bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced Heart Rate Variability in Patients With Medically Unexplained Physical Symptoms: A Meta-Analysis of HF-HRV and RMSSD
Authors: Vreijling Sarah R. , Troudart Yael , Brosschot Jos F. 
Published: October 2020

ABSTRACT

Objective
Medically unexplained physical symptoms (MUPS) and related syndromes are common and place a substantial burden on both patients and society. Chronic psychological distress and dysregulation of the autonomic nervous system may be common factors associated with MUPS, although previous studies have reported mixed results. The aims of this meta-analysis are to provide an updated synthesis of studies investigating heart rate variability (HRV) indices associated with autonomic nervous system functioning in three common MUPS syndromes and to explain inconsistencies in previous study findings.

Methods
Literature search yielded 58 studies comparing HRV indices of reduced parasympathetic activity of healthy individuals with those of patients with chronic fatigue syndrome (n
patients = 271), irritable bowel syndrome (n
patients = 1005), and fibromyalgia (n
patients = 534). Separate random-effects meta-analyses were conducted on studies measuring root mean square of successive differences (RMSSD) and high-frequency HRV (HF-HRV).

Results
Regardless of syndrome type, patients had significantly lower RMSSD (k = 22, Hedges g = −0.37 [−0.53 to −0.21], p < .001) and HF-HRV (k = 52, Hedges g = −0.69 [−1.03 to −0.36], p < .001) than did healthy individuals. Sample age and publication year explained a substantial variation in RMSSD, whereas controlling for confounders in statistical analyses explained variation in HF-HRV.

Conclusions
Lower RMSSD and HF-HRV in patients with MUPS versus healthy controls indicates that autonomic nervous system dysregulation, particularly lower parasympathetic activity, may play a role in patients with these conditions. This conclusion may have important implications for the underlying mechanisms and treatment of MUPS and related syndromes.
Implicit Affect, Heart Rate Variability, and the Metabolic Syndrome
Authors: Gouin Jean-Philippe , Thayer Julian F. , Deschênes Sonya S. , MacNeil Sasha , Booij Linda 
Published: October 2020

ABSTRACT

Objective
Greater negative affect has been associated with an increased risk of the metabolic syndrome (METs). However, all studies to date have examined this association using explicit affect measures based on subjective ratings of emotional experiences. Prior studies suggest that implicit affect, representing the automatic, prereflective appraisal process involved in conscious emotional experiences, is associated with physiological stress responses independent of explicit affect. Furthermore, low resting heart rate variability (HRV) may increase the risk of stress-related diseases. The goals of this study were to evaluate the associations between implicit and explicit affect and METs and to assess whether these associations were amplified by lower HRV.

Methods
This secondary analysis of a larger study included 217 middle-aged women who completed measures of implicit affect, explicit affect, high-frequency HRV, and the different components of METs.

Results
There was a significant interaction between implicit negative affect and HRV predicting METs (odds ratio = 0.57, 95% confidence interval = 0.35–0.92), such that the combination of higher implicit affect and lower HRV was associated with a greater likelihood of METs. Similarly, there was a main effect of implicit negative affect as well as an interaction between implicit negative affect and HRV on the lipid accumulation product (b (standard error) = −0.06 (0.02), 95% confidence interval = −0.11 to −0.02), a combination of waist circumference and triglycerides.

Conclusions
Higher implicit negative affect in the context of lower HRV may be related to a greater risk of METs. The present findings highlight the relevance of including implicit affect measures in psychosomatic medicine research.
Preparing and Promoting Women for Leadership Positions in Radiology and the Imaging Industry
Authors: Rofsky Neil M. , Meltzer Carolyn , Chertoff Jocelyn D. , Gilbreath Rachel , Canon Cheri L. 
Published: October 2020

Abstract
A dearth of women leaders in the field of radiology and affiliated industries persists despite a recognition of the importance, value, and impact that would derive from its rectification. A targeted educational collaboration, described herein, was established between academia and industry to address this deficit and to facilitate the placement of highly qualified women into leadership positions. The actionable platform offered has the potential to narrow the gap for underrepresented groups in professional leadership positions.
Atypical Large Vessel Vasculitis Presenting With Cholestatic Liver Abnormalities
Authors: Sangha Sameet , Lenert Aleksander , Dawoud Salma , Kaur Aneet , Yazan Hasan , Voigt Michael D. , Lenert Petar 
Published: October 2020

Abstract
Clinicians usually easily recognize cranial manifestations of giant cell arteritis (GCA) such as new-onset headache, jaw claudication, scalp tenderness, and abrupt changes in visual acuity or blindness; however, when presented with an aberrant clinical course, the diagnosis becomes more elusive. In addition to temporal arteries and other extracranial branches of the carotid arteries, large vessel vasculitis (LVV) can also affect other blood vessels including coronary arteries, aorta with its major branches, intracranial blood vessels, and hepatic arteries.
Over time, the scope of the symptoms typically associated with LVV has broadened and includes cases of fever of unknown origin accompanied with other constitutional symptoms that can mimic a range of neoplastic and infectious diseases. In up to half of patients with atypical LVV, liver enzyme level elevations with a cholestatic pattern have been observed. Alkaline phosphatase level and γ-glutamyl transferase level elevations tend to be more prevalent in those LVV patients with vigorous inflammatory responses, particularly in those with fever and other nonspecific constitutional symptoms. These patients also have more profound anemia and thrombocytosis. With the exception of rare instances of vasculitides and granulomas affecting the liver tissue, liver biopsy is generally of little help and primarily shows nonspecific changes of fatty liver.
In this article, we review 3 patients who were eventually diagnosed with atypical LVV. The diagnosis was confirmed with temporal artery biopsy in 2 patients and with positron emission tomography/computed tomography in 1 patient. The common hepatic abnormality observed in all patients was the elevation of alkaline phosphatase level, which tended to respond rapidly to initiation of immunosuppressive treatment.
Dual PET Imaging of an H3K27M-Mutant Glioma With 18F-GE-180 and 18F-FET PET
Authors: Vettermann Franziska J. , Unterrainer Marcus , Ruf Viktoria , Fleischmann Daniel F. , Rupprecht Rainer , Forbrig Robert , Herms Jochen , Tonn Joerg C. , Belka Claus , Bartenstein Peter , Niyazi Maximilian , Albert Nathalie L. 
Published: October 2020

Abstract
A 25-year-old man presented with headache and intracranial pressure symptoms. On MRI, an intracranial lesion was detected in the right thalamus with exophytic growth into the third ventricle and inhomogeneous contrast enhancement without necrosis. Dual amino acid (18F-FET) and TSPO (18F-GE-180) PET imaging showed high tumor-to-background ratios in both scans and a short time-to-peak in 18F-FET uptake dynamics. Biopsy revealed a diffuse midline glioma, H3K27M-mutant (WHO grade IV), a novel entity in the 2016 WHO classification with poor clinical outcome. Our case shows that the highly aggressive features of this tumor entity can be visualized in vivo by both PET modalities.
A Peptide-Based Checkpoint Immunomodulator Alleviates Immune Dysfunction in Murine Polymicrobial Sepsis
Authors: Phares Timothy W. , Kotraiah Vinayaka , Chung Chun-Shiang , Unsinger Jacqueline , Mazer Monty , Remy Kenneth E. , Browne Cecille D. , Buontempo Peter , Mansour Marc , Pannucci James , Ayala Alfred , Hotchkiss Richard S. , Gutierrez Gabriel M. 
Published: October 2020

ABSTRACT
Sepsis-induced immunosuppression involves both innate and adaptive immunity and is associated with the increased expression of checkpoint inhibitors, such as programmed cell-death protein 1 (PD-1). The expression of PD-1 is associated with poor outcomes in septic patients, and in models of sepsis, blocking PD-1 or its ligands with antibodies increased survival and alleviated immune suppression. While inhibitory antibodies are effective, they can lead to immune-related adverse events (irAEs), in part due to continual blockade of the PD-1 pathway, resulting in hyperactivation of the immune response. Peptide-based therapeutics are an alternative drug modality that provide a rapid pharmacokinetic profile, reducing the incidence of precipitating irAEs. We recently reported that the potent, peptide-based PD-1 checkpoint antagonist, LD01, improves T-cell responses. The goal of the current study was to determine whether LD01 treatment improved survival, bacterial clearance, and host immunity in the cecal-ligation and puncture (CLP)-induced murine polymicrobial sepsis model. LD01 treatment of CLP-induced sepsis significantly enhanced survival and decreased bacterial burden. Altered survival was associated with improved macrophage phagocytic activity and T-cell production of interferon-γ. Further, myeloperoxidase levels and esterase-positive cells were significantly reduced in LD01-treated mice. Taken together, these data establish that LD01 modulates host immunity and is a viable therapeutic candidate for alleviating immunosuppression that characterizes sepsis and other infectious diseases.
Neoadjuvant S-1 With Concurrent Radiotherapy Followed by Surgery for Borderline Resectable Pancreatic Cancer
Authors: Takahashi Shinichiro , Ohno Izumi , Ikeda Masafumi , Konishi Masaru , Kobayashi Tatsushi , Akimoto Tetsuo , Kojima Motohiro , Morinaga Soichiro , Toyama Hirochika , Shimizu Yasuhiro , Miyamoto Atsushi , Tomikawa Moriaki , Takakura Norihisa , Takayama Wataru , Hirano Satoshi , Otsubo Takehito , Nagino Masato , Kimura Wataru , Sugimachi Keishi , Uesaka Katsuhiko 
Published: October 2020

Objective:This study assessed whether neoadjuvant chemoradiotherapy (CRT) with S-1 increases the R0 resection rate in BRPC.Summary of Background Data:Although a multidisciplinary approach that includes neoadjuvant treatment has been shown to be a better strategy for BRPC than upfront resection, a standard treatment for BRPC has not been established.Methods:A multicenter, single-arm, phase II study was performed. Patients who fulfilled the criteria for BRPC received S-1 (40 mg/m2bid) and concurrent radiotherapy (50.4 Gy in 28 fractions) before surgery. The primary endpoint was the R0 resection rate. At least 40 patients were required, with a 1-sidedα= 0.05 andβ= 0.05 and expected and threshold values for the primary endpoint of 30% and 10%, respectively.Results:Fifty-two patients were eligible, and 41 were confirmed to have definitive BRPC by a central review. CRT was completed in 50 (96%) patients and was well tolerated. The rate of grade 3/4 toxicity with CRT was 43%. The R0 resection rate was 52% among the 52 eligible patients and 63% among the 41 patients who were centrally confirmed to have BRPC. Postoperative grade III/IV adverse events according to the Clavien-Dindo classification were observed in 7.5%. Among the 41 centrally confirmed BRPC patients, the 2-year overall survival rate and median overall survival duration were 58% and 30.8 months, respectively.Conclusions:S-1 and concurrent radiotherapy seem to be feasible and effective at increasing the R0 resection rate and improving survival in patients with BRPC.Trial Registration:UMIN000009172
sMAdCAM:IL-6 ratio influences disease progression and anti-viral responses in SARS-CoV-2 infection
Authors: Jagtap Dhanashree , Bhor Vikrant M , Bhowmick Shilpa , Kasarpalkar Nandini , Sagvekar Pooja , Kulkarni Bhalchandra , Pathak Manish , Chatterjee Nirjhar , Dolas Pranam , Palav Harsha , Kaginkar Snehal , Bhagat Sharad , Munshi Itti , Parikh Swapneil , Agrawal Sachee , Pawar Chandrakant , Kaneria Mala , Mahale Smita D , Shastri Jayanthi , Patel Vainav 
Published: October 2020

AbstractRecent studies positing the gut as a sanctuary site for viral persistence in SARS-CoV-2 infection highlight the importance of assimilating profiles of systemic as well as gut inflammatory mediators to understand the pathology of COVID-19. Also, the role of these markers in governing virus specific immunity following infection remains largely unexplored. A cohort (n=84) of SARS-C0V-2 infected individuals included a group of in-patients (n=60) at various stages of disease progression together with convalescent individuals (n=24) recruited between April and June 2020 from Mumbai, India. Follow-up of 35 in-patients at day 7 post diagnosis was carried out. Th1/Th2/Th17 cytokines along with soluble MAdCAM (sMAdCAM) levels in plasma were measured. Also, anti-viral humoral response as measured by rapid antibody test (IgG, IgM), Chemiluminescent Immunoassay (IgG) and antibodies binding to SARS-CoV-2 proteins were measured by Surface Plasmon Resonance (SPR) from plasma.IL-6 and sMAdCAM levels among in-patients inversely correlated with one another. When expressed as a novel integrated marker –sMIL index (sMAdCAM/IL-6 ratio), these levels were incrementally and significantly higher in various disease states with convalescents exhibiting the highest values. Importantly, sMAdCAM levels as well as sMIL index (fold change) correlated with peak association rates of receptor binding domain and fold change in binding to spike respectively as measured by SPR. Our results highlight key systemic and gutassociated parameters that need to be monitored and investigated further to optimally guide therapeutic and prophylactic interventions for COVID-19.
p-tau/Aβ42 Ratio Associates with Cognitive Decline in Alzheimer’s disease, Mild Cognitive Impairment, and Cognitively Unimpaired Older Adults
Authors: Prakash Ruchika Shaurya , McKenna Michael R. , Gbadeyan Oyetunde , Andridge Rebecca , Scharre Douglas W. ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: October 2020

AbstractINTRODUCTIONThe most well-studied biomarkers in AD are CSF amyloid beta-42 (Aβ42), tau, p-tau, and the ratio p-tau/Aβ42. The ratiometric measure of p-tau/Aβ42shows the best diagnostic accuracy, and correlates reliably with metrics of cognition in unimpaired participants. However, no study has examined the impact of the CSF p-tau/Aβ42ratio in predicting cognitive decline in both healthy and AD individuals in one sample. The goal of this study was to examine whether CSF-based p-tau/Aβ42predicts changes in global cognitive functioning, episodic memory, and executive functioning over a two-year period in cognitively impaired older adults (CU), and in individuals with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD).METHODSThis study involves secondary analysis of data from 1215 older adults available in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Neuropsychological variables, collected at baseline, 6-month, 12-month, and 24-month follow-ups, included the Preclinical Alzheimer’s Cognitive Composite (PACC) to assess global cognitive functioning, ADNI-MEM to assess episodic memory functioning, and ADNI-EF to assess executive functioning. Linear mixed models were constructed to examine the effect of CSF p-tau/Aβ42, diagnostic group, and change over time (baseline, 6-month, 12-month, and 24-month) on cognitive scores.RESULTSCSF p-tau/Aβ42ratios predicted worsening cognitive impairment, both on global cognition and episodic memory in individuals with MCI and AD, but not in CU older adults and predicted decline in executive functioning for all three diagnostic groups.DISCUSSIONOur study, including CU, MCI, and AD individuals, provides evidence for differential cognitive consequences of accumulated AD pathology based on diagnostic groups.
m6A RNA methylation regulators contribute to progression and impact the prognosis of breast cancer
Authors: Jiang Wenjie , Dong Minglong , Hu Zebin , Wan Kaidi , Wang Han 
Published: October 2020

AbstractN6-methyladenosine (m6A) is the most commonly modified form of mRNA.M6ARNA methylation regulators are proved to be expressed clearly in some cancers by plenty of studies. Moreover, they also are proved to be indirectly involved in the growth of cancers. However, it remains unclear that the role ofm6ARNA methylation regulator in the prognosis of breast cancer (BRCA). The data that we used in this study is the mRNA expression data obtained from the corresponding clinical information and the Tumor Genome Atlas (TCGA) database. And the goal we used the Wilcoxon rank-sum test was to evaluate the difference in the expression ofm6ARNA methylation regulators in the normal group and the tumor group, and analyze the correlation betweenm6ARNA methylation regulators. We identified two subgroups of BRCA (cluster1 and 2) by using the K-mean algorithm and analyzing the correlation between clinic information and subgroups. The LASSO regression model then was used to figure out threem6ARNA methylation regulators, namely YTHDF3, ZC3H13, and HNRNPC. The riskScore of each patient was calculated according to the regression coefficients of the threem6ARNA methylation regulators. Base on the riskScore, we divided the patients into two groups, the high-risk group, and the low-risk group. After analyzing, we found that the overall survival rate (OS) of the low-risk group was higher than that of the other group. We conducted a univariate and multi-factor independent prognostic analysis of riskScore and threem6ARNA methylation regulators, and found that riskScore has a significant correlation with BRCA.In conclusion, them6ARNA methylation regulator is closely related to the development of BRCA, and the prognostic factor riskScore obtained from the regression of the expression of the threem6ARNA methylation regulators in the human body are likely to guide the individualization of BRCA patients A useful prognostic biomarker for treatment.
Development and Validation of a Deep Learning Model for Automated View Classification of Pediatric Focused Assessment with Sonography for Trauma (FAST)
Authors: Kornblith Aaron E. , Addo Newton , Dong Ruolei , Rogers Robert , Grupp-Phelan Jacqueline , Butte Atul , Gupta Pavan , Callcut Rachael A , Arnaout Rima 
Published: October 2020

ABSTRACTThe pediatric Focused Assessment with Sonography for Trauma (FAST) is a sequence of ultrasound views rapidly performed by the clinician to diagnose hemorrhage. One limitation of FAST is inconsistent acquisition of required views. We sought to develop a deep learning model and classify FAST views using a heterogeneous dataset of pediatric FAST. This study of diagnostic test developed and tested a deep learning model for view classification of archived real-world pediatric FAST studies collected from two pediatric emergency departments. FAST frames were randomly distributed to training, validation, and test datasets in a 70:20:10 ratio; each patient was represented in only one dataset to maintain sample independence. The outcome was the prediction accuracy of the model in classifying FAST frames and video clips. FAST studies performed by 30 different clinicians from 699 injured children included 4,925 videos representing 1,062,612 frames from children who were a median of 9 years old. On test dataset, the overall view classification accuracy for the model was 93.4% (95% CI: 93.3-93.6) for frames and 97.8% (95% CI: 96.0-99.0) for video clips. Frames were correctly classified with an accuracy of 96.0% (95% CI: 95.9-96.1) for cardiac, 99.8% (95% CI: 99.8-99.8) for thoracic, 95.2% (95% CI: 95.0-95.3) for abdominal upper quadrants, and 95.9% (95% CI: 95.8-96.0) for suprapubic. A deep learning model can be developed to accurately classify pediatric FAST views. Accurate view classification is the important first step to support developing a consistent and accurate multi-stage deep learning model for pediatric FAST interpretation.
Identifying Factors Associated with Neonatal Mortality in Sub-Saharan Africa using Machine Learning
Authors: Ogallo William , Speakman Skyler , Akinwande Victor , Varshney Kush R. , Walcott-Bryant Aisha , Wayua Charity , Weldemariam Komminist , Mershon Claire-Helene , Orobaton Nosa 
Published: October 2020

AbstractThis study aimed at identifying the factors associated with neonatal mortality. We analyzed the Demographic and Health Survey (DHS) datasets from 10 Sub-Saharan countries. For each survey, we trained machine learning models to identify women who had experienced a neonatal death within the 5 years prior to the survey being administered. We then inspected the models by visualizing the features that were important for each model, and how, on average, changing the values of the features affected the risk of neonatal mortality. We confirmed the known positive correlation between birth frequency and neonatal mortality and identified an unexpected negative correlation between household size and neonatal mortality. We further established that mothers living in smaller households have a higher risk of neonatal mortality compared to mothers living in larger households; and that factors such as the age and gender of the head of the household may influence the association between household size and neonatal mortality.
TREATMENT PROFILES AND CLINICAL OUTCOMES OF COVID-19 PATIENTS AT PRIVATE HOSPITAL IN JAKARTA
Authors: Ramatillah Diana Laila , Isnaini Suri 
Published: October 2020

AbstractBackgroundSevere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a virus that causes COVID-19, which has become a worldwide pandemic. However, until now, there is no vaccine or specific drug to prevent or treat COVID-19.ObjectivesTo find out the effective treatment as an antiviral agent for COVID-19, to determine the correlation between sociodemography with clinical outcomes and duration of treatment, and to determine the relationship between comorbidities with clinical outcomes and duration of treatment for COVID-19 patients.MethodsA prospective cohort study was conducted in this study. This study included only confirmed COVID-19 patients who were admitted to the hospital during April-May 2020. Convenience sampling was used to select 103 patients, but only 72 patients were suitable for inclusion.ResultsThe survival analysis for COVID-19 patients using the Kaplan Meier method showed that patients receiving Oseltamivir + Hydroxychloroquine had an average survival rate of about 83% after undergoing treatment for about ten days. Gender (p = 0.450) and age (p = 0.226) did not have a significant correlation with the duration of treatment for COVID-19 patients. Gender (p = 0.174) and age (p = 0.065) also did not have a significant correlation with clinical outcome of COVID-19 patients. Comorbidities showed a significant correlation with duration of treatment (p = 0.002) and clinical outcome (p = 0.014) of COVID-19 patients.ConclusionThe most effective antiviral agent in this study based on treatment duration was the combination of Oseltamivir + Hydroxychloroquine. The higher the patient’s average treatment duration, the lower the average survival rate for COVID-19 patients.