bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term use of somatostatin analogs for chronic gastrointestinal bleeding in hereditary hemorrhagic telangiectasia
Authors: Torres-Iglesias Raquel , Mora-Luján José María , Iriarte Adriana , Cerdà Pau , Alba Esther , Sánchez-Corral Miguel Ángel , Berrozpe Ana , Cruellas Francesc , Gamundí Enric , Ribas Jesús , Castellote Jose , Riera-Mestre Antoni 
Published: May 2023

BackgroundChronic bleeding due to gastrointestinal (GI) involvement in patients with hemorrhagic hereditary telangiectasia (HHT) can provoke severe anemia with high red blood cells (RBC) transfusion requirements. However, the evidence about how to deal with these patients is scarce. We aimed to assess the long-term efficacy and safety of somatostatin analogs (SA) for anemia management in HHT patients with GI involvement.MethodsThis is a prospective observational study including patients with HHT and GI involvement attended at a referral center. SA were considered for those patients with chronic anemia. Anemia-related variables were compared in patients receiving SA before and during treatment. Patients receiving SA were divided into responders (patients with minimal hemoglobin levels improvement &gt;10 g/L and maintaining hemoglobin levels ≥80 g/L during treatment), and non-responders. Adverse effects during follow-up were collected.ResultsAmong 119 HHT patients with GI involvement, 67 (56.3%) received SA. These patients showed lower minimal hemoglobin levels (73 [60–87] vs. 99 [70.2–122.5], p &lt; 0.001), and more RBC transfusion requirements (61.2% vs. 38.5%, p = 0.014) than patients without SA therapy. Median treatment period was 20.9 ± 15.2 months. During treatment, there was a statistically significant improvement in minimum hemoglobin levels (94.7 ± 29.8 g/L vs. 74.7 ± 19.7, p &lt; 0.001) and a reduction of patients with minimal hemoglobin levels &lt;80 g/L (39 vs. 61%, p = 0.007) and RBC transfusions requirement (33.9% vs. 59.3%, p &lt; 0.001). Sixteen (23.9%) patients showed mild adverse effects, mostly diarrhea or abdominal pain, leading to treatment discontinuation in 12 (17.9%) patients. Fifty-nine patients were eligible for efficacy assessment and 32 (54.2%) of them were considered responders. Age was associated with non-responder patients, OR 95% CI; 1.070 (1.014–1.130), p = 0.015.ConclusionSA can be considered a long-term effective and safe option for anemia management in HHT patients with GI bleeding. Older age is associated with poorer response.
Indocyanine green fluorescence angiography decreases the risk of anastomotic leakage after rectal cancer surgery: a systematic review and meta-analysis
Authors: Xia Shijun , Wu Wenjiang , Luo Lidan , Ma Lijuan , Yu Linchong , Li Yue 
Published: May 2023

BackgroundAnastomotic leakage is a serious complication after rectal cancer resection. Intraoperative use of indocyanine green fluorescence angiography (ICGFA) can help prevent anastomotic leakage, but its use is controversial. We conducted a systematic review and meta-analysis to determine the efficacy of ICGFA in reducing anastomotic leakage.MethodsRelevant data and research published until September 30, 2022, was retrieved from the PubMed, Embase, and Cochrane Library databases, and the difference in the incidence of anastomotic leakage after rectal cancer resection between ICGFA and standard treatment was compared.ResultsThis meta-analysis included 22 studies with a total of 4,738 patients. The results showed that ICGFA use during surgery decreased the incidence of anastomotic leakage after rectal cancer surgery [risk ratio (RR) = 0.46; 95% confidence interval (95% CI), 0.39–0.56; p &lt; 0.001]. Simultaneously, in subgroup analyses for different regions, ICGFA was found to be used to reduce the incidence of anastomotic leakage after rectal cancer surgery in Asia (RR = 0.33; 95% CI, 0.23–0.48; p &lt; 0.00001) and Europe (RR = 0.38; 95% CI, 0.27–0.53; p &lt; 0.00001) but not in North America (RR = 0.72; 95% CI, 0.40–1.29; p = 0.27). Regarding different levels of anastomotic leakage, ICGFA reduced the incidence of postoperative type A anastomotic leakage (RR = 0.25; 95% CI, 0.14–0.44; p &lt; 0.00001) but did not reduce the incidence of type B (RR = 0.70; 95% CI, 0.38–1.31; p = 0.27) and type C (RR = 0.97; 95% CI, 0.51–1.97; p = 0.93) anastomotic leakages.ConclusionICGFA has been linked to a reduction in anastomotic leakage after rectal cancer resection. However, multicenter randomized controlled trials with larger sample sizes are required for further validation.
Prediction of postoperative visual acuity in patients with age-related cataracts using macular optical coherence tomography-based deep learning method
Authors: Wang Jingwen , Wang Jinhong , Chen Dan , Wu Xingdi , Xu Zhe , Yu Xuewen , Sheng Siting , Lin Xueqi , Chen Xiang , Wu Jian , Ying Haochao , Xu Wen 
Published: May 2023

BackgroundTo predict postoperative visual acuity (VA) in patients with age-related cataracts using macular optical coherence tomography-based deep learning method.MethodsA total of 2,051 eyes from 2,051 patients with age-related cataracts were included. Preoperative optical coherence tomography (OCT) images and best-corrected visual acuity (BCVA) were collected. Five novel models (I, II, III, IV, and V) were proposed to predict postoperative BCVA. The dataset was randomly divided into a training (n = 1,231), validation (n = 410), and test set (n = 410). The performance of the models in predicting exact postoperative BCVA was evaluated using mean absolute error (MAE) and root mean square error (RMSE). The performance of the models in predicting whether postoperative BCVA was improved by at least two lines in the visual chart (0.2LogMAR) was evaluated using precision, sensitivity, accuracy, F1 and area under curve (AUC).ResultsModel V containing preoperative OCT images with horizontal and vertical B-scans, macular morphological feature indices, and preoperative BCVA had a better performance in predicting postoperative VA, with the lowest MAE (0.1250 and 0.1194LogMAR) and RMSE (0.2284 and 0.2362LogMAR), and the highest precision (90.7% and 91.7%), sensitivity (93.4% and 93.8%), accuracy (88% and 89%), F1 (92% and 92.7%) and AUCs (0.856 and 0.854) in the validation and test datasets, respectively.ConclusionThe model had a good performance in predicting postoperative VA, when the input information contained preoperative OCT scans, macular morphological feature indices, and preoperative BCVA. The preoperative BCVA and macular OCT indices were of great significance in predicting postoperative VA in patients with age-related cataracts.
The prognostic effects of the geriatric nutritional risk index on elderly acute kidney injury patients in intensive care units
Authors: Liao Dan , Deng Yonghua , Li Xinchun , Huang Ju , Li Jiayue , Pu Ming , Zhang Fenglian , Wang Lijun 
Published: May 2023

IntroductionThe geriatric nutritional risk index (GNRI), a nutritional screening tool specifically for the aging population, has been proven to be associated with worse outcomes in chronic kidney disease patients, especially in the hemodialysis population. However, the predictive validity of GNRI in critically ill elderly patients with acute kidney injury (AKI) is yet to be determined. This analysis sought to examine the prognostic effects of GNRI on elderly AKI patients in intensive care units (ICUs).MethodsWe collected elderly AKI patient-relevant data from the Medical Information Mart for Intensive Care III database. AKI was diagnosed and staged according to the “Kidney Disease Improving Global Outcomes” criteria. In the study, 1-year mortality was considered the primary outcome, whereas in-hospital, ICU, 28-day and 90-day mortality, and prolonged length of stay in ICU and hospital were selected as the secondary outcomes.ResultsIn all, 3,501 elderly patients with AKI were selected for this study, with a 1-year mortality rate of 36.4%. We classified the study population into low (≤98) and high (&gt;98) GNRI groups based on the best cutoff value. The incidence of endpoints was remarkably lower in patients with elevated GNRI (p &lt; 0.001). When stratified by the AKI stage, patients with high GNRI at AKI stages 1, 2, and 3 had markedly lower 1-year mortality than those with low GNRI (all p &lt; 0.05). The multivariable regression analysis identified the independent prognostic ability of GNRI on the research outcomes (all p &lt; 0.05). Restricted cubic spline exhibited a linear correlation between GNRI and 1-year death (p for non-linearity = 0.434). The prognostic implication of GNRI on 1-year mortality was still significant in patients with the most subgroups.ConclusionIn critically ill elderly patients with AKI, elevated GNRI upon admission was strongly correlated with a lower risk of unfavorable outcomes.
Assessment of causal associations among gut microbiota, metabolites, and celiac disease: a bidirectional Mendelian randomization study
Authors: Li Ting , Feng Yan , Wang Chun , Shi Tian , Abudurexiti Adilai , Zhang Mengxia , Gao Feng 
Published: May 2023

BackgroundA growing number of studies have implicated that gut microbial abundance and metabolite concentration alterations are associated with celiac disease (CD). However, the causal relationship underlying these associations is unclear. Here, we used Mendelian randomization (MR) to reveal the causal effect of gut microbiota and metabolites on CD.MethodsGenome-wide association study (GWAS) summary-level data for gut microbiota, metabolites, and CD were extracted from published GWASs. Causal bacterial taxa and metabolites for CD were determined by two-sample MR analyses. The robustness of the results was assessed with sensitivity analyses. Finally, reverse causality was investigated with a reverse MR analysis.ResultsGenetically, increased genus Bifidobacterium was potentially associated with higher CD risk (odds ratio [OR] = 1.447, 95% confidence interval [CI]: 1.054–1.988, p = 0.022) while phylum Lentisphaerae (OR = 0.798, 95% CI: 0.648–0.983, p = 0.034) and genus Coprobacter (OR = 0.683, 95% CI: 0.531–0.880, p = 0.003) were related to lower CD risk. Moreover, there were suggestive associations between CD and the following seven metabolites: 1-oleoylglycerophosphoethanolamine, 1-palmitoylglycerophosphoethanolamine, 1,6-anhydroglucose, phenylacetylglutamine, tryptophan betaine, 10-undecenoate, and tyrosine. Sensitivity analyses deemed the results reliable without pleiotropy.ConclusionWe investigated the causal relationships between gut microbiota, metabolites, and CD with two-sample MR. Our findings suggest several novel potential therapeutic targets for CD treatment. Further understanding of the underlying mechanism may provide insights into CD pathogenesis.
Spatiotemporal dissemination of ESBL-producing Enterobacterales in municipal sewer systems: a prospective, longitudinal study in the city of Basel, Switzerland
Authors: Gómez-Sanz Elena , Bagutti Claudia , Roth Jan A. , Alt Hug Monica , García-Martín Ana B. , Maurer Pekerman Laura , Schindler Ruth , Furger Reto , Eichenberger Lucas , Steffen Ingrid , Egli Adrian , Hübner Philipp , Stadler Tanja , Aguilar-Bultet Lisandra , Tschudin-Sutter Sarah 
Published: May 2023

BackgroundThe contribution of community and hospital sources to the transmission of extended-spectrum β-lactamase producing Enterobacterales (ESBL-PE) remains elusive.AimTo investigate the extent of community dissemination and the contribution of hospitals to the spread of ESBL-PE by exploring their spatiotemporal distribution in municipal wastewater of the central European city of Basel.MethodsWastewater samples were collected monthly for two consecutive years throughout Basel, Switzerland, including 21 sites across 10 postcode areas of the city collecting either community wastewater (urban sites, n = 17) or community and hospital wastewater (mixed sites, n = 4). Presumptive ESBL-PE were recovered by selective culture methods. Standard methodologies were applied for species identification, ESBL-confirmation, and quantification.ResultsNinety-five percent (477/504) of samples were positive for ESBL-PE. Among these isolates, Escherichia coli (85%, 1,140/1,334) and Klebsiella pneumoniae (11%, 153/1,334) were most common. They were recovered throughout the sampling period from all postcodes, with E. coli consistently predominating. The proportion of K. pneumoniae isolates was higher in wastewater samples from mixed sites as compared to samples from urban sites, while the proportion of E. coli was higher in samples from urban sites (p = 0.003). Higher numbers of colony forming units (CFUs) were recovered from mixed as compared to urban sites (median 3.2 × 102 vs. 1.6 × 102 CFU/mL). E. coli-counts showed moderate correlation with population size (rho = 0.44), while this correlation was weak for other ESBL-PE (rho = 0.21).ConclusionESBL-PE are widely spread in municipal wastewater supporting that community sources are important reservoirs entertaining the spread of ESBL-PE. Hospital-influenced abundance of ESBL-PE appears to be species dependent.
Free fatty acids support oligodendrocyte survival in a mouse model of amyotrophic lateral sclerosis
Authors: Maruyama Takashi , Tanabe Shogo , Uyeda Akiko , Suzuki Tatsunori , Muramatsu Rieko 
Published: May 2023

IntroductionAmyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the white matter degeneration. Although changes in blood lipids are involved in the pathogenesis of neurological diseases, the pathological role of blood lipids in ALS remains unclear.Methods and resultsWe performed lipidome analysis on the plasma of ALS model mice, mutant superoxide dismutase 1 (SOD1G93A) mice, and found that the concentration of free fatty acids (FFAs), including oleic acid (OA) and linoleic acid (LA), decreased prior to disease onset. An in vitro study revealed that OA and LA directly inhibited glutamate-induced oligodendrocytes cell death via free fatty acid receptor 1 (FFAR1). A cocktail containing OA/LA suppressed oligodendrocyte cell death in the spinal cord of SOD1G93A mice.DiscussionThese results suggested that the reduction of FFAs in the plasma is a pathogenic biomarker for ALS in the early stages, and supplying a deficiency in FFAs is a potential therapeutic approach for ALS by preventing oligodendrocyte cell death.
The influence of non-stationarity of spike signals on decoding performance in intracortical brain-computer interface: a simulation study
Authors: Wan Zijun , Liu Tengjun , Ran Xingchen , Liu Pengfu , Chen Weidong , Zhang Shaomin 
Published: May 2023

IntroductionIntracortical Brain-Computer Interfaces (iBCI) establish a new pathway to restore motor functions in individuals with paralysis by interfacing directly with the brain to translate movement intention into action. However, the development of iBCI applications is hindered by the non-stationarity of neural signals induced by the recording degradation and neuronal property variance. Many iBCI decoders were developed to overcome this non-stationarity, but its effect on decoding performance remains largely unknown, posing a critical challenge for the practical application of iBCI.MethodsTo improve our understanding on the effect of non-stationarity, we conducted a 2D-cursor simulation study to examine the influence of various types of non-stationarities. Concentrating on spike signal changes in chronic intracortical recording, we used the following three metrics to simulate the non-stationarity: mean firing rate (MFR), number of isolated units (NIU), and neural preferred directions (PDs). MFR and NIU were decreased to simulate the recording degradation while PDs were changed to simulate the neuronal property variance. Performance evaluation based on simulation data was then conducted on three decoders and two different training schemes. Optimal Linear Estimation (OLE), Kalman Filter (KF), and Recurrent Neural Network (RNN) were implemented as decoders and trained using static and retrained schemes.ResultsIn our evaluation, RNN decoder and retrained scheme showed consistent better performance under small recording degradation. However, the serious signal degradation would cause significant performance to drop eventually. On the other hand, RNN performs significantly better than the other two decoders in decoding simulated non-stationary spike signals, and the retrained scheme maintains the decoders’ high performance when changes are limited to PDs.DiscussionOur simulation work demonstrates the effects of neural signal non-stationarity on decoding performance and serves as a reference for selecting decoders and training schemes in chronic iBCI. Our result suggests that comparing to KF and OLE, RNN has better or equivalent performance using both training schemes. Performance of decoders under static scheme is influenced by recording degradation and neuronal property variation while decoders under retrained scheme are only influenced by the former one.
Magnetic resonance spectroscopy investigation in the right human hippocampus following spinal cord injury
Authors: Pfyffer Dario , Zimmermann Sandra , Şimşek Kadir , Kreis Roland , Freund Patrick , Seif Maryam 
Published: May 2023

ObjectivePreclinical studies have shown that cognitive impairments following spinal cord injury (SCI), such as impaired spatial memory, are linked to inflammation, neurodegeneration, and reduced neurogenesis in the right hippocampus. This cross-sectional study aims to characterize metabolic and macrostructural changes in the right hippocampus and their association to cognitive function in traumatic SCI patients.MethodsWithin this cross-sectional study, cognitive function was assessed in 28 chronic traumatic SCI patients and 18 age-, sex-, and education-matched healthy controls by a visuospatial and verbal memory test. A magnetic resonance spectroscopy (MRS) and structural MRI protocol was performed in the right hippocampus of both groups to quantify metabolic concentrations and hippocampal volume, respectively. Group comparisons investigated changes between SCI patients and healthy controls and correlation analyses investigated their relationship to memory performance.ResultsMemory performance was similar in SCI patients and healthy controls. The quality of the recorded MR spectra was excellent in comparison to the best-practice reports for the hippocampus. Metabolite concentrations and volume of the hippocampus measured based on MRS and MRI were not different between two groups. Memory performance in SCI patients and healthy controls was not correlated with metabolic or structural measures.ConclusionThis study suggests that the hippocampus may not be pathologically affected at a functional, metabolic, and macrostructural level in chronic SCI. This points toward the absence of significant and clinically relevant trauma-induced neurodegeneration in the hippocampus.
Brain fog in long COVID limits function and health status, independently of hospital severity and preexisting conditions
Authors: Nordvig Anna S. , Rajan Mangala , Lau Jennifer D. , Kingery Justin R. , Mahmud Meem , Chiang Gloria C. , De Leon Mony J. , Goyal Parag 
Published: May 2023

ImportanceThe U.S. government has named post-acute sequelae of COVID-19 (longCOVID) as influential on disability rates. We previously showed that COVID-19 carries a medical/functional burden at 1  year, and that age and other risk factors of severe COVID-19 were not associated with increased longCOVID risk. Long-term longCOVID brain fog (BF) prevalence, risk factors and associated medical/functional factors are poorly understood, especially after mild SARS-CoV-2 infection.MethodsA retrospective observational cohort study was conducted at an urban tertiary-care hospital. Of 1,032 acute COVID-19 survivors from March 3–May 15, 2020, 633 were called, 530 responded (59.2 ± 16.3  years, 44.5% female, 51.5% non-White) about BF prevalence, other longCOVID, post-acute ED/hospital utilization, perceived health/social network, effort tolerance, disability.ResultsAt approximately 1-year, 31.9% (n = 169) experienced BF. Acute COVID-19 severity, age, and premorbid cardiopulmonary comorbidities did not differ between those with/without BF at 1  year. Patients with respiratory longCOVID had 54% higher risk of BF than those without respiratory longCOVID. BF associated with sleep disturbance (63% with BF vs.29% without BF, p &lt; 0.0001), shortness of breath (46% vs.18%, p &lt; 0.0001), weakness (49% vs.22%, p &lt; 0.0001), dysosmia/dysgeusia (12% vs.5%, p &lt; 0.004), activity limitations (p &lt; 0.001), disability/leave (11% vs.3%, p &lt; 0.0001), worsened perceived health since acute COVID-19 (66% vs.30%, p &lt; 0.001) and social isolation (40% vs.29%, p &lt; 0.02), despite no differences in premorbid comorbidities and age.Conclusions and relevanceA year after COVID-19 infection, BF persists in a third of patients. COVID-19 severity is not a predictive risk factor. BF associates with other longCOVID and independently associates with persistent debility.
Deep brain stimulation for patients with refractory epilepsy: nuclei selection and surgical outcome
Authors: Yan Hao , Wang Xueyuan , Zhang Xiaohua , Qiao Liang , Gao Runshi , Ni Duanyu , Shu Wei , Xu Cuiping , Ren Liankun , Yu Tao 
Published: May 2023

ObjectiveBy studying the surgical outcome of deep brain stimulation (DBS) of different target nuclei for patients with refractory epilepsy, we aimed to explore a clinically feasible target nucleus selection strategy.MethodsWe selected patients with refractory epilepsy who were not eligible for resective surgery. For each patient, we performed DBS on a thalamic nucleus [anterior nucleus of the thalamus (ANT), subthalamic nucleus (STN), centromedian nucleus (CMN), or pulvinar nucleus (PN)] selected based on the location of the patient's epileptogenic zone (EZ) and the possible epileptic network involved. We monitored the clinical outcomes for at least 12 months and analyzed the clinical characteristics and seizure frequency changes to assess the postoperative efficacy of DBS on the different target nuclei.ResultsOut of the 65 included patients, 46 (70.8%) responded to DBS. Among the 65 patients, 45 underwent ANT-DBS, 29 (64.4%) responded to the treatment, and four (8.9%) of them reported being seizure-free for at least 1 year. Among the patients with temporal lobe epilepsy (TLE, n = 36) and extratemporal lobe epilepsy (ETLE, n = 9), 22 (61.1%) and 7 (77.8%) responded to the treatment, respectively. Among the 45 patients who underwent ANT-DBS, 28 (62%) had focal to bilateral tonic-clonic seizures (FBTCS). Of these 28 patients, 18 (64%) responded to the treatment. Out of the 65 included patients, 16 had EZ related to the sensorimotor cortex and underwent STN-DBS. Among them, 13 (81.3%) responded to the treatment, and two (12.5%) were seizure-free for at least 6 months. Three patients had Lennox–Gastaut syndrome (LGS)-like epilepsy and underwent CMN-DBS; all of them responded to the treatment (seizure frequency reductions: 51.6%, 79.6%, and 79.5%). Finally, one patient with bilateral occipital lobe epilepsy underwent PN-DBS, reducing the seizure frequency by 69.7%.SignificanceANT-DBS is effective for patients with TLE or ETLE. In addition, ANT-DBS is effective for patients with FBTCS. STN-DBS might be an optimal treatment for patients with motor seizures, especially when the EZ overlaps the sensorimotor cortex. CMN and PN may be considered modulating targets for patients with LGS-like epilepsy or occipital lobe epilepsy, respectively.