bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between healthy eating index-2015 and cognitive function among the United States elderly adults: the National Health and Nutrition Examination Survey (NHANES) 2011–2012
Authors: Fan Yameng , Zhang Yinyin , Li Jiaqiao , Liu Yamei , Chang Huan , Jiang Yude , Tuo Xingxia , Zhou Long , Yu Yan 
Published: March 2021

Abstract
BackgroundDiet quality plays an important role in the development of age-related chronic diseases. However, the association between dietary quality assessed by Healthy Eating Index (HEI)-2015 and cognitive function among the United States (US) elderly adults remains unclear. The present study aims to explore the association between HEI-2015 and cognitive function in elderly adults using data from National Health and Nutrition Examination Survey (NHANES) 2011-2012. MethodsHEI-2015 scores were calculated from two days 24-hour recall interviews. The cognitive function was evaluated by Digit Symbol Substitution Test (DSST), Animal Fluency Test (AFT) and a global cognition level derived by summing the z scores of individual tests. The associations between HEI-2015 and cognitive function were explored using multiple linear regression and binary logistic regression models. ResultsA total of 1278 participants aged 60 years or older were included. Compared to the lowest HEI-2015 tertile, the elderly adults in highest tertile had a higher global cognition, DSST and AFT scores (P＜0.05); with the lowest quartile of global cognition as cognitive impairment, those who were in the highest HEI-2015 tertile had 38% lower odds of cognitive impairment (OR: 0.62; 95%CI: 0.42-0.91). Among HEI-2015 components, the elderly adults adhering to recommended intake of whole grains and whole fruits components were more likely to have better performance on global cognition (P＜0.05). ConclusionThe higher HEI-2015 was positively associated the better cognitive performance on the global cognition, DSST, and AFT in the US elderly adults.
The Dosimetric Impact of Deep Learning-Based Auto-Segmentation of Organs at Risk on Nasopharyngeal and Rectal Cancer
Authors: Guo Hongbo , Wang Jiazhou , Xia Xiang , Zhong Yang , Peng Jiayuan , Zhang Zhen , Hu Weigang 
Published: March 2021

Abstract
PurposeTo investigate the dosimetric impact of deep learning-based auto-segmentation of organs at risk (OARs) on nasopharyngeal and rectal cancer.Methods and MaterialsTwenty patients, including ten nasopharyngeal carcinoma (NPC) patients and ten rectal cancer patients, who received radiotherapy in our department were enrolled in this study. Two deep learning-based auto-segmentation systems, including an in-house developed system (FD) and a commercial product (UIH), were used to generate two auto-segmented OARs sets (OAR_FD and OAR_UIH). Treatment plans based on auto-segmented OARs and following our clinical requirements were generated for each patient on each OARs set (Plan_FD and Plan_UIH). Geometric metrics (Hausdorff distance (HD), mean distance to agreement (MDA), the Dice similarity coefficient (DICE) and the Jaccard index) were calculated for geometric evaluation. The dosimetric impact was evaluated by comparing Plan_FD and Plan_UIH to original clinically approved plans (Plan_Manual) with dose-volume indices and 3D gamma pass rates. Spearman’s correlation analysis was performed to investigate the correlation between dosimetric deviation and geometric metrics.ResultsFD and UIH could provide similar geometric performance in parotids, temporal lobes, lens, and eyes (DICE, p > 0.05). OAR_FD had better geometric performance in the optic nerves, oral cavity, larynx, and femoral heads (DICE, p < 0.05). OAR_UIH had better geometric performance in the bladder (DICE, p < 0.05). In dosimetric analysis, both Plan_FD and Plan_UIH had nonsignificant dosimetric differences compared to Plan_Manual for most PTV and OARs dose-volume indices. The only significant dosimetric difference was the Dmax of the left temporal lobe for Plan_FD vs. Plan_Manual (p = 0.05). Only one significant correlation was found between the mean dose of the femoral head and its HD index (R = 0.4, p = 0.01).ConclusionsDeep learning-based OARs auto-segmentation for NPC and rectal cancer has a nonsignificant impact on most PTV and OARs dose-volume indices. Correlations between the auto-segmentation geometric metric and dosimetric difference were not observed for most OARs.
Knowledge and Implementation of Protective Measures for Oral and Maxillofacial Injuries of Ice Hockey Players in Primary and Secondary Schools in Beijing
Authors: Li Bing , Bai Xue , Sun Hui , Cui Chunyan , Liu Weihong 
Published: March 2021

Abstract
Background: There is little information regarding knowledge and implementation of sports-related oral and maxillofacial injury prevention measures of ice hockey players in primary and secondary schools. Thus, we investigated methods to improve the safety of juvenile ice hockey players in Beijing and reduce the incidence of oral and maxillofacial injuries, including tooth avulsions, tooth fractures, and jaw fractures. Methods: Using a convenience sampling method, we obtained consent from young ice hockey players from five primary and secondary schools and six special sports training institutions in Beijing; we administered a total of 280 questionnaires. Results: Only 12.50% of respondents reported wearing mouth guards during ice hockey; 62.50% of respondents reported never wearing a mouth guard; 43.58% did not know the risk of sports-related oral injury. Not understanding the necessity of wearing teeth protection was the most common reason reported why athletes do not wear protective gear (89.64%). Inconsistent behaviour among teammates (67.14%) was the psychological factor related to refusal to wear the mouth guard. Wearing discomfort (34.33%) and communication influence (33.14%) were also mentioned; 77.14% of the parents reported that the formulation and enforcement of the relevant regulatory agencies' standards were important to encourage young athletes to wear protective gear. Conclusion: Young ice hockey players in Beijing lack knowledge of sports-related oral injuries and effective protective measures, despite the high risks. The most effective way to improve compliance is to draw up and enforce the Ice Hockey Association's relevant standards and the coach's guidance.
Discovery of an ancient massive merger event in the For- nax cluster galaxy NGC 1380
Authors: Zhu Ling , Ven Glenn van de , Leaman Ryan , Pillepich Annalisa , Iodice Enrica , Pinna Francesca , Navarro Ignacio Martin , Coccato Lodovico , Falcón-Barroso Jesus , Zhang Le , Corsini Enrico , Gadotti Dimitri , Fahrion Katja , Hernquist Lars , Lyubenova Mariya , Mao Shude , McDermid Richard , Nelson Dylan , Pakmor Rüdiger , Poci Adriano , Sarzi Mark , Vogelsberger Mark , Zeeuw Tim de 
Published: March 2021

Abstract
Driven by gravity, galaxies are expected to continuously grow through the merging of smaller systems. To derive their past merger history is challenging, as the accreted stars disperse quickly; yet, it is a needed step to test the theory of hierarchical evolution. The merger histories of the most massive Local Group spirals, the Milky Way and M31, have been re- cently uncovered by using the motion and chemistry of their individual stars. On the other hand, the details of the merger history of galaxies at larger distance have so far remained hidden. Here we report the discovery of an ancient, massive merger event in the lenticu- lar galaxy NGC 1380 in the Fornax cluster. By applying a recently developed population-orbital superposition model (Zhu at al 2020) to NGC 1380’s surface brightness as well as stellar kinematic, age, and metallicity maps from VLT/MUSE IFU data (Sarzi et al 2018), we obtain the stellar orbits, age and metallicity distributions of this galaxy. The highly radial orbits which make up an inner stellar halo are ∼ 13 Gyr old with metallicity Z/Z⊙ ∼ 1.2 and comprise a stellar mass of M∗,halo(r<2Re)∼3.4×10^10 M⊙. By comparing to analogues from the cosmological galaxy simulation TNG50 (Pillepich 2019), we find that the formation of the inner stellar halo of NGC 1380 requires a merger with a massive satellite galaxy with stellar mass of ∼ 3 × 10^10 M⊙ that occurred roughly ∼ 10 Gyr ago. Moreover, we infer the total accreted stellar mass of NGC 1380 to be ∼ 6 × 10^10 M⊙. The massive merger in NGC 1380 is the first major merger event found in a normal phase-mixed galaxy beyond the Local Volume, and it is the oldest and most massive one identified in nearby galaxies so far. Our chemo-dynamical method, when applied to extended deep IFU data and in combination with cosmological galaxy simulations, can quantitatively unravel the merger history of a large number of nearby galaxies.
VHL Expression Level in the Pathological Tissue is Significantly Associated with Clinical Outcomes of Platinum-Based Chemotherapy in Non-Small Cell Lung Cancer Patients.
Authors: Cao Yejun , Wang Lingwei , Zhang Qiying , Zhang Qiyan , Han Yang , Liu Jie , Wang Jinyi , Ma Liang , Sun Zhengliang , Zhao Tian , Wang Guangxue , Li Qinchuan , Chen Guohan , Hong Xuan 
Published: March 2021

Abstract
Objective: To investigate the association between expression level of Von Hippel-Lindau(VHL) in pathological tissue and outcomes of platinum-based chemotherapy in non-small cell lung cancer (NSCLC) patients. Methods: The pathological samples of NSCLC patients were obtained for immunohistochemical staining to evaluate the expression level of VHL. Furthermore, their clinical data were collected and prognosis was traced by phone. The correlation between gene expression level and the hematotoxicity was evaluated by chi-square test. The influence of VHL expression level on the risk of hematotoxicity was tested by logistic regression model. The survival curve was plotted by Kaplan-Meier method and the survival rate between the two groups was compared by log-rank test. Results: A total of 110 NSCLC patients were enrolled in this study, the median follow-up time of these patients was 27.5 months. In the whole group, 31 patients had died by the last date of follow-up to get their survival information (Nov.10,2020), with a median survival time of 24.3 months. Though immunohistochemical analysis,we found that 59 patients(53.6%) had weak expression level of VHL or lack of expression in their tumor tissues,while 51 patients(46.4%) presented moderate or high expression. We found that the patients with weak expression of VHL in their carcinoma tissue or lack of expression had more opportunities to occur neutropenia after platinum-based chemotherapy(OR=0.264,95%CI=0.085-0.818,P-value=0.021).And the expression level of VHL was correlated with OS(Logrank test：P-value= 0.007，HR= 4.219,95%CI: 1.75-10.174, P-value=0.001), while not related with DFS(Logrank test：P-value=0.256，HR= 1.334,95%CI:0.642-2.769, P-value=0.440). Conclusion: The expression level of VHL gene in pathological tissue is related with Granulocytosis and leukocytotoxicity after platinum-based chemotherapy in NSCLC patients. It can be used as a biomarker to predict the risk of neutropenia and the prognosis of NSCLC patients.
Bladder Malignant Granular Cell Tumor With EP300 Gene Mutation: A Case Report and Literature Review
Authors: Huang Jian , Zhu Di , Ren Xinle , Huang Bing 
Published: March 2021

Abstract
Background Malignant granular cell tumor (GCT) is extremely rare. Malignant GCT with EP300 gene mutation in the bladder has not been reported in the literature.Case presentation We report a special case of 45 years old female with malignant GCT of the bladder. Physical examination found a pelvic mass in the patient. Magnetic resonance imaging showed a huge mass between the posterior wall of the bladder, the cervix, and the anterior wall of the vagina. Pathological examination showed that the mass was 11×11×4.5cm in size, involved in the bladder's posterior wall. Under the microscope, the tumor cells were arranged in the shape of a nest or cord to infiltrate the bladder's wall. The tumor cells were pleomorphic, red-stained granular within the cytoplasm, with increased nuclear/cytoplasmic ratio, vacuolar nuclei, and obvious nucleoli. The tumor cells were showed obvious nuclear atypia, and the mitosis was more than 5/50HPF. Coagulative necrosis was widely showed within the tumor. Immunohistochemistry(IHC) showed that S-100, NSE, CD68, CR, α-AT, and TFE-3 were strongly positive, and the Ki-67 proliferation index was around 15%. The next-generation high throughput sequencing indicated that EP300 gene was missense mutated (c.457A>G) with 33% mutation abundance, and genes of DPYD(c.1627A>G),ERCC1( c.354T>C),NQO1(c.559C>T),TPMT(c.719A>G) and XRCC1(c.1196A>G) were polymorphic mutated. The patient died after three months of the second surgical treatment. Conclusions We report for the first time a primary bladder malignant GCM accompanied by mutations in special driving genes such as EP300. We also conducted a comprehensive literature review and an in-depth discussion.
Gait training with a wearable curara® robot for cerebellar ataxia: a single-arm study
Authors: Matsushima Akira , Maruyama Yoichi , Mizukami Noriaki , Tetsuya Mikio , Hashimoto Minoru , Yoshida Kunihiro 
Published: March 2021

Abstract
Background: Ataxic gait is one of the most common and problematic symptoms in people with degenerative cerebellar ataxia. Intensive and well-coordinated inpatient rehabilitation has been shown to improve ataxic gait. In addition to therapist-assisted gait training, robot-assisted gait training has been introduced for several neurological disorders; however, only a small number of trials have been conducted for degenerative cerebellar ataxia. We aimed to validate the rehabilitation effect of a wearable “curara®” robot we developed in a single-arm study of people with degenerative cerebellar ataxia.Methods: Twenty participants with spinocerebellar ataxia or multiple system atrophy with predominant cerebellar ataxia were enrolled. The clinical trial period was 15 days. We used a curara® type 4 wearable robot for gait training. We measured the following items on days 0, 7, and 14: Scale for the Assessment and Rating of Ataxia, 10-m walking time (10mWT), 6-min walking distance (6MWD), and timed up and go test. Gait parameters (i.e., stride duration and length, standard deviation of stride duration and length, cadence, ratio of the stance/swing phases, minimum/maximum knee joint angle, and minimum/maximum hip joint angle) were obtained using a RehaGait®. On the other days (days 1–6 and 8–13), the participants were instructed to conduct gait training for 30 ± 5 min with curara®. We calculated the improvement rate as the difference of values between days 14 and 0 divided by the value on day 0. Differences in the gait parameters were analyzed using a generalized linear mixed model with Bonferroni’s correction.Results: Eighteen participants were analyzed. The mean improvement rate of the 10mWT and 6MWD was 19.0% and 29.0%, respectively. All gait parameters, except the standard deviation of stride duration and length, improved on day 14.Conclusions: The wearable curara® robot has the potential to facilitate gait training in people with degenerative cerebellar ataxia.Trial registration: jRCT, jRCTs032180164. Registered 27 February 2019 - Retrospectively registered, https://jrct.niph.go.jp/en-latest-detail/jRCTs032180164
Bayesian modelling of population trends in alcohol consumption provides empirically based country estimates for South Africa
Authors: Cois Annibale , Matzopoulos Richard , Wyk Victoria Pillay-van , Bradshaw Debbie 
Published: March 2021

Abstract
Background: Alcohol use has widespread effects on health and contributes to over 200 detrimental conditions. Although the pattern of heavy episodic drinking independently increases the risk for injuries and transmission of some infectious diseases, long-term average consumption is the fundamental predictor of risk for most conditions. Population surveys, which are the main source of data on alcohol exposure, suffer from bias and uncertainty. This article proposes a novel triangulation method to reduce bias by rescaling consumption estimates by sex and age to match country-level consumption from administrative data.Methods: We used data from 17 population surveys to estimate age- and sex-specific trends in alcohol consumption in the adult population of South Africa between 1998 and 2016. Independently for each survey, we calculated sex- and age-specific estimates of the prevalence of drinkers and the distribution of individuals across consumption categories. We used these aggregated results, together with data on alcohol production, sales and import/export, as inputs of a Bayesian model and generated yearly estimates of the prevalence of drinkers in the population and the parameters that characterise the distribution of the average consumption among drinkers.Results: Among males, the prevalence of drinkers decreased between 1998 and 2009, from 56.2% (95% CI : 53.7%;58.7%) to 50.6% (49.3%;52.0%), and increased afterwards to 53.9% (51.5%;56.2%) in 2016. The average consumption from 52.1 g/day (49.1; 55.6) in 1998 to 42.8 g/day (40.0; 45.7) in 2016. Among females the prevalence of current drinkers rose from 19.0% (17.2%;20.8%) in 1998 to 20.0% (18.3%; 21.7%) in 2016 while average consumption decreased from 32.7 g/day (30.2; 35.0) to 26.4 g/day (23.8; 28.9).Conclusions : The methodology provides a viable alternative to current approaches to reconcile survey estimates of individual alcohol consumption patterns with aggregate administrative data. It provides sex- and age-specific estimates of prevalence of drinkers and distribution of average daily consumption among drinkers in populations. Reliance on locally sourced data instead of global and regional trend estimates better reflects local nuances and is adaptable to the inclusion of additional data. This provides a powerful tool to monitor consumption, develop burden of disease estimates and inform and evaluate public health interventions.
Optimization of epilepsy surgery through virtual resections on individual structural brain networks
Authors: Nissen Ida A. , Stam Cornelis J. , Straaten Elisabeth C.W. , Millán Ana P. , Douw Linda , Pouwels Petra J.W. , Idema Sander , Baayen Johannes C. , Velis Demetrios , Mieghem Piet Van , Hillebrand Arjan 
Published: March 2021

Abstract
BackgroundThe success of epilepsy surgery in patients with refractory epilepsy depends upon correct identification of the epileptogenic zone (EZ) and an optimal choice of the resection area. In this study we developed individualized computational models based upon structural brain networks to explore the impact of different virtual resections on the propagation of seizures.MethodsThe propagation of seizures was modelled as an epidemic process (susceptible-infected-recovered (SIR) model) on individual structural networks derived from presurgical diffusion tensor imaging (DTI) in 19 patients. The candidate connections for the virtual resection were all connections from the clinically hypothesized EZ, from which the seizures were modelled to start, to other brain areas. As a computationally feasible surrogate for the SIR model, we also removed the connections that maximally reduced the Eigenvector Centrality (EC) (large values indicate network hubs) of the hypothesized EZ, with a large reduction meaning a large effect. The optimal combination of connections to be removed for a maximal effect were found using simulated annealing. For comparison, the same number of connections were removed randomly, or based on measures that quantify the importance of a node or connection within the network.ResultsWe found that 90% of the effect (defined as reduction of EC of the hypothesized EZ) could already be obtained by removing substantially less than 90% of the connections. Thus, a smaller, optimized, virtual resection achieved almost the same effect as the actual surgery yet at a considerably smaller cost, sparing on average 27.49% (standard deviation: 4.65%) of the connections. Furthermore, the maximally effective connections linked the hypothesized EZ to hubs. Finally, the optimized resection was more effective than random removal of the same number of connections, and equally or more effective than removal based on structural network characteristics.ConclusionThe approach of using reduced EC as a surrogate for simulating seizure propagation can suggest more restrictive resection strategies, whilst obtaining an almost optimal effect on reducing seizure propagation, by taking into account the unique topology of individual structural brain networks of patients.
Short Term Outcomes of Gastric Cancer at University Teaching Hospital of Kigali (CHUK), Rwanda.
Authors: Niyongombwa Irénée , Karenzi Irénée David , Sibomana Isaie , Muvunyi Vital , Kagimbangabo Jean Marie Vianney , Urimubabo Jean Christian , Nifasha Antoine , Abahuje Egide 
Published: March 2021

Abstract
Purpose:

Gastric cancer is endemic in the so called stomach cancer region comprising Rwanda, Burundi, South Western Uganda and eastern Kivu province of Democratic Republic of Congo but its outcomes in that region are under investigated. This is the first study ever conducted in Rwanda with the purpose to describe the short term outcomes (in-hospital mortality rate, length of hospital stay, 3, 6, 12 and 24 months survival rates) in patients treated for gastric cancer.
Methods:

We retrospectively reviewed the data collected from records of patients who consulted CHUK over a period of 10 years from September 2007 to August 2016. Patients were followed in hospital and after discharge for survival length. Descriptive statistics were used for baseline demographic data, Kaplan-Meier model and univariate cox regression were used for survival analysis.
Results:

Of the 199 patients enrolled in the study, 92 (46%) were males and 107 (54%) females. The mean age was 55.4 ranging between 24 and 93. The mean symptoms duration was 15 months. Most patients consulted with advanced disease, 62.3% with distant metastases. Treatment with curative intent was offered for only 19.9% of patients. The in-hospital mortality rate was 13.3%. The 3, 6, 12 and 24 months survival rate was 52%, 40.5%, 28% and 23.4% respectively. The Overall survival rate was 7 months.
Conclusion:

In Rwanda, patients with gastric cancer have delayed consultations and advanced disease at the time of presentation. This cancer is associated with poor outcomes in terms of hospital mortality and post discharge survival rates.