participants without 22q11DS. There was an inverse relationship between TVP abnormalities noted above and the severity of audiologic and otologic histories.Conclusion:The TVP muscle is substantially reduced in volume, length, and thickness in children with 22q11DS. These findings serve as preliminary support for the association of patient hearing and otologic severity and TVP dysmorphology.
Prenatal Yoga for Back Pain, Balance, and Maternal Wellness: A Randomized, Controlled Pilot Study
Authors: Holden Selma C , Manor Brad , Zhou Junhong , Zera Chloe , Davis Roger B , Yeh Gloria Y 
Published: August 2019

Background The objective was to assess the feasibility of a prenatal yoga randomized controlled trial (RCT) for gestational low back pain (LBP), mobility, and maternal well-being. Methods In this pilot, women aged 18 to 39 years with uncomplicated pregnancies at 12 to 26 weeks were randomized, stratified by presence of LBP, to attend a weekly yoga class or a time-matched educational support group for 12 weeks. Sample size was based on anticipated enrollment of 2 subjects per month. Primary outcomes were measures of feasibility and acceptability. Secondary outcomes included LBP disability, pregnancy symptom burden, childbirth self-efficacy, instrumented gait, balance, and falls at baseline, every 4 weeks, and 6 weeks postpartum. Results From April 2015 to December 2015, 168 women were contacted and 115 (68%) were eligible. Twenty women enrolled (N = 11 yoga; N = 9 control; mean gestational age 20.2 weeks). Retention at 12 weeks was 81% in yoga and 77% in control. There were no yoga-related adverse events. Exploratory analyses show no differences in back pain disability between groups. Significant groups effects were found on biomechanical assessments, including percentage change in gait speed ( F = 4.4, P =  .04), double support time ( F = 23.6, P < .01), instrumented timed-up-and-go ( F = 8.6, P < .01), and turn time ( F = 5.7, P = .02) suggesting clinically relevant improvements with yoga. Pregnancy Symptom Inventory (PSI) scores improved (13.1 point difference, 95% confidence interval, 5.1–21.1) at 12 weeks in yoga compared to control, adjusted for baseline gestational age. Conclusion Conducting an RCT of prenatal yoga to improve gestational LBP and maternal well-being is feasible and safe. While no differences in back pain were observed, biomechanical measures were sensitive assessments for evaluating gestational LBP-related mobility impairment and showed group differences. Additionally, the PSI showed significant differences in symptom burden over 12 weeks, supporting the ongoing claims that yoga improves a pregnant woman’s overall well-being.
Geographic disparity in systemic sclerosis mortality in the United States: 1999–2017
Authors: Rodriguez-Pla Alicia , Simms Robert W 
Published: August 2019

Introduction: Previous studies reported a progressive decrease in the systemic sclerosis mortality rates in the United States from 1959 to 2002. Identification of areas with clusters of higher mortality rates is important to implement targeted interventions. In this study, we aimed to estimate the mortality rates of scleroderma and to analyze its geographic variability at the state level in the United States. Methods: Mortality rates of scleroderma from 1999 to 2017 were obtained from the CDC Wonder Underlying Cause of Death database and its query system, using International Classification of Diseases, Tenth Revision codes. Age-adjusted rates were calculated by state and demographics. A linear regression model was applied to evaluate trends over time. Results: Over the period studied, a total of 24,525 deaths had scleroderma as the underlying cause of death. The age-adjusted mortality rate was 3.962 per million (95% CI: 3.912–4.012), decreasing progressively from 4.679 (95%CI: 4.423–4.934) in 1999 to 2.993 (95% CI: 2.817–3.170) per million in 2017. The age-adjusted mortality rate was 5.885 (95% CI: 5.802–5.967) and 1.651 (95% CI: 1.604–1.698) per million in females and males, respectively. Per races, the highest age-adjusted mortality rate was in Blacks or African Americans, at 5.703 per million (95% CI: 5.521–5.885), followed by American Indians or Alaska Native at 5.047 per million (95% CI: 4.428–5.667). Clusters of states with higher and lower mortality rates were identified. South Dakota had the highest whereas Hawaii had the lowest mortality rate. Conclusion: We found a trend to a progressive decrease in mortality rates of scleroderma during the years of our study. In addition, we found relevant state-by-state variation in mortality with several geographical clusters with higher mortality rates. Further analyses are warranted in order to better understand the factors associated with the observed geographic disparities.
Retinal Vascular Changes on Optical Coherence Tomography Angiography and Ultra-widefield Fluorescein Angiography in Patients With Chronic Leukemia
Authors: Liu T. Y. Alvin , Smith B. Douglas , Mackey Karen , Linz Marguerite O. , Scott Adrienne W. 
Published: August 2019

Purpose: This article describes pathological retinal vascular changes on multimodal imaging in patients with chronic leukemia. Methods: A prospective, observational study was conducted. Patients with chronic leukemia and concurrent leukocytosis were recruited from a tertiary-referral, academic medical center. Eligible patients received complete ophthalmic examinations and multimodal retinal imaging: spectral-domain optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCTA), and ultra-widefield fluorescein angiography (UWF FA). Results: Six patients (11 eyes) were consecutively enrolled. At presentation, mean age was 56.9 years, median visual acuity was Snellen 20/20, and median leukocyte count was 114.5 K/mm3 (upper limit of normal: 11.00). Three of 11 eyes had SD-OCT abnormalities, including focal retinal thinning and hyperreflective material at the level of the retinal pigment epithelium. Five of 11 eyes showed OCTA abnormalities, including focal vascular flow loss and a diffuse decrease in vascular density. Four of 11 eyes had peripheral retinal abnormalities on UWF FA, including microaneurysms and nonperfusion. Five of 11 eyes showed pathological vascular changes on retinal imaging, and of these 5 eyes, 3 had unremarkable retinal examinations. Conclusions: Retinal vascular pathologies are frequently seen in patients with chronic leukemia and concurrent leukocytosis, though these patients are rarely symptomatic. Multimodal imaging allows for more sensitive detection of these pathologies compared with clinical examination alone. On OCTA, pathological vascular flow loss is more evident in the superficial capillary plexus. There may be a correlation between pathologies seen in the central and peripheral retina, but this observation will need to be confirmed by a future study with a larger cohort.