bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atuação fonoaudiológica em home care
Authors: Silva Keyla Maria da Rocha , Sampaio Danilo 
Published: January 2021

O fonoaudiólogo em Home care atua gerenciando as necessidade dos paciented, como por exemplo, em disfagias, realizando avaliações contínuas, além de especificar os métodos mais adequados de tratamento. O objetivo geral da presente pesquisa consiste em analisar a importância da atuação do fonoaudiólogo no ambiente domiciliar. Dentre os objetivos específicos ressaltam-se: identificar qual o papel do fonoaudiólogo no home care; verificar quais os benefícios para o paciente em realizar o tratamento em casa; demonstrar quais as principais demandas da atuação do fonoaudiólogo em home care. A problemática da pesquisa reside no seguinte questionamento: qual a importância da atuação fonoaudiológica na residencia dos pacientes? No que se refere a metologia a pesquisa pode ser caracterizada como uma revisão bibliográfica do tipo integrativa, de análise qualitativa, tendo como intuito a sistematização de resultados de fontes teóricas variadas sobre a presente temática, em especial artigos disponibilizados em bases de dados direcionadas a pesquisa científica, como Scielo, Capes, Scholar. Evidenciou-se por meio dos estudos encontrados que o fonoaudiólogo é de suma importância para um atendimento personalizado, pois proporciona a diminuição dos riscos de internações, evitando, dessa forma, exposições ao ambiente hospitalar, com a privacidade do leito familiar, facilitando o tratamento, pois o apoio emocional é de fundamental importância para a recuperação.
An Immune Gene-Related Five-lncRNA Signature for to Predict Glioma Prognosis
Authors: Wang Xinzhuang , Gao Ming , Ye Junyi , Jiang Qiuyi , Yang Quan , Zhang Cheng , Wang Shengtao , Zhang Jian , Wang Ligang , Wu Jianing , Zhan Hua , Hou Xu , Han Dayong , Zhao Shiguang 
Published: January 2021

BackgroundThe tumor immune microenvironment is closely related to the malignant progression and treatment resistance of glioma. Long non-coding RNA (lncRNA) plays a regulatory role in this process. We investigated the pathological mechanisms within the glioma microenvironment and potential immunotherapy resistance related to lncRNAs.MethodWe downloaded datasets derived from glioma patients and analyzed them by hierarchical clustering. Next, we analyzed the immune microenvironment of glioma, related gene expression, and patient survival. Coexpressed lncRNAs were analyzed to generate a model of lncRNAs and immune-related genes. We analyzed the model using survival and Cox regression. Then, univariate, multivariate, receiver operating characteristic (ROC), and principle component analysis (PCA) methods were used to verify the accuracy of the model. Finally, GSEA was used to evaluate which functions and pathways were associated with the differential genes.ResultsNormal brain tissue maintains a low-medium immune state, and gliomas are clearly divided into three groups (low to high immunity). The stromal, immune, and estimate scores increased along with immunity, while tumor purity decreased. Further, human leukocyte antigen (HLA), programmed cell death-1 (PDL1), T cell immunoglobulin and mucin domain 3 (TIM-3), B7-H3, and cytotoxic T lymphocyte-associated antigen-4 (CTLA4) expression increases concomitantly with immune state, and the patient prognosis worsens. Five immune gene-related lncRNAs (AP001007.1, LBX-AS1, MIR155HG, MAPT-AS1, and LINC00515) were screened to construct risk models. We found that risk scores are related to patient prognosis and clinical characteristics, and are positively correlated with PDL1, TIM-3, and B7-H3 expression. These lncRNAs may regulate the tumor immune microenvironment through cytokine–cytokine receptor interactions, complement, and coagulation cascades, and may promote CD8 + T cell, regulatory T cell, M1 macrophage, and infiltrating neutrophils activity in the high-immunity group. In vitro, the abnormal expression of immune-related lncRNAs and the relationship between risk scores and immune-related indicators (PDL1, CTLA4, CD3, CD8, iNOS) were verified by q-PCR and immunohistochemistry (IHC).ConclusionFor the first time, we constructed immune gene-related lncRNA risk models. The risk score may be a new biomarker for tumor immune subtypes and provide molecular targets for glioma immunotherapy.
A Mineralocorticoid Receptor Deficiency in Myeloid Cells Reduces Liver Steatosis by Impairing Activation of CD8+ T Cells in a Nonalcoholic Steatohepatitis Mouse Model
Authors: Muñoz-Durango Natalia , Arrese Marco , Hernández Alejandra , Jara Evelyn , Kalergis Alexis M. , Cabrera Daniel 
Published: January 2021

Background and AimsThe mineralocorticoid receptor (MR) and renin-angiotensin-aldosterone system (RAAS) are implicated in non-alcoholic liver fatty disease (NALFD). However, inflammatory mechanisms linking MR and RAAS with disease pathology remain unclear. Here we aimed to evaluate the contribution of myeloid MR to the inflammatory response in an animal model of non-alcoholic steatohepatitis (NASH), induced with a methionine-choline deficient diet (MCD).MethodsMice with a conditional deficiency of MR in myeloid cells (MyMRKO) and their counterpart floxed control mice (FC) were fed for 18 days with MCD or chow diet, respectively. Serum levels of aminotransferases and aldosterone levels were measured and hepatic steatosis, inflammation and fibrosis scored histologically. Hepatic triglyceride content (HTC) and hepatic mRNA levels of pro-inflammatory pro-fibrotic-associated genes were also assessed. Deep flow cytometric analysis was used to dissect the immune response during NASH development.ResultsMyMRKO mice fed with an MCD diet exhibited reduced hepatic inflammation and lower HTC than controls. Absolute number and percentage of liver inflammatory infiltrate cells (except for CD8+ T lymphocytes) were similar in both MyMRKO and control mice fed with an MCD diet but expression of the costimulatory molecule CD86 by dendritic cells and the CD25 activation marker in CD8+ T cells were significantly reduced in MyMRKO.ConclusionsProinflammatory cells are functionally suppressed in the absence of MR. We hypothesized that loss of MR in myeloid cells reduces lipid accumulation in the liver, in part through modulating the adaptive immune response, which is pivotal for the development of steatosis.
Integrated Analysis of Key Pathways and Drug Targets Associated With Vogt-Koyanagi-Harada Disease
Authors: Chen Zhijun , Zhong Zhenyu , Zhang Wanyun , Su Guannan , Yang Peizeng 
Published: January 2021

BackgroundVogt-Koyanagi-Harada (VKH) disease is a complex disease associated with multiple molecular immunological mechanisms. As the underlying mechanism for VKH disease is unclear, we hope to utilize an integrated analysis of key pathways and drug targets to develop novel therapeutic strategies.MethodsCandidate genes and proteins involved in VKH disease were identified through text-mining in the PubMed database. The GO and KEGG pathway analyses were used to examine the biological functions of the involved pathways associated with this disease. Molecule-related drugs were predicted through Drug-Gene Interaction Database (DGIdb) analysis.ResultsA total of 48 genes and 54 proteins were associated with VKH disease. Forty-two significantly altered pathways were identified through pathway analysis and were mainly related to immune and inflammatory responses. The top five of significantly altered pathways were termed as “inflammatory bowel disease,” “cytokine-cytokine receptor interaction,” “allograft rejection,” “antigen processing,” and “presentation and Herpes simplex infection” in the KEGG database. IFN-γ and IL-6 were identified as the key genes through network analysis. The DGIdb analysis predicted 48 medicines as possible drugs for VKH disease, among which Interferon Alfa-2B was co-associated both with IFN-γ and IL-6.ConclusionsIn this study, systematic analyses were utilized to detect key pathways and drug targets in VKH disease via bioinformatics analysis. IFN-γ and IL-6 were identified as the key mediators and possible drug targets in VKH disease. Interferon Alfa-2B was predicted to be a potentially effective drug for VKH disease treatment by targeting IFN-γ and IL-6, which warrants further experimental and clinical investigations.
Deep Sequencing of B Cell Receptor Repertoires From COVID-19 Patients Reveals Strong Convergent Immune Signatures
Authors: Galson Jacob D. , Schaetzle Sebastian , Bashford-Rogers Rachael J. M. , Raybould Matthew I. J. , Kovaltsuk Aleksandr , Kilpatrick Gavin J. , Minter Ralph , Finch Donna K. , Dias Jorge , James Louisa K. , Thomas Gavin , Lee Wing-Yiu Jason , Betley Jason , Cavlan Olivia , Leech Alex , Deane Charlotte M. , Seoane Joan , Caldas Carlos , Pennington Daniel J. , Pfeffer Paul , Osbourn Jane 
Published: January 2021

Deep sequencing of B cell receptor (BCR) heavy chains from a cohort of 31 COVID-19 patients from the UK reveals a stereotypical naive immune response to SARS-CoV-2 which is consistent across patients. Clonal expansion of the B cell population is also observed and may be the result of memory bystander effects. There was a strong convergent sequence signature across patients, and we identified 1,254 clonotypes convergent between at least four of the COVID-19 patients, but not present in healthy controls or individuals following seasonal influenza vaccination. A subset of the convergent clonotypes were homologous to known SARS and SARS-CoV-2 spike protein neutralizing antibodies. Convergence was also demonstrated across wide geographies by comparison of data sets between patients from UK, USA, and China, further validating the disease association and consistency of the stereotypical immune response even at the sequence level. These convergent clonotypes provide a resource to identify potential therapeutic and prophylactic antibodies and demonstrate the potential of BCR profiling as a tool to help understand patient responses.
Susceptibility of Clinical Enterobacterales Isolates With Common and Rare Carbapenemases to Mecillinam
Authors: Fuchs Frieder , Ahmadzada Aysel , Plambeck Lars , Wille Thorsten , Hamprecht Axel 
Published: January 2021

Purpose: To investigate the susceptibility of carbapenemase-producing Enterobacterales (CPE) to mecillinam based on the recently updated European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints for uncomplicated Urinary Tract Infection (uUTI).Methods: The challenge collection consisted of 105 molecularly characterized Enterobacterales [Klebsiella spp. (N = 49), Escherichia coli (N = 30), Enterobacter cloacae (n = 13), Citrobacter freundii (N = 9), Proteus mirabilis (N = 3), and Raoultella ornithinolytica (N = 1)]. Isolates produced OXA-48 (N = 18), OXA-48-like (N = 18), VIM (N = 22), NDM (N = 22), KPC (N = 12), IMI (N = 9), IMP (N = 6), GES (N = 1), OXA-58 (N = 2) or combinations thereof (N = 5). MICs of carbapenems were determined by agar gradient diffusion (AGD). MICs of mecillinam were assessed by agar dilution (reference method) and compared to disk diffusion (DD) and AGD.Results: Overall 23/105 CPE (21.9%) were susceptible to mecillinam. Susceptibility was observed in E. coli (N = 12), E. cloacae (N = 7), and Klebsiella pneumoniae (N = 4) producing IMI, OXA-48, OXA-48-like, and NDM-1 carbapenemases. MIC50 for mecillinam in all isolates was 128 mg/L while MIC50 for meropenem was 8 mg/L. Lower MICs for mecillinam were found in IMI (MIC50 8 mg/L) and OXA-48-like (MIC50 16 mg/L) producers. The comparison of the different susceptibility methods showed very major errors of 12.2% with AGD and 8.5% with disk diffusion when compared to the reference method.Conclusion: Mecillinam susceptibility was restricted to isolates producing IMI-, OXA-48-like, and NDM-1 carbapenemases and was documented despite high carbapenem MICs in some isolates. Mecillinam could be a promising oral antimicrobial in uUTI caused by E. coli and E. cloacae isolates carrying IMI- and OXA-48-like carbapenemases; however, susceptibility testing by AGD and disk diffusion remains problematic.
“Complex” Vasovagal Syncope: A Zebra Among Horses
Authors: Siddiqi Anwer Zohaib , Blackmore Derrick , Siddiqi Zaeem Azfer 
Published: January 2021

Background: Vasovagal syncope (VVS) occurs due to cerebral hypoperfusion from a fall in blood pressure, with accompanying bradycardia in most cases. Seizure and/or asystole may accompany VVS, though their prediction within the VVS cohort remains elusive.Objective: To further characterize VVS and to find predictive features of “complex” VVS (defined as VVS associated with seizures and/or asystole).Methods: We reviewed medical records of all patients who were referred for orthostatic intolerance and had a definite VVS during the head-up tilt table testing (HUTT). The following variables were recorded: cardiovascular indices during HUTT, autonomic testing results, and semiology of asystole and/or seizure when present. Simple frequency and correlation analysis were performed using the ANOVA.Results: A total of 78 independent VVS were recorded in 60 patients of which 24% were not preceded by presyncope. Vasodepressor (45%) and mixed (38%) VVS were the most prevalent types. Eighteen (23%) were complex VVS; five had an associated seizure (SySz), nine were accompanied by asystole (SyAs), and four had both (SySzAs). Males were significantly more likely to have complex VVS. Mean asystole duration was somewhat longer in the SyAsSz group. The severity of bradycardia significantly correlated with complex VVS and was a predictor of SySz. Autonomic abnormalities were frequent but did not distinguish the two VVS subgroups. Seizures had multiple distinguishing features from those typically associated with epileptic seizures.Conclusions: The underlying pathophysiologic mechanisms of complex VVS remain unclear, but the severity of cerebral hypoperfusion due to bradycardia likely plays a key role in seizure generation.
Risk of Valproic Acid-Related Tremor: A Systematic Review and Meta-Analysis
Authors: Zhang Chen qi , He Bao ming , Hu Mei ling , Sun Hong bin 
Published: January 2021

Purpose: To evaluate the incidence and risk of tremor in patients treated with valproic aid (VPA) monotherapy.Methods: We searched the PubMed, Embase, and Cochrane Library databases to gather relevant data on tremor in patients taking VPA and other drugs and performed a meta-analysis using Stata15.1 software.Results: Twenty-nine randomized controlled trials (RCTs) met the inclusion criteria and were included in the meta-analysis. The overall incidence of tremor in patients receiving VPA therapy was 14% [OR = 0.14, 95% CI (0.10–0.17)]. The pooled estimate risk of tremor showed a significant difference between patients treated with VPA and all other drugs [OR = 5.40, 95% CI (3.22–9.08)], other antiepileptic drugs (AEDs) [OR = 5.78, 95% CI (3.18–10.50)], and other non-AEDs [OR = 4.77, 95% CI (1.55–14.72)]. Both a dose of &lt;1,500 mg/d of VPA [included 500 mg/d: OR = 3.57, 95% CI (1.24–10.26), 500–999 mg/d: OR = 3.99, 95% CI (1.95–8.20), 1,000–1,499 mg/d: OR = 8.82, 95% CI (3.25–23.94)] and a VPA treatment duration of &lt;12 m [included ≤ 3 months: OR = 3.06, 95% CI (1.16–8.09), 3–6 months: OR = 16.98, 95% CI (9.14–31.57), and 6–12 months: OR = 4.15, 95% CI (2.74–6.29)] led to a higher risk of tremor than did other drugs, as did higher doses and longer treatment times.Conclusion: Compared with other drugs, VPA led to a higher risk of tremor, and the level of risk was associated with the dose and duration of treatment.
Pathomechanisms of HIV-Associated Cerebral Small Vessel Disease: A Comprehensive Clinical and Neuroimaging Protocol and Analysis Pipeline
Authors: Murray Kyle D. , Singh Meera V. , Zhuang Yuchuan , Uddin Md Nasir , Qiu Xing , Weber Miriam T. , Tivarus Madalina E. , Wang Henry Z. , Sahin Bogachan , Zhong Jianhui , Maggirwar Sanjay B. , Schifitto Giovanni 
Published: January 2021

Rationale: We provide an in-depth description of a comprehensive clinical, immunological, and neuroimaging study that includes a full image processing pipeline. This approach, although implemented in HIV infected individuals, can be used in the general population to assess cerebrovascular health.Aims: In this longitudinal study, we seek to determine the effects of neuroinflammation due to HIV-1 infection on the pathomechanisms of cerebral small vessel disease (CSVD). The study focuses on the interaction of activated platelets, pro-inflammatory monocytes and endothelial cells and their impact on the neurovascular unit. The effects on the neurovascular unit are evaluated by a novel combination of imaging biomarkers.Sample Size: We will enroll 110 HIV-infected individuals on stable combination anti-retroviral therapy for at least three months and an equal number of age-matched controls. We anticipate a drop-out rate of 20%.Methods and Design: Subjects are followed for three years and evaluated by flow cytometric analysis of whole blood (to measure platelet activation, platelet monocyte complexes, and markers of monocyte activation), neuropsychological testing, and brain MRI at the baseline, 18- and 36-month time points. MRI imaging follows the recommended clinical small vessel imaging standards and adds several advanced sequences to obtain quantitative assessments of brain tissues including white matter microstructure, tissue susceptibility, and blood perfusion.Discussion: The study provides further understanding of the underlying mechanisms of CSVD in chronic inflammatory disorders such as HIV infection. The longitudinal study design and comprehensive approach allows the investigation of quantitative changes in imaging metrics and their impact on cognitive performance.
Possibility of Worsening Flow Diversion Effect Due to Morphological Changes of a Stented Artery With Multiple Overlapping Stents for Partially Thrombosed Vertebral Artery Aneurysms
Authors: Suzuki Tomoaki , Hasegawa Hitoshi , Ando Kazuhiro , Shibuya Kouhei , Takahashi Haruhiko , Saito Shoji , Oishi Makoto , Fujii Yukihiko 
Published: January 2021

Background: Morphological changes of a stented artery can cause a flow diversion effect to reduce intra-aneurysmal flow; however, there is a potential for the negative effect of increased intra-aneurysmal flow. We present cases with multiple overlapping stents for a partially thrombosed vertebral artery aneurysm and characterize the hemodynamic properties of a recurrent case by focusing on the morphological changes of the stented artery.Methods: Between October 2017 and April 2019, four consecutive cases of symptomatic unruptured large and giant partially thrombosed vertebral artery aneurysms were treated with multiple overlapping low-profile visualized intraluminal support stents and no coils. Both angiographic and clinical outcomes were assessed. Computational fluid dynamics analysis was performed to clarify hemodynamic features. The degree of pressure elevation was calculated as the pressure difference (Pd). Wall shear stress (WSS) was also calculated.Results: In three of the four cases, successful flow reduction was achieved with no morphological change of the stented arteries. The patients' symptoms were gradually improved. The remaining case required additional stents after the initial treatment. In the recurrent case, Pd was noticeably elevated at the aneurysm neck after treatment, and WSS was generally increased in the area due to altered blood flow into the aneurysm dome caused by morphological changes of the stented artery.Conclusion: Overlapping stents can be used for the treatment of large and giant thrombosed vertebral artery aneurysms with flow diversion effect; however, morphological changes of the stented artery requires careful attention as it may lead to an increase in the intra-aneurysmal flow, causing negative outcomes.
Predictors of CT Morphologic Features to Identify Spread Through Air Spaces Preoperatively in Small-Sized Lung Adenocarcinoma
Authors: Qi Lin , Xue Ke , Cai Yongjun , Lu Jinjuan , Li Xiaohu , Li Ming 
Published: January 2021

ObjectivesThis study aimed to explore the predictive CT features of spread through air spaces (STAS) in patients with small-sized lung adenocarcinoma.MethodsFrom January 2017 to May 2019, patients with confirmed pathology of small-sized lung adenocarcinoma (less than or equal to 2 cm) and who underwent surgery were retrospectively analyzed. The clinical, pathological, and surgical information and CT features were analyzed.ResultsA total of 47 patients with STAS (males, 61.7%; mean age, 56 ± 8years) and 143 patients without STAS (males, 58%; mean age, 53 ± 11 years) were included. Pathologically, papillary, micropapillary, solid predominant subtypes, and vascular and pleural invasion were most commonly observed features in the STAS group. Radiologically, higher consolidation tumor ratio (CTR), presence of spiculation, satellites, ground glass ribbon sign, pleural attachment, and unclear tumor–lung interface were more commonly observed features in the STAS group. CTR, presence of ground glass ribbons and pleural connection, and absence of cystic airspaces were considered as stable predictors of STAS in multivariate logistic models. The receiver operating characteristic curve (ROC) analysis for predicting STAS demonstrated higher area under the curve (AUC) in the model that used CTR (0.760, 95% confidence interval, 0.69–0.83) for predicting STAS than in the model that used long diameter of entire lesion (0.640).ConclusionsCTR is the best CT sign for predicting STAS in small-sized lung adenocarcinoma. The ground glass ribbon is a newly found indicator and has the potential for predicting STAS.
The Performance of a Dual-Energy CT Derived Radiomics Model in Differentiating Serosal Invasion for Advanced Gastric Cancer Patients After Neoadjuvant Chemotherapy: Iodine Map Combined With 120-kV Equivalent Mixed Images
Authors: Wang Lingyun , Zhang Yang , Chen Yong , Tan Jingwen , Wang Lan , Zhang Jun , Yang Chunxue , Ma Qianchen , Ge Yingqian , Xu Zhihan , Pan Zilai , Du Lianjun , Yan Fuhua , Yao Weiwu , Zhang Huan 
Published: January 2021

ObjectivesThe aim was to determine whether the dual-energy CT radiomics model derived from an iodine map (IM) has incremental diagnostic value for the model based on 120-kV equivalent mixed images (120 kVp) in preoperative restaging of serosal invasion with locally advanced gastric cancer (LAGC) after neoadjuvant chemotherapy (NAC).MethodsA total of 155 patients (110 in the training cohort and 45 in the testing cohort) with LAGC who had standard NAC before surgery were retrospectively enrolled. All CT images were analyzed by two radiologists for manual classification. Volumes of interests (VOIs) were delineated semi-automatically, and 1,226 radiomics features were extracted from every segmented lesion in both IM and 120 kVp images, respectively. Spearman’s correlation analysis and the least absolute shrinkage and selection operator (LASSO) penalized logistic regression were implemented for filtering unstable and redundant features and screening out vital features. Two predictive models (120 kVp and IM-120 kVp) based on 120 kVp selected features only and 120 kVp combined with IM selected features were established by multivariate logistic regression analysis. We then build a combination model (ComModel) developed with IM-120 kVp signature and ycT. The performance of these three models and manual classification were evaluated and compared.ResultThree radiomics models showed great predictive accuracy and performance in both the training and testing cohorts (ComModel: AUC: training, 0.953, testing, 0.914; IM-120 kVp: AUC: training, 0.953, testing, 0.879; 120 kVp: AUC: training, 0.940, testing, 0.831). All these models showed higher diagnostic accuracy (ComModel: 88.9%, IM-120 kVp: 84.4%, 120 kVp: 80.0%) than manual classification (68.9%) in the testing group. ComModel and IM-120 kVp model had better performances than manual classification both in the training (both p&lt;0.001) and testing cohorts (p&lt;0.001 and p=0.034, respectively).ConclusionsDual-energy CT-based radiomics models demonstrated convincible diagnostic performance in differentiating serosal invasion in preoperative restaging for LAGC. The radiomics features derived from IM showed great potential for improving the diagnostic capability.