bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantification of Cervical Cord Cross-Sectional Area: Which Acquisition, Vertebra Level, and Analysis Software? A Multicenter Repeatability Study on a Traveling Healthy Volunteer
Authors: Lukas Carsten , Bellenberg Barbara , Prados Ferran , Valsasina Paola , Parmar Katrin , Brouwer Iman , Pareto Deborah , Rovira Àlex , Sastre-Garriga Jaume , Gandini Wheeler-Kingshott Claudia A. M. , Kappos Ludwig , Rocca Maria A. , Filippi Massimo , Yiannakas Marios , Barkhof Frederik , Vrenken Hugo 
Published: August 2021

Background: Considerable spinal cord (SC) atrophy occurs in multiple sclerosis (MS). While MRI-based techniques for SC cross-sectional area (CSA) quantification have improved over time, there is no common agreement on whether to measure at single vertebral levels or across larger regions and whether upper SC CSA can be reliably measured from brain images.Aim: To compare in a multicenter setting three CSA measurement methods in terms of repeatability at different anatomical levels. To analyze the agreement between measurements performed on the cervical cord and on brain MRI.Method: One healthy volunteer was scanned three times on the same day in six sites (three scanner vendors) using a 3T MRI protocol including sagittal 3D T1-weighted imaging of the brain (covering the upper cervical cord) and of the SC. Images were analyzed using two semiautomated methods [NeuroQLab (NQL) and the Active Surface Model (ASM)] and the fully automated Spinal Cord Toolbox (SCT) on different vertebral levels (C1–C2; C2/3) on SC and brain images and the entire cervical cord (C1–C7) on SC images only.Results: CSA estimates were significantly smaller using SCT compared to NQL and ASM (p &lt; 0.001), regardless of the cord level. Inter-scanner repeatability was best in C1–C7: coefficients of variation for NQL, ASM, and SCT: 0.4, 0.6, and 1.0%, respectively. CSAs estimated in brain MRI were slightly lower than in SC MRI (all p ≤ 0.006 at the C1–C2 level). Despite protocol harmonization between the centers with regard to image resolution and use of high-contrast 3D T1-weighted sequences, the variability of CSA was partly scanner dependent probably due to differences in scanner geometry, coil design, and details of the MRI parameter settings.Conclusion: For CSA quantification, dedicated isotropic SC MRI should be acquired, which yielded best repeatability in the entire cervical cord. In the upper part of the cervical cord, use of brain MRI scans entailed only a minor loss of CSA repeatability compared to SC MRI. Due to systematic differences between scanners and the CSA quantification software, both should be kept constant within a study. The MRI dataset of this study is available publicly to test new analysis approaches.
Extrahippocampal Radiomics Analysis Can Potentially Identify Laterality in Patients With MRI-Negative Temporal Lobe Epilepsy
Authors: Cheong E-Nae , Park Ji Eun , Jung Da Eun , Shim Woo Hyun 
Published: August 2021

Objective: The objective of the study was to investigate whether radiomics features of extrahippocampal regions differ between patients with epilepsy and healthy controls, and whether any differences can identify patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE).Methods: Data from 36 patients with hippocampal sclerosis (HS) and 50 healthy controls were used to construct a radiomics model. A total of 1,618 radiomics features from the affected hippocampal and extrahippocampal regions were compared with features from healthy controls and the unaffected side of patients. Using a stepwise selection method with a univariate t-test and elastic net penalization, significant predictors for identifying TLE were separately selected for the hippocampus (H+) and extrahippocampal region (H–). Each model was independently validated with an internal set of MRI-negative adult TLE patients (n = 22) and pediatric validation cohort with MRI-negative TLE (n = 20) from another tertiary center; diagnostic performance was calculated using area under the curve (AUC) of the receiver-operating-characteristic curve analysis.Results: Forty-eight significant H+ radiomic features and 99 significant H– radiomic features were selected from the affected side of patients and used to create a hippocampus model and an extrahippocampal model, respectively. Texture features were the most frequently selected feature. Training set showed slightly higher accuracy between hippocampal (AUC = 0.99) and extrahippocampal model (AUC = 0.97). In the internal validation and external validation sets, the extrahippocampal model (AUC = 0.80 and 0.92, respectively) showed higher diagnostic performance for identifying the affected side of patients than the hippocampus model (AUC = 0.67 and 0.69).Significance: Radiomics revealed extrahippocampal abnormality in the affected side of patients with TLE and could potentially help to identify MRI-negative TLE.Classification of Evidence: Class IV Criteria for Rating Diagnostic Accuracy Studies.
The Feasibility of a Fast Liver MRI Protocol for Lesion Detection of Adults at 3.0-T
Authors: Li Jing , Ma Chao , Chen Yukun , Fu Caixia , Wang Xinrui , Kuehn Bernd , Yang Qingsong , Lu Jianping 
Published: August 2021

PurposeTo investigate the feasibility of a fast liver magnetic resonance imaging (MRI) protocol for lesion detection in adults using 3.0-T MRI.MethodsA fast liver MRI exam protocol was proposed. The protocol included motion-resistant coronal T2-w sequence, axial T2-w fast spin echo sequence with fat suppression, axial in-op phase gradient recalled echo (GRE) T1, axial diffusion weighted imaging (DWI), and axial contrast-enhanced T1 sequences. To evaluate the diagnostic capacity of the proposed protocol, 31 consecutive patients (20 males and 11 females; mean age, 53.2 years) underwent a liver MRI exam with conventional sequences, including the proposed protocol as a subset. Images from the conventional protocol and extracted abbreviated protocol were independently read, and the diagnostic concordance rate was assessed for each patient. The concordance analysis is presented as the proportion of concordant cases between the two protocols.ResultsThe net measurement time of the fast liver MRI protocol without adjustment and waiting time were 4 min and 28 s. In the 31 patients included in this study, 139 suspicious findings were found from both the conventional liver MR protocol and the fast liver MRI protocol. The diagnostic concordance rate was 96.4%.ConclusionsThe fast liver MRI protocol is feasible at 3.0-T, with a shorter exam time and high diagnostic concordance compared to the conventional liver MRI workflow.
Efficacy and Safety of Astragalus-Containing Traditional Chinese Medicine Combined With Platinum-Based Chemotherapy in Advanced Gastric Cancer: A Systematic Review and Meta-Analysis
Authors: Cheng Mengqi , Hu Jiaqi , Zhao Yuwei , Jiang Juling , Qi Runzhi , Chen Shuntai , Li Yaoyuan , Zheng Honggang , Liu Rui , Guo Qiujun , Zhang Xing , Qin Yinggang , Hua Baojin 
Published: August 2021

BackgroundAstragalus-containing traditional Chinese medicine (TCM) is widely used as adjunctive treatment to platinum-based chemotherapy (PBC) in patients with advanced gastric cancer (AGC) in China. However, evidence regarding its efficacy remains limited. This study aimed to evaluate the efficacy and safety of Astragalus-containing TCM combined with PBC in AGC treatment.MethodsWe searched for literature (up to July 19, 2020) in eight electronic databases. The included studies were reviewed by two researchers. The main outcomes were the objective response rate (ORR), disease control rate (DCR), survival rate, quality of life (QOL), adverse drug reactions (ADRs), and peripheral blood lymphocyte levels. The effect estimate of interest was the risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CIs). Trial sequential analysis (TSA) was used to detect the robustness of the primary outcome and to calculate the required information size (RIS). Certainty of the evidence was assessed using the GRADE profiler.ResultsResults based on available literature showed that, compared with patients treated with PBC alone, those treated with Astragalus-containing TCM had a better ORR (RR: 1.24, 95% CI: 1.15–1.34, P &lt; 0.00001), DCR (RR: 1.10, 95% CI: 1.06–1.14, P &lt; 0.00001), 1-year survival rate (RR: 1.41, 95% CI: 1.09–1.82, P = 0.009), 2-year survival rate (RR: 3.13, 95% CI: 1.80–5.46, P &lt; 0.0001), and QOL (RR: 2.03, 95% CI: 1.70–2.43, P &lt; 0.00001 and MD: 12.39, 95% CI: 5.48–19.30, P = 0.0004); higher proportions of CD3+ T cells and CD3+ CD4+ T cells; higher ratio of CD4+/CD8+ T cells; nature killer cells; and lower incidence of ADRs. Subgroup analysis showed that both oral and injection administration of Astragalus-containing TCM increased tumor response. Whether treatment duration was ≥8 weeks or &lt;8 weeks, Astragalus-containing TCM could increase tumor response in AGC patients. Furthermore, Astragalus-containing TCM combined with oxaliplatin-based chemotherapy could increase the ORR and DCR; when with cisplatin, it could only increase the ORR.ConclusionCurrent low to moderate evidence revealed that Astragalus-containing TCM combined with PBC had better efficacy and less side effects in the treatment of AGC; however, more high-quality randomized studies are warranted.Systematic Review RegistrationPROSPERO, identifier CRD42020203486.
Tumor Burden Measured by 18F-FDG PET/CT in Predicting Efficacy and Adverse Effects of Chimeric Antigen Receptor T-Cell Therapy in Non-Hodgkin Lymphoma
Authors: Hong Ruimin , Tan Su Yin Elaine , Wang Linqin , Zhao Xin , Zhou Linghui , Wang Guangfa , Zhang Mingming , Zhao Houli , Wei Guoqing , Wang Yiyun , Wu Wenjun , Zhang Yafei , Ni Fang , Hu Yongxian , Huang He , Zhao Kui 
Published: August 2021

Chimeric antigen receptor (CAR) T-cell therapy has exhibited promising clinical outcomes in treating relapsed/refractory (R/R) B-cell hematologic malignancies. Current studies have shown a close correlation between baseline tumor burden and therapeutic response in CAR-T cell therapy. However, the roles of PET/CT metabolic parameters, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG), remain unclear in this setting. In this study, we retrospectively reviewed 41 R/R NHL patients. 18F-FDG PET/CT was used to measure the average standardized uptake value (SUVavg), MTV, and TLG of the lymphomatous lesions. These patients were divided into two groups according to the optimal cutoff values of respective PET/CT metabolic parameters. The multivariate analysis depicted that early post-therapy SUVavg (HR: 1.418, 95% CI: 1.029, 1.955; p = 0.033) and MTV (HR: 1.001, 95% CI: 1.000, 1.002; p = 0.041) were independent risk factors associated with OS and PFS, respectively. Patients with baseline SUVavg &lt; 4.36 achieved a superior 1-year OS rate than the SUVavg ≥ 4.36 group (100.0% vs. 44.9%, p = 0.019). For the patients with lower values in early post-therapy SUVavg (&lt;2.60) (51.1% vs. 0%, p &lt; 0.001), MTV (&lt;0.55 cm3) (53.6% vs. 0.0%, p = 0.001), and TLG (&lt;1.54) (53.6% vs. 0.0%, p = 0.001), their 1-year PFS rates were higher than the compared groups. Moreover, patients with higher baseline tumor burdens were found to have significantly increased CRS incidence and cytokine levels. In conclusion, the PET/CT metabolic parameters are closely related to OS, PFS, and CRS in R/R NHL patients treated with CAR-T cells. This study may pave the way for building a comprehensive assessment system of tumor burden using 18F-FDG PET/CT, which can optimize therapeutic and supportive approaches in CAR-T cell therapy.
Identification of the Crucial Gene in Overflow Arteriovenous Fistula by Bioinformatics Analysis
Authors: Zhao Zhengde , Fu Qining , Hu Liangzhu , Liu Yangdong 
Published: August 2021

Objective: The aim was to study the preliminary screening of the crucial genes in intimal hyperplasia in the venous segment of arteriovenous (AV) fistula and the underlying potential molecular mechanisms of intimal hyperplasia with bioinformatics analysis.Methods: The gene expression profile data (GSE39488) was analyzed to identify differentially expressed genes (DEGs). We performed Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis of DEGs. Gene set enrichment analysis (GSEA) was used to understand the potential activated signaling pathway. The protein–protein interaction (PPI) network was constructed with the STRING database and Cytoscape software. The Venn diagram between 10 hub genes and gene sets of 4 crucial signaling pathways was used to obtain core genes and relevant potential pathways. Furthermore, GSEAs were performed to understand their biological functions.Results: A total of 185 DEGs were screened in this study. The main biological function of the 111 upregulated genes in AV fistula primarily concentrated on cell proliferation and vascular remodeling, and the 74 downregulated genes in AV fistula were enriched in the biological function mainly relevant to inflammation. GSEA found four signaling pathways crucial for intimal hyperplasia, namely, MAPK, NOD-like, Cell Cycle, and TGF-beta signaling pathway. A total of 10 hub genes were identified, namely, EGR1, EGR2, EGR3, NR4A1, NR4A2, DUSP1, CXCR4, ATF3, CCL4, and CYR61. Particularly, DUSP1 and NR4A1 were identified as core genes that potentially participate in the MAPK signaling pathway. In AV fistula, the biological processes and pathways were primarily involved with MAPK signaling pathway and MAPK-mediated pathway with the high expression of DUSP1 and were highly relevant to cell proliferation and inflammation with the low expression of DUSP1. Besides, the biological processes and pathways in AV fistula with the high expression of NR4A1 similarly included the MAPK signaling pathway and the pathway mediated by MAPK signaling, and it was mainly involved with inflammation in AV fistula with the low expression of NR4A1.Conclusion: We screened four potential signaling pathways relevant to intimal hyperplasia and identified 10 hub genes, including two core genes (i.e., DUSP1 and NR4A1). Two core genes potentially participate in the MAPK signaling pathway and might serve as the therapeutic targets of intimal hyperplasia to prevent stenosis after AV fistula creation.
Psychosocial Factors Associated With Resilience Among Iranian Nurses During COVID-19 Outbreak
Authors: Afshari Davood , Nourollahi-darabad Maryam , Chinisaz Niloofar 
Published: August 2021

Background: In the face of COVID-19, healthcare workers need to cope with the ongoing stressors at play and keep psychological distress at a minimum level. This study examined the psychosocial and demographic factors associated with nurse's resilience in the hospitals of Ahvaz that is one of the top cities infected with COVID-19 in Iran.Methods: The present cross-sectional study was conducted on 387 Iranian nurses in Ahvaz city. For data collection purposes, three online questionnaires (including Copenhagen Psychosocial, Demographic, and Connor–Davidson Resilience Scale) were distributed among the participants.Results: The mean resilience score was equal to 61.8 ± 14.8 for 387 nurses. Resilience had a statistically significant negative correlation with quantitative demand (r = −0.273, P &lt; 0.008), work pace (r = −0.262, P &lt; 0.011), emotional demand (r = −0.226, P &lt; 0.030), stress (r = −0.458, P &lt; 0.000), and burnout (r = −0.287, P &lt; 0.005). Multiple linear regression analysis indicated that stress, job satisfaction, burnout and age were the main predictors of nurses' resilience during the (COVID-19) pandemic (R2 = 0.45).Conclusions: We identified psychosocial and demographic predictive factors that may contribute to greater resilience among nurses during the COVID-19 outbreak. The findings of this study can be used to implement psychosocial interventions to amplify the resilience of medical staff during the COVID-19 outbreak.
Counterstreaming Cold H+, He+, O+, and N+ Outflows in the Plasmasphere
Authors: Krall J. , Huba J. D. 
Published: August 2021

The Naval Research Laboratory (NRL) Sami3 is Also a Model of the Ionosphere (SAMI3) ionosphere/plasmasphere code is used to examine H+, He+, N+, and O+ thermal outflows during a storm. Here, H+ and He+ outflows are associated with refilling while O+ and N+ outflows are associated with ring current heating. An improved model of counterstreaming H+ outflows from the two hemispheres is presented, using an implementation of SAMI3 with two fluid species for H+. The two-fluid H+ model avoids nonphysical high-altitude “top-down refilling” density peaks seen in one-fluid H+ simulations. Counterstreaming cold ion populations are found in all cases. In these fully three-dimensional simulations with realistic magnetosphere boundary conditions, nonphysical top-down refilling density peaks were milder than those found in previous single-field-line or single-magnetic-longitude simulations. In the present two-fluid H+ case, “bottom-up refilling” density peaks were so mild as to be difficult to detect. For O+ and N+, the nonphysical high-altitude density peak is a brief (1–2 h) transient that occurs when heating-driven northward and southward flows first meet. In general, He+ outflows mimic H+ outflows while N+ outflows mimic O+ outflows.
Effects of Intraoperative Fluid Management on Postoperative Outcomes After Pericardiectomy
Authors: Fang Likui , Zheng Hong , Yu Wenfeng , Chen Gang , Zhong Fangming 
Published: August 2021

Background: The effects of intraoperative fluid management on the patients with constrictive pericarditis undergoing pericardiectomy remain unclear. This study explored the relationship between intraoperative fluid management and postoperative outcomes in these patients.Methods: We retrospectively studied 92 patients with constrictive pericarditis undergoing pericardiectomy and assigned them to the restrictive group and the liberal group according to the intraoperative total fluid infusion rate. Postoperative outcomes were compared between the two groups. Binary logistic regression analysis was performed to determine the relationship between the intraoperative total fluid infusion rate and postoperative outcomes.Results: There were 46 (50.0%) cases in the restrictive group and 46 (50.0%) cases in the liberal group. Compared with the liberal group, the restrictive group had significantly lower incidences of postoperative complications and cardiac complications (P = 0.005 and P = 0.006, respectively). Binary logistics regression analysis also showed the increased risks of postoperative complications (OR, 3.551; 95% CI, 1.192–10.580; P = 0.023) and cardiac complications (OR, 6.037; 95% CI, 1.472–25.052; P = 0.013) at the liberal group. In addition, the restrictive group had shorter postoperative hospital stay (P = 0.026) in comparison to the liberal group.Conclusion: In patients with constrictive pericarditis undergoing pericardiectomy the intraoperative total fluid infusion rate was significantly associated with postoperative outcomes. Restrictive fluid management strategy was related to the positive effects on enhanced recovery after surgery and could be advised as the preferred intraoperative fluid management policy.
A Meta-Analysis of Randomized Controlled Trials Concerning the Efficacy of Transversus Abdominis Plane Block for Pain Control After Laparoscopic Cholecystectomy
Authors: Wang Weihua , Wang Lishan , Gao Yan 
Published: August 2021

Background and Purpose: Transverse abdominis plane (TAP) block has been suggested to reduce post-operative pain after laparoscopic cholecystectomy (LC). However, the literature is divided on whether ultrasound (USG)-guided TAP block is effective for pain control after LC. The present meta-analysis therefore evaluated the efficacy of USG-guided TAP block vs. controls and port site infiltration for pain control after LC.Methods: A comprehensive literature search of online academic databases was performed for published randomized controlled trials (RCTs) for studies published to January 31, 2021. The primary outcome analyzed was post-operative pain score at 0, 6, 12, and 24 h post-surgery, both during rest and while coughing. Secondary outcomes included morphine consumption and post-operative nausea and vomiting (PONV) incidence.Results: A total of 23 studies with data on 1,450 LC patients were included in our meta-analysis. A reduction in pain intensity at certain post-operative timepoints was observed for USG-guided TAP block patients compared to control group patients. No reduction in pain intensity was observed for patients receiving USG-guided TAP block patients vs. conventional Port site infiltration.Conclusion: This meta-analysis concludes that TAP block is more effective than a conventional pain control, but not significatively different from another local incisional pain control that is port site infiltration. Additional prospective randomized controlled trials are required to further validate our findings.
The Impact of Low-luminosity AGNs on Their Host Galaxies: A Radio and Optical Investigation of the Kiloparsec-scale Outflow in MaNGA 1-166919
Authors: Al Yazeedi Aisha , Katkov Ivan Yu. , Gelfand Joseph D. , Wylezalek Dominika , Zakamska Nadia L. , Liu Weizhe 
Published: August 2021

Abstract
One way an active galactic nucleus (AGN) influences the evolution of their host galaxy is by generating a large-scale (kiloparsec-scale) outflow. The content, energetics, and impact of such outflows depend on the properties of both the AGN and host galaxy, and understanding the relationship between them requires measuring the properties of all three. In this paper, we do so by analyzing recent radio and optical integral field unit spectroscopic observations of MaNGA 1-166919. Our results indicate that the biconical outflow in this galaxy is powered by a low-luminosity, low Eddington ratio AGN ejecting material that drives ∼100–200 km s−1 shocks into the surrounding interstellar medium—producing the hot, ionized gas and relativistic particles associated with the observed outflow. The energetics of the relativistic and ionized gas material produced at this shock are comparable, and both the mass outflow and kinetic power of the ionized gas in this outflow are higher than other AGNs with similar bolometric luminosities. Lastly, while the host galaxy’s total star formation rate is comparable to that of other star-forming galaxies with a similar stellar mass, there is evidence that the outflow both suppresses and enhances star formation in its immediate surroundings.
A Signature of 27 day Solar Rotation in the Concentration of Metallic Ions within the Terrestrial Ionosphere
Authors: Yu Bingkun , Scott Christopher J. , Xue Xianghui , Yue Xinan , Chi Yutian , Dou Xiankang , Lockwood Mike 
Published: August 2021

Abstract
We present observations during the interval 2006–2014 of 27 day and 13.5 day periodic oscillations in the ionospheric sporadic E (Es) layer. This is a thin, dense layer composed of metallic ions in the Earth’s upper atmosphere between 90 and 130 km. Lomb–Scargle spectral and wavelet analyses reveal that these pronounced periodicities observed from ground-based ionosondes and GPS/GNSS radio occultations are associated with high-speed solar winds generated from persistent coronal holes on successive 27 day solar rotations. The 27 day and 13.5 day oscillations in the Es layers are dependent on latitude, showing a higher magnitude of periodicities at low latitudes between 0° and 15° and at high latitudes between 45° and 90° (10%–14%) than those at midlatitudes between 15° and 45° (4%–10%). The 27 day and 13.5 day oscillations in the high-latitude Es layers correlate well with the geomagnetic activity Dst and Ap indices, and these periodic oscillations become more significant at the solar maximum (2000–2003 and 2011–2014) than at the solar minimum.