bluuebunny/crossref_metadata_2025_split huggingface dataset:
Onset of action of naldemedine in the treatment of opioid-induced constipation in patients with chronic noncancer pain: results from 2 randomized, placebo-controlled, phase 3 trials
Authors: Wild James , Yamada Tadaaki , Arjona Ferreira Juan Camilo , Hale Martin 
Published: May 2019

Abstract
Opioid-induced constipation (OIC) is a common side effect of chronic opioid therapy. Previously, naldemedine, a peripherally acting μ-opioid receptor antagonist demonstrated efficacy in the treatment of OIC. In this exploratory analysis, the onset of action of naldemedine was evaluated in 2 identically designed phase 3, randomized, placebo-controlled trials. Proportion of patients experiencing a spontaneous bowel movement (SBM) within 24 hours of treatment initiation, time from initial dose to first SBM and weekly SBM frequency were assessed. Naldemedine was associated with significant increases in the proportion of patients experiencing an SBM at 4, 8, 12, and 24 hours after the initial dose compared with placebo (all P < 0.0001). Within 24 hours in both studies, statistically significantly (P < 0.0001) more patients treated with naldemedine compared with placebo experienced an SBM (61.2% vs 28.3% and 56.5% vs 33.6%, respectively). Median times to first SBM were significantly shorter in the naldemedine group vs placebo (COMPOSE-1, 16.1 vs 46.7 hours; COMPOSE-2, 18.3 vs 45.9 hours; P < 0.0001). Naldemedine was also associated with significant increases in weekly SBM frequency vs placebo within 1 week (P < 0.001). Most common treatment-emergent adverse events were gastrointestinal-related (abdominal pain, diarrhea, and nausea). Treatment-emergent adverse events were reported most frequently on day 1, followed by a decrease from days 2 to 7. Naldemedine had a timely onset of effect, and gastrointestinal adverse events largely resolved within the first week. These findings should assist clinicians counseling patients with chronic noncancer pain on expectations when initiating naldemedine for OIC.
Elevated neutrophil gelatinase-associated lipocalin levels before contrast media administration among ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention
Authors: Rozenfeld Keren-Lee , Zahler David , Shtark Moshe , Goldiner Ilana , Keren Gad , Shacham Yacov 
Published: May 2019

Background
Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein released by renal tubular cells upon nephrotoxic or ischemic events and is considered an early marker of tubular damage. We aimed to demonstrate the presence of early renal injury detected by elevated NGAL levels taken before contrast administration in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).

Patients and methods
We prospectively included 88 patients with STEMI treated with PCI. Blood samples for plasma NGAL were drawn immediately before PCI (baseline NGAL; NGAL1) and 24 h after PCI (NGAL2). Abnormal elevations in NGAL levels were defined using the cardiac surgery associated NGAL score (NGAL score) with NGAL levels at least 100 ng/ml, suggesting renal tubular damage. Patients were also assessed for the dynamics between NGAL2 and NGAL1 levels.

Results
The mean age of the patients was 62 ± 13 years and 78% were men. A total of 50/88 (56%) patients had baseline NGAL level of at least 100, suggesting possible tubular damage before PCI. Only 10 patients progressed to clinical acute kidney injury during hospitalization, all of whom had baseline NGAL level of at least 100 (P < 0.001). Among patients with baseline NGAL at least 100, 28/50 (56%) showed a decrease in the NGAL level within 24 h, whereas only 9/50 (18%) showed an elevation in the NGAL level. In contrast, only 7/38 (19%) patients with baseline NGAL level less than 100 showed an elevation in NGAL levels within 24 h.

Conclusion
Elevated NGAL levels before primary PCI suggesting renal tubular damage are common among STEMI patients. Further trials are needed to assess the complex cardio–renal interactions.
CD4+CD25+Foxp3+ regulatory T cells suppress NKG2D-mediated NK cell cytotoxicity in peripheral blood
Authors: Geng Xu , Li Ming , Cui Bin , Lu Chao , Liu Xiaowen , Zhang Peng , Liu Bin , Ma Chunyan , Shen Yajuan , Lu Zhiming 
Published: May 2019

Abstract

Background:
Studies have shown that CD4+CD25+Foxp3+Treg cells suppress NKG2D expression on NK cells via a cell contact-dependent mechanism and increased TGF-β and IL-10 production in some cancer models. We herein aimed to explore whether CD4+CD25+Foxp3+Tregs suppress NKG2D-mediated NK cell cytotoxicity in peripheral blood and elucidate the exact mechanism underlying this phenomenon.

Methods:
To explore the function of NKG2D, NK cell cultures were treated with an NKG2D-blocking antibody to block these receptors. Additionally, TGF-β- and IL-10-blocking antibodies were added to NK and CD4+CD25+Foxp3+Treg cell cocultures to evaluate whether the latter cells suppress NKG2D expression of NK cells via increasing the production of TGF-β and IL-10. The expression of NKG2D on NK cells was detected by 3-color flow cytometry, and NK cell activity was assessed by 3 assays: a nonradioactive cytotoxicity assay, an ELISA measuring IFN-γ production and a flow cytometry assay to evaluate CD107a expression.

Results:
Blocking NKG2D decreased NK cell cytotoxicity, IFN-γ production and CD107a expression. Moreover, blocking TGF-β and IL-10 substantially increased the NKG2D expression in NK and CD4+CD25+Foxp3+Treg cell cocultures. Similarly, blocking TGF-β and IL-10 enhanced NK cell cytotoxicity, IFN-γ production and CD107a expression; Transwell insert assays also revealed increased IFN-γ production and CD107a and NKG2D expression.

Conclusion:
CD4+CD25+Foxp3+Tregs suppress NKG2D-mediated NK cell cytotoxicity in peripheral blood via a cell contact-dependent mechanism and increased TGF-β and IL-10 production.
Robot-assisted and laparoscopic vs open radical prostatectomy in clinically localized prostate cancer: perioperative, functional, and oncological outcomes
Authors: Cao Lan , Yang Zhenyu , Qi Lin , Chen Minfeng 
Published: May 2019

Abstract

Background:
To perform a systematic review and meta-analysis evaluating the perioperative, functional, and oncological outcomes and cost of robot-assisted radical prostatectomy (RARP), or laparoscopic radical prostatectomy (LRP) comparing with open radical prostatectomy (ORP) in men with clinically localized prostate cancer through all prospective comparative studies.

Methods:
A comprehensive literature search was performed in August 2018 using the Pubmed, Medline, Embase, and Cochrane databases. Only randomized controlled trials (RCTs) and prospective studies including patients with clinically localized prostate cancer were eligible for study inclusion. Cumulative analysis was conducted using Review Manager v. 5.3 software.

Results:
Two RCTs and 9 prospective studies were included in this systematic review. There were no significant differences between RARP/LRP and ORP in overall complication rate, major complication rate, overall positive surgical margin (PSM) rate, ≤pT2 tumor PSM rate, ≥pT3 tumor PSM rate. Moreover, RARP/LRP and ORP showed similarity in biochemical recurrence (BCR) rate at 3, 12, 24 months postoperatively. Urinary continence and erectile function at 12 months postoperatively between RARP and ORP are also comparable. RARP/LRP were associated with significantly lower estimated blood loss [mean difference (MD) −749.67, 95% CI −1038.52 to −460.82, P = .001], lower transfusion rate (OR 0.17, 95% CI 0.10 to 0.30, P < .001) and less hospitalization duration (MD −1.18, 95% CI −2.18 to −0.19, P = .02). And RARP/LRP required more operative time (MD 50.02, 95% CI 6.50 to 93.55, P = .02) and cost.

Conclusion:
RARP/LRP is associated with lower blood loss, transfusion rate and less hospitalization duration. The available data were insufficient to prove the superiority of any surgical approach in terms of postoperative complications, functional and oncologic outcomes.
Decreased let-7b is associated with poor prognosis in glioma
Authors: Zhang Wanzeng , Zhao Wangmiao , Ge Chunyan , Li Xiaowei , Yang Xuehui , Xiang Yi , Sun Zhaosheng 
Published: May 2019

Abstract
Abnormal expression of let-7b has been observed in many tumors, including glioma. However, the clinical significance of let-7b in glioma remained unclear. The aim of the study was to explore the correlation of let-7b expression with clinicopathological factors and prognosis in human glioma.
Quantitative real-time polymerase chain reaction (qRT-PCR) was carried out to detect the relative expression of let-7b in glioma tissues. The association of let-7b expression with clinicopatholoigcal features of glioma patients was estimated using chi-square test. Overall survival curves were plotted using Kaplan–Meier method with log rank test. The prognosis analysis was performed using Cox regression model, and the results were shown as hazard ration (HR) with 95% confidence interval (CI).
The relative expression of let-7b was significantly lower in glioma tissues than that in normal brain tissues (P < .001). Furthermore, let-7b level was closely correlated with World Health Organization (WHO) grade (P = .027) and Karnofsky performance score (KPS) (P = .018). Survival analysis indicated that glioma patients with low let-7b expression had significantly shorter overall survival time than those with high expression (log rank test, P < .001). Let-7b might be an independent prognostic biomarker for glioma (P < .001, HR = 2.415; 95% CI: 1.531–3.808).

Let-7b may be a promising prognostic factor in glioma.
A high mutation rate of immunoglobulin heavy chain variable region gene associates with a poor survival and chemotherapy response of mantle cell lymphoma patients
Authors: Li Xianqian , Wu Ning , Li Bin 
Published: May 2019

Abstract
Immunoglobulin heavy chain variable region (IGHV) gene mutation status is a biomarker for the prognosis of chronic lymphocytic leukemia, whether it is associated with the diagnosis, staging, and prognosis of patients with mantle cell lymphoma (MCL) remains to be determined.
The IGHV gene mutations of 52 MCL patients were determined by DNA sequencing and compared with published IGHV germline sequences.
DNA sequence alignment of IGHV variable regions with published IGHV germline sequences showed that the coincidence rate was 94% to 100%. Ten cases (21%) were significantly mutated with the rate of 96.9% to 94.0%. The overall survival time of patients was negatively correlated with the degree of IGHV gene mutation. Further survival analysis with log-rank test demonstrated that the patients with significant IGHV gene mutations showed a trend towards poor survival.
The mutation rate of the IGHV variant region may be determined to assess the prognosis and overall survival time of MCL patients.
The association between occupational stress and psychosomatic wellbeing among Chinese nurses
Authors: Gu Bo , Tan Qiling , Zhao Shangping 
Published: May 2019

Abstract
Occupational stress impairs nurses’ psychosomatic wellbeing, which includes anxiety, depression, sleep quality, and somatic symptoms; however, few studies have focused on the associations between the subdimensions of occupational stress [workload and time pressure (WTP), professional and career issues (PC), patient care and interaction (PCI), interpersonal relationships and management problems (IRMP), resource and environment problem (REP)] and psychosomatic wellbeing among nurses in China. This study thus examined these associations using a cross-sectional survey in Sichuan, China. An online application was devised to collect data, with the scales of sociodemographic and occupational variables, Nurse Job Stressor Questionnaire, the 9- and 15-item Patient Health Questionnaires, the 7-item Generalized Anxiety Disorder scale, and the Pittsburgh Sleep Quality Index. Investigation was completed by 2889 nurses (96.7% women; mean age = 31.20 ± 6.72 years). Relationships were identified by correlation and multivariate regression analyses. Most (68.3%) nurses had high levels of occupational stress. The multivariate analyses revealed that WTP was correlated with anxiety (P = .003). PC was associated with depression (P = .033) and sleep quality (P = .078). PCI was correlated with anxiety (P = .031) and somatic symptoms (P = .005). IRMP was associated with anxiety (P = .018), depression (P = .001), and somatic symptoms (P = .025). Lastly, REPs had nonsignificant relationships with depression, anxiety, sleep quality, and somatic symptoms. In sum, nurses had high levels of occupational stress; therefore, a series of strategies should be implemented to help nurses cope with the above issues, which could promote nurses’ psychosomatic wellbeing, and have a buffering effect on nurses’ depression, anxiety, poor sleep quality, and somatic symptoms.
A meta-analysis of the diagnostic value of microRNA-1246 for malignant tumors
Authors: Xie Chunlin , Huang Tao , Teng Zhaowei , Xu Shuanglan , Bu Junhui , Li Mengzhou , Zhang Yibing , Zhang Jing 
Published: May 2019

Abstract

Background:
Cancer morbidity and mortality are growing rapidly worldwide. There have been an increasing number of studies on the correlation between miRNA1246 expression in circulating blood and tumors; however, no comprehensive conclusion has been reached. Therefore, this meta-analysis was carried out to systematically evaluate the diagnostic value of blood levels of microRNA-1246 for malignant tumors.

Methods:
We searched PubMed, MEDLINE, Embase, The Cochrane Library, the China National Knowledge Internet (CNKI), and Wanfang databases from the inception of each database until November 2018. The quality of the included literature was evaluated using the quality assessment tool called Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The data were pooled using Stata14 and Meta-DiSc 1.4 software.

Results:
Seven studies were included. The pooled sensitivity (SENS) was 0.80 (95% CI 0.65–0.89), the pooled specificity (SPEC) was 0.77 (95% CI 0.70–0.83), the pooled positive likelihood ratio (PLR) was 3.55 (95% CI 2.53–4.99), the pooled negative likelihood ratio (NLR) was 0.26 (95% CI 0.16–0.47), the pooled diagnostic odds ratio (DOR) was 13.78 (95% CI 5.84–32.5), and the area under the curve (AUC) was 0.83 (95% CI 0.79–0.86). The result of Deeks’ funnel plot was P = 0.31, indicating a lack of publication bias.

Conclusion:
MicroRNA-1246 in the blood can be used as a good indicator for the diagnosis of malignant tumor diseases and has a moderate diagnostic accuracy for the differentiation of patients with malignant tumors from healthy people.
Typical manifestations of Hürthle cell adenoma of the thyroid on contrast-enhanced CT
Authors: Deng Dayong , Chen Xi , Wang Hongru , Wu Haidi 
Published: May 2019

Abstract

Rationale:
Hürthle cell adenoma (HCA) of the thyroid is a rare thyroid tumor, and there are limited studies on the contrast-enhanced computed tomography (CT).

Patient concerns:
We report the case of a 63-year-old woman with gradual enlargement of the thyroid over 10 years.

Diagnoses:
Preoperative contrast-enhanced CT revealed typical lesion characteristics of HCA, confirmed by postoperative pathology.

Interventions:
Left thyroidectomy and partial right thyroidectomy were performed on the patient after general anesthesia.

Outcomes:
At follow-up of 12 months after surgery, the patient was in good health without recurrence.

Lessons:
The typical imaging features of HCA on contrast-enhanced CT are helpful for the early diagnosis of thyroid eosinophilic adenoma. This will provide an important basis for the preoperative diagnosis and treatment strategy of HCA of the thyroid in future.
Increased risk of gallstones after gastrectomy
Authors: Kim So Young , Bang Woo Jin , Lim Hyun , Lim Man Sup , Kim Miyoung , Choi Hyo Geun 
Published: May 2019

Abstract
This study sought to evaluate the association between gastrectomy and the occurrence of gallstones using a national sample cohort from Korea.
Data from 2002 to 2013 were collected for individuals ≥20 years of age in the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC). We extracted data for patients who had undergone gastrectomy (n = 1998) and a 1:4 matched control group (n = 7992) and then analyzed the occurrence of gallstones. The patients were matched according to age, sex, income, region of residence, hypertension, diabetes mellitus, and history of dyslipidemia. Gastrectomies were identified using operation codes (Q2533-Q2537, Q2594-Q2596, and Q2598). Gallstones were diagnosed if the corresponding International Classification of Disease-10 code (K80) was reported ≥2 times. Crude (simple) and adjusted hazard ratios (HRs) were analyzed using Cox proportional hazard models, and 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed based on age and sex.
The adjusted HR for gallstones was 1.77 (95% CI = 1.34–2.35, P < .001) in the gastrectomy group compared to control. Consistent HRs were found in the analyses of all of the subgroups determined using age and sex.
The occurrence of gallstones was increased in the patients who had undergone gastrectomy compared to their matched control group.
Post-stroke rehabilitation
Authors: Rakesh Neal , Boiarsky Daniel , Athar Ammar , Hinds Shaliesha , Stein Joel 
Published: May 2019

Abstract
The aim of this study was to examine predictors of discharge of hospitalized stroke patients to either an acute inpatient rehabilitation facility (IRF) or subacute skilled nursing facility (SNF).
A retrospective cohort study was done in a large multicampus urban academic medical center of individuals hospitalized for stroke between January 1, 2015 and December 31, 2015 and who were discharged to either an IRF (n = 84) or SNF (n = 59). A set of characteristics and scales were collected on each patient and assessed using univariate and multivariate regression analyses.
Although univariate analyses revealed multiple measures were associated with discharge destination, the most predictive multivariate logistic regression model for discharge to SNF incorporated age (odds ratio [OR] = 1.09, 95% confidence interval [CI], 1.05–1.13), premorbid physical disability (OR 7.52, 95% CI 1.66–34.14), and inability to ambulate before discharge (OR 5.84, 95% CI 2.01–16.92) with an overall c-statistic of 0.85.
Increasing age, premorbid physical disability, and inability to ambulate increase the overall likelihood of discharge to a SNF. These findings need to be replicated in larger samples to determine whether they are generalizable.
Ultra-low-dose chest computed tomography for interstitial lung disease using model-based iterative reconstruction with or without the lung setting
Authors: Hata Akinori , Yanagawa Masahiro , Honda Osamu , Miyata Tomo , Tomiyama Noriyuki 
Published: May 2019

Abstract
The aim of this study was to assess the effects of reconstruction on the image quality and quantitative analysis for interstitial lung disease (ILD) using filtered back projection (FBP) and model-based iterative reconstruction (MBIR) with the lung setting and the conventional setting on ultra-low-dose computed tomography (CT).
Fifty-two patients with known ILD were prospectively enrolled and underwent CT at an ultra-low dose (0.18 ± 0.02 mSv) and a standard dose (7.01 ± 2.66 mSv). Ultra-low-dose CT was reconstructed using FBP (uFBP) and MBIR with the lung setting (uMBIR-Lung) and the conventional setting (uMBIR-Stnd). Standard-dose CT was reconstructed using FBP (sFBP). Three radiologists subjectively evaluated the images on a 3-point scale (1 = worst, 3 = best). For objective image quality analysis, regions of interest were placed in the lung parenchyma and the axillary fat, and standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were evaluated. For 32 patients with clinically diagnosed idiopathic interstitial pneumonia, quantitative measurements including total lung volume (TLV) and the percentage of ILD volume (%ILDV) were obtained. The medians of 3 radiologists’ scores were analyzed using the Wilcoxon signed-rank test and the objective noise was analyzed using the paired t test. The Bonferroni correction was used for multiple comparisons. The quantitative measurements were analyzed using the Bland-Altman method.
uMBIR-Lung scored better than uMBIR-Stnd and worse than sFBP (P < .001), except for noise and streak artifact in subjective analysis. The SD decreased significantly in the order of uMBIR-Stnd, uMBIR-Lung, sFBP, and uFBP (P < .001). The SNR and CNR increased significantly in the order of uMBIR-Stnd, uMBIR-Lung, sFBP, and uFBP (P < .001). For TLV, there was no significant bias between ultra-low-dose MBIRs and sFBP (P > .3). For %ILDV, there was no significant bias between uMBIR-Lung and sFBP (p = 0.8), but uMBIR-Stnd showed significantly lower %ILDV than sFBP (P = .013).
uMBIR-Lung provided more appropriate image quality than uMBIR-Stnd. Although inferior to standard-dose CT for image quality, uMBIR-Lung showed equivalent CT quantitative measurements to standard-dose CT.
Therapeutic effects of acupuncture plus fire needle versus acupuncture alone in lateral epicondylitis
Authors: Wu Szu-Ying , Lu Cheng-Nan , Chung Chia-Jung , Kuo Chun-En , Sheen Jer-Ming , Hsueh Tun-Pin , Chen Ching-Chih , Bi Kuo-Wei 
Published: May 2019

Abstract

Background:
The aim of this study was to compare the short-term and intermediate-term efficacy of acupuncture plus fire needle therapy with that of acupuncture alone in the treatment of lateral epicondylitis (LE).

Methods:
Thirty-eight patients with LE who had persisted for at least 2 months were enrolled in this prospective, assessor-blinded, randomized controlled pilot trial. Twenty-one patients were randomized to the acupuncture plus fire needle group and 17 to the acupuncture-only group. The primary outcome was the visual analog scale pain score for the previous 24 hours and the secondary outcomes were the maximum grip strength, Patient-rated Forearm Evaluation Questionnaire score, and Medical Outcomes Study 36-Item Short-form Health Survey score. The values at baseline (pretreatment), at the end of treatment, and at 3 months after treatment were used to assess the short-term and intermediate-term effects of treatment. The data were analyzed using the Chi-square test and t test.

Results:
Within-group analyses showed better results for acupuncture plus fire needle therapy in the short term and intermediate term. Differences in the severity of pain and secondary outcomes were significant in the intermediate term in the acupuncture group. At the end of treatment, none of the differences in outcome scores were significant, except for maximum grip strength in the affected hand in the acupuncture group. No significant between-group differences in short-term or intermediate-term outcomes were observed.

Conclusion:
Acupuncture plus fire needle therapy was effective in the short term in patients seeking improvement of LE. Twelve treatments were effective for relieving pain and improving disability in the intermediate term in patients with chronic LE in both study groups. The findings of the pilot study confirm the feasibility of proceeding to a larger randomized controlled study of the longer-term effects of acupuncture plus fire needle therapy in patients with LE.