bluuebunny/crossref_metadata_2025_split huggingface dataset:
The diagnostic value of quantitative parameters on dual-layer detector-based spectral CT in identifying ischaemic stroke
Authors: Huang Jian , Chen Jinghua , Wang Ximing , Hao Ling , Zhang Jinfeng , Zhang Xiaohui , Sheng Zhihong , Liu Kefu 
Published: February 2023

ObjectiveTo investigate the diagnostic value of quantitative parameters of spectral computed tomography (CT) in ischaemic stroke areas.MethodsThe medical records of 57 patients with acute ischaemic stroke (AIS) who underwent plain computed tomography (CT) head scans, CT angiography (CTA), and CT perfusion (CTP) were retrospectively reviewed. The ischaemic areas (including the core infarct area and penumbra) and non-ischaemic areas in each patient were quantitatively analyzed using F-STROKE software. Two independent readers measured the corresponding values of the spectroscopic quantitative parameters (effective atomic number [Zeff value], iodine density value, and iodine–no-water value) in the ischaemic area and contralateral normal area alone. The differences in spectroscopic quantitative parameters between the two groups were compared, and their diagnostic efficacy was obtained.ResultsThe Zeff, iodine–no-water value, and iodine density value of the ischaemic area all showed significant lower than those of non-ischaemic tissue (P &lt; 0.001). For differentiating the ischaemic area from non-ischaemic tissue, the area under the curve (AUC) of the Zeff value reached 0.869 (cut-off value: 7.385; sensitivity: 93.0%; specificity: 70.2%), the AUC of the iodine density value reached 0.932 (cut-off value: 0.235; sensitivity: 91.2%; specificity: 82.5%), and the AUC of the iodine–no-water value reached 0.922 (cut-off value: 0.205; sensitivity: 96.5%; specificity: 78.9%).ConclusionThe study showed the spectral CT would be a potential novel rapid method for identifying AIS. The spectral CT quantitative parameters (Zeff, iodine density values, and iodine–no-water values) can effectively differentiate the ischaemic area from non-ischaemic tissue in stroke patients.
Spontaneous nystagmus with an upbeat component: Central or peripheral vestibular disorders?
Authors: Ling Xia , Wu Yue-Xia , Feng Yu-Fei , Zhao Tong-Tong , Zhao Gui-Ping , Kim Ji-Soo , Yang Xu , Wang Zhao-Xia 
Published: February 2023

ObjectiveTo determine the topical diagnosis and etiologies of spontaneous nystagmus (SN) with an upbeat component.MethodsWe retrospectively recruited 43 patients with SN with an upbeat component at a university hospital in China from 2020 to 2022. SN with an upbeat component was divided into pure upbeat nystagmus (UBN), SN with a predominant upbeat component, and SN with a non-predominant upbeat component. We analyzed their clinical and neurotologic findings and the final diagnosis.ResultsFourteen (32.6%) of them showed pure UBN, while 29 (67.4%) exhibited SN mixed with an upbeat component, mixed upbeat-horizontal in 15, mixed upbeat-horizontal-torsional in 13, and upbeat-torsional in the remaining one. Pure UBN and SN with a predominant upbeat component were more common in central than in peripheral vestibular disorders [16 (80.0%) vs. 0 (0%), Chi-Square test, p &lt; 0.001]. Central vestibular disorders were diagnosed in 20 (46.5%) patients, peripheral in 14 (32.6%), and undetermined in nine (20.9%) patients. The underlying causes mainly included acute unilateral peripheral vestibulopathy (n = 11), posterior circulation infarction (n = 9), benign recurrent vertigo (n = 4), vestibular migraine (VM, n = 3), and VM of childhood (n = 2).ConclusionSN with an upbeat component can be seen in both central and peripheral vestibular disorders. Pure UBN was a characteristic sign of central vestibular dysfunction. Central vestibular disorders should be highly suspected when patients show pure UBN or SN with a predominant upbeat component.
Effects of synbiotics supplementation on anthropometric and lipid profile parameters: Finding from an umbrella meta-analysis
Authors: Musazadeh Vali , Mohammadi Anilou Maryam , Vajdi Mahdi , Karimi Arash , Sedgh Ahrabi Sana , Dehghan Parvin 
Published: February 2023

IntroductionSeveral systematic reviews and meta-analyses have been carried out to assess the impact of synbiotics on lipid profiles and anthropometric parameters. In this regard, an umbrella meta-analysis was performed to provide a more accurate view of the overall impacts of synbiotic supplementation on lipid profile and anthropometric parameters.MethodsDatabases such as PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched for this study from inception to January 2022. A random-effects model was applied to evaluate the effects of synbiotic supplementation on lipid profile and anthropometric parameters. The methodological quality of eligible articles was evaluated using the AMSTAR2 questionnaire. The GRADE approach was used to evaluate the overall certainty of the evidence in the meta-analyses.ResultsMeta-analyses of 17 studies revealed significant decreases in body mass index (BMI) (ES: −0.13 kg/m2; 95% CI: −0.19, −0.06, p &lt; 0.001, I2 = 0.0%, p = 0.870), BW (ES: −1.30 kg; 95% CI: −2.19, −0.41, p = 0.004, I2 = 88.9%, p &lt; 0.001), waist circumference (WC) (ES: −1.80 cm; 95% CI: −3.26, −0.34, p = 0.016, I2 = 94.1%, p &lt; 0.001), low-density lipoprotein cholesterol (LDL-C) (ES: −2.81 mg/dl; 95% CI: −3.90, −1.72, p &lt; 0.001, I2 = 95.1%, p &lt; 0.001), total cholesterol (TC) (ES = −2.24 mg/dl; 95% CI: −3.18, −1.30, p &lt; 0.001, I2 = 94.5%, p &lt; 0.001), and triglyceride (TG) (ES: −0.43 mg/dl; 95% CI: −0.79, −0.07, p = 0.019, I2 = 78.0%, p &lt; 0.001) but not high-density lipoprotein cholesterol (HDL-C) (ES: 0.23 mg/dl; 95% CI: −0.11, 0.56, p = 0.193, I2 = 45.2%, p = 0.051) following synbiotic supplementation.DiscussionThe present umbrella meta-analysis suggests synbiotic supplementation can slightly improve lipid profile and anthropometric indices and might be a therapeutic option for obesity and its related disorders.Systematic review registrationwww.crd.york.ac.uk/prospero, identifier CRD42022304376.
Circulating immune index predicting the prognosis of patients with hepatocellular carcinoma treated with lenvatinib and immunotherapy
Authors: Guo De-Zhen , Zhang Shi-Yu , Dong San-Yuan , Yan Jia-Yan , Wang Yu-Peng , Cao Ya , Rao Sheng-Xiang , Fan Jia , Yang Xin-Rong , Huang Ao , Zhou Jian 
Published: February 2023

BackgroundImmune checkpoint inhibitor (ICI)-based combination therapy has opened a new avenue for the treatment of multiple malignancies including hepatocellular carcinoma (HCC). However, considering the unsatisfactory efficacy, biomarkers are urgently needed to identify the patients most likely to benefit from ICI-based combination therapy.MethodsA total of 194 patients undergoing ICI-based combination therapy for unresectable HCC were retrospectively enrolled and divided into a training cohort (n = 129) and a validation cohort (n = 65) randomly. A novel circulating immune index (CII) defined as the ratio of white blood cell count (×109/L) to lymphocyte proportion (%) was constructed and its prognostic value was determined and validated.ResultsPatients with CII ≤ 43.1 reported prolonged overall survival (OS) compared to those with CII &gt; 43.1 (median OS: 24.7 vs 15.1 months; 6-, 12-, 18-month OS: 94.2%, 76.7%, 66.1% vs 86.4%, 68.2%, 22.8%, P = 0.019), and CII was identified as an independent prognostic factor for OS (hazard ratio, 2.24; 95% confidence interval, 1.17-4.31; P = 0.015). These results were subsequently verified in the validation cohort. Additionally, patients with low CII levels had improved best radiological tumor response (complete response, partial response, stable disease, progressive disease: 3%, 36%, 50%, 11% vs 0%, 27%, 46%, 27%; P = 0.037) and disease control rate (89% vs 73%; P = 0.031) in the pooled cohort and better pathologic response (pathologic complete response, major pathologic response, partial pathologic response, no pathologic response: 20%, 44%, 28%, 8% vs 0%, 0%, 40%, 60%; P = 0.005) in the neoadjuvant cohort. Detection of lymphocyte subsets revealed that an elevated proportion of CD4+ T cells was related to better OS, while the proportion of CD8+ T cells was not.ConclusionsWe constructed a novel circulating immune biomarker that was capable of predicting OS and therapeutic efficacy for HCC patients undergoing ICI and lenvatinib combination therapy.
Integrating copy number data of 64 iAMP21 BCP-ALL patients narrows the common region of amplification to 1.57 Mb
Authors: Hormann Femke M. , Hoogkamer Alex Q. , Boeree Aurélie , Sonneveld Edwin , Escherich Gabriele , den Boer Monique L. , Boer Judith M. 
Published: February 2023

Background and purposeIntrachromosomal amplification of chromosome 21 (iAMP21) is a rare subtype of B-cell precursor acute lymphoblastic leukaemia (BCP-ALL). It is unknown how iAMP21 contributes to leukaemia. The currently known commonly amplified region is 5.1 Mb.MethodsWe aimed to narrow down the common region of amplification by using high resolution techniques. Array comparative genomic hybridization (aCGH) was used to determine copy number aberrations, Affymetrix U133 Plus2 expression arrays were used to determine gene expression. Genome-wide expression correlations were evaluated using Globaltest.ResultsWe narrowed down the common region of amplification by combining copy number data from 12 iAMP21 cases with 52 cases from literature. The combined common region of amplification was 1.57 Mb, located from 36.07 to 37.64 Mb (GRCh38). This region is located telomeric from, but not including, RUNX1, which is the locus commonly used to diagnose iAMP21. This narrow region, which falls inside the Down Syndrome critical region, includes 13 genes of which the expression of eight genes was significantly upregulated compared with 143 non-iAMP21 B-other cases. Among these, transcriptional repressor RIPPLY3 (also known as DSCR6) was the highest overexpressed gene (fold change = 4.2, FDR &lt; 0.001) and most strongly correlated (R = 0.58) with iAMP21-related genome-wide expression changes.DiscussionThe more precise definition of the common region of amplification could be beneficial in the diagnosis of iAMP21 based on copy number analysis from DNA sequencing or arrays as well as stimulate functional research into the role of the included genes in iAMP21 biology.
Association of circulating tumor cells and IMP3 expression with metastasis of osteosarcoma
Authors: Dai Shuangwu , Shao Xinxin , Wei Qingzhu , Du Shaohua , Hou Changhe , Li Haomiao , Jin Dadi 
Published: February 2023

BackgroundCirculating tumor cells (CTCs) have been identified as a prognostic biomarker of tumors such as breast cancer and nasopharyngeal carcinoma, because they are obtained through a simple and noninvasive blood draw or liquid biopsy, but its clinical significance in osteosarcoma is still unclear. In this study, we analyzed the relationship between CTCs and clinicopathological features and discussed whether CTCs could be used as a biomarker for metastasis in osteosarcoma.MethodsWe enrolled 50 osteosarcoma patients with Enneking Stage IIB and Stage III and detected CTCs in 5 ml of peripheral blood samples collected from patients using the Canpatrol® CTC detection platform. Subsequently, multiplex RNA in situ hybridization (RNA-ISH) based on various molecular markers was performed to identify and classify CTCs. The relationships between clinical pathological features and CTC counts, subtypes (epithelial type, E type; hybrid epithelial/mesenchymal type, H type; mesenchymal type, M type), and insulin-like growth factor mRNA-binding protein 3 (IMP3) expression in CTCs were analyzed.ResultsCTCs were detected in 86% (43/50) of the osteosarcoma patients. The CTC counts, especially the total CTCs and H-type CTCs, signifcantly differed between Enneking Stage IIB and Stage III patients (P &lt; 0.05). No significant differences were observed between the CTC count or type and other clinicopathological features (P &gt; 0.05). There were significant differences in the expression of IMP3 in different types of CTCs, and the IMP3 positive rates in E/H/M type CTCs were 38.4, 65.6, and 62.0%, respectively (P &lt; 0.001). Receiver operating characteristic (ROC) curve analysis showed that IMP3-positive CTC count had the best performance for diagnostic metastasis, with the largest area under the curve of 0.873 and cutoff value of four cells/5ml blood (sensitivity = 87.5%; specificity = 82.4%). Serial CTC monitoring in one patient suggested that total CTCs and H-type CTCs were associated with disease progression.ConclusionThis study demonstrates that the CTCs, especially the IMP3-positive CTCs and H/M-type CTCs, are related to the metastasis of osteosarcoma.
A feasibility study of pre-sleep audio and visual alpha brain entrainment for people with chronic pain and sleep disturbance
Authors: Halpin Stephen J. , Casson Alexander J. , Tang Nicole K. Y. , Jones Anthony K. P. , O’Connor Rory J. , Sivan Manoj 
Published: February 2023

IntroductionChronic pain and sleep disturbance are bi-directionally related. Cortical electrical activity in the alpha frequency band can be enhanced with sensory stimulation via the phenomenon of entrainment, and may reduce pain perception. A smartphone based programme which delivers 10 Hz stimulation through flickering light or binaural beats was developed for use at night, pre-sleep, with the aim of improving night time pain and sleep and thereby subsequent pain and related daytime symptoms. The aim of this study was to assess the feasibility and give an indication of effect of this programme for individuals with chronic pain and sleep disturbance.Materials and methodsIn a non-controlled feasibility study participants used audio or visual alpha entrainment for 30 min pre-sleep each night for 4 weeks, following a 1 week baseline period. The study was pre-registered at ClinicalTrials.gov with the ID NCT04176861.Results28 participants (79% female, mean age 45 years) completed the study with high levels of data completeness (86%) and intervention adherence (92%). Daily sleep diaries showed an increase compared to baseline in total sleep time of 29 min (p = 0.0033), reduction in sleep onset latency of 13 min (p = 0.0043), and increase in sleep efficiency of 4.7% (p = 0.0009). Daily 0–10 numerical rating scale of average pain at night improved by 0.5 points compared to baseline (p = 0.027). Standardised questionnaires showed significant within-participant improvements in sleep quality (change in median Global PSQI from 16 to 12.5), pain interference (change in median BPI Pain Interference from 7.5 to 6.8), fatigue (change in median MFI total score from 82.5 to 77), and depression and anxiety (change in median HADS depression score from 12 to 10.5 and anxiety from 13.5 to 11).DiscussionPre-sleep use of a smartphone programme for alpha entrainment by audio or visual stimulation was feasible for individuals with chronic pain and sleep disturbance. The effect on symptoms requires further exploration in controlled studies.
Right ventricular electromechanical dyssynchrony in adults with repaired Tetralogy of Fallot
Authors: Bowen Daniel , Kauling Martijn , Loff Barreto Bernardo , McGhie Jackie , Cuypers Judith , Szili-Torok Tamas , Roos-Hesselink Jolien , van den Bosch Annemien 
Published: February 2023

Background and purposeElectromechanical dyssynchrony, manifested by right bundle branch block and regional wall mechanical dysfunction, contributes to inefficient RV function in repaired Tetralogy of Fallot (ToF). This study aims to evaluate the synchronicity of multiple RV walls using two-dimensional multi-plane echocardiography (2D-MPE) in order to augment current understanding of the mechanisms behind RV dyssynchrony.MethodsSixty-nine adult ToF patients [aged 33 (23–45) years; 61% male] and twenty-five matched healthy controls underwent deformational analysis of the RV lateral, anterior, inferior and septal walls following 2D-MPE acquisitions. RV synchronicity was assessed by the intra-RV deformation delay between each basal RV wall and mid-septal segment in addition to mechanical dispersion calculated across four, six and eight segments (MD).ResultsAll RV wall-septum delays plus MD-4 and MD-6 indices were significantly greater in ToF patients compared to healthy controls (p &lt; 0.001–0.03). In ToF patients, the lateral and anterior RV walls were last to reach peak deformation and anterior wall longitudinal strain was lower (p = 0.001). Post systolic shortening of at least one RV wall segment was identified in 19 (28%) ToF patients. Despite similar ECG characteristics, lateral and anterior wall-septum delays were significantly longer in patients with greater degrees of dyssynchrony (73 [37–108]ms vs. 37 [0–63]ms, p = 0.006; 91 [52-116]ms vs. 41 [1–69]ms, p = 0.013), although RV ejection fraction (RVEF) was not significantly lower. MD-4 and MD-8 indices displayed moderate negative associations with RVEF, strengthened by inclusion of lateral wall longitudinal strain (r = 0.64/0.65; p ≤0.01).ConclusionRV dyssynchrony in ToF is characterised by electromechanical delays between the lateral, anterior and septal walls, with anterior wall dysfunction likely associated with surgical repair of the RV outflow tract. Prospectively, 2D-MPE may have an emerging role evaluating RV mechanical response to electrical resynchronisation therapy
Protective effect of antihypertensive drugs on the risk of Parkinson’s disease lacks causal evidence from mendelian randomization
Authors: Jiang Zheng , Gu Xiao-Jing , Su Wei-Ming , Duan Qing-Qing , Ren Yan-Lin , Li Ju-Rong , Chi Li-Yi , Wang Yi , Cao Bei , Chen Yong-Ping 
Published: February 2023

Background: Evidence from observational studies concerning the causal role of blood pressure (BP) and antihypertensive medications (AHM) on Parkinson’s disease (PD) remains inconclusive. A two-sample Mendelian randomization (MR) study was performed to evaluate the unconfounded association of genetic proxies for BP and first-line AHMs with PD.Methods: Instrumental variables (IV) from the genome-wide association study (GWAS) for BP traits were used to proxy systolic BP (SBP), diastolic BP, and pulse pressure. SBP-associated variants either located within encoding regions or associated with the expression of AHM targets were selected and then scaled to proxy therapeutic inhibition of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, calcium channel blockers, and thiazides. Positive control analyses on coronary heart disease (CHD) and stroke were conducted to validate the IV selection. Summary data from GWAS for PD risk and PD age at onset (AAO) were used as outcomes.Results: In positive control analyses, genetically determined BP traits and AHMs closely mimicked the observed causal effect on CHD and stroke, confirming the validity of IV selection methodology. In primary analyses, although genetic proxies identified by “encoding region-based method” for β-blockers were suggestively associated with a delayed PD AAO (Beta: 0.115; 95% CI: 0.021, 0.208; p = 1.63E-2; per 10-mmHg lower), sensitivity analyses failed to support this association. Additionally, MR analyses found little evidence that genetically predicted BP traits, overall AHM, or other AHMs affected PD risk or AAO.Conclusion: Our data suggest that BP and commonly prescribed AHMs may not have a prominent role in PD etiology.
Quality of life in parents of autistic children: A transcultural perspective
Authors: Eapen Valsamma , Karlov Lisa , John James Rufus , Beneytez Carmen , Grimes Poppy Z. , Kang Ying Qi , Mardare Ileana , Minca Dana Galieta , Voicu Laura , Malek Khasnur Abd , Ramkumar Aishworiya , Stefanik Krisztina , Gyori Miklos , Volgyesi-Molnar Marta 
Published: February 2023

IntroductionThe concepts of health, illness, and disability as well as the perceptions of autism and quality of life (QoL) vary greatly across cultures and across time. This study sought to explore the interplay of culture on QoL and impact on parents caring for autistic children.MethodsWe used a transcultural dataset from seven countries (Australia, Hungary, Malaysia, Romania, Singapore, Spain, and the United Kingdom) with participating parents/carers reporting on the Quality of Life in Autism (QoLA) questionnaire. The QoLA questionnaire is a validated measure of QoL for parents of autistic children, with Part A subscale measuring parental QoL and part B subscale assessing the parental impact of the child’s autism spectrum disorder (ASD) symptoms or features. We used the Quade’s ranked analysis of covariance to determine significant differences between the countries in relation to QoLA Part A and Part B scores while adjusting for baseline differences using covariates such as parents’ gender, child’s age, and gender. Additionally, a post-hoc analysis with Bonferroni correction was also conducted to examine multiple pairwise comparisons.Results and conclusionWe found that while the effect of features of ASD (Part B subscale) stayed strongly comparable between cultures, the self-reported parental QoL was most likely determined by different aspects of culture in different countries. It is concluded that while the ASD symptoms or features appear to affect parents in the same way across different countries, the parental QoL may be a culturally informed construct.
Influence of letter shape on readers’ emotional experience, reading fluency, and text comprehension and memorisation
Authors: Medved Tanja , Podlesek Anja , Možina Klementina 
Published: February 2023

IntroductionThe amount of educational material delivered to pupils and students through digital screens is increasing. This method of delivering educational materials has become even more prevalent during the COVID-19 pandemic. To be as effective as possible, educational material must be properly designed not only in terms of content, but also in terms of form, e.g., the typeface. The present study investigated the effect of letter shape on readers’ feelings of pleasantness during reading, reading fluency, and text comprehension and memorisation.MethodsTo find out whether age influences the effects of typeface shape on reading measures, we divided the participants into a group of less experienced readers (children) and more experienced readers (adults). Both groups read texts in eight different typefaces: four of them were round or in rounded shape, and four were angular or in pointed shape. With an eye-tracker, the reading speed and the number of regressive saccades were recorded as measures of reading fluency and changes in pupil size as an indicator of emotional response. After reading each text, the participants rated the pleasantness of the typeface, and their comprehension and memorisation of texts were checked by asking two questions about the text content.ResultsWe found that compared to angular letters or letters in pointed shape, round letters or letters in round shape created more pleasant feelings for readers and lead to a faster reading speed. Children, as expected, read more slowly due to less reading experiences, but, interestingly, had a similar number of regressive saccades and did not comprehend or remember the text worse than university students.DiscussionWe concluded that softer typefaces of rounder shapes should be used in educational materials, as they make the reading process easier and thus support the learning process better for both younger and adult readers. The results of our study also showed that a comparison of findings of different studies may depend on the differences among the used letter shapes.