bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Intraoperative Cerebral Oximetry Monitoring on Postoperative Cognitive Dysfunction and ICU Stay in Adult Patients Undergoing Cardiac Surgery: An Updated Systematic Review and Meta-Analysis
Authors: Tian Li-Juan , Yuan Su , Zhou Cheng-Hui , Yan Fu-Xia 
Published: February 2022

AimDetermining whether intraoperative cerebral oximetry monitoring-guided intervention reduces the risk of postoperative cognitive dysfunction remains controversial. The objective of this study was to conduct an up-to-date meta-analysis to comprehensively assess the effects of regional cerebral oxygen saturation (rSO2) monitoring-guided intervention on cognitive outcomes after cardiac surgery.MethodsPubMed, EMBASE, Ovid, and Cochrane Library databases were systematically searched using the related keywords for cardiac surgical randomized-controlled trials (RCTs) published from their inception to July 31, 2021. The primary outcome was postoperative delirium (POD). The secondary outcomes were postoperative cognitive decline (POCD) and other major postoperative outcomes. The odds ratio (OR) or weighted mean differences (WMDs) with 95% confidence interval (CI) were used to pool the data. The random-effect model was used for the potential clinical inconsistency. We performed meta-regression and subgroup analyses to assess the possible influence of rSO2 monitoring-guided intervention on clinical outcomes.ResultsIn total, 12 RCTs with 1,868 cardiac surgical patients were included. Compared with controls, the incidences of POD (n = 6 trials; OR, 0.28; 95% CI, 0.09–0.84; p = 0.02; I2 = 81%) and POCD (n = 5 trials; OR, 0.38; 95% CI, 0.16–0.93; p = 0.03; I2 = 78%) were significantly lower in the intervention group. Cerebral oximetry desaturation also showed a positive association with the incidence of POD (n = 5 trials; OR, 2.02; 95% CI, 1.25–3.24; p = 0.004; I2 = 81%). The duration of intensive care unit (ICU) stay was markedly shorter in the intervention group than in the control group (n = 10 trials; WMD, −0.22 days; 95% CI, −0.44 to −0.00; p = 0.05; I2 = 74%). Univariate meta-regression analyses showed that the major sources of heterogeneity were age (p = 0.03), body mass index (BMI, p = 0.05), and the proportion of congenital heart disease (CHD, p = 0.02) for POD, age (p = 0.04) for POCD, diabetes mellitus (DM, p = 0.07), cerebrovascular accident (CVA, p = 0.02), and chronic obstructive pulmonary disease (COPD, p = 0.09) for ICU stay. Subsequent subgroup analyses also confirmed these results.ConclusionAvailable evidence from the present study suggests that an intraoperative cerebral oximetry desaturation is associated with an increased POD risk, and the rSO2 monitoring-guided intervention is correlated with a lower risk of POD and POCD, and a shorter ICU stay in adults undergoing cardiac surgery. These clinical benefits may be limited in patients with older age, diabetes status, high BMI, non-CHD, non-COPD, or a previous cardiovascular accident.Systematic Review Registration: [PROSPREO], identifier: [CRD42021252654].
Tidal Modulation of Hydrothermal Tremor: Examples From Ischia and Campi Flegrei Volcanoes, Italy
Authors: Petrosino Simona , Dumont Stéphanie 
Published: February 2022

Volcano dynamics results from an interplay between internal and external processes spanning different time scales. Unravelling how such processes interact may provide key insights into the mechanisms that may lead to the destabilization of the volcanoes and eruption, a critical information to forecast hazards. Studies dealing with tidal influence on volcanoes fall within this context, yet the cause-effect relationship between tides and eruptions is still poorly understood. In the present study, we investigate the tidal influence on two nearby volcanoes, Ischia and Campi Flegrei (Italy), characterized by intense hydrothermal activity. We analyze the seismic tremor of hydrothermal origin recorded by four seismic stations between January and June 2020 by using Singular Spectrum Analysis. We detect up to five long term tidal periodicities ranging from ∼5 to ∼29 days. The results indicate that the seismic tremor is modulated by Earth tides at both volcanoes. In addition, differences in phase and amplitude modulation between the response of both hydrothermal systems to tidal forcing reveal specific features related to the tremor source and to properties of the surrounding medium. These phenomena indicate an interplay between solid Earth and the dynamics of these two volcanoes. Similar approaches on hydrothermal systems at volcanoes would contribute to better characterize the hydrothermal circulation and their evolving conditions that may represent a precursor of a new phase of activity.
Pharmacological Inhibition of FAK-Pyk2 Pathway Protects Against Organ Damage and Prolongs the Survival of Septic Mice
Authors: Alves Gustavo Ferreira , Aimaretti Eleonora , Einaudi Giacomo , Mastrocola Raffaella , de Oliveira Junior Garcia , Collotta Debora , Porchietto Elisa , Aragno Manuela , Cifani Carlo , Sordi Regina , Thiemermann Christoph , Fernandes Daniel , Collino Massimo 
Published: February 2022

Sepsis and septic shock are associated with high mortality and are considered one of the major public health concerns. The onset of sepsis is known as a hyper-inflammatory state that contributes to organ failure and mortality. Recent findings suggest a potential role of two non-receptor protein tyrosine kinases, namely Focal adhesion kinase (FAK) and Proline-rich tyrosine kinase 2 (Pyk2), in the inflammation associated with endometriosis, cancer, atherosclerosis and asthma. Here we investigate the role of FAK-Pyk2 in the pathogenesis of sepsis and the potential beneficial effects of the pharmacological modulation of this pathway by administering the potent reversible dual inhibitor of FAK and Pyk2, PF562271 (PF271) in a murine model of cecal ligation and puncture (CLP)-induced sepsis. Five-month-old male C57BL/6 mice underwent CLP or Sham surgery and one hour after the surgical procedure, mice were randomly assigned to receive PF271 (25 mg/kg, s.c.) or vehicle. Twenty-four hours after surgery, organs and plasma were collected for analyses. In another group of mice, survival rate was assessed every 12 h over the subsequent 5 days. Experimental sepsis led to a systemic cytokine storm resulting in the formation of excessive amounts of both pro-inflammatory cytokines (TNF-α, IL-1β, IL-17 and IL-6) and the anti-inflammatory cytokine IL-10. The systemic inflammatory response was accompanied by high plasma levels of ALT, AST (liver injury), creatinine, (renal dysfunction) and lactate, as well as a high, clinical severity score. All parameters were attenuated following PF271 administration. Experimental sepsis induced an overactivation of FAK and Pyk2 in liver and kidney, which was associated to p38 MAPK activation, leading to increased expression/activation of several pro-inflammatory markers, including the NLRP3 inflammasome complex, the adhesion molecules ICAM-1, VCAM-1 and E-selectin and the enzyme NOS-2 and myeloperoxidase. Treatment with PF271 inhibited FAK-Pyk2 activation, thus blunting the inflammatory abnormalities orchestrated by sepsis. Finally, PF271 significantly prolonged the survival of mice subjected to CLP-sepsis. Taken together, our data show for the first time that the FAK-Pyk2 pathway contributes to sepsis-induced inflammation and organ injury/dysfunction and that the pharmacological modulation of this pathway may represents a new strategy for the treatment of sepsis.
Microstructure and Genetic Polymorphisms: Role in Motor Rehabilitation After Subcortical Stroke
Authors: Liu Jingchun , Wang Caihong 
Published: February 2022

Background and Purpose: Motor deficits are the most common disability after stroke, and early prediction of motor outcomes is critical for guiding the choice of early interventions. Two main factors that may impact the response to rehabilitation are variations in the microstructure of the affected corticospinal tract (CST) and genetic polymorphisms in brain-derived neurotrophic factor (BDNF). The purpose of this article was to review the role of these factors in stroke recovery, which will be useful for constructing a predictive model of rehabilitation outcomes.Summary of Review: We review the microstructure of the CST, including its origins in the primary motor area (M1), primary sensory area (S1), premotor cortex (PMC), and supplementary motor area (SMA). Damage to these fibers is disease-causing and can directly affect rehabilitation after subcortical stroke. BDNF polymorphisms are not disease-causing but can indirectly affect neuroplasticity and thus motor recovery. Both factors are known to be correlated with motor recovery. Further work is needed using large longitudinal patient samples and animal experiments to better establish the role of these two factors in stroke rehabilitation.Conclusions: Microstructure and genetic polymorphisms should be considered possible predictors or covariates in studies investigating motor recovery after subcortical stroke. Future predictive models of stroke recovery will likely include a combination of structural and genetic factors to allow precise individualization of stroke rehabilitation strategies.
Drug-Coated Balloon-Oriented Angioplasty for Severe Symptomatic Atherosclerotic MCA Stenosis in Young Adults
Authors: Zhang Yuyan , Chu Xi , Meng Yao , Zhang Jun , Sun Lili , Zhao Wei , Zheng Meimei , Yin Hao , Wang Wei , Zhang Jinping , Song Yun , Han Ju 
Published: February 2022

PurposeThe clinical significance of endovascular therapy in young patients with symptomatic intracranial atherosclerotic stenosis is not clear. We aimed to report our preliminary findings on the safety and effectiveness of a new endovascular treatment strategy, drug-coated balloon (DCB)-oriented angioplasty for young adults with severe symptomatic atherosclerotic middle cerebral artery (MCA) stenosis.MethodsWe retrospectively retrieved the data of seven young patients aged 21–32 years old with severe symptomatic atherosclerotic MCA stenosis treated with DCB-oriented angioplasty from January 2018 to October 2020. We collected clinical presentations, perioperative complications, and clinical and radiological outcomes.ResultsThe DCB was successfully dilated at the lesions in all seven patients and good antegrade perfusion was achieved in five. The other two patients underwent remedial stent implantation due to residual stenosis &gt;50% and unstable antegrade perfusion after DCB dilatation. However, none of the patients had perioperative complications. There were no recurrent ischemic symptoms after a mean clinical follow-up period of 15.4 ± 6.9 months. Repeat vascular images of the patients showed no restenosis at 3- or 6-month imaging follow-up periods. High-resolution MRI (HRMRI) was completed in all the patients before the angioplasty procedure and at follow-up. Focal eccentric wall thickening was present at the site of stenosis preoperatively; however, the plaques had disappeared by the time of follow-up for all patients.ConclusionDCB-oriented angioplasty may be safe and effective for young patients with severe symptomatic atherosclerotic MCA stenosis.
Postoperative Loss of Skeletal Muscle Mass Predicts Poor Survival After Gastric Cancer Surgery
Authors: Tan Shanjun , Zhuang Qiulin , Zhang Zhige , Li Shuhao , Xu Jiahao , Wang Junjie , Zhang Yanni , Xi Qiulei , Meng Qingyang , Jiang Yi , Wu Guohao 
Published: February 2022

BackgroundSkeletal muscle mass deterioration is common in gastric cancer (GC) patients and is linked to poor prognosis. However, information regarding the effect of skeletal muscle mass changes in the postoperative period is scarce. This study was to investigate the link between postoperative loss of skeletal muscle mass and survival following GC surgery.MethodsPatients who underwent GC surgery between January 2015 and December 2016 were recruited into the study. Computed tomography at L3 vertebral level was used to examine skeletal muscle index prior to surgery and about 6 months after surgery. Skeletal muscle index changes were categorized as presence or absence of ≥5% loss. Overall survival (OS) and disease-free survival (DFS) were analyzed, and Cox proportional hazard models used to identify their predictors.ResultsThe study comprised of 318 gastric cancer patients of which 63.5% were male. The group's mean age was 58.14 ± 10.77 years. Sixty-five patients experienced postoperative skeletal muscle index loss ≥5% and had poorer OS (P = 0.004) and DFS (P = 0.020). We find that postoperative skeletal muscle index loss ≥ 5% predicts OS [hazard ratio (HR): 2.769, 95% confidence interval (CI): 1.865–4.111; P &lt; 0.001] and DFS (HR: 2.533, 95% CI: 1.753–3.659; P &lt; 0.001).ConclusionsLoss of skeletal muscle mass postoperatively is linked to poor survival following GC surgery. Further studies are needed to determine whether stabilizing or enhancing skeletal muscle mass after surgery improves survival.
Simultaneous Image Reconstruction and Element Decomposition for Iodine Contrast Agent Visualization in Multienergy Element-Resolved Cone Beam CT
Authors: Wang Chao , Jung Hyunuk , Yang Ming , Shen Chenyang , Jia Xun 
Published: February 2022

Iodine contrast agent is widely used in liver cancer radiotherapy at CT simulation stage to enhance detectability of tumor. However, its application in cone beam CT (CBCT) for image guidance before treatment delivery is still limited because of poor image quality and excessive dose of contrast agent during multiple treatment fractions. We previously developed a multienergy element-resolved (MEER) CBCT framework that included x-ray projection data acquisition on a conventional CBCT platform in a kVp-switching model and a dictionary-based image reconstruction algorithm that simultaneously reconstructed x-ray attenuation images at each kilovoltage peak (kVp), an electron density image, and elemental composition images. In this study, we investigated feasibility using MEER-CBCT for low-concentration iodine contrast agent visualization. We performed simulation and experimental studies using a phantom with inserts containing water and different concentrations of iodine solution and the MEER-CBCT scan with 600 projections in a full gantry rotation, in which the kVp level sequentially changed among 80, 100, and 120 kVps. We included iodine material in the dictionary of the reconstruction algorithm. We analyzed iodine detectability as quantified by contrast-to-noise ratio (CNR) and compared results with those of CBCT images reconstructed by the standard filter back projection (FBP) method with 600 projections. MEER-CBCT achieved similar contrast enhancement as FBP method but significantly higher CNR. At 2.5% iodine solution concentration, FBP method achieved 170 HU enhancement and CNR of 2.0, considered the standard CNR for successful tumor visualization. MEER-CBCT achieved the same CNR but at ~6.3 times lower iodine concentration of 0.4%.
Quantile Treatment Effect of Zinc Lozenges on Common Cold Duration: A Novel Approach to Analyze the Effect of Treatment on Illness Duration
Authors: Hemilä Harri , Chalker Elizabeth , Tukiainen Janne 
Published: February 2022

Calculation of the difference of means is the most common approach when analyzing treatment effects on continuous outcomes. Nevertheless, it is possible that the treatment has a different effect on patients who have a lower value of the outcome compared with patients who have a greater value of the outcome. The estimation of quantile treatment effects (QTEs) allows the analysis of treatment effects over the entire distribution of a continuous outcome, such as the duration of illness or the duration of hospital stay. Furthermore, most of these outcomes have asymmetric distributions with fat tails, and censored observations are not uncommon. These features can be accounted for in the analysis of the QTE. In this paper, we use the QTE approach to analyze the effect of zinc lozenges on common cold duration. We use the data set of the Mossad (1996) trial with zinc gluconate lozenges, and three data sets of trials with zinc acetate lozenges. In the Mossad (1996) trial, zinc gluconate lozenges shortened common cold duration on average by 4.0 days (95% CI 2.3–5.7 days). However, the QTE analysis indicates that 15- to 17-day colds were shortened by 8 days, and 2-day colds by just 1 day, for the group taking zinc lozenges. Thus, the overall 4.0-day average effect of zinc gluconate lozenges in the Mossad (1996) trial is inconsistent with our QTE findings for both short and long colds. Similar results were found in our QTE analysis of the pooled data sets of the three zinc acetate lozenge trials. The average effect of 2.7 days (95% CI 1.8–3.3 days) was inconsistent with the effects on short and long colds. The QTE approach may have broad usefulness for examining treatment effects on the duration of illness and hospital stay, and on other similar outcomes.
Expressed Emotion in the Family: A Meta-Analytic Review of Expressed Emotion as a Mechanism of the Transgenerational Transmission of Mental Disorders
Authors: Fahrer Julia , Brill Nathalie , Dobener Lisa Marie , Asbrand Julia , Christiansen Hanna 
Published: February 2022

BackgroundHigh Expressed Emotion (HEE) has been identified as a risk factor for the exacerbation and course of mental illness. EE has been investigated as a caregiver's response to an offspring's problem behavior and pathology. The present meta-analysis regards EE from a transgenerational perspective and as one mechanism that might explain the transgenerational transmission of mental disorders.MethodWe identified a total of 13 studies relying on 16 independent samples of parent-child dyads of parents with a mental illness and healthy controls; these were included in our analysis. Results were synthesized into one effect size per sample; meta-regression on additional effects of parental diagnostic category, child mental illness, and child age were also applied.ResultsParents with a mental illness are classified as HEE significantly more often. Effects were established for high criticism, albeit of small size (OR = 1.45), although they become stronger whenever offspring exhibit mental illness themselves (OR = 2.82).ConclusionThe current study highlights the dearth of studies on EE in families in which a parent has a mental illness and its effects on their children. Our findings highlight EE as a potential mechanism for attributing the transgenerational transmission of mental disorders, especially for the EE-variable criticism, indicating dysfunctional parent-child interactions.Systematic Review Registrationhttp://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019117609, identifier: CRD42019117609.
Patient Preferences for Diabetes Treatment Among People With Type 2 Diabetes Mellitus in China: A Discrete Choice Experiment
Authors: Huang Yuankai , Huang Qixiang , Xu Ailin , Lu Mengqing , Xi Xiaoyu 
Published: February 2022

IntroductionPreferences for diabetes treatment-related attributes may be significant in diabetes management. However, there is a lack of evidence on patient preferences for diabetes in China.MethodsA large-scale questionnaire survey was conducted in the hospitals of mainland China. Participants' preferences for six attributes were evaluated via a discrete choice experiment (DCE) using the conditional logit model. Patients' willingness to pay (WTP) for each attribute was calculated based on the cost attribute.ResultsThe sample consisted of 709 patients (male 51.9%; female 48.1%). The results of the model indicated that patients' preference weight (PW) of days on which the blood glucose level is under control per week was the highest (1.41), and the PW of blood glucose monitoring frequency was the lowest (0.642). Patients were generally willing to pay for improvements in their type 2 diabetes mellitus (T2DM) treatment, and they had relatively higher WTP to avoid the blood glucose level within a normal value of 1 day/week (¥176.01) and also to avoid the frequency of hypoglycemic events within the range of 1–2/month (¥144.53).ConclusionThe number of days on which the blood glucose level is under control per week is the most important attribute in the treatment choice for patients with T2DM in China, followed by the frequency of hypoglycemic events, medication regimen, weight change, and blood glucose monitoring.
The Racial Disparities in the Epidemic of Metabolic Syndrome With Increased Age: A Study From 28,049 Chinese and American Adults
Authors: Zhang Ruiying , Sun Jie , Wang Chaofan , Wang Xiangtuo , Zhao Pei , Yuan Yucong , Ai Hu , Zhou Qi 
Published: February 2022

BackgroundPrevious studies have revealed ethnic disparities in the prevalence of metabolic syndrome (MetS); however, the literature regarding aging-related patterns of disparities in MetS and its components remains limited.MethodsThis cross-sectional study recruited 28,049 subjects, consisting of one Chinese race and three American races, 18–85 years of age, from the National Health and Nutrition Examination Survey (NHANES, 1999–2018) of the United States, and the Guangdong Gut Microbiome Project (GGMP, 2018) of China. MetS was defined in accordance with the National Cholesterol Education Program Adult Treatment Panel III. A modified sliding-window-based algorithm was used to depict the trajectories of the prevalence of MetS with increased age. Logistic regression analysis was performed to investigate associations between MetS and its components.ResultsThe prevalence of MetS increased non-linearly with age, with growth speed reaching its maximum at approximately 40–50 years. Chinese subjects exhibited a lower prevalence of MetS than non-Hispanic whites, non-Hispanic blacks, and Mexican Americans in all age groups. The two most prevalent components in Chinese subjects were reduced high-density lipoprotein cholesterol levels (42.0%) and elevated blood pressure (49.5%), and elevated triglyceride levels (36.3–49.5%) and abdominal obesity (55.8–55.9%) in Americans. Before 40 years of age, the top two MetS-associated components were abdominal obesity and elevated triglyceride levels in all races, while after 40 years, the prominent associations between MetS and its components varied among the different races and age groups.ConclusionsAlthough racial disparities in the epidemic of MetS varied with increased age, abdominal obesity and elevated triglyceride levels were the top two MetS-associated components in all younger adults of different races.