bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional and effective connectivity analysis of drug-resistant epilepsy: a resting-state fMRI analysis
Authors: Bacon Eric Jacob , Jin Chaoyang , He Dianning , Hu Shuaishuai , Wang Lanbo , Li Han , Qi Shouliang 
Published: April 2023

ObjectiveEpilepsy is considered as a neural network disorder. Seizure activity in epilepsy may disturb brain networks and damage brain functions. We propose using resting-state functional magnetic resonance imaging (rs-fMRI) data to characterize connectivity patterns in drug-resistant epilepsy.MethodsThis study enrolled 47 participants, including 28 with drug-resistant epilepsy and 19 healthy controls. Functional and effective connectivity was employed to assess drug-resistant epilepsy patients within resting state networks. The resting state functional connectivity (FC) analysis was performed to assess connectivity between each patient and healthy controls within the default mode network (DMN) and the dorsal attention network (DAN). In addition, dynamic causal modeling was used to compute effective connectivity (EC). Finally, a statistical analysis was performed to evaluate our findings.ResultsThe FC analysis revealed significant connectivity changes in patients giving 64.3% (18/28) and 78.6% (22/28) for DMN and DAN, respectively. Statistical analysis of FC was significant between the medial prefrontal cortex, posterior cingulate cortex, and bilateral inferior parietal cortex for DMN. For DAN, it was significant between the left and the right intraparietal sulcus and the frontal eye field. For the DMN, the patient group showed significant EC connectivity in the right inferior parietal cortex and the medial prefrontal cortex for the DMN. There was also bilateral connectivity between the medial prefrontal cortex and the posterior cingulate cortex, as well as between the left and right inferior parietal cortex. For DAN, patients showed significant connectivity in the right frontal eye field and the right intraparietal sulcus. Bilateral connectivity was also found between the left frontal eye field and the left intraparietal sulcus, as well as between the right frontal eye field and the right intraparietal sulcus. The statistical analysis of the EC revealed a significant result in the medial prefrontal cortex and the right intraparietal cortex for the DMN. The DAN was found significant in the left frontal eye field, as well as the left and right intraparietal sulcus.ConclusionOur results provide preliminary evidence to support that the combination of functional and effective connectivity analysis of rs-fMRI can aid in diagnosing epilepsy in the DMN and DAN networks.
Physiological ischemic training improves cardiac function through the attenuation of cardiomyocyte apoptosis and the activation of the vagus nerve in chronic heart failure
Authors: Zhu Xiuhua , Wang Shenrui , Cheng Yihui , Gu Hongmei , Zhang Xiu , Teng Meiling , Zhang Yingjie , Wang Jiayue , Hua Wenjie , Lu Xiao 
Published: April 2023

PurposeThis study investigated the functional outcomes of patients with chronic heart failure (CHF) after physiological ischemic training (PIT), identified the optimal PIT protocol, evaluated its cardioprotective effects and explored the underlying neural mechanisms.MethodsPatients with CHF were randomly divided into experimental group (n = 25, PIT intervention + regular treatment) and control group (n = 25, regular treatment). The outcomes included the left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP) and cardiopulmonary parameters. LVEF and cardiac biomarkers in CHF rats after various PIT treatments (different in intensity, frequency, and course of treatment) were measured to identify the optimal PIT protocol. The effect of PIT on cardiomyocyte programmed cell death was investigated by western blot, flow cytometry and fluorescent staining. The neural mechanism involved in PIT-induced cardioprotective effect was assessed by stimulation of the vagus nerve and muscarinic M2 receptor in CHF rats.ResultsLVEF and VO2max increased while BNP decreased in patients subjected to PIT. The optimal PIT protocol in CHF rats was composed of five cycles of 5 min ischemia followed by 5 min reperfusion on remote limbs for 8 weeks. LVEF and cardiac biomarker levels were significantly improved, and cardiomyocyte apoptosis was inhibited. However, these cardioprotective effects disappeared after subjecting CHF rats to vagotomy or muscarinic M2 receptor inhibition.ConclusionPIT improved functional outcomes in CHF patients. The optimal PIT protocol required appropriate intensity, reasonable frequency, and adequate treatment course. Under these conditions, improvement of cardiac function in CHF was confirmed through cardiomyocyte apoptosis reduction and vagus nerve activation.
Application of artificial intelligence for automatic cataract staging based on anterior segment images: comparing automatic segmentation approaches to manual segmentation
Authors: Gan Fan , Liu Hui , Qin Wei-Guo , Zhou Shui-Lian 
Published: April 2023

PurposeCataract is one of the leading causes of blindness worldwide, accounting for &gt;50% of cases of blindness in low- and middle-income countries. In this study, two artificial intelligence (AI) diagnosis platforms are proposed for cortical cataract staging to achieve a precise diagnosis.MethodsA total of 647 high quality anterior segment images, which included the four stages of cataracts, were collected into the dataset. They were divided randomly into a training set and a test set using a stratified random-allocation technique at a ratio of 8:2. Then, after automatic or manual segmentation of the lens area of the cataract, the deep transform-learning (DTL) features extraction, PCA dimensionality reduction, multi-features fusion, fusion features selection, and classification models establishment, the automatic and manual segmentation DTL platforms were developed. Finally, the accuracy, confusion matrix, and area under the receiver operating characteristic (ROC) curve (AUC) were used to evaluate the performance of the two platforms.ResultsIn the automatic segmentation DTL platform, the accuracy of the model in the training and test sets was 94.59 and 84.50%, respectively. In the manual segmentation DTL platform, the accuracy of the model in the training and test sets was 97.48 and 90.00%, respectively. In the test set, the micro and macro average AUCs of the two platforms reached &gt;95% and the AUC for each classification was &gt;90%. The results of a confusion matrix showed that all stages, except for mature, had a high recognition rate.ConclusionTwo AI diagnosis platforms were proposed for cortical cataract staging. The resulting automatic segmentation platform can stage cataracts more quickly, whereas the resulting manual segmentation platform can stage cataracts more accurately.
Medial and dorsal lateral septum involving social disruption stress-primed escalation in acid-induced writhes
Authors: Liao Yi-Han , Sun Li-Han , Su Yi-Chi , Yao Wei-Jen , Yu Lung 
Published: April 2023

IntroductionStress may cause prospective escalations in abdominal pain magnitude and accumbal TRPV1 expression, while central neural circuits mediating these stress effects remain unclear.MethodsUsing retrograde tracing methods, we first demonstrated the existence of a medial septal-dorsal lateral septal -accumbal circuit very likely involving social disruption stress-primed escalations in acid-induced writhes and accumbal TRPV1 level. An intersectional viral strategy and virus-carrying hM3Dq and hM4Di DREADDs were, then, employed to selectively modulate GABAergic and cholinergic neuronal activity in medial and dorsal lateral septum.ResultsExciting medial septal GABAergic neuron was found to prevent social disruption stress-primed escalations in acid-induced writhes and accumbal TRPV1 and PKCε expressions. Likewise, inactivating dorsal lateral septal cholinergic neurons was also effective in abolishing these stress-primed escalations. Inactivating GABAergic neuron in non-stressed animals’ medial septum was found to reproduce the stress-primed effects in causing heightened acid-induced writhes and accumbal TRPV1 and PKCε levels.DiscussionThese results, taken together, prompt us to conclude that social disruption stress may produce plastic changes in a newly-identified medial septal-dorsal lateral septal-accumbal circuit. Moreover, medial septal GABAergic hypoactivity and dorsal lateral septal cholinergic hyperactivity are, at least, two likely causes reflecting such stress-produced escalations in abdominal pain magnitude and pain transduction-related protein over-expression in nucleus accumbens.
Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective study
Authors: Tang Shi , Cong Xiaofeng , Zheng Dan , Chen Chen , Liu Zengguang , Gao Jie , Zhang Huimin , Zhang Youhao , Liu Ziling 
Published: April 2023

BackgroundConcurrent programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors with sequential chemoradiotherapy (SCRT) have been reported in only a limited number of studies involving patients with unresectable stage III non-small-cell lung cancer (NSCLC). A retrospective study was conducted to systematically analyze the efficacy and safety of the emerging therapy among Chinese patients.Materials and methodsWe included patients with unresectable, stage III NSCLC who received concurrent sintilimab with chemotherapy or chemotherapy alone for 3-6 cycles, followed by radical radiotherapy at the First Hospital of Jilin University from Dec 15, 2019, to Jul 15, 2022. The primary end point was the objective response rate (ORR). The secondary end points included progression-free survival (PFS), overall survival (OS), 12-month and 18-month PFS rates, the duration of response (DoR), and safety.ResultsThe retrospective study involved 77 patients, of which 49 receiving concurrent sintilimab with SCRT were assigned to cohort A, and 28 receiving SCRT alone were assigned to cohort B. The ORR was significantly higher in cohort A (79.6%, 95% CI 65.7–89.8) than in cohort B (35.7%, 95% CI 18.6–55.9) (p&lt;0.001). Median PFS was significantly longer in cohort A than in cohort B (NR [95% CI 21.4–NR] vs. 16.0 months [13.0–22.5]; HR 0.375, 95% CI 0.192–0.735; p=0.003). The PFS rates at 12 and 18 months were 84.8% (95% CI 75.0–95.9) and 71.3% (95% CI 58.7–86.7) in cohort A and 75.0% (95% CI 60.6–92.9) and 38.3% (95% CI 23.7–61.7) in cohort B, respectively. Grade 3 or 4 adverse events (AEs) were reported in 19 patients (38.8%) and seven patients (25.0%) in two cohorts, respectively. Grade 3 or 4 pneumonitis or immune-mediated pneumonitis, radiation pneumonitis, and pneumonia occurred in five (10.2%), four (8.2%), and two (4.1%) cohort A patients, and zero, two (7.1%), and two (7.1%) cohort B patients, respectively. Only cohort A reported AE leading to death in one (2.0%) patient (immune-mediated pneumonitis).ConclusionConcurrent sintilimab with SCRT resulted in a significantly better ORR and longer PFS than SCRT alone, with manageable safety profiles in Chinese patients with unresectable stage III NSCLC.
Isolated Crohn's Colitis: Is Localization Crucial? Characteristics of Pediatric Patients From the CEDATA–GPGE Registry
Authors: Elonen Lotta , Wölfle Lena , de Laffolie Jan , Posovszky Carsten ,   the CEDATA–GPGE-Study-Group
Published: April 2023

IntroductionPediatric patients with inflammatory bowel disease (IBD) are classified into Crohn's disease (CD), ulcerative colitis (UC), and unclassifiable (IBD-U). However, data provide evidence that ileal CD (L1) is distinct from colonic CD (L2). The aim of this study was to investigate the clinical features of isolated Crohn's colitis in a pediatric population.Material and MethodsChildren who were prospectively included in the CEDATA–GPGE registry on diagnosis were compared according to the diagnosis of CD with L2 vs. L1 and ileocolonic (L3) involvement pattern as well as IBD-U and UC. The clinical significance of L2 was investigated with regard to extraintestinal manifestations, treatment, surgery, and disease activity.ResultsFifty-two patients with L2 CD at a median age of 13.4 years (±3.8 SD) were compared with 182 L1 (13.8 ± 2.9 SD), 782 with L3 (12.8 ± 3.3 SD), 653 with UC (12.7 ± 3.8 SD), and 111 patients with IBD-U (11.9 ± 4.7 SD). Bloody stools at diagnosis were more common in L2 (44%) than in L1 (19.7%) and L3 (28.8%), but not as common as in UC (66.5%) and IBD-U (61.3%). Fewer CD patients with L2 (10.2%) received exclusive enteral nutrition therapy (EEN) as induction than patients with L1 (34.3%) and L3 (33.3%). After induction therapy, 42.3% of patients with L2 received immunosuppressants and 21% biologicals during follow-up (L1 56.5/10.5%; L3 59/21%; CU 43.5/11.9%; IBD-U 26.1/12.6%). Extraintestinal manifestations were more frequent in L2 (23.1%) vs. L1 (18.7%), L3 (20.2%), CU (15.8%), and IBD-U (11.7%). The number of patients requiring surgery did not differ within the CD subgroups and was significantly lower in UC and IBD-U. Perianal fistula surgery was significantly more common in L2 (44%) than in L1 (4.8%) or L3 (21.7%). In addition, the frequency of surgery for perianal abscesses was also more frequent in L2 (55.6%) than in L1 (12.7%) or L3 (38.4%).ConclusionsThe consideration of pediatric Crohn's colitis as a distinct disease seems necessary as it is characterized by extraintestinal manifestations (EIMs) with mainly joint involvement and perianal fistulas or abscesses requiring surgery and biologic therapy. Thus, colonic Crohn's disease may have an influence on the therapeutic stratification and should be addressed in further studies.
JAK inhibitors in systemic juvenile idiopathic arthritis
Authors: He Tingyan , Xia Yu , Luo Ying , Yang Jun 
Published: April 2023

ObjectiveSystemic juvenile idiopathic arthritis (SJIA) is characterized by excessive and inappropriate production of proinflammatory cytokines. Janus kinase inhibitors (JAKi) can block the downstream pathway of many cytokines. The use of JAKi in SJIA or macrophage activation syndrome (MAS) has only been described in a limited number of case reports. In this study, we aimed to assess the efficacy and potential adverse effects of JAKi in SJIA patients.MethodsPatients with SJIA who received JAKi and underwent at least one assessment of efficacy and safety after JAKi initiation were eligible for this study. Data were collected retrospectively from inpatient or outpatient medical records at JAKi initiation, at 1, 3, 6, 9, and 12 months, after disease flare, after JAKi discontinuation, or at the last follow-up.ResultsTen patients with SJIA were included in the study. At the start of JAKi treatment, all patients presented with active disease; five showed variable adverse effects secondary to glucocorticoids. Seven patients received tofacitinib (one later switched to ruxolitinib). Of these, only two patients showed a complete response of persistent arthritis associated with tocilizumab; tofacitinib was used without a biological DMARD only in two patients, together with MTX, showing a partial response; three patients were nonresponders. Four patients with SJIA-related MAS or persistent hyperferritinemia were treated with ruxolitinib. Ruxolitinib allowed a good response on MAS parameters in three of them. All these four patients required an adjunction or switch to canakinumab later. The median decrease in the daily glucocorticoid dose between JAKi initiation and the last follow-up was 90.6% in patients with complete remission and 77.4% in other patients. Three patients discontinued glucocorticoid treatment after the introduction of JAKi. Severe adverse events, notably serious infection or thrombosis, were not observed during JAKi treatment.ConclusionJAKi may be an alternative or adjuvant agent for SJIA patients, especially in those with persistently active disease, glucocorticoid-related adverse reactions, or SJIA-MAS.
Case report: Neonatal autoimmune lymphoproliferative syndrome with a novel pathogenic homozygous FAS variant effectively treated with sirolimus
Authors: Elgharbawy Fawzia M. , Karim Mohammed Yousuf , Soliman Dina Sameh , Hassan Amel Siddik , Sudarsanan Anoop , Gad Ashraf 
Published: April 2023

BackgroundAutoimmune lymphoproliferative syndrome (ALPS) is a rare disease characterized by defective FAS signaling, which results in chronic, nonmalignant lymphoproliferation and autoimmunity accompanied by increased numbers of “double-negative” T-cells (DNTs) (T-cell receptor αβ+ CD4−CD8−) and an increased risk of developing malignancies later in life.Case presentationWe herein report a case of a newborn boy with a novel germline homozygous variant identified in the FAS gene, exon 9, c.775del, which was considered pathogenic. The consequence of this sequence change was the creation of a premature translational stop signal p.(lle259*), associated with a severe clinical phenotype of ALPS-FAS. The elder brother of the proband was also affected by ALPS and has been found to have the same FAS homozygous variant associated with a severe clinical phenotype of ALPS-FAS, whereas the unaffected parents are heterozygous carriers of this variant. This new variant has not previously been described in population databases (gnomAD and ExAC) or in patients with FAS-related conditions. Treatment with sirolimus effectively improved the patient clinical manifestations with obvious reduction in the percentage of DNTs.ConclusionWe described a new ALPS-FAS clinical phenotype-associated germline FAS homozygous pathogenic variant, exon 9, c.775del, that produces a premature translational stop signal p.(lle259*). Sirolimus significantly reduced DNTs and substantially relieved the patient's clinical symptoms.
Detection and analysis of graduate students’ academic emotions in the online academic forum based on text mining with a deep learning approach
Authors: Xu Qiaoyun , Chen Sijing , Xu Yan , Ma Chao 
Published: April 2023

PurposeThe possibility of mental illness caused by the academic emotions and academic pressure of graduate students has received widespread attention. Discovering hidden academic emotions by mining graduate students’ speeches in social networks has strong practical significance for the mental state discovery of graduate students.Design/methodology/approachThrough data collected from online academic forum, a text based BiGRU-Attention model was conducted to achieve academic emotion recognition and classification, and a keyword statistics and topic analysis was performed for topic discussion among graduate posts.FindingsFemale graduate students post more than male students, and graduates majoring in chemistry post the most. Using the BiGRU-Attention model to identify and classify academic emotions has a performance with precision, recall and F1 score of more than 95%, the category of PA (Positive Activating) has the best classification performance. Through the analysis of post topics and keywords, the academic emotions of graduates mainly come from academic pressure, interpersonal relationships and career related.OriginalityA BiGRU-Attention model based on deep learning method is proposed to combine classical academic emotion classification and categories to achieve a text academic emotion recognition method based on user generated content.
Active self-motion control and the role of agency under ambiguity
Authors: Rineau Anne-Laure , Berberian Bruno , Sarrazin Jean-Christophe , Bringoux Lionel 
Published: April 2023

PurposeSelf-motion perception is a key factor in daily behaviours such as driving a car or piloting an aircraft. It is mainly based on visuo-vestibular integration, whose weighting mechanisms are modulated by the reliability properties of sensory inputs. Recently, it has been shown that the internal state of the operator can also modulate multisensory integration and may sharpen the representation of relevant inputs. In line with the concept of agency, it thus appears relevant to evaluate the impact of being in control of our own action on self-motion perception.MethodologyHere, we tested two conditions of motion control (active/manual trigger versus passive/ observer condition), asking participants to discriminate between two consecutive longitudinal movements by identifying the larger displacement (displacement of higher intensity). We also tested motion discrimination under two levels of ambiguity by applying acceleration ratios that differed from our two “standard” displacements (i.e., 3 s; 0.012 m.s−2 and 0.030 m.s−2).ResultsWe found an effect of control condition, but not of the level of ambiguity on the way participants perceived the standard displacement, i.e., perceptual bias (Point of Subjective Equality; PSE). Also, we found a significant effect of interaction between the active condition and the level of ambiguity on the ability to discriminate between displacements, i.e., sensitivity (Just Noticeable Difference; JND).OriginalityBeing in control of our own motion through a manual intentional trigger of self-displacement maintains overall motion sensitivity when ambiguity increases.
A workplace mindfulness training program may affect mindfulness, well-being, health literacy and work performance of upper-level ICT-managers: An exploratory study in times of the COVID-19 pandemic
Authors: Schubin Kristina , Seinsche Laura , Pfaff Holger , Zeike Sabrina 
Published: April 2023

IntroductionMindfulness-based interventions have gained more importance in workplace health promotion due to increased psychological distress in the digital era. Although managers in the information communication technology sector (ICT)-sector are at risk for lower mental health, few studies have evaluated the effects of workplace mindfulness trainings (WMT) on upper-level ICT-managers.MethodsBy applying a mixed methods approach, the study aimed at exploring differences in upper-level ICT-managers’ mindfulness, well-being, health literacy and work performance at the beginning of a WMT (t0), immediately after (t1) and 3  months after (t2) a WMT. Thirteen groups of managers (n = 56) completed the training and three corresponding surveys consecutively from October 2019 to April 2021. Managers rated their mindfulness (MAAS), well-being (WHO-5), health literacy, and work performance (HPQ). During the COVID-19-pandemic the training switched from a live on-site mode to a hybrid mode and finally to a digital mode. Repeated measures ANOVAs and Bonferroni-adjusted post hoc analyses were used for data analysis. Open-ended responses were content analyzed.ResultsWe found significant differences in managers’ mindfulness [F(2.106) = 3.376, p = 0.038, ηp2 = 0.06, n = 54], well-being [F(2.106) = 73.019, p &lt; 0.001, ηp2 = 0.17, n = 54], health literacy [F(2.108) = 9.067, p &lt; 0.001, ηp2 = 0.15, n = 55], and work performance [F(2.80) = 7.008, p = 0.002, ηp2 = 0.15, n = 41] between t0 and t2. Significant differences between t0 and t1 were also found for well-being, health literacy and work performance, but not for mindfulness. Qualitative findings demonstrated positive training effects, barriers and facilitators to daily application of mindfulness practice.DiscussionThe results suggest that compared to the beginning of the WMT, the post and follow-up measurements showed outcome improvements. The workplace mindfulness training may thus be a promising program to facilitate mental health and working capabilities among upper-level ICT-managers. Contextual workplace factors need to be considered to sustain long-term mindfulness practice of managers.