bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unsupervised but not supervised gait parameters are related to fatigue in Parkinson’s disease: a pilot study
Authors: Pilotto Andrea , Rizzardi Andrea , Zatti Cinzia , Hansen Clint , Donini Antonio , Romijnders Robbin , Maetzler Walter , Padovani Alessandro 
Published: November 2023

IntroductionFatigue is a common and disabling symptom in Parkinson’s disease (PD), also affecting gait. Detection of fatigue-associated changes of gait using mobile health technologies (MHT) could become increasingly effective.MethodsCognitively unimpaired PD patients without fluctuations (UPDRS IV &lt; 1) underwent a standard neurological assessment including the PD-Fatigue scale (PFS-16). PD patients with (PD-F) and without fatigue (PD-N) were matched for age, sex, cognitive function and disease severity. Each participant underwent MHT gait assessment under supervised condition (SC) and unsupervised condition (UC).ResultsGait parameters of 21 PD-F and 21 PD-N did not significantly differ under SC. Under UC, PD-F showed higher step time, step time variability and asymmetry index compared to PD-N and the PFS-16 correlated with step time.ConclusionThis is the first MHT-based study with PD patients showing a correlation between fatigue and gait parameters. In addition, the data collected suggest that UC is clearly superior to SC in addressing this question.
Prevalence of non-neurological autoantibodies and related comorbidities in stiff person spectrum disorders
Authors: Balshi Alexandra , Taylor Elena , Huang Yishang , Obando Danielle , Miles Ashley , Comisac Michael , Wang Yujie , Newsome Scott D. 
Published: November 2023

BackgroundStiff Person Syndrome Spectrum Disorders (SPSD) are a group of rare neurological disorders that can present alongside other autoimmune conditions. However, not much is known about the breadth of non-neurological autoantibodies seen in SPSD nor the observed prevalence of co-existing autoimmune comorbidities and their impact on SPSD.ObjectiveThis study aimed to investigate the prevalence of non-neurological autoantibodies and associated conditions in a large cohort of people with SPSD.MethodsA retrospective review of 205 patients with suspected/definitive SPSD seen at Johns Hopkins Hospital from 1997 to 2023 was performed as part of an ongoing, observational study. Relevant demographics, clinical data (e.g., SPSD phenotypes, comorbid conditions, and dates of diagnoses), and laboratory values were collected from electronic medical records. Lab values were excluded if completed within 6 months of receiving intravenous immunoglobin treatment. Summary statistics were performed and assessment for any associations between autoimmune comorbidities and disease burden (modified Rankin score [mRS] and ambulation status) was performed.ResultsThe majority of participants had classic SPS (66%), followed by SPS-plus (18%) and PERM (6%) with less than 5% each of the remaining phenotypes and suspected SPS. The average age at symptom onset in this cohort was 44.1 ± 14.5 years (mean ± standard deviation). The majority of the cohort was white (66%) and female patients (75%). The mean mRS was 2.5, and over 70% required assistive devices for ambulation. The most commonly identified non-neurological autoantibodies were anti-nuclear (ANA) (31%), thyroperoxidase (30%), thyroglobulin (20%), and anti-parietal cell (18%) autoantibodies. The most common comorbid autoimmune conditions were autoimmune thyroiditis (38%), insulin-dependent diabetes mellitus (26%), and pernicious anemia (10%). Having more autoimmune comorbidities was weakly associated with higher mRS and a greater need for ambulatory assistance.ConclusionThe results of this study will hopefully help promote awareness of which autoantibody and medical comorbidity clinicians should be aware of and monitor people with SPSD. Further research is needed to identify if poorly controlled non-neurological autoimmune disorders contribute to disease burden in SPSD and/or if the timing of being diagnosed with one of these conditions plays a role in future disability.
Evidence for vibration coding of sliding tactile textures in auditory cortex
Authors: Roberts Roberta D. , Loomes Aldrin R. , Kwok Hoi Fei , Wing Alan M. , Allen Harriet A. 
Published: November 2023

IntroductionPsychophysical studies suggest texture perception is mediated by spatial and vibration codes (duplex theory). Vibration coding, driven by relative motion between digit and stimulus, is involved in the perception of very fine gratings whereas coarse texture perception depends more on spatial coding, which does not require relative motion.MethodsWe examined cortical activation, using functional Magnetic Resonance Imaging associated with fine and coarse tactile spatial gratings applied by sliding or touching (sliding vs. static contact) on the index finger pad.ResultsWe found regions, contralateral to the stimulated digit, in BA1 in S1, OP1, OP3, and OP4 in S2, and in auditory cortex, which were significantly more activated by sliding gratings but did not find this pattern in visual cortex. Regions in brain areas activated by vibrotactile stimuli (including auditory cortex) were also modulated by whether or not the gratings moved. In a control study we showed that this contrast persisted when the salience of the static condition was increased by using a double touch.DiscussionThese findings suggest that vibration from sliding touch invokes multisensory cortical mechanisms in tactile processing of roughness. However, we did not find evidence of a separate visual region activated by static touch nor was there a dissociation between cortical response to fine vs. coarse gratings as might have been expected from duplex theory.
rTMS regulates homotopic functional connectivity in the SCD and MCI patients
Authors: Ge Honglin , Chen ShanShan , Che Zigang , Wu Huimin , Yang Xinyi , Qiao Meizhao , Chi Lei , Fan Jia , Zhong Yeming , Zou Caiyun , Lin Xingjian , Chen Jiu 
Published: November 2023

ObjectiveImpaired interhemispheric connectivity and corpus callosum atrophy have been linked to cognitive impairment in Alzheimer’s disease (AD). Existing evidence indicates that repetitive transcranial magnetic stimulation (rTMS) targeting the bilateral precuneus may enhance cognitive function in AD. This study aims to investigate the effects of precuneus rTMS on cognitive function, as well as alterations in interhemispheric functional connectivity (FC) and its structural basis in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI).MethodsA total of 14 patients with SCD and 16 patients with MCI were enrolled in this study and received 10 Hz rTMS intervention on the bilateral precuneus for 2 weeks. Neurocognitive scales, structural and functional magnetic resonance imaging were collected at enrollment and after the rTMS intervention. Interhemispheric FC was assessed using mirror homotopic functional connectivity (VMHC), while the structural equation modeling (SEM) was employed to analyze the relationship between corpus callosum volume, interhemispheric connectivity, and cognitive function after rTMS intervention.ResultsThe precuneus rTMS not only enhanced episodic memory in SCD, but also improved multiple cognitive domains in MCI. Post-rTMS intervention, decreased VMHC values in the lingual cortex, middle occipital gyrus, putamen, and fusiform gyrus were observed in SCD, and an increased VMHC value in the postcentral gyrus along with reduced VMHC value in the cerebellum and putamen in MCI. After intervention, more brain regions show decreased FC in SCD and MCI patients, suggesting that precuneus rTMS may protect cerebral cortical plasticity by reducing excessive functional compensation, and thus improve cognitive function. The SEM indicated that the corpus callosum serves as the structural foundation for rTMS regulation of interhemispheric FC to further improve cognitive function.Conclusion10 Hz rTMS in the bilateral precuneus could be a promising strategy to improve cognitive function in patients with SCD and MCI. Our study implies that improvements in cognition brought about by precuneus rTMS may result from the remodeling of interhemispheric FC, with the corpus callosum possibly acting as the anatomical basis for functional modulation.
Breast milk immune composition varies during the transition stage of lactation: characterization of immunotypes in the MAMI cohort
Authors: Rio-Aige Karla , Fernández-Bargalló Aina , Vegas-Lozano Esteban , Miñarro-Alonso Antonio , Castell Margarida , Selma-Royo Marta , Martínez-Costa Cecilia , Rodríguez-Lagunas Maria José , Collado Maria Carmen , Pérez-Cano Francisco José 
Published: November 2023

BackgroundBreast milk is a complex and dynamic fluid needed for infant development and protection due to its content of bioactive factors such as immunoglobulins (Igs). Most studies focus primarily on IgA, but other types of Ig and even other immune components (cytokines and adipokines) may also play significant roles in neonatal health. As a first step, we aimed to characterize the Ig profile, many cytokines, and two adipokines (leptin and adiponectin) at two sampling time points within the transitional stage, which is the least studied phase in terms of these components. The secondary objective was to identify different breast milk immunotypes in the MAMI cohort substudy, and finally, we further aimed at analyzing maternal and infant characteristics to identify influencing factors of breast milk immune composition.MethodsBreast milk samples from 75 mothers were studied between days 7 and 15 postpartum. The Igs, cytokines, and adipokine levels were determined by a multiplex approach, except for the IgA, IgM, and leptin that were evaluated by ELISA.ResultsIgA, IgM, IgE, IgG2, IL-1β, IL-5, IL-6, IL-10, and IL-17 were significantly higher on day 7 with respect to day 15. The multiple factor analysis (MFA) allowed us to identify two maternal clusters (immunotypes) depending on the breast milk immune profile evolution from day 7 to day 15, mainly due to the IgE and IgG subtypes, but not for IgA and IgM, which always presented higher levels early in time.ConclusionAll these results demonstrated the importance of the dynamics of the breast milk composition in terms of immune factors because even in the same lactation stage, a difference of 1 week has induced changes in the breast milk immune profile. Moreover, this immune profile does not evolve in the same way for all women. The dynamic compositional changes may be maternal-specific, as we observed differences in parity and exclusive breastfeeding between the two BM immunotype groups, which could potentially impact infant health.
Single energy CT-based mass density and relative stopping power estimation for proton therapy using deep learning method
Authors: Gao Yuan , Chang Chih-Wei , Roper Justin , Axente Marian , Lei Yang , Pan Shaoyan , Bradley Jeffrey D. , Zhou Jun , Liu Tian , Yang Xiaofeng 
Published: November 2023

BackgroundThe number of patients undergoing proton therapy has increased in recent years. Current treatment planning systems (TPS) calculate dose maps using three-dimensional (3D) maps of relative stopping power (RSP) and mass density. The patient-specific maps of RSP and mass density were obtained by translating the CT number (HU) acquired using single-energy computed tomography (SECT) with appropriate conversions and coefficients. The proton dose calculation uncertainty of this approach is 2.5%-3.5% plus 1 mm margin. SECT is the major clinical modality for proton therapy treatment planning. It would be intriguing to enhance proton dose calculation accuracy using a deep learning (DL) approach centered on SECT.ObjectivesThe purpose of this work is to develop a deep learning method to generate mass density and relative stopping power (RSP) maps based on clinical single-energy CT (SECT) data for proton dose calculation in proton therapy treatment.MethodsArtificial neural networks (ANN), fully convolutional neural networks (FCNN), and residual neural networks (ResNet) were used to learn the correlation between voxel-specific mass density, RSP, and SECT CT number (HU). A stoichiometric calibration method based on SECT data and an empirical model based on dual-energy CT (DECT) images were chosen as reference models to evaluate the performance of deep learning neural networks. SECT images of a CIRS 062M electron density phantom were used as the training dataset for deep learning models. CIRS anthropomorphic M701 and M702 phantoms were used to test the performance of deep learning models.ResultsFor M701, the mean absolute percentage errors (MAPE) of the mass density map by FCNN are 0.39%, 0.92%, 0.68%, 0.92%, and 1.57% on the brain, spinal cord, soft tissue, bone, and lung, respectively, whereas with the SECT stoichiometric method, they are 0.99%, 2.34%, 1.87%, 2.90%, and 12.96%. For RSP maps, the MAPE of FCNN on M701 are 0.85%, 2.32%, 0.75%, 1.22%, and 1.25%, whereas with the SECT reference model, they are 0.95%, 2.61%, 2.08%, 7.74%, and 8.62%. ConclusionThe results show that deep learning neural networks have the potential to generate accurate voxel-specific material property information, which can be used to improve the accuracy of proton dose calculation.Advances in knowledgeDeep learning-based frameworks are proposed to estimate material mass density and RSP from SECT with improved accuracy compared with conventional methods.
Association between increased C-reactive protein and cardiovascular disease among patients with rectal cancer
Authors: Qiao Huimin , Wang Changxin , Yang Chunhong , Lei Lei , Chen Yijing , Luo Yun , Zeng Xiangfu , Guo You 
Published: November 2023

PurposeThis study aimed to investigate the association between increased C-reactive protein (CRP) and cardiovascular disease (CVD) in individuals with rectal cancer, as well as to understand the effect of chemotherapy for cancer on increasing CRP and its underlying mechanisms.Patients and methodsFrom January 1, 2010 to December 31, 2020, individuals with rectal cancer were evaluated at the First Affiliated Hospital of Gannan Medical University. Then, in patients with rectal cancer, the relationship between increased CRP and CVD attributes was summarized, and the impact of chemotherapy on CRP levels was qualitatively assessed. For further investigation into potential regulatory mechanisms of CRP, differentially expressed genes (DEGs), GO and KEGG enrichment analyses were conducted.ResultsA total of 827 individuals were included in the study, including 175 with CVD (21.16%) and 652 without CVD. A significant association between increased CRP and CVD events was observed in rectal cancer patients (p &lt; 0.01), and it significantly improved the classification performance of the CVD predictive model in the AUC (0.724 vs 0.707) and NRI (0.069, 95% CI 0.05-0.14). Furthermore, a comparison of CRP levels before and after chemotherapy revealed a significant increase among rectal cancers post-treatment (p &lt; 0.001). Analysis of differentially expressed genes and co-expression indicated that 96 DEGs were involved in the pathophysiology of increased CRP after chemotherapy, and three hub genes were implicated in atherosclerotic susceptibility.ConclusionIn conclusion, our findings indicated that increased CRP levels following chemotherapy profoundly impacted CVD events in individuals with rectal cancer, and may be beneficial in promoting CVD prediction in clinical practice.
Association of atopy with disease severity in children with Mycoplasma pneumoniae pneumonia
Authors: Bian ChenRong , Li SongTao , Huo ShaoHu , Yang BeiBei , Wang PingPing , Li WenHong , Ding ShengGang 
Published: November 2023

BackgroundMycoplasma pneumoniae pneumonia (MPP) is common among children, but the impact of atopy on MPP severity in children is unknown. This study investigated whether atopic vs. nonatopic children had greater MPP severity.MethodsRetrospective analysis was conducted on 539 (ages 3–14 years) patients who were hospitalized in the First Affiliated Hospital of Anhui Medical University for MPP between January 2018 and December 2021, 195 were atopic and 344 were nonatopic. Of them, 204 had refractory MPP, and 335 had general MPP. And of atopic children, 94 had refractory MPP, and 101 had general MPP. Data on demographic and clinical characteristics, laboratory findings, clinical treatments were analyzed.ResultsSignificantly more boys with MPP were atopic than nonatopic (P &lt; 0.05). More atopic (than nonatopic) children presented with prolonged fever and hospitalization, severe extra-pulmonary complications, asthma attaking, steroid and oxygen treatment, and increased IgE levels (all P &lt; 0.05). In atopic (vs. nonatopic) children with MPP, the incidence of sputum plugs under the fiberoptic bronchoscopy and lobar pneumonia was significantly increased and required bronchoscopy-assisted and steroid therapy. Compared with nonatopic children, more atopic children developed refractory MPP (P &lt; 0.05). Prolonged fever and hospitalization, severe extra-pulmonary complications, lymphocyte count, procalcitonin and lactate dehydrogenase levels, and percentages of atopy were all significantly higher (P &lt; 0.05) among children with refractory MPP vs. general MPP. Moreover, Prolonged fever and hospitalization, lymphocyte count, procalcitonin and lactate dehydrogenase levels, and the treantment of steroid were all significantly higher (P &lt; 0.05) among atopic children with refractory MPP vs. general MPP. Spearman correlation analysis showed strong associations between atopy and male sex, length of hospital stay, fever duration, IgE level, wheezing, lobar pneumonia, refractory MPP, and treatment with oxygen, hormones or bronchoscopy (P &lt; 0.05).ConclusionsAtopy may be a risk factor for and was positively correlated with the severity of MPP in children.
Gestational hypertension and risk of atopic diseases in offspring, a national-wide cohort study
Authors: Yang Chun-Ti , Lin Ching-Heng , Lin Ming-Chih 
Published: November 2023

IntroductionGestational hypertension can lead to complications, such as preeclampsia. Preeclampsia is one of leading causes of perinatal morbidity and mortality. Abnormal placentation, immune dysregulation, and maternal inflammatory response are possible etiologies. The burden of atopic diseases is increasing worldwide. Prenatal exposure might play a role in the pathogenesis of these two diseases. The aim of this study was to evaluate the association between gestational hypertension and atopic diseases from a nationwide perspective.Material and methodsThe primary data were retrieved from Taiwan's National Health Insurance Research Database. The Maternal and Child Health Database was used to generate links between mothers and children. From 2004 to 2019, mothers with a diagnosis of gestational hypertension were identified as cases. The control groups were matched to the cases by maternal age, neonatal gender, date of birth, at a control-to-case ratio of 4:1. Each child was reviewed to confirm the diagnosis of atopic disease. Covariates including both maternal and neonatal factors were also collected.ResultsA total of 1,935,874 primiparas were enrolled in this study. After excluding 16,851 mothers with a history of hypertension, a total of 1,919,023 offspring were included in the study for the period 2004–2019. Gestational hypertension was associated with asthma (HR, 1.12, 95% CI, 1.02–1.23) and atopic dermatitis (HR, 1.10, 95% CI, 1.00–1.21) in offspring after controlling for cofactors. Nevertheless, gestational hypertension did not play an independent factor for allergic rhinitis (HR, 1.02, 95% CI, 0.95–1.10) or urticaria (HR, 1.02, 95% CI, 0.91–1.15).ConclusionMaternal gestational hypertension increases the cumulative risk for asthma and atopic dermatitis in offspring.
Healthcare professional perspectives on medication challenges in the post-stroke patient
Authors: Bell Shauna , Kelly Helen , Hennessy Eva , Bermingham Margaret , O’Flynn Jennifer Raymy , Sahm Laura J. 
Published: November 2023

Background: Medications play an essential role in the management of patients who have experienced a stroke. Despite the recognised importance and widespread availability of secondary prevention guidelines, Irish research has shown a continuous failure to meet secondary prevention targets upon discharge. While complex interventions involving healthcare professionals (HCPs) such as Speech and Language Therapists (SLT), Occupational Therapists (OTs) and Pharmacists have been effective in combatting medication non-adherence, community multidisciplinary teams (MDTs) are not as well defined as in the acute setting, leading to wide variation in patient care. Therefore, this study aims to investigate the knowledge, attitudes, beliefs, and challenges faced by HCPs in the continuity of care post-discharge from a hospital stroke ward, and its impact on medication adherence.Methods: Semi-structured interviews and one focus group with HCPs were conducted, and data were analysed using Braun &amp; Clarke’s reflexive Thematic Analysis.Results: Fourteen HCPs (6 Pharmacy, 4 SLT, 4 OTs) participated in this study. Participants discussed their views under two main themes 1) continuity of care and 2) medication adherence. Sub-themes observed regarding continuity of care include management and organisation, interpersonal continuity, and informational continuity. Themes generated which impact medication adherence post-discharge include condition-related factors, medication-related factors, systemic and HCP factors, and patient-related factors.Discussion: Additional resources are required to bring community healthcare in line with the standard of acute care. Increased channels of communication must be established across contexts and disciplines, and may be achieved using interprofessional training through continuous professional development or third-level education, a more clearly defined community team structure, and discharge summaries completed to relevant quality standards. While suboptimal continuity of care was reported as contributing to medication non-adherence, HCPs also acknowledged the complexities of medication management post-stroke.