bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Vestibular Schwannoma Enlargement After Radiosurgery Using Tumor Shape and MRI Texture Features
Authors: George-Jones Nicholas A. , Wang Kai , Wang Jing , Hunter Jacob B. 
Published: October 2020

Objective:
Determine if vestibular schwannoma (VS) shape and MRI texture features predict significant enlargement after stereotactic radiosurgery (SRS).

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
Fifty-three patients were selected who underwent SRS and had a contrast-enhanced T1 sequence planning MRI scan and a follow-up contrast enhanced T1 MRI available for review. Median follow-up of 6.5 months (interquartile range/IQR, 5.9–7.4). Median pretreatment tumor volume was 1,006 mm3 (IQR, 465–1,794).

Intervention(s):
Stereotactic radiosurgery.

Main Outcome Measure(s):
Texture and shape features from the SRS planning scans were extracted and used to train a linear support vector machine binary classifier to predict post-SRS enlargement >20% of the pretreatment volume. Sensitivity, specificity, area under the receiver-operating-characteristic curve (AUC), and positive likelihood ratio were computed. A stratified analysis based on pretreatment tumor volume greater or less than the median volume was also performed.

Results:
The model had a sensitivity of 92%, specificity of 65%, AUC of 0.75, and a positive likelihood ratio of 2.6 (95% CI 1.4–5.0) for predicting post-SRS enlargement of >20%. In the larger tumor subgroup, the model had a sensitivity of 87%, specificity of 73%, AUC of 0.76, and a positive likelihood ratio of 3.2 (95% CI 1.2–8.5). In the smaller tumor subgroup, the model had a sensitivity of 95%, specificity of 50%, AUC of 0.65, and a positive likelihood ratio of 1.9 (95% CI 0.8–4.3).

Conclusions:
VS shape and texture features may be useful inputs for machine learning models that predict VS enlargement after SRS.
Convergence Vestibulo-ocular Reflex in Unilateral Vestibular Hypofunction: Behavioral Evidence in Support of a Novel Gaze Stability Exercise
Authors: Chang Tzu-Pu , Schubert Michael C. 
Published: October 2020

Background and Purpose:
Convergence of the eyes during head rotation increases the gain (eye velocity/head velocity) of the vestibulo-ocular reflex (VOR). We sought to know whether convergence would increase the VOR gain (mean + SD) in unilateral vestibular hypofunction (UVH).

Methods:
Vestibulo-ocular reflex gain during ipsi- and contralesional horizontal head rotation at near (15 cm) and far (150 cm) targets was measured in 22 subjects with UVH and 12 healthy controls. Retinal slip was estimated (retinal slip index [RSI]) as the difference between ideal VOR gain (no retinal slip) and the actual VOR gain.

Results:
Convergence did not significantly enhance VOR gain for ipsilesional rotation (mean difference, 0.04; 95% confidence interval [CI], −0.01 to 0.09), near viewing (0.77 ± 0.34) versus far viewing (0.72 ± 0.29), yet the VOR gain during contralesional rotation was greater for near viewing (1.20 ± 0.23) than for far viewing (0.97 ± 0.21; mean difference, 0.23; 95% CI, 0.13-0.32). In the 36% of subjects with recovery of their ipsilesional VOR gain, the vergence effect trended to recover (far VOR gain: 1.06 ± 0.17 vs near VOR gain 1.16 ± 0.21; mean difference, 0.10; 95% CI, −0.02 to 0.22). Ipsilesional head rotation induced greater retinal slip for near (RSI = 0.90 ± 0.34) targets than for far targets (RSI = 0.35 ± 0.29; mean difference, 0.56; 95% CI, 0.51-0.61).

Discussion and Conclusions:
The convergence-mediated VOR gain enhancement is preserved during contralesional but impaired during ipsilesional head rotation. Recovery of ipsilesional passive VOR gain does not equate to restored convergence enhancement, although it did increase ∼10%. These data suggest head motion viewing near targets will increase retinal slip, which warrants consideration as a gaze stability exercise for subjects with UVH.

Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A325).
Fecal Calprotectin Is Elevated in HIV and Related to Systemic Inflammation
Authors: Eckard Allison Ross , Hughes Heather Y. , Hagood Nancy L. , O'Riordan Mary Ann , Labbato Danielle , Kosco Julia C. , Scott Sarah E. , McComsey Grace A. 
Published: October 2020

Background:
Fecal calprotectin (FC), a biomarker of gastrointestinal (GI) inflammation, is used in the diagnosis and management of inflammatory bowel disease. HIV infection severely damages gut-associated lymphoid and epithelial tissues leading to GI inflammation that drives systemic inflammation and increases subsequent risk of comorbidities. For the first time, we compared FC concentrations by HIV and antiretroviral therapy (ART) status and determined the relationship to systemic inflammation.

Methods:
People with and without HIV were enrolled and underwent a comprehensive clinical and laboratory assessment. Stool samples were collected, and FC was measured by enzyme-linked immunosorbent assay ELISA. Plasma biomarkers of inflammation were also measured.

Results:
One hundred one participants with HIV (83 ART-treated and 18 ART-naive) and 89 uninfected controls were enrolled. There were no significant differences between ART-naive and ART-treated participants, but both HIV groups had significantly higher FC concentrations than controls when FC was considered as a continuous variable or by cut-offs used in inflammatory bowel disease. The highest median and largest proportion of participants with FC >100 µg/g were seen in ART-naive, followed by ART-treated and then controls. Among HIV participants, FC concentrations were positively associated with high-sensitivity C-reactive protein, soluble tumor necrosis factor receptor II, and soluble vascular cellular adhesion molecule and inversely associated with CD4 counts.

Conclusions:
FC concentrations are elevated in HIV regardless of ART status. ART and immune reconstitution seem to reduce FC but not to concentrations seen in uninfected controls. Our results suggest a role for FC as a noninvasive surrogate measurement of GI inflammation and associated systemic inflammation in HIV.
Association of Obesity With Lower Rates of Remission in a Colombian Cohort of Patients With Rheumatoid Arthritis
Authors: Flórez-Suárez Jorge Bruce , Mendez-Patarroyo Paul , Coral-Alvarado Paola , Quintana-López Gerardo 
Published: October 2020

Objectives
Modifiable risk factors associated with the severity of rheumatoid arthritis have been studied, including the body mass index (BMI). The aim was to compare the evolution of disease activity during 24 months of follow-up in different initial BMI groups of patients with rheumatoid arthritis.

Method
Patients were classified based on their initial BMI (normal weight, overweight, and obese). Data were collected during 24 months of follow-up. At 24 months, they were reclassified based on their BMI. The proportion of patients in each BMI category was calculated. The mean differences between the initial and final DAS-28 (Disease Activity Score 28) were calculated using the Kruskal-Wallis test. Results were stratified based on sex and age. Survival analysis and Mantel-Cox test for the achievement of sustained remission during follow-up were calculated.

Results
A total of 269 patients were included. Most patients were at the normal weight category (n = 111). Normal weight group had the highest initial score (DAS-28, 4.01). Women present higher variability in BMI and greater disease activity compared with men. Based on age group, patients between the ages 31 and 50 years are more stable in their BMI, whereas those older than 50 years had lower BMI with time. Sustained remission was achieved by 58% of patients from the normal weight group, by 57% of patients from the overweight group, and by 42% of patients from the obese group. Survival curves of the initial normal and obese groups were significantly different (p = 0.0209).

Conclusions
Patients with initial obesity were less likely to achieve remission compared with patients with initial overweight or normal weight. Sex and age affects disease activity and BMI variation.
Bilateral Peritoneoscrotal Communication—“Chicken Leg” Appearance Demonstrated on 99mTc–Sulfur Colloid Scintigraphy
Authors: Sindhu Tanigassalam , Kavanal Anwin Joseph , Goyal Harish , Mittal Bhagwant Rai , Bhattacharya Anish 
Published: October 2020

Abstract
Continuous ambulatory peritoneal dialysis is a convenient alternate form of treatment in patients receiving hemodialysis for renal failure. Sometimes during the procedure, patients may develop scrotal swelling because of patent processus vaginalis. The diagnostic utility of the peritoneal scintigraphy, an infrequently performed nuclear medicine scan to identify peritoneoscrotal communication, has been reported by many authors. Most of the previous case reports in the literature demonstrated unilateral peritoneoscrotal communication. We present an interesting 99mTc–sulfur colloid peritoneal scintigraphic image finding of bilateral peritoneoscrotal communication in a 67-year-old man who developed scrotal swelling while undergoing continuous ambulatory peritoneal dialysis.
68Ga-PSMA PET/CT With Incidental Finding of COVID-19 in an Asymptomatic Patient
Authors: Morón Sarai , González Eliana , Rojas Julián 
Published: October 2020

Abstract
A 70-year-old man with prostate adenocarcinoma was diagnosed by transrectal biopsy, with Gleason of 4 + 5 and initial PSA of 225 ng/mL since March 2020. 68Ga-PSMA PET/CT was performed as part of initial staging. The images showed an enlarged prostate with focal PSMA uptake in both lobes. Retroperitoneal and pelvic lymph nodes with moderate uptake of PSMA were shown. Another finding was a moderate PSMA uptake in the both lung parenchymas associated with opacities in CT. The patient denied any symptoms of coronavirus disease and was referred to the emergency department for RT-PCR COVID-19, and the result was positive.
A National Assessment of Trauma Systems Using the American College of Surgeons NBATS Tool: Geographic Distribution of Trauma Center Need
Authors: Dalton Michael K. , Uribe-Leitz Tarsicio , Hashmi Zain G. , Salim Ali , Haider Adil H. , Jarman Molly P. 
Published: October 2020

Objective:
To compare the needs based assessment of trauma systems (NBATS) tool estimates of trauma center need to the existing trauma infrastructure using observed national trauma volume.

Summary of Background Data:
Robust trauma systems have improved outcomes for severely injured patients. The NBATS tool was created by the American College of Surgeons to align trauma resource allocation with regional needs.

Methods:
Data from the Agency for Healthcare Research and Quality Healthcare Costs and Utilization Project State Inpatient Databases, the Trauma Information Exchange Program, and US Census was used to calculate an NBATS score for each trauma service area (TSA) as defined by the Pittsburgh Atlas. This score was used to estimate the number of trauma centers allocated to each TSA and compared to the number of existing trauma centers.

Results:
NBATS predicts the need for 117 additional trauma centers across the United States to provide adequate access to trauma care nationwide. At least 1 additional trauma center is needed in 49% of TSAs.

Conclusions:
Application of the NBATS tool nationally shows the need for additional trauma infrastructure across a large segment of the United States. We identified some limitations of the NBATS tool, including preferential weighting based on current infrastructure. The NBATS tool provides a good framework to begin the national discussion around investing in the expansion of trauma systems nationally, however, in many instances lacks the granularity to drive change at the local level.
Anti-ICOS mAb Targets Pathogenic IL-17A-expressing Cells in Canine Model of Chronic GVHD
Authors: Parker Maura H. , Stone Diane , Abrams Kraig , Johnson Melissa , Granot Noa , Storb Rainer 
Published: October 2020

Background.
Chronic graft-versus-host disease (GVHD) is a significant cause of morbidity and mortality in transplant patients. We have previously shown that 3 doses of an anti-inducible costimulator (ICOS) mAb transiently ameliorated symptoms and extended survival of dogs affected by chronic GVHD over that of control dogs. The purpose of this study was to specifically correlate changes in T-cell populations in the peripheral blood with anti-ICOS treatment and chronic GVHD progression and regression to reach a better understanding of the mechanism of the disease and prioritize future studies.

Methods.
Peripheral blood cells from canines transplanted with DLA-mismatched bone marrow and peripheral blood mononuclear cells to generate chronic GVHD were analyzed by flow cytometry using a panel of antibodies specific to helper and cytolytic T cells.

Results.
Chronic GVHD was specifically associated with an increase in CD4+ICOS+ cells, ICOS+ cells expressing IL-17A, and CD8+ cells generating granzyme B. Treatment with anti-ICOS mAb at onset of chronic GVHD symptoms specifically targeted IL-17A+-expressing cells, transiently relieved symptoms, and lengthened survival but was unable to reduce the percentage of CD8+ T-cells expressing granzyme B.

Conclusions.
These studies suggested a role for both CD4+ and CD8+ T cells in pathogenesis of chronic GVHD in the canine model. We propose that future studies should focus on further extending survival by developing a treatment that would control both CD4+ and CD8+ T cells.
Do Spike Domain Analysis Interictally Correlate With the Ictal Patterns in Temporal Lobe Epilepsy?
Authors: Radhakrishnan Ashalatha , Parameswaran Sajeesh , Chandran Anuvitha , Unnithan Gopeekrishnan , Menon Ramshekhar N. , Cherian Ajith , Thomas Sanjeev V. 
Published: October 2020

Purpose:To study if one can conceptualize the scalp ictal onset pattern through analysis of interictal spike domain analysis in temporal lobe epilepsy (TLE).Methods:Seventy-four patients with unilateral mesial temporal sclerosis (MTS) were categorized into “type A” interictal epileptiform discharges (IEDs) with negativity over infero-lateral scalp electrodes over temporal region and contralateral central region showing positivity; all IEDs other than type A were categorized as type B. The ictal electrographic patterns was termed “focal” when confined to side of MTS, was “regional” when lateralized to the ipsilateral hemisphere; “diffuse” if nonlateralized/localized; and ictal onset contralateral to MTS termed as “discordant.”Results:A total of 377 seizures and 5,476 spikes were studied. These were divided into four types: (1) type A IEDs ipsilateral to MTS (44 patients), (2) type A IEDs bitemporally (16 patients), (3) type A IEDs contralaterally (7 patients) and type B IEDs ipsilaterally, and (4) bilateral type B IEDs (7 patients). The ictal pattern was either focal or regional in 51 of 60 patients (85%) with type A IEDs; it was “diffuse” in 9 patients (15%). Diffuse ictal onset was seen in 12 of 14 (86%) with either ipsilateral/bitemporal type B IEDs. Ictal onset on the opposite hemisphere was noted in 2 (14%).Conclusions:Type A IEDs signify a focal ictal onset and type B IEDs suggest a diffuse ictal onset in patients with MTS on one side.Significance:Interictal spike domain analysis helps predicting ictal patterns in temporal lobe epilepsy.
Genetic Landscape of Gullah African Americans
Authors: Zimmerman Kip D. , Schurr Theodore G. , Chen Wei-Min , Nayak Uma , Mychaleckyj Josyf C. , Quet Queen , Moultrie Lee H. , Divers Jasmin , Keene Keith L. , Kamen Diane L. , Gilkeson Gary S. , Hunt Kelly J. , Spruill Ida J. , Fernandes Jyotika K. , Aldrich Melinda C. , Reich David , Garvey W. Timothy , Langefeld Carl D. , Sale Michèle M. , Ramos Paula S. 
Published: October 2020

AbstractObjectivesGullah African Americans are descendants of formerly enslaved Africans living in the Sea Islands along the coast of the southeastern U.S., from North Carolina to Florida. Their relatively high numbers and geographic isolation were conducive to the development and preservation of a unique culture that retains deep African features. Although historical evidence supports a West and Central African ancestry for the Gullah, linguistic and cultural evidence of a connection to Sierra Leone has led to the suggestion of this country/region as their ancestral home. This study sought to elucidate the genetic structure and ancestry of the Gullah.Materials and MethodsWe leveraged whole-genome genotype data from Gullah, African Americans from Jackson, Mississippi, Sierra Leone Africans, and population reference panels from Africa and Europe, to infer population structure, ancestry proportions, and global estimates of admixture.ResultsRelative to southeastern non-Gullah African Americans, the Gullah exhibit higher mean African ancestry, lower European admixture, a similarly small Native American contribution, and stronger male-biased European admixture. A slightly tighter bottleneck in the Gullah 13 generations ago suggests a largely shared demographic history with non-Gullah African Americans. Despite a slightly higher relatedness to Sierra Leone, our data demonstrate that the Gullah are genetically related to many West African populations.DiscussionThis study confirms that subtle differences in African American population structure exist at finer regional levels. Such observations can help to inform medical genetics research in African Americans, and guide the interpretation of genetic data used by African Americans seeking to explore ancestral identities.Research HighlightsUsing genomic data, we show that the Gullah have lower European and higher West African genomic background compared to non-Gullah African Americans, confirming their diverse African ancestry and rejecting a model that asserts a predominant Sierra Leone origin.Our data reveal a largely shared demographic history with southeastern non-Gullah African Americans, but also subtle differences related to high African genetic ancestry due to isolation in the Sea Islands.
Ongoing Global and Regional Adaptive Evolution of SARS-CoV-2
Authors: Rochman Nash D. , Wolf Yuri I. , Faure Guilhem , Mutz Pascal , Zhang Feng , Koonin Eugene V. 
Published: October 2020

AbstractUnderstanding the trends in SARS-CoV-2 evolution is paramount to control the COVID- 19 pandemic. We analyzed more than 300,000 high quality genome sequences of SARS-CoV-2 variants available as of January 2021. The results show that the ongoing evolution of SARS-CoV-2 during the pandemic is characterized primarily by purifying selection, but a small set of sites appear to evolve under positive selection. The receptor-binding domain of the spike protein and the nuclear localization signal (NLS) associated region of the nucleocapsid protein are enriched with positively selected amino acid replacements. These replacements form a strongly connected network of apparent epistatic interactions and are signatures of major partitions in the SARS-CoV-2 phylogeny. Virus diversity within each geographic region has been steadily growing for the entirety of the pandemic, but analysis of the phylogenetic distances between pairs of regions reveals four distinct periods based on global partitioning of the tree and the emergence of key mutations. The initial period of rapid diversification into region- specific phylogenies that ended in February 2020 was followed by a major extinction event and global homogenization concomitant with the spread of D614G in the spike protein, ending in March 2020. The NLS associated variants across multiple partitions rose to global prominence in March-July, during a period of stasis in terms of inter- regional diversity. Finally, beginning July 2020, multiple mutations, some of which have since been demonstrated to enable antibody evasion, began to emerge associated with ongoing regional diversification, which might be indicative of speciation.SignificanceUnderstanding the ongoing evolution of SARS-CoV-2 is essential to control and ultimately end the pandemic. We analyzed more than 300,000 SARS-CoV-2 genomes available as of January 2021 and demonstrate adaptive evolution of the virus that affects, primarily, multiple sites in the spike and nucleocapsid protein. Selection appears to act on combinations of mutations in these and other SARS-CoV-2 genes. Evolution of the virus is accompanied by ongoing adaptive diversification within and between geographic regions. This diversification could substantially prolong the pandemic and the vaccination campaign, in which variant-specific vaccines are likely to be required.
Peto odds ratios demonstrate no advantage over classic odds ratios in meta-analysis of binary rare outcomes
Authors: Xu Chang , Furuya-Kanamori Luis , Lin Lifeng , Doi Suhail A. 
Published: October 2020

AbstractIn this study, we examined the discrepancy between large studies and small studies in meta-analyses of rare event outcomes and the impact of Peto versus the classic odds ratios (ORs) through empirical data from the Cochrane Database of Systematic Reviews that collected from January 2003 to May 2018. Meta-analyses of binary outcomes with rare events (event rate ≤5%), with at least 5 studies, and with at least one large study (N≥1000) were extracted. The Peto and classic ORs were used as the effect sizes in the meta-analyses, and the magnitude and direction of the ORs of the meta-analyses of large studies versus small studies were compared. The p-values of the meta-analyses of small studies were examined to assess if the Peto and the classic OR methods gave similar results. Totally, 214 meta-analyses were included. Over the total 214 pairs of pooled ORs of large studies versus pooled small studies, 66 (30.84%) had a discordant direction (kappa=0.33) when measured by Peto OR and 69 (32.24%) had a discordant direction (kappa=0.22) when measured by classic OR. The Peto ORs resulted in smaller p-values compared to classic ORs in a substantial (83.18%) number of cases. In conclusion, there is considerable discrepancy between large studies and small studies among the results of meta-analyses of sparse data. The use of Peto odds ratios does not improve this situation and is not recommended as it may result in less conservative error estimation.