bluuebunny/crossref_metadata_2025_split huggingface dataset:
Steroid profiling using liquid chromatography mass spectrometry during adrenal vein sampling in patients with primary bilateral macronodular adrenocortical hyperplasia
Authors: Zhang Ru , Rubinstein German , Vetrivel Sharmilee , Kunz Sonja , Vogel Frederick , Bouys Lucas , Bertherat Jérôme , Kroiss Matthias , Deniz Sinan , Osswald Andrea , Knösel Thomas , Bidlingmaier Martin , Sbiera Silviu , Reincke Martin , Riester Anna 
Published: December 2022

IntroductionAdrenal vein sampling (AVS) is not a routine procedure in patients with primary bilateral macronodular adrenocortical hyperplasia (PBMAH), but has been used to determine lateralization of cortisol secretion in order to guide decision of unilateral adrenalectomy. Our aim was to characterize the steroid fingerprints in AVS samples of patients with PBMAH and hypercortisolism and to identify a reference hormone for AVS interpretation.MethodRetrospectively, we included 17 patients with PBMAH from the German Cushing’s registry who underwent AVS. 15 steroids were quantified in AVS and peripheral blood samples using LC-MS/MS. We calculated lateralization indices and conversion ratios indicative of steroidogenic enzyme activity to elucidate differences between individual adrenal steroidomes and in steroidogenic pathways.ResultsAdrenal volume was negatively correlated with peripheral cortisone (r=0.62, p&lt;0.05). 24-hour urinary free cortisol correlated positively with peripheral androgens (rDHEA=0.57, rDHEAS=0.82, rA=0.73, rT=0.54, p&lt;0.05). DHEA was found to be a powerful reference hormone with high selectivity index, which did not correlate with serume cortisol and has a short half-life. All investigated steroids showed lateralization in single patients indicating the heterogenous steroid secretion pattern in patients with PBMAH. The ratios of corticosterone/aldosterone (catalyzed by CYP11B2), androstenedione/dehydroepiandrosterone (catalyzed by HSD3B2) and cortisone/cortisol (catalyzed by HSD11B2) in adrenal vein samples were higher in smaller adrenals (p&lt;0.05). ARMC5 mutation carriers (n=6) showed lower androstenedione/17-hydroxyprogesterone and higher testosterone/androstenedione (p&lt;0.05) ratios in peripheral blood, in line with lower peripheral androstenedione concentrations (p&lt;0.05).ConclusionSteroid profiling by LC-MS/MS led us to select DHEA as a candidate reference hormone for cortisol secretion. Lateralization and different steroid ratios showed that each steroid and all three steroidogenic pathways may be affected in PBMAH patients. In patients with germline ARMC5 mutations, the androgen pathway was particularly dysregulated.
Safety and efficacy of electrical stimulation for lower-extremity muscle weakness in intensive care unit 2019 Novel Coronavirus patients: A phase I double-blinded randomized controlled trial
Authors: Zulbaran-Rojas Alejandro , Mishra Ramkinker , Rodriguez Naima , Bara Rasha O. , Lee Myeounggon , Bagheri Amir Behzad , Herlihy James P. , Siddique Muhammad , Najafi Bijan 
Published: December 2022

BackgroundIntensive care unit (ICU) prolonged immobilization may lead to lower-extremity muscle deconditioning among critically ill patients, particularly more accentuated in those with 2019 Novel Coronavirus (COVID-19) infection. Electrical stimulation (E-Stim) is known to improve musculoskeletal outcomes. This phase I double-blinded randomized controlled trial examined the safety and efficacy of lower-extremity E-Stim to prevent muscle deconditioning.MethodsCritically ill COVID-19 patients admitted to the ICU were randomly assigned to control (CG) or intervention (IG) groups. Both groups received daily E-Stim (1 h) for up to 14 days on both gastrocnemius muscles (GNMs). The device was functional in the IG and non-functional in the CG. Primary outcomes included ankle strength (Ankles) measured by an ankle-dynamometer, and GNM endurance (GNMe) in response to E-Stim assessed with surface electromyography (sEMG). Outcomes were measured at baseline, 3 and 9 days.ResultsThirty-two (IG = 16, CG = 16) lower extremities in 16 patients were independently assessed. The mean time between ICU admission and E-Stim therapy delivery was 1.8 ± 1.9 days (p = 0.29). At 3 days, the IG showed an improvement compared to the CG with medium effect sizes for Ankles (p = 0.06, Cohen’s d = 0.77) and GNMe (p = 0.06, d = 0.69). At 9 days, the IG GNMe was significantly higher than the CG (p = 0.04, d = 0.97) with a 6.3% improvement from baseline (p = 0.029). E-Stim did not alter vital signs (i.e., heart/respiratory rate, blood saturation of oxygen), showed no adverse events (i.e., pain, skin damage, discomfort), nor interfere with ICU standard of care procedures (i.e., mechanical ventilation, prone rotation).ConclusionThis study supports the safety and efficacy of early E-Stim therapy to potentially prevent deterioration of lower-extremity muscle conditions in critically ill COVID-19 patients recently admitted to the ICU. If confirmed in a larger sample, E-Stim may be used as a practical adjunctive therapy.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT04685213].
Acute thrombocytopenia induced by trastuzumab due to complement reaction: A case report
Authors: Chen Guoping , Ou Jianghua , Liu Jun , Liao Haoran , Ding Linwei , Fan Pingming , Du Guankui 
Published: December 2022

BackgroundThe usual treatment option for HER2 breast cancer is targeted therapy with trastuzumab. The common adverse effects of trastuzumab treatment are thrombocytopenia, however, acute thrombocytopenia is rare and its mechanism is still largely unknown.Case presentationWe reported a patient who presented with acute thrombocytopenia on two consecutive occasions, and the predisposing factor was identified on the second occasion because of trastuzumab-only treatment. Routine blood results showed a dramatic increase in white blood cell count and neutrophil count after both trastuzumab treatments. Moreover, the complement reaction results suggested that the dramatic thrombocytopenia was probably due to platelet destruction after complement activation.ConclusionThis case suggests that it would be useful to perform a platelet complement reaction test before trastuzumab treatment in patients with HER2 breast cancer.
Comparison of Aspergillus-specific antibody cut-offs for the diagnosis of aspergillosis
Authors: Hsiao Chien-Wen , Yen Tsai-Hung , Wu Yen-Ching , Chen Jun-Peng , Chen Yun-Yu , Huang Wen-Nan , Chen Yi-Hsing , Chen Yi-Ming 
Published: December 2022

BackgroundAspergillus diseases are frequently encountered in patients who are immunocompromised. Without a prompt diagnosis, the clinical consequences may be lethal. Aspergillus-specific antibodies have been widely used to facilitate the diagnosis of Aspergillus diseases. To date, universally standardized cut-off values have not been established. This study aimed to investigate the cut-off values of Aspergillus-specific antibodies and perform a narrative review to depict the geographic differences in the Taiwanese population.MethodsWe analyzed enrolled 118 healthy controls, 29 patients with invasive aspergillosis (IA), chronic pulmonary aspergillosis (CPA), and allergic bronchopulmonary aspergillosis (ABPA) and 99 with disease control, who were tested for Aspergillus fumigatus and Aspergillus niger-specific IgG and IgE using ImmunoCAP. 99 participants not fulfilling the diagnosis of IA, CPA, and ABPA were enrolled in the disease control group. The duration of retrieval of medical records from June 2018 to September 2021. Optimal cut-offs and association were determined using receiver operating characteristic curve (ROC) analysis.ResultsWe found that patients with CPA had the highest A. fumigatus-specific IgG levels while patients with ABPA had the highest A. fumigatus-specific IgE, and A. niger-specific IgG and IgE levels. In patients with CPA and ABPA, the optimal cut-offs of A. fumigatus-specific IgG and A. niger-specific IgG levels were 41.6, 40.8, 38.1, and 69.9 mgA/l, respectively. Geographic differences in the cut-off values of A. fumigatus-specific IgG were also noted. Specifically, the levels were different in eco-climatic zones.ConclusionWe identified the optimal cut-offs of Aspergillus-specific antibodies to facilitate a precise diagnosis of aspergillosis. The observed geographic differences of the antibody levels suggest that an eco-climatic-specific reference is needed to facilitate a prompt and accurate diagnosis of aspergillosis.
Instability of non-REM sleep in older women evaluated by sleep-stage transition and envelope analyses
Authors: Park Insung , Kokudo Chihiro , Seol Jaehoon , Ishihara Asuka , Zhang Simeng , Uchizawa Akiko , Osumi Haruka , Miyamoto Ryusuke , Horie Kazumasa , Suzuki Chihiro , Suzuki Yoko , Okura Tomohiro , Diaz Javier , Vogt Kaspar E. , Tokuyama Kumpei 
Published: December 2022

Study objectiveTraditionally, age-related deterioration of sleep architecture in older individuals has been evaluated by visual scoring of polysomnographic (PSG) recordings with regard to total sleep time and latencies. In the present study, we additionally compared the non-REM sleep (NREM) stage and delta, theta, alpha, and sigma wave stability between young and older subjects to extract features that may explain age-related changes in sleep.MethodsPolysomnographic recordings were performed in 11 healthy older (72.6 ± 2.4 years) and 9 healthy young (23.3 ± 1.1 years) females. In addition to total sleep time, the sleep stage, delta power amplitude, and delta, theta, alpha, and sigma wave stability were evaluated by sleep stage transition analysis and a novel computational method based on a coefficient of variation of the envelope (CVE) analysis, respectively.ResultsIn older subjects, total sleep time and slow-wave sleep (SWS) time were shorter whereas wake after sleep onset was longer. The number of SWS episodes was similar between age groups, however, sleep stage transition analysis revealed that SWS was less stable in older individuals. NREM sleep stages in descending order of delta power were: SWS, N2, and N1, and delta power during NREM sleep in older subjects was lower than in young subjects. The CVE of the delta-band is an index of delta wave stability and showed significant differences between age groups. When separately analyzed for each NREM stage, different CVE clusters in NREM were clearly observed between young and older subjects. A lower delta CVE and amplitude were also observed in older subjects compared with young subjects in N2 and SWS. Additionally, lower CVE values in the theta, alpha and sigma bands were also characteristic of older participants.ConclusionThe present study shows a decrease of SWS stability in older subjects together with a decrease in delta wave amplitude. Interestingly, the decrease in SWS stability coincided with an increase in short-term delta, theta, sigma, and alpha power stability revealed by lower CVE. Loss of electroencephalograms (EEG) variability might be a useful marker of brain age.
Quantitative pupillometry and radiographic markers of intracranial midline shift: A pilot study
Authors: Kim Ivy So Yeon , Balogun Oluwafemi O. , Prescott Brenton R. , Saglam Hanife , Olson DaiWai M. , Speir Kinley , Stutzman Sonja E. , Schneider Nathan , Aguilera Veronica , Lussier Bethany L. , Smirnakis Stelios M. , Dupuis Josée , Mian Asim , Greer David M. , Ong Charlene J. 
Published: December 2022

BackgroundAsymmetric pupil reactivity or size can be early clinical indicators of midbrain compression due to supratentorial ischemic stroke or primary intraparenchymal hemorrhage (IPH). Radiographic midline shift is associated with worse functional outcomes and life-saving interventions. Better understanding of quantitative pupil characteristics would be a non–invasive, safe, and cost-effective way to improve identification of life-threatening mass effect and resource utilization of emergent radiographic imaging. We aimed to better characterize the association between midline shift at various anatomic levels and quantitative pupil characteristics.MethodsWe conducted a multicenter retrospective study of brain CT images within 75 min of a quantitative pupil observation from patients admitted to Neuro-ICUs between 2016 and 2020 with large (&gt;1/3 of the middle cerebral artery territory) acute supratentorial ischemic stroke or primary IPH &gt; 30 mm3. For each image, we measured midline shift at the septum pellucidum (MLS-SP), pineal gland shift (PGS), the ratio of the ipsilateral to contralateral midbrain width (IMW/CMW), and other exploratory markers of radiographic shift/compression. Pupil reactivity was measured using an automated infrared pupillometer (NeurOptics®, Inc.), specifically the proprietary algorithm for Neurological Pupil Index® (NPi). We used rank-normalization and linear mixed-effects models, stratified by diagnosis and hemorrhagic conversion, to test associations of radiographic markers of shift and asymmetric pupil reactivity (Diff NPi), adjusting for age, lesion volume, Glasgow Coma Scale, and osmotic medications.ResultsOf 53 patients with 74 CT images, 26 (49.1%) were female, and median age was 67 years. MLS-SP and PGS were greater in patients with IPH, compared to patients with ischemic stroke (6.2 v. 4.0 mm, 5.6 v. 3.4 mm, respectively). We found no significant associations between pupil reactivity and the radiographic markers of shift when adjusting for confounders. However, we found potentially relevant relationships between MLS-SP and Diff NPi in our IPH cohort (β = 0.11, SE 0.04, P = 0.01), and PGS and Diff NPi in the ischemic stroke cohort (β = 0.16, SE 0.09, P = 0.07).ConclusionWe found the relationship between midline shift and asymmetric pupil reactivity may differ between IPH and ischemic stroke. Our study may serve as necessary preliminary data to guide further prospective investigation into how clinical manifestations of radiographic midline shift differ by diagnosis and proximity to the midbrain.
A meta-analysis of brain morphometric aberrations in adolescents who experienced childhood trauma
Authors: Tymofiyeva Olga , Hu Rebecca , Kidambi Roma , Nguyen Ca , Max Jeffrey E. , Yang Tony T. 
Published: December 2022

IntroductionChildhood trauma is known to have dramatic effects on the risks for developing psychiatric disorders and increased suicidality. We conducted a meta-analysis of whole brain voxel-based morphometry (VBM) correlates of childhood trauma in adolescents exposed to childhood maltreatment (N = 379) and unexposed controls (N = 348).MethodsAnisotropic effect size-signed differential mapping (AES-SDM) was utilized to synthesize the studies.ResultsWe observed increased volume amongst adolescents with a history of childhood trauma in regions that are involved in motor functions and language production: left precentral gyrus, including part of the left inferior frontal gyrus, left fibers of the body of corpus callosum, and left postcentral gyrus. We observed decreased volume amongst adolescents with a history of childhood trauma in regions that are involved in language processing and/or sensory processing: bilateral cerebellum, bilateral middle temporal gyrus, left rostrum of corpus callosum, and bilateral supramarginal gyrus.DiscussionWe suggest that these morphometric differences may be reflective of impaired motor development and increased sensory sensitivity and hypervigilance in adolescents with experiences of childhood trauma. Our results differ from meta-analytical findings in adults with history of childhood trauma and may contribute to a better understanding of neural mechanisms of childhood trauma, prediction of neurodevelopmental outcomes, and development of more effective and personalized therapies.
Indigenous yeast can increase the phenolic acid and volatile ester compounds in Petit Manseng wine
Authors: Wang Yanyu , Wang Miao , Li Wenjuan , Wang Xinyuan , Kong Weifu , Huang Weidong , Zhan Jicheng , Xia Guangli , You Yilin 
Published: December 2022

IntroductionIndigenous yeasts are generally found in grapes, vineyards, and natural environments. Sequential inoculation and fermentation with non-Saccharomyces cerevisiae yeast (H30) and Saccharomyces cerevisiae (YT13) also improve the flavor of wine.MethodsThis study sequentially inoculated fermented Petit Manseng and natural grape juice with native H30 and YT13 selected from vineyards in Yantai, China.Results and discussionThe sensory characteristics of Petit Manseng wine were evaluated by detecting the primary organic acids, phenolic acid compounds, and volatile ester compounds. The results showed that the lactic acid content of the natural wine fermented sequentially with H30 and YT13 increased by 490 μg/L compared with the control group, while the ferulic acid content was 1.4 times that of the single-yeast fermentation group. Furthermore, butyrolactone and anthocyanidin propionate were present in the mixed fermentation group, increasing the aroma complexity of Petit Manseng wine and providing high-quality yeast resources that increase the regional characteristics when producing dry white wine.
The prevention and treatment of breast cancer- related lymphedema: A review
Authors: McEvoy Maureen P. , Gomberawalla Ameer , Smith Mark , Boccardo Francesco M. , Holmes Dennis , Djohan Risal , Thiruchelvam Paul , Klimberg Suzanne , Dietz Jill , Feldman Sheldon 
Published: December 2022

BackgroundBreast cancer- related lymphedema (BCRL) affects about 3 to 5 million patients worldwide, with about 20,000 per year in the United States. As breast cancer mortality is declining due to improved diagnostics and treatments, the long-term effects of treatment for BCRL need to be addressed.MethodsThe American Society of Breast Surgeons Lymphatic Surgery Working Group conducted a large review of the literature in order to develop guidelines on BCRL prevention and treatment. This was a comprehensive but not systematic review of the literature. This was inclusive of recent randomized controlled trials, meta-analyses, and reviews evaluating the prevention and treatment of BCRL. There were 25 randomized clinical trials, 13 systemic reviews and meta-analyses, and 87 observational studies included.ResultsThe findings of our review are detailed in the paper, with each guideline being analyzed with the most recent data that the group found evidence of to suggest these recommendations.ConclusionsPrevention and treatment of BCRL involve a multidisciplinary team. Early detection, before clinically apparent, is crucial to prevent irreversible lymphedema. Awareness of risk factors and appropriate practice adjustments to reduce the risk aids are crucial to decrease the progression of lymphedema. The treatment can be costly, time- consuming, and not always effective, and therefore, the overall goal should be prevention.
Predicting of axillary lymph node metastasis in invasive breast cancer using multiparametric MRI dataset based on CNN model
Authors: Zhang Xiaodong , Liu Menghan , Ren Wanqing , Sun Jingxiang , Wang Kesong , Xi Xiaoming , Zhang Guang 
Published: December 2022

PurposeTo develop a multiparametric MRI model for predicting axillary lymph node metastasis in invasive breast cancer.MethodsClinical data and T2WI, DWI, and DCE-MRI images of 252 patients with invasive breast cancer were retrospectively analyzed and divided into the axillary lymph node metastasis (ALNM) group and non-ALNM group using biopsy results as a reference standard. The regions of interest (ROI) in T2WI, DWI, and DCE-MRI images were segmented using MATLAB software, and the ROI was unified into 224 × 224 sizes, followed by image normalization as input to T2WI, DWI, and DCE-MRI models, all of which were based on ResNet 50 networks. The idea of a weighted voting method in ensemble learning was employed, and then T2WI, DWI, and DCE-MRI models were used as the base models to construct a multiparametric MRI model. The entire dataset was randomly divided into training sets and testing sets (the training set 202 cases, including 78 ALNM, 124 non-ALNM; the testing set 50 cases, including 20 ALNM, 30 non-ALNM). Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of models were calculated. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the diagnostic performance of each model for axillary lymph node metastasis, and the DeLong test was performed, P&lt; 0.05 statistically significant.ResultsFor the assessment of axillary lymph node status in invasive breast cancer on the test set, multiparametric MRI models yielded an AUC of 0.913 (95% CI, 0.799-0.974); T2WI-based model yielded an AUC of 0.908 (95% CI, 0.792-0.971); DWI-based model achieved an AUC of 0.702 (95% CI, 0.556-0.823); and the AUC of the DCE-MRI-based model was 0.572 (95% CI, 0.424-0.711). The improvement in the diagnostic performance of the multiparametric MRI model compared with the DWI and DCE-MRI-based models were significant (P&lt; 0.01 for both). However, the increase was not meaningful compared with the T2WI-based model (P = 0.917).ConclusionMultiparametric MRI image analysis based on an ensemble CNN model with deep learning is of practical application and extension for preoperative prediction of axillary lymph node metastasis in invasive breast cancer.
Cost-effectiveness analysis of sintilimab vs. placebo in combination with chemotherapy as first-line therapy for local advanced or metastatic oesophageal squamous cell carcinoma
Authors: Shao Taihang , Zhao Mingye , Tang Wenxi 
Published: December 2022

ObjectiveResults of Orient 15 indicated the health benefits to patients with local advanced or metastatic oesophageal squamous cell carcinoma (OSCC). This study aimed to evaluate the cost-effectiveness of sintilimab plus chemotherapy in treating OSCC from the perspective of Chinese healthcare system.MethodsA partitioned survival model was constructed to evaluate the cost-effectiveness of sintilimab plus chemotherapy vs. chemotherapy in treating OSCC. Baseline characteristics of patients and key clinical data were extracted from Orient 15. Costs and utilities were collected from published studies and open-access databases. Costs, quality-adjusted life-years (QALYs), life-years gained, and incremental cost-effectiveness ratios (ICER) were chosen as economic outcome indicators. We also performed sensitivity analyses and subgroup analyses to verify the stability of results.ResultsCombination therapy provided additional 0.84 QALYs and 1.46 life-years with an incremental cost of $25,565.48 than chemotherapy, which had an ICER of $30,409.44 per QALY. The probabilistic sensitivity analysis indicated that combination therapy had a 98.8% probability of cost-effectiveness at the willingness-to-pay threshold (WTP) of $38,184 per QALY. Deterministic sensitivity analysis showed that model outcomes were sensitive to the utilities of progression-free survival and progression disease. The subgroup analysis revealed that combination therapy was cost-effective in patients with high expression of PD-L1 and several specific subgroups.ConclusionIn this economic evaluation, sintilimab plus chemotherapy was likely to be cost-effective compared with chemotherapy in the first-line therapy of advanced OSCC from the perspective of Chinese healthcare system. Our findings may provide evidence for clinicians to make optimal decisions in clinical practice and for decision-makers to evaluate the cost-effectiveness of sintilimab.