bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Vascular Risk Factors on Post-stroke Cognitive Impairment: The Nor-COAST Study
Authors: Aam Stina , Gynnild Mari Nordbø , Munthe-Kaas Ragnhild , Saltvedt Ingvild , Lydersen Stian , Knapskog Anne-Brita , Ihle-Hansen Hege , Ellekjær Hanne , Eldholm Rannveig Sakshaug , Fure Brynjar 
Published: August 2021

Introduction: Post-stroke cognitive impairment (PSCI) is common, but evidence on the impact of vascular risk factors is lacking. We explored the association between pre-stroke vascular risk factors and PSCI and studied the course of PSCI.Materials and Methods: Vascular risk factors were collected at baseline in stroke survivors (n = 635). Cognitive assessments of attention, executive function, memory, language, and the Montreal Cognitive Assessment (MoCA) were performed at 3 and/or 18 months post-stroke. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). PSCI was measured with global z; MoCA z-score; and z-score of the four assessed cognitive domains. Mixed-effect linear regression was applied with global z, MoCA z-score, and z-scores of the cognitive domains as dependent variables. Independent variables were the vascular risk factors (hypertension, hypercholesterolemia, smoking, diabetes mellitus, atrial fibrillation, coronary heart disease, previous stroke), time, and the interaction between these. The analyses were adjusted for age, education, and sex. There were between 5 and 25% missing data for the variables for PSCI.Results: Mean age was 71.6 years (SD 11.7); 42% were females; and the mean NIHSS score at admittance was 3.8 (SD 4.8). Regardless of vascular risk factors, global z, MoCA, and all the assessed cognitive domains were impaired at 3 and 18 months, with MoCA being the most severely impaired. Atrial fibrillation (AF) was associated with poorer language at 18 months and coronary heart disease (CHD) with poorer MoCA at 18 months (LR = 12.80, p = 0.002, and LR = 8.32, p = 0.004, respectively). Previous stroke was associated with poorer global z and attention at 3 and 18 months (LR = 15.46, p &lt; 0.001, and LR = 16.20, p &lt; 0.001). In patients without AF, attention improved from 3 to 18 months, and in patients without CHD, executive function improved from 3 to 18 months (LR = 10.42, p &lt; 0.001, and LR = 9.33, p = 0.009, respectively).Discussion: Our findings indicate that a focal stroke lesion might be related to pathophysiological processes leading to global cognitive impairment. The poorer prognosis of PSCI in patients with vascular risk factors emphasizes the need for further research on complex vascular risk factor interventions to prevent PSCI.
Added Value of Rescue Devices in Intra-Arterial Thrombectomy: When Should We Apply Them?
Authors: Ni Cheng-Fu , Cheng Sho-Jen , Chen Cheng-Yu , Yeh Tu-Hsueh , Hsieh Kevin Li-Chun 
Published: August 2021

Introduction: Recent trials have demonstrated the superior efficacy of mechanical thrombectomy over other medical treatments for acute ischemic stroke; however, not every large vessel occlusion (LVO) can be recanalized using a single thrombectomy device. Rescue devices were proved to increase the reperfusion rate, but the efficacy is unclear.Objective: In this retrospective study, we evaluated the efficacy of rescue therapy in different locations of LVO.Methods: We analyzed the outcomes of mechanical thrombectomy from a prospective registry of consecutive 82 patients in Taipei Medical University Hospital. The reperfusion rate and the functional outcome were compared in patients who received first-line therapy only and patients who need rescue therapy.Results: An 84.1% reperfusion rate was achieved in our cohort. We applied first-line stent retriever (SR) treatment in 6 patients, among which 4 (66.6%) achieved successful reperfusion. We applied a direct-aspiration first-pass technique (ADAPT) as the first-line treatment in 76 patients, among which 46 (60.5%) achieved successful reperfusion. Successful reperfusion could not be achieved in 30 cases (39.5%); therefore, we applied a second-line rescue SR for 28 patients, and reperfusion was established in 18 (64.3%) of them. These results revealed that the LVO in anterior circulation has a higher chance to respond to SR rescue therapy than posterior circulation lesions (68 vs. 33.3%, P &lt; 0.001). Patients who received only first-line therapy exhibited significantly better functional outcomes than those who were also treated with rescue SR therapy (41.2 vs. 16.7%, P = 0.001). In addition, patients with LVO in the anterior circulation were found to have a higher probability of achieving functional independence than patients with posterior circulation lesions (10.7 vs. 0.0%, P &lt; 0.001). The adjusted multivariate analysis revealed that successful reperfusion and treatment type (first-line or rescue therapy) were significantly related to a modified Rankin Scale (mRS) score at 90 days.Conclusion: This study reveals that rescue SR therapy improves the reperfusion rate. Patients who require rescue SR therapy have a lower likelihood of functional independence. LVO in the anterior circulation responds better to rescue SR therapy and results in better functional outcomes than posterior circulation lesions.
Disrupted Topological Organization of Functional Networks in Asymptomatic Carotid Plaque Without Significant Carotid Stenosis: A Resting-State fMRI Study
Authors: Tuo Jia , He Wei , Yang Shuai , Liu Lihui , Liu Xiaojuan , Liu Hui , Wang Yang , Tang Tao , Xia Jian , Liao Weihua , Liu Yunhai , Huang Qing 
Published: August 2021

Purpose: Previous studies have found that there are significant changes in functional network properties for patients with moderate to severe carotid artery stenosis. Our study aimed to explore the topology properties of brain functional network in asymptomatic patients with carotid plaque without significant stenosis.Methods: A total of 61 asymptomatic patients with carotid plaque (mean age 61.79 ± 7.35 years) and 25 healthy control subjects (HC; 58.12 ± 6.79 years) were recruited. General data collection, carotid ultrasound examination and resting state functional magnetic resonance imaging were performed on all subjects. Graph-theory was applied to examine the differences in the brain functional network topological properties between two groups.Results: In the plaque group, Eloc(P = 0.03), γ (P = 0.01), and σ (P = 0.01) were significantly higher than in the HC group. The degree centrality of left middle frontal gyrus and the nodal efficiency of left middle frontal gyrus and right inferior parietal angular gyrus were significantly higher in the plaque group than in HC. The degree centrality and betweenness centrality of right middle temporal gyrus, as well as the nodal efficiency of right middle temporal gyrus, were significantly lower in the plaque group than in HC.Conclusions: The brain functional networks of patients with carotid plaques differ from those of healthy controls. Asymptomatic patients with carotid plaques exhibit increased local and global connectivity, which may reflect subtle reorganizations in response to early brain damage.
Differences in Multimodal Electroencephalogram and Clinical Correlations Between Early-Onset Alzheimer’s Disease and Frontotemporal Dementia
Authors: Lin Nan , Gao Jing , Mao Chenhui , Sun Heyang , Lu Qiang , Cui Liying 
Published: August 2021

BackgroundAlzheimer’s disease (AD) and frontotemporal dementia (FTD) are the two main types of dementia. We investigated the electroencephalogram (EEG) difference and clinical correlation in early-onset Alzheimer’s disease (EOAD), and FTD using multimodal EEG analyses. EOAD had more severe EEG abnormalities than late-onset AD (LOAD). Group comparisons between EOAD and LOAD were also performed.MethodsThirty patients diagnosed with EOAD, nine patients with LOAD, and 14 patients with FTD (≤65 y) were recruited (2008.1–2020.2), along with 24 healthy controls (≤65 y, n = 18; &gt;65 y, n = 6). Clinical data were reviewed. Visual EEG, EEG microstate, and spectral analyses were performed.ResultsCompared to controls, markedly increased mean microstate duration, reduced mean occurrence, and reduced global field power (GFP) peaks per second were observed in EOAD and FTD. We found increased durations of class B in EOAD and class A in FTD. EOAD had reduced occurrences in classes A, B, and C, while only class C occurrence was reduced in FTD. The visual EEG results did not differ between AD and FTD. Microstate B showed correlations with activities of daily living score (r = 0.780, p = 0.008) and cerebrospinal fluid (CSF) Aβ42 (r = −0.833, p = 0.010) in EOAD. Microstate D occurrence was correlated with the CSF Aβ42 level in FTD (r = 0.786, p = 0.021). Spectral analysis revealed a general slowing EEG, which may contribute to microstate dynamic loss. Power in delta was significantly higher in EOAD than in FTD all over the head. In addition, EOAD had a marked increased duration and decreased occurrence than late-onset AD (LOAD), with no group differences in visual EEG results.ConclusionThe current study found that EOAD and FTD had different EEG changes, and microstate had an association with clinical severity and CSF biomarkers. EEG microstate is more sensitive than visual EEG and may be useful for the differentiation between AD and FTD. The observations support that EEG can be a potential biomarker for the diagnosis and assessment of early-onset dementias.
Plasma Exosome-Derived SENP1 May Be a Potential Prognostic Predictor for Melanoma
Authors: Hu Hejuan , Ling Bai , Shi Yuhan , Wu Haohao , Zhu Bingying , Meng Yiling , Zhang Guo-Ming 
Published: August 2021

ObjectiveTo evaluate plasma exosome-derived SUMO-specific protease (SENP)1 levels and assess their prognostic value in melanoma.Patients and MethodsWe extracted exosomes from the plasma of 126 melanoma patients, and identified them with transmission electron microscopy, nanoparticle tracking analysis and western blotting. The plasma exosome-derived SENP1 levels of melanoma patients and healthy controls were detected with ELISA.ResultsPlasma exosome-derived SENP1 levels in melanoma patients were significantly upregulated than in healthy controls (P &lt; 0.001). Plasma exosome-derived SENP1 levels in melanoma patients with tumor size &gt;10 cm, located in the mucosa or viscera, with Clark level IV/V, with lymph node metastasis, and TNM stages IIb–IV were significantly higher than in patients in with tumor size &lt;10 cm, located in the skin, with Clark level I–III, without lymph node metastasis, and TNM stages IIb–IV (all P &lt; 0.05). Disease-free survival (DFS) and overall survival (OS) were worse in melanoma patients who had higher plasma exosome-derived SENP1 levels than lower plasma exosome-derived SENP1 levels (both P &lt; 0.001). Area under the receiver operating characteristic curve (AUROC) of plasma exosome-derived SENP1 for predicting 3-year DFS of melanoma patients was 0.82 [95% confidence interval (CI): 0.74–0.88], with a sensitivity of 81.2% (95% CI: 69.9–89.6%) and specificity of 75.4% (95% CI: 62.2–85.9%). The AUROC of plasma exosome-derived SENP1 for predicting 3-year OS of melanoma patients was 0.76 (95% CI: 0.67–0.83), with a sensitivity of 95.7% (95% CI: 85.5–99.5%) and specificity of 62.0% (95% CI: 50.4–72.7%).ConclusionsMelanoma patients with higher plasma exosome-derived SENP1 levels had worse DFS and OS. The plasma exosome-derived SENP1 levels may be a potential prognostic predictor for 3-year DFS and 3-year OS of melanoma.
Evaluation of the Radiomics Method for the Prediction of Atypical Adenomatous Hyperplasia in Patients With Subcentimeter Pulmonary Ground-Glass Nodules
Authors: Wang Bin , Hamal Preeti , Meng Xue , Sun Ke , Yang Yang , Sun Yangyang , Sun Xiwen 
Published: August 2021

ObjectivesWe aimed to develop a prediction model to distinguish atypical adenomatous hyperplasia (AAH) from early lung adenocarcinomas in patients with subcentimeter pulmonary ground-glass nodules (GGNs), which may help avoid aggressive surgical resection for patients with AAH.MethodsSurgically confirmed cases of AAH and lung adenocarcinomas manifesting as GGNs of less than 1 cm were retrospectively collected. A prediction model based on radiomics and clinical features identified from a training set of cases was built to differentiate AAH from lung adenocarcinomas and tested on a validation set.ResultsFour hundred and eighty-five eligible cases were included and randomly assigned to the training (n = 339) or the validation sets (n = 146). The developed radiomics prediction model showed good discrimination performance to distinguish AAH from adenocarcinomas in both the training and the validation sets, with, respectively, 84.1% and 82.2% of accuracy, and AUCs of 0.899 (95% CI: 0.867–0.931) and 0.881 (95% CI: 0.827–0.936).ConclusionThe prediction model based on radiomics and clinical features can help differentiate AAH from adenocarcinomas manifesting as subcentimeter GGNs and may prevent aggressive resection for AAH patients, while reserving this treatment for adenocarcinomas.
A Combined Technology to Protect the Anatomic Integrity of Distal Urethral Sphincter Complex in Radical Prostatectomy Improves Early Urinary Continence Recovery Without Sacrifice of Oncological Outcomes
Authors: Liu Ao , Gao Yi , Huang Hai , Yang Xiaoqun , Lin Wenhao , Chen Lu , Xu Danfeng 
Published: August 2021

PurposeOur primary aim was to present a combined technique to protect the anatomic integrity of distal urethral sphincter complex (DUSC) during minimally invasive radical prostatectomy (RP) and discuss its impact on urinary continence (UC) recovery. The second aim was to define the learning curve of the combined technique.MethodsWe conducted a non-randomized retrospective study. There were 314 consecutive patients who received RP by the same urologist surgeon with more than 2,000 prior cases in Shanghai Ruijin Hospital between March 2017 and April 2020. Included in this study were 263 patients with clinical T1–T2 stage. We modified a combined RP (Comb-RP) technique including endopelvic fascia no-incising technique, dorsal venous complex (DVC) no-ligation technique, intrafascial dissection technique, and anterior reconstruction technique so as to preserve the anatomic integrity of DUSC. The patients were assigned to two groups: a Comb-RP group and a conventional RP (Conv-RP) group. Continence rates were assessed every 3 months after removal of the catheter. UC was defined as 0 pad per day. Peri-operative variables of the patient including operation time, estimated blood lost (EBL), positive surgical margin (PSM), and postoperative complications were also collected. Scatter-graphs of learning curves were drawn using locally weighted scatterplot smoothing (LOWESS).ResultsRP was accomplished smoothly in all 263 cases. The pad-free UC rates in Conv-RP group and Comb-RP group were 17.3 vs. 27.8% (P = 0.048) at the removal of the catheter, 35.8 vs. 50.0% (P = 0.027) at 1 month, 60.5 vs. 76.1% (P = 0.012) at 3 months, 87.7 vs. 96.5% (P = 0.022) at 6 months, and 94.7 vs. 97.7% (P = 0.343) at 12 months. Kaplan–Meier analysis showed significantly higher and faster continence recovery in the Comb-RP group (mean 4.9 vs. 2.6 months, Log Rank P = 0.001). There was no significant difference in PSM rate between the Comb-RP and Conv-RP group (31.1 vs. 31.2%, P =0.986). The learning curves of peri-operative variables, oncological and functional outcomes achieved the lowest point or plateau at the 20th–60th cases.ConclusionsThe anatomic integrity and intact pelvic floor interplay of DUSC is important for its function. Our combined technique was a safe and feasible technique for improving early UC in RP with no significantly increased PSM rate and no significant difference in long-term UC.
A Mixed Comparisons of Different Intensities and Types of Physical Exercise in Patients With Diseases Related to Oxidative Stress: A Systematic Review and Network Meta-Analysis
Authors: Lu Zhenghui , Xu Yining , Song Yang , Bíró István , Gu Yaodong 
Published: August 2021

The balance of oxidative and antioxidant systems is of great importance to the human body. Physical exercise, as one of the ways to improve physical health, seems to modulate this balance. However, different intensities and types of physical exercise have other effects on the treatment of unhealthy people. To understand the impact of exercise training on the oxidative and antioxidant systems of adults with oxidative stress-related disorders, a network meta-analysis was used to compare the mixed effects of different intensities and types of exercise training. This systematic review included all eligible RCTs from PubMed, Medline, Cochrane Library, and CINAHL. Eleven of the studies met the inclusion criteria (at study completion, n = 666 participants). Seven studies reported that the level of MDA decreased significantly after exercise (p &lt; 0.05), and 3 studies reported that the level of SOD increased significantly after exercise (p &lt; 0.05). In conclusion, long-term high-intensity aerobic training and Tai Chi or Yoga can effectively improve oxidative stress in unhealthy people. In addition, different types of diseases on the effect of exercise intervention seems to be other, diabetes and chronic kidney patients using moderate-intensity aerobic training or Tai chi and Yoga effect are better; Moderate-intensity aerobic training had a better impact on OS improvement in patients with irritable bowel syndrome and severe depression. However, more research is needed to determine the effects of different levels and types of physical activity on oxidative stress in unhealthy populations.Systematic Review Registration: PROSPERO identifier: CRD42021242025. https://www.crd.york.ac.uk/prospero/.
Infectious Disease Outbreak and Post-Traumatic Stress Symptoms: A Systematic Review and Meta-Analysis
Authors: Qiu Dan , Li Yilu , Li Ling , He Jun , Ouyang Feiyun , Xiao Shuiyuan 
Published: August 2021

Background: As one of the most widely researched consequence of traumatic events, the prevalence of post-traumatic stress symptoms (PTSS) among people exposed to the trauma resulting from infectious disease outbreak varies greatly across studies. This review aimed at examining the pooled prevalence of PTSS among people exposed to the trauma resulting from infectious disease outbreak, summarizing the possible causes of the inconsistencies in the current estimates.Methods: Systematic searches of databases were conducted for literature published on PubMed, EMBASE, Web of Science, the Cochrane Library, PsycArticles, and Chinese National Knowledge Infrastructure (CNKI) until 14 October 2020. Statistical analyses were performed using R software (registration number: CRD42020182366).Results: About 106 studies were included. The results showed that the pooled prevalence of PTSS among the general population exposed to the trauma resulting from infectious disease outbreak was 24.20% (95% CI: 18.54–30.53%), the pooled prevalence of PTSS among healthcare workers was 24.35% (95% CI: 18.38–1.51%), the pooled prevalence of PTSS among patients with infectious disease was 28.83% (95% CI: 18.53–44.86%), and the pooled prevalence of PTSS among suspected cases of infectious disease was 25.04% (95% CI: 18.05–34.73%). Mortality rate was a significant contributor to heterogeneity.Conclusions: Evidence suggests that PTSS were very common among people exposed to the trauma resulting from infectious disease outbreak. Health policymakers should consider both short-term and long-term preventive strategy of PTSS.
Physical Activity Is Associated With Sleep Quality: Results of the ESSE-RF Epidemiological Study
Authors: Dubinina Elena , Korostovtseva Lyudmila S. , Rotar Oxana , Amelina Valeria , Boyarinova Maria , Bochkarev Mikhail , Shashkova Tatiana , Baranova Elena , Libis Roman , Duplyakov Dmitry , Sviryaev Yurii , Konradi Aleksandra , Shlyakhto Eugene 
Published: August 2021

Background and hypothesisPhysical activity (PA) is an important behavioral factor associated with the quality of life and healthy longevity. We hypothesize that extremely low and extremely high levels of daily PA (including occupational PA) may have a negative impact on sleep quality and psychological well-being.ObjectiveThe aim of the study is to investigate the association between the level and type of PA and sleep problems in adult population.Materials and methodsThe sample of the study consisted of the participants from the population-based cohort of The Epidemiology of Cardiovascular Risk Factors and Diseases in Regions of the Russian Federation Study (ESSE-RF). The data of three regions (Saint Petersburg, Samara, Orenburg), varying in geographic, climatic, socioeconomic characteristics, was included into analysis. The total sample consisted of 4,800 participants (1,600 from each region; 1,926 males, 2,874 females), aged 25–64. The level of PA was evaluated using three parameters: the type of PA at work, the frequency of an intensive/high PA including sport (times a week), the mean duration of leisure-time walking (minutes a day). The measures of sleep quality were sleep duration and the frequency of difficulty falling asleep, difficulty maintaining sleep, daytime sleepiness, and sleep medication use. PA and sleep characteristics were assessed by interview carried by the trained medical staff.ResultsWhen controlling for gender, age and socioeconomic status (SES) extremely high occupational PA was a significant risk factor for difficulty falling asleep three or more times a week [OR(CI95%) = 1.9(1.2–3.0), p = 0.003] while working in a sitting position or having moderate physical load at work were not associated with sleep characteristics. Having a high physical load six or more times a week was a risk factor for difficulty falling asleep controlling for gender, age and SES [OR(CI95%) = 1.9(1.4–3.4), p = 0.001]. The association between leisure-time walking and sleep characteristics was insignificant. Walking less than an hour a day was associated with increased depression scores (46.5 vs. 41.9%, p = 0.006).ConclusionHigh physical load at work and excessively frequent intensive PA are associated with difficulties initiating sleep and may represent a risk factor for insomnia.