bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing the efficacy of nutritional interventions on muscle mass in older adults: a systematic review and meta-analysis
Authors: Martin-Cantero Aitana , Reijnierse Esmee M , Gill Benjamin M T , Maier Andrea B 
Published: June 2020

Abstract

Context
Nutritional interventions stimulate muscle protein synthesis in older adults. To optimize muscle mass preservation and gains, several factors, including type, dose, frequency, timing, duration, and adherence have to be considered.

Objective
This systematic review and meta-analysis aimed to summarize these factors influencing the efficacy of nutritional interventions on muscle mass in older adults.

Data Sources
A systematic search was performed using the electronic databases MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus from inception date to November 22, 2017, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria included randomized controlled trials, mean or median age ≥65 years, and reporting muscle mass at baseline and postintervention. Exclusion criteria included genetically inherited diseases, anabolic drugs or hormone therapies, neuromuscular electrical stimulation, chronic kidney disease, kidney failure, neuromuscular disorders, and cancer.

Data Extraction
Extracted data included study characteristics (ie, population, sample size, age, sex), muscle mass measurements (ie, method, measure, unit), effect of the intervention vs the control group, and nutritional intervention factors (ie, type, composition, dose, duration, frequency, timing, and adherence).

Data Analysis
Standardized mean differences and 95%CIs were calculated from baseline to postintervention. A meta-analysis was performed using a random-effects model and grouped by the type of intervention.

Conclusions
Twenty-nine studies were included, encompassing 2255 participants (mean age, 78.1 years; SD, 2.22). Amino acids, creatine, β-hydroxy-β-methylbutyrate, and protein with amino acids supplementation significantly improved muscle mass. No effect was found for protein supplementation alone, protein and other components, and polyunsaturated fatty acids. High interstudy variability was observed regarding the dose, duration, and frequency, coupled with inconsistency in reporting timing and adherence. Overall, several nutritional interventions could be effective to improve muscle mass measures in older adults. Because of the substantial variability of the intervention factors among studies, the optimum profile is yet to be established.

Systematic Review Registration
PROSPERO registration no. CRD42018111306.
External Fixation Devices Within the Magnetic Resonance Imaging Bore: A Safety and Radiologic Analysis
Authors: Ryan Scott , Moon Andrew S. , Gordon Matthew , Flacke Sebastian , Soni Shalin , Salzler Matthew J. , Stelma Sarah , Marcantonio Andrew 
Published: June 2020

Objectives:
To (1) report the thermal changes encountered at the pin/skin interface in a cadaver with a knee-spanning external fixator inside the magnetic resonance imaging (MRI) bore and (2) report on the quality of the MRI sequences collected.

Methods:
Three commonly used external fixation systems were placed on cadaveric lower extremities to simulate knee external fixation. Fiber optic thermal probes were placed at the pin/skin interface of a femoral and tibial pin. A control probe was embedded in the soft tissues of the thigh. Full knee MRI scans were performed using a 1.5-Tesla magnet. Real-time thermal data were collected. A clinically significant increase in temperature compared with the control was defined as 2°C. Two blinded radiologists evaluated the images for image quality and overall diagnostic utility using a standardized 5-point grading scale.

Results:
There were statistically significant differences in the temperature changes between the femoral/tibial pin sites and the control probe sites during each phase of the MRI scan. However, there was only one clinically significant difference in temperature change during a single sequence of one MRI scan of one of the external fixator devices. Overall image quality was graded as a 4 for each image set with 100% interobserver agreement (k = 1.0).

Conclusions:
Despite significant differences in temperature changes between the pin sites and controls over multiple MRI sequences in commonly used external fixator devices, the differences in temperature change are likely not clinically relevant. Overall image quality and interpretability of the images were excellent.
Medical treatment of advanced malignant perivascular epithelioid cell tumors
Authors: Fabbroni Chiara , Sbaraglia Marta , Sanfilippo Roberta 
Published: June 2020

Purpose of review
Malignant PEComa are rare mesenchymal tumors characterized by genetic alterations actionable by target therapy. Indeed, they harbour loss of function of TSC1/TSC2, which lead to the activation of the mammalian target of rapamycin (mTOR) pathway, which is targetable therapeutically with mTOR inhibitors like sirolimus. A small subset of malignant PEComas instead harbor TFE3 gene fusions known to be mutually exclusive with TSC1/TSC2 loss-of-function mutations; therefore, leading to different therapeutic implication.

Recent findings
mTOR inhibitors showed a response rate around 40% with a median PFS of 9 months both in retrospective case series than in phase 2 prospective clinical trials, therefore, representing the most active therapeutic drug. Up to now, the issue is the lack of further therapeutic lines in the advanced setting. Chemotherapy has a marginal role, while some responses were reported using Vascular endothelial growth factor-Tyrosine kynase inhibitors (VEGF-TKI) inhibitors.

Summary
Malignant PEComas display some sensitivity to mTOR inhibitors. If progression thereto, no other drugs are available. Preclinical studies are ongoing to explore the potential combination of hormonal blockade in women and the potential use of PD1 checkpoint inhibitors.
Impact of Pain, Opioids, and the Mu-opioid Receptor on Progression and Survival in Patients With Newly Diagnosed Stage IV Pancreatic Cancer
Authors: Steele Grant L. , Dudek Arkadiusz Z. , Gilmore Grace E. , Richter Sara A. , Olson Douglas A. , Eklund Justin P. , Zylla Dylan M. 
Published: June 2020

Objectives:
Pancreatic adenocarcinoma is frequently associated with pain requiring opioid therapy. Opioids, however, have been implicated in causing tumor progression, ultimately shortening survival. We examined the impact of pain, opioid use, and the mu-opioid receptor (MOP-R) expression in tumor tissue on progression-free survival and overall survival of patients with metastatic pancreatic cancer.

Methods:
We identified 103 patients with metastatic pancreatic adenocarcinoma receiving chemotherapy and abstracted data from Tumor Registry, in addition to pain, opioid exposure, carbohydrate antigen 19-9 values, survival, and imaging response. MOP-R expression was evaluated using an immunohistochemistry assay. The association of variables with progression-free survival and overall survival was analyzed in univariate and multivariate models.

Results:
Patients with low opioid use (<5 mg oral morphine equivalent/d) survived longer than patients with high opioid (HO) use (≥5 mg oral morphine equivalent/d) (median overall survival of 315 vs. 150 d; hazard ratio [HR]=1.79; 95% confidence interval [CI]: 1.13, 2.84). This effect persisted on multivariate models (adjusted HR=2.76; 95% CI: 1.39, 5.48). Low opioid patients tended to respond better to treatment than HO patients, based on carbohydrate antigen 19-9. Patients with low MOP-R expression had longer median survival (230 vs. 193 d), though the HR was not significant (1.15; 95% CI: 0.71, 1.88). Baseline pain was not associated with outcomes.

Conclusion:
In patients with metastatic pancreatic adenocarcinoma, HO use is associated with decreased survival, but the severity of baseline pain and MOP-R expression score in tumor tissue does not correlate with clinical outcomes.
Comprehensive review of pelvic congestion syndrome: causes, symptoms, treatment options
Authors: Bendek Boleslaw , Afuape Nicole , Banks Elizabeth , Desai Nita A. 
Published: June 2020

Purpose of review
The purpose of this publication is to review the currently available and most up-to-date information regarding the pathogenesis, diagnosis, and treatment of pelvic congestion syndrome.

Recent findings
The diagnosis of pelvic congestion syndrome is difficult to make; however, it should remain on the differential for chronic pelvic pain. The most recent available research seems to favour endovascular treatment with interventional radiology over surgical management, with high success rate and low occurrence of complications.

Summary
High-level evidence on the diagnosis and management of pelvic congestion syndrome is lacking. Only a small number of randomized controlled trials exist. More high-quality research is needed, particularly involving practicing obstetrician and gynecologists as the majority of these patients, and the clinical outcomes of any interventions implemented for pelvic congestion syndrome are ultimately managed by OB/GYN providers.
Daily Morning Blue Light Therapy Improves Daytime Sleepiness, Sleep Quality, and Quality of Life Following a Mild Traumatic Brain Injury
Authors: Raikes Adam C. , Dailey Natalie S. , Shane Bradley R. , Forbeck Brittany , Alkozei Anna , Killgore William D. S. 
Published: June 2020

Objective:Identify the treatment effects of 6 weeks of daily 30-minute sessions of morning blue light therapy compared with placebo amber light therapy in the treatment of sleep disruption following mild traumatic brain injury.Design:Placebo-controlled randomized trial.Participants:Adults aged 18 to 45 years with a mild traumatic brain injury within the past 18 months (n= 35).Main Outcome Measures:Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory II, Rivermead Post-concussion Symptom Questionnaire, Functional Outcomes of Sleep Questionnaire, and actigraphy-derived sleep measures.Results:Following treatment, moderate to large improvements were observed with individuals in the blue light therapy group reporting lower Epworth Sleepiness Scale (Hedges'g= 0.882), Beck Depression Inventory II (g= 0.684), Rivermead Post-concussion Symptom Questionnaire chronic (g= 0.611), and somatic (g= 0.597) symptoms, and experiencing lower normalized wake after sleep onset (g= 0.667) than those in the amber light therapy group. In addition, individuals in the blue light therapy group experienced greater total sleep time (g= 0.529) and reported improved Functional Outcomes of Sleep Questionnaire scores (g= 0.929) than those in the amber light therapy group.Conclusion:Daytime sleepiness, fatigue, and sleep disruption are common following a mild traumatic brain injury. These findings further substantiate blue light therapy as a promising nonpharmacological approach to improve these sleep-related complaints with the added benefit of improved postconcussion symptoms and depression severity.
Mitochondrial dysfunction in critical illness during acute metabolic stress and convalescence: consequences for nutrition therapy
Authors: Moonen Hanneke Pierre Franciscus Xaverius , Van Zanten Arthur Raymond Hubert 
Published: June 2020

Purpose of review
Mitochondrial dysfunction is associated with increased morbidity and mortality during and after critical illness. The concept of adaptive mitochondrial metabolic-bio-energetic downregulation rather than bio-energetic failure during the acute phase of critical illness has gained traction. As mitochondria are not able to utilize substrate during adaptive hibernation and aggressive feeding induces further harm, this condition has consequences for nutrition therapy.

Recent findings
Meeting resting energy expenditure in early critical illness is associated with enhanced oxidative stress and attenuation of autophagy, as is hyperglycemia. The negative effect of early high protein administration remains unclear, whereas fat appears bio-energetically inert. Although antioxidant micronutrients are essential to mitochondrial function, high-dosage studies of single vitamins (C and D) failed to show benefit. Convalescence probably requires increased micronutrient and macronutrient administration to aid anabolism and restore mitochondrial function, although robust data on requirements and actual intake are lacking.

Summary
Optimal nutrition therapy in the early phase of critical illness should avoid overfeeding and preserve (adaptive) mitochondrial function. Micronutrient supplementation probably requires a strategic cocktail instead of a high dosage of a single nutrient. Focus on identification of distinct metabolic phases to adapt nutrition during and after critical illness is essential.
Artificial intelligence in transplantation (machine-learning classifiers and transplant oncology)
Authors: Ivanics Tommy , Patel Madhukar S. , Erdman Lauren , Sapisochin Gonzalo 
Published: June 2020

Purpose of review
To highlight recent efforts in the development and implementation of machine learning in transplant oncology – a field that uses liver transplantation for the treatment of hepatobiliary malignancies – and particularly in hepatocellular carcinoma, the most commonly treated diagnosis in transplant oncology.

Recent findings
The development of machine learning has occurred within three domains related to hepatocellular carcinoma: identification of key clinicopathological variables, genomics, and image processing.

Summary
Machine-learning classifiers can be effectively applied for more accurate clinical prediction and handling of data, such as genetics and imaging in transplant oncology. This has allowed for the identification of factors that most significantly influence recurrence and survival in disease, such as hepatocellular carcinoma, and thus help in prognosticating patients who may benefit from a liver transplant. Although progress has been made in using these methods to analyse clinicopathological information, genomic profiles, and image processed data (both histopathological and radiomic), future progress relies on integrating data across these domains.
Application of Suprafascially Harvested Anterolateral Thigh Perforator Flap for the Reconstruction of Oral and Maxillofacial Defects
Authors: Zhang Shanshan , Li Panchun , Liu Chang , Wu Hanjiang , Gong Zhaojian 
Published: June 2020

Purpose:
The aim of this study was to evaluate the feasibility and efficacy of the suprafascially elevated anterolateral thigh (ALT) perforator flap for reconstructing oral and maxillofacial defects.

Patients and Methods:
The authors analyzed a retrospective case series of 15 patients who underwent reconstruction of oral and maxillofacial defects with the suprafascially raised ALT perforator flap from June 2015 through January 2017 at the Second Xiangya Hospital. The flap harvest and the methods for defect reconstruction are described, and the reconstructive efficacy is reported.

Results:
Of the 15 patients, 12 were men, and 3 were women, with an average age of 49.5 years. Postoperatively, all flaps survived completely, without vascular compromise or major wound complications. All patients were followed for approximately 1 to 37 months, and they were satisfied with the esthetic and functional results of the recipient- and donor- sites after the reconstruction.

Conclusions:
Because of the reduced donor-site complications, satisfactory esthetic and functional results, and high success rate of flap transplantation, the use of suprafascially harvested ALT perforator flap is a good choice for the reconstruction of oral and maxillofacial defects, in cases in which the fascia lata is not needed.
Cardiopexy at the Time of Sleeve Gastrectomy as a Preventive Measure for Reflux
Authors: Moon Rena C. , Teixeira Andre F. , Treto Jessica , Jawad Muhammad A. 
Published: June 2020

Background:
One of the most significant concerns after laparoscopic sleeve gastrectomy (LSG) is the new-onset or worsening of gastroesophageal reflux disease (GERD). Some patients with LSG undergo a conversion to Roux-en-Y gastric bypass (RYGB) because of severe GERD. Cardiopexy at the time of LSG may help prevent GERD. This study aims to examine the safety and effectiveness of cardiopexy at the time of LSG.

Methods:
A retrospective chart review was performed on 161 consecutive patients who underwent LSG between May 1, 2017 and April 30, 2018. Of these, 79 underwent cardiopexy at the time of LSG. Weight, comorbidities, and complications were recorded at 6 months after LSG.

Results:
Baseline characteristics were similar between the cardiopexy and noncardiopexy groups of patients. In the cardiopexy group, 8 (10.1%) patients reported having GERD at the time of LSG, whereas 12 (14.6%) patients did in the noncardiopexy group. At 6 months after the procedure, 5 (8.9%) patients in the cardiopexy group reported symptoms of GERD, whereas 14 (17.7%) patients did in the noncardiopexy group (P=0.15). One (1.3%) patient in the cardiopexy group and 2 (2.4%) patients in the noncardiopexy group were converted to an RYGB because of severe reflux (P=0.58). The percentage of excess body mass index loss and the percentage of total weight loss were similar between the 2 groups.

Conclusion:
Cardiopexy was not associated with a reduced rate of symptomatic GERD and conversion to RYGB after 6 months.
COVID-19 Trend and Forecast in India: A Joinpoint Regression Analysis
Authors: Chaurasia Aalok Ranjan 
Published: June 2020

AbstractThis paper analyses the trend in daily reported confirmed cases of COVID-19 in India using joinpoint regression analysis. The analysis reveals that there has been little impact of the nation-wide lockdown and subsequent extension on the progress of the COVID-19 pandemic in the country and there is no empirical evidence to suggest that relaxations under the third and the fourth phase of the lockdown have resulted in a spike in the reported confirmed cases. The analysis also suggests that if the current trend continues, in the immediate future, then the daily reported confirmed cases of COVID-19 in the country is likely to increase to 21 thousand by 15 June 2020 whereas the total number of confirmed cases of COVID-19 will increase to around 422 thousand. The analysis calls for a population-wide testing approach to check the increase in the reported confirmed cases of COVID-19.
The Aging Slow Wave: A Shifting Amalgam of Distinct Slow Wave and Spindle Coupling Subtypes Define Slow Wave Sleep Across the Human Lifespan
Authors: McConnell Brice V. , Kronberg Eugene , Teale Peter D. , Fishback Grace M. , Kaplan Rini I. , Sillau Stefan H. , Fought Angela J. , Dhanasekaran A. Ranjitha , Berman Brian D. , Ramos Alberto R. , McClure Rachel L. , Bettcher Brianne M. 
Published: June 2020

AbstractStudy ObjectivesSlow wave and spindle coupling supports memory consolidation, and loss of coupling is linked with cognitive decline and neurodegeneration. Coupling is proposed to be a possible biomarker of neurological disease, yet little is known about the different subtypes of coupling that normally occur throughout human development and aging. Here we identify distinct subtypes of spindles within slow wave upstates and describe their relationships with sleep stage across the human lifespan.MethodsCoupling within a cross-sectional cohort of 582 subjects was quantified from stages N2 and N3 sleep across ages 6-88 years old. Results were analyzed across the study population via mixed model regression. Within a subset of subjects, we further utilized coupling to identify discrete subtypes of slow waves by their coupled spindles.ResultsTwo different subtypes of spindles were identified during the upstates of (distinct) slow waves: an “early-fast” spindle, more common in stage N2 sleep, and a “late-fast” spindle, more common in stage N3. We further found stages N2 and N3 sleep are composed of two discrete subtypes of slow waves, each identified by their unique coupled-spindle timing and frequency. The relative contribution of coupling subtypes shifts across the human lifespan, and a deeper sleep phenotype prevails during old age.ConclusionsDistinct subtypes of slow waves and coupled spindles form the composite of slow wave sleep. Our findings support a model of sleep-dependent synaptic regulation via discrete slow wave/spindle coupling subtypes and advance a conceptual framework for the development of coupling-based biomarkers in age-associated neurological disease.Statement of SignificanceSlow waves of nonrapid eye movement sleep couple with sleep spindles in a process hypothesized to support memory functions. This coupling has recently gained interest as a possible biomarker of cognitive aging and onset of Alzheimer’s disease. Most studies have been limited by an assumption that all slow waves (and coupled spindles) are fundamentally the same physiological events. Here we demonstrate that distinct subtypes of slow waves and their coupled spindles can be identified in human sleep. A mixture of different slow wave and spindle subtypes shifts in composition during lighter versus deeper sleep, and aging favors the deep sleep subtypes. These data should inform any future attempts to use slow wave sleep as a biomarker or clinical interventional target.
Evaluating the impact of demographic, socioeconomic factors, and risk aversion on mobility during COVID-19 epidemic in France under lockdown: a population-based study
Authors: Pullano Giulia , Valdano Eugenio , Scarpa Nicola , Rubrichi Stefania , Colizza Vittoria 
Published: June 2020

ABSTRACTOn March 17, 2020, French authorities implemented a nationwide lockdown to respond to COVID-19 epidemic and curb the surge of patients requiring critical care, similarly to other countries. Evaluating the impact of lockdown on population mobility is essential to quantify achievable reductions and identify the factors driving the changes in social dynamics that affected viral diffusion. We used temporally resolved travel flows among 1,436 administrative areas of mainland France reconstructed from mobile phone trajectories. We measured mobility changes before and during lockdown at both local and country scales. Lockdown caused a 65% reduction in countrywide number of displacements, and was particularly effective in reducing work-related short-range mobility, especially during rush hours, and recreational trips. Geographical heterogeneities showed anomalous increases in long-range movements even before lockdown announcement that were tightly localized in space. During lockdown, mobility drops were unevenly distributed across regions. They were strongly associated with active population, workers employed in sectors highly impacted by lockdown, and number of hospitalizations per region, and moderately associated with socio-economic level of the region. Major cities largely shrank their pattern of connectivity, reducing it mainly to short-range commuting. Lockdown was effective in reducing population mobility across scales. Caution should be taken in the timing of policy announcements and implementation, as anomalous mobility followed policy announcements that may act as seeding events. On the other hand, risk aversion may be beneficial in further decreasing mobility in largely affected regions. Socio-economic and demographic constraints to the efficacy of restrictions were also identified. The unveiled links between geography, demography, and timing of the response to mobility restrictions may help design interventions that minimize invasiveness while contributing to the current epidemic response.FundingANR projects EVALCOVID-19 (ANR-20-COVI-0007) and DATAREDUX (ANR-19-CE46-0008-03); EU H2020 grants RECOVER (H2020-101003589) and MOOD (H2020-874850); REACTing COVID-19 modeling grant.