bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stimulation of the Subthalamic Nucleus Changes Cortical-Subcortical Blood Flow Patterns During Speech: A Positron Emission Tomography Study
Authors: Sidtis John J. , Sidtis Diana Van Lancker , Dhawan Vijay , Tagliati Michele , Eidelberg David 
Published: May 2021

Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for Parkinson's disease (PD) but can have an adverse effect on speech. In normal speakers and in those with spinocerebellar ataxia, an inverse relationship between regional cerebral blood flow (rCBF) in the left inferior frontal (IFG) region and the right caudate (CAU) is associated with speech rate. This pattern was examined to determine if it was present in PD, and if so, whether it was altered by STN-DBS.Methods: Positron Emission Tomography (PET) measured rCBF during speech in individuals with PD not treated with STN-DBS (n = 7), and those treated with bilateral STN-DBS (n = 7). Previously reported results from non-PD control subjects (n = 16) were reported for comparison. The possible relationships between speech rate during scanning and data from the left and right IFG and CAU head regions were investigated using a step-wise multiple linear regression to identify brain regions that interacted to predict speech rate.Results: The multiple linear regression analysis replicated previously reported predictive coefficients for speech rate involving the left IFG and right CAU regions. However, the relationships between these predictive coefficients and speech rates were abnormal in both PD groups. In PD who had not received STN-DBS, the right CAU coefficient decreased normally with increasing speech rate but the left IFG coefficient abnormally decreased. With STN-DBS, this pattern was partially normalized with the addition of a left IFG coefficient that increased with speech rate, as in normal controls, but the abnormal left IFG decreasing coefficient observed in PD remained. The magnitudes of both cortical predictive coefficients but not the CAU coefficient were exaggerated with STN-DBS.Conclusions: STN-DBS partially corrects the abnormal relationships between rCBF and speech rate found in PD by introducing a left IFG subregion that increases with speech rate, but the conflicting left IFG subregion response remained. Conflicting IFG responses may account for some of the speech problems observed after STN-DBS. Cortical and subcortical regions may be differentially affected by STN-DBS.
Contrast-Enhanced Ultrasound in the Differential Diagnosis and Risk Stratification of ACR TI-RADS Category 4 and 5 Thyroid Nodules With Non-Hypovascular
Authors: Wang Yanfang , Dong Tiantian , Nie Fang , Wang Guojuan , Liu Ting , Niu Qian 
Published: May 2021

ObjectiveThis study aims to investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis and risk stratification of ACR TI-RADS category 4 and 5 thyroid nodules with non-hypovascular.MethodsFrom January 2016 to December 2019 in our hospital, 217 ACR TI-RADS category 4 and 5 nodules with non-hypovascular in 210 consecutive patients were included for a derivation cohort. With surgery and/or fine-needle aspiration (FNA) as a reference, conventional ultrasound (US) features and CEUS features were analyzed. Multivariate logistic regression analysis was used to screen the independent risk factors and establish a risk predictive model. Between January 2020 and March 2021, a second cohort of 100 consecutive patients with 101 nodules were included for an external validation cohort. The model was converted into a simplified risk score and was validated in the validation cohort. The area under the receiver operating characteristic curves (AUC) were used to assess the models’ diagnostic performance.ResultsMicro-calcification, irregular margin, earlier wash-out, centripetal enhancement, and absence of ring enhancement were independent risk factors and strongly discriminated malignancy in the derivation cohort (AUC = 0.921, 95% CI 0.876–0.953) and the validation cohort (0.900, 0.824–0.951). There was no significant difference (P = 0.3282) between the conventional US and CEUS in differentiating malignant non-hypovascular thyroid nodules, but a combination of them (the predictive model) had better performance than the single method (all P &lt;0.05), with a sensitivity of 87.0%, specificity of 86.2%, and accuracy of 86.6% in the derivation cohort. The risk score based on the independent risk factors divided non-hypovascular thyroid nodules into low-suspicious (0–3 points; malignancy risk &lt;50%) and high-suspicious (4–7 points; malignancy risk ≥ 50%), the latter with nodule ≥10mm was recommended for FNA. The risk score showed a good ability of risk stratification in the validation cohort. Comparing ACR TI-RADS in screening suitable non-hypovascular nodules for FNA, the risk score could avoid 30.8% benign nodules for FNA.ConclusionsCEUS is helpful in combination with conventional US in differentiating ACR TI-RADS category 4 and 5 nodules with non-hypovascular. The risk score in this study has the potential to improve the diagnosis and risk stratification of non-hypovascular thyroid nodules.
Usefulness and Prospects of Sentinel Lymph Node Biopsy for Patients With Breast Cancer Using the Medical Imaging Projection System
Authors: Nakamura Yuki , Takada Masahiro , Imamura Michiko , Higami Akane , Jiaxi He , Fujino Makoto , Nakagawa Rie , Inagaki Yukiko , Matsumoto Yoshiaki , Kawaguchi Kosuke , Kawashima Masahiro , Suzuki Eiji , Toi Masakazu 
Published: May 2021

BackgroundThe Medical Imaging Projection System (MIPS) projects indocyanine green (ICG) fluorescence images directly on the surgical field using a projection mapping technique. We conducted an observational study of sentinel lymph node (SLN) biopsy using the prototype MIPS; we found a high identification rate. However, the number of SLN-positive cases was small, and the sensitivity could not be evaluated. The aim of this study was to investigate the clinical usefulness of the MIPS assisted ICG fluorescence method using commercially available equipment.MethodsThis was a retrospective observational study. Patients with primary breast cancer who underwent SLN biopsy using the MIPS at Kyoto University Hospital from April to December 2020 were included in the study. The primary endpoints were the identification rate of SLNs and detection of positive SLNs by the MIPS. The secondary endpoint was the number of SLNs excised using the MIPS per patient. We also conducted a questionnaire survey focused on the utility of the MIPS; it involved doctors with an experience in using the MIPS.ResultsSeventy-nine patients (84 procedures) were included in the study. In 60 (71%) procedures, both the radioisotope (RI) method and MIPS were used. At least one SLN could be detected by the MIPS in all the procedures, with an identification rate of 100% (95% confidence interval 95.6–100%). A total of 19 (7%) positive SLNs were removed, which were identifiable by the MIPS. Among 57 patients in whom the MIPS and RI methods were used, there was no positive SLN only identified by the RI method. The results of the questionnaire survey showed that the MIPS enabled the operator and assistant to share the ICG fluorescence image in the surgical field and to communicate with each other easily.ConclusionThe current study demonstrated that the identification rate of SLNs using the MIPS was high, and the MIPS can be used for detecting positive SLNs. It was suggested that the MIPS will be useful in learning SLN biopsy procedures.
Identification of Two Novel Compound Heterozygous EIF2AK3 Mutations Underlying Wolcott–Rallison Syndrome in a Chinese Family
Authors: Zhao Na , Yang Yanling , Li Ping , Xiong Qiuhong , Xiao Han , Wu Changxin 
Published: May 2021

Objective: Wolcott–Rallison syndrome is a rare autosomal recessive inheritance disorder caused by the defectiveness of eukaryotic translation initiation factor 2 alpha kinase 3 (EIF2AK3), which encodes the PKR-like endoplasmic reticulum kinase (PERK). Defect in EIF2AK3 results in a permanent diabetes in early infancy or newborn period, a tendency to develop skeletal fractures and other associated disorders such as severe liver and renal dysfunction, and central hypothyroidism. Two patients with Wolcott–Rallison syndrome-like manifestations in a Chinese family and family members were genetically analyzed to identify if any variations that occurred in EIF2AK3, which may cause Wolcott–Rallison syndrome.Methods: Whole-exome sequencing (WES) was performed to identify genetic variations, and Sanger sequencing was conducted to verify the identified variations in the family members with Wolcott–Rallison syndrome (WRS) clinical manifestations. Several bioinformatics tools were employed to predict the effect of EIF2AK3 variations on the protein function. The impact on PERK protein was analyzed by sequential analysis and evolution conservation study.Results: Two novel EIF2AK3 heterozygous single base variations (c.2818C&gt;T and c.2980G&gt;C) were detected in the proband. PERK has two functional domains: one is regulatory domain (aa 1–576), and the other is catalytic domain (aa 577–1,115). Both variations are missense mutations and locate in catalytic domain of PERK; c.2818C&gt;T resulted in a residue substitution of proline for serine at amino acid site 940 (p.Pro940Ser), and variation c.2980G&gt;C caused an amino acid change at position 994 from glutamic acid to glutamine (p.Glu994Gln). These novel missense variations may affect the physiological functions of PERK protein.Conclusions: Two novel compound heterozygous EIF2AK3 variations (c.2818C&gt;T, p.Pro940Ser and c.2980G&gt;C, p.Glu994Gln) were found in a Chinese family. The identification of the variations and verification of their pathogenicity extended the variation spectrum of EIF2AK3 variations causing Wolcott–Rallison syndrome and enriched valuable information for precise medical intervention for Wolcott–Rallison syndrome in China.
Solifenacin/Mirabegron Induces an Acute Compliance Increase in the Filling Phase of the Capacity-Reduced Urinary Bladder: A Pressure-Volume Analysis in Rats
Authors: Peng Hsien-Yu , Lai Cheng-Yuan , Hsieh Ming-Chun , Lin Tzer-Bin 
Published: May 2021

Aims: Pressure in the bladder, which is a high compliance organ, is only slightly elevated to a considerable filling volume during storage. Although cystometry off-line offers mean compliance, no protocol is available for real-time assays of the dynamics of bladder compliance, and the potential impact of solifenacin and mirabegron on dynamic bladder compliance has not been established.Methods: Along with constantly infused cystometry, a pressure-volume analysis (PVA) was performed by plotting intra-vesical volume against pressure in Sprague-Dawley rats. The instant compliance was assayed as the slope of the trajectory, and the mean compliance (Cm) was determined by the slope of the line produced by regression of the data points at the end of the first, second, and third quarters of the filling phase.Results: Under a steady-state, the PVA trajectory moved clockwise which shaped coincident enclosed loops with stable compliance. Though administering to naïve animals solifenacin, but not mirabegron (both 1 × 10−5−1 × 10−1 mg/kg, i.a.) decreased the peak pressure, both of these reagents exhibited acute increments in the trajectory slope and Cm of the filling phase in a dose-dependent manner (ED50 = 1.4 × 10−4 and 2.2 × 10−5 mg/kg, respectively). Resembling urine frequency/urgency in OAB patients, the voiding frequency of a capacity-reduced bladder was increased in association with decreased compliance which was ameliorated by both acute solifenacin and mirabegron injections (both 1 × 10−1 mg/kg).Conclusion: In addition to their well-known anti-inotropic/relaxative effects, solifenacin, and mirabegron induce an acute increase in bladder compliance to ameliorate OAB-like syndromes. Together with time-domain cystometry, PVA offers a platform for investigating the physiology/pathophysiology/pharmacology of bladder compliance which is crucial for urine storage.
Immediate and Delayed Response of Simulated Human Atrial Myocytes to Clinically-Relevant Hypokalemia
Authors: Clerx Michael , Mirams Gary R. , Rogers Albert J. , Narayan Sanjiv M. , Giles Wayne R. 
Published: May 2021

Although plasma electrolyte levels are quickly and precisely regulated in the mammalian cardiovascular system, even small transient changes in K+, Na+, Ca2+, and/or Mg2+ can significantly alter physiological responses in the heart, blood vessels, and intrinsic (intracardiac) autonomic nervous system. We have used mathematical models of the human atrial action potential (AP) to explore the electrophysiological mechanisms that underlie changes in resting potential (Vr) and the AP following decreases in plasma K+, [K+]o, that were selected to mimic clinical hypokalemia. Such changes may be associated with arrhythmias and are commonly encountered in patients (i) in therapy for hypertension and heart failure; (ii) undergoing renal dialysis; (iii) with any disease with acid-base imbalance; or (iv) post-operatively. Our study emphasizes clinically-relevant hypokalemic conditions, corresponding to [K+]o reductions of approximately 1.5 mM from the normal value of 4 to 4.5 mM. We show how the resulting electrophysiological responses in human atrial myocytes progress within two distinct time frames:(i) Immediately after [K+]o is reduced, the K+-sensing mechanism of the background inward rectifier current (IK1) responds. Specifically, its highly non-linear current-voltage relationship changes significantly as judged by the voltage dependence of its region of outward current. This rapidly alters, and sometimes even depolarizes, Vr and can also markedly prolong the final repolarization phase of the AP, thus modulating excitability and refractoriness.(ii) A second much slower electrophysiological response (developing 5–10 minutes after [K+]o is reduced) results from alterations in the intracellular electrolyte balance. A progressive shift in intracellular [Na+]i causes a change in the outward electrogenic current generated by the Na+/K+ pump, thereby modifying Vr and AP repolarization and changing the human atrial electrophysiological substrate.In this study, these two effects were investigated quantitatively, using seven published models of the human atrial AP. This highlighted the important role of IK1 rectification when analyzing both the mechanisms by which [K+]o regulates Vr and how the AP waveform may contribute to “trigger” mechanisms within the proarrhythmic substrate. Our simulations complement and extend previous studies aimed at understanding key factors by which decreases in [K+]o can produce effects that are known to promote atrial arrhythmias in human hearts.
Living in the “Bubble”: Athletes' Psychological Profile During the Sambo World Championship
Authors: Gentile Ambra , Trivic Tatjana , Bianco Antonino , Lakicevic Nemanja , Figlioli Flavia , Roklicer Roberto , Eliseev Sergey , Tabakov Sergey , Maksimovic Nebojsa , Drid Patrik 
Published: May 2021

Background: The COVID-19 pandemic has changed the way we conduct daily life, as well as sports training and sports competitions. Given the stress produced by COVID-19, and the “bubble” safety measures for the World Sambo Championship, held in Novi Sad, from the 6th to the 8th of November, 2020, athletes might have experienced more stress than athletes normally would in non-pandemic conditions. Therefore, the current study aimed to create a psychological profile of sambo athletes participating in the Sambo World Championship and living in this condition.Methods: One-hundred-fifteen participants took part in the study, completing the Profile of Mood Scale (POMS), the Pittsburg Sleep Quality Index, the Perceived Stress Scale (PSS), and the Fear of COVID-19 Scale. A mediation model with Fear of COVID-19 predicting both stress level directly and stress level through mood disturbance was hypothesized. Gender differences were evaluated through t-test.Results: The results showed that the sample presented higher levels of stress but no problems in sleeping. In particular, data analysis confirmed an indirect effect of Fear of COVID on Perceived stress through mood disturbance (β = 0.14, Z = 2.80, and p = 0.005), but did not have a significant impact on the direct effect (β = −0.04, Z = −0.48, and p = 0.63). Gender differences emerged in the perceived stress level (t = −2.86, df = 114, and p = 0.005) and daytime dysfunction (t = −2.52, df = 114, and p = 0.01) where females scored higher than males for both aspects.Conclusion: The athletes participating to the World Sambo Championship experienced stress levels determined by the mood disturbance produced by the fear of the COVID-19 pandemic. Female athletes were more stressed and showed higher daytime dysfunction. The findings of the current study are useful to understand the psychological profile of the athletes competing in the “bubble” conditions during COVID-19 pandemic.
Protective Predictors Associated With Posttraumatic Stress and Psychological Distress in Chinese Nurses During the Outbreak of COVID-19
Authors: Xia Lu , Yan Yajun , Wu Daxing 
Published: May 2021

Background: The novel coronavirus disease 2019 (COVID-19) posed an unprecedented threat to Chinese healthcare professionals. Nevertheless, few studies notably focused on the mental health conditions of nurses and explored protective factors to prevent posttraumatic stress and psychological distress. This study aimed to explore the prevalence and the predictive factors especially defensive predictors associated with posttraumatic stress and psychological distress in nurses during the COVID-19 pandemic.Methods: In this online study, 1,728 nurses (~77.5% came from the COVID-19 pandemic frontline) were included in the final analysis. Posttraumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (PCL-5) and Self-Reporting Questionnaire (SRQ) was used to assess posttraumatic stress and psychological distress.Results: The results demonstrated that the prevalence of posttraumatic stress and psychological distress in nurses throughout China between February 1, 2020 and February 13, 2020 was 39.12 and 24.36%, respectively. Multivariate logistic regression indicated that insomnia, high panic intensity, and high impact of the COVID-19 pandemic were risk predictors of posttraumatic stress and psychological distress in nurses. Married participants had a 1.58 times increased risk of having posttraumatic stress when compared with the single participants. Frontline medical staff were more likely to suffer from psychological distress. The adequate exercise was a protective predictor of psychological distress [adjusted odds ratio (AOR) = 0.655, 95% CI = 0.486–0.883], but not with posttraumatic stress. High-quality diet was a protective predictor of posttraumatic stress (AOR = 0.112, 95% CI = 0.037–0.336) and psychological distress (AOR = 0.083, 95% CI = 0.028–0.247).Conclusions: Our study revealed the prevalence and factors associated with posttraumatic stress and psychological distress in nurses during the COVID-19 pandemic. Low panic intensity, low level of impact, satisfactory sleep, adequate exercise, and better diet were protective factors of posttraumatic stress and psychological distress. It indicated that the psychological status of nurses (particularly those from the COVID-19 pandemic frontline) should be monitored, and protective factors associated with posttraumatic stress and psychological distress should be increased.
Psychometric Properties of the Chinese Version of the 10-Item Ruminative Response Scale Among Undergraduates and Depressive Patients
Authors: He Jiayue , Liu Yalin , Cheng Chang , Fang Shulin , Wang Xiang , Yao Shuqiao 
Published: May 2021

Objective: Rumination is considered as a key process in the mechanism of depression. Assessing rumination is important for both research and clinical practice. The Ruminative Response Scale (RRS) is a widely-used instrument to measure rumination. This study aimed to examine the psychometric properties of the Chinese 10-item Ruminative Response Scale (RRS-10) in a large sample of Chinese undergraduates and depressive patients.Methods: A total of 1,773 university students and 286 clinical patients with major depressive disorder finished the Chinese version of the RRS10, State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). A confirmatory factor analysis (CFA) was performed to examine the two-factor structure (reflection and brooding) of the RRS-10. The correlations among RRS-10, STAI, and BDI were explored in two samples. In addition, the measurement invariance of the RRS-10 across gender, time, and groups with and without depressive symptoms were further investigated. The internal consistency and test-retest reliability were also evaluated.Results: Confirmatory Factor Analysis revealed that the two-factor structure of RRS-10 fitted reasonably both in undergraduates (CFI = 0.933, TLI = 0.905, RMSEA = 0.071, SRMR = 0.035) and depressive patients (CFI = 0.941, TLI = 0.910, RMSEA = 0.077, SRMR = 0.057). The results of the multi-group confirmatory factor analysis supported the full strict invariance across genders and across groups (undergraduates and depressive patients). The full strong invariance over time was also supported by MGCFA. Besides, the RRS-10 showed acceptable internal consistency and good stability.Conclusions: The RRS-10 has good reliability and validity in different samples and over time, which demonstrated that RRS-10 is a valid measurement instrument to assess rumination.
The Relationship Between Childhood Physical and Sexual Abuse and Adolescent Cannabis Use: A Systematic Review
Authors: De la Peña-Arteaga Víctor , Nogueira Sarah O. , Lynskey Michael , Hines Lindsey A. 
Published: May 2021

Background: Among adolescents, cannabis use is a health concern due to associations with drug addiction and mental health disorders across the life course. It has been shown that childhood maltreatment is associated with drug addiction in adulthood. However, a better understanding of the relationship between maltreatment and drug use may improve targeted prevention and interventions. The aim of this systematic review is to describe the association between exposure to childhood maltreatment, specifically physical and sexual abuse, with adolescent cannabis use.Methods: A systematic search strategy was applied to Embase, PsycINFO, and Ovid MEDLINE(R) databases. Methods followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Abstract and title screening was performed to identify papers which reported an estimate of the association between childhood physical or sexual abuse and adolescent cannabis use. Full text screening of each paper was performed, and data were extracted and study quality assessed. Weighted means meta-analysis was performed on studies reporting odds ratios as effect estimates.Results: Of 8,780 screened articles, 13 were identified for inclusion. Eight papers received a quality rating score indicating lower risk of bias. Eleven papers reported the relationship between childhood sexual abuse and adolescent cannabis use; effect estimates ranged from AOR 0.53–AOR 2.18 (weighted mean OR 1.29, 95% CI 1.08–1.49). The relationship between childhood physical abuse and adolescent cannabis use was reported in 7 papers; effect estimates ranged from AOR 1.25–AOR 1.87 (weighted mean OR 1.39, 95% CI 1.12–1.66). Differences in the strength of the evidence were observed by the method of exposure ascertainment, and there was some evidence of differences in association by gender, age of cannabis initiation, and the severity of the abuse.Conclusions: This systematic review indicates childhood physical or sexual abuse may increase risk of adolescent-onset cannabis use. Few studies considered variation in timing of onset, or by gender. Adolescent cannabis use precedes is strongly associated with increased risk of negative mental health outcomes; further exploration of adolescent cannabis use's place on the causal pathway between childhood abuse and adult mental health problems is warranted to improve intervention.