bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinal microvascular and microstructural alterations in the diagnosis of dermatomyositis: a new approach
Authors: Huang Bo-Zhi , Ling Qian , Xu San-Hua , Zou Jie , Zang Miao-Miao , Liao Xu-Lin , Wei Hong , Ying Ping , Pei Chong-Gang , Shao Yi 
Published: May 2023

PurposeTo study the relationship between fundus alterations, including retinal thickness and microvascular changes, and dermatomyositis (DM) using optical coherence tomography angiography (OCTA).MethodsA total of 16 patients with DM (32 eyes) and 16 healthy controls (HCs; 32 eyes) participated in this study. Based on the Early Treatment Diabetic Retinopathy Study subzones, OCTA fundus data were divided into different layers and regions for comparison.ResultsThe full retinal thickness (RT) in the inner nasal (IN), outer nasal (ON), inner inferior (II), and outer inferior (OI) regions of patients with DM was significantly lower than that of HCs (P &lt; 0.001). The inner layer RT was also significantly lower in the IN, ON, II, and OI regions in patients with DM (P &lt; 0.001). The outer layer RT was lower only in the II region in patients with DM compared to HCs (P &lt; 0.001). The full RT of the II region was more sensitive to the pathological changes of disease since its ROC curve had an AUC of 0.9028, 95% CI: 0.8159–0.9898. Meanwhile, the superficial vessel density (SVD) of patients with DM was significantly lower in the IN, ON, II, and OI regions compared to HCs (P &lt; 0.001). The AUC for region II was 0.9634 (95% CI: 0.9034–1.0), which indicated good diagnostic sensitivity.ConclusionOptical coherence tomography angiography can be used to evaluate relevant ocular lesions and monitor disease progression in patients with DM and interstitial lung disease.
Lymphocyte HVEM/BTLA co-expression after critical illness demonstrates severity indiscriminate upregulation, impacting critical illness-induced immunosuppression
Authors: Wakeley Michelle E. , Armstead Brandon E. , Gray Chyna C. , Tindal Elizabeth W. , Heffernan Daithi S. , Chung Chun-Shiang , Ayala Alfred 
Published: May 2023

IntroductionThe co-regulatory molecule, HVEM, can stimulate or inhibit immune function, but when co-expressed with BTLA, forms an inert complex preventing signaling. Altered HVEM or BTLA expression, separately have been associated with increased nosocomial infections in critical illness. Given that severe injury induces immunosuppression, we hypothesized that varying severity of shock and sepsis in murine models and critically ill patients would induce variable increases in HVEM/BTLA leukocyte co-expression.MethodsIn this study, varying severities of murine models of critical illness were utilized to explore HVEM+BTLA+ co-expression in the thymic and splenic immune compartments, while circulating blood lymphocytes from critically ill patients were also assessed for HVEM+BTLA+ co-expression.ResultsHigher severity murine models resulted in minimal change in HVEM+BTLA+ co-expression, while the lower severity model demonstrated increased HVEM+BTLA+ co-expression on thymic and splenic CD4+ lymphocytes and splenic B220+ lymphocytes at the 48-hour time point. Patients demonstrated increased co-expression of HVEM+BTLA+ on CD3+ lymphocytes compared to controls, as well as CD3+Ki67- lymphocytes. Both L-CLP 48hr mice and critically ill patients demonstrated significant increases in TNF-α.DiscussionWhile HVEM increased on leukocytes after critical illness in mice and patients, changes in co-expression did not relate to degree of injury severity of murine model. Rather, co-expression increases were seen at later time points in lower severity models, suggesting this mechanism evolves temporally. Increased co-expression on CD3+ lymphocytes in patients on non-proliferating cells, and associated TNF-α level increases, suggest post-critical illness co-expression does associate with developing immune suppression.
Construction of a novel clinical nomogram to predict cancer-specific survival in patients with primary malignant adrenal tumors: a large population-based retrospective study
Authors: Li Mingzhen , Duan Xiaoying , You Di , Liu Linlin 
Published: May 2023

BackgroundPrimary malignant adrenal tumors were rare and had a poor prognosis. This investigation aimed to create a useful clinical prediction nomogram to anticipate cancer-specific survival (CSS) of patients with a primary malignant adrenal tumor.MethodThis study included 1748 patients with malignant adrenal tumor diagnoses subjects from 2000 to 2019. These subjects were allocated randomly into training (70%) and validation (30%) cohorts. Patients with adrenal tumors underwent univariate and multivariate Cox regression analyses to identify the CSS-independent predictive biomarkers. Therefore, a nomogram was created depending on those predictors, and calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA) were used to assess the calibration capacity of the nomogram, discriminative power, and clinical efficiency, respectively. Afterward, a risk system for categorizing patients with adrenal tumors was established.ResultThe univariate and multivariate Cox analysis demonstrated the CSS-independent predictive factors, including age, tumor stage, size, histological type, and surgery. As a result, a nomogram was developed using these variables. For the 3-, 5-, and 10-year CSS of this nomogram, the values of the area under the curve (AUC) of the ROC curves were 0.829, 0.827, and 0.822, respectively. Furthermore, the AUC values of the nomogram were higher than those of the individual independent prognostic components of CSS, indicating that the nomogram had stronger prognostic prediction reliability. A novel risk stratification method was created to further improve patient stratification and give clinical professionals a better reference for clinical decision-making.ConclusionThrough the developed nomogram and risk stratification method, the CSS of patients with malignant adrenal tumors could be predicted more precisely, assisting physicians to differentiate patients better and creating personalized treatment strategies to optimize patient benefits.
Case report: Giant coronary artery aneurysms with severe stenosis and multiple abdominal artery aneurysms
Authors: Gao Hongli , Li Hongwei 
Published: May 2023

BackgroundGiant coronary artery aneurysms (GCAAs) were relatively rare. Little was known about its characteristics, its etiology and its therapy. GCAAs with multiple abdominal artery aneurysms (AAAs) were more unusual and rarer.Case presentationA 29-year-old female presented to our hospital with abrupt-onset abdominal pain in the left upper quadrant and then she died in 2018. In 2016, prior to this visit, she came to our department for intermittent retrosternal compression pain during rest or sports activities. Medical history showed she had a coronary artery aneurysm (CAA) in 2004. We found evidence of multiple coronary aneurysms with severe stenosis and multiple AAAs and coronary artery bypass grafting (CABG) was carried out. In combination with laboratory analysis, imaging studies, and pathological examination, CAA may result from the long-term effects of Kawasaki disease (KD). Finally, the patient died of a ruptured abdominal aneurysm.ConclusionsWe report a rare case of GCAAs with severe stenosis and multiple AAAs in a young woman with a history of KD-induced coronary aneurysm. Although the understanding of the optimal treatment strategy for GCAAs combined with multiple aneurysms was limited, we found that CABG was effective in the treatment of GCAAs in this patient. In the clinical treatment of patients with GCAAs, attention should be paid to the examination of systemic blood vessels.
Hindlimb muscle representations in mouse motor cortex defined by viral tracing
Authors: Maurer Lauren , Brown Maia , Saggi Tamandeep , Cardiges Alexia , Kolarcik Christi L. 
Published: May 2023

IntroductionDescending pathways from the cortex to the spinal cord are involved in the control of natural movement. Although mice are widely used to study the neurobiology of movement and as models of neurodegenerative disease, an understanding of motor cortical organization is lacking, particularly for hindlimb muscles.MethodsIn this study, we used the retrograde transneuronal transport of rabies virus to compare the organization of descending cortical projections to fast- and slow-twitch hindlimb muscles surrounding the ankle joint in mice.ResultsAlthough the initial stage of virus transport from the soleus muscle (predominantly slow-twitch) appeared to be more rapid than that associated with the tibialis anterior muscle (predominantly fast-twitch), the rate of further transport of virus to cortical projection neurons in layer V was equivalent for the two injected muscles. After appropriate survival times, dense concentrations of layer V projection neurons were identified in three cortical areas: the primary motor cortex (M1), secondary motor cortex (M2), and primary somatosensory cortex (S1).DiscussionThe origin of the cortical projections to each of the two injected muscles overlapped almost entirely within these cortical areas. This organization suggests that cortical projection neurons maintain a high degree of specificity; that is, even when cortical projection neurons are closely located, each neuron could have a distinct functional role (controlling fast- versus slow-twitch and/or extensor versus flexor muscles). Our results represent an important addition to the understanding of the mouse motor system and lay the foundation for future studies investigating the mechanisms underlying motor system dysfunction and degeneration in diseases such as amyotrophic lateral sclerosis and spinal muscular atrophy.
Predatory behavior under monocular and binocular conditions in the semiterrestrial crab Neohelice granulata
Authors: Harper Thomas , Nemirovsky Sergio Iván , Tomsic Daniel , Sztarker Julieta 
Published: May 2023

IntroductionNeohelice granulata crabs live in mudflats where they prey upon smaller crabs. Predatory behavior can be elicited in the laboratory by a dummy moving at ground level in an artificial arena. Previous research found that crabs do not use apparent dummy size nor its retinal speed as a criterion to initiate attacks, relying instead on actual size and distance to the target. To estimate the distance to an object on the ground, Neohelice could rely on angular declination below the horizon or, since they are broad-fronted with eye stalks far apart, on stereopsis. Unlike other animals, binocular vision does not widen the visual field of crabs since they already cover 360° monocularly. There exist nonetheless areas of the eye with increased resolution.MethodsWe tested how predatory responses towards the dummy changed when animals’ vision was monocular (one eye occluded by opaque black paint) compared to binocular.ResultsEven though monocular crabs could still perform predatory behaviors, we found a steep reduction in the number of attacks. Predatory performance defined by the probability of completing the attacks and the success rate (the probability of making contact with the dummy once the attack was initiated) was impaired too. Monocular crabs tended to use frontal, ballistic jumps (lunge behavior) less, and the accuracy of those attacks was reduced. Monocular crabs used prey interception (moving toward the dummy while it approached the crab) more frequently, favoring attacks when the dummy was ipsilateral to the viewing eye. Instead, binocular crabs’ responses were balanced in the right and left hemifields. Both groups mainly approached the dummy using the lateral field of view, securing speed of response.ConclusionAlthough two eyes are not strictly necessary for eliciting predatory responses, binocularity is associated with more frequent and precise attacks.
Tongue acupuncture for the treatment of post-stroke dysphagia: a meta-analysis of randomized controlled trials
Authors: Li Li , Xu Fei , Yang Shengping , Kuang Peng , Ding Haoying , Huang Mei , Guo Chunyan , Yuan Zishui , Xiao Xiao , Wang Zuhong , Zhang Pengyue 
Published: May 2023

ObjectivesPost-stroke dysphagia is the most common neurological impairment after stroke. The swallowing process is controlled by a network made up of the cerebral cortex, subcortical area, and brainstem structure. The disruption of the swallowing network after stroke leads to dysphagia. The affected swallowing muscles after stroke mainly include the laryngeal muscles (suprahyoid muscle and thyrohyoid muscle) and infrahyoid muscle. These muscles experience kinematic effects and muscle strength weakens, resulting in reduced movement in the swallowing process. Acupuncture can change the excitability of cerebral cortical nerve cells, promote the recovery of neurological function, and enhance neuromuscular excitability, ultimately improving the control of swallowing-related nerves and muscles and promoting swallowing functional recovery. In this meta-analysis, we systematically evaluate the clinical efficacy of acupuncture in the treatment of post-stroke dysphagia.MethodsRandomized controlled trials of tongue acupuncture therapy for post-stroke dysphagia were searched and selected from seven electronic databases (PubMed, CBM, Cochrane, Embase, CNKI, VPCS, and Wan fang). The Cochrane Collaboration tool was used to conduct methodological quality assessment. Rev. Man 5.4 software was utilized to perform data analysis.ResultsA total of 15 studies with 1,094 patients were included. Meta-analysis Showed that WST score WST score (MD = −0.56, 95% CI (−1.23, 0.12), Z = 1.62, p &lt; 0.00001), SSA score (MD = −1.65, 95% CI (−2.02, −1.28), Z = 8.77, p &lt; 0.00001). These results suggested that the treatment group (tongue acupuncture or tongue acupuncture combined with other therapies) was superior to the control group in reducing WST scores and SSA scores. The clinical efficacy of the tongue acupuncture group was better compared with the control group (MD = 3.83, 95% CI (2.61, 5.62), Z = 6.88, p &lt; 0.00001).ConclusionThe meta-analysis showed that the total effective rate of patients with dysphagia after stroke in the treatment group (acupuncture, tongue acupuncture, and acupuncture combined with other therapy) was higher than that in the control group. These results indicated that acupuncture, tongue acupuncture, and acupuncture combined with other therapy can improve post-stroke dysphagia.
Aberrant structural and functional alterations in postpartum depression: a combined voxel-based morphometry and resting-state functional connectivity study
Authors: Chen Chunlian , Li Bo , Zhang Shufen , Liu Zhe , Wang Yu , Xu Minghe , Ji Yuqing , Wang Shuang , Sun Gang , Liu Kai 
Published: May 2023

ObjectivesPostpartum depression (PPD) is a severe postpartum psychiatric disorder with unclear pathogenesis. Previous neuroimaging studies have reported structural or functional alterations in areas associated with emotion regulation, cognitive disorder, and parenting behaviors of PPD. The primary goal of this investigation was to explore the presence of brain structural alterations and relevant functional changes in PPD patients.MethodsA total of 28 patients and 30 matched healthy postnatal women (HPW) underwent both three-dimensional T1-weighted magnetic resonance imaging (MRI) and resting-state functional MRI. Structural analysis was performed by voxel-based morphometry (VBM), followed by resting-state functional analysis using a seed-based whole-brain functional connectivity (FC) approach with abnormal gray matter volume (GMV) regions as seed.ResultsCompared with HPW, the PPD patients showed increased GMV in the left dorsolateral prefrontal cortex (DLPFC.L), the right precentral gyrus (PrCG.R), and the orbitofrontal cortex (OFC). In the PPD group, the DLPFC.L showed increased FC with the right anterior cingulate and paracingulate gyri (ACG.R) and the right middle frontal gyrus (MFG.R); the FC between the PrCG.R and the right median cingulate and paracingulate gyri (DCG.R) exhibited enhanced; the OFC showed increased FC with MFG.R and the left inferior occipital gyrus (IOG.L). In PPD, GMV of DLPFC.L was positively correlated with EDPS scores (r = 0.409 p = 0.031), and FC of PrCG.R-DCG.R was positively correlated with EDPS scores (r = 0.483 p = 0.020).ConclusionStructural and functional damage of the DLPFC.L and OFC is associated with cognitive disorders and parenting behaviors in PPD, while structural abnormalities of the DLPFC.L and PrCG.R are involved in impaired executive function. The increased GMV of DLPFC.L may be a unique structural pathological mechanism of PPD related to the inability of PPD patients to withstand long-term parenting stress. These findings have important implications for understanding neural mechanisms in PPD.
Prognosis of resectable colorectal liver metastases after surgery associated with pathological features of primary tumor
Authors: Chen Dawei , Li Qingshan , Yu Haibo 
Published: May 2023

BackgroundSurgery is an important means for patients with colorectal liver metastases (CRLM) to improve their long-term survival, and accurate screening of high-risk factors is crucial to guiding postoperative monitoring and treatment. With this in mind, the aim of this study was to investigate the expression levels and prognostic roles of Mismatch Repair (MMR), Ki67, and Lymphovascular invasion(LVI) in the tumor tissues of colorectal of CRLM.Methods85 Patients with CRLM who received surgical treatment for liver metastases after colorectal cancer resection from June, 2017 and Jan, 2020 were included in this study. Independent risk factors affecting the survival of patients with CRLM were investigated using a Cox regression model and the Kaplan-Meier method, and a nomogram for predicting the OS of patients with CRLM was established according to a Cox multivariate regression model. Calibration plots and Kaplan-Meier curves were used to assess the performance of the nomogram.ResultsThe median survival time was 39 months (95% CI: 32.05-45.950), and MMR, Ki67 and LVI were significantly correlated with prognosis. Univariate analysis indicated that larger metastasis size (p=0.028), more than one liver metastases (p=0.001),higher serum CA199 (p&lt;0.001), N1-2 stage (p&lt;0.001), the presence of LVI (p=0.001), higher Ki67 (p&lt;0.001), and pMMR predicted worse OS. In addition, synchronous liver metastasis (p = 0.008), larger metastasis size (p=0.02), more than one liver metastases (p&lt;0.001),higher serum CA199 (p&lt;0.001), the presence of LVI (p=0.001), nerve invasion (p=0.042) higher Ki67 (p=0.014), and pMMR (p=0.038) were each associated with worse DFS. Multivariate analysis indicated that higher serum CA199 (HR = 2.275, 95%CI: 1.302-3.975 p=0.004), N1-2 stage(HR = 2.232, 95%CI: 1.239-4.020 p=0.008), the presence of LVI (HR = 1.793, 95%CI: 1.030-3.121 p=0.039), higher Ki67 (HR = 2.700, 95%CI: 1.388-5.253\ p=0.003), and pMMR (HR = 2.213, 95%CI: 1.181-4.993 p=0.046) all predicted worse OS. Finally, synchronous liver metastasis (HR = 2.059, 95%CI: 1.087-3.901 p=0.027), more than one liver metastases ((HR =2.025, 95%CI: 1.120-3.662 p=0.020),higher serum CA199 (HR =2.914, 95%CI: 1.497-5.674 p=0.002), present LVI (HR = 2.055, 95%CI: 1.183-4.299 p=0.001), higher Ki67 (HR = 3.190, 95%CI: 1.648-6.175 p=0.001) and pMMR(HR = 1.676, 95%CI: 1.772-3.637 p=0.047) predicted worse DFS, and the nomogram achieved an effective level of predictive ability.ConclusionThis study showed that MMR, Ki67, and Lymphovascular invasion were independent risk factors for the postoperative survival of CRLM patients, and a nomogram model was constructed to predict the OS of these patients after liver metastasis surgery. These results can help surgeons and patients to develop more accurate and individualized follow-up strategies and treatment plans after this surgery.
Mixed comparison of interventions for different exercise types on students with Internet addiction: a network meta-analysis
Authors: Zhang Yihan , Li Geng , Liu Chengzhen , Chen Huohong , Guo Jianping , Shi Zifu 
Published: May 2023

BackgroundInternet addiction (IA) has a significant negative impact on students. The condition of students with IA can be improved by exercise, which has been identified as an effective intervention strategy. However, the relative effectiveness of different exercise types and the most effective ones remains unknown. This study presents a network meta-analysis to compare six exercise types (team sport, double sport, single sport, team + double sport, team + single sport, and team + double + single sport) based on their effectiveness in reducing Internet addiction and maintaining mental health.MethodsSystematic searches were conducted in PubMed, EMBASE, Cochrane Library, CNKI, Wan Fang, CQVIP, Web of Science, CBM, EBSCO, APA PsycNet, and Scopus, and all relevant studies from the beginning to 15 July 2022 were included on. According to the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria, the listed studies' bias risk was assessed, while the network meta-analysis was performed using STATA 16.0.ResultsA total of 39 randomized controlled trials that met all inclusion criteria including 2,408 students with IA were examined. The meta-analysis results showed that compared with the control group, exercising significantly improved loneliness, anxiety, depression, and interpersonal sensitivity (p &lt; 0.05). Specifically, the network meta-analysis discovered that the single sport, team sport, double sport, team + double sport, and team + double + single sport had significant effects on improving Internet addiction as compared to the respective control group (p &lt; 0.05); the single sport, team sport, and double sport tend to be effective compared with controls in improving mental health (p &lt; 0.05). Compared with the other five types of sports, the double sport was ranked first and showed the greatest potential to be the best choice (cluster ranking value = 3699.73) in improving Internet addiction (SUCRA = 85.5) and mental health (SUCRA = 93.1).ConclusionExercise could be suggested as the best alternative when treating IA in students, based on the extensive positive effects of exercise on IA, anxiety, depression, interpersonal sensitivity, loneliness, and mental health in IA students. Double sport may be the best type of exercise for Internet-addicted students. However, to further examine the benefits of exercise for IA students, more research is required.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=377035, identifier: CRD42022377035.