bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oligoclonal IgM bands in the cerebrospinal fluid of patients with relapsing MS to inform long-term MS disability
Authors: Capuano Rocco , Zubizarreta Irati , Alba-Arbalat Salut , Sepulveda María , Sola-Valls Nuria , Pulido-Valdeolivas Irene , Andorra Magi , Martinez-Heras Eloy , Solana Elisabeth , Lopez-Soley Elisabet , Montejo Carmen , Blanco Yolanda , Fernández-Velasco Jose Ignacio , Gallo Antonio , Bisecco Alvino , Villoslada Pablo , Saiz Albert , Llufriu Sara , Villar Luisa M , Martinez-Lapiscina Elena H 
Published: January 2021

Background: Prognostic markers are needed to guide multiple sclerosis (MS) management in the context of large availability of disease-modifying drugs (DMDs). Objective: To investigate the role of cerebrospinal fluid (CSF) markers to inform long-term MS outcomes. Methods: Demographic features, IgM index, oligoclonal IgM bands (OCMB), lipid-specific OCMB, CSF neurofilament light chain protein levels, expanded disability status scale (EDSS), relapses and DMD use over the study period and peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell plus inner plexiform layer (GCIPL) thicknesses in non-optic neuritis eyes (end of follow-up) were collected from relapsing MS (RMS) patients with CSF obtained ⩽2 years after MS onset prospectively followed at the Hospital Clinic of Barcelona. We assessed associations between CSF markers and MS outcomes using multivariable models. Results: A total of 89 patients (71 females; median 32.9 years of age) followed over a median of 9.6 years were included. OCMB were associated with a 33% increase in the annualized relapse rate (ARR; p = 0.06), higher odds for high-efficacy DMDs use (OR = 4.8; 95% CI = (1.5, 16.1)), thinner pRNFL (β = −4.4; 95% CI = (−8.6, −0.2)) and GCIPL (β = −2.9; 95% CI = (−5.9, +0.05)), and higher rates to EDSS ⩾ 3.0 (HR = 4.4; 95% CI = (1.6, 11.8)) and EDSS ⩾ 4.0 (HR = 5.4; 95% CI = (1.1, 27.1)). No overall associations were found for other CSF markers. Conclusion: The presence of OCMB was associated with unfavorable long-term outcomes. OCMB should be determined in RMS to inform long-term prognosis.
Health Care Utilization Following Inpatient Femoropopliteal Revascularization With Drug-Coated Balloon Angioplasty: A Nationwide Cohort Analysis
Authors: Gurin Michael I. , Beyer Sebastian E. , Weinberg Mitchell , Parikh Sahil A. , Armstrong Ehrin J. , Albaghdadi Mazen S. , Aronow Herbert D. , Carroll Brett J. , Yeh Robert , Secemsky Eric A. 
Published: January 2021

Purpose To examine nationwide variations in inpatient use of drug-coated balloons (DCBs) for treating femoropopliteal segment occlusive disease and whether DCBs are associated with reduced early out-of-hospital health care utilization. Materials and Methods The study included 24,022 patients who survived hospitalization for femoropopliteal revascularization using DCB angioplasty (n=7850) or uncoated balloon angioplasty (n=16,172) in the 2016–2017 Nationwide Readmissions Database. Differences in patient, hospitalization, and institutional characteristics were compared between treatment strategies. Adjusted logistic regression models were used to examine differences in 6-month rates of readmission, amputation, and repeat intervention. Results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results Patients treated with DCBs had a higher prevalence of chronic limb-threatening ischemia, diabetes, hypertension, and tobacco use. Revascularization with a DCB was associated with shorter hospitalizations, lower median hospitalization costs, and fewer inpatient lower extremity amputations. Readmissions at 6 months were decreased in patients treated with DCBs compared with uncoated balloon angioplasty (OR 0.90, 95% CI 0.83 to 0.98, p=0.014). The most common reasons for readmission were complications related to procedures (15.4%) and diabetes (15.4%). Compared to patients treated with DCBs, patients treated with uncoated balloon angioplasty were more often readmitted with early procedure-related complications (13.3% vs 17.5%). There were no between-group differences in readmission for sepsis, myocardial infarction, or congestive heart failure. Conclusion DCBs are less often used compared to uncoated balloons during inpatient femoropopliteal procedures. While DCB utilization is associated with more severe comorbidities and advanced peripheral artery disease, readmission rates are decreased through the first 6 months.
Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trial
Authors: Walsh Thomas P. , Baird Grayson L. , Atalay Michael K. , Agarwal Saurabh , Arcuri Daniel , Klinger James R. , Mullin Christopher J. , Morreo Heather , Normandin Brynn , Shiva Sruti , Whittenhall Mary , Ventetuolo Corey E. 
Published: January 2021

Pulmonary arterial hypertension (PAH) remains life‐limiting despite numerous approved vasodilator therapies. Right ventricular (RV) function determines outcome in PAH but no treatments directly target RV adaptation. PAH is more common in women, yet women have better RV function and survival as compared to men with PAH. Lower levels of the adrenal steroid dehydroepiandrosterone (DHEA) and its sulfate ester are associated with more severe pulmonary vascular disease, worse RV function, and mortality independent of other sex hormones in men and women with PAH. DHEA has direct effects on nitric oxide (NO) and endothelin‐1 (ET‐1) synthesis and signaling, direct antihypertrophic effects on cardiomyocytes, and mitigates oxidative stress. Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) is an on‐going randomized double‐blind placebo‐controlled crossover trial of DHEA in men (n = 13) and pre‐ and post‐menopausal women (n = 13) with Group 1 PAH funded by the National Heart, Lung and Blood Institute. We will determine whether orally administered DHEA 50 mg daily for 18 weeks affects RV longitudinal strain measured by cardiac magnetic resonance imaging, markers of RV remodeling and oxidative stress, NO and ET‐1 signaling, sex hormone levels, other PAH intermediate end points, side effects, and safety. The crossover design will elucidate sex‐based phenotypes in PAH and whether active treatment with DHEA impacts NO and ET‐1 biosynthesis. EDIPHY is the first clinical trial of an endogenous sex hormone in PAH. Herein we present the study’s rationale and experimental design.
Study of the effect of Occlutech Atrial Flow Regulator on symptoms, hemodynamics, and echocardiographic parameters in advanced pulmonary arterial hypertension
Authors: Sivakumar Kothandam , Rohitraj Gopalavilasam R. , Rajendran Monica , Thivianathan Nithya 
Published: January 2021

Optimal sized balloon atrial septostomy improves hemodynamics in advanced pulmonary arterial hypertension. Occlutech Atrial Flow Regulator is designed to provide an atrial septal fenestration diameter titrated according to the age and right atrial pressures. This observational study analyzed symptoms, exercise distance, oxygen saturations, hemodynamics and echocardiographic parameters after Atrial Flow Regulator implantation in patients with syncope or right‐heart failure. Patients with high‐risk predictors of mortality during septostomy were scrutinized. Thirty‐nine patients (9 children) with syncope (34/39) or right‐heart failure (27/39) underwent Atrial Flow Regulator implantation without procedural complications. Six‐minute walk distance increased from 310 ± 158.2 to 376.4 ± 182.6 m, none developed syncope. Oxygen saturations reduced from 96.4 ± 6.4% to 92 ± 4.9% at rest and further to 80.3 ± 5.9% on exercise. Right atrial pressures reduced from 9.4 ± 5 (2–27) mmHg to 6.9 ± 2.6 (1–12) mmHg, while cardiac index increased from 2.4 ± 0.8 (0.98–4.3) to 3 ± 1 (1.1–5.3) L/min/m2 and systemic oxygen transport increased from 546.1 ± 157.9 (256.2–910.5) to 637.2 ± 191.1 (301.3–1020.2) ml/min. Echocardiographic improvement included significant reduction of pericardial effusion and inferior caval congestion at a median follow‐up of 37 months. Overall survival improved except two early and one late deaths in high‐risk patients. Five of seven patients with advanced disease and key hemodynamic predictors of mortality survived. Acute hemodynamic benefits in pulmonary arterial hypertension after Atrial Flow Regulator were improved cardiac output, systemic oxygen transport, and reduced right atrial pressures. Improvement of symptoms especially syncope, exercise duration, and right ventricular systolic function as well as device patency were sustained on mid‐term follow‐up. Implantation was safe in all including young children without procedural complications. Mortality was noted only in patients who had high‐risk predictors and patients at advanced stage of the disease.
Impaired T- and NK-cell reconstitution after haploidentical HCT with posttransplant cyclophosphamide
Authors: Rambaldi Benedetta , Kim Haesook T. , Reynolds Carol , Chamling Rai Sharmila , Arihara Yohei , Kubo Tomohiro , Buon Leutz , Gooptu Mahasweta , Koreth John , Cutler Corey , Nikiforow Sarah , Ho Vincent T. , Alyea Edwin P. , Antin Joseph H. , Wu Catherine J. , Soiffer Robert J. , Ritz Jerome , Romee Rizwan 
Published: January 2021

Abstract
Administration of posttransplant cyclophosphamide (PTCy) has significantly expanded the number of patients undergoing HLA-haploidentical hematopoietic cell transplantation (haplo-HCT). To examine immune reconstitution in these patients, we monitored T- and natural killer (NK)-cell recovery in 60 patients receiving bone marrow or peripheral blood stem cell (PBSC) grafts after haplo-HCT with PTCy and 35 patients receiving HLA-matched donor PBSC grafts with standard graft-versus-host disease (GVHD) prophylaxis. Compared with HLA-matched recipients, early T-cell recovery was delayed in haplo-HCT patients and skewed toward effector memory T cells with markedly reduced naive T cells. We found higher regulatory T (Treg)-cell/conventional T (Tcon)-cell ratios early after HCT and increased PD-1 expression on memory T cells. Within the haplo-HCT, patients who did not develop chronic GVHD (cGVHD) had higher PD-1 expression on central and effector memory CD4+ Treg cells at 1 month after transplant. These findings suggest an immunologic milieu that promotes immune tolerance in haplo-HCT patients. NK cells were decreased early after haplo-HCT with preferential expansion of immature CD56brightCD16− NK cells compared with matched donor transplants. One month after transplant, mass cytometry revealed enrichment of immature NK-cell metaclusters with high NKG2A, low CD57, and low killer-cell immunoglobulin-like receptor expression after haplo-HCT, which partially recovered 3 months post-HCT. At 2 months, immature NK cells from both groups were functionally impaired, but interleukin-15 priming corrected these defects in vitro. Increased immature/mature NK-cell ratios were associated with cytomegalovirus reactivation and increased incidence of cGVHD after haplo-HCT. These homeostatic imbalances in T- and NK-cell reconstitution after haplo-HCT reveal opportunities for early immune-based interventions to optimize clinical outcomes.
A predictive nomogram for mortality of cancer patients with invasive candidiasis: a 10-year study in a cancer center of North China
Authors: Li Ding , Li Tianjiao , Bai Changsen , Zhang Qing , Li Zheng , Li Xichuan 
Published: January 2021

Abstract
Background
Invasive candidiasis is the most common fungal disease among hospitalized patients and continues to be a major cause of mortality. Risk factors for mortality have been studied previously but rarely developed into a predictive nomogram, especially for cancer patients. We constructed a nomogram for mortality prediction based on a retrospective review of 10 years of data for cancer patients with invasive candidiasis.

Methods
Clinical data for cancer patients with invasive candidiasis during the period of 2010–2019 were studied; the cases were randomly divided into training and validation cohorts. Variables in the training cohort were subjected to a predictive nomogram based on multivariate logistic regression analysis and a stepwise algorithm. We assessed the performance of the nomogram through the area under the receiver operating characteristic (ROC) curve (AUC) and decision curve analysis (DCA) in both the training and validation cohorts.

Results
A total of 207 cases of invasive candidiasis were examined, and the crude 30-day mortality was 28.0%. Candida albicans (48.3%) was the predominant species responsible for infection, followed by the Candida glabrata complex (24.2%) and Candida tropicalis (10.1%). The training and validation cohorts contained 147 and 60 cases, respectively. The predictive nomogram consisted of bloodstream infections, intensive care unit (ICU) admitted > 3 days, no prior surgery, metastasis and no source control. The AUCs of the training and validation cohorts were 0.895 (95% confidence interval [CI], 0.846–0.945) and 0.862 (95% CI, 0.770–0.955), respectively. The net benefit of the model performed better than “treatment for all” in DCA and was also better for opting low-risk patients out of treatment than “treatment for none” in opt-out DCA.

Conclusion
Cancer patients with invasive candidiasis exhibit high crude mortality. The predictive nomogram established in this study can provide a probability of mortality for a given patient, which will be beneficial for therapeutic strategies and outcome improvement.
Asymmetric response to ranibizumab in mixed choroidal neovascularization in a neovascular age-related macular degeneration diagnosed on OCT angiography – case report
Authors: Pencak Martin , Veith Miroslav 
Published: January 2021

Abstract
Background
To present a case report of a patient with a mixed choroidal neovascular membrane (CNV) with an asymmetric response to ranibizumab diagnosed on optical coherence tomography angiography (OCTa).

Case presentation
A 61-year-old male was referred to our department in September 2017 due to decreased vision in his left eye. Best-corrected visual acuity (BCVA) was 43 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the left eye. Macular edema was present in the left eye, and a mixed CNV was identified on the OCTa. Therapy with intravitreal ranibizumab was commenced. After 5 ranibizumab injections, the BCVA was 42 ETDRS letters, and considerable intraretinal edema was still present. OCTa showed a resolution of the type 2 lesion of the mixed CNV; however, the type 1 lesion had continued to grow. The patient was then switched to intravitreal aflibercept. After 3 monthly aflibercept injections, the BCVA improved to 53 ETDRS letters, and a reduction of the edema was observed on the optical coherence tomography (OCT). OCTa showed a decrease in both the area and vessel density in the type 1 lesion of the CNV. Therapy with aflibercept was continued; however, while the intraretinal edema continued to improve, atrophy developed in the macula and the BCVA worsened to 43 ETDRS letters.

Conclusions
Ranibizumab nonresponse in a neovascular age-related macular degeneration is not uncommon. However, to our knowledge, this is the first described case of an asymmetric response to ranibizumab in a mixed CNV. While the type 2 lesion of the CNV reacted swiftly to the ranibizumab therapy, the type 1 lesion continued to grow. As with some other cases of ranibizumab resistance, switching to aflibercept proved effective.
Analysis of hand-forearm anthropometric components in assessing handgrip and pinch strengths of school-aged children and adolescents: a partial least squares (PLS) approach
Authors: Rostamzadeh Sajjad , Saremi Mahnaz , Vosoughi Shahram , Bradtmiller Bruce , Janani Leila , Farshad Ali Asghar , Taheri Fereshteh 
Published: January 2021

Abstract
Background
The purpose of this study was to examine the influence of hand-forearm anthropometric dimensions on handgrip and pinch strengths among 7–18 years children and adolescents and to investigate the extent to which these variables can be used to predict hand strength.

Methods
Four types of hand strengths including handgrip, tip to tip, key, and three-jaw chuck pinches were measured in 2637 healthy children and adolescents (1391 boys and 1246 girls) aged 7–18 years using standard adjustable Jamar hydraulic hand dynamometer and pinch gauge. A set of 17 hand-forearm anthropometric dimensions were also measured with an accurate digital caliper and tape measure.

Results
No significant differences were found between the hand strengths of boys and girls up to the age of 10 years. Gender related differences in handgrip and pinches were observed from the age of 11 years onwards, with boys always being stronger. The dominant hand was stronger than the non-dominant hand (8% for handgrip and by about 10% for all three types of pinches). The strongest correlations were found between the hand length and hand strengths (r > 0.83 for handgrip and three all pinches; p < 0.001, 2-tailed). Based on the partial least squares (PLS) analysis, 8 out of 17 anthropometric indices including hand length, hand circumference, thumb length, index finger length, middle finger length, and forearm length had considerable loadings in the PLS analysis, which together accounted for 46% of the total variance.

Conclusions
These results may be used by health professionals in clinical settings as well as by designers to create ergonomic hand tools.
Cloud-based intelligent self-diagnosis and department recommendation service using Chinese medical BERT
Authors: Wang Junshu , Zhang Guoming , Wang Wei , Zhang Ka , Sheng Yehua 
Published: January 2021

AbstractWith the rapid development of hospital informatization and Internet medical service in recent years, most hospitals have launched online hospital appointment registration systems to remove patient queues and improve the efficiency of medical services. However, most of the patients lack professional medical knowledge and have no idea of how to choose department when registering. To instruct the patients to seek medical care and register effectively, we proposed CIDRS, an intelligent self-diagnosis and department recommendation framework based on Chinese medical Bidirectional Encoder Representations from Transformers (BERT) in the cloud computing environment. We also established a Chinese BERT model (CHMBERT) trained on a large-scale Chinese medical text corpus. This model was used to optimize self-diagnosis and department recommendation tasks. To solve the limited computing power of terminals, we deployed the proposed framework in a cloud computing environment based on container and micro-service technologies. Real-world medical datasets from hospitals were used in the experiments, and results showed that the proposed model was superior to the traditional deep learning models and other pre-trained language models in terms of performance.
Past, present, and future of smart learning: a topic-based bibliometric analysis
Authors: Chen Xieling , Zou Di , Xie Haoran , Wang Fu Lee 
Published: January 2021

AbstractInnovative information and communication technologies have reformed higher education from the traditional way to smart learning. Smart learning applies technological and social developments and facilitates effective personalized learning with innovative technologies, especially smart devices and online technologies. Smart learning has attracted increasing research interest from the academia. This study aims to comprehensively review the research field of smart learning by conducting a topic modeling analysis of 555 smart learning publications collected from the Scopus database. In particular, it seeks answers to (1) what the major research topics concerning smart learning were, and (2) how these topics evolved. Results demonstrate several major research issues, for example, Interactive and multimedia learning, STEM (science, technology, engineering, and mathematics) education, Attendance and attention recognition, Blended learning for smart learning, and Affective and biometric computing. Furthermore, several emerging topics were identified, for example, Smart learning analytics, Software engineering for e-learning systems, IoT (Internet of things) and cloud computing, and STEM education. Additionally, potential inter-topic directions were highlighted, for instance, Attendance and attention recognition and IoT and cloud computing, Semantics and ontology and Mobile learning, Feedback and assessment and MOOCs (massive open online courses) and course content management, as well as Blended learning for smart learning and Ecosystem and ambient intelligence.
A novel roadmap connecting the 1H-MRS total choline resonance to all hallmarks of cancer following targeted therapy
Authors: Iorio Egidio , Podo Franca , Leach Martin O. , Koutcher Jason , Blankenberg Francis G. , Norfray Joseph F. 
Published: January 2021

AbstractThis review describes a cellular adaptive stress signalling roadmap connecting the1H magnetic resonance spectroscopy (MRS) total choline peak at 3.2 ppm (tCho) to cancer response after targeted therapy (TT). Recent research on cell signalling, tCho metabolism, and TT of cancer has been retrospectively re-examined. Signalling research describes how the unfolded protein response (UPR), a major stress signalling network, transduces, regulates, and rewires the total membrane turnover in different cancer hallmarks after a TT stress. In particular, the UPR signalling maintains or increases total membrane turnover in all pro-survival hallmarks, whilst dramatically decreases turnover during apoptosis, a pro-death hallmark. Recent research depicts the TT-induced stress as a crucial event responsible for interrupting UPR pro-survival pathways, leading to an UPR-mediated cell death. The1H-MRS tCho resonance represents the total mobile precursors and products during the enzymatic modification of phosphatidylcholine membrane abundance. The tCho profile represents a biomarker that noninvasively monitors TT-induced enzymatic changes in total membrane turnover in a wide variety of existing and new anticancer treatments targeting specific layers of the UPR signalling network. Our overview strongly suggests further evaluating and validating the1H-MRS tCho peak as a powerful noninvasive imaging biomarker of cancer response in TT clinical trials.