bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of dual-task training in patients with post-stroke cognitive impairment: A randomized controlled trial
Authors: Sun Ruifeng , Li Xiaoling , Zhu Ziman , Li Tiancong , Zhao Man , Mo Linhong , Li Wenshan , Xi Xiaoshuang , Huang Peiling , Gong Weijun 
Published: October 2022

BackgroundEvidence for the efficacy of cognitive-motor dual-task (CMDT) training in patients with post-stroke cognitive impairment (PSCI) and no dementia is still lacking. More importantly, although some studies on the cognitive effect of CMDT training show an improvement in cognitive performance, the results are still controversial, and the intervention mechanism of CMDT training on cognitive function improvement is not clear. The main purpose of this study was to analyze the effects of CMDT training on cognitive function, neuron electrophysiology, and frontal lobe hemodynamics in patients with PSCI.MethodsHere we tested the effects of CMDT training on cognitive function in PSCI patients. Forty subjects who met the criteria of PSCI were randomly assigned to control and experimental groups. CMDT training or cognitive task (CT) training was administered to each patient in the experimental and control groups, respectively. All subjects performed Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale before and after the intervention, and the event-related potentials (ERP) and functional near-infrared spectroscopy (fNIRS) were used to evaluate the changes in neuron electrophysiology and hemodynamics.ResultsForty patients were randomized across Beijing Rehabilitation Hospital Capital Medical University in Beijing. At the end of the intervention, 33 subjects completed the experimental process. The CMDT group showed significant improvement in the MMSE (P = 0.01) and MoCA (P = 0.024) relative to the CT group. The results of ERP and fNIRS showed that CMDT training could shorten the latency of P300 (P = 0.001) and the peak time of oxygenated hemoglobin (P = 0.004). The results showed that CMDT training shortened the response time of central neurons and significantly increased the rate of oxygen supply to the frontal lobe.ConclusionCMDT training in patients with PSCI improved global cognitive function, which was supported by the improved neural efficiency of associated brain areas.Clinical trial registrationhttp://www.chictr.org.cn, identifier ChiCTR2000034862.
Effect of garlic extract on weight loss and gut microbiota composition in obese women: A double-blind randomized controlled trial
Authors: Ettehad-Marvasti Fateme , Ejtahed Hanieh-Sadat , Siadat Seyed-Davar , Soroush Ahmad-Reza , Hoseini-Tavassol Zahra , Hasani-Ranjbar Shirin , Larijani Bagher 
Published: October 2022

ObjectiveFrom a nutritional perspective, garlic extract could be a prebiotic product, which is useful for obese subjects, and one of its health-promoting underlying mechanisms is modulating gut microbiota composition. In this randomized double-blind clinical trial, the goal was to determine the effect of Allium (garlic extract) on anthropometric indices and gut microbiota composition in obese women following a low-calorie diet.Materials and methodsForty-three obese women were randomly divided into garlic extract (400 mg Allium sativum powder containing 1,100 mcg allicin/tablet) or placebo groups. During the 2 months of the study, each participant took two tablets per day. At the beginning and at the end of the clinical trial, anthropometric measurements were done and blood and fecal samples were collected. We evaluated the gut microbiota composition using quantitative real-time PCR.ResultsIn total, 16 subjects in each group completed the 2-month trial. Allium and placebo groups’ participants had mean ages of 37.8 ± 7.4 and 34.2 ± 6.8 years, respectively (P &gt; 0.05). Baseline body mass index (BMI) was significantly different between groups, subjects in the placebo group had lower BMI compared with the Allium group (P &lt; 0.05). Allium and placebo caused a 1.7% and 2.7% decrease in BMI from the baseline values, respectively (P &lt; 0.01). Fasting insulin level significantly decreased in the both groups (P &lt; 0.01). Level of homeostasis model assessment of insulin resistance (HOMA-IR) has decreased significantly in the Allium group (P = 0.007). The frequency of Akkermansia had decreasing trend while the abundance of Faecalibacterium and Bifidobacterium showed increasing trend in the Allium group.ConclusionIn the both groups, a decrease in BMI and other anthropometric indices has been observed. Despite weight loss after following a low-calorie diet and taking Allium, slight changes have been shown in the composition of gut microbiota in obese women.Trial registrationThis trial was registered in the Iranian Registry of Clinical Trials (IRCT) (code: IRCT090420001825N2).
Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index
Authors: Huang Benjamin , Huang Weiting , Allen John Carson , Sun Lijuan , Goh Hui Jen , Kong Siew Ching , Lee Dewaine , Ding Cherlyn , Bosco Nabil , Egli Leonie , Actis-Goretta Lucas , Magkos Faidon , Arigoni Fabrizio , Leow Melvin Khee-Shing , Tan Swee Yaw , Yeo Khung Keong 
Published: October 2022

BackgroundSubclinical atherosclerosis can be present in individuals with an optimal cardiovascular risk factor profile. Traditional risk scores such as the Framingham risk score do not adequately capture risk stratification in low-risk individuals. The aim of this study was to determine if markers of metabolic syndrome and insulin resistance can better stratify low-risk individuals.MethodsA cross-sectional study of 101 healthy participants with a low Framingham risk score and no prior morbidities was performed to assess prevalence of subclinical atherosclerosis using computed tomography (CT) and ultrasound. Participants were compared between groups based on Metabolic Syndrome (MetS) and Insulin-Sensitivity Index (ISI-cal) scores.ResultsTwenty three individuals (23%) had subclinical atherosclerosis with elevated CT Agatston score ≥1. Presence of both insulin resistance (ISI-cal &lt;9.23) and fulfillment of at least one metabolic syndrome criterion denoted high risk, resulting in significantly improved AUC (0.706 95%CI 0.588–0.822) over the Framingham risk score in predicting elevated CT Agatston score ≥1, with net reclassification index of 50.9 ± 23.7%. High-risk patients by the new classification also exhibited significantly increased carotid intima thickness.ConclusionsThe overlap of insulin resistance and presence of ≥1 criterion for metabolic syndrome may play an instrumental role in identifying traditionally low-risk individuals predisposed to future risk of atherosclerosis and its sequelae.
Strategies in activating lymphatic system to promote lymph flow on lymphedema symptoms in breast cancer survivors: A randomized controlled trial
Authors: Du Xinwen , Li Yuan , Fu Lan , Chen Huaying , Zhang Xiaoxia , Shui Yuping , Zhang Aihua , Feng Xianqiong , Fu Mei Rosemary 
Published: October 2022

BackgroundMany breast cancer survivors face long-term postoperative challenges as a result of developing lymphedema symptoms and chronic lymphedema. The-Optimal-Lymph-Flow (TOLF) program is an intervention based on physiological-cognitive-behavioral principles that teaches patients self-management strategies to activate lymphatic system and promote lymph flow to decrease lymphatic pain, reduce the risk and severity of lymphedema.ObjectiveThe purpose of this pilot clinical trial was to evaluate the use of TOLF program as an early intervention on improving lymphedema symptom experience (i.e., symptom number, symptom severity, symptom distress, and the impact of symptoms on patients’ activities of daily living) and optimizing lymph fluid levels (measured by the arm volume differences) among breast cancer survivors.MethodsThis study is a parallel, randomized clinical trial. A total of 92 breast cancer patients were randomly assigned to either the TOLF intervention group or the control group focusing on promoting arm mobility. Data were collected at baseline and end of the trial at the 3-month post intervention. The Breast Cancer and Lymphedema Symptom Experience Index was used to measure lymphedema symptom experience. Anthropometric measurements were used for circumferential arm measurements. Generalized linear mixed-effects models were used to evaluate the trial outcomes.ResultsSignificant improvements of lymphedema symptom experience were found in patients in the TOLF intervention group in comparison with patients in control group: the number of lymphedema symptoms (P&lt;0.001) and the severity of lymphedema symptoms (P&lt;0.001) as well as the impact of symptoms on patients’ daily living function (P&lt;0.001). Patients in both groups showed improvements in all study outcomes over the 3 months, whereas those in the TOLF group gained greater benefits in reducing the number and severity of lymphedema symptoms. Moreover, the TOLF group had significantly fewer patients with ≥5% arm volume differences ([5/45] vs [13/43], P=0.035) at the study endpoint.ConclusionsFindings of the study demonstrated positive outcomes of relieving lymphedema symptom experience, optimizing arm circumference and halting the progression of lymphedema status in breast cancer survivors receiving TOLF intervention during early postoperative time. Given its feasibility, acceptability, and effectiveness, this program may be incorporated in routine breast cancer care.Clinical Trial Registrationhttp://www.chictr.org.cn/index.aspx, identifier ChiCTR1800016713.
Improved risk stratification by PET-based intratumor heterogeneity in children with high-risk neuroblastoma
Authors: Li Chao , Wang Shaoyan , Li Can , Yin Yafu , Feng Fang , Fu Hongliang , Wang Hui , Chen Suyun 
Published: October 2022

PurposeThe substratification of high-risk neuroblastoma is challenging, and new predictive imaging biomarkers are warranted for better patient selection. The aim of the study was to evaluate the prognostic role of PET-based intratumor heterogeneity and its potential ability to improve risk stratification in neuroblastoma.MethodsPretreatment 18F-FDG PET/CT scans from 112 consecutive children with newly diagnosed neuroblastoma were retrospectively analyzed. The primary tumor was segmented in the PET images. SUVs, volumetric parameters including metabolic tumor volume (MTV) and total lesion glycolysis (TLG), and texture features were extracted. After the exclusion of imaging features with poor and moderate reproducibility, the relationships between the imaging indices and clinicopathological factors, as well as event-free survival (EFS), were assessed.ResultsThe median follow-up duration was 33 months. Multivariate analysis showed that PET-based intratumor heterogeneity outperformed clinicopathological features, including age, stage, and MYCN, and remained the most robust independent predictor for EFS [training set, hazard ratio (HR): 6.4, 95% CI: 3.1–13.2, p &lt; 0.001; test set, HR: 5.0, 95% CI: 1.8–13.6, p = 0.002]. Within the clinical high-risk group, patients with a high metabolic heterogeneity showed significantly poorer outcomes (HR: 3.3, 95% CI: 1.6–6.8, p = 0.002 in the training set; HR: 4.4, 95% CI: 1.5–12.9, p = 0.008 in the test set) compared to those with relatively homogeneous tumors. Furthermore, intratumor heterogeneity outran the volumetric indices (MTVs and TLGs) and yielded the best performance of distinguishing high-risk patients with different outcomes with a 3-year EFS of 6% vs. 47% (p = 0.001) in the training set and 9% vs. 51% (p = 0.004) in the test set.ConclusionPET-based intratumor heterogeneity was a strong independent prognostic factor in neuroblastoma. In the clinical high-risk group, intratumor heterogeneity further stratified patients with distinct outcomes.
Anal squamous cell carcinoma: Impact of radiochemotherapy evolution over years and an explorative analysis of MRI prediction of tumor response in a mono-institutional series of 131 patients
Authors: Bonù Marco Lorenzo , La Mattina Salvatore , Singh Navdeep , Toraci Cristian , Spiazzi Luigi , Terraneo Fabrizia , Barbera Fernando , Vitali Paola , Frassine Francesco , Guerini Andrea , Triggiani Luca , Tomasini Davide , Morelli Vittorio , Imbrescia Jessica , Andreuccetti Jacopo , Frittoli Barbara , Pittiani Frida , Grazioli Luigi , Portolani Nazario , Nicosia Luca , Albano Domenico , Bertagna Francesco , Magrini Stefano Maria , Buglione Michela 
Published: October 2022

IntroductionRadiochemotherapy (RCHT) for the treatment of anal squamous cell carcinoma (ASCC) has evolved dramatically, also thanks to intensity-modulated RT (IMRT) and 3D image guidance (3D IGRT). Despite most patients presenting fair outcomes, unmet needs still exist. Predictors of poor tumor response are lacking; acute toxicity remains challenging; and local relapse remains the main pattern of failure.Patients and methodsBetween 2010 and 2020, ASCC stages I–III treated with 3D conformal radiotherapy or IMRT and CDDP-5FU or Mytomicine-5FU CHT were identified. Image guidance accepted included 2D IGRT or 3D IGRT. The study endpoints included freedom from locoregional recurrence (FFLR), colostomy free survival (CFS), freedom from distant metastasis (FFDM), overall survival (OS), and acute and late toxicity as measured by common terminology criteria for adverse events (CTCAE) version 5.0. An exploratory analysis was performed to identify possible radiomic predictors of tumor response. Feature extraction and data analysis were performed in Python™, while other statistics were performed using SPSS® v.26.0 software (IBM®).ResultsA total of 131 patients were identified. After a median FU of 52 months, 83 patients (63.4%) were alive. A total of 35 patients (26.7%) experienced locoregional failure, while 31 patients (23.7%) relapsed with distant metastasis. Five year FFLR, CFS, DMFS and PS resulted 72.3%, 80.1%, 74.5% and 64.6%. In multivariate analysis, 2D IGRT was associated with poorer FFLR, OS, and CFS (HR 4.5, 4.1, and 5.6, respectively); 3DcRT was associated with poorer OS and CFS (HR 3.1 and 6.6, respectively). IMRT reduced severe acute gastro-intestinal (GI) and severe skin acute toxicity in comparison with 3DcRT. In the exploratory analysis, the risk of relapse depended on a combination of three parameters: Total Energy, Gray Level Size Zone Matrix’s Large Area High Gray Level Emphasis (GLSZM’s LAHGLE), and GTV volume.ConclusionsAdvances in radiotherapy have independently improved the prognosis of ASCC patients over years while decreasing acute GI and skin toxicity. IMRT and daily 3D image guidance may be considered standard of care in the management of ASCC. A combination of three pre-treatment MRI parameters such as low signal intensity (SI), high GLSZM’s LAHGLE, and GTV volume could be integrated in risk stratification to identify candidates for RT dose-escalation to be enrolled in clinical trials.
Case report: First case of undifferentiated embryonal sarcoma of the liver in a child with neurofibromatosis type 1, treated by hepatic chemoperfusion with transcatheter arterial chemoembolization
Authors: Sinichenkova Ksenia , Yasko Ludmila , Akhaladze Dmitry , Petrushin Anton , Konovalov Dmitry , Abasov Ruslan , Mareeva Yulia , Melekhina Olga , Usman Natalia , Karachunsky Alexander , Novichkova Galina , Litvinov Dmitry , Druy Alexander 
Published: October 2022

IntroductionIn this report we firstly describe undifferentiated embryonal sarcoma of the liver (UESL) in a patient with neurofibromatosis type 1 (NF1), fatally complicated by synchronous malignant peripheral nerve sheath tumor (MPNST) with a highly aggressive metastatic course. The case also represents our first experience of chemoperfusion involving the transcatheter arterial chemoembolization (TACE) in a pediatric patient, applied as a treatment for UESL.Case presentationA 13-year-old girl was diagnosed with NF1 and presented with a liver tumor identified as UESL by histological assessment. The tumor was refractive to the conventional first-line chemotherapy. The patient received hepatic chemoperfusion with TACE, which was efficacious; however, the overall curative outcome was unsatisfactory due to synchronous unresectable retroperitoneal MPNST with mesenteric metastases and ultimate progression of the UESL.ConclusionThis is the first reported case of UESL in a patient with NF1. The results demonstrate the efficacy of hepatic chemoperfusion with TACE in pediatric UESL.
Liver injury during durvalumab-based immunotherapy is associated with poorer patient survival: A retrospective analysis
Authors: Swanson Linnea A. , Kassab Ihab , Tsung Irene , Schneider Bryan J. , Fontana Robert J. 
Published: October 2022

BackgroundDurvalumab is approved for the treatment of lung cancer, advanced biliary tract cancers, and is also being evaluated in many other solid organ tumors. The aim of our study is to define the incidence, etiology, and outcomes of liver injury in consecutive patients receiving durvalumab-based immunotherapy.Patients and methodsDurvalumab treated patients between 1/2016 – 7/2020 were identified from the electronic medical record. Liver injury was defined as serum AST or ALT ≥ 5x upper limit of normal (ULN), ALP ≥ 2x ULN, bilirubin ≥ 2.5 mg/dl, or INR ≥ 1.5. Potential drug induced liver injury (DILI) cases were adjudicated using expert opinion scoring and confirmed with Roussel Uclaf Causality Assessment Method (RUCAM).ResultsAmongst 112 patients, 58 (52%) had non-small cell lung cancer, the median age was 65 years, and 60% were male. The 21 (19%) liver injury patients were significantly more likely to harbor hepatic metastases (52% vs 17%, p=&lt;0.001), experience tumor progression (67% vs 32%, p=0.01) or die (48% vs 11%, p&lt;0.001) during follow-up compared to the 91 without liver injury. Using multivariate regression analysis, the development of liver injury during treatment as well as baseline hepatic metastases were independently associated with mortality during follow-up. Six of the 21 (29%) liver injury cases were adjudicated as probable DILI with four attributed to durvalumab and two due to other drugs (paclitaxel, pembrolizumab). Durvalumab was permanently discontinued in two DILI patients, three received corticosteroids, and one was successfully rechallenged. Only one patient with DILI developed jaundice, and none required hospitalization. Liver biochemistries normalized in all 6 DILI cases, while they only normalized in 27% of the 15 non-DILI cases (p=0.002). The 6 DILI patients also had a trend towards improved survival compared to those with other causes of liver injuryConclusionLiver injury was observed in 19% of durvalumab-treated patients and is associated with a greater likelihood of tumor progression and death during follow-up. The four durvalumab DILI cases were mild and self-limited, highlighting the importance of causality assessment to determine the cause of liver injury in oncology patients receiving immunotherapy.
Development and validation of a population-based prognostic nomogram for primary colorectal lymphoma patients
Authors: Chen Qian , Feng Yang , Yang Jiaxin , Liu Rui 
Published: October 2022

BackgroundPrimary colorectal lymphoma (PCL) is a relatively rare cancer type, constituting 15%–20% of primary gastrointestinal lymphoma and &lt;1% of all colorectal malignancies. Given its low incidence, standard guidelines for case management are not available. This large population-based study aims to construct a nomogram to predict survival outcomes and to help tailor individualised treatment decisions in patients with PCL.MethodsA retrospective cohort study of patients with PCL was developed using data registered in the Surveillance, Epidemiology, and End Results (SEER) database between 1990 and 2015. The prognostic nomogram was constructed using R software after univariate and multivariate Cox regression analyses. Cox regression models were assessed using the proportional hazards (PH) assumption. Kaplan−Meier survival analysis was used to analyze survival outcomes. The 1-, 3-, 5-, and 10-year area under the curve (AUC) values of ROC (receiver operating characteristic) curves, the concordance index (C-index), and calibration curves were calculated to verify the predictive performance of the nomogram.ResultsThe final nomogram included age, Ann Arbor stage, histology, location, marital status, and treatment, all of which had an important effect on overall survival (OS). The discrimination of the nomogram revealed good prognostic accuracy and clinical applicability as indicated by C-index values of 0.713 and 0.711 in the training and validation cohorts, respectively. Kaplan−Meier survival curves were significantly different for distinct conditions.ConclusionThis study developed and validated a six-factor nomogram for predicting PCL patient prognosis. This nomogram might be useful for risk stratification and making better individualised decisions for PCL patients.
Discovery of novel anti-tumor compounds targeting PARP-1 with induction of autophagy through in silico and in vitro screening
Authors: Shi Danfeng , Pang Qianqian , Qin Qianyu , Yao Xinsheng , Yao Xiaojun , Yu Yang 
Published: October 2022

Poly (ADP-ribose) polymerase 1 (PARP-1) is a critical enzyme involved in DNA damage repair and recombination, and shows great potential for drug development in the treatment of cancers with defective DNA repair. The anti-tumor activities of PARP-1 inhibitors are regulated by both inhibition activities and allosteric mechanisms of PARP-1, and may also be involved in an autophagy-mediated process. Screening PARP-1 inhibitors with potential allosteric mechanisms and induced autophagy process could achieve elevated potency toward cancer cell killing. In this study, we tried to discover novel anti-tumor compounds targeting PARP-1 by computer simulations and in vitro screening. In order to filter PARP-1 inhibitors that could affect the folding state of the helix domain (HD) on PARP-1, the free energy contribution of key residues on HD were systematically analyzed using the ligand-binding crystal structures and integrated into in silico screening workflow for the selection of 20 pick-up compounds. Four compounds (Chemdiv codes: 8012-0567, 8018-6529, 8018-7168, 8018-7603) were proved with above 40% inhibitory ratio targeting PARP-1 under 20 μM, and further performed binding mode prediction and dynamic effect evaluation by molecular dynamics simulation. Further in vitro assays showed that compounds 8018-6529 and 8018-7168 could inhibit the growth of the human colorectal cancer cell (HCT-116) with IC50 values of 4.30 and 9.29 μM and were accompanied with an induced autophagy process. Taken together, we discover two novel anti-tumor compounds that target PARP-1 with an induced autophagy process and provide potential hit compounds for the anti-cancer drug development.