bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring New Characteristics: Using Deep Learning and 3D Reconstruction to Compare the Original COVID-19 and Its Delta Variant Based on Chest CT
Authors: Bai Na , Lin Ruikai , Wang Zhiwei , Cai Shengyan , Huang Jianliang , Su Zhongrui , Yao Yuanzhen , Wen Fang , Li Han , Huang Yuxin , Zhao Yi , Xia Tao , Lei Mingsheng , Yang Weizhen , Qiu Zhaowen 
Published: March 2022

Purpose: Computer-aided diagnostic methods were used to compare the characteristics of the Original COVID-19 and its Delta Variant.Methods: This was a retrospective study. A deep learning segmentation model was applied to segment lungs and infections in CT. Three-dimensional (3D) reconstruction was used to create 3D models of the patient’s lungs and infections. A stereoscopic segmentation method was proposed, which can subdivide the 3D lung into five lobes and 18 segments. An expert-based CT scoring system was improved and artificial intelligence was used to automatically score instead of visual score. Non-linear regression and quantitative analysis were used to analyze the dynamic changes in the percentages of infection (POI).Results: The POI in the five lung lobes of all patients were calculated and converted into CT scores. The CT scores of Original COVID-19 patients and Delta Variant patients since the onset of initial symptoms were fitted over time, respectively. The peak was found to occur on day 11 in Original COVID-19 patients and on day 15 in Delta Variant patients. The time course of lung changes in CT of Delta Variant patients was redetermined as early stage (0–3 days), progressive and peak stage (4–16 days), and absorption stage (17–42 days). The first RT-PCR negative time in Original COVID-19 patients appeared earlier than in Delta Variant patients (22 [17–30] vs. 39 [31–44], p &lt; 0.001). Delta Variant patients had more re-detectable positive RT-PCR test results than Original COVID-19 patients after the first negative RT-PCR time (30.5% vs. 17.1%). In the early stage, CT scores in the right lower lobe were significantly different (Delta Variant vs. Original COVID-19, 0.8 ± 0.6 vs. 1.3 ± 0.6, p = 0.039). In the absorption stage, CT scores of the right middle lobes were significantly different (Delta Variant vs. Original COVID-19, 0.6 ± 0.7 vs. 0.3 ± 0.4, p = 0.012). The left and the right lower lobes contributed most to lung involvement at any given time.Conclusion: Compared with the Original COVID-19, the Delta Variant has a longer lung change duration, more re-detectable positive RT-PCR test results, different locations of pneumonia, and more lesions in the early stage, and the peak of infection occurred later.
Sensorimotor Rhythm-Brain Computer Interface With Audio-Cue, Motor Observation and Multisensory Feedback for Upper-Limb Stroke Rehabilitation: A Controlled Study
Authors: Li Xin , Wang Lu , Miao Si , Yue Zan , Tang Zhiming , Su Liujie , Zheng Yadan , Wu Xiangzhen , Wang Shan , Wang Jing , Dou Zulin 
Published: March 2022

Several studies have shown the positive clinical effect of brain computer interface (BCI) training for stroke rehabilitation. This study investigated the efficacy of the sensorimotor rhythm (SMR)-based BCI with audio-cue, motor observation and multisensory feedback for post-stroke rehabilitation. Furthermore, we discussed the interaction between training intensity and training duration in BCI training. Twenty-four stroke patients with severe upper limb (UL) motor deficits were randomly assigned to two groups: 2-week SMR-BCI training combined with conventional treatment (BCI Group, BG,n= 12) and 2-week conventional treatment without SMR-BCI intervention (Control Group, CG,n= 12). Motor function was measured using clinical measurement scales, including Fugl-Meyer Assessment-Upper Extremities (FMA-UE; primary outcome measure), Wolf Motor Functional Test (WMFT), and Modified Barthel Index (MBI), at baseline (Week 0), post-intervention (Week 2), and follow-up week (Week 4). EEG data from patients allocated to the BG was recorded at Week 0 and Week 2 and quantified by mu suppression means event-related desynchronization (ERD) in mu rhythm (8–12 Hz). All functional assessment scores (FMA-UE, WMFT, and MBI) significantly improved at Week 2 for both groups (p&lt; 0.05). The BG had significantly higher FMA-UE and WMFT improvement at Week 4 compared to the CG. The mu suppression of bilateral hemisphere both had a positive trend with the motor function scores at Week 2. This study proposes a new effective SMR-BCI system and demonstrates that the SMR-BCI training with audio-cue, motor observation and multisensory feedback, together with conventional therapy may promote long-lasting UL motor improvement.Clinical Trial Registration:[http://www.chictr.org.cn], identifier [ChiCTR2000041119].
Short- and Mid-Term Impacts of COVID-19 Outbreak on the Nutritional Quality and Environmental Impact of Diet
Authors: Marty Lucile , de Lauzon-Guillain Blandine , Nicklaus Sophie 
Published: March 2022

BackgroundChanges in dietary behaviors that occurred at the beginning of the COVID-19 outbreak and in particular during the first national lockdowns have been extensively studied across countries. Beyond the understanding of contextual changes in diets due to a temporary lockdown, it is of interest to study longer-term consequences of the COVID-19 outbreak as sustained changes in diets may have both an impact on population health and the environment.ObjectivesThis study aimed to examine both short- (after 1 month) and mid-term (after 1 year) impacts of the COVID-19 outbreak on the nutritional quality and environmental impact of diets, and as a secondary objective on food choice motives.MethodsWe collected dietary data [food frequency questionnaire (FFQ)] and the importance of nine food choice motives through online questionnaires before, during, and after 1 year of the first lockdown for 524 French participants. Adherence to the French dietary recommendations was estimated using the simplified PNNS-GS2, which scores from −17 to 11.5. Environmental impact of diets was assessed by calculating greenhouse gas emissions in CO2eq/2,000 kcal.ResultsWe showed a short-term decrease in nutritional quality (−0.26 points on sPNNS-GS2, p = 0.017) and environmental impact (−0.17 kg CO2eq/2,000 kcal, p = 0.004) but this decrease was only temporary, and nutritional quality (−0.01 points on sPNNS-GS2, p = 0.974) and environmental impact (−0.04 kg CO2eq/2,000 kcal, p = 0.472) were not different from their initial values 1 year later. Some of the food choice motives followed the trend of a short-term increase and a mid-term stability (health, natural content, ethical concern, and weight control). On the contrary, we showed both short- and mid-term decreases in convenience, familiarity, and price motives.ConclusionChanges in diets and motives observed during the first lockdown were mostly temporary. However, we highlighted a sustained decrease in the importance of perceived constraints due to food shopping and food preparation which may suggest a trend toward a more positive perception of food-related activities.
Single-Cell RNA Sequencing Revealed a 3-Gene Panel Predicted the Diagnosis and Prognosis of Thyroid Papillary Carcinoma and Associated With Tumor Immune Microenvironment
Authors: Chen Zuoyu , Wang Yizeng , Li Dongyang , Le Yuting , Han Yue , Jia Lanning , Yan Caigu , Tian Zhigang , Song Wenbin , Li Fuxin , Zhao Ke , He Xianghui 
Published: March 2022

ObjectiveThe objective of this research was to screen prognostic related genes of thyroid papillary carcinoma (PTC) by single-cell RNA sequencing (scRNA-seq), to construct the diagnostic and prognostic models based on The Cancer Genome Atlas Thyroid Cancer (TCGA-THCA) data, and to evaluate the association between tumor immune microenvironment and the prognostic model.MethodThe differentially expressed genes (DEGs) and tumor evolution were analyzed by scRNA-seq based on public databases. The potential regulatory networks of DEGs related to prognosis were analyzed by multi-omics data in the THCA. Logistic regression and Cox proportional hazards regression were utilized to construct the diagnosis and prognostic model of PTC. The performance of the diagnostic model was verified by bulk RNA sequencing (RNA-seq) of our cohort. The tumor immune microenvironment associated with the prognostic model was evaluated using multi-omics data. In addition, qRT-PCR was performed on tumor tissues and adjacent normal tissues of 20 patients to verify the expression levels of DEGs.ResultsThe DEGs screened by scRNA-seq can distinguish between tumor and healthy samples. DEGs play different roles in the evolution from normal epithelial cells to malignant cells. Three DEGs ((FN1, CLU, and ANXA1)) related to prognosis were filtered, which may be regulated by DNA methylation, RNA methylation (m6A) and upstream transcription factors. The area under curve (AUC) of the diagnostic model based on 3-gene in the validation of our RNA-seq was 1. In the prognostic model based on 3-gene, the overall survival (OS) of high-risk patients was shorter. Combined with the clinical information of patients, a nomogram was constructed by using tumor size (pT) and risk score to quantify the prognostic risk. The age and tumor size of high-risk patients in the prognostic model were greater. In addition, the increase of tumor mutation burden (TMB) and diversity of T cell receptor (TCR), and the decrease of CD8+ T cells in high-risk group suggest the existence of immunosuppressive microenvironment.ConclusionWe applied the scRNA-seq pipeline to focus on epithelial cells in PTC, simulated the process of tumor evolution, and revealed a prognostic prediction model based on 3 genes, which is related to tumor immune microenvironment.
Association Between Neonatal Arrhythmia and Mortality and Recurrence: A Retrospective Study
Authors: Ran Lihong , Li Jie , Bao Lei , Chen Long 
Published: March 2022

ObjectiveThe aim of the present study was to explore the association between neonatal arrhythmia (NA) and mortality and recurrence.MethodsA single-center, retrospective study was performed between January 1, 2015, and December 31, 2019. Neonates with NA were eligible and divided into either benign or non-benign groups. The primary outcomes were mortality and recurrence within 2 to 6 years.ResultsNA was diagnosed in 189 patients (0.39%) after screening 47,911 hospitalized neonates, and 10 of them did not finish the follow-up. Finally, 179 neonates were included into the final analysis (58 in the non-benign NA and 121 in the benign NA groups). The incidences of death and recurrence for NA were 5.59% (10/179) and 18.44% (33/179). Compared with neonates with benign NA, those neonates with non-benign NA were shown higher rates of death (13.79% vs. 1.65%; odds ratio [OR], 5.73; 95% confidence interval [CI], 1.07–31.01; p = 0.04) and recurrence (44.83% vs. 5.79%; OR, 8.49; 95% CI, 3.12–23.08; p &lt; 0.001).ConclusionsNeonates with non-benign NA were shown higher rates of death and recurrence when compared with benign NA. Because of high recurrence, more attention was needed in neonates with non-benign NA after discharge.
Atypical Neurological Manifestation in Childhood Microscopic Polyangiitis: A Case Report and Review of Literature
Authors: Suksai Preawkalaya , Wasuanankun Suphawe , Lekhavat Vitit , Sirimongkolchaiyakul Ornatcha , Tangcheewinsirikul Sirikarn 
Published: March 2022

Microscopic polyangiitis (MPA), a systemic necrotizing vasculitis of small vessels, is primarily associated with necrotizing and crescentic glomerulonephritis and pulmonary capillaritis. Neurological involvement, particularly of the central nervous system (CNS) is scarcely observed. The diversity of CNS symptoms could puzzle the diagnosis causing delays in treatment and potentially having a considerable effect on patient's quality of life or even death. The aim of this case report is to highlight the unusual manifestation of MPA in order to raise awareness of this orphaned disease among pediatricians or even pediatric rheumatologists and neurologists.Case ReportHerein we report the case of a 13-year-old Thai girl diagnosed with MPA presented with rapidly progressive glomerulonephritis (RPGN). Renal biopsy was performed demonstrated crescentic glomerulonephritis with negative immunofluorescence and positive titer of myeloperoxidase (MPO) antibody. Pulse methylprednisolone (MP) and cyclophosphamide (CYC) as well as plasmapheresis were initiated. Despite treatment with prednisolone (45 mg/day) and monthly CYC for two doses, she experienced a brief generalized tonic–clonic seizure during the follow-up period. The potential differential diagnosis of new-onset neurological manifestation contains infection owing to the immunocompromised status of the patient and CNS vasculitis as a result of the disease itself. Lumbar puncture was performed, and cerebrospinal fluid analysis demonstrated pleocytosis with negative infectious panel. Contrast magnetic resonance imaging studies of the brain showed multifocal patchy T2/FLAIR-hyperintense lesions in the cerebral as well as cerebellum regions, and irregular narrowing along the V4 segment of the right vertebral artery was demonstrated in magnetic resonance angiography. In the presence of CNS vasculitis, pulse MP and CYC were provided. The symptom of nervous system has progressively improved.ConclusionIn our case, MPA revealed RPGN with neurological manifestation. Despite the fact that it is scarcely reported, CNS vasculitis is one of the organ-threatening symptoms. To improve patient morbidity and mortality, multidisciplinary care teams with prompt diagnosis and treatment are highly recommended.
Identifying Patients at Risk of Acute Kidney Injury Among Medicare Beneficiaries With Type 2 Diabetes Initiating SGLT2 Inhibitors: A Machine Learning Approach
Authors: Yang Lanting , Gabriel Nico , Hernandez Inmaculada , Vouri Scott M. , Kimmel Stephen E. , Bian Jiang , Guo Jingchuan 
Published: March 2022

Introduction: To predict acute kidney injury (AKI) risk in patients with type 2 diabetes (T2D) prescribed sodium-glucose cotransporter two inhibitors (SGLT2i).Methods: Using a 5% random sample of Medicare claims data, we identified 17,694 patients who filled ≥1 prescriptions for canagliflozin, dapagliflozin and empagliflozin in 2013–2016. The cohort was split randomly and equally into training and testing sets. We measured 65 predictor candidates using claims data from the year prior to SGLT2i initiation. We then applied three machine learning models, including random forests (RF), elastic net and least absolute shrinkage and selection operator (LASSO) for risk prediction.Results: The incidence rate of AKI was 1.1% over a median 1.5 year follow up. Among three machine learning methods, RF produced the best prediction (C-statistic = 0.72), followed by LASSO and elastic net (both C-statistics = 0.69). Among individuals classified in the top 10% of the RF risk score (i.e., high risk group), the actual incidence rate of AKI was as high as 3.7%. In the logistic regression model including 14 important risk factors selected by LASSO, use of loop diuretics [adjusted odds ratio (95% confidence interval): 3.72 (2.44–5.76)] had the strongest association with AKI incidence.Disscusion: Our machine learning model efficiently identified patients at risk of AKI among Medicare beneficiaries with T2D undergoing SGLT2i treatment.
Nocebo Effects of Clinical Communication and Placebo Effects of Positive Suggestions on Respiratory Muscle Strength
Authors: Zech Nina , Scharl Leoni , Seemann Milena , Pfeifer Michael , Hansen Ernil 
Published: March 2022

Introduction:The effects of specific suggestions are usually studied by measuring parameters that are directly addressed by these suggestions. We recently proposed the use of a uniform, unrelated, and objective measure like maximal muscle strength that allows comparison of suggestions to avoid nocebo effects and thus to improve communication. Since reduced breathing strength might impair respiration and increase the risk of post-operative pulmonary complications, the aim of the present study was to evaluate the effects of the suggestions on respiratory muscle power. Both the identification and neutralization of negative suggestions in the clinical context and stimulating suggestions could improve breathing force, a predictor of physical fitness and convalescence.MethodsIn 50 healthy, adult volunteers, respiratory muscle strength was measured by maximal inspiratory and expiratory pressures, as well as by maximal inspiratory and expiratory flows. Baseline was compared to values after application of eleven suggestions, five out of clinical context, including memory of negative or positive past, risk information for informed consent, and a non-verbal suggestion. Six stimulating suggestions included self-affirmation, empowering words, a heroic mirror image, and an imagination.ResultsAll suggestions showed an impact on respiratory muscle strength, indicating placebo and nocebo effects. No single parameter could represent the breathing force in its complexity, however, trends and different specific aspects of it were measured. The strongest reaction was observed with the recall of a previous negative situation resulting in a reduction in expiratory flow to 96.1% of baseline (p = 0.041). After risk information, a decrease was observed in three of the parameters, with the highest extend in expiratory pressure by 4.4%. This nocebo effect was neutralized by adding positive aspects to the risk information. Every intended strengthening suggestion resulted in statistically significant increases of at least one parameter, with changes of up to 10% (e.g., MEP 110.3%, p = 0.001), indicating placebo effects. Here, expiration was more affected than inspiration. Sex was the only influencing factor reaching statistical significance, with stronger reactions in women.ConclusionRespiratory muscle strength proved to be sensitive to suggestions with clinical context, as well as suggestions intended for stimulation. With this objective measurement, evaluation, and comparison of different suggestions is possible to help avoid nocebo effects. The demonstrated effect of supporting suggestions can be followed up and used in clinical practice.
Stigmatization and Social Support of Pregnant Women With HIV or Syphilis in Eastern China: A Mixed-Method Study
Authors: Zhang Xiaohui , Wang Xiaoyan , Wang Hong , He Xinmei , Wang Xinyu 
Published: March 2022

BackgroundStigmatization and poor social support are challenges faced by individuals living with HIV or sexually transmitted disease, which can have a profound negative impact on their healthcare. Mother-to-child transmission of either HIV or syphilis can lead to adverse maternal and fetal outcomes. The aim of this study was to investigate stigmatization and social support of pregnant women with HIV or syphilis in eastern China.MethodsThis was an explanatory sequential mixed-method study conducted in Zhejiang province, China in 2019. Stigmatization, social support, and the associated factors toward HIV or syphilis were evaluated using questionnaires. The social support rating scale was used to evaluate social support, where a score &lt;25% was defined as poor social support. A logistic regression model was used to explore the association between stigmatization and poor social support.ResultsA total of 448 women (HIV positive, N = 93; syphilis, N = 355) were recruited in this study. Higher stigmatization was observed in pregnant women with HIV compared to those with syphilis (53.76% vs. 24.36%, p &lt; 0.001), and poorer social support was observed in women with HIV compared with those with syphilis (40.86% vs. 19.86%, p &lt; 0.001), with significant distributions of the total social support scores (Z = −1.976, p = 0.048) and scores on objectivity (Z = −2.036, p = 0.042) and subjectivity (Z = −2.500, p = 0.012). Similar social support among HIV or syphilis pregnant women was observed in medical healthcare facilities. In multivariable logistic model analysis, stigmatization (ORadj = 2.927; 95%CI, 1.714–4.996; p &lt; 0.001) and ethnic minority (ORadj = 2.373; 95%CI, 1.113–5.056; p = 0.025) were negatively associated with social support. Interestingly, employment status was associated with improved social support (ORadj = 0.345; 95%CI, 0.180–0.662; p = 0.001).ConclusionStigmatization among pregnant women with HIV or syphilis remains high. We demonstrated that stigmatization was a significant predictor of low social support in pregnant women with HIV or syphilis. The support shown in medical facilities was similar toward pregnant women with HIV or syphilis. Implementation of stigmatization eradication and social support strategies targeting pregnant women with HIV or syphilis may therefore improve the dual elimination of mother-to-child transmission service.
Inflammatory Indexes for Assessing the Severity and Disease Progression of Ulcerative Colitis: A Single-Center Retrospective Study
Authors: Lin Hanyang , Bai Zhaohui , Wu Qiong , Chu Guiyang , Zhang Yongguo , Guo Xiaozhong , Qi Xingshun 
Published: March 2022

BackgroundActive and severe ulcerative colitis (UC) and non-response to 5-aminosalicylic acid (5-ASA) are related to poor outcomes and should be accurately identified. Several integrated inflammatory indexes are potentially useful to assess the disease severity in patients with acute or critical diseases but are underexplored in patients with UC.MethodsPatients with UC consecutively admitted to our hospital between January 2015 and December 2020 were retrospectively grouped according to the activity and severity of UC and response to 5-ASA. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), neutrophil-to-platelet ratio (NPR), platelet-to-albumin ratio (PAR), C-reactive protein-to-albumin ratio (CAR), and C-reactive protein-to-lymphocyte ratio (CLR) were calculated. The areas under receiver operating characteristic curves (AUC) were calculated.ResultsOverall, 187 patients with UC were included, of whom 151 were active, 55 were severe, and 14 were unresponsive to 5-ASA. The active UC group had significantly higher NLR, PLR, SII, and PAR levels. SII had the greatest predictive accuracy for active UC, followed by PLR, PAR, and NLR (AUC = 0.647, 0.641, 0.634, and 0.626). The severe UC group had significantly higher NLR, PLR, SII, PAR, CAR, and CLR levels. CLR had the greatest predictive accuracy for severe UC, followed by CAR, PLR, SII, NLR, and PAR (AUC = 0.732, 0.714, 0.693, 0.669, 0.646, and 0.63). The non-response to the 5-ASA group had significantly higher CAR and CLR levels. CAR had a greater predictive accuracy for non-response to 5-ASA than CLR (AUC = 0.781 and 0.759).ConclusionSII, CLR, and CAR may be useful for assessing the severity and progression of UC, but remain not optimal.