bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Cerebral Small Vessel Disease Burden on MRI Correlates With Medial Temporal Lobe Atrophy and Cognitive Performance in Patients of a Memory Clinic
Authors: Fan Yangyi , Shen Ming , Huo Yang , Gao Xuguang , Li Chun , Zheng Ruimao , Zhang Jun 
Published: September 2021

Background: Cerebral small vessel disease (cSVD) and neurodegeneration are the two main causes of dementia and are considered distinct pathological processes, while studies have shown overlaps and interactions between the two pathological pathways. Medial temporal atrophy (MTA) is considered a classic marker of neurodegeneration. We aimed to investigate the relationship of total cSVD burden and MTA on MRI using a total cSVD score and to explore the impact of the two MRI features on cognition.Methods: Patients in a memory clinic were enrolled, who underwent brain MRI scan and cognitive evaluation within 7 days after the first visit. MTA and total cSVD score were rated using validated visual scales. Cognitive function was assessed by using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales. Spearman's correlation and regression models were used to test (i) the association between MTA and total cSVD score as well as each cSVD marker and (ii) the correlation of the MRI features and cognitive status.Results: A total of 312 patients were finally enrolled, with a median age of 75.0 (66.0–80.0) years and 40.7% (127/312) males. All of them finished MRI and MMSE, and 293 subjects finished MoCA. Of note, 71.8% (224/312) of the patients had at least one of the cSVD markers, and 48.7% (152/312) of them had moderate–severe MTA. The total cSVD score was independently associated with MTA levels, after adjusting for age, gender, years of education, and other vascular risk factors (OR 1.191, 95% CI 1.071–1.324, P = 0.001). In regard to individual markers, a significant association existed only between white matter hyperintensities and MTA after adjusting for the factors mentioned above (OR 1.338, 95% CI 1.050–1.704, P = 0.018). Both MTA and total cSVD score were independent risk factors for MMSE ≤ 26 (MTA: OR 1.877, 95% CI 1.407–2.503, P &lt; 0.001; total cSVD score: OR 1.474, 95% CI 1.132–1.921, P = 0.004), and MoCA &lt; 26 (MTA: OR 1.629, 95% CI 1.112–2.388, P = 0.012; total cSVD score: OR 1.520, 95% CI 1.068–2.162, P = 0.020). Among all the cSVD markers, microbleed was found significantly associated with MMSE ≤ 26, while no marker was demonstrated a relationship with MoCA &lt; 26.Conclusion: Cerebral small vessel disease was related to MTA in patients of a memory clinic, and both the MRI features had a significant association with cognitive impairment.
Posterior Interosseous Fascicular Constriction Within the Radial Nerve in a Diabetic Patient With Bilateral Neuralgic Amyotrophy: A Case Report
Authors: Kim Woojun , Kang Soo Hwan , An Jae Young 
Published: September 2021

Background: Neuralgic amyotrophy (NA) is an acute, monophasic, painful inflammatory dysimmune focal, or multifocal mononeuropathy. The lesion in NA is not always restricted to the brachial plexus but also involves individual nerves or branches. The prognosis of NA is less favorable than previously assumed, but the reasons for poor recovery remain unknown. Nerve constriction may be one of the causes of poor prognosis in NA.Case Presentation: Herein, we described a 54-year-old male with a history of type 2 diabetes in whom bilateral neuralgic amyotrophy developed with constriction of the posterior interosseous fascicle within the radial nerve. The patient experienced sudden-onset severe pain in both shoulders followed, 2 days later, by weakness in bilateral shoulders and the left forearm extensors over the subsequent month. The left forearm extensors were more severely affected than both shoulder girdle muscles. He noted a 7-kg weight loss for 1 month before pain onset. After diagnosing diabetic NA based on the clinical symptoms, imaging, and electrophysiological studies, treatment with systemic steroids improved pain and weakness in both shoulder muscles. Weakness in the left forearm extensors persisted after 1 month of steroid treatment. Follow-up ultrasound revealed constriction of the posterior interosseous fascicle within the main trunk of the left radial nerve at the elbow. Surgical exploration at 6 months after onset identified fascicle constriction, for which neurolysis was performed. Weakness in the extensors of the wrist and fingers did not improve during the 16-month follow-up.Conclusion: A single constriction of the fascicle within a peripheral nerve may often be under-recognized if NA presents with variable degrees of weakness in bilateral upper limbs. Furthermore, fascicular constriction without edema of the parent nerve may be easily missed on the initial ultrasound. A lack of early recognition of nerve constriction and delay in surgical intervention can result in unfavorable outcomes. The physician should consider the possibility of the fascicular constriction when evaluating patients suspected of brachial NA with significant weakness in the distal upper limb compared to the proximal weakness or weakness of the distal upper limb that does not improve over time.
Age-Related Disparities in Stroke Knowledge Among Community Older Adults
Authors: Liu Xiaochuan , Gui Huiwen , Yao Sichen , Li Zhongcheng , Zhao Jing 
Published: September 2021

Background: This study aimed to investigate the disparities in stroke knowledge between older adults and the oldest old.Methods: Family physicians conducted a cross-sectional survey through face-to-face interviews with the older and oldest old adults of two suburban communities in the Minhang district, Shanghai between October 1, 2020, and November 30, 2020. All participants were classified as oldest old (age ≥80 years) and older adults (age 60–79 years). Between-group differences in stroke knowledge were investigated by multivariate logistic regression analysis.Results: Overall, 466 older adults including 101 (21.67%) oldest old persons were qualified. Older adults were more familiar with the risk factors and symptoms of stroke than the oldest old. By multivariable logistic regression analysis, older adults were more familiar with the following risk factors: smoking [odds ratio (OR) 0.32, 95% confidence interval (CI) 0.16–0.61], alcohol abuse (OR 0.45, 95% CI 0.23–0.87), dyslipidemia (OR 0.51, 95% CI 0.31–0.85), and obesity (OR 0.30, 95% CI 0.17–0.53) than the oldest old. Regarding stroke symptoms, older adults were more aware regarding vision alteration (OR 0.42, 95% CI 0.25–0.69) and face-drop (OR 0.57, 95% CI 0.35–0.95) than the oldest old. The oldest old were less aware of acute stroke therapy (OR 0.11, 95% CI 0.02–0.48) and calling the emergency medical service (OR 0.30, 95% CI 0.12–0.70) than older adults. Finally, the older adults used television (OR 0.53, 95% CI 0.28–1.0), WeChat (OR 0.21, 95% CI 0.05–0.89), and the community bulletin board (OR 0.43, 95% CI 0.23–0.80) as knowledge sources more than the oldest old.Conclusion: The older adults and the oldest old had significantly high disparities in stroke knowledge. Given the aging population across China, the life expectancy is expected to be longer in future decades. These differences should be addressed in stroke educational campaigns targeting the oldest old.
Decreased IL-6 and NK Cells in Early-Stage Lung Adenocarcinoma Presenting as Ground-Glass Opacity
Authors: Zhang Pengfei , He Boxue , Cai Qidong , Tu Guangxu , Peng Xiong , Zhao Zhenyu , Peng Weilin , Yu Fenglei , Wang Min , Tao Yongguang , Wang Xiang 
Published: September 2021

BackgroundLung ground-glass opacities (GGOs) are an early manifestation of lung adenocarcinoma. It is of great value to study the changes in the immune microenvironment of GGO to elucidate the occurrence and evolution of early lung adenocarcinoma. Although the changes of IL-6 and NK cells in lung adenocarcinoma have caught global attention, we have little appreciation for how IL-6 and NK cells in the lung GGO affect the progression of early lung adenocarcinoma.MethodsWe analyzed the RNA sequencing data of surgical specimens from 21 patients with GGO-featured primary lung adenocarcinoma and verified the changes in the expression of IL-6 and other important immune molecules in the TCGA and GEO databases. Next, we used flow cytometry to detect the protein expression levels of important Th1/Th2 cytokines in GGO and normal lung tissues and the changes in the composition ratio of tumor infiltrating lymphocytes (TILs). Then, we analyzed the effect of IL-6 on NK cells through organoid culture and immunofluorescence. Finally, we explored the changes of related molecules and pathway might be involved.ResultsIL-6 may play an important role in the tumor microenvironment of early lung adenocarcinoma. Further research confirmed that the decrease of IL-6 in GGO tissue is consistent with the changes in NK cells, and there seems to be a correlation between these two phenomena.ConclusionThe IL-6 expression status and NK cell levels of early lung adenocarcinoma as GGO are significantly reduced, and the stimulation of IL-6 can up-regulate or activate NK cells in GGO, providing new insights into the diagnosis and pathogenesis of early lung cancer.
Dosimetric Validation of a System to Treat Moving Tumors Using Scanned Ion Beams That Are Synchronized With Anatomical Motion
Authors: Lis Michelle , Newhauser Wayne , Donetti Marco , Wolf Moritz , Steinsberger Timo , Paz Athena , Graeff Christian 
Published: September 2021

PurposeThe purpose of this study was to validate the dosimetric performance of scanned ion beam deliveries with motion-synchronization to heterogenous targets.MethodsA 4D library of treatment plans, comprised of up to 10 3D sub-plans, was created with robust and conventional 4D optimization methods. Each sub-plan corresponded to one phase of periodic target motion. The plan libraries were delivered to a test phantom, comprising plastic slabs, dosimeters, and heterogenous phantoms. This phantom emulated range changes that occur when treating moving tumors. Similar treatment plans, but without motion synchronization, were also delivered to a test phantom with a stationary target and to a moving target; these were used to assess how the target motion degrades the quality of dose distributions and the extent to which motion synchronization can improve dosimetric quality. The accuracy of calculated dose distributions was verified by comparison with corresponding measurements. Comparisons utilized the gamma index analysis method. Plan quality was assessed based on conformity, dose coverage, overdose, and homogeneity values, each extracted from calculated dose distributions.ResultsHigh pass rates for the gamma index analysis confirmed that the methods used to calculate and reconstruct dose distributions were sufficiently accurate for the purposes of this study. Calculated and reconstructed dose distributions revealed that the motion-synchronized and static deliveries exhibited similar quality in terms of dose coverage, overdose, and homogeneity for all deliveries considered. Motion-synchronization substantially improved conformity in deliveries with moving targets. Importantly, measurements at multiple locations within the target also confirmed that the motion-synchronized delivery system satisfactorily compensated for changes in beam range caused by the phantom motion. Specifically, the overall planning and delivery approach achieved the desired dose distribution by avoiding range undershoots and overshoots caused by tumor motion.ConclusionsWe validated a dose delivery system that synchronizes the movement of the ion beam to that of a moving target in a test phantom. Measured and calculated dose distributions revealed that this system satisfactorily compensated for target motion in the presence of beam range changes due to target motion. The implication of this finding is that the prototype system is suitable for additional preclinical research studies, such as irregular anatomic motion.
Prognostic and Clinicopathological Value of Ki-67 in Melanoma: A Meta-Analysis
Authors: Liu Qixin , Peng Ziheng , Shen Liangfang , Shen Lin 
Published: September 2021

BackgroundThe prognostic and clinicopathological value of Ki-67 in melanoma is controversial. The purpose of this meta-analysis was to determine the prognostic role of Ki-67 in melanoma patients.Materials and MethodsThe PubMed, Cochrane Library, Web of Science, and Embase databases were searched systematically up to April 9, 2021. We calculated the pooled hazard ratios (HRs) and 95% confidence intervals (CIs) to determine the relationship between Ki-67 overexpression and survival outcomes. We also calculated the combined odds ratios (ORs) and 95% CIs to determine the relationship between Ki-67 expression levels and clinicopathologic parameters. All data were statistically analyzed by Stata 11.0.ResultsA total of 10 studies involving 929 patients were included in our meta-analysis. The pooled HR showed that Ki-67 overexpression was connected with poor overall survival rates (HR=2.92, 95% CI=2.17-3.91, p&lt;0.000). However, there was no correlation between Ki-67 overexpression and the PFS (HR=0.999, 95% CI =0.958-1.041, P =0.958; I2 = 21.80%, P =0.258) or RFS (HR=1.14, 95% CI = 0.42-3.11, P =0.993; I2 = 85.00%, P =0.01) rates. Ki-67 expression levels were associated with tumor thickness, but not sex, location, ulceration or vascular invasion.ConclusionKi-67 is a useful poor prognostic indicator for melanoma patients.
Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study
Authors: Perramon Aida , Soriano-Arandes Antoni , Pino David , Lazcano Uxue , Andrés Cristina , Català Martí , Gatell Anna , Carulla Mireia , Canadell Dolors , Ricós Gemma , Riera-Bosch M. Teresa , Burgaya Silvia , Salvadó Olga , Cantero Javier , Vilà Mònica , Poblet Miriam , Sánchez Almudena , Ristol Anna M. , Serrano Pepe , Antón Andrés , Prats Clara , Soler-Palacin Pere 
Published: September 2021

Objective: We describe and analyze the childhood (&lt;18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults.Methods: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data including age-group incidence, diagnostic effort, and positivity rate per 100,000 population to analyze the relative results for these epidemiological characteristics.Results: Despite a great diagnostic effort among children, with a difference of 1,154 tests per 100,000 population in relation to adults, the relative incidence of SARS-CoV-2 for &lt;18 years was slightly lower than for the general population, and it increased with the age of the children. Additionally, positivity of SARS-CoV-2 in children (5.7%) was lower than in adults (7.2%), especially outside vacation periods, when children were attending school (4.9%).Conclusions: A great diagnostic effort, including mass screening and systematic whole-group contact tracing when a positive was detected in the class group, was associated with childhood SARS-CoV-2 incidence and lower positivity rate in the 2020-2021 school year. Schools have been a key tool in epidemiological surveillance rather than being drivers of SARS-CoV-2 incidence in Catalonia, Spain.
Coupling Radiation Transport and Track-Structure Simulations: Strategy Based on Analytical Formulas Representing DNA Damage Yields
Authors: Kundrát Pavel , Friedland Werner , Ottolenghi Andrea , Baiocco Giorgio 
Published: September 2021

Existing radiation codes for biomedical applications face the challenge of dealing with largely different spatial scales, from nanometer scales governing individual energy deposits to macroscopic scales of dose distributions in organs and tissues in radiotherapy. Event-by-event track-structure codes are needed to model energy deposition patterns at cellular and subcellular levels. In conjunction with DNA and chromatin models, they predict radiation-induced DNA damage and subsequent biological effects. Describing larger-scale effects is the realm of radiation transport codes and dose calculation algorithms. A coupling approach with a great potential consists in implementing into radiation transport codes the results of track-structure simulations captured by analytical formulas. This strategy allows extending existing transport codes to biologically relevant endpoints, without the need of developing dedicated modules and running new computationally expensive simulations. Depending on the codes used and questions addressed, alternative strategies can be adopted, reproducing DNA damage in dependence on different parameters extracted from the transport code, e.g., microdosimetric quantities, average linear energy transfer (LET), or particle energy. Recently, a comprehensive database on DNA damage induced by ions from hydrogen to neon, at energies from 0.5 GeV/u down to their stopping, has been created with PARTRAC biophysical simulations. The results have been captured as a function of average LET in the cell nucleus. However, the formulas are not applicable to slow particles beyond the Bragg peak, since these can have the same LET as faster particles but in narrower tracks, thus inducing different DNA damage patterns. Particle energy distinguishes these two cases. It is also more readily available than LET from some transport codes. Therefore, a set of new analytical functions are provided, describing how DNA damage depends on particle energy. The results complement the analysis of the PARTRAC database, widening its potential of application and use for implementation in transport codes.
Cardiorespiratory Coordination During Exercise in Adults With Down Syndrome
Authors: Oviedo Guillermo R. , Garcia-Retortillo Sergi , Carbó-Carreté María , Guerra-Balic Myriam , Balagué Natàlia , Javierre Casimiro , Guàrdia-Olmos Joan 
Published: September 2021

Introduction:Down syndrome (DS) is a chromosomal disorder affecting simultaneously cardiovascular and respiratory systems. There is no research studying the coupling between these systems during cardiorespiratory exercise testing in a population with DS. Cardiorespiratory coordination (CRC), evaluated through principal component analysis (PCA), measures the covariation of cardiorespiratory variables during exercise.Objective:To investigate and compare CRC in adults with and without DS during maximal cardiorespiratory exercise testing.Methods:Fifteen adults with DS and 15 adults without disabilities performed a maximal cardiorespiratory exercise test on a treadmill. First, the slope, and afterward the velocity was increased regularly until participants reached exhaustion. The time series of six selected cardiorespiratory variables [ventilation per minute, an expired fraction of O2, the expired fraction of CO2, heart rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP)] were extracted for the analysis. The number of principal components (PCs), the first PC eigenvalues (PC1), and the information entropy were computed for each group (non-DS and DS) and compared using at-test or a Mann-Whitney U test.Results:Two PCs in the non-DS group and three PCs in the DS group captured the variance of the studied cardiorespiratory variables. The formation of an additional PC in the DS group was the result of the shift of SBP and DBP from the PC1cluster of variables. Eigenvalues of PC1were higher in the non-DS (U= 30;p= 0.02;d= 1.47) than in the DS group, and the entropy measure was higher in the DS compared with the non-DS group (U= 37.5;p= 0.008;d= 0.70).Conclusion:Adults with Down syndrome showed higher CRC dimensionality and a higher entropy measure than participants without disabilities. Both findings point toward a lower efficiency of the cardiorespiratory function during exercise in participants with DS. CRC appears as an alternative measure to investigate the cardiorespiratory function and its response to exercise in the DS population.
Início da mobilização em pacientes com hemorragia subaracnoidea aneurismatica
Authors: Santos Domingos Jozilane , De Alencar Andrade Emília , Albuquerque Brito Rogleson , Maria da Silva Bezerra Aila 
Published: September 2021

Introdução. As diretrizes para o manejo de pacientes com Hemorragia Subaracnóidea Aneurismática não apontam o momento ideal para iniciar a mobilização. Objetivo. Identificar critérios de segurança para o início da fisioterapia motora nesses pacientes. Método. Foi realizada uma revisão sistemática, desenvolvida conforme as recomendações do Preferred Reporting Intens for Systematic Reviews and Meta-Analyses (PRISMA). A busca foi feita por dois pesquisadores independentes nas bases de dados eletrônicos LILACS, SciELO, MedLine/PubMed e PEDro, utilizando a combinação dos termos: “Early Ambulation”, “Early Mobilization”, “Intracranial aneurysms”, “Subarachnoid hemorrhage. Definidos os critérios de inclusão: artigos publicados desde o início das bases até agosto de 2020, sem restrição de idioma, que abordam sobre intervenção com fisioterapia motora e/ou sobre efeitos da quebra do repouso no paciente adulto com Hemorragia Subaracnóidea Aneurismática. Resultados. Foram incluídos nove artigos a partir dos 95 estudos encontrados na busca. Foram excluídos estudos que não atenderam aos critérios acima estabelecidos e revisões de literatura. A qualidade metodológica dos ensaios clínicos foi avaliada de acordo com a escala PEDro. O nível de evidência destes variou de quatro a cinco, sendo considerados de qualidade baixa e intermediária respectivamente. Os resultados permitiram a sumarização dos critérios de segurança em três categorias: cardiovascular, respiratória e neurológica. Nesta obtivemos maior número de itens com variáveis a serem consideradas para a elegibilidade do paciente a iniciar a mobilização. Conclusão. Os critérios de segurança concentraram-se em garantir a estabilidade neurológica e fisiológica do paciente antes do início das primeiras sessões de mobilização.