bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long Atrial Fibrillation Duration and Early Recurrence Are Reliable Predictors of Late Recurrence After Radiofrequency Catheter Ablation
Authors: Li Zhitong , Wang Shihao , Hidru Tesfaldet H. , Sun Yuanjun , Gao Lianjun , Yang Xiaolei , Xia Yunlong 
Published: March 2022

BackgroundRecurrence after atrial fibrillation (AF) ablation is still common.ObjectiveThis study aimed to evaluate the predictive abilities of AF duration and early recurrence (ER) to discriminate high-risk patients for recurrence.MethodsWe enrolled 1,763 consecutive patients with AF who were scheduled to receive the index radiofrequency catheter ablation (RFCA) from January 2016 to August 2021 in Dalian, China. Long AF duration (LAFD) was considered if the course of AF lasted for ≥ 12 months. ER was defined as any atrial tachycardia (AT) or AF event longer than 30 s occurring within a 3-month post-RFCA.ResultsLate recurrence occurred in 643 (36.5%) of the 1,763 patients at a median of 35 months after RFCA. Multivariate analysis identified LAFD (hazard ratio (HR): 1.80, 95% confidence interval (CI): 1.38–2.35, p &lt; 0.001) and ER (HR: 2.34, 95% CI: 1.82–3.01, p &lt; 0.001) as strong independent predictors of late recurrence in non-paroxysmal AF. Similarly, LAFD (HR: 1.48, 95% CI: 1.20–1.84, p &lt; 0.001) and ER (HR: 3.40, 95% CI: 2.68–4.30, p &lt; 0.001) were significantly associated with late recurrence in paroxysmal AF. Receiver operating curve analyses revealed that the CAAP-AF (CAD, Atrial diameter, Age, Persistent or longstanding AF, Antiarrhythmic drugs failed, Female) had the highest predict power [area under ROC curve (AUC) 0.586]. The addition of ER and LAFD to the CAAP-AF score significantly improved risk discrimination for late recurrence after AF ablation from 0.586 to 0.686.ConclusionLong AF duration and ER were independently associated with late recurrence. The prediction performance of the CAAP-AF model for recurrence was improved by the addition of LAFD and ER.
Dissolved Organic Carbon (DOC) in Ground Ice on Northeastern Tibetan Plateau
Authors: Yang Yuzhong , Guo Xiaoyan , Wang Qingfeng , Jin Huijun , Yun Hanbo , Wu Qingbai 
Published: March 2022

Ground ice in permafrost stores substantial amounts of dissolved organic carbon (DOC) upon thaw, which may perpetuate a carbon feedback in permafrost regions, yet little is known to date about the dynamics of DOC and source variability of ground ice on the Tibetan Plateau. Here, the high-resolution data of DOC in ground ice (4.8 m in depth) from two permafrost profiles on the Northeastern Tibetan Plateau (NETP) were firstly presented. We quantified the DOC concentrations (mean: 9.7–21.5 mg/L) of ground ice and revealed sizeable—by a factor of 7.0–36.0—enrichment of the ground ice relative to the other water elements on the TP. Results indicated remarkable depth differences in the DOC of ground ice, suggestive of diverse sources of DOC and different sequestration processes of DOC into ice during permafrost evolution. Combined with DOC and carbon isotopes (δ13CDOC), we clarified that decomposition of soil organic matter and leaching of DOC from organic layers and surrounding permafrost sediments are the important carbon sources of ground ice. The DOC sequestration of ground ice in the upper layers was related to the active layer hydrology and freeze–thaw cycle. However, the permafrost evolution controlled the decomposition of organic carbon and sequestration of DOC in the deep layers. A conceptual model clearly illustrated the dynamics of DOC in ground ice and suggested a significant impact on the carbon cycle on the NETP. The first attempt to explore the DOC in ground ice on the NETP is important and effective for further understanding of carbon cycle under permafrost degradation on the Tibetan Plateau.
The Mediating Role of Endocrine Factors in the Positive Relationship Between Fat Mass and Bone Mineral Content in Children Aged 9–11 Years: The Physical Activity and Nutrition in Children Study
Authors: Constable Annie M. , Vlachopoulos Dimitris , Barker Alan R. , Moore Sarah A. , Soininen Sonja , Haapala Eero A. , Väistö Juuso , Jääskeläinen Jarmo , Voutilainen Raimo , Auriola Seppo , Häkkinen Merja R. , Laitinen Tomi , Lakka Timo A. 
Published: March 2022

IntroductionWe aimed to investigate whether the relationship between fat mass and bone mineral content (BMC) is mediated by insulin, leptin, adiponectin, dehydroepiandrosterone sulphate, testosterone and estradiol in children aged 9-11 years.Materials and MethodsWe utilised cross-sectional data from the Physical Activity and Nutrition in Children study (n = 230 to 396; 112 to 203 girls). Fat mass and BMC were assessed with dual-energy X-ray absorptiometry. Endocrine factors were assessed from fasted blood samples. We applied the novel 4-way decomposition method to analyse associations between fat mass, endocrine factors, and BMC.ResultsFat mass was positively associated with BMC in girls (ß = 0.007 to 0.015, 95% confidence interval (CI) 0.005 to 0.020) and boys (ß = 0.009 to 0.015, 95% CI 0.005 to 0.019). The relationship between fat mass and BMC was mediated by free leptin index in girls (ß = -0.025, 95% CI -0.039 to -0.010) and boys (ß = -0.014, 95% CI -0.027 to -0.001). The relationship between fat mass and BMC was partially explained by mediated interaction between fat mass and free leptin index in boys (ß = -0.009, 95% CI -0.013 to -0.004) and by interaction between fat mass and adiponectin in girls (ß = -0.003, 95% CI -0.006 to -0.000).ConclusionAt greater levels of adiponectin and free leptin index, the fat mass and BMC relationship becomes less positive in girls and boys respectively. The positive association between fat mass with BMC was largely not explained by the endocrine factors we assessed.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT01803776], identifier NCT01803776.
Normal Weight Obesity and Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis
Authors: Mohammadian Khonsari Nami , Khashayar Patricia , Shahrestanaki Ehsan , Kelishadi Roya , Mohammadpoor Nami Sahar , Heidari-Beni Motahar , Esmaeili Abdar Zahra , Tabatabaei-Malazy Ozra , Qorbani Mostafa 
Published: March 2022

BackgroundObesity is one of the most significant causes of morbidity and mortality worldwide. Current studies suggest a new type of obesity, normal weight obesity (NWO), which is defined as having a normal body mass index (BMI), but a high-fat percentage increases the risk of cardiometabolic risk factors (CMRFs). This systematic review and meta-analysis aimed to pool the association between NWO with CMRFs.MethodsA systematic search of the literature in all available electronic databases, including Scopus, Web of Science, EMBASE, and PubMed, was performed until October 2021. All English studies that assessed the association of NWOs [compared to normal weight non-obese (NWNO)] and the CMRFs were included. Two investigators extracted data and performed a quality assessment. The heterogeneity between studies was assessed with I-squared and Cochran’s Q tests. Odds ratio (OR) was used as an effect size to pool the association of NWO with CMRFs.ResultsTwenty-five articles that met the inclusion criteria entered the study. The total number of participants was 177,792, with an age range of 13 to 75 years. Most studies were conducted on the general population (adults) and were from China. The result of fixed-effect model meta-analysis indicated an increased odds of hyperglycemia (OR:1.50, 95%:1.23, 1.76), high TG (OR:1.90, 95% CH:1.44, 2.35), low HDL (OR: 1.28, 95% CI:1.06, 1.49) and diabetes (OR:1.39, 95% CI:1.30, 1.49). Moreover, the random effect meta-analysis showed that NWO increased the odds of dyslipidemia (OR:1.83, 95% CI:1.61, 20.4), HTN (OR:1.40, 95% CI:1.28, 1.51) and metabolic syndrome (OR:1.92, 95% CI:1.58, 2.26). Moreover, the mean of all CMRFs except plasma glucose in NWO subjects was statistically higher than NWNO subjects (p-value&lt;0.05).ConclusionThe present study showed that NWO increased the odds of CMRFs. These findings indicate the inadequacy of the BMI measurement and the need for body fat assessment for a better obesity risk assessment.
IPRS: Leveraging Gene-Environment Interaction to Reconstruct Polygenic Risk Score
Authors: Tang Yingdan , You Dongfang , Yi Honggang , Yang Sheng , Zhao Yang 
Published: March 2022

Background: Polygenic risk score (PRS) is widely regarded as a predictor of genetic susceptibility to disease, applied to individuals to predict the risk of disease occurrence. When the gene-environment (G×E) interaction is considered, the traditional PRS prediction model directly uses PRS to interact with the environment without considering the interactions between each variant and environment, which may lead to prediction performance and risk stratification of complex diseases are not promising.Methods: We developed a method called interaction PRS (iPRS), reconstructing PRS by leveraging G×E interactions. Two extensive simulations evaluated prediction performance, risk stratification, and calibration performance of the iPRS prediction model, and compared it with the traditional PRS prediction model. Real data analysis was performed using existing data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial study to predict genetic susceptibility, pack-years of smoking history, and G×E interactions in patients with lung cancer.Results: Two extensive simulations indicated iPRS prediction model could improve the prediction performance of disease risk, the accuracy of risk stratification, and clinical calibration performance compared with the traditional PRS prediction model, especially when antagonism accounted for the majority of the interaction. PLCO real data analysis also suggested that the iPRS prediction model was superior to the PRS prediction model in predictive effect (p = 0.0205).Conclusion: IPRS prediction model could have a good application prospect in predicting disease risk, optimizing the screening of high-risk populations, and improving the clinical benefits of preventive interventions among populations.
TMEM199-Congenital Disorder of Glycosylation With Novel Phenotype and Genotype in a Chinese Boy
Authors: Fang Yuan , Abuduxikuer Kuerbanjiang , Wang Yi-Zhen , Li Shao-Mei , Chen Lian , Wang Jian-She 
Published: March 2022

Background: TMEM199-congenital disorder of glycosylation (TMEM199-CDG) is a rare autosomal recessive inherited disease characterized by chronically elevated serum transaminase, decreased serum ceruloplasmin, steatosis and/or fibrosis, TMEM199 mutation, reduced level of TMEM199 protein, and abnormal protein glycosylation.Methods: The information of a Chinese patient with TMEM199-CDG in the Children’s Hospital of Fudan University was reviewed. The patient’s clinical, pathological, and molecular features were obtained by clinical data study, liver biopsy, immunohistochemistry, and molecular genetic analysis.Results: A 4-year-old Chinese boy presented with hypertransaminasemia, hypercholesterolemia, elevated alkaline phosphatase, decreased serum ceruloplasmin and serum copper level, and coagulopathy since birth. To the best of our knowledge, novel findings included strabismus, cirrhosis by liver biopsy, reduced expression of TMEM199 by immunohistochemistry, and a frameshift variant of c.128delA/p.Lys43Argfs*25 in the TMEM199 gene.Conclusion: This case added to the phenotypic and genotypic spectrum of TMEM199-CDG.
“Some They Need Male, Some They Need Female”: A Gendered Approach for Breast Cancer Detection in Uganda
Authors: Ikhile Deborah , Omodara Damilola , Seymour-Smith Sarah , Musoke David , Gibson Linda 
Published: March 2022

IntroductionThere are several challenges associated with breast cancer detection in Uganda and other low-and-middle-income countries. One of the identified challenges is attributed to the health workers' gender, which facilitates gender disparities in access to breast cancer detection services. Although this challenge is well acknowledged in existing literature, there are hardly any studies on how it can be addressed. Therefore, drawing on an intersectionality lens, our study examined how to address gender disparities facilitated by health workers' gender in accessing breast cancer detection services in Uganda.Materials and MethodsWe collected qualitative data through semi-structured interviews with twenty participants comprising community health workers, primary health care practitioners, non-governmental organizations, district health team, and the Ministry of Health. For the data analysis, thematic analysis was conducted on NVivo using Braun and Clarke's non-linear 6-step process to identify the themes presented in the results section.ResultsFour themes emerged from the data analysis: understanding a woman's gender constructions; health workers' approachability; focus on professionalism, not sex; and change in organizational culture. These themes revealed participants' perceptions regarding how to address gender disparities relating to the role health workers' gender play in breast cancer detection. Through the intersectionality lens, our findings showed how gender intersects with other social stratifiers such as religious beliefs, familial control, health worker's approachability, and professionalism within the health workforce.ConclusionOur findings show that the solutions to address gender disparities in breast cancer detection are individually and socially constructed. As such, we recommend a gendered approach to understand and redress the underlying power relations perpetuating such constructions. We conclude that taking a gendered approach will ensure that breast cancer detection programs are context-appropriate, cognizant of the prevailing cultural norms, and do not restrict women's access to breast cancer detection services.
Janus Kinase Inhibitors in the Treatment of Type I Interferonopathies: A Case Series From a Single Center in China
Authors: Li Wendao , Wang Wei , Wang Wei , Zhong Linqing , Gou Lijuan , Wang Changyan , Ma Jingran , Quan Meiying , Jian Shan , Tang Xiaoyan , Zhang Yu , Wang Lin , Ma Mingsheng , Song Hongmei 
Published: March 2022

ObjectiveThis study aimed to assess the efficacy and safety of 2 Janus kinase (JAK) inhibitors (jakinibs) tofacitinib and ruxolitinib in the treatment of type I interferonopathies patients including STING-associated vasculopathy with onset in infancy (SAVI), Aicardi-Goutières syndrome (AGS), and spondyloenchondrodysplasia with immune dysregulation (SPENCD).MethodsA total of 6 patients were considered in this study: 2 patients with SAVI, 1 patient with AGS1, 1 patient with AGS7, and 2 patients with SPENCD. Clinical manifestations, laboratory investigations, radiology examinations, treatment, and outcomes were collected between November 2017 and November 2021 in Peking Union Medical College Hospital. The disease score for patients with SAVI and AGS scale for patients with AGS were documented. The expression of 6 interferon-stimulated genes (ISGs) was assessed by real-time PCR.ResultsThree patients (1 patient with SAVI, 2 patients with AGS) were treated with ruxolitinib and 3 patients (1 patient with SAVI, 2 patients with SPENCD) were treated with tofacitinib. The mean duration of the treatment was 2.5 years (1.25–4 years). Upon treatment, cutaneous lesions and febrile attacks subsided in all affected patients. Two patients discontinued the corticoid treatment. Two patients with SAVI showed an improvement in the disease scores (p &lt; 0.05). The erythrocyte sedimentation rate normalized in 2 patients with AGS. The interferon score (IS) was remarkably decreased in 2 patients with SPENCD (p &lt; 0.01). Catch-ups with growth and weight gain were observed in 3 and 2 patients, respectively. Lung lesions improved in 1 patient with SAVI and remained stable in 3 patients. Lymphopenia was found in 3 patients during the treatment without severe infections.ConclusionThe JAK inhibitors baricitinib and tofacitinib are promising therapeutic agents for patients with SAVI, AGS, and SPENCD, especially for the improvement of cutaneous lesions and febrile attacks. However, further cohort studies are needed to assess the efficacy and safety.
Female Genital Schistosomiasis Lesions Explored Using Circulating Anodic Antigen as an Indicator for Live Schistosoma Worms
Authors: Nemungadi Takalani Girly , Kleppa Elisabeth , van Dam Govert J. , Corstjens Paul L. A. M. , Galappaththi-Arachchige Hashini Nilushika , Pillay Pavitra , Gundersen Svein Gunnar , Vennervald Birgitte J. , Ndhlovu Patricia , Taylor Myra , Naidoo Saloshni , Kjetland Eyrun F. 
Published: March 2022

BackgroundIn areas where reinfection with schistosomiasis is rampant, it is not known if the lesions of Female Genital Schistosomaisis are a consequence of live worms, or caused by dead ova. Live schistosome worms regurgitate Circulating Anodic Antigen (CAA). We sought to explore the association between the different lesions of FGS (grainy sandy patches, homogenous yellow patches, rubbery papules and abnormal blood vessels) and the presence of live worms as indicated by S. haematobium-derived CAA in blood.Materials and MethodsIn this cross-sectional study, rural high schools were randomly selected from Ilembe, uThungulu and Ugu Districts on the East Coast of South Africa, KwaZulu-Natal Province. Serum samples for CAA analysis were collected from 246 female learners aged 16 - 23 years. Uncorrected chi-square and odds ratio with 95% confidence interval (CI) were used to evaluate the null hypothesis.ResultsCAA was positive in 82/246 (33%) of the participants. Sandy patches were found in 123 (50%) of the study population. Grainy sandy patches were significantly associated with CAA even after controlling for age (Adjusted Odds Ratio (AOR) 4.2, 95% CI 2.3 - 7.9, p &lt; 0.001). Likewise, abnormal blood vessels were associated with CAA (AOR 3.0, 95% CI 1.5-4.5, p = 0.001) whereas homogenous yellow patches were not associated with CAA (p = 0.57). Rubbery papules were not found in this study population.ConclusionGrainy sandy patches and abnormal blood vessels are found more commonly in women who harbour live Schistosoma haematobium worms whilst homogenous yellow patches may indicate chronic tissue damage due to dead ova.
Fully Automatic Classification of Brain Atrophy on NCCT Images in Cerebral Small Vessel Disease: A Pilot Study Using Deep Learning Models
Authors: Wang Jincheng , Chen Sijie , Liang Hui , Zhao Yilei , Xu Ziqi , Xiao Wenbo , Zhang Tingting , Ji Renjie , Chen Tao , Xiong Bing , Chen Feng , Yang Jun , Lou Haiyan 
Published: March 2022

ObjectiveBrain atrophy is an important imaging characteristic of cerebral small vascular disease (CSVD). Our study explores the linear measurement application on CT images of CSVD patients and develops a fully automatic brain atrophy classification model. The second aim was to compare it with the end-to-end Convolutional Neural Networks (CNNs) model.MethodsA total of 385 subjects such as 107 no-atrophy brain, 185 mild atrophy, and 93 severe atrophy were collected and randomly separated into training set (n = 308) and test set (n = 77). Key slices for linear measurement were manually identified and used to annotate nine linear measurements and a binary classification of cerebral sulci widening. A linear-measurement-based pipeline (2D model) was constructed for two-types (existence/non-existence brain atrophy) or three-types classification (no/mild atrophy/severe atrophy). For comparison, an end-to-end CNN model (3D-deep learning model) for brain atrophy classification was also developed. Furthermore, age and gender were integrated to the 2D and 3D models. The sensitivity, specificity, accuracy, average F1 score, receiver operating characteristics (ROC) curves for two-type classification and weighed kappa for three-type classification of the two models were compared.ResultsAutomated measurement of linear measurements and cerebral sulci widening achieved moderate to almost perfect agreement with manual annotation. In two-type atrophy classification, area under the curves (AUCs) of the 2D model and 3D model were 0.953 and 0.941 with no significant difference (p = 0.250). The Weighted kappa of the 2D model and 3D model were 0.727 and 0.607 according to standard classification they displayed, mild atrophy and severe atrophy, respectively. Applying patient age and gender information improved classification performances of both 2D and 3D models in two-type and three-type classification of brain atrophy.ConclusionWe provide a model composed of different modules that can classify CSVD-related brain atrophy on CT images automatically, using linear measurement. It has similar performance and better interpretability than the end-to-end CNNs model and may prove advantageous in the clinical setting.
Evaluation of the Effectiveness of the Tap Test by Combining the Use of Functional Gait Assessment and Global Rating of Change
Authors: Kameda Masahiro , Kajimoto Yoshinaga , Nikaido Yasutaka , Kambara Akihiro , Tsujino Kohei , Yamada Hironori , Takagi Fugen , Fukuo Yusuke , Kosaka Takuya , Kanemitsu Takuya , Katayama Yoshihide , Tsuji Yuichiro , Yagi Ryokichi , Hiramatsu Ryo , Ikeda Naokado , Nonoguchi Naosuke , Furuse Motomasa , Kawabata Shinji , Takami Toshihiro , Wanibuchi Masahiko 
Published: March 2022

BackgroundAlthough the tap test for patients with suspected idiopathic normal pressure hydrocephalus (iNPH) is still often performed as part of the preoperative evaluation, it is true that some studies have reported the limitations of the tap test, claiming that it does not provide the additional information for appropriate patient selection for surgery. We aimed to determine whether a better method of pre- and post-tap test assessment could lead to appropriate patient selection for shunting.MethodsWe performed the tap test as part of the preoperative evaluation in all 40 patients who underwent lumboperitoneal shunt surgery for iNPH from April 2021 to September 2021. We retrospectively analyzed the patient data. We examined whether a comprehensive evaluation of the effect of the tap test using the Functional Gait Assessment (FGA) and Global Rating of Change (GRC) scales would identify a wider range of patients who would benefit from shunt surgery than the 3-m Timed Up and Go test (TUG) alone.ResultsAssuming a prevalence of 1% for iNPH, the TUG had a sensitivity of 0.23, specificity of 0.71, positive likelihood ratio of 0.79, and negative likelihood ratio of 1.09. When improvement in either the FGA or the GRC was used as a criterion for the validity of the tap test, the sensitivity was 0.88, specificity was 0.17, positive likelihood ratio was 1.06, and negative likelihood ratio was 0.71.ConclusionImprovement in either the FGA or the GRC is a more sensitive criterion for the effectiveness of the tap test for the gait aspect than the TUG. Since the negative likelihood ratio is lower than that for the TUG alone, it is more appropriate to exclude patients with neither FGA nor GRC improvement from surgical indications than to exclude surgical indications based on a negative TUG.