bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravitreal aflibercept for diabetic macular edema: structural and functional improvements
Authors: Zhang Chuanhe , Chen Tianyu , Jia Ru , Gong Di , Liu Zhigao , Wu Changlong , Shu Xiangwen , Han Fangju , Gong Bin 
Published: February 2025

IntroductionThe aim of this study was to evaluate the changes in macular structure and visual function of patients with diabetic macular edema (DME) after intravitreal aflibercept injection.MethodsTwenty-five patients (43 eyes) diagnosed with DME were included in this study. All patients underwent aflibercept monthly for 3 months. The study’s endpoints included the best corrected visual acuity (BCVA), central retinal thickness (CRT), fovea avascular zone (FAZ) area, vessel density of superficial retinal capillary plexus (SVD), vessel density of deep retinal capillary plexus (DVD), mean light sensitivity (MLS), 2° fixation rate (P1) and 4° fixation rate (P2).ResultsBefore treatment and after the third treatment, the LogMAR BCVA was 0.69 ± 0.27 and 0.40 ± 0.18, the CRT was 471.10 ± 159.93 μm and 319.84 ± 113.51 μm, the MLS was 18.14 ± 3.97 dB and 21.68 ± 3.55 dB, P1 was 69 (47, 87)% and 88 (72, 92)%, and P2 was 90 (83, 97)% and 97 (93, 99)%, respectively. After treatment, CRT decreased, BVCA, MLS, and fixation stability improved (all p &lt; 0.001). Post-treatment, FAZ area, SVD, and DVD showed no significant changes (all P &gt; 0.05). MLS was negatively correlated with LogMAR BCVA and CRT, and positively correlated with P1 and P2.ConclusionIn short term, aflibercept was effective in reducing CRT and improving BCVA, MLS, and fixation stability in DME patients.
Prognostic analysis of sepsis-induced myocardial injury patients using propensity score matching and doubly robust analysis with machine learning-based risk prediction model development
Authors: Guo Pan , Xue Li , Tao Fang , Yang Kuan , Gao YuXia , Pei Chongzhe 
Published: February 2025

BackgroundSepsis-induced myocardial injury (SIMI) is a severe and common complication of sepsis; However, its definition remains unclear. Prognostic analyses may vary depending on the definition applied. Early prediction of SIMI is crucial for timely intervention, ultimately improving patient outcomes. This study aimed to evaluate the prognostic impact of SIMI and develop validated predictive models using advanced machine learning (ML) algorithms for identifying SIMI in critically ill sepsis patients.MethodsData were sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV, v3.0) database. Patients meeting Sepsis-3.0 criteria were included, and SIMI was defined as troponin T (TNT) levels ≥0.1 ng/mL. Prognostic evaluation involved propensity score matching, inverse probability weighting, doubly robust analysis, logistic regression, and Cox regression. Patients were divided into training and testing datasets in a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) regression was used for variable selection to simplify the model. Twelve hyperparameter-tuned ML models were developed and evaluated using visualized heatmaps. The best-performing model was deployed as a web-based application.ResultsAmong 2,435 patients analyzed, 571 (23.45%) developed SIMI following intensive care unit (ICU) admission. Boruta and LASSO identified 46 and 10 key variables, respectively, for prognostic and predictive modeling. Doubly robust analysis revealed significantly worse short- and intermediate-term outcomes for SIMI patients, including increased in-ICU mortality [odds ratio (OR) 1.39, 95% confidence interval (CI) 1.02–1.85, p &lt; 0.05], 28-day mortality (OR 1.35, 95% CI 1.02–1.79, p &lt; 0.05), and 180-day mortality [hazard ratio (HR) 1.21, 95% CI 1.01–1.44, p &lt; 0.05]. However, one-year mortality showed no significant difference (HR 1.03, 95% CI 0.99–1.08, p = 0.169). The XGBoost model outperformed others, achieving an area under the receiver operating characteristic curve (AUROC) of 0.83 (95% CI 0.79–0.87). SHapley Additive exPlanations (SHAP) analysis highlighted the top five predictive features: creatine kinase-myocardial band (CKMB), creatinine, alanine aminotransferase (ALT), lactate, and blood urea nitrogen (BUN). A web-based application was subsequently developed for real-world use.ConclusionSIMI significantly worsens patient prognosis, while the XGBoost model demonstrated excellent predictive performance. The development of a web-based application provides clinicians with a practical tool for timely intervention, potentially improving outcomes for septic patients.
Impact of circuit configuration on the mechanical performance of CPAP therapy devices: an experimental study
Authors: De Luca Margherita , Formaggio Andrea , Terzini Mara , Borrelli Simone , Putame Giovanni , Moretto Francesca , Esposito Teresa , Vaschetto Rosanna , Morbiducci Umberto , Olivieri Carlo , Audenino Alberto L. 
Published: February 2025

IntroductionCPAP therapy treats various respiratory disorders. The overall performance of therapy delivery can be affected by the adopted circuit configuration. Recently, parallel to the canonical open configuration (OC), closed configurations (CC) have been proposed with potential advantages in terms of oxygen consumption, noise, airway dryness and contamination. However, the mechanical performance of CPAP devices in CC has been marginally investigated. The aim of this study is to clarify whether CPAP therapy delivered in CC configuration retains mechanical performances equivalent to that achieved in the canonical OC stipulated by the manufacturers.MethodsOCs and CCs implemented on seven different ventilation devices, classified as flowmeter, obstructive sleep apnoea device, and mechanical ventilator, were tested at different set CPAP levels. Mask and helmet interfaces were tested, and healthy, post-surgery and ARDS respiratory conditions were simulated. The mechanical performance was compared in terms of mean static pressure (Pmean), pressure oscillations, areas between pressure curve and Pmean during inspiration (Ai) and expiration (Ae), and the time in which the pressure curve remains above the Pmean along the expiration phase (T%).ResultsThe mechanical performances of CCs with helmet interface were comparable to canonical OCs used with mask interface. Globally, a CC supplied a reduced Pmean (on average, −1.3 cmH2O for the mask and −0.3 cmH2O for the helmet) and an increased ΔP, Ae and Ai (on average +0.5, +2.5, +2 times, respectively).ConclusionThe closed configuration proved its capability to effectively deliver CPAP therapy, thus making its intrinsic advantages available for future clinical use.
Bordetella pertussis bacteremia in infants co-infected with cytomegalovirus and respiratory syncytial virus
Authors: Sun Wenqiang , Li Mengzhao , Zhu Xueping 
Published: February 2025

IntroductionHematogenous infections caused by Bordetella pertussis are rare. This study aimed to increase clinicians’ knowledge of B. pertussis bacteremia.MethodsWe described a case of an infant with B. pertussis bacteremia, searched and reviewed for B. pertussis bacteremia-related literatures published in the PubMed database between 1946 to 2022.ResultsA 3-month-old male infant was admitted to the hospital with a respiratory tract infection. Respiratory pathogen testing indicated the presence of B. pertussis, cytomegalovirus, and respiratory syncytial viruses. Blood metagenomic next-generation sequencing (mNGS) confirmed B. pertussis bacteremia. After 32 days of anti-infective treatment and supportive therapy, the patient’s condition improved, and he was discharged. The literature review found that B. pertussis bacteremia is rare, often with fever as the first symptom, and is most common in individuals with underlying diseases or prolonged immunosuppressive therapy.DiscussionIn infants lacking specific protective antibodies against B. pertussis, B. pertussis bacteremia should be considered when bacteremia-associated clinical manifestations are present and the causative organism remains undetected. Timely refinement of mNGS can help clarify the diagnosis.
Efficacy of transcranial direct current stimulation on cognitive function in patients with Parkinson's disease: a systematic review and meta-analysis
Authors: Ma Shenhong , Zhuang Weisheng , Wang Xu , Zhang Di , Wang Heling , Han Qiaohua , Ding Qixin , Li Yuefang , Li Wanyue , Li Tianshu 
Published: February 2025

ObjectiveTo assess the therapeutic effect of tDCS on cognitive function in patients with Parkinson's disease.MethodsFrom the start of the library's construction until June 24, 2024, we searched the following databases for literature: PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), and China Biomedical Literature Database (CBM). We also looked through the references in the articles. The improvement of overall cognition in patients with Parkinson's disease with tDCS was the primary outcome indicator. The improvement of executive function, memory, attention, language, quality of life, and depression with tDCS were the secondary outcome indicators. Two researchers extracted data independently, with a third researcher mediating in the event of a dispute. The Cochrane risk of bias tool was used to evaluate the quality of the included literature.ResultsA total of 23 articles encompassing 874 subjects were included. tDCS has shown significant efficacy on overall cognition (SMD = 0.73, 95% CI = 0.57 to 0.89, I2 = 0%, P &lt; 0.00001), particularly in the areas of executive function (SMD = −0.32, 95% CI = −0.56 to −0.07, I2 = 0%, P = 0.01) and language function (SMD = 0.5, 95% CI = 0.2 to 0.8, I2 = 0%, P = 0.001). Furthermore, the clinical efficacy of tDCS was enhanced with a stimulation intensity of 2 mA (SMD = 0.76, 95% CI = 0.58 to 0.93, I2 = 7%, P &lt; 0.00001), a stimulation duration of ≥25 min (SMD = 0.70, 95% CI = 0.49 to 0.91, I2 = 6%, P &lt; 0.00001), and a minimum of 10 stimulation sessions (SMD = 0.74, 95% CI = 0.56 to 0.92, I2 = 0%, P &lt; 0.00001). Furthermore, tDCS has shown efficacy in alleviating depressive mood (SMD = −0.46, 95% CI = −0.79 to −0.13, I2 = 0%, P = 0.006).ConclusiontDCS demonstrated substantial efficacy in enhancing overall cognition in patients with PD. The efficacy of tDCS was obvious in executive function, language, and depressive mood. Nonetheless, a substantial quantity of rigorous clinical trials on tDCS for cognitive function in patients with PD remains necessary in the future.
Unraveling progressive verbal memory deficits in Huntington’s disease: insights from the LASSI-L
Authors: Sierra Luis A. , Kaur Japleen , Frank Samuel A. , Halko Mark A. , Curiel Cid Rosie E. , Loewenstein David A. , Corey-Bloom Jody , Laganiere Simon 
Published: February 2025

Background and objectivesHuntington’s disease (HD) is characterized by progressive cognitive decline, with early deficits often preceding motor symptoms. The Loewenstein-Acevedo Scales for Semantic Interference and Learning (LASSI-L) captures many types of deficits in verbal memory including susceptibility to interference. The current study aims to delineate the progression of these deficits across different stages of HD.Methods151 participants (89 HD, 62 healthy controls) were recruited across three sites. HD participants were classified into three groups using a PIN score and TMS: &gt;10 years from manifest HD, &lt;10 years from manifest HD, and manifest HD. Group comparisons on the LASSI-L were assessed using multiple ANCOVAs adjusting for age, followed by post-hoc pairwise comparisons and a Bonferroni correction.ResultsSequential group differences for susceptibility to interference effects were observed on the LASSI-L. Proactive Semantic Interference (PSI) deficits emerged &gt;10 years before manifest HD, Failure to Recover from PSI (frPSI) emerged &lt;10 years before manifest HD, and in the Manifest HD stage, participants exhibited additional deficits in Retroactive Semantic Interference (RSI). Based on cutoff scores derived from healthy control performance, 98% (87/89) of the HD cohort demonstrated either normal performance or significant impairments, primarily in PSI, with some showing concurrent deficits in frPSI and/or RSI. Furthermore, 88% of participants adhered to the full sequential decline pattern, progressing from deficits in PSI, to frPSI, and then to RSI.DiscussionThe LASSI-L appears to be a useful tool for detecting early and progressive cognitive changes in Huntington’s disease, particularly by capturing the sequential nature of verbal memory deficits, including early vulnerability to interference. These findings suggest that the LASSI-L may help refine HD staging by integrating sequential neuropsychological markers of cognitive decline.
A prospective multicenter study on prognostic factors and quality of care in Severe Acquired Brain Injury rehabilitation units: a project from the Tiresia network
Authors: Nattino Giovanni , Acler Michele , Bargellesi Stefano , Bertagnoni Giannettore , Carrara Greta , De Tanti Antonio , Estraneo Anna , Ghilardi Giulia Irene , Lavezzi Susanna , Lombardi Francesco , Lucca Lucia Francesca , Mancuso Mauro , Montis Andrea , Mulè Chiara , Navarro Jorge , Posteraro Federico , Rossato Elena , Simoncini Laura , Bertolini Guido 
Published: February 2025

BackgroundSevere Acquired Brain Injury (sABI) presents significant challenges in clinical management and rehabilitation due to its diverse and complex nature. The primary objective of the Tiresia project is to identify medium and medium-to-long-term prognostic factors for patients with sABI and to develop outcome indicators to evaluate the quality of care in rehabilitation units.MethodsThis paper outlines the protocol for a prospective observational multicenter study conducted within the Tiresia Network. The study relies on a comprehensive data collection with stringent quality control measures. Ethical considerations emphasize patient privacy protection and adherence to regulatory standards. All of the Italian intensive rehabilitation units dedicated to sABI patients were eligible to participate in the study. Twenty-seven of them joined the project and started the data collection.DiscussionThe present study represents a comprehensive effort to address critical gaps in sABI research and practice through a multicenter, prospective study design. Through rigorous data collection, analysis, and ethical oversight, the Tiresia project endorses the commitment of the research community to advancing evidence-based care and optimizing patient outcomes in sABI rehabilitation.Clinical trial registrationThe study was registered on ClinicalTrials.gov (ID: NCT04905264), on 24 May 2021.
P300 as an index of speech-in-noise understanding in complex acoustic environments in young and older adults
Authors: Pearson Dylan V. , Shen Yi , Hetrick William P. , O’Donnell Brian F. , Lundin Nancy B. , McAuley J. Devin , Kidd Gary R. 
Published: February 2025

IntroductionAging is associated with decrements in speech-in-noise perception which make communication in real world environments difficult. However, the neural correlates of these difficulties are not well characterized and finding correlations between speech-in-noise performance and electrophysiological measures has been difficult due in part to the fact that speech-in-noise perception is a multi-faceted process. The current study used a wide range of speech-in-noise tasks in an attempt to more completely capture speech-in-noise performance and compared these with electrophysiological measures.MethodsP300 event related brain responses were elicited in young and older adult listeners to spoken isochronous syllable sequences presented in quiet and noisy (i.e., multi-talker babble) background conditions. To investigate the extent to which P300 responses are associated with speech-in-noise understanding, listeners also completed a separate battery of speech-in-noise recognition tasks.ResultsOverall P300 amplitudes measured in noisy conditions, but not in quiet conditions, were associated with performance on a variety of speech recognition tasks and were positively correlated with a composite measure of speech understanding in noise based on the full battery. In addition, older adults had P300 responses to deviant and omitted speech stimuli with lower amplitudes, longer latencies, and relatively greater frontal topographies than young adults.DiscussionThe results demonstrate that P300 amplitudes elicited in competing noise were a strong predictor of speech-in-noise understanding. This, in addition to the age-related differences in P300 responses, highlights the relevance of neural attentional mechanisms for understanding age-related differences in speech understanding in noise.
Input–output organization of the mouse BLA-projecting IL neurons
Authors: Li Zhuo , Qu Yu , Wu Qi-Lin , Tang Li , Dong Yuan , Xu Xu-Feng 
Published: February 2025

IntroductionThe infralimbic cortex (IL), a critical subregion within the ventromedial prefrontal cortex (vmPFC), modulates emotion, memory, and social functions via robust projections to the basolateral amygdala (BLA). However, the afferent brain regions that innervate BLA-projecting IL neurons (IL-BLA PNs) and their efferent targets have not been systematically characterized.MethodsWe employed tracing techniques integrating adeno-associated virus (AAV) and monosynaptic rabies to systematically investigate the presynaptic inputs and axonal outputs of IL-BLA PNs.ResultsOur findings revealed widespread synaptic inputs to IL-BLA PNs from subcortical areas, with the strongest inputs originating from the dorsomedial thalamus (MD) and anterior medial thalamus (AM) in the thalamic region, as well as from the ventral hippocampus (vHPC) and piriform cortex (Pir) in the limbic system. Sparse labeling of the virus demonstrated that IL-BLA PNs collateralize to innervate various subcortical regions, including the horizontal diagonal band (HDB), lateral preoptic area (LPO), ventral pallidum (VP), and lateral hypothalamus (LH).DiscussionThis work establishes essential theoretical frameworks for the functional investigation and targeted intervention in neurological disorders.
Evaluating robotic actions: spatiotemporal brain dynamics of performance assessment in robot-assisted laparoscopic training
Authors: Lingelbach Katharina , Rips Jennifer , Karstensen Lennart , Mathis-Ullrich Franziska , Vukelić Mathias 
Published: February 2025

IntroductionEnhancing medical robot training traditionally relies on explicit feedback from physicians to identify optimal and suboptimal robotic actions during surgery. Passive brain-computer interfaces (BCIs) offer an emerging alternative by enabling implicit brain-based performance evaluations. However, effectively decoding these evaluations of robot performance requires a comprehensive understanding of the spatiotemporal brain dynamics identifying optimal and suboptimal robot actions within realistic settings.MethodsWe conducted an electroencephalographic study with 16 participants who mentally assessed the quality of robotic actions while observing simulated robot-assisted laparoscopic surgery scenarios designed to approximate real-world conditions. We aimed to identify key spatiotemporal dynamics using the surface Laplacian technique and two complementary data-driven methods: a mass-univariate permutation-based clustering and multivariate pattern analysis (MVPA)-based temporal decoding. A second goal was to identify the optimal time interval of evoked brain signatures for single-trial classification.ResultsOur analyses revealed three distinct spatiotemporal brain dynamics differentiating the quality assessment of optimal vs. suboptimal robotic actions during video-based laparoscopic training observations. Specifically, an enhanced left fronto-temporal current source, consistent with P300, LPP, and P600 components, indicated heightened attentional allocation and sustained evaluation processes during suboptimal robot actions. Additionally, amplified current sinks in right frontal and mid-occipito-parietal regions suggested prediction-based processing and conflict detection, consistent with the oERN and interaction-based ERN/N400. Both mass-univariate clustering and MVPA provided convergent evidence supporting these neural distinctions.DiscussionThe identified neural signatures propose that suboptimal robotic actions elicit enhanced, sustained brain dynamics linked to continuous attention allocation, action monitoring, conflict detection, and ongoing evaluative processing. The findings highlight the importance of prioritizing late evaluative brain signatures in BCIs to classify robotic actions reliably. These insights have significant implications for advancing machine-learning-based training paradigms.
The association of dietary fatty acids intake with overall and cause-specific mortality: a prospective cohort study from 1999–2018 cycles of the NHANES
Authors: Zhang Zhaoxiang , Ding Lei , Liang Yali , Yang Hu , Zhu Yu 
Published: February 2025

BackgroundExisting studies have evaluated the association of dietary fatty acids with mortality. However, the findings remained contentious. Our aimed to investigate the association of total dietary fat and each type of fatty acids with overall and cause-specific mortality.MethodsWe conducted a population-based prospective cohort study derived from the U.S. NHANES from 1999 to 2018. Baseline dietary information was assessed utilizing two 24-h dietary recalls. The death status was followed up to December 31, 2019. Hazard ratio (HR) was calculated by Cox regression and competing risk model. The effects of isocaloric replacement saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) were estimated using the leave-one-out method.ResultsA total of 49,884 U.S. adults were included. 7,347 deaths, including 2,288 and 1,652 deaths from cardio-cerebrovascular disease (CCVD) and cancer, arose during 494,277 person-years. The intake of SFAs was positively associated with an increased risk of overall mortality, with extreme-quintile HR of 1.10 (95% CI: 1.02–1.19, Ptrend = 0.013); whereas an inverse association of PUFAs intake with overall mortality was observed, with extreme-quintile HR of 0.87 (95% CI: 0.81–0.94, Ptrend = 0.001). Greater intake of PUFAs was associated with a lower risk of CCVD-and cancer-specific mortality at borderline statistical significance. The isocaloric substitutions of 5% energy from MUFAs and PUFAs for SFAs was associated with 13 and 12% lower risk of overall mortality.ConclusionGreater intake of SFAs was positively associated with mortality, while greater intake of PUFAs was negatively associated with mortality. Reducing SFA by increasing MUFAs and PUFAs was an attractive strategy to lower mortality.