bluuebunny/crossref_metadata_2025_split huggingface dataset:
Testosterone and Estradiol as Novel Prognostic Indicators for HBV-Related Acute-on-Chronic Liver Failure
Authors: Sun Shuning , Xu Baoyan , Tan Wenting , Xiang Xiaomei , Zhou Yi , Dan Yunjie , Guo Yanzhi , Tan Zhaoxia , Deng Guohong 
Published: September 2021

Background: HBV-related acute-on-chronic liver failure (HBV-ACLF) has a high short-term mortality and urgently needs an early warning system with simplicity and high accuracy. Previous studies show that sex hormones play potential roles in the progression of HBV-related liver diseases.Aims: To explore the effect of testosterone and estradiol on the occurrence and prognosis of HBV-ACLF.Methods: A prospective cohort of 300 chronic hepatitis B (CHB) patients was enrolled among which 108 were diagnosed with HBV-ACLF at admission and 20 developed to HBV-ACLF during hospitalization. We compared the level of serum testosterone and estradiol of patients with varied ACLF background, disease severity and cirrhosis conditions and analyzed the predictive ability of short-term prognosis. A novel prognostic model involving testosterone was developed and further validated in the HBV-ACLF group.Results: The baseline estradiol level of HBV-ACLF group was significantly higher while testosterone was lower than that of non-ACLF group. The estradiol level increased while the testosterone level decreased as the number of organ failures increased. Testosterone had high accuracy in predicting the short-term mortality in HBV-ACLF (AUROC = 0.726) and estradiol did better in predicting the occurrence of ACLF during hospitalization (AUROC = 0.695). The novel prognostic model involving testosterone (TATIM model) was proved to have considerable prediction efficiency in HBV-ACLF cohort with or without cirrhosis.Conclusion: Testosterone could be utilized as short-term prognostic indicator for HBV-related ACLF and estradiol can help to predict its occurrence. TATIM model is a novel prognostic model for HBV-related ACLF with simplicity and good performance irrespectively of liver cirrhosis.Clinical Trial Registration Number: This study was based on a sub-cohort from the prospective multicenter cohort (NCT02457637).
Hypothetical Interventions for Falls Among Older Adults: An Application of the Parametric G-Formula
Authors: Ren Jiaojiao , Li Guangyou , Zhang Liju , Zhang Na , Ren Juan 
Published: September 2021

Introduction: Falls, which have a higher incidence and mortality due to accidental injuries, are a major global health challenge. The effects of lifestyle factor, health indicator, psychological condition, and functional status interventions on the risk of falls are unknown and the conventional regression model would not adjust for the confounders. This study aimed to evaluate the 4-year risk of falls on the basis of these hypothetical interventions among Chinese older adults.Methods: Data were obtained from 9,692 aged 65 years and over older adults in the China Health and Retirement Longitudinal Study wave, from 2011 to 2015. We used the parametric g-formula to evaluate the risk of falls on the basis of independent hypothetical interventions of sleep duration, social activities, smoking status, drinking status, body mass index (BMI), systolic blood pressure (SBP), vision, depression, activities of daily living (ADL), and their different joint intervention combinations.Results: During the follow-up of 4 years, we documented 1,569 falls. The observed risk of falls was 23.58%. The risk ratios (95% confidence intervals [CIs]) of falls under the intensive hypothetical interventions on increasing sleep duration, participating in more social activities, quit smoking and drinking, reducing BMI and SBP, better vision, alleviating depressive symptoms, and improving ADL capability were 0.93 (0.87–0.96), 0.88 (0.79–0.92), 0.98 (0.95–1.03), 0.97 (0.95–1.02), 0.92 (0.86–1.03), 0.93 (0.87–1.04), 0.86 (0.74–0.91), 0.91 (0.85–0.96), and 0.79 (0.74–0.85), respectively. The feasible and intensive joint hypothetical intervention reduced the 4-year fall risk by 22% (95% CI: 0.52–0.91) and 33% (95% CI: 0.56–0.72), respectively.Conclusions: Hypothetical interventions for increasing sleep duration, participating in more social activities, better vision, alleviating depressive symptoms, and improving ADL capability help protect older adults from falls. Our findings suggest that a combination of lifestyle factors, health indicators, psychological conditions, and functional status may prove to be an effective strategy for preventing falls among older adults.
Associations Between Polyvascular Disease and Stroke Recurrence in Patients With Lacunar Stroke
Authors: Ma Lin , Wang Anxin , Zhang Yijun , Wang Yilong , Wang Yongjun , Meng Xia 
Published: September 2021

Background and purpose: This study aimed to examine the association of polyvascular disease and clinical outcomes in patients with lacunar stroke.Methods: Data of patients with recent lacunar stroke were collected from The Third China National Stroke Registry. Polyvascular disease is defined as the existence of atherosclerosis across two or more vascular beds. For the present study, polyvascular disease patients were grouped as follows: coronary heart disease (CHD) and lacunar stroke, peripheral arterial disease (PAD) and lacunar stroke, and CHD/PAD and lacunar stroke. The major clinical outcome was recurrence, and the secondary clinical outcome was major adverse cardiovascular events (MACEs). A Cox proportional multivariable hazards regression model was applied to estimate the association between polyvascular disease and outcomes.Results: Among 3,165 patients with recent lacunar stroke, CHD was present in 375 (11.8%) and peripheral arterial disease in 168 (5.3%). The hazard ratio (HR) for stroke recurrence was 0.98 (95% confidence interval [CI], 0.65–1.46; p = 0.91) for patients with CHD and lacunar stroke, 1.07 (95% CI, 0.61–1.87; p = 0.82) for patients with PAD and lacunar stroke, and 0.95 (95% CI, 0.66–1.35; p = 0.75) for patients with CHD/PAD and lacunar stroke compared with patients with isolated lacunar stroke. The HR for MACEs was 1.01 (95% CI, 0.69–1.49; p = 0.94) for patients with CHD and lacunar stroke, 1.11 (95% CI, 0.65–1.90; p = 0.71) for patients with PAD and lacunar stroke, and 0.99 (95% CI, 0.70–1.40; p = 0.95) for patients with CHD/PAD and lacunar stroke.Conclusion: Polyvascular disease is not associated with recurrence of stroke and MACEs in patients with recent lacunar stroke at 1 year.
Multi-Target and Multi-Session Transcranial Direct Current Stimulation in Patients With Prolonged Disorders of Consciousness: A Controlled Study
Authors: Zhang Xu , Liu Baohu , Li Yuanyuan , Duan Guoping , Hou Jun , Wu Dongyu 
Published: September 2021

Objectives: To investigate the effect of multi-session transcranial direct current stimulation (tDCS) over the prefrontal area, left dorsolateral prefrontal cortex (DLPFC), and bilateral fronto-temporo-parietal cortices (FTPCs) in patients with prolonged disorders of consciousness (DOC) and to examine the altered cortical interconnections using non-linear electroencephalography (EEG).Methods: In this open-label controlled study, conventional treatments were implemented in both the control and tDCS groups, together with 80 tDCS sessions only in the tDCS group. The order of tDCS targets was as follows: prefrontal area, left FTPC, right FTPC, and left DLPFC. The Coma Recovery Scale-Revised (CRS-R) and non-linear EEG index were evaluated before and after the treatment. Additionally, the modified Glasgow Outcome Scale (mGOS) was used as a follow-up evaluation at 12 months after the disease onset.Results: The CRS-R improved significantly in both groups after the treatment. However, the CRS-R and mGOS were more significantly improved in the tDCS group than in the control group. Among the cross approximate entropy (C-ApEn) indices, the local CA-PA and CA-FA under the affected painful stimulus condition and all local and remote indices of the unaffected side under the unaffected painful stimulus condition were significantly higher in the tDCS group than in the control group. Multivariate logistic regression analysis revealed that group and type were the main relevant factors based on mGOS improvement. Multivariate linear regression analysis revealed that group, CA-FA, and CU-MTU were the main relevant factors based on CRS-R improvement under the affected painful stimulus conditions, whereas only CU-MTU and CU-FPU were relevant under the unaffected painful stimulus condition.Conclusion: Multi-target and multi-session tDCS could improve the cortical connections between the primary sensorimotor and frontal cortices of the affected hemisphere and the prefrontal-parietal and temporo-parietal associative cortical networks of the unaffected hemisphere. Thus, this tDCS protocol may be used as an add-on treatment for prolonged DOC.
Transcriptomic and Mutational Analysis Discovering Distinct Molecular Characteristics Among Chinese Thymic Epithelial Tumor Patients
Authors: Liang Naixin , Liu Lei , Huang Cheng , Liu Hongsheng , Guo Chao , Li Ji , Wang Weiwei , Li Nan , Lin Rui , Wang Tao , Ding Lieming , Mao Li , Li Shanqing 
Published: September 2021

IntroductionThymic epithelial tumors (TETs) are malignancies arising from the epithelium of the thymic gland, rare but with relatively favorable prognosis. TETs have different pathological subtypes: thymomas and thymic carcinoma, and they show different clinical characteristics regarding prognosis, pathology, and molecular profiles, etc. Although some studies have investigated the pathogenesis of TETs, more molecular data is still needed to further understand the underlying mechanisms among different TETs subtypes and populations.MethodsIn this study, we performed targeted gene panel sequencing and whole transcriptome sequencing on the tumor tissues from 27 Chinese TET patients, including 24 thymomas (A, AB, and B subtypes) and 3 thymic squamous cell carcinomas. We analyzed the genetic variations and differentially expressed genes among multiple TET subtypes. Moreover, we compared our data with the published The Cancer Genome Atlas (TCGA) TET data on both the genetic and transcriptomic levels.ResultsCompared with the TCGA TET genomic data, we found that NF1 and ATM were the most frequently mutated genes (each with a frequency of 11%, 3/27). These mutations were not mutually exclusive, since one B1 thymoma showed mutations of both genes. The GTF2I mutation was mainly enriched in subtype A and AB thymomas, consistent with the previous reports. RNA-seq results unveiled that the genes related to thymus development (FGF7, FGF10 and CLDN4) were highly expressed in certain TET subtypes, implicating that the developmental process of thymus might be linked to the tumorigenesis of these subtypes. We found high expression of CD274 (PD-L1) in B2 and B3 thymoma samples, and validated its expression using immunohistochemistry (IHC). Based on the expression profiles, we further established a machine learning model to predict the myasthenia gravis status of TET patients and achieved 90% sensitivity and 70.6% specificity in the testing cohort.ConclusionThis study provides the first genomic and transcriptomic analysis of a Chinese TET cohort. The high expression of genes involved in thymus developmental processes suggests the potential association between tumorigenesis of TETs and dysregulation of developmental pathways. The high expression of PD-L1 in B2 and B3 thymomas support the potential application of immunotherapy on certain thymoma subtypes.
Development of Nomograms for Predicting Lymph Node Metastasis and Distant Metastasis in Newly Diagnosed T1-2 Non-Small Cell Lung Cancer: A Population-Based Analysis
Authors: Qi Yiming , Wu Shuangshuang , Tao Linghui , Shi Yunfu , Yang Wenjuan , Zhou Lina , Zhang Bo , Li Jing 
Published: September 2021

BackgroundFor different lymph node metastasis (LNM) and distant metastasis (DM), the diagnosis, treatment and prognosis of T1-2 non-small cell lung cancer (NSCLC) are different. It is essential to figure out the risk factors and establish prediction models related to LNM and DM.MethodsBased on the surveillance, epidemiology, and end results (SEER) database from 1973 to 2015, a total of 43,156 eligible T1-2 NSCLC patients were enrolled in the retrospective study. Logistic regression analysis was used to determine the risk factors of LNM and DM. Risk factors were applied to construct the nomograms of LNM and DM. The predictive nomograms were discriminated against and evaluated by Concordance index (C-index) and calibration plots, respectively. Decision curve analysis (DCAs) was accepted to measure the clinical application of the nomogram. Cumulative incidence function (CIF) was performed further to detect the prognostic role of LNM and DM in NSCLC-specific death (NCSD).ResultsEight factors (age at diagnosis, race, sex, histology, T-stage, marital status, tumor size, and grade) were significant in predicting LNM and nine factors (race, sex, histology, T-stage, N-stage, marital status, tumor size, grade, and laterality) were important in predicting DM(all, P&lt; 0.05). The calibration curves displayed that the prediction nomograms were effective and discriminative, of which the C-index were 0.723 and 0.808. The DCAs and clinical impact curves exhibited that the prediction nomograms were clinically effective.ConclusionsThe newly constructed nomograms can objectively and accurately predict LNM and DM in patients suffering from T1-2 NSCLC, which may help clinicians make individual clinical decisions before clinical management.
Development and Validation of a 18F-FDG PET-Based Radiomic Model for Evaluating Hypermetabolic Mediastinal–Hilar Lymph Nodes in Non-Small-Cell Lung Cancer
Authors: Ouyang Ming-li , Wang Yi-ran , Deng Qing-shan , Zhu Ye-fei , Zhao Zhen-hua , Wang Ling , Wang Liang-xing , Tang Kun 
Published: September 2021

BackgroundAccurate evaluation of lymph node (LN) status is critical for determining the treatment options in patients with non-small cell lung cancer (NSCLC). This study aimed to develop and validate a 18F-FDG PET-based radiomic model for the identification of metastatic LNs from the hypermetabolic mediastinal–hilar LNs in NSCLC.MethodsWe retrospectively reviewed 259 patients with hypermetabolic LNs who underwent pretreatment 18F-FDG PET/CT and were pathologically confirmed as NSCLC from two centers. Two hundred twenty-eight LNs were allocated to a training cohort (LN = 159) and an internal validation cohort (LN = 69) from one center (7:3 ratio), and 60 LNs were enrolled to an external validation cohort from the other. Radiomic features were extracted from LNs of PET images. A PET radiomics signature was constructed by multivariable logistic regression after using the least absolute shrinkage and selection operator (LASSO) method with 10-fold cross-validation. The PET radiomics signature (model 1) and independent predictors from CT image features and clinical data (model 2) were incorporated into a combined model (model 3). A nomogram was plotted for the complex model, and the performance of the nomogram was assessed by its discrimination, calibration, and clinical usefulness.ResultsThe area under the curve (AUC) values of model 1 were 0.820, 0.785, and 0.808 in the training, internal, and external validation cohorts, respectively, showing good diagnostic efficacy for lymph node metastasis (LNM). Furthermore, model 2 was able to discriminate metastatic LNs in the training (AUC 0.780), internal (AUC 0.794), and external validation cohorts (AUC 0.802), respectively. Model 3 showed optimal diagnostic performance among the three cohorts, with an AUC of 0.874, 0.845, and 0.841, respectively. The nomogram based on the model 3 showed good discrimination and calibration.ConclusionsOur study revealed that PET radiomics signature, especially when integrated with CT imaging features, showed the ability to identify true and false positives of mediastinal–hilar LNM detected by PET/CT in patients with NSCLC, which would help clinicians to make individual treatment decisions.
Extraction Optimization of Polysaccharides From Corn Silk and Their Antioxidant Activities in vitro and in vivo
Authors: Zhang Liang , Yang Yang , Wang Zhanyong 
Published: September 2021

Response surface technique was employed for improving the extraction of corn silk polysaccharides (CSP). Temperature, liquid-to-solid ratio, and per extraction time were all examined as separate factors. The optimal extraction parameters were determined by fitting experimental data to a second-order polynomial; a liquid-to-solid ratio of 21.5 ml/g, temperature equivalent to 88°C, and extraction time of 1.87 h. The experimental yield of the extracted polysaccharides following the application of these conditions was 4.33 ± 0.08% (dry weight), which fit quite well with the predicted value. CSP’s strong scavenging capabilities against hydroxyls, 1,1-diphenyl-2-picrylhydrazyl radicals, and superoxide anions along with its excellent reducing potential, were demonstrated in an in vitro antioxidant experiment. Meanwhile, in vivo testing revealed that CSP substantially enhanced glutathione peroxidase and superoxide dismutase activities. The Malondialdehyde levels in the liver and serum of aged mice also underwent a decrease. This study found that CSP has a substantial antioxidant potential in vitro and in vivo, suggesting that it might be used as an antioxidant in food and medicine.
Influence of Perceptual Discriminability and Spatial Distance on Holistic Processing of Faces
Authors: Wang Chao-Chih , Shyi Gary C.-W. , Cheng Peter Kuan-Hao 
Published: September 2021

Background: Holistic processing is defined as the perceptual integration of facial features, and plays an important role in face recognition. While researchers recognize the crucial role played by holistic processing in face perception, a complete delineation of the underlying mechanisms is impending. Very few studies have examined the effects of perceptual discrimination and spatial perception on holistic processing. Hence, the present study aimed to examine the influence of perceptual discrimination and spatial perception on face recognition.Methods: We conducted two experiments by manipulating the perceptual discriminability of the target (the top-half faces) and non-target face (the bottom-half faces) parts in the composite-face task and examined how perceptual discriminability may affect holistic processing of faces.Results: The results of Experiment 1 illustrated that holistic processing was modulated by the perceptual discriminability of the face. Furthermore, differential patterns of perceptual discriminability with the target and non-target parts suggested that different mechanisms may be responsible for the influence of target and non-target parts on face perception. The results of Experiment 2 illustrated that holistic processing was modulated by spatial distance between two faces, implicating that feature-by-feature strategy might decrease the magnitude of holistic processing.Conclusion: The results of the present study suggest that holistic processing may lead to augmented perception effect exaggerating the differences between the two faces and may also be affected by the feature-by-feature strategy.
The Positive Impact of Joint Activities on Students Attitudes Toward Peers With Disabilities
Authors: Alnahdi Ghaleb H. , Schwab Susanne , Elahdi Ayman , Alnahdi Aminah H. 
Published: September 2021

Background:Attitudes toward peers with disabilities play a crucial role in implementing inclusive education. This study examines how students' attitudes are associated with gender; having relatives with disabilities and the frequency of contact with them; attending a class that includes students with special educational needs (SEN); and having previous contact with SEN students through joint activities.Methods and Procedures:The participants included 652 elementary school students (grades 4–6) who completed a short version of the Chedoke-McMaster Attitudes Toward Children with Handicaps (CATCH) questionnaire in Arabic.Outcomes and Results:Students in inclusive classes express more positive attitudes in comparison with students in regular classes. However, previous contact through joint activities was associated with more positive attitudes. Females were more likely to hold positive views than males. Having relatives with disabilities had no effect; however, a high frequency of contact with them was associated with more positive perspectives.Conclusions and Implications:The findings on students' attitudes indicate that joint activities between students with and without disabilities are important to promote positive attitudes. Planned opportunities to increase frequent contact, and to promote joint activities between students with and without SEN are recommended.
How Do Music Activities Affect Health and Well-Being? A Scoping Review of Studies Examining Psychosocial Mechanisms
Authors: Dingle Genevieve A. , Sharman Leah S. , Bauer Zoe , Beckman Emma , Broughton Mary , Bunzli Emma , Davidson Robert , Draper Grace , Fairley Sheranne , Farrell Callyn , Flynn Libby Maree , Gomersall Sjaan , Hong Mengxun , Larwood Joel , Lee Chiying , Lee Jennifer , Nitschinsk Lewis , Peluso Natalie , Reedman Sarah Elizabeth , Vidas Dianna , Walter Zoe C. , Wright Olivia Renee Louise 
Published: September 2021

Background: This scoping review analyzed research about how music activities may affect participants' health and well-being. Primary outcomes were measures of health (including symptoms and health behaviors) and well-being. Secondary measures included a range of psychosocial processes such as arousal, mood, social connection, physical activation or relaxation, cognitive functions, and identity. Diverse music activities were considered: receptive and intentional music listening; sharing music; instrument playing; group singing; lyrics and rapping; movement and dance; and songwriting, composition, and improvisation.Methods: Nine databases were searched with terms related to the eight music activities and the psychosocial variables of interest. Sixty-three papers met selection criteria, representing 6,975 participants of all ages, nationalities, and contexts.Results: Receptive and intentional music listening were found to reduce pain through changes in physiological arousal in some studies but not others. Shared music listening (e.g., concerts or radio programs) enhanced social connections and mood in older adults and in hospital patients. Music listening and carer singing decreased agitation and improved posture, movement, and well-being of people with dementia. Group singing supported cognitive health and well-being of older adults and those with mental health problems, lung disease, stroke, and dementia through its effects on cognitive functions, mood, and social connections. Playing a musical instrument was associated with improved cognitive health and well-being in school students, older adults, and people with mild brain injuries via effects on motor, cognitive and social processes. Dance and movement with music programs were associated with improved health and well-being in people with dementia, women with postnatal depression, and sedentary women with obesity through various cognitive, physical, and social processes. Rapping, songwriting, and composition helped the well-being of marginalized people through effects on social and cultural inclusion and connection, self-esteem and empowerment.Discussion: Music activities offer a rich and underutilized resource for health and well-being to participants of diverse ages, backgrounds, and settings. The review provides preliminary evidence that particular music activities may be recommended for specific psychosocial purposes and for specific health conditions.