bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential effects of chronotype on physical activity and cognitive performance in older adults
Authors: Hicks Hilary , Meyer Kayla , Watts Amber 
Published: April 2023

IntroductionChronotypes reflect individuals' preferred activity and sleep patterns (e.g., “morning-types” vs. “evening-types”) and are associated with health and physical activity. Less is known about the relationship between chronotype and cognitive health in older adults. It is unclear whether chronotype's influence is driven by sleep timing or disruption. This study explored the relationship between chronotype, physical activity, and cognitive performance in older adults with and without self-reported sleep disorders.MethodsParticipants were 153 older adults (M = 70.35, SD = 5.89) who wore an Actigraph on the non-dominant wrist for seven days to measure total physical activity, peak physical activity, and chronotype (sleep interval midpoint). We categorized participants as morning-, evening-, and intermediate-chronotypes and assessed cognitive performance in domains of attention, executive function, and verbal memory.ResultsMANCOVAs showed patterns of activity across the 24-hour day differed between chronotypes such that morning-types were active earlier and evening-types active later, ps &gt; .001. Total physical activity and average peak activity did not differ between chronotypes, (ps ≥ .117). Timing of peak activity followed expectations (morning-types peaked earliest (p = .019). Evening-types exhibited significantly worse executive function and attention than intermediate-types, p = .008. When excluding participants with sleep disorders, evening-types engaged in significantly less total physical activity than other groups, but cognitive performance did not differ.DiscussionWe found no differences in total or peak physical activity between groups, which is inconsistent with findings from studies in younger samples. This suggests the role of chronotype on physical activity may change with age and points to the potential impact of methodological discrepancies. While evening-types exhibited worse executive function and attention performance, this finding disappeared when participants with sleep disorders were excluded. Sleep dysregulation rather than sleep timing may be driving this difference. Recent trends in physical activity research explore activity patterns across the 24-hour day and acknowledge codependence between different activity types. Our findings suggest chronotype and activity timing may be important as researchers advance this line of research in older adults.
Rare primary dyslipidaemias associated with low LDL and HDL cholesterol values in Portugal
Authors: Alves Ana Catarina , Miranda Beatriz , Moldovan Oana , Santo Raquel Espírito , Gouveia Silva Raquel , Soares Cardoso Sandra , Diogo Luísa , Seidi Mónica , Sequeira Silvia , Bourbon Mafalda 
Published: April 2023

Background: Dyslipidaemia represents a group of disorders of lipid metabolism, characterized by either an increase or decrease in lipid particles, usually associated with triglycerides, LDL cholesterol (LDL-C) and/or HDL cholesterol (HDL-C). Most hyperlipidaemias and HDL deficiencies confer an increased cardiovascular risk, while hypolipidaemia, such as abeta or hypobetalipoproteinemia, may present different manifestations ranging from poor weight progression to neurological manifestations. The aim of this study is to present 7 cases with rare dyslipidaemias associated with low LDL or low HDL cholesterol values, referred to our laboratory for the genetic identification of the cause of the dyslipidaemia.Methods: Lipid profile was determined for each individual in an automated equipment Integra Cobas (Roche). Molecular analysis was performed by NGS with a target panel of 57 genes involved in lipid metabolism (Sure select QXT, Agilent) and samples were run in a NextSEQ Sequencer (Illumina). Only genes associated to rare forms of low HDL-c or LDL-c were analysed for this work, namely: ABCA1, APOA1, LCAT, SCARB1, APOB, PCSK9, MTTP, SAR1B, and ANGPTL3. All rare variants (MAF&lt;5%) found in these genes were confirmed by Sanger sequencing.Results and discussion: This study includes 7 index cases (IC), with the following clinical diagnoses: Fish Eye Disease (1), Hypoalphalipoproteinemia (1) and Abetalipoproteinemia (ABL) / Familial Hypobetalipoproteinemia (FHBL) (5). We have identified one IC with a compound heterozygosity in LCAT causing Fish Eye Disease and one IC with a variant in ABCA1 in homozygosity causing Tangier disease. We found variants causing homozygous FHBL in 2 IC, one of whom has an undescribed pathogenic variant in homozygosity in APOB (c.12087+1G&gt;A) and the other is a possible compound heterozygous for APOB variants c.2604+1G&gt;A and c.4651C&gt;T/p.(Gln1551*). In two patients only a variant in heterozygosity (c.3365delG/p.(Gly1122Vfs*62) and c.11095A&gt;T/p.(Arg3699*)). In the remaining patient, no variants were identified. NGS proved to be a fundamental key for genetic testing of rare lipid disorders, allowing us to find the genetic cause of disease in 6/7 patients with low HDL-c and LDL-c. Patients with these rare conditions should be identified as early as possible in order to minimize or prevent clinical manifestations. The unsolved case is still under investigation.
Lumbar posterior group muscle degeneration: Influencing factors of adjacent vertebral body re-fracture after percutaneous vertebroplasty
Authors: Chen Ming , Yang Cekai , Cai Zhuoyan , Liu Youtao , Liu Hao , Cui Jianchao , Yao Zhensong , Chen Yuan 
Published: April 2023

ObjectiveThe purpose of the study was to explore the influencing factors of adjacent vertebral re-fracture after percutaneous vertebroplasty (PVP) for osteoporosis vertebral compression fractures (OVCFs).MethodsWe retrospectively analyzed the clinical data of 55 patients with adjacent vertebral re-fracture after PVP operation for OVCFs in our hospital from January 2016 to June 2019, they were followed up for 1 year and included in the fracture group. According to the same inclusion and exclusion criteria, we collected the clinical data of 55 patients with OVCFs without adjacent vertebral re-fracture after PVP in the same period and included them in the non-fracture group. We performed univariate and multivariate logistic regression analysis on the influencing factors of adjacent vertebral re-fracture in patients with OVCFs after PVP.ResultsThere were significant differences in body mass index (BMI), bone mineral density (BMD) T-value, amount of bone cement injected, bone cement leakage, history of glucocorticoid use, cross-sectional area (CSA), cross-sectional area asymmetry (CSAA), fat infiltration rate (FIR), and fat infiltration rate asymmetry (FIRA) of lumbar posterior group muscles [multifidus (MF) and erector spinae (ES)] between the two groups (p &lt; 0.05). There was no significant difference in sex, age, or time from the first fracture to operation, the CAS, CSAA, FIR, and FIRA of psoas major (PS) between the two groups (p &gt; 0.05). Multivariate logistic regression showed that a higher dose of bone cement, greater CSAA and FIR of multifidus, and higher CSAA of erector spinae were independent risk factors for recurrent fractures of adjacent vertebrae after PVP.ConclusionThere are many risk factors for recurrent vertebral fracture after PVP in patients with OVCFs, and degeneration of paraspinal muscles (especially posterior lumbar muscles) may be one of the risks.
Enhanced recovery after surgery program alleviates neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients undergoing gynecological surgery
Authors: Xing Naidong , Wang Hongyan , Huang Yan , Peng Jin 
Published: April 2023

BackgroundTo evaluate the efficacy of the enhanced recovery after surgery (ERAS) programs on the systemic inflammatory response (SIR) of patients following gynecological surgery, a randomized controlled trial was performed to compare the ERAS programs with the conventional perioperative care programs. Furthermore, novel SIR markers could be identified to evaluate the ERAS programs of gynecological surgery.MethodsPatients undergoing gynecological surgery were randomly allocated to either the ERAS group or the conventional group. The correlations between the elements of ERAS protocols and SIR markers following gynecological surgery were evaluated.ResultsA total of 340 patients who underwent gynecological surgery were enrolled (ERAS = 170; conventional = 170). First, we identified whether the ERAS programs after gynecological surgery reduced the perioperative difference between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Interestingly, first flatus time postoperatively, visual analog scale (VAS) score of patients was positively correlated with the perioperative difference NLR or PLR. Moreover, we discovered that the perioperative difference NLR or PLR was correlated with elements of ERAS protocol, including first sips of water, first semifluid diet postoperatively, pelvic drain duration, and out-of-bed time of patients.ConclusionWe originally reveal that certain elements of ERAS programs alleviated SIR to operation. The implementation of ERAS programs enhances postoperative recovery after gynecological surgery via improving system inflammatory status. NLR or PLR could be the novel and inexpensive marker to assess ERAS programs in gynecological surgery.Clinical trial registration:ClinicalTrials.gov, identifier, NCT03629626.
Pathogenesis and treatment of chronic rhinosinusitis from the perspective of sinonasal epithelial dysfunction
Authors: He Yuanqiong , Fu Yijie , Wu Yuqi , Zhu Tianmin , Li Hui 
Published: April 2023

BackgroundChronic rhinosinusitis (CRS) is a clinical syndrome primarily characterized by long-term mucosal inflammation of the nasal cavity and sinuses. The pathogenesis of CRS is still unclear due to its high heterogeneity. A number of studies have recently focused on the sinonasal epithelium. Thus, there has been a quantum leap in awareness of the role of the sinonasal epithelium, which is now understood as an active functional organ rather than simply an inert mechanical barrier. Undoubtedly, epithelial dysfunction plays a vital role in the onset and development of CRS.ObjectiveIn this article, we discuss the potential contribution of sinonasal epithelium dysfunction to CRS pathogenesis and explore a few current and developing therapeutic options targeting the sinonasal epithelium.ResultsImpaired mucociliary clearance (MCC) and an abnormal sinonasal epithelial barrier are usually considered to be the main causative factors in CRS. Epithelial-derived bioactive substances, such as cytokines, exosomes, and complements, play a vital role in the regulation of innate and adaptive immunity and contribute to the pathophysiological alterations of CRS. The phenomena of epithelial–mesenchymal transition (EMT), mucosal remodeling, and autophagy observed in CRS offer some novel insights into the pathogenesis of this disease. In addition, existing treatment options targeting disorder of sinonasal epithelium can help to relieve the main symptoms associated with CRS to some extent.ConclusionThe presence of a normal epithelium is fundamental for maintaining homeostasis in the nasal and paranasal sinuses. Here, we describe various aspects of the sinonasal epithelium and highlight the contributions of epithelial dysfunction to CRS pathogenesis. Our review provides sound evidence of the need for in-depth study of the pathophysiological alterations of this disease and for the development of novel epithelium-targeting alternative treatments.
Effect of gait training using Welwalk on gait pattern in individuals with hemiparetic stroke: a cross-sectional study
Authors: Ii Takuma , Hirano Satoshi , Imoto Daisuke , Otaka Yohei 
Published: April 2023

IntroductionWe aimed to explore the effect of gait training using Welwalk on gait patterns by comparing differences in gait patterns between robotic-assisted gait training using Welwalk and gait training using an orthosis in individuals with hemiparetic stroke.MethodsThis study included 23 individuals with hemiparetic stroke who underwent gait training with Welwalk combined with overground gait training using an orthosis. Three-dimensional motion analysis on a treadmill was performed under two conditions for each participant: during gait training with Welwalk and with the ankle-foot orthosis. The spatiotemporal parameters and gait patterns were compared between the two conditions.ResultsThe affected step length was significantly longer, the step width was significantly wider, and the affected single support phase ratio was significantly higher in the Welwalk condition than in the orthosis condition. The index values of abnormal gait patterns were significantly lower while using Welwalk than in the orthosis condition. The following four indices were lower in the Welwalk condition: contralateral vaulting, insufficient knee flexion, excessive hip external rotation during the paretic swing phase, and paretic forefoot contact.DiscussionGait training using Welwalk increased the affected step length, step width, and single support phase while suppressing abnormal gait patterns as compared to gait training using the ankle-foot orthosis. This study suggests that gait training using Welwalk may promote a more efficient gait pattern reacquisition that suppresses abnormal gait patterns.Trial registrationProspectively registered in the Japan Registry of Clinical Trials (https://jrct.niph.go.jp; jRCTs042180152).
Reduced C9orf72 expression exacerbates polyGR toxicity in patient iPSC-derived motor neurons and a Type I protein arginine methyltransferase inhibitor reduces that toxicity
Authors: Dane Therese L. , Gill Anna L. , Vieira Fernando G. , Denton Kyle R. 
Published: April 2023

IntroductionIntronic repeat expansions in the C9orf72 gene are the most frequent known single genetic causes of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). These repeat expansions are believed to result in both loss-of-function and toxic gain-of-function. Gain-of-function results in the production of toxic arginine-rich dipeptide repeat proteins (DPRs), namely polyGR and polyPR. Small-molecule inhibition of Type I protein arginine methyltransferases (PRMTs) has been shown to protect against toxicity resulting from polyGR and polyPR challenge in NSC-34 cells and primary mouse-derived spinal neurons, but the effect in human motor neurons (MNs) has not yet been explored.MethodsTo study this, we generated a panel of C9orf72 homozygous and hemizygous knockout iPSCs to examine the contribution of C9orf72 loss-of-function toward disease pathogenesis. We differentiated these iPSCs into spinal motor neurons (sMNs).ResultsWe found that reduced levels of C9orf72 exacerbate polyGR15 toxicity in a dose-dependent manner. Type I PRMT inhibition was able to partially rescue polyGR15 toxicity in both wild-type and C9orf72-expanded sMNs.DiscussionThis study explores the interplay of loss-of-function and gain-of-function toxicity in C9orf72 ALS. It also implicates type I PRMT inhibitors as a possible modulator of polyGR toxicity.
Comparison of neostigmine and sugammadex for hemodynamic parameters in neurointerventional anesthesia
Authors: Tsai Yu-Hsun , Chen Chun-Yu , Wong Ho-Fai , Chou An-Hsun 
Published: April 2023

IntroductionHemodynamic stability is important during neurointerventional procedures. However, ICP or blood pressure may increase due to endotracheal extubation. The aim of this study was to compare the hemodynamic effects of sugammadex and neostigmine with atropine in neurointerventional procedures during emergence from anesthesia.MethodsPatients undergoing neurointerventional procedures were allocated to the sugammadex group (Group S) and the neostigmine group (Group N). Group S was administered IV 2 mg/kg sugammadex when a train-of-four (TOF) count of 2 was present, and Group N was administered neostigmine 50 mcg/kg with atropine 0.2 mg/kg at a TOF count of 2. We recorded heart rate, systolic blood pressure, diastolic blood pressure, mean blood pressure (MAP), and peripheral arterial oxygen saturation during administration of the reverse agent and at 2, 5, 10, 15, 30, 120 min, and 24 h thereafter. The primary outcome was blood pressure and heart rate change after the reversal agent was given. The secondary outcomes were systolic blood pressure variability standard deviation (a measure of the amount of variation or dispersion of a set of values), systolic blood pressure variability-successive variation (square root of the average squared difference between successive blood pressure measurements), nicardipine use, time-to-TOF ratio ≥0.9 after the administration of reversal agent, and time from the administration of the reversal agent to tracheal extubation.ResultsA total of 31 patients were randomized to sugammadex, and 30 patients were randomized to neostigmine. Except for anesthesia time, there were no significant differences in any of the clinical characteristics between the two groups. The results demonstrated that the increase in MAP from period A to B was significantly greater in Group N than in Group S (regression coefficient = −10, 95% confidence interval = −17.3 to −2.7, P = 0.007). The MAP level was significantly increased from period A to B in the neostigmine group (95.1 vs. 102.4 mm Hg, P = 0.015), but it was not altered in Group S. In contrast, the change in HR from periods A to B was not significantly different between groups.ConclusionWe suggest that sugammadex is a better option than neostigmine in interventional neuroradiological procedures due to the shorter extubation time and more stable hemodynamic change during emergence.
Does MRI add value in selecting patients for thrombectomy beyond the 6 h window? A matched-control analysis
Authors: Cheng Huiran , Yu Zequan , Ma Gaoting , Wang Anxin , Jia Baixue , Tong Xu , Ma Ning , Gao Feng , Mo Dapeng , Song Ligang , Xuan Sun , Huo Xiaochuan , Zhang Zi-Xian , Ren Zeguang , Miao Zhongrong 
Published: April 2023

BackgroundControversy exists regarding the need of advanced imaging for patient selection in the extended window.AimsTo analyze the effect of initial imaging modalities on clinical outcomes of patients underwent MT in the extended window.MethodsThis was a retrospective analysis of a prospective registry, the Endovascular Treatment Key Technique and Emergency Workflow Improvement of Acute Ischemic Stroke (ANGEL-ACT) registry which was conducted at 111 hospitals between November 2017 and March 2019 in China. Primary study cohort and Guideline like cohort were identified, in each cohort, two imaging modalities for patient selection in 6 to 24 h window were defined: (1) NCCT ± CTA, (2) MRI. Guideline-like cohort were further screened based on key features of the DAWN and DEFUSE 3 trials. The primary outcome was 90 day mRS. The safety outcomes were sICH, any ICH and 90-day mortality.ResultsAfter adjusting for covariates, there were no significant differences in 90 day mRS or any safety outcomes between two imaging modalities groups in both cohorts. All outcome measures of mixed-effects logistic regression model were consistent with propensity score matching model.ConclusionOur results indicate that patients presented with anterior large vessel occlusion in the extended time window can potentially benefit from MT even in the absence of MRI selection. This conclusion needs to be verified by the prospective randomized clinical trials.
Functional connectivity changes are correlated with sleep improvement in chronic insomnia patients after rTMS treatment
Authors: Zhu Lin , Dang Ge , Wu Wei , Zhou Junhong , Shi Xue , Su Xiaolin , Ren Huixia , Pei Zian , Lan Xiaoyong , Lian Chongyuan , Xie Peng , Guo Yi 
Published: April 2023

BackgroundRepetitive transcranial magnetic stimulation (rTMS) has been increasingly used as a treatment modality for chronic insomnia disorder (CID). However, our understanding of the mechanisms underlying the efficacy of rTMS is limited.ObjectiveThis study aimed to investigate rTMS-induced alterations in resting-state functional connectivity and to find potential connectivity biomarkers for predicting and tracking clinical outcomes after rTMS.MethodsThirty-seven patients with CID received a 10-session low frequency rTMS treatment applied to the right dorsolateral prefrontal cortex. Before and after treatment, the patients underwent resting-state electroencephalography recordings and a sleep quality assessment using the Pittsburgh Sleep Quality Index (PSQI).ResultsAfter treatment, rTMS significantly increased the connectivity of 34 connectomes in the lower alpha frequency band (8–10 Hz). Additionally, alterations in functional connectivity between the left insula and the left inferior eye junction, as well as between the left insula and medial prefrontal cortex, were associated with a decrease in PSQI score. Further, the correlation between the functional connectivity and PSQI persisted 1 month after the completion of rTMS as evidenced by subsequent electroencephalography (EEG) recordings and the PSQI assessment.ConclusionBased on these results, we established a link between alterations in functional connectivity and clinical outcomes of rTMS, which suggested that EEG-derived functional connectivity changes were associated with clinical improvement of rTMS in treating CID. These findings provide preliminary evidence that rTMS may improve insomnia symptoms by modifying functional connectivity, which can be used to inform prospective clinical trials and potentially for treatment optimization.
The effects of blurred visual inputs with different levels on the cerebral activity during free level walking
Authors: Ao Mingxin , Ren Shuang , Yu Yuanyuan , Huang Hongshi , Miao Xin , Ao Yingfang , Wang Wei 
Published: April 2023

ObjectiveThe aim of this study was to evaluate the effects of blurred vision on electrocortical activities at different levels during walking.Materials and methodsA total of 22 healthy volunteers (all men; mean age: 24.4 ± 3.9 years) underwent an electroencephalography (EEG) test synchronous with free level walking. Visual status was simulated by goggles covered by the occlusion foil targeted at a Snellen visual acuity of 20/60 (V0.3), 20/200 (V0.1), and light perception (V0). At each of these conditions, the participants completed barefoot walking for five blocks of 10 m. The EEG signals were recorded by a wireless EEG system with electrodes of interest, namely, Cz, Pz, Oz, O1, and O2. The gait performances were assessed by the Vicon system.ResultsDuring walking with normal vision (V1.0), there were cerebral activities related to visual processing, characterized as higher spectral power of delta (Oz and O2 vs. Cz, Pz, and O1, p ≤ 0.033) and theta (Oz vs. Cz and O1, p = 0.044) bands in occipital regions. Moderately blurred vision (V0.3) would attenuate the predominance of delta- and theta-band activities at Oz and O2, respectively. At the statuses of V0.1 and V0, the higher power of delta (at V0.1 and V0, Oz, and O2 vs. Cz, Pz, and O1, p ≤ 0.047) and theta bands (at V0.1, Oz vs. Cz, p = 0.010; at V0, Oz vs. Cz, Pz, and O1, p ≤ 0.016) emerged again. The cautious gait pattern, characterized by a decrease in gait speed (p &lt; 0.001), a greater amplitude of deviation from the right ahead (p &lt; 0.001), a prolonged stance time (p = 0.001), a restricted range of motion in the hip on the right side (p ≤ 0.010), and an increased knee flexion during stance on the left side (p = 0.014), was only detected at the status of V0. The power of the alpha band at the status of V0 was higher than that at V1.0, V0.3, and V0.1 (p ≤ 0.011).ConclusionMildly blurred visual inputs would elicit generalization of low-frequency band activity during walking. In circumstance to no effective visual input, locomotor navigation would rely on cerebral activity related to visual working memory. The threshold to trigger the shift might be the visual status that is as blurred as the level of Snellen visual acuity of 20/200.