bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normative data for instrumented posturography: a systematic review and meta-analysis
Authors: Julienne Angela , Verbecque Evi , Besnard Stéphane 
Published: December 2024

Postural control is a multisensory adaptive system performing predictive (anticipatory) and/or reactive (compensatory) actions, with varying degrees of accuracy, to maintain balance in a changing environmental context. Common instrumentation to evaluate balance includes static and dynamic force platforms; added sway-referenced perturbations on the dynamic platform constitute its main advantage. Clinical applications notwithstanding, normative data are needed for interpretation in clinical settings. Posturography norms are used to compare a reference group (healthy individuals) and a specific patient population. This work, to the best of our knowledge, represents the first attempt to synthesize the literature on normative data for computerized posturography using a combined mixed method. The search strategy resulted in the retrieval of 1,244 articles from PubMed, Web of Science, and Science Direct. After deduplication, 689 articles were screened based on title and abstract. One hundred and seven articles met the criteria after the first screening. In-depth, full-text screening resulted in the inclusion of 44 studies for the systematic review and 17 studies for the meta-analyses. The main findings of the systematic review are (1) extensive heterogeneity was found in methodological characteristics, (2) there was insufficient risk of bias mitigation, (3) the majority of tasks evaluated less than four components of the systems framework for postural control (SFPC), and (4) studies mostly used distance domain sway parameters and did not report the influence of other variables on postural sway. Based on the multilevel meta-analyses, females appeared to outperform males in eyes closed (EC) conditions significantly. Based on the network meta-analyses, we found that younger children swayed more than those aged between 8 and 14 years both in eyes open (EO) conditions and EC conditions significantly. The results also revealed a significant difference in sway between individuals of age range between 50 and 79 years old and younger individuals, with more instability observed in older participants both in EO conditions and in EC conditions. Thus, future studies need to ensure that enough information about participants is provided. Standardization of experimental conditions and sway parameters harmonization are still needed to ensure high-quality assessment (QA). Finally, evidence-based postural impairment management requires both age- and sex-related normative data.Systematic review registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023378144, identifier PROSPERO 2023 CRD42023378144.
Waist-to-height ratio and body roundness index: superior predictors of insulin resistance in Chinese adults and take gender and age into consideration
Authors: Li Anxiang , Liu Yunwei , Liu Qi , Peng You , Liang Qingshun , Tao Yiming , Liu Yunyi , Cui Chongsong , Ren Qiqi , Zhou Yingling , Long Jieer , Fan Guanjie , Lu Qiyun , Liu Zhenjie 
Published: December 2024

Background and objectivesMetabolic disease has become a global health concern, and insulin resistance (IR) is a crucial underlying mechanism in various metabolic diseases. This study aims to compare the ability of seven anthropometric indicators in predicting IR in the Chinese population, and to find more sensitive and simple anthropometric indicator for early identification of IR.MethodsThis prospective cross-sectional study obtained participants’ medical history, anthropometric indicators, and serum samples from three hospitals in China. Various anthropometric indicators were calculated, including body mass index (BMI), Waist-to-hip ratio (WHR), waist-to-height ratio (WtHR), conicity index (CI), A Body Shape Index (ABSI), body roundness index (BRI), abdominal volume index (AVI). The evaluation of IR is performed using the homeostasis model assessment-insulin resistance (HOMA-IR). Logistic regression analysis examined the relationship between indicators and HOMA-IR. The ability of the anthropometric indicators to predict IR was analyzed using the receiver operating characteristic (ROC) curve. Additionally, a stratified analysis was performed to evaluate the ability of the indicators in different age and gender groups.ResultsThe study included 1,592 adult subjects, with 531 in the non-IR group and 1,061 in the IR group. After adjusting for confounding factors, the anthropometric indicators showed a positive correlation with IR in the general population and across different genders and age groups (OR &gt; 1, p &lt; 0.05), except for ABSI. In the ROC curve analysis, WtHR and BRI had the highest AUC values of 0.711 for detecting IR. The optimal cut-off value for WtHR to diagnose IR was 0.53, while for BRI, it was 4.00. In the gender-stratified and age-stratified analysis, BMI, WtHR, BRI, and AVI all had AUC values &gt;0.700 in females and individuals below 60.ConclusionWtHR and BRI demonstrated a better ability to predict IR in the overall study population, making them preferred indicators for screening IR, and gender and age are important considerations. In the stratified analysis of different genders or age, BMI, WtHR, BRI, and AVI are also suitable for detecting IR in women or individuals under 60 years old in this study.Clinical trial registrationwww.chictr.org.cn, ChiCTR2100054654.
The mediating role of vitamin D in the relationship between triglyceride glucose index and mortality in patients with diabetes mellitus: a causal mediation analysis
Authors: Zhang Fan , Li Wenjian 
Published: December 2024

ObjectiveThis study investigated the effects of triglyceride glucose index (TyG) and vitamin D levels on all-cause and cardiovascular mortality in diabetic patients and assessed the potential mediating role of vitamin D in the relationship between TyG and mortality.MethodsThe study was based on data from the National Health and Nutrition Examination Survey (NHANES) database from 2001 to 2018, which included 6,318 patients with diabetes. Multivariable Cox proportional risk regression models were employed to assess the association between TyG and vitamin D levels and the risk of death in diabetic patients. The interaction between TyG and vitamin D and its effect on mortality was explored through restricted cubic spline analysis and causal mediation analysis.ResultsThe results demonstrated that the TyG index was positively associated with all-cause and cardiovascular mortality in diabetic patients, whereas vitamin D levels were negatively associated with mortality, exhibiting an overall U-shaped association. The results indicated that vitamin D partially mediated the association between TyG and all-cause mortality. Further analysis revealed a significant mediation between vitamin D and TyG, whereby alterations in vitamin D levels influenced the impact of TyG on mortality. Subgroup analyses demonstrated that the correlation between TyG and mortality was more pronounced in diabetic patients with vitamin D insufficiency.ConclusionThe study demonstrates the mediating influence of vitamin D on the relationship between TyG and mortality in diabetic patients. This finding underscores the necessity of evaluating the influence of vitamin D on survival outcomes in individuals with disparate levels of the TyG index.
Stromal immune cells expression of Siglec-15 is associated with lower T stage and better prognosis of urinary bladder cancer
Authors: Chu Chengbiao , Fu Yao , Yang Jun , Fan Xiangshan , Shi Jiong 
Published: December 2024

IntroductionSialic acid-binding immunoglobulin-like lectin 15 (Siglec-15) is a novel immune checkpoint, similar to programmed death-ligand (PD-L1), and has emerged as a potential target for cancer immunotherapy. Until recently, little was known about the expression and role of Siglec-15 in bladder cancer (BC).MethodsIn this study, we used immunohistochemical staining to assess the expression of Siglec-15 and PD-L1 in 69 primary BC samples and analyzed their relationship with clinicopathologic characters and prognosis.ResultsThe expression rates of Siglec-15 in the tumor cells, stromal immune cells, and both the tumor and stromal cells were 84.1% (58/69), 50.7% (35/69), and 44.9% (31/69), respectively. The PD-L1 expression rate was 52.2% (36/69), with a positive rate of 17.4% (12/69). PD-L1 expression was inversely correlated with Siglec-15 expression, but the statistical significance was not achieved (P = 0.072). Low stromal Siglec-15 expression was associated with advanced tumor stage (P = 0.010). PD-L1 expression was associated with tumor stage (P = 0.008) and perineural invasion (PNI) (P = 0.048). Kaplan-Meier survival curves showed that stromal Siglec-15 expression was associated with a better prognosis (P = 0.012), although it was not an independent prognostic factor after multivariate analysis (P = 0.236) .DiscussionThis study revealed a high expression rate of Siglec-15 in BC and may provide valuable insights for patient selection in future clinical trials.
Identifying subtle differences : a radiomics model assessment for gastric schwannomas and gastrointestinal stromal tumors across risk grades
Authors: Yang Zimei , Ma Chongfei , Ren Jialiang , Li Min , Xv Xiaosheng , Fu Xin , Yang Li 
Published: December 2024

ObjectiveThis study aims to develop and validate an enhanced computed tomography (CT)-based radiomics model to differentiate gastric schwannomas (GS) from gastrointestinal stromal tumors (GIST) across various risk categories.MethodsThis retrospective analysis was conducted on 26 GS and 82 GIST cases, all confirmed by postoperative pathology. Data was divided into training and validation cohorts at a 7:3 ratio. We collected patient demographics, clinical presentations, and detailed CT imaging characteristics. Through univariable and multivariable logistic regression analyses, we identified independent predictors for discriminating between GS and GIST, facilitating the construction of a conventional model. Radiomic features were extracted and refined through manual 3D segmentation of venous phase thin-slice images to develop a radiomics model. Subsequently, we constructed a comprehensive combined model by integrating selected clinical and radiomics indicators. The diagnostic performances of all models in differentiating GS from GIST and stratifying GISTs according to malignancy risk were evaluated.ResultsWe identified several key independent variables distinguishing GS from GIST, including tumor location, cystic changes, degree of enhancement in arterial phase, and enhancement uniformity. The conventional model achieved AUCs of 0.939 and 0.869 in the training and validation cohort, respectively. Conversely, the radiomics model, predicated on eight pivotal radiomics features, demonstrated AUCs of 0.949 and 0.839. The combined model, incorporating tumor location, degree of enhancement in arterial phase, enhancement uniformity, and a radiomics model derived rad-score, significantly outperformed the traditional approach, achieving AUCs of 0.989 and 0.964 in the respective cohorts. The combined model showed superior diagnostic accuracy in distinguishing GS from GIST, as well as GS from high or low malignancy potential GISTs, as evidenced by IDI values of 0.2538, 0.2418, and 0.2749 (P&lt;0.05 for all).ConclusionThe combined model based on CT imaging features and radiomics features presents a promising non-invasive approach for accurate preoperative differentiation between gastric schwannomas and gastrointestinal stromal tumors.
Temporal and spatial trends in gastric cancer burden in the USA from 1990 to 2021: findings from the global burden of disease study 2021
Authors: Zhan Chengwei , Qiu Binxu , Wang Jun , Li Yanhua , Yu Jinhai 
Published: December 2024

BackgroundGastric cancer (GC) is a significant public health concern in the USA, and its burden is on the rise.MethodsThis study utilized the latest data from the Global Burden of Disease (GBD) study. We provided descriptive statistics on the incidence, prevalence, mortality, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of GC across the USA and states. By calculating percentage changes and average annual percentage changes (AAPC), along with conducting age-period-cohort analysis, we assessed the trends in the burden of GC. Decomposition analysis was then performed, followed by the application of an autoregressive integrated moving average (ARIMA) model to forecast changes in ASRs through 2036.ResultsFrom 1990 to 2021, the number of incidence and prevalence of GC in the USA increased, but age-standardized incidence rates (ASIR) trended downward (AAPC = -0.73, 95% confidence interval [CI]: -0.77 to -0.68) and age-standardized prevalence rates (ASPR) (AAPC = -0.99, 95% CI: -1.08 to -0.9) showed a decreasing trend. In addition, the number of deaths, DALYs, age-standardized mortality rates (ASMR) and age-standardized DALYs rates (ASDR) in GC showed a decreasing trend. The burden of GC was significantly higher in males compared to females. In addition, we found that the highest incidence and prevalence in females was in the age group of 75-79 years, whereas the highest incidence and prevalence in males was in the age group of 70-74 years.ConclusionGC is a major public health issue in the USA. Although ASIR, ASPR, ASMR, and ASDR for GC are decreasing, the number of incidence and prevalence of GC in the USA remains high, and the disease burden of GC in the USA remains high. Strengthening preventive interventions, particularly for men and patients over the age of 60, will be crucial in the future.
Case report: Improving quality of life through hyaluronic acid-based fillers after orbital cancer treatment
Authors: Egidi Sara , Valentini Valentino , Schiavetti Amalia 
Published: December 2024

BackgroundMyoepithelial carcinoma is a very rare yet aggressive tumor in children. Surgical intervention and local radiotherapy often lead to post-therapy complications, affecting both the aesthetic and functional quality of life in survivors. Hyaluronic acid (HA) dermal fillers offer a minimally invasive option to improve the appearance and quality of life for these patients once they are declared tumor-free.Case presentationWe present the case of an 18-year-old girl with a history of myoepithelial carcinoma in the right upper orbit, diagnosed at the age of 8. The patient underwent surgery to remove the tumor and lacrimal gland, followed by chemotherapy and radiotherapy. A complete response to treatment was achieved, and the patient was monitored with regular clinical and radiological exams for 5 years, after which she was declared tumor-free and followed for late effects of therapy. Post-surgical radiotherapy resulted in atrophy of the upper orbital frame and functional complications. The patient exhibited upper eyelid retraction, ptosis, continuous lacrimation, and conjunctival redness. Ten years after treatment, the patient underwent dermal filler injections using Aliaxin® Essential Volume (AEV) and Aliaxin® Superior Volume (ASV) to address the aesthetic impairment of the upper right orbit. ASV was administered using a 22G x 50mm cannula on the periosteum of the superior orbital frame, entering from the outer canthus. AEV was injected with a cannula into the muscle, also entering from the outer canthus. Before treatment, the patient exhibited upper eyelid retraction, ptosis, continuous lacrimation, and conjunctival redness. Following the injections, improvements were observed in all pre-treatment symptoms. The closing ability of the upper eyelid was restored, along with superior orbital volume and symmetry. Enhanced eyelid function improved eye hydration, reduced redness in the conjunctiva, and led to better vision and overall quality of life.ConclusionTo our knowledge, this is the first reported case of using dermal fillers to treat ocular changes resulting from cancer treatment. Injections of AEV and ASV provided both aesthetic and functional improvements.
Deep learning-based automation for segmentation and biometric measurement of the gestational sac in ultrasound images
Authors: Danish Hafiz Muhammad , Suhail Zobia , Farooq Faiza 
Published: December 2024

IntroductionMonitoring the morphological features of the gestational sac (GS) and measuring the mean sac diameter (MSD) during early pregnancy are essential for predicting spontaneous miscarriage and estimating gestational age (GA). However, the manual process is labor-intensive and highly dependent on the sonographer's expertise. This study aims to develop an automated pipeline to assist sonographers in accurately segmenting the GS and estimating GA.MethodsA novel dataset of 500 ultrasound (US) scans, taken between 4 and 10 weeks of gestation, was prepared. Four widely used fully convolutional neural networks: UNet, UNet++, DeepLabV3, and ResUNet were modified by replacing their encoders with a pre-trained ResNet50. These models were trained and evaluated using 5-fold cross-validation to identify the optimal approach for GS segmentation. Subsequently, novel biometry was introduced to assess GA automatically, and the system's performance was compared with that of sonographers.ResultsThe ResUNet model demonstrated the best performance among the tested architectures, achieving mean Intersection over Union (IoU), Dice, Recall, and Precision values of 0.946, 0.978, 0.987, and 0.958, respectively. The discrepancy between the GA estimations provided by the sonographers and the biometry algorithm was measured at a Mean Absolute Error (MAE) of 0.07 weeks.ConclusionThe proposed pipeline offers a precise and reliable alternative to conventional manual measurements for GS segmentation and GA estimation. Furthermore, its potential extends to segmenting and measuring other fetal components in future studies.
Reduced kidney size and renal function of high-grade vesicoureteral reflux and intrarenal reflux in contrast-enhanced voiding urosonography
Authors: Yan Hualin , Wu Cong , Zhou Jiehong , Huang Cairong , Ma Xue , Huang Yidong , Huang Lugang , Liu Juxian 
Published: December 2024

BackgroundVesicoureteral reflux (VUR) is a common pediatric urological condition associated with renal scarring, hypertension, and chronic kidney disease. Contrast-enhanced voiding urosonography (ceVUS) has emerged as a promising technique for diagnosing and evaluating VUR, with intrarenal reflux (IRR) often detected using this method. This study aimed to explore the relationship between different VUR grades and IRR on ceVUS, and assess the impact of VUR and IRR on kidney size and function.MethodsWe reviewed all ceVUS studies from January 2019 to December 2023 conducted at West China Hospital, Sichuan University. Both video clips and digital images of the ceVUS examinations were recorded. A total of 220 uretero-renal units (URUs) of 110 children (67 males and 43 females) were included in this study.ResultsAmong the 220 URUs assessed, 134 were diagnosed with VUR, and 25 exhibited IRR, with IRR exclusively observed in patients with grade II VUR or higher. Upon age and sex matching, the severity of IRR showed a significant positive correlation with high-grade VUR (P &lt; 0.001). Notably, patients with high-grade VUR and IRR displayed reduced kidney size compared to those without VUR or IRR (P &lt; 0.05). Furthermore, patients with high-grade VUR and IRR had reduced DMSA renal function (P = 0.015, P = 0.012, respectively), and patients with high-grade VUR had more DMSA scars (P = 0.027), compared with those without VUR or IRR.ConclusionOur study highlights that on ceVUS, the IRR degree was associated with the high-grade VUR, along with reductions in kidney size and renal function in patients with high-grade VUR and IRR.
Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients
Authors: Wawruch Martin , Petrova Miriam , Celovska Denisa , Alfian Sofa D. , Tesar Tomas , Murin Jan , Trnka Michal , Paduch Tomas , Aarnio Emma 
Published: December 2024

IntroductionThe benefit of secondary prevention in hypertensive patients with peripheral arterial disease (PAD) is based on continual simultaneous taking of statins, antiplatelet agents and antihypertensive agents, preferably angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). Our study was aimed at a) the analysis of the extent of non-persistence with multiple medication classes, and b) identifying factors associated with the likelihood of non-persistence.MethodsIn our cohort study, 3,401 hypertensive patients (1,853 females and 1,548 males) aged ≥65 years treated simultaneously with statins, antiplatelet agents and ACEIs/ARBs and in whom PAD was newly diagnosed during 2012 were analysed. A patient was classified as non-persistent when he/she was non-persistent with at least one of the three analysed medication classes. The most important characteristics associated with the probability of non-persistence were identified using the Cox regression.ResultsAt the end of the follow-up period (mean length 1.8 years), 1,869 (55.0%) patients (including 1,090 females and 779 males) were classified as non-persistent. In the whole study cohort, factors associated with non-persistence were female sex, atrial fibrillation, and being a new user of at least one of the analysed medication classes; in males, they were university education, atrial fibrillation, and epilepsy, and, in females, being a new user.ConclusionIdentification of sex differences in factors associated with non-persistence makes it possible to determine the groups of patients in whom special attention should be paid to improving their persistence with a combination of medicines in order to ensure successful secondary prevention of PAD.
The daily minimum leaf turgor pressure can represent the water status of apple trees under drip irrigation
Authors: Chen Ruixia , Xu Quanyue , Wan Junliang , Jiang Nan , Ma Juanjuan , Zheng Lijian 
Published: December 2024

IntroductionAccurate diagnosis of the water status of fruit trees is a prerequisite for precise irrigation. Measurement of leaf turgor pressure provides a means to explore the water utilization mechanisms of fruit trees and their responses to water stress. However, there are few studies on the use of daily minimum leaf turgor pressure (Ppmax) to indicate water information in apple tree.MethodsWe monitored Ppmax, stem flow rate (Vstem), leaf water potential, soil water, and the main meteorological factors under two drip irrigation levels (fully irrigated and under-irrigated) to elucidate the temporal dynamics of the daily leaf turgor minimum of apple trees and diagnose the water status of fruit trees.ResultsThe results showed that soil water deficiency could reduce leaf turgor pressure and increase Ppmax. In both years, the signal intensity and sensitivity of Ppmax were better than those of Vstem, and the sensitivity was 3.31 and 2.94 times of Vstem, respectively. Compared to Ppmax, Vstem had a higher correlation with meteorological factors and was more affected by meteorological conditions, independent of irrigation treatment. Ppmax was significantly negatively correlated with soil and leaf water potential, and its correlation coefficient was 2.58–4.89 times higher than that between Vstem and both.DiscussionThese results not only enhance our understanding of the water regulation strategies employed by apple trees under drought conditions but also provide a theoretical foundation for developing efficient water-saving practices and precision irrigation strategies for fruit trees.