bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Anthropometric Indices With the Development of Diabetes Among Hypertensive Patients in China: A Cohort Study
Authors: Liu Yingshan , Liu Xiaocong , Zhang Shuting , Zhu Qibo , Fu Xiaoying , Chen Hongmei , Guan Haixia , Xia Yinghua , He Qun , Kuang Jian 
Published: October 2021

BackgroundPatients with comorbidity of hypertension and diabetes are associated with higher morbidity and mortality of cardiovascular disease than those with hypertension or diabetes alone. The present study aimed to identify anthropometric risk factors for diabetes among hypertensive patients who were included in a retrospective cohort study.MethodsHypertensive adults without diabetes were recruited in China. Demographic, clinical, biochemical, and anthropometric indices were collected at baseline and during the follow-up. Anthropometric measures included BMI, waist circumference, waist-to-height ratio (WHtR), and waist-to-hip ratio, and several novel indices. To estimate the effect of baseline and dynamic changes of each anthropometric index on risk of new-onset diabetes (defined as self-reported physician-diagnosed diabetes and/or use of hypoglycemic medication, or new-onset FPG≥7.0 mmol/L during follow-up), Cox regression models were used.ResultsA total of 3852 hypertensive patients were studied, of whom 1167 developed diabetes during follow-up. Multivariate Cox regression analyses showed that there was a graded increased risk of incident diabetes with successively increasing anthropometric indices mentioned above (all P&lt;0.05). Regardless of the baseline general obesity status, elevated WHtR was both related to higher risk of diabetes; the HRs (95%CI) of baseline BMI&lt;24 kg/m2 &amp; WHtR≥0.5 group and BMI≥24 kg/m2 &amp; WHtR≥0.5 group were 1.34 (1.05, 1.72), 1.85 (1.48, 2.31), respectively. Moreover, the dynamic changes of WHtR could sensitively reflect diabetes risk. Diabetes risk significantly increased when patients with baseline WHtR&lt;0.5 progressed to WHtR≥0.5 during the follow-up (HR=1.63; 95%CI, 1.11, 2.40). There was also a decreasing trend towards the risk of incident diabetes when baseline abnormal WHtR reversed to normal at follow-up (HR=1.93; 95%CI, 1.36, 2.72) compared with those whose WHtR remained abnormal at follow-up (HR=2.04; 95%CI, 1.54, 2.71).ConclusionsCentral obesity is an independent and modifiable risk factor for the development of diabetes among hypertensive patients. Measuring indices of central obesity in addition to BMI in clinics could provide incremental benefits in the discrimination of diabetes among Chinese hypertensive patients. Dynamic changes of WHtR could sensitively reflect changes in the risk of diabetes. Therefore, long-term monitoring of hypertensive patients using non-invasive anthropometric measures and timely lifestyle intervention could effectively reduce the development of diabetes.
Unsatisfied Reporting Quality of Clinical Trials Evaluating Immune Checkpoint Inhibitor Therapy in Cancer
Authors: Chen Chen , Zhou Yixin , Zhang Xuanye , Wang Yuhong , He Li-na , Lin Zuan , Chen Tao , Jiang Yongluo , Hong Shaodong , Zhang Li 
Published: October 2021

BackgroundMore and more immune-oncology trials have been conducted for treating various cancers, yet it is unclear what the reporting quality of immune-oncology trials is,and characteristics associated with higher reporting quality.ObjectiveThis study aims to evaluate the reporting quality of immune-oncology trials.MethodsThe PubMed and Cochrane library were searched to identify all English publications of clinical trials assessing immunotherapy for cancer. Reporting quality of immune-oncology trials was evaluated by a quality score with 11 points derived from the Trial Reporting in Immuno-Oncology (TRIO) statement, which contained two parts: an efficacy score of 6 points and toxicity score of 5 point. Linear regression was used to identify characteristics associated with higher scores.ResultsOf the 10,169 studies screened, 298 immune-oncology trial reports were enrolled. The mean quality score, efficacy score, and toxicity score were 6.46, 3.61, and 2.85, respectively. The most common well-reported items were response evaluation criteria (96.0%) and toxicity grade (98.7%), followed by Kaplan-Meier survival analyses (80.5%). Treatment details beyond progression (12.8%) and toxicity onset time and duration (7.7%) were poorly reported. Multivariate regression revealed that higher impact factor (IF) (IF &gt;20 vs. IF &lt;5, p &lt; 0.001), specific tumor type (p = 0.018 for lung, p = 0.021 for urinary system, vs. pan cancer), and a certain kind of immune checkpoint blocking agent (p &lt; 0.001 for anti-PD-1 or multiagents, vs. anti-CTLA-4) were independent predictors of higher-quality score. Similar independent predictive characteristics were revealed for high-efficacy score. Only IF &gt;20 had a significant high-toxicity score (p &lt; 0.001).ConclusionImmune-oncology trial reports presented an unsatisfied quality score, especially in the reporting of treatment details beyond progression and toxicity onset time and duration. High IF journals have better reporting quality. Future improvement of trial reporting was warranted to the benefit-risk assessment of immunotherapy.
Epidemiological and Clinical Characteristics of Sporadic Creutzfeldt–Jakob Disease: A Retrospective Study in Eastern China
Authors: Feng Shuo , Zhao Xinjing , Zhou Xueying , Ye Xiang , Yu Xiaolin , Jiang Wei , Deng Yu , Zhou Shengnian , Ma Lin , Shan Peiyan , Zhou Guoyu 
Published: October 2021

Objective: We aimed to characterize the epidemiological and clinical characteristics of sporadic Creutzfeldt–Jakob disease (sCJD) in eastern China in this retrospective study.Methods: This study enrolled 67 patients with sCJD hospitalized in a grade-A tertiary hospital in eastern China from January 2010 to January 2020. Demographic data, clinical symptoms, brain magnetic resonance imaging (MRI), electroencephalogram (EEG), cerebrospinal fluid (CSF) 14-3-3 protein test, polymerase chain reaction (PCR), and DNA sequence determination of genes were collected and analyzed.Results: There were 62 patients with probable sCJD and 5 patients with possible sCJD. Male (28 cases) to female (39 cases) ratio was 1:1.39. Mean age at disease onset was 64.42 ± 9.00 years (range: 29–88 years), and mean survival time was 9.39 ± 12.58 months (range: 1–60 months for patients who received the follow-ups). The most common onset symptoms were dementia (49.25%), movement disorder (44.78%), and visual disturbance (22.39%), while the most frequent clinical manifestations were language disorders (74.63%), ataxia (70.15%), and myoclonus (70.15%). The positive rates of brain MRI abnormalities, 14-3-3 protein in CSF, and periodic sharp wave complexes (PSWCs) on EEG were 84.90, 68.00, and 46.03%, respectively. The 14-3-3 protein positive (p = 0.033) and PSWCs on EEG (p = 0.020) acted as the favorable and unfavorable factor for over 1 year of survival time, respectively.Conclusions: There were some differences in epidemiological and clinical characteristics among patients in China and those of other countries. The prognosis and its influencing factors were relatively unexplored in China. The mean survival time of Chinese patients was longer than that of Caucasian patients but shorter than that of Japanese patients. The 14-3-3 protein in CSF and PSWCs on EEG were both closely related to the survival time. It is necessary to promote autopsy or biopsy to better understand sCJD in China.
Neuropoly: An Educational Board Game to Facilitate Neurology Learning
Authors: Raskurazhev Anton , Kuznetsova Polina , Khizhnikova Anastasia Evgenievna , Klochkov Anton , Bakulin Ilya , Annushkin Vladislav , Tanashyan Marine , Suponeva Natalya , Gnedovskaya Elena 
Published: October 2021

Introduction: Neurology is arguably one of the most difficult subjects to teach and study in the medical curriculum. Educational games (EG) may be a valid option to enhance motivation in neurology residents.Methods: We developed an educational board game (Neuropoly) to assist in teaching neurology. We present here an overview of the game, as well as the results of a pilot study aimed at determining: (a) the efficacy of the game in teaching certain neurological concepts; and (b) student compliance and satisfaction with the EG.Results: The pre- and post-play questionnaire scores differed significantly (3.2 ± 1.7 vs. 7.8 ± 1.6, p &lt; 0.001). Our group of residents, showing an overwhelmingly positive response, very well received the game. The questions were rated as above average regarding difficulty.Conclusion: The “Neuropoly” educational board game has been shown to be interesting, efficient, and motivational among first- and second-year neurology residents. Novel educational methods for complex medical disciplines should be developed, with board games being a viable and inexpensive approach.
Development of Models to Predict Postoperative Complications for Hepatitis B Virus-Related Hepatocellular Carcinoma
Authors: Bao Mingyang , Zhu Qiuyu , Aji Tuerganaili , Wei Shuyao , Tuergan Talaiti , Ha Xiaoqin , Tulahong Alimu , Hu Xiaoyi , Hu Yueqing 
Published: October 2021

BackgroundSurgical treatment remains the best option for patients with hepatocellular carcinoma (HCC) caused by chronic hepatitis B virus (HBV) infection. However, there is no optimal tool based on readily accessible clinical parameters to predict postoperative complications. Herein, our study aimed to develop models that permitted risk of severe complications to be assessed before and after liver resection based on conventional variables.MethodsA total of 1,047 patients treated by hepatectomy for HCC with HBV infection at three different centers were recruited retrospectively between July 1, 2014, and July 1, 2018. All surgical complications were recorded and scored by the Comprehensive Complication Index (CCI). A CCI ≥26.2 was used as a threshold to define patients with severe complications. We built two models for the CCI, one using preoperative and one using preoperative and postoperative data. Besides, CCI and other potentially relevant factors were evaluated for their ability to predict early recurrence and metastasis. All the findings were internally validated in the Hangzhou cohort and then externally validated in the Lanzhou and Urumqi cohorts.ResultsMultivariable analysis identified National Nosocomial Infections Surveillance (NNIS) index, tumor number, gamma-glutamyltransferase (GGT), total cholesterol (TC), potassium, and thrombin time as the key preoperative parameters related to perioperative complications. The nomogram based on the preoperative model [preoperative CCI After Surgery for Liver tumor (CCIASL-pre)] showed good discriminatory performance internally and externally. A more accurate model [postoperative CCI After Surgery for Liver tumor (CCIASL-post)] was established, combined with the other four postoperative predictors including leukocyte count, basophil count, erythrocyte count, and total bilirubin level. No significant association was observed between CCI and long-term complications.ConclusionBased on the widely available clinical data, statistical models were established to predict the complications after hepatectomy in patients with HBV infection. All the findings were extensively validated and shown to be applicable nationwide. Such models could be used as guidelines for surveillance follow-up and the design of post-resection adjuvant therapy.
Utilization Pattern for Eculizumab Among Children With Hemolytic Uremic Syndrome
Authors: Ranabothu Saritha , Brown Clare C. , Blaszak Richard , Millner Rachel , Moore Kristen Rice , Prodhan Parthak 
Published: October 2021

Background: Hemolytic uremic syndrome (HUS) is a complex disease with multi-organ involvement. Eculizumab therapy is recommended for treatment of complement mediated hemolytic uremic syndrome (cHUS). However, there are few studies evaluating eculizumab therapy among children with HUS. The primary objectives of the study were to describe and identify factors associated with eculizumab therapy in children with HUS.Design/Methods: This large, retrospective, multi-center, cohort study used the Pediatric Health Information System (PHIS) database to identify the index HUS-related hospitalization among patients ≤18 years of age from September 23, 2011 (Food and Drug Administration approval date of eculizumab) through December 31, 2018. Multivariate analysis was used to identify independent factors associated with eculizumab therapy during or after the index hospitalization.Results: Among 1,885 children included in the study, eculizumab therapy was noted in 167 children with a median age of 3.99 years (SD ± 4.7 years). Eculizumab therapy was administered early (within the first 7 days of hospitalization) among 65% of children who received the drug. Mortality during the index hospitalization among children with eculizumab therapy was 4.2 vs. 3.0% without eculizumab therapy (p = 0.309). Clinical factors independently associated with eculizumab therapy were encephalopathy [odds ratio (OR) = 3.09; p ≤ 0.001], seizure disorder (OR = 2.37; p = 0.006), and cardiac involvement (OR = 6.36, p &lt; 0.001).Conclusion(s): Only 8.9% of children received eculizumab therapy. Children who presented with neurological and cardiac involvement with severe disease were more likely to receive eculizumab therapy, and children who received therapy received it early during their index hospitalization. Further prospective studies are suggested to confirm these findings.
Case Report: The Association of Wilson Disease in a Patient With Ataxia and GLUT-1 Deficiency
Authors: Diaz Jenna , Fonseca Ashley G. , Arboleda Richard , Frade Alejandro , Gennaro Maria Pilar , Jayakar Parul , Schleifer Paula , Hernandez Erick 
Published: October 2021

Background: Wilson disease (WD) and glucose transporter type 1 (GLUT1) deficiency syndrome are two syndromes with different modes of inheritance but share certain similarities on neurological presentation. To date we have not found previous reports of an association between these two disorders.Case Presentation: Here we describe a 9-year-old male with global developmental delay that presented with intermittent and sudden onset weakness that first occurred at age 3. He was diagnosed with a mutation in the SLC2A1 (Solute Carrier Family 2 Member 1) gene, which results in GLUT1 deficiency. A ketogenic diet could not be started because of unexplained elevated liver enzymes. Due to his liver enzymes' persistent elevation, further investigations demonstrated mildly decreased ceruloplasmin levels, high basal 24-h urinary copper excretion, and an elevated hepatic parenchymal copper concentration on liver biopsy, consistent with WD. Genetic testing revealed two separate mutations in the ATP7B (ATPase Copper Transporting Beta) gene, consistent with WD. The patient was treated with a low copper diet, zinc acetate, and trientine hydrochloride. When liver enzymes normalized, he was subsequently started on a ketogenic diet with improvement in neurological symptoms. His neurological symptoms were most likely secondary to GLUT1 deficiency syndrome, as WD's neurological symptoms are primarily observed in the second decade of life.Conclusion: Recent studies have demonstrated the importance of genetic testing upon unexplained persistent elevation of liver enzymes. This case highlights the importance of carefully evaluating a patient with an unexplained liver disorder, even in the presence of primary neurological disease, as it can have significant therapeutic implications.
A Lightweight One-Stage Defect Detection Network for Small Object Based on Dual Attention Mechanism and PAFPN
Authors: Zhang Yue , Xie Fei , Huang Lei , Shi Jianjun , Yang Jiale , Li Zongan 
Published: October 2021

Normally functioning and complete printed circuit board (PCB) can ensure the safety and reliability of electronic equipment. PCB defect detection is extremely important in the field of industrial inspection. For traditional methods of PCB inspection, such as contact detection, are likely to damage the PCB surface and have high rate of erroneous detection. In recent years, methods of detection through image processing and machine learning have gradually been put into use. However, PCB inspection is still an extremely challenging task due to the small defects and the complex background. To solve this problem, a lightweight one-stage defect detection network based on dual attention mechanism and Path Aggregation Feature Pyramid Network (PAFPN) has been proposed. At present, some methods of defect detection in industrial applications are often based on object detection algorithms in the field of deep learning. Through comparative experiments, compared with the Faster R-CNN and YOLO v3 which are usually used in the current industrial detection, the inference time of our method are reduced by 17.46 milliseconds (ms) and 4.75 ms, and the amount of model parameters is greatly reduced. It is only 4.42 M, which is more suitable for industrial fields and embedded development systems. Compared with the common one-stage object detection algorithm Fully Convolutional One-Stage Object Detection (FCOS), mean Average Precision (mAP) is increased by 9.1%, and the amount of model parameters has been reduced by 86.12%.
Neck Chamber Technique Revisited: Low-Noise Device Delivering Negative and Positive Pressure and Enabling Concomitant Carotid Artery Imaging With Ultrasonography
Authors: Seredyński Rafał , Okupnik Tymoteusz , Musz Przemysław , Tubek Stanisław , Ponikowska Beata , Paleczny Bartłomiej 
Published: October 2021

Background and Objectives: Recently, novel noiseless device for the assessment of baroreceptor function with the neck suction (NS) has been presented. In this study, we present another in-house approach to the variable-pressure neck chamber method. Our device offers further critical improvements. First, it enables delivery of negative (NS) as well as positive pressure (neck pressurizing, NP) in a noiseless manner. Second, we used small, 3D-printed cups positioned over the carotid sinuses instead of cumbersome neck collar to improve subject comfort and to test feasibility of tracking the pressure-induced changes in carotid artery with ultrasonography.Methods: Five healthy, non-smoking, normal-weight subjects aged 29 ± 3 years (mean ± SD) volunteered for the study. Heart rate (HR, bpm) and mean arterial pressure (MAP, mmHg) responses to short, 7-s long episodes of NS and NP were recorded. Each trial consisted of 12 episodes of variable-pressure: six episodes of NS (suction ranging between -10 and -80 mmHg) and six episodes of NP (pressure ranging between + 10 and + 80 mmHg). Carotid artery sonography was performed during the NS and NP in four subjects, on another occasion.Results: The variable-pressure episodes resulted consistently in the expected pattern of hemodynamic alterations: HR and MAP increases or decreases following the NP and NS, respectively, as evidenced by the coefficient of determination (R2) of ≥0.78 for the carotid-HR response curve (for all five participants) and the carotid-MAP response curve (for four out of five participants; the curve cannot be calculated for one subject). We found a linear, dose-dependent relation between the applied pressure and the systolic-diastolic difference in carotid artery diameter.Conclusion: The novel device enables noiseless stimulation and unloading of the carotid baroreceptors with the negative and positive pressure, respectively, applied on the subject’s neck via small, asymmetric and one-side flattened, 3D-printed cups. The unique design of the cups enables concomitant visualizing of the carotid artery during the NS or NP administration, and thereby direct monitoring of the intensity of mechanical stimulus targeting the carotid baroreceptors.
Acute Effects of Foam Rolling on Hamstrings After Half-Marathon: A Muscle Functional Magnetic Resonance Imaging Study
Authors: Shu Dingbo , Zhang Chuan , Dai Siyu , Wang Shubo , Liu Jie , Ding Jianping 
Published: October 2021

Purpose: Foam rolling (FR) is widely used for post-exercise muscle recovery; yet, the effects of FR on skeletal muscle inflammation and microvascular perfusion following prolonged exercise are poorly understood. We aim to address the gap in knowledge by using magnetic resonance imaging (MRI) T2 mapping and intravoxel incoherent motion (IVIM) sequences to study the acute effects of FR on hamstrings following half-marathon running in recreational runners.Methods: Sixteen healthy recreational marathon runners were recruited. After half-marathon running, FR was performed on the hamstrings on the dominant side, while the other limb served as a control. MRI T2 and IVIM scans were performed bilaterally at baseline (pre-run), 2–3 h after running (post-run), immediately after FR (post-FR0), 30 min after FR (post-FR30) and 60 min after FR (post-FR60). T2, a marker for inflammatory edema, as well as IVIM microvascular perfusion fraction index f for biceps femoris long head (BFL), semitendinosus (ST) and semimembranosus (SM) were determined. Total Quality Recovery (TQR) scale score was also collected.Results: Both T2 and f were higher at post-run compared to pre-run in all hamstrings on both sides (all p &lt; 0.05; all d &gt; 1.0). For the FR side, T2 decreased, and f increased significantly at post-FR0 and post-FR30 compared to post-run in all muscles (p &lt; 0.05; all d &gt; 0.4) except for f at BFL and SM at post-FR30 (both p &gt; 0.05), though f at BFL was still marginally elevated at post-FR30 (p = 0.074, d = 0.91). Both parameters for all muscles returned to post-run level at post-FR60 (all p &gt; 0.05; all d &lt; 0.4) except for T2 at SM (p = 0.037). In contrast, most MRI parameters were not changed at post-FR0, post-FR30 and post-FR60 compared to post-run for the control side (p &lt; 0.05; d &lt; 0.2). TQR scores were elevated at post-FR0 and post-FR30 compared to post-run (both p &lt; 0.05; both d &gt; 1.0), and returned to the post-run level at post-FR60 (p &gt; 0.99; d = 0.09). Changes in TQR scores compared to post-run at any time points after FR were correlated to T2 for ST at post-FR30 (r = 0.50, p = 0.047) but not T2 for other muscles and any changes in f values.Conclusions: Hamstrings inflammatory edema and microvascular perfusion were elevated following half-marathon running, which were detectable with MRI T2 mapping and IVIM sequences. FR resulted in acute alleviation in inflammation and greater microvascular perfusion; however, the effects seemed to last only for a short period of time (30–60 min). FR can provide short-term benefits to skeletal muscle after prolonged running.