bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Dementia in Cerebral Small Vessel Disease Using an Automatic Diffusion Tensor Image Segmentation Technique
Authors: Williams Owen A. , Zeestraten Eva A. , Benjamin Philip , Lambert Christian , Lawrence Andrew J. , Mackinnon Andrew D. , Morris Robin G. , Markus Hugh S. , Barrick Thomas R. , Charlton Rebecca A. 
Published: September 2019

Background and Purpose—
Cerebral small vessel disease (SVD) is the most common cause of vascular cognitive impairment, with a significant proportion of cases going on to develop dementia. We explore the extent to which diffusion tensor image segmentation technique (DSEG; which characterizes microstructural damage across the cerebrum) predicts both degree of cognitive decline and conversion to dementia, and hence may provide a useful prognostic procedure.

Methods—

Ninety-nine SVD patients (aged 43–89 years) underwent annual magnetic resonance imaging scanning (for 3 years) and cognitive assessment (for 5 years). DSEG-
θ
was used as a whole-cerebrum measure of SVD severity. Dementia diagnosis was based
Diagnostic and Statistical Manual of Mental Disorders V
criteria. Cox regression identified which DSEG measures and vascular risk factors were related to increased risk of dementia. Linear discriminant analysis was used to classify groups of stable versus subsequent dementia diagnosis individuals.

Results—

DSEG-
θ
was significantly related to decline in executive function and global cognition (
P
<0.001). Eighteen (18.2%) patients converted to dementia. Baseline DSEG-
θ
predicted dementia with a balanced classification rate=75.95% and area under the receiver operating characteristic curve=0.839. The best classification model included baseline DSEG-
θ
, change in DSEG-
θ
, age, sex, and premorbid intelligence quotient (balanced classification rate of 79.65%; area under the receiver operating characteristic curve=0.903).

Conclusions—

DSEG is a fully automatic technique that provides an accurate method for assessing brain microstructural damage in SVD from a single imaging modality (diffusion tensor imaging). DSEG-
θ
is an important tool in identifying SVD patients at increased risk of developing dementia and has potential as a clinical marker of SVD severity.
Cancer-Related Ischemic Stroke Has a Distinct Blood mRNA Expression Profile
Authors: Navi Babak B. , Mathias Ryna , Sherman Carla P. , Wolfe Julia , Kamel Hooman , Tagawa Scott T. , Saxena Ashish , Ocean Allyson J. , Iadecola Costantino , DeAngelis Lisa M. , Elkind Mitchell S.V. , Hull Heather , Jickling Glen C. , Sharp Frank R. , Ander Bradley P. , Stamova Boryana 
Published: September 2019

Background and Purpose—
Comorbid cancer is common in patients with acute ischemic stroke (AIS). As blood mRNA profiles can distinguish AIS mechanisms, we hypothesized that cancer-related AIS would have a distinctive gene expression profile.

Methods—
We evaluated 4 groups of 10 subjects prospectively enrolled at 3 centers from 2009 to 2018. This included the group of interest with active solid tumor cancer and AIS and 3 control groups with active cancer only, AIS only, or vascular risk factors only. Subjects in the AIS-only and cancer-only groups were matched to subjects in the cancer-stroke group by age, sex, and cancer type (if applicable). Subjects in the vascular risk factor group were matched to subjects in the cancer-stroke and stroke-only groups by age, sex, and vascular risk factors. Blood was drawn 72 to 120 hours after stroke. Total RNA was processed using 3′ mRNA sequencing. ANOVA and Fisher least significant difference contrast methods were used to estimate differential gene expression between groups.

Results—
In the cancer-stroke group, 50% of strokes were cryptogenic. All groups had differentially expressed genes that could distinguish among them. Comparing the cancer-stroke group to the stroke-only group and after accounting for cancer-only genes, 438 genes were differentially expressed, including upregulation of multiple genes/pathways implicated in autophagy signaling, immunity/inflammation, and gene regulation, including IL (interleukin)-1, interferon, relaxin, mammalian target of rapamycin signaling, SQSTMI1 (sequestosome-1), and CREB1 (cAMP response element binding protein-1).

Conclusions—
This study provides evidence for a distinctive molecular signature in blood mRNA expression profiles of patients with cancer-related AIS. Future studies should evaluate whether blood mRNA can predict detection of occult cancer in patients with AIS.

Clinical Trial Registration—

URL:
https://clinicaltrials.gov
. Unique identifier: NCT02604667.
Impacts of Convective Activity over the Tibetan Plateau on Plateau Vortex, Southwest Vortex, and Downstream Precipitation
Authors: Fu Shen-Ming , Mai Zi , Sun Jian-Hua , Li Wan-Li , Ding Yang , Wang Ya-Qiang 
Published: September 2019

Abstract
In summer, convective activity over the Tibetan Plateau (TP) is vigorous, with some of it moving eastward and vacating the plateau [defined as the eastward-moving type (EMT)]. Although the EMT only accounts for a small proportion, it is closely related to heavy precipitation east of the TP. This study investigates EMT impacts based on a series of composite semi-idealized simulations and piecewise potential vorticity (PV) inversion. The main results are as follows. (i) An EMT begins to affect downstream precipitation before it vacates the TP. A weaker EMT tends to cause the main downstream rainband to reduce in intensity and move southward. (ii) The EMT contributes to the formation of an eastward-moving plateau vortex (PLV) by enhancing convergence-induced stretching. Over the TP, the PLV mainly enhances/maintains the EMT, whereas during the vacating stage, the PLV dissipates (since convergence decreases rapidly when sensible heating from the TP reduces), which substantially reduces the intensity of the EMT. (iii) After PLV dissipation, a southwest vortex (SWV) forms around the Sichuan basin mainly due to convergence-induced stretching, convection-related tilting, and background transport. Piecewise PV inversion indicates that an EMT can directly contribute to SWV formation via lowering geopotential height and enhancing cyclonic wind perturbations around the Sichuan basin (even before its vacating stage), while neither of them governs the SWV formation. Sensitivity runs show that an EMT is not necessary for SWV formation, but can modify the SWV formation time and location, as well as its displacement, which significantly affects downstream precipitation.
Dual-Task Interference Between Swimming and Verbal Memory
Authors: Stets Andrew , Smith Samantha L. , Helton William S. 
Published: September 2019

Objective A dual-task study was performed to explore the performance effects for swimming, word recall, and the combination of the two tasks performed simultaneously. Background Dual-task interference studies have been performed for a variety of tasks; however, there has not been much dual-task interference research where one of the tasks is a naturalistic physically strenuous task. Swimming is a unique physical task that requires spatial orientation on three dimensional axes, similar to that of flying, but has no risk of falling. Previous studies have been conducted in other activity combinations with word-free recall, such as running and climbing, but swimming has yet to be explored. Method A verbal memory recall task and swimming task were performed in isolated (single-task) and simultaneous conditions. A comparison of effects across these different activities was also explored. Results Swimming and the word-recall task resulted in significant dual-task interference: almost as much as when word recall was paired with another verbal task, but more than running and less than climbing. Conclusion Consistent with other dual-task studies, this study observed dual-task interference between the physical swimming task and the cognitive verbal memory task. Application Future technologies and training for personnel who engage in water rescue or commercial diving, such as underwater welding and fiber optic cable, may be improved by these findings.
The effects of a sleep/recovery supplement: ‘Night Time Recharge’ on sleep parameters in young adults
Authors: Simper Trevor , Gilmartin Molly , Allwood Daniel , Taylor Luke , Chappell Andrew 
Published: September 2019

Background: Concentrated cherry juice reportedly contains melatonin which, in turn, has been highlighted as an important regulator in initiating sleep. Aim: The present investigation aims to clarify whether Night Time Recharge (NTR), a marketed sleep aid containing cherry extract, improves key sleep parameters in young, active adults with mildly poor sleep. Methods: A double-blind, randomized, placebo-controlled, cross-over study design was employed. Twenty participants (nine female) consumed either NTR or a placebo for seven days. Accelerometers were used to assess sleep quality and physical activity levels. Urinary levels of 6-sulphatoxymelatonin (6-SMT), a marker of melatonin synthesis, was assessed via enzyme-linked immunosorbent assay. Results: 6-SMT levels increased following NTR treatment (28.95 ng/ml) compared with placebo (4.0 ng/ml) ( p < 0.001). There was also a significant difference ( p = 0.047) in dietary tryptophan consumption during the NTR treatment (1236 mg) versus placebo (1149 mg). No trace of melatonin was detected from our analysis of the supplement. NTR had no significant effect on any sleep parameters with the exception of sleep latency ( p = 0.001). Conclusions: As chemical analysis of NTR by liquid-chromatography mass-spectrometry identified no detectable melatonin, the tryptophan content of the supplement is a likely reason for improvement in sleep latency. These results are in contrast to previous studies which have found a positive effect on sleep following cherry supplementation. Future work should focus on sleep latency and investigating whether cherry juice is effective in participants with problems in initiating sleep.
Chronic administration of buprenorphine in combination with samidorphan produces sustained effects in olfactory bulbectomised rats and Wistar-Kyoto rats
Authors: Burke Nikita N , Li Yan , Deaver Daniel R , Finn David P , Roche Michelle , Eyerman David J , Sanchez Connie , Kelly John P 
Published: September 2019

Background: The combination of buprenorphine, a partial mu-opioid receptor agonist and a functional kappa-opioid receptor antagonist, with samidorphan, a functional mu-opioid receptor antagonist, is being developed as an adjunct therapy for major depressive disorder, in order to harness the mood-enhancing effects of opioids without unwanted side-effects such as a risk of addiction. Acute and subacute administration of the combination of buprenorphine and samidorphan is effective in reducing forced swim immobility in the Wistar-Kyoto rat, but the chronic effects have not been examined. Aims and methods: The purpose of this study was to assess if chronic (14-day) administration of buprenorphine (0.1 mg/kg, subcutaneous) alone or in combination with samidorphan (0.3 mg/kg, subcutaneous) maintains antidepressant-like activity in the olfactory bulbectomised rat model and the Wistar-Kyoto rat, two models that exhibit ongoing behavioural deficits in tests commonly used to study effects of antidepressants. Results: Olfactory bulbectomised-induced hyperactivity was attenuated by chronic administration of buprenorphine alone and in combination with samidorphan, to that of sham control activity levels. Neither buprenorphine nor samidorphan altered stress-associated defecation in sham or olfactory bulbectomised rats in the open field. In Wistar-Kyoto rats, buprenorphine alone significantly reduced forced swim immobility and increased locomotor activity three hours post-final dosing. Buprenorphine plus samidorphan significantly reduced forced swim immobility without changing locomotor activity at this time point. Buprenorphine alone also significantly reduced forced swim immobility 24 h post-final dosing. Conclusion: Chronic treatment of buprenorphine alone or buprenorphine plus samidorphan is effective in reversing behavioural deficits in distinct non-clinical paradigms. These non-clinical results complement the antidepressant effect of this combination observed in clinical studies.
Inhibition of histone deacetylase 3 by MiR-494 alleviates neuronal loss and improves neurological recovery in experimental stroke
Authors: Zhao Haiping , Li Guangwen , Zhang Sijia , Li Fangfang , Wang Rongliang , Tao Zhen , Ma Qingfeng , Han Ziping , Yan Feng , Fan Junfen , Li Lingzhi , Ji Xunming , Luo Yumin 
Published: September 2019

HDAC3 is an essential negative regulator of neuronal plasticity and memory formation. Although a chemical inhibitor has been invented, little is known about its endogenous modulators. We explored whether miR-494 affects HDAC3-mediated neuronal injury following acute ischemic stroke. A substantial increase in plasma miR-494 was detected in AIS patients and was positively associated with the mRS at one year after symptom onset. The miR-494 levels were transiently increased in the infarcted brain tissue of mice. In contrast, miR-494 levels were reduced in neurons but increased in the medium after OGD. Intracerebroventricular injection of miR-494 agomir reduced neuronal apoptosis and infarct volume at the acute stage of MCAO, promoted axonal plasticity and long-term outcomes at the recovery stage, suppressed neuronal ataxin-3 and HDAC3 expression and increased acetyl-H3K9 levels in the ipsilateral hemisphere. In vitro studies confirmed that miR-494 posttranslationally inhibited HDAC3 in neurons and prevented OGD-induced neuronal axonal injury. The HDAC3 inhibitor increased acetyl-H3K9 levels and reversed miR-494 antagomir-aggravated acute cerebral ischemic injury, as well as brain atrophy and long-term functional recovery. These results suggest that miR-494 may serve as a predictive biomarker of functional outcomes in AIS patients and a potential therapeutic target for the treatment of ischemic stroke.
Reproducibility of measurements with a semi-automatic software package for the evaluation of rectal cancer
Authors: Hörberg Lisa , Roth Daniel , Leander Peter , Månsson Sven , Fält Tobias , Ekberg Olle , Zackrisson Sophia 
Published: September 2019

BackgroundStaging of rectal cancer with MRI has major impact on treatment choice and may be of importance in new cancer management strategies such as “wait-and-see” policy.PurposeTo assess the reproducibility of a software package recently developed at our department to measure volumes, apparent diffusion coefficient, and the skewness of apparent diffusion coefficient in lymph nodes and tumors in rectal cancer patients before and after chemoradiation treatment.Material and MethodsThis study included 20 consecutive patients with biopsy-verified rectal cancer, in whom MRI staging had been performed both before and after chemoradiation treatment. The diffusion-weighted images were transferred to the software. The volume, apparent diffusion coefficient, and skewness were determined for 93 lymph nodes and 40 tumors. The volumes were compared with manual measurements of the volume of the same lymph nodes and tumors.ResultsThe agreement in semi-automatic measurements of lymph nodes was very good (ICC = 0.99), and in tumors good (ICC = 0.88). The agreement in manual measurements of lymph nodes was very good (ICC = 0.95) when all lymph nodes were included, but low (ICC = 0.52) if three outliers were excluded. Bland–Altman plots showed clear agreement between manual and semi-automatic measurements in the lymph nodes, but not in measurements of tumors. The values of apparent diffusion coefficient and skewness in tumors differed before and after treatment but did not differ in lymph nodes as a group.ConclusionThe software package showed a high degree of reproducibility in measurements on lymph nodes but requires further development to improve the reproducibility of tumor measurements.
Diagnostic performance of ankle ultrasound for diagnosing anterior talofibular and calcaneofibular ligament injuries: a meta-analysis
Authors: Seok Hosik , Lee Sun Hwa , Yun Seong Jong 
Published: September 2019

Background Ankle ultrasound imaging could be an option with higher priority due to its lack of radiation, and cost- and time-effectiveness. However, previous studies regarding anterior tibiofibular ligament and calcaneofibular ligament injuries have shown varied results. Purpose To evaluate the diagnostic performance of ankle ultrasound for anterior tibiofibular ligament and calcaneofibular ligament injuries. Material and Methods PubMed and EMBASE databases were searched for diagnostic accuracy studies that used ultrasound for diagnosing anterior tibiofibular ligament and calcaneofibular ligament injuries. Bivariate and hierarchical summary receiver operating characteristic modeling were used to evaluate diagnostic performance. Subgroup analysis was performed using studies according to severity of the injury (complete and partial anterior tibiofibular ligament tear). We performed meta-regression analyses for heterogeneity exploration. Results Ten articles involving a total of 380 patients were included. For anterior tibiofibular ligament injury, the summary sensitivity, summary specificity, and area under the hierarchical summary receiver operating characteristic curve (AUC) were 0.99, 0.92, and 0.99, respectively. For calcaneofibular ligament injury, the summary sensitivity, summary specificity, and AUC were 0.95, 0.99, and 0.95, respectively. In subgroup analysis, for complete anterior tibiofibular ligament tear, the summary sensitivity, summary specificity, and AUC were 0.96, 0.82, and 0.96, respectively. For partial anterior tibiofibular ligament tear, the summary sensitivity, summary specificity, and AUC were 0.90, 0.82, and 0.93, respectively. Among the various potential covariates, proportion of anterior tibiofibular ligament tear, ultrasound interpreter, and reference standard were associated with specificity heterogeneity. Conclusion Ankle ultrasound demonstrates high diagnostic performance in the diagnosis of anterior tibiofibular ligament and calcaneofibular ligament injuries. We recommend ultrasound performed by a musculoskeletal radiologist as a first-line diagnostic tool to diagnose anterior tibiofibular ligament and calcaneofibular ligament injuries.
Incidence and pattern of epidural spread during lumbar facet joint injection: a prospective study
Authors: Yoo Bo Reum , Lee Eugene , Lee Joon Woo , Kang Yusuhn , Ahn Joong Mo , Kang Heung Sik 
Published: September 2019

BackgroundIn clinical practice, we have often observed contrast material spreading into the epidural space during lumbar facet joint injection. However, the exact incidence of epidural spread and contrast pattern have not been reported.PurposeTo evaluate the incidence and pattern of epidural spread in lumbar facet joint injection.Material and MethodsOne hundred consecutive patients (38 men, 62 women; mean age 68 years; age range 20–88 years) who underwent lumbar facet joint injection at two sites between April 2014 and June 2014 were investigated in this prospective study. Initial oblique, final anteroposterior, and lateral fluoroscopic images were obtained and evaluated for the presence of epidural spread and its contrast pattern (based on direction and extent) with the consensus of three radiologists. The relationship between epidural spread and its potential predictors was analyzed using the chi-squared test, Fisher’s exact test, and the t-test.ResultsThe incidence of epidural spread during lumbar facet joint injection was 64.6% (n=64) in 99 patients and 49.5% (n=95) in 192 procedures; ventral spread occurred in 29.2% and foraminal spread in 18.8%. When epidural spread occurred, the most commonly identified distributions were unilateral (73.7%), dorsal (92.6%), and cephalad (92.6%). Epidural spread increased significantly in the caudocephalic direction ( P < 0.0001), in men (relative risk [RR]=1.478), in the adjacency of posterior fusion level (RR=1.545), in patients with spondylolisthesis (RR=1.454), and when there was no other leakage (RR=0.334).ConclusionEpidural spread occurred at about half the number of lumbar facet joint injections and showed a contrast pattern similar to that seen with the interlaminar approach.
Clinical aspects and risk factors of lupus nephritis: a retrospective study of 156 adult patients
Authors: Yuan Fang , Wei Fenghua , Wang Junjie , You Yanwu 
Published: September 2019

Objective To analyze the clinical manifestations, laboratory indexes, disease activity, and pathological types of lupus nephritis (LN) in adult patients. Methods We retrospectively analyzed the clinical manifestations, laboratory indexes, and pathological classifications of 156 adult patients first diagnosed with LN between July 2013 and November 2017. Patients were categorized according to the following criteria: active or inactive LN, LN with or without renal damage, and mild or severe LN. Results Immunoglobulin G and A levels, 24-hour proteinuria, and anti-dsDNA, anti-Sm, and anti-ribosomal P protein antibody positivity rates were all significantly increased in patients with active LN compared with inactive LN. Anti-dsDNA antibody positivity and 24-hour proteinuria were significantly increased, whereas hemoglobin, serum albumin, and C3 and C4 levels were significantly decreased in patients with LN and renal damage compared with those without renal damage. Anti-dsDNA and anti-Sm antibody positivity rates and 24-hour proteinuria were significantly increased, while hemoglobin, serum albumin, C3 and C4 levels, and estimated glomerular filtration rate were significantly decreased in patients with severe LN compared with patients with mild LN. Conclusions LN can display various clinical manifestations, laboratory indexes, levels of disease activity, and pathological types in adult patients.
Do Expectant Mothers’ Breastfeeding Plans Influence Provider Prenatal Contraceptive Counseling?
Authors: Furman Lydia , Shaker Maria , Arora Kavita Shah 
Published: September 2019

Background Breastfeeding and optimal birth spacing are associated with improved maternal and infant health outcomes worldwide. Provision of contraceptive advice that is aligned with recommendations for breastfeeding has potential to maximize maternal and infant health. Although there is broad agreement regarding the breastfeeding compatibility of specific postpartum contraceptive methods, it is not known whether maternal breastfeeding intention influences prenatal provider contraceptive counseling. Research aim We aimed to determine if maternal feeding intention is considered by prenatal providers during contraceptive counseling. Methods This was a cross-sectional online author-created survey including all prenatal providers ( N = 40) at two academic safety-net institutions in Cleveland, Ohio. Of 100 obstetrics/gynecology faculty members, 40 (40%) completed the survey, which included multiple-choice questions. Nominal and ordinal survey results were reported with percentages and frequencies, and categorical variables were compared using the Fisher exact test. Results Participants appropriately promoted breastfeeding-compatible postplacental intrauterine device placement, even though maternal feeding intention was specifically considered by just 12 (30%). Endorsed barriers to contraception for breastfeeding mothers included provider medical worries, patient concerns, and colleague resistance. Postplacental levonorgestrel intrauterine devices were recommended for all mothers by 92.5% of participants ( n = 37). Recommendations regarding progestin-only and combined oral contraceptive pills were influenced by maternal breastfeeding versus formula-feeding intention. Conclusion Asking expectant women about their feeding intentions within each contraceptive discussion may create opportunities for shared decision making that can optimize perinatal outcomes for both mother and infant worldwide.