bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of autonomic dysfunction in neuronal intranuclear inclusion disease
Authors: Zhou Lu , Tian Yun , Zhang Sizhe , Jiao Bin , Liao Xinxin , Zhou Yafang , Xiao Qiao , Xue Jin , Duan Ranhui , Tang Beisha , Shen Lu 
Published: June 2023

BackgroundThis study aimed to investigate the features of autonomic dysfunction (AutD) in a large cohort of patients with neuronal intranuclear inclusion disease (NIID).MethodsA total of 122 patients with NIID and 122 controls were enrolled. All participants completed the Scales for Outcomes in Parkinson’s Disease-Autonomic Questionnaire (SCOPA-AUT) and genetic screening for GGC expanded repeats within the NOTCH2NLC gene. All patients underwent neuropsychological and clinical assessments. SCOPA-AUT was performed to compare AutD between patients and controls. The associations between AutD and disease-related characteristics of NIID were studied.Results94.26% of patients had AutD. Compared with controls, patients had more severe AutD in total SCOPA-AUT, gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor and sexual domains (all p &lt; 0.05). The area under the curve (AUC) value for the total SCOPA-AUT (AUC = 0.846, sensitivity = 69.7%, specificity = 85.2%, cutoff value = 4.5) was high in differentiating AtuD of patients with NIID from controls. The total SCOPA-AUT was significantly and positively associated with age (r = 0.185, p = 0.041), disease duration (r = 0.207, p = 0.022), Neuropsychiatric Inventory (NPI) (r = 0.446, p &lt; 0.01), and Activities of Daily Living (ADL) (r = 0.390, p &lt; 0.01). Patients with onset-of-AutD had higher SCOPA-AUT scores than patients without onset-of-AutD (p &lt; 0.001), especially in the urinary system (p &lt; 0.001) and male sexual dysfunction (p &lt; 0.05).ConclusionSCOPA-AUT can be used as a diagnostic and quantitative tool for autonomic dysfunction in NIID. The high prevalence of AutD in patients suggests that NIID diagnosis should be considered in patients with AutD, especially in those with unexplained AutD alone. AutD in patients is related to age, disease duration, impairment of daily living ability, and psychiatric symptoms.
Predicting the fatigue in Parkinson's disease using inertial sensor gait data and clinical characteristics
Authors: Wang Hui , Hu Binbin , Huang Juan , Chen Lin , Yuan Min , Tian Xingfu , Shi Ting , Zhao Jiahao , Huang Wei 
Published: June 2023

ObjectivesThe study aimed to analyze the clinical features and gait characteristics of patients with Parkinson's disease (PD) who also suffer from fatigue and to develop a model that can help identify fatigue states in the early stages of PD.MethodologyA total of 81 PD patients have been enrolled for the Parkinson's Fatigue Scale (PFS-16) assessment and divided into two groups: patients with or without fatigue. Neuropsychological assessments of the two groups, including motor and non-motor symptoms, were collected. The patient's gait characteristics were collected using a wearable inertial sensor device.ResultsPD patients who experienced fatigue had a more significant impairment of motor symptoms than those who did not, and the experience of fatigue became more pronounced as the disease progressed. Patients with fatigue had more significant mood disorders and sleep disturbances, which can lead to a poorer quality of life. PD patients with fatigue had shorter step lengths, lower velocity, and stride length and increased stride length variability. As for kinematic parameters, PD patients with fatigue had lower shank-forward swing max, trunk-max sagittal angular velocity, and lumbar-max coronal angular velocity than PD patients without fatigue. The binary logistic analysis found that Movement Disorder Society-Unified Parkinson's Disease Rating Scale-I (MDS-UPDRS-I) scores, Hamilton Depression Scale (HAMD) scores, and stride length variability independently predicted fatigue in PD patients. The area under the curve (AUC) of these selected factors in the receiver operating characteristic (ROC) analysis was 0.900. Moreover, HAMD might completely mediate the association between Hamilton Anxiety Scale (HAMA) scores and fatigue (indirect effect: β = 0.032, 95% confidence interval: 0.001–0.062), with a percentage of mediation of 55.46%.ConclusionCombining clinical characteristics and gait cycle parameters, including MDS-UPDRS-I scores, HAMD scores, and stride length variability, can identify PD patients with a high fatigue risk.
Association between cognitive diagnosis and a range of significant life events in an elderly essential tremor cohort: a longitudinal, prospective analysis
Authors: Berry Diane S. , Nguyen Diep , Cosentino Stephanie , Louis Elan D. 
Published: June 2023

BackgroundAlthough essential tremor (ET) patients have greater odds of mild cognitive impairment (MCI) and dementia than age-matched controls, the functional consequences of these enhanced odds are unknown. We examined associations between cognitive diagnosis and the occurrence of near falls, falls, use of a walking aid or a home health aide, non-independent living, or hospitalizations within a prospective, longitudinal study of ET patients.MethodsA total of 131 ET patients (mean baseline age = 76.4 ± 9.4 years) completed a battery of neuropsychological tests and questions about life events and were assigned diagnoses of normal cognition (NC), MCI, or dementia at the baseline and at 18-, 36-, and 54-month follow-ups. Kruskall–Wallis, chi-square, and Mantel–Haenszel tests assessed whether the diagnosis was associated with the occurrence of these life events.ResultsPatients with final diagnoses of dementia were more often reported as living non-independently than NC or MCI patients and more often used walking aids than NC patients, with a p-value of &lt;0.05. Patients with a final MCI or dementia diagnosis more often employed a home health aide than NC patients, with a p-value of &lt;0.05. Moreover, Mantel–Haenzsel tests revealed linear associations between the occurrence of these outcomes and the level of cognitive impairment, with a p-value of &lt;0.001 (i.e., dementia &gt; MCI &gt; NC).ConclusionCognitive diagnosis was associated with reported life events of ET patients, including the use of a mobility aid, employment of a home health aide, and removal from an independent living situation. These data provide rare insights into the important role cognitive decline plays in the experiences of ET patients.
Neuromodulation in new-onset refractory status epilepticus
Authors: Stavropoulos Ioannis , Khaw Jin Han , Valentin Antonio 
Published: June 2023

BackgroundNew-onset refractory status epilepticus (NORSE) and its subset of febrile infection-related epilepsy syndrome (FIRES) are devastating clinical presentations with high rates of mortality and morbidity. The recently published consensus on the treatment of these conditions includes anesthetics, antiseizure drugs, antivirals, antibiotics, and immune therapies. Despite the internationally accepted treatment, the outcome remains poor for a significant percentage of patients.MethodsWe conducted a systematic review of the use of neuromodulation techniques in the treatment of the acute phase of NORSE/FIRES using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.ResultsOur search strategy brought up 74 articles of which 15 met our inclusion criteria. A total of 20 patients were treated with neuromodulation. Thirteen cases represented FIRES and in 17 cases the NORSE remained cryptogenic. Ten had electroconvulsive therapy (ECT), seven had vagal nerve stimulation (VNS), and four had deep brain stimulation (DBS); one patient had initially VNS and later DBS. Eight patients were female and nine were children. In 17 out of 20 patients, the status epilepticus was resolved after neuromodulation, while three patients died.ConclusionNORSE can have a catastrophic course and the first treatment goal should be the fastest possible termination of status epilepticus. The data presented are limited by the small number of published cases and the variability of neuromodulation protocols used. However, they show some potential clinical benefits of early neuromodulation therapy, suggesting that these techniques could be considered within the course of FIRES/NORSE.
Classification of temporal lobe epilepsy based on neuropsychological tests and exploration of its underlying neurobiology
Authors: Meng Xianghong , Deng Kan , Huang Bingsheng , Lin Xiaoyi , Wu Yingtong , Tao Wei , Lin Chuxuan , Yang Yang , Chen Fuyong 
Published: June 2023

ObjectiveTo assist improving long-term postoperative seizure-free rate, we aimed to use machine learning algorithms based on neuropsychological data to differentiate temporal lobe epilepsy (TLE) from extratemporal lobe epilepsy (extraTLE), as well as explore the relationship between magnetic resonance imaging (MRI) and neuropsychological tests.MethodsTwenty-three patients with TLE and 23 patients with extraTLE underwent neuropsychological tests and MRI scans before surgery. The least absolute shrinkage and selection operator were firstly employed for feature selection, and a machine learning approach with neuropsychological tests was employed to classify TLE using leave-one-out cross-validation. A generalized linear model was used to analyze the relationship between brain alterations and neuropsychological tests.ResultsWe found that logistic regression with the selected neuropsychological tests generated classification accuracies of 87.0%, with an area under the receiver operating characteristic curve (AUC) of 0.89. Three neuropsychological tests were acquired as significant neuropsychological signatures for the diagnosis of TLE. We also found that the Right-Left Orientation Test difference was related to the superior temporal and the banks of the superior temporal sulcus (bankssts). The Conditional Association Learning Test (CALT) was associated with the cortical thickness difference in the lateral orbitofrontal area between the two groups, and the Component Verbal Fluency Test was associated with the cortical thickness difference in the lateral occipital cortex between the two groups.ConclusionThese results showed that machine learning-based classification with the selected neuropsychological data can successfully classify TLE with high accuracy compared to previous studies, which could provide kind of warning sign for surgery candidate of TLE patients. In addition, understanding the mechanism of cognitive behavior by neuroimaging information could assist doctors in the presurgical evaluation of TLE.
Representation and decoding of bilateral arm motor imagery using unilateral cerebral LFP signals
Authors: Lin Jiafan , Lai Dongrong , Wan Zijun , Feng Linqing , Zhu Junming , Zhang Jianmin , Wang Yueming , Xu Kedi 
Published: June 2023

IntroductionIn the field of upper limb brain computer interfaces (BCIs), the research focusing on bilateral decoding mostly based on the neural signals from two cerebral hemispheres. In addition, most studies used spikes for decoding. Here we examined the representation and decoding of different laterality and regions arm motor imagery in unilateral motor cortex based on local field potentials (LFPs).MethodsThe LFP signals were recorded from a 96-channel Utah microelectrode array implanted in the left primary motor cortex of a paralyzed participant. There were 7 kinds of tasks: rest, left, right and bilateral elbow and wrist flexion. We performed time-frequency analysis on the LFP signals and analyzed the representation and decoding of different tasks using the power and energy of different frequency bands.ResultsThe frequency range of &lt;8 Hz and &gt;38 Hz showed power enhancement, whereas 8–38 Hz showed power suppression in spectrograms while performing motor imagery. There were significant differences in average energy between tasks. What’s more, the movement region and laterality were represented in two dimensions by demixed principal component analysis. The 135–300 Hz band signal had the highest decoding accuracy among all frequency bands and the contralateral and bilateral signals had more similar single-channel power activation patterns and larger signal correlation than contralateral and ipsilateral signals, bilateral and ipsilateral signals.DiscussionThe results showed that unilateral LFP signals had different representations for bilateral motor imagery on the average energy of the full array and single-channel power levels, and different tasks could be decoded. These proved the feasibility of multilateral BCI based on the unilateral LFP signal to broaden the application of BCI technology.Clinical trial registrationhttps://www.chictr.org.cn/showproj.aspx?proj=130829, identifier ChiCTR2100050705.
Age-integrated artificial intelligence framework for sleep stage classification and obstructive sleep apnea screening
Authors: Kang Chaewon , An Sora , Kim Hyeon Jin , Devi Maithreyee , Cho Aram , Hwang Sungeun , Lee Hyang Woon 
Published: June 2023

IntroductionSleep is an essential function to sustain a healthy life, and sleep dysfunction can cause various physical and mental issues. In particular, obstructive sleep apnea (OSA) is one of the most common sleep disorders and, if not treated in a timely manner, OSA can lead to critical problems such as hypertension or heart disease.MethodsThe first crucial step in evaluating individuals’ quality of sleep and diagnosing sleep disorders is to classify sleep stages using polysomnographic (PSG) data including electroencephalography (EEG). To date, such sleep stage scoring has been mainly performed manually via visual inspection by experts, which is not only a time-consuming and laborious process but also may yield subjective results. Therefore, we have developed a computational framework that enables automatic sleep stage classification utilizing the power spectral density (PSD) features of sleep EEG based on three different learning algorithms: support vector machine, k-nearest neighbors, and multilayer perceptron (MLP). In particular, we propose an integrated artificial intelligence (AI) framework to further inform the risk of OSA based on the characteristics in automatically scored sleep stages. Given the previous finding that the characteristics of sleep EEG differ by age group, we employed a strategy of training age-specific models (younger and older groups) and a general model and comparing their performance.ResultsThe performance of the younger age-specific group model was similar to that of the general model (and even higher than the general model at certain stages), but the performance of the older age-specific group model was rather low, suggesting that bias in individual variables, such as age bias, should be considered during model training. Our integrated model yielded an accuracy of 73% in sleep stage classification and 73% in OSA screening when MLP algorithm was applied, which indicates that patients with OSA could be screened with the corresponding accuracy level only with sleep EEG without respiration-related measures.DiscussionThe current outcomes demonstrate the feasibility of AI-based computational studies that when combined with advances in wearable devices and relevant technologies could contribute to personalized medicine by not only assessing an individuals’ sleep status conveniently at home but also by alerting them to the risk of sleep disorders and enabling early intervention.
In Type 2 Diabetes Mellitus, normalization of hemoglobin A1c accompanies reduced sensitivity to pressure at the sternum
Authors: Faber Jens , Ballegaard Søren , Ørsted Nanna , Eldrup Ebbe , Karpatschof Benny , Gyntelberg Finn , Hecquet Sofie Korsgaard , Gjedde Albert 
Published: June 2023

BackgroundThe autonomic nervous system (ANS) maintains glucose homeostasis. While higher than normal glucose levels stimulate the ANS toward reduction, previous findings suggest an association between sensitivity to, or pain from, pressure at the chest bone (pressure or pain sensitivity, PPS) and activity of the ANS. A recent randomized controlled trial (RCT) of type 2 diabetes (T2DM) suggested that addition of an experimental, non-pharmacological intervention more effectively than conventional treatment lowered the levels of both PPS and HbA1c.Materials and analysesWe tested the null hypothesis that conventional treatment (n = 60) would reveal no association between baseline HbA1c and normalization of HbA1c in 6 months, related to change of PPS. We compared the changes of HbA1c in PPS reverters who experienced a minimum reduction of 15 units of PPS and in PPS non-reverters who experienced no reduction. Depending on the result, we tested the association in a second group of participants with addition of the experimental program (n = 52).ResultsIn the conventional group, PPS reverters experienced normalization of HbA1c that corrected the basal increase, thus disproving the null hypothesis. With the addition of the experimental program, PPS reverters experienced similar reduction. The reduction of HbA1c among reverters averaged 0.62 mmol/mol per mmol/mol increase of baseline HbA1c (P &lt; 0.0001 compared to non-reverters). For baseline HbA1c ≥ 64 mmol/mol, reverters averaged 22% reduction of HbA1c (P &lt; 0.01).ConclusionIn consecutive analyses of two different populations of individuals with T2DM, we demonstrated that the higher the baseline HbA1c, the greater the reduction of HbA1c but only in individuals with a concomitant reduction of sensitivity to PPS, suggesting a homeostatic effect of the autonomic nervous system on glucose metabolism. As such, ANS function, measured as PPS, is an objective measure of HbA1c homeostasis. This observation may be of great clinical importance.
Probiotics for the prevention of mortality and sepsis in preterm very low birth weight neonates from low- and middle-income countries: a Bayesian network meta-analysis
Authors: Thomas Deena , Sharma Akash , Sankar M. Jeeva 
Published: June 2023

BackgroundProbiotics have been shown to reduce the risk of mortality and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) neonates. The probiotic species with the maximal benefits in neonates from low- and middle-income countries are unknown.ObjectiveTo identify the strain of probiotics with the maximum benefit in preventing neonatal mortality, sepsis, and NEC using the Bayesian network meta-analysis.Search methodsWe searched Medline via PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). We also hand-searched reference lists of previous systematic reviews to identify eligible studies.Selection criteriaRandomized controlled trials (RCTs) from LMICs comparing enteral supplementation of one or more probiotics with another probiotic species or placebo were included.Data collection and analysisTwo authors screened the studies, extracted the data, and examined the risk of bias using the Cochrane risk of bias 2 (RoB 2) tools. Bayesian network meta-analysis was performed using the “BUGSnet” package in R and RStudio (version 1.4.1103). The confidence in the findings was assessed using the Confidence in Network Meta-analysis (CINeMA) web application.ResultsTwenty-nine RCTs enrolling 4,906 neonates and evaluating 24 probiotics were included. Only 11 (38%) studies had a low risk of bias. All the studies compared the probiotics with a placebo; none had a head-to-head comparison of different probiotic species. Also, only one study each had evaluated most probiotic regimens. When compared to placebo, the combination of B longum, B bifidum, B infantis, and L acidophilus may reduce the risk of mortality (relative risk [RR] 0.26; 95% credible interval [CrI] 0.07 to 0.72), sepsis (RR 0.47; 95% CrI 0.25 to 0.83), and NEC (RR 0.31; 95% CrI 0.10 to 0.78) but the evidence is very uncertain. There is low certainty evidence that the single probiotic species, B lactis, could reduce the risk of mortality (RR 0.21; 0.05 to 0.66) and NEC (RR 0.09; 0.01 to 0.32).ConclusionGiven the low to very low certainty of evidence for the efficacy of the two probiotics found to reduce mortality and necrotizing enterocolitis, no firm conclusions can be made on the optimal probiotics for use in preterm neonates in low- and middle-income countries.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022353242, identifier: CRD42022353242.
Chronic obstructive pulmonary disease alters the genetic landscape and tumor immune microenvironment in lung cancer patients
Authors: Zhang Qiurui , Feng Xijia , Hu Weiting , Li Chengqiang , Sun Debin , Peng Zhao , Wang Shengzhou , Li Hecheng , Zhou Min 
Published: June 2023

BackgroundChronic obstructive pulmonary disease (COPD) and lung cancer are leading causes of morbidity and mortality worldwide. Studies have reported molecular alterations in patients with lung cancer and in patients with COPD. However, few investigation has been conducted on the molecular characteristics of lung cancer patients with COPD.Materials and methodsWe performed a retrospective cohort study that included 435 patients with pathologically confirmed lung cancer at the Ruijin Hospital. For patients with documented spirometry, Global Initiative for Chronic Obstructive Lung Disease criteria were used to define COPD. For patients without documented spirometry, chest computed tomography and other clinical information were used to define COPD. Tumor tissue DNA was extracted from formalin-fixed paraffin-embedded samples. DNA mutation analysis, multiplex immunohistochemistry (mIHC), calculation of tumor mutational burden (TMB), mutant-allele tumor heterogeneity (MATH), and predication of neoantigens were performed.ResultsAlthough SNV mutations in lung cancer patients with COPD (G1 group) were generally higher than those in lung cancer patients without COPD (G2 group), the difference in the number of mutations was insignificant between the two groups. Of the 35 mutated genes, the number of them was higher in G1 than in G2, except that of EGFR. PI3K-Akt signaling pathway was enriched from significantly different genes. While TMB and MATH levels were not significantly different, the tumor neoantigen burdenwas markedly higher in G1 than that in G2. The level of CD68+ macrophages was significant higher in the stroma and total areas in the G1 group than in G2 group. The level of CD8+ lymphocytes was markedly higher in the stroma and showed a clear tendency forhigher expression in the G1 group than inthe G2 group. No significant differences were observed for the level of programmed death-ligand 1+ (PD-L1+), programmed death 1+ (PD-1+), and CD68PD-L1 in the stroma, tumor and total areas.ConclusionOur study revealed different genetic aberrations and pathways, higher neoantigen burden, and higher level of CD68+ macrophages and CD8+ T lymphocytes in lung cancer patients with COPD. Our investigation implies that the existence of COPD should be considered and immunotherapy is a potential choice when treating lung cancer patients with COPD.