bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Axial Length From Choroidal Thickness on Optical Coherence Tomography Images With Machine Learning Based Algorithms
Authors: Lu Hao-Chun , Chen Hsin-Yi , Huang Chien-Jung , Chu Pao-Hsien , Wu Lung-Sheng , Tsai Chia-Ying 
Published: June 2022

PurposeWe formulated and tested ensemble learning models to classify axial length (AXL) from choroidal thickness (CT) as indicated on fovea-centered, 2D single optical coherence tomography (OCT) images.DesignRetrospective cross-sectional study.ParticipantsWe analyzed 710 OCT images from 355 eyes of 188 patients. Each eye had 2 OCT images.MethodsThe CT was estimated from 3 points of each image. We used five machine-learning base algorithms to construct the classifiers. This study trained and validated the models to classify the AXLs eyes based on binary (AXL &lt; or &gt; 26 mm) and multiclass (AXL &lt; 22 mm, between 22 and 26 mm, and &gt; 26 mm) classifications.ResultsNo features were redundant or duplicated after an analysis using Pearson’s correlation coefficient, LASSO-Pattern search algorithm, and variance inflation factors. Among the positions, CT at the nasal side had the highest correlation with AXL followed by the central area. In binary classification, our classifiers obtained high accuracy, as indicated by accuracy, recall, positive predictive value (PPV), negative predictive value (NPV), F1 score, and area under ROC curve (AUC) values of 94.37, 100, 90.91, 100, 86.67, and 95.61%, respectively. In multiclass classification, our classifiers were also highly accurate, as indicated by accuracy, weighted recall, weighted PPV, weighted NPV, weighted F1 score, and macro AUC of 88.73, 88.73, 91.21, 85.83, 87.42, and 93.42%, respectively.ConclusionsOur binary and multiclass classifiers classify AXL well from CT, as indicated on OCT images. We demonstrated the effectiveness of the proposed classifiers and provided an assistance tool for physicians.
Associations Between Sarcopenia, Heart Failure and Myocardial Infarction in Patients With Systemic Lupus Erythematosus and Rheumatoid Arthritis
Authors: Chang Ching-Mao , Lin Jr-Rung , Fu Tieh-Cheng 
Published: June 2022

ObjectivesTo evaluate associations between sarcopenia, type of autoimmune disease and risk of heart failure (HF) and myocardial infarction (MI) in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).MethodsIn this population-based, cross-sectional study, discharge data from the 2005–2014 US Nationwide Inpatient Sample (NIS) of hospitalized patients with SLE or RA were extracted and analyzed. Univariate and multivariable regression analyses were conducted to determine associations between sarcopenia, type of autoimmune disease and risk of HF/MI.ResultsAfter exclusions, 781,199 hospitalized patients diagnosed with SLE or RA were included. Among the study cohort, 127,812 (16.4%) were hospitalized with HF, and 12,781 (1.6%) were hospitalized with MI. Sarcopenia was found in only 0.1% of HF/MI patients. Logistic regression analyses revealed that sarcopenia was not significantly associated with presence of either HF or MI. Patients with RA had significantly lower odds of HF than SLE patients (aOR = 0.77, 95%CI: 0.76, 0.79) or MI (aOR = 0.86, 95%CI: 0.82, 0.91).ConclusionIn the US, among hospitalized adults diagnosed with SLE or RA, patients with RA are significantly less likely to have HF or MI than those with SLE. Whether sarcopenia leads to increased HF or MI remains inconclusive. Further studies are warranted to investigate the pathophysiology underlying discrepancies between RA and SLE regarding risk for MI or HF.
Longitudinal Photoreceptor Phenotype Observation and Therapeutic Evaluation of a Carbonic Anhydrase Inhibitor in a X-Linked Retinoschisis Mouse Model
Authors: Liu Meng , Liu Jingyang , Wang Weiping , Liu Guangming , Jin Xiuxiu , Lei Bo 
Published: June 2022

PurposeTo study the long-term photoreceptor changes and to evaluate the effects of topical application of a carbonic anhydrase inhibitor (CAI) in a mouse model of X-linked retinoschisis (XLRS).MethodsConventional electroretinograms (ERGs) and dark-adapted 10-Hz flicker ERGs were recorded in control and Rs1−/Y mice generated with CRISPR/Cas9. ON-pathway blocker 2-amino-4-phosphobutyric acid (APB) was injected intravitreally. Morphology was evaluated with histology and optical coherence tomography (OCT). Mice were treated with a CAI inhibitor brinzolamide eye drops (10 mg/ml) three times a day for 3 months. OCT and ERG findings at 1, 4, and 10 months were analyzed.ResultsNegative ERGs and retinal cavities were evident in Rs1−/Y mice. Both a-wave and b-wave amplitudes decreased with age when compared with age-matched controls. The APB-isolated a-wave (a′) amplitudes of Rs1−/Y mice were reduced in all age groups. In dark-adapted 10-Hz flicker ERG, the amplitude-intensity curve of Rs1−/Y mice shifted down. The thickness of ONL and IS/OS decreased in Rs1−/Y mice. CAI reduced the splitting retinal cavities but didn't affect the ERG.ConclusionsIn addition to post receptoral impairments, photoreceptor cells underwent progressive dysfunction since early age in Rs1−/Y mice. Long-term CAI treatment improved the shrinkage of the splitting retinal cavity, while no functional improvement was observed.
Effect of the Age-Adjusted Charlson Comorbidity Index on All-Cause Mortality and Readmission in Older Surgical Patients: A National Multicenter, Prospective Cohort Study
Authors: Zhang Xiao-Ming , Wu Xin-Juan , Cao Jing , Guo Na , Bo Hai-Xin , Ma Yu-Fen , Jiao Jing , Zhu Chen 
Published: June 2022

BackgroundIdentifying a high-risk group of older people before surgical procedures is very important. The study aimed to explore the association between the age-adjusted Charlson comorbidity index (ACCI) and all-cause mortality and readmission among older Chinese surgical patients (age ≥65 years).MethodsA large-scale cohort study was performed in 25 general public hospitals from six different geographic regions of China. Trained registered nurses gathered data on clinical and sociodemographic characteristics. All-cause mortality was recorded when patients died during hospitalization or during the 90-day follow-up period. Readmission was also tracked from hospital discharge to the 90-day follow-up. The ACCI, in assessing comorbidities, was categorized into two groups (≥5 vs. &lt;5). A multiple regression model was used to examine the association between the ACCI and all-cause mortality and readmission.ResultsThere were 3,911 older surgical patients (mean = 72.46, SD = 6.22) in our study, with 1,934 (49.45%) males. The average ACCI score was 4.77 (SD = 1.99), and all-cause mortality was 2.51% (high ACCI = 5.06% vs. low ACCI = 0.66%, P &lt; 0.001). After controlling for all potential confounders, the ACCI score was an independent risk factor for 90-day hospital readmission (OR = 1.18, 95% CI: 1.14, 1.23) and 90-day all-cause mortality (OR = 1.26, 95% CI: 1.16–1.36). Furthermore, older surgical patients with a high ACCI (≥5) had an increased risk of all-cause mortality (OR = 6.13, 95% CI: 3.17, 11.85) and readmission (OR = 2.13, 95% CI: 1.78, 2.56) compared to those with a low ACCI (&lt;5). The discrimination performance of the ACCI was moderate for mortality (AUC:0.758, 95% CI: 0.715–0.80; specificity = 0.591, sensitivity = 0.846) but poor for readmission (AUC: 0.627, 95% CI: 0.605–0.648; specificity = 0.620; sensitivity = 0.590).ConclusionsThe ACCI is an independent risk factor for all-cause mortality and hospital readmission among older Chinese surgical patients and could be a potential risk assessment tool to stratify high-risk older patients for surgical procedures.
What Determines That Older Adults Feel Younger Than They Are? Results From a Nationally Representative Study in Germany
Authors: Heimrich Konstantin G. , Prell Tino , Schönenberg Aline 
Published: June 2022

BackgroundThere is increasing evidence that subjective age is an important predictor of beneficial health outcomes besides chronological age. However, little is known about the factors associated with younger subjective age. This study aimed to identify which factors are predictive of feeling younger in old age. In this context, feeling younger was defined as an individual's perception of being younger than their current chronological age.MethodsData from 4,665 community-dwelling older people were drawn from wave 7 (2020) of the German Aging Survey (DEAS), a nationally representative study in Germany. Network, mediation, and binomial logistic regression analyses were performed to reveal the associations between feeling younger and biopsychosocial factors.ResultsA total of 4,039 participants reported feeling younger, while 626 did not. Older chronological age, engaging in sports more frequently, a better standard of living, a better state of health, higher satisfaction with life, more positive attitudes toward one's aging, and fewer depressive symptoms are associated with feeling younger in older people.ConclusionThe present study provides novel and consistent evidence regarding the association between feeling younger and biopsychosocial factors. Further research is needed to confirm these factors and identify how they can be adapted in potential intervention studies to generate the life and health circumstances that allow older people the benefit of feeling younger.
The Association Between METS-IR and Serum Ferritin Level in United States Female: A Cross-Sectional Study Based on NHANES
Authors: Hao Han , Chen Yan , Xiaojuan Ji , Siqi Zhang , Hailiang Chu , Xiaoxing Sun , Qikai Wang , Mingquan Xing , Jiangzhou Feng , Hongfeng Ge 
Published: June 2022

AimThe aim of this study was to investigate the association between the metabolic score for insulin resistance (METS-IR) and serum ferritin in females from the United States.MethodsWe conducted a cross-sectional study with 4,182 participants from the National Health and Nutrition Examination Survey (NHANES). We used METS-IR and serum ferritin as the independent and dependent variables in this study and investigated the relationship by using multiple linear regression and verified the non-linear relationship with a smooth curve fit and threshold effect model.ResultsThere was a positive relationship between METS-IR and serum ferritin, with an effect value of (β = 0.29, 95% CI: 0.14–0.44) in a fully adjusted model adjusted for potential confounders. This positive correlation became more significant as METS-IR increased (p for trend &lt; 0.001). Subsequent subgroup analyses showed that sensitive cohorts were those aged ≥40 years, black, and with a body mass index (BMI) &lt; 24.9 kg/m2. In a smoothed curve fit analysis, the correlation between METS-IR and serum ferritin was a straight linear relationship in all participants included in this study, but when stratified by age, race, and BMI, this positive correlation in the participants who were aged ≥40 years old, other race, and had a BMI &lt; 24.9 kg/m2 was non-linear.ConclusionsThere was a positive association between METS-IR and serum ferritin in United States females, and this positive association was more pronounced in participants aged ≥40 years, black race and BMI &lt; 24.9 kg/m2. This positive association was non-linear in the subgroups aged ≥40 years, white race and BMI &lt; 24.9 kg/m2, with inflection points for METS-IR of 69.97, 67.84 and 35.84 in these respective subgroups.
New Screening System Using Forward-Viewing Radial Endoscopic Ultrasound and Magnetic Resonance Imaging for High-Risk Individuals With Familial History of Pancreatic Cancer
Authors: Ashida Reiko , Ioka Tatsuya , Takada Ryoji , Fukutake Nobuyasu , Ikezawa Kenji , Ohkawa Kazuyoshi , Nagata Shigenori , Takahashi Hidenori 
Published: June 2022

Background and AimsAttention is increasingly being paid to family history of pancreatic cancer (PC) as a risk factor for developing PC. It is mandatory to develop a screening system for early detection of PC; however, the relationship between a family history of PC and the incidence of pancreatic abnormalities, such as pancreatic cyst and chronic pancreatitis (CP), in the Japanese population remains unknown.Patients and MethodsIndividuals with a family history of PC were prospectively enrolled in a screening program using forward-viewing radial endoscopic ultrasound (FR-EUS) and magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) as the diagnostic modalities.ResultsIn total, forty-three individuals in 37 families were enrolled (mean age, 54 years). All individuals underwent FR-EUS and MRI with no complications. FR-EUS revealed resectable PC (n = 1, 2.3%), pancreatic cysts (n = 24, 55.8%), intraductal papillary mucinous neoplasm (IPMN; n = 13, 30.2%), and early CP-like appearance (n = 15, 34.9%). The detection rate of early CP-like appearance was significantly higher by EUS than by MRI. Pancreatic cysts and IPMN detected by FR-EUS were significantly correlated to age (≥60 years) and less correlated to men (hazard ratio [HR] 22.4; 95% confidence interval [CI], 2.10–236.0; p &lt; 0.01 and HR 0.092; 95% CI, 0.01–0.83; p = 0.033, respectively). Early CP-like appearance detected by FR-EUS was significantly correlated with men and smoking (HR 5.0; 95% CI, 1.3–19.3; p = 0.02 and HR 4.02; 95% CI, 0.991–16.3; p = 0.05, respectively).ConclusionA screening system using FR-EUS and MRI/MRCP for individuals with a family history of PC was useful for identifying curable PC and pancreatic abnormalities. The incidence of pancreatic cysts, such as IPMN and early CP-like appearance, was also high in the Japanese cohort.
Trabeculectomy With Antimetabolite Agents for Normal Tension Glaucoma: A Systematic Review and Meta-Analysis
Authors: Lai Chin , Shao Shih-Chieh , Chen Yi-Hung , Kuo Yu-Kai , Lai Chi-Chun , Chuang Lan-Hsin 
Published: June 2022

BackgroundEvidence regarding the impact on visual field (VF), intraocular pressure (IOP), and antiglaucoma medications from trabeculectomy with antimetabolites for normal tension glaucoma (NTG) is conflicting because of insufficient study sample sizes. The aim of this study is to systematically assess VF progression rate, IOP control and antiglaucoma medication use after trabeculectomy with antimetabolites for progressing NTG.MethodsWe searched published articles on PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials from database inception to March 21, 2022. We selected studies that reported VF data before and after trabeculectomy with antimetabolite agents for NTG. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. Data were extracted by 2 independent reviewers, and a random-effects model was employed for the meta-analysis. Study outcomes were VF progression rates measured using the pooled mean deviation (MD) slope, changes in antiglaucoma medications, and IOP. Subgroup analyses of the MD slope according to mean age (over or under 65 years), baseline MD (over or under –12 dB), and baseline IOP (over or under 15 mmHg) were performed to determine the results’ robustness.ResultsWe included 7 retrospective observational studies (Japan: 6 studies, United States: 1 study) comprising a total of 166 eyes. Mean preoperative VF MD slopes ranged from –0.52 to –1.05 dB/year. The meta-analysis demonstrated significant MD slope improvement after trabeculectomy (pooled mean difference: 0.54 dB/year, 95% CI: 0.40 to 0.67, I2 = 9%). Mean age, baseline MD, and baseline IOP subgroup analyses revealed MD slope results were consistent with those of the main analyses. The mean IOP (pooled mean difference: –5.54 mmHg, 95% CI: –6.02 to –5.06, I2 = 0%) and mean number of antiglaucoma medications (pooled mean difference: –1.75, 95% CI: –2.97 to –0.53, I2 = 98%) significantly decreased after trabeculectomy. The most frequently reported early complications after trabeculectomy were hypotony, hyphema, and shallow anterior chamber.ConclusionThis systematic review and meta-analysis indicated that trabeculectomy with antimetabolites is beneficial for progressing NTG; it preserves visual function by alleviating the MD slope and reducing antiglaucoma medication use. However, several post-trabeculectomy complications should be monitored.
Wild-Type α-Synuclein and Variants Occur in Different Disordered Dimers and Pre-Fibrillar Conformations in Early Stage of Aggregation
Authors: Guzzo Adrien , Delarue Patrice , Rojas Ana , Nicolaï Adrien , Maisuradze Gia G. , Senet Patrick 
Published: June 2022

α-Synuclein is a 140 amino-acid intrinsically disordered protein mainly found in the brain. Toxic α-synuclein aggregates are the molecular hallmarks of Parkinson’s disease. In vitro studies showed that α-synuclein aggregates in oligomeric structures of several 10th of monomers and into cylindrical structures (fibrils), comprising hundred to thousands of proteins, with polymorphic cross-β-sheet conformations. Oligomeric species, formed at the early stage of aggregation remain, however, poorly understood and are hypothezised to be the most toxic aggregates. Here, we studied the formation of wild-type (WT) and mutant (A30P, A53T, and E46K) dimers of α-synuclein using coarse-grained molecular dynamics. We identified two principal segments of the sequence with a higher propensity to aggregate in the early stage of dimerization: residues 36–55 and residues 66–95. The transient α-helices (residues 53–65 and 73–82) of α-synuclein monomers are destabilized by A53T and E46K mutations, which favors the formation of fibril native contacts in the N-terminal region, whereas the helix 53–65 prevents the propagation of fibril native contacts along the sequence for the WT in the early stages of dimerization. The present results indicate that dimers do not adopt the Greek key motif of the monomer fold in fibrils but form a majority of disordered aggregates and a minority (9–15%) of pre-fibrillar dimers both with intra-molecular and intermolecular β-sheets. The percentage of residues in parallel β-sheets is by increasing order monomer < disordered dimers < pre-fibrillar dimers. Native fibril contacts between the two monomers are present in the NAC domain for WT, A30P, and A53T and in the N-domain for A53T and E46K. Structural properties of pre-fibrillar dimers agree with rupture-force atomic force microscopy and single-molecule Förster resonance energy transfer available data. This suggests that the pre-fibrillar dimers might correspond to the smallest type B toxic oligomers. The probability density of the dimer gyration radius is multi-peaks with an average radius that is 10 Å larger than the one of the monomers for all proteins. The present results indicate that even the elementary α-synuclein aggregation step, the dimerization, is a complicated phenomenon that does not only involve the NAC region.
Towards Photodynamic Image-Guided Surgery of Head and Neck Tumors: Photodynamic Priming Improves Delivery and Diagnostic Accuracy of Cetuximab-IRDye800CW
Authors: Bhandari Chanda , Fakhry John , Eroy Menitte , Song Jane Junghwa , Samkoe Kimberley , Hasan Tayyaba , Hoyt Kenneth , Obaid Girgis 
Published: June 2022

Fluorescence image-guided surgery (IGS) using antibody conjugates of the fluorophore IRDye800CW have revolutionized the surgical debulking of tumors. Cetuximab, an anti-epidermal growth factor receptor (EGFR) monoclonal antibody, conjugated to IRDye800CW (Cet-IRDye800) is the first molecular targeted antibody probe to be used for IGS in head and neck cancer patients. In addition to surgical debulking, Cetuximab-targeted photodynamic therapy (photoimmunotherapy; PIT) is emerging in the clinic as a powerful modality for head and neck tumor photodestruction. A plethora of other photoactivable agents are also in clinical trials for photodynamic-based therapies of head and neck cancer. Considering the vascular and stromal modulating effects of sub-therapeutic photodynamic therapy, namely photodynamic priming (PDP), this study explores the potential synergy between PDP and IGS for a novel photodynamic image-guided surgery (P-IGS) strategy. To the best of our knowledge, this is the first demonstration that PDP of the tumor microenvironment can augment the tumor delivery of full-length antibodies, namely Cet-IRDye800. In this study, we demonstrate a proof-of-concept that PDP primes orthotopic FaDu human head and neck tumors in mice for P-IGS by increasing the delivery of Cet-IRDye800 by up to 138.6%, by expediting its interstitial accumulation by 10.5-fold, and by increasing its fractional tumor coverage by 49.5% at 1 h following Cet-IRDye800 administration. Importantly, PDP improves the diagnostic accuracy of tumor detection by up to 264.2% with respect to vicinal salivary glands at 1 h. As such, PDP provides a time-to-surgery benefit by reducing the time to plateau 10-fold from 25.7 h to 2.5 h. We therefore propose that a pre-operative PDP regimen can expedite and augment the accuracy of IGS-mediated surgical debulking of head and neck tumors and reduce the time-to-IGS. Furthermore, this P-IGS regimen, can also enable a forward-looking post-operative protocol for the photodestruction of unresectable microscopic disease in the surgical bed. Beyond this scope, the role of PDP in the homogenous delivery of diagnostic, theranostic and therapeutic antibodies in solid tumors is of considerable significance to the wider community.
Use of Laparoscopic and Laparotomic J-Plasma Handpiece in Gynecological Malignancies: Results From A Pilot Study in A Tertiary Care Center
Authors: Gueli Alletti Salvatore , Rosati Andrea , Capozzi Vito Andrea , Pavone Matteo , Gioè Alessandro , Cianci Stefano , Chiantera Vito , Vizzielli Giuseppe , Scaglione Giulia , Fagotti Anna , Scambia Giovanni 
Published: June 2022

IntroductionThe J-Plasma has recently been introduced into the surgical community with different intrinsic characteristics aimed to further reduce the thermal effect and enhance precision when compared to standard radiofrequency. This study aimed to investigate the role of this new technology in different conditions of gynecological carcinomatosis characterized by the indication for regional peritonectomy and/or ablation, either in laparotomy (LPT) or in laparoscopy (LPS), in the context of a modern personalized approach to the surgical management of gynecological malignancies.Material and MethodsFrom January 2019 to April 2019, 12 patients were selected for this prospective pilot study at the Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome. In this single surgeon experience, the inclusion criteria were: histologically proven advanced ovarian/endometrial cancer, primary or interval debulking surgery, and intraoperative indication for regional peritonectomy. Six patients were treated by LPS (Group 1) and 6 by LPT (Group 2).ResultsIn Group 1 the indication for debulking surgery was in 4 cases an interval debulking surgery and 2 advanced endometrial cancer. All patients in Group 2 underwent primary debulking surgery for advanced ovarian cancer. The whole cohort achieved a complete tumor excision after surgery. The median OT and median EBL were 195 min and 100 ml in Group 1, and 420 min and 500 ml in Group 2. The median hospital stay was 4 days in Group 1 and 13 days in Group 2, respectively. No intra and postoperative complications were registered within 60 days after surgery.ConclusionsJ-Plasma allows to approach delicate maneuvers on viscera, mesentery, and blood vessels with a high degree of safety and precision thanks to its limited vertical and lateral thermal spread, favoring the surgeon to push ever higher the cytoreduction/morbidity tradeoff. The use of J-Plasma in cytoreductive surgery could also increase the range of possible minimally invasive procedures, narrowing the technical distance with the open technique and thus contributing to designing a personalized surgical strategy for each patient in different scenarios of peritoneal carcinomatosis.