bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Severity of Leptospirosis and Subsequent Major Autoimmune Diseases: A Nationwide Observational Cohort Study
Authors: Chen Chih-Chung , Hung Yao-Min , Chiu Lu-Ting , Chou Mei-Chia , Chang Renin , Wei James Cheng-Chung 
Published: September 2021

IntroductionInfections play a role in autoimmune diseases (AD). Leptospirosis has been linked to the trigger of systemic lupus erythematosus.ObjectiveTo investigate subsequent risk of major AD in hospitalized Taiwanese for Leptospirosis.MethodsRetrospective observational cohort study was employed. The enrolled period was from 2000 to 2012. In the main model, we extracted 4026 inpatients with leptospirosis from the Taiwan National Health Insurance Research Database (NHIRD) and 16,104 participants without leptospirosis at a 1:4 ratio propensity-score matched (PSM) by age, gender, index year, and comorbidities. The follow-up period was defined as the time from the initial diagnosis of leptospirosis to major AD occurrence or 2013. This study was re-analyzed by frequency-matching as a sensitivity analysis for cross-validation. Univariable and multivariable Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsThe adjusted HR (95% CI) of major ADs for the leptospirosis group was 4.45 (3.25–6.79) (p &lt; 0.001) compared to the controls after full adjustment. The risk of major ADs was 5.52-fold (95% CI, 3.82–7.99) higher in leptospirosis patients hospitalized for seven days and above than the controls, while 2.80-fold (95% CI, 1.68–5.61) in those hospitalized less than seven days. The sensitivity analysis yields consistent findings. Stratified analysis revealed that the association between leptospirosis and major ADs was generalized in both genders, and all age groups.ConclusionsSymptomatic leptospirosis is associated with increased rate of subsequent major ADs, and the risk seems to be higher in severe cases.
Effect of the Alkalized Rice Straw Content on Strength Properties and Microstructure of Cemented Tailings Backfill
Authors: Wang Shi , Song Xuepeng , Wei Meiliang , Liu Wu , Wang Xiaojun , Ke Yuxian , Tao Tiejun 
Published: September 2021

The tailings and rice straw are waste by-products, and the storage of tailings on the ground and the burning of rice straws will seriously damage the ecological environment. In this study, the effect of different contents of alkalized rice straw (ARS; rice straw was alkalized with 4% NaOH solution) on the mechanical properties and microstructure of cemented tailings backfill (CTB; ARSCTB) was studied through uniaxial compressive strength (UCS), scanning electron microscopy (SEM), and X-ray diffraction (XRD) tests. The results indicated that 1) the UCS of ARSCTB could be improved by ARS. However, with the increase in the ARS content from 0.1 to 0.4 wt%, the UCS showed a monotonous decreasing trend. The UCS improvement effect was best when the ARS content was 0.1 wt%, and at 7, 14, and 28 days curing ages, the UCS increased rate was 6.0, 8.3, 14.7% respectively. 2) The tensile strength of ARSCTB was generally higher than that of CTB and positively correlated with the ARS content. The tensile strength increase rate was 24.1–34.2% at 28 days curing age. 3) The SEM test indicated that the ARS was wrapped by cement hydration products, which improves its connection with the ARSCTB matrix. ARS performed a bridging role, inhibited cracks propagation, and provided drag or pulling force for the block that is about to fall off. Therefore, the mechanical properties of ARSCTB were enhanced. However, under high ARS content, the inhibition of ARS on hydration reaction and the overlap between ARS were not conducive to the improvement of the UCS of ARSCTB. 4) The post-peak residual strength and integrity effect of ARSCTB were greater. It is recommended to add 0.1–0.2 wt% ARS to the backfill with high compressive strength requirements such as the empty field subsequent filling mining method and the artificial pillar. 0.3–0.4 wt% ARS is incorporated into backfill with high tensile strength requirements such as high-stage filling with lateral exposure and artificial roof. This study further makes up for the blank of the application of plant fiber in the field of mine filling and helps to improve the mechanical properties of backfill through low-cost materials.
Molecular Characteristics, Clinical Implication, and Cancer Immunity Interactions of Pyroptosis-Related Genes in Breast Cancer
Authors: Xu Dandan , Ji Zhipeng , Qiang Ling 
Published: September 2021

Objective: Pyroptosis represents an emerging inflammatory form of programmed cell death. Herein, specific functions and clinical implications of pyroptosis-related genes were systematically characterized in breast cancer.Methods: Expression, somatic mutation and copy number variation of 33 pyroptosis-related genes were assessed in breast cancer from TCGA dataset. Their interactions, biological functions and prognostic values were then observed. By stepwise Cox regression analysis, a pyroptosis-related gene signature was generated. The predictive efficacy in survival was examined by survival analyses, ROCs, univariate and multivariate analyses and subgroup analyses. Associations between risk score (RS) and cancer immunity cycle, HLA, immune cell infiltrations, and immune checkpoints were analyzed.Results: Most of pyroptosis-related genes were abnormally expressed in breast cancer. CASP8, NLRC4, NLRP3, NLRP2, PLCG1, NLRP1, NLRP7, SCAF11, GSDMC, and NOD1 occurred somatic mutations as well as most of them had high frequency of CNV. There were closely interactions between them. These genes were distinctly enriched in immune-related processes. A three-gene signature was generated, containing IL-18, GSDMC, and TIRAP. High RS predicted poorer overall survival, progression, and recurrence. After verification, this RS was an independent and sensitive predictive index. This RS was negatively correlated to cancer immunity cycle. Also, low RS was characterized by high HLA, immune cell infiltrations and immune checkpoints. A nomogram including age and RS was generated for accurately predicting 5-, 8-, and 10-year survival probabilities.Conclusion: Pyroptosis-related genes exert key roles in cancer immunity and might be applied as a prognostic factor of breast cancer.
A Quantitative Comparison of Multispectral Refraction Topography and Autorefractometer in Young Adults
Authors: Liao Yunru , Yang Zhenlan , Li Zijing , Zeng Rui , Wang Jing , Zhang Yichi , Lan Yuqing 
Published: September 2021

Purpose: Purpose of this study is to evaluate the measuring consistency of central refraction between multispectral refraction topography (MRT) and autorefractometry.Methods: This was a descriptive cross-sectional study including subjects in Sun Yat-sen Memorial Hospital from September 1, 2020, to December 31, 2020, ages 20 to 35 years with a best corrected visual acuity of 20/20 or better. All patients underwent cycloplegia, and the refractive status was estimated with autorefractometer, experienced optometrist and MRT. We analyzed the central refraction of the autorefractometer and MRT. The repeatability and reproducibility of values measured using both devices were evaluated using intraclass correlation coefficients (ICCs).Results: A total of 145 subjects ages 20 to 35 (290 eyes) were enrolled. The mean central refraction of the autorefractometer was −4.69 ± 2.64 diopters (D) (range −9.50 to +4.75 D), while the mean central refraction of MRT was −4.49 ± 2.61 diopters (D) (range −8.79 to +5.02 D). Pearson correlation analysis revealed a high correlation between the two devices. The intraclass correlation coefficient (ICC) also showed high agreement. The intrarater and interrater ICC values of central refraction were more than 0.90 in both devices and conditions. At the same time, the mean central refraction of experienced optometrist was −4.74 ± 2.66 diopters (D) (range −9.50 to +4.75D). The intra-class correlation coefficient of central refraction measured by MRT and subjective refraction was 0.939.Conclusions: Results revealed that autorefractometry, experienced optometrist and MRT show high agreement in measuring central refraction. MRT could provide a potential objective method to assess peripheral refraction.
Effectiveness of Telemonitoring for Reducing Exacerbation Occurrence in COPD Patients With Past Exacerbation History: A Systematic Review and Meta-Analysis
Authors: Lu Jing-wen , Wang Yu , Sun Yue , Zhang Qin , Yan Li-ming , Wang Ying-xi , Gao Jing-han , Yin Yan , Wang Qiu-yue , Li Xue-lian , Hou Gang 
Published: September 2021

Background: Although an increasing number of studies have reported that telemonitoring (TM) in patients with chronic obstructive pulmonary disease (COPD) can be useful and efficacious for hospitalizations and quality of life, its actual utility in detecting and managing acute exacerbation of COPD (AECOPD) is less established. This meta-analysis aimed to identify the best available evidence on the effectiveness of TM targeting the early and optimized management of AECOPD in patients with a history of past AECOPD compared with a control group without TM intervention.Methods: We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials published from 1990 to May 2020. Primary endpoints included emergency room visits and exacerbation-related readmissions. P-values, risk ratios, odds ratios, and mean differences with 95% confidence intervals were calculated.Results: Of 505 identified citations, 17 original articles with both TM intervention and a control group were selected for the final analysis (N = 3,001 participants). TM was found to reduce emergency room visits [mean difference (MD) −0.70, 95% confidence interval (CI) −1.36 to −0.03], exacerbation-related readmissions (risk ratio 0.74, 95% CI 0.60–0.92), exacerbation-related hospital days (MD −0.60, 95% CI −1.06 to −0.13), mortality (odds ratio 0.71, 95% CI 0.54–0.93), and the St. George's Respiratory Questionnaire (SGRQ) score (MD −3.72, 95% CI −7.18 to −0.26) but did not make a difference with respect to all-cause readmissions, the rate of exacerbation-related readmissions, all-cause hospital days, time to first hospital readmission, anxiety and depression, and exercise capacity. Furthermore, the subgroup analysis by observation period showed that longer TM (≥12 months) was more effective in reducing readmissions.Conclusions: TM can reduce emergency room visits and exacerbation-related readmissions, as well as acute exacerbation (AE)-related hospital days, mortality, and the SGRQ score. The implementation of TM intervention is thus a potential protective therapeutic strategy that could facilitate the long-term management of AECOPD.Systematic Review Registration: This systematic review and meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and was registered at International Prospective Register of Systematic Reviews (number: CRD42020181459).
A Dual-Task Paradigm Using the Oral Trail Making Test While Walking to Study Cognitive-Motor Interactions in Older Adults
Authors: Langeard Antoine , Torre Marta Maria , Temprado Jean-Jacques 
Published: September 2021

Objective: With aging, gait becomes more dependent on executive functions, especially on switching abilities. Therefore, cognitive-motor dual-task (DT) paradigms should study the interferences between gait and switching tasks. This study aimed to test a DT paradigm based on a validated cognitive switching task to determine whether it could distinguish older-old adults (OO) from younger-old adults (YO).Methods: Sixty-five healthy older participants divided into 29 younger-old (&lt;70 years) and 36 older-old (≥70 years) age groups were evaluated in three single-task (ST) conditions as follows: a cognitive task including a processing speed component [Oral Trail Making Test part A (OTMT-A)], a cognitive task including a switching component [Oral Trail Making Test part B (OTMT-B)], and a gait evaluation at normal speed. They were also evaluated under two DT conditions, i.e., one associating gait with OTMT-A and the other associating gait with OTMT-B. Cognitive and gait performances were measured. The comparison of cognitive and gait performances between condition, logistic regression, and receiver operating characteristic (ROC) analyses were performed.Results: The cognitive and gait performances were differently affected by the different conditions (i.e., ST, DT, OTMT-A, and OTMT-B). The OTMT-B produced higher interference on gait and cognitive performances. Moreover, a higher number of errors on the OTMT-B performed while walking was associated with the older-old age group.Conclusion: Using validated cognitive flexibility tasks, this DT paradigm confirms the high interference between switching tasks and gait in older age. It is easily implemented, and its sensitivity to age may highlight its possible usefulness to detect cognitive or motor declines.
Left Atrial Dilatation and Reduced Left Ventricular Ejection Fraction Are Associated With Cardioembolic Stroke
Authors: Hosseini Farahabadi Maryam , Milani-Nejad Shadi , Liu Shimeng , Yu Wengui , Shafie Mohammad 
Published: September 2021

Objective: Left atrial (LA) dilatation and heart failure are independent risk factors for ischemic stroke. The goal of this study is to evaluate the association between LA dilatation and reduced left ventricular ejection fraction (EF) with cardioembolic stroke.Methods: Four hundred fifty-three patients with ischemic stroke admitted to the University of California, Irvine between 2016 and 2017 were included based on the following criteria: age &gt;18 and availability of echocardiogram. Stroke was categorized into cardioembolic and non-cardioembolic. EF was categorized into normal: 52–72% (male), 54–74% (female), mildly abnormal: 41–51% (male), 41–53% (female), moderately abnormal: 30–40%, and severely abnormal: &lt;30%. LA volume was categorized into normal (≤34 ml/m2) vs. enlarged (≥35 ml/m2). Other variables included gender, hypertension [systolic blood pressure (SBP) ≥ 140 or diastolic blood pressure (DBP) ≥ 90], and known history of atrial fibrillation (Afib).Results: Two hundred eighteen patients had cardioembolic, and 235 had non-cardioembolic stroke. Among patients with cardioembolic stroke, 49 (22.4%) and 142 (65%) had reduced EF and enlarged LA, respectively, as compared with 19 (8.1%) and 65 (27.7%) patients with non-cardioembolic stroke (p &lt; 0.0001). The odds of cardioembolic stroke were 2.0 (95% CI: 0.1–6.0) and 8.8 times (95% CI: 1.9–42.3) higher in patients with moderately and severely reduced EF, respectively, than in patients with normal EF. The odds of cardioembolic stroke was 2.4 times (95% CI: 1.5–3.9) higher in patients with enlarged LA than in patients with normal LA size. Compared with patients with normal LA and EF, patients with combined enlarged LA and reduced EF had significantly higher rates of Afib (43.4 vs. 9.0%, p &lt; 0.0001) and cardioembolic stroke (78.3 vs. 43.4%, p &lt; 0.0001).Conclusions: LA dilatation along with reduced EF is a reliable predictor of Afib and cardioembolic stroke. Further studies are warranted to determine the benefit of anticoagulation for secondary stroke prevention in such patient population.
Near-Infrared Spectroscopy-Derived Dynamic Cerebral Autoregulation in Experimental Human Endotoxemia—An Exploratory Study
Authors: Eleveld Nick , Hoedemaekers Cornelia W. E. , van Kaam C. Ruud , Leijte Guus P. , van den Brule Judith M. D. , Pickkers Peter , Aries Marcel J. H. , Maurits Natasha M. , Elting Jan Willem J. 
Published: September 2021

Cerebral perfusion may be altered in sepsis patients. However, there are conflicting findings on cerebral autoregulation (CA) in healthy participants undergoing the experimental endotoxemia protocol, a proxy for systemic inflammation in sepsis. In the current study, a newly developed near-infrared spectroscopy (NIRS)-based CA index is investigated in an endotoxemia study population, together with an index of focal cerebral oxygenation.Methods: Continuous-wave NIRS data were obtained from 11 healthy participants receiving a continuous infusion of bacterial endotoxin for 3 h (ClinicalTrials.gov NCT02922673) under extensive physiological monitoring. Oxygenated–deoxygenated hemoglobin phase differences in the (very)low frequency (VLF/LF) bands and the Tissue Saturation Index (TSI) were calculated at baseline, during systemic inflammation, and at the end of the experiment 7 h after the initiation of endotoxin administration.Results: The median (inter-quartile range) LF phase difference was 16.2° (3.0–52.6°) at baseline and decreased to 3.9° (2.0–8.8°) at systemic inflammation (p = 0.03). The LF phase difference increased from systemic inflammation to 27.6° (12.7–67.5°) at the end of the experiment (p = 0.005). No significant changes in VLF phase difference were observed. The TSI (mean ± SD) increased from 63.7 ± 3.4% at baseline to 66.5 ± 2.8% during systemic inflammation (p = 0.03) and remained higher at the end of the experiment (67.1 ± 4.2%, p = 0.04). Further analysis did not reveal a major influence of changes in several covariates such as blood pressure, heart rate, PaCO2, and temperature, although some degree of interaction could not be excluded.Discussion: A reversible decrease in NIRS-derived cerebral autoregulation phase difference was seen after endotoxin infusion, with a small, sustained increase in TSI. These findings suggest that endotoxin administration in healthy participants reversibly impairs CA, accompanied by sustained microvascular vasodilation.
Bone Scintigraphy of Vertebral Fractures With a Whole-Body CZT Camera in a PET-Like Utilization
Authors: Bahloul Achraf , Verger Antoine , Blum Alain , Chawki Mohammad Bilal , Perrin Mathieu , Melki Saifeddine , Karcher Gilles , Marie Pierre-Yves , Imbert Laetitia 
Published: September 2021

Objective: An image display with a standardized uptake value (SUV) scale is recommended for analyzing PET exams, thus requiring the reconstruction of accurate images for both SUV measurement and visual analysis. This study aimed to determine whether such images may also be obtained with a high-speed CZT-SPECT/CT system, with a further application for the longitudinal monitoring of vertebral fractures.Materials and Methods: SPECT image reconstruction was optimized with an IEC phantom according to both image quality parameters and accuracy of measured activity. The optimized reconstruction process was applied to ≤15 min 99mTc-HDP SPECT spine recordings previously acquired from 25 patients (74 ± 12 years old) at both early (1.3 ± 1.1 months) and late (5.2 ± 2.3 months) stages after an acute vertebral fracture.Results: A SPECT reconstruction with 32 equivalent iterations was selected based on the association of high detectability for spheres down to 0.6 ml in volume, with accurate measured activity, although the latter was affected by partial volume effect for spheres ≤5.6 ml. Coherent measurements were obtained on these high-quality SPECT images for the SUVmax from the intact vertebrae of patients, which were stable between basal SPECT/CT and follow-up SPECT/CT (for T1 vertebrae: 5.7 ± 1.1 vs. 5.8 ± 1.1, p = 0.76), and from initially fractured vertebrae, which were dramatically higher on the basal compared with the follow-up SPECT (21.0 ± 8.5 vs. 11.2 ± 4.2, p &lt; 0.001), whereas inverse changes in SUVmax were observed for newly compacted fractures identified on follow-up SPECT (74.4 ± 2.0 vs. 21.8 ± 10.3, p = 0.002). Finally, an image display with an SUV scale was shown to be advantageous for highlighting areas with &gt;7.5 SUV, a level reached by 98% of vertebral fractures of &lt;7 months and 4% of reference intact vertebrae.Conclusion: Bone scintigraphy of vertebral fractures may be obtained with this CZT-SPECT/CT system with fast 3D acquisitions and high-quality images displayed with a reliable SUV scale, approaching what is achieved and recommended for PET imaging.
Relationship Between Nutrition Knowledge and Dietary Intake: An Assessment Among a Sample of Italian Adults
Authors: Scalvedi Maria Luisa , Gennaro Laura , Saba Anna , Rossi Laura 
Published: September 2021

Background:Assessing nutrition knowledge provides useful information especially if coupled with the self-perception of nutrition knowledge that could lead to bias and personal conviction. The objective of this study was to assess nutrition knowledge (NK) and its relationship with eating habits in a group of adults.Methods:A cross-sectional study with the administration of self-reported questionnaires was conducted on a sample of 591 parents (43 ± 5.82 years old) of primary school pupils recruited from the municipality of Rome (urban) and province (rural). The fieldwork was carried out in May 2017. An indicator to evaluate adherence to Italian dietary guidelines was developed. ANOVA (Welch's ANOVA in case of unequal variances) test and chi-squared test were used fixing the significance level at 5% (p&lt; 0.05).Results:The percentage of correct answers to nutrition knowledge was 46%, with the expert recommendation section having the highest percentage (59%). The majority of the respondents (66%) were confident that they had a high level of nutrition knowledge. In 37% of the sample, nutrition knowledge and self-perception nutrition knowledge levels were found to be associated. A total of 40% of the sample showed eating habits congruent with nutrition knowledge level. In the investigated sample, living in rural areas, being young, and having low school education level were factors associated with low nutrition literacy or/and unhealthy eating habits.Conclusions:This study provided a demonstration that an assessment based on a multidimensional and multilevel approach is helpful to identify knowledge gaps and to profile critical segments to put in place targeted policy interventions.