bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Characteristics and Risk Factors for Mortality in Cryptococcal Meningitis: Evidence From a Cohort Study
Authors: Wang Fengjuan , Wang Yu , He Jianqing , Cheng Zhe , Wu Shouquan , Wang Minggui , Niu Ting 
Published: April 2022

IntroductionDespite advances in the diagnosis and management, cryptococcal meningitis (CM) is still associated with high mortality due to insufficient knowledge about clinical characteristics and risk factors for poor outcomes. The aim of the present study is to provide additional evidence for regarding clinical characteristics, diagnosis, and factors associated with increased risk of mortality in CM patients.MethodsIn this cohort study, we included eligible patients consecutively admitted to West China Hospital between January 2009 and December 2018. The clinical characteristics and diagnosis method of cerebrospinal fluid culture and India ink stain were analyzed. Independent risk factors were identified by a multivariable logistic regression.ResultsA total of 186 CM patients were included in the analysis. After a 1-year follow-up, 63 patients had died. Headache is the most common presenting symptom (97.3%), followed by vomiting (72%), fever (71.5%), altered consciousness (45.7%), abnormal vision (32.8%), and seizure (15.1%). Older age, altered consciousness or seizures, lower white blood cell count or total protein in cerebrospinal fluid (CSF), and unidentified CSF cryptococcal antigen (CrAg) are all factors associated with increasing risk of death (P &lt; 0.05). We also found a dose-dependent trend between the number of symptoms and risk of death (trend p &lt; 0.001). Multivariate logistic regression revealed that age (P = 0.004, OR = 1.042, 95% CI 1.013–1.071), seizure (P = 0.025, OR = 3.105, 95% CI 1.152–8.369), altered consciousness (P &lt; 0.001, OR=6.858, 95% CI 3.063–15.38), and unidentified CSF CrAg are the independent prognostic factors. In addition, we observed that diagnosis of 28.5% and 22.5% CM could not be established by a single testing of CSF India ink stain or culture, respectively. Use of multiple testing methods or combination of the two assays increases the detection rate.ConclusionOur data show that older age, seizures, altered consciousness, and an inability to detect CSF CrAg are the independent risk factors of death within 1 year in CM patients. Moreover, we recommend use of multiple testing methods with CSF culture and India ink stain. Combined testing with both assays should be considered for initial CM diagnosis.
Exploring Muscle Health Deterioration and Its Determinants Among Community-Dwelling Older Adults
Authors: Chao Yuan-Ping , Fang Wen-Hui , Chen Wei-Liang , Peng Tao-Chun , Yang Wei-Shiung , Kao Tung-Wei 
Published: April 2022

BackgroundAge-related muscle mass and function decline are critical issues that have gained attention in clinical practice and research. Nevertheless, little is known regarding the time course of muscle health progression, and its determinants during this transition should be estimated.MethodsWe enrolled community-dwelling adults aged ≥65 years during their regular health checkup. The participants’ body composition and muscle function were measured annually from 2015 to 2021. Presarcopenia was characterized by the loss of muscle mass only; dynapenia was defined as low muscle function without changes in muscle mass; and sarcopenia was indicated as a decline in both muscle mass and muscle function. We observed the natural course of muscle health progression during aging. The relationship between muscle health decline and different determinants among old adults was examined.ResultsAmong 568 participants, there was 18.49%, 3.52%, and 1.06% of healthy individuals transited to dynapenia, presarcopenia, and sarcopenia, respectively. Significant positive correlations between age, fat-to-muscle ratio (FMR) and the dynapenia transition were existed [hazard ratio (HR) = 1.08 and HR = 1.73, all p &lt; 0.05]. Serum albumin level had negative correlation with the dynapenia transition risk (HR = 0.30, p = 0.004). Participants with these three risk factors had the highest HR of dynapenia transition compared to those without (HR = 8.67, p = 0.001). A dose-response effect existed between risk factors numbers and the risk of dynapenia transition (p for trend &lt; 0.001). This positive association and dose-response relationship remains after multiple covariates adjustment (HR = 7.74, p = 0.002, p for trend &lt; 0.001). Participants with two or more than two risk factors had a higher risk of dynapenia transition than those with low risk factors (p = 0.0027), and the HR was 1.96 after multiple covariate adjustment (p = 0.029).ConclusionHealthy community-dwelling old adults tended to transit to dynapenia during muscle health deterioration. Individuals with older age, higher FMR, lower albumin level had a higher risk of dynapenia transition; and a positive dose-response effect existed among this population as well.
Pre-sleep Protein Supplementation Affects Energy Metabolism and Appetite in Sedentary Healthy Adults
Authors: Hao Yingying , Li Xingchen , Zhu Zheng , Cao Zhen-Bo 
Published: April 2022

PurposeTo assess the acute effect of pre-sleep protein supplementation combined with resistance exercise on energy metabolism (including 24-h total energy expenditure (TEE), sleep energy expenditure (SEE), basal energy expenditure (BEE), glycolipid oxidation, and appetite of sedentary adults.MethodsA total of thirty-one sedentary participants completed this randomized, double-blind, crossover study. Participants completed the following 24-h experimental conditions in random order in the Human Calorimeter chamber: (1) 40-g protein supplementation with dinner before a nighttime resistance exercise, and followed by pre-sleep placebo intake (PRO-PLA); (2) placebo intake with dinner before a nighttime resistance exercise, and followed by pre-sleep 40-g protein supplementation (PLA-PRO); and (3) placebo supplementation both with dinner and pre-sleep combined with a nighttime resistance exercise (PLA). Subjective appetite score before breakfast the next day was evaluated using the visual analog scale.ResultsThe SEE values were significantly higher by a mean of 21.7 kcal and 33.3 kcal in PRO-PLA (318.3 ± 44.3 kcal) and PLA-PRO (329.9 ± 45.2 kcal), respectively, than in PLA (296.6 ± 46.6 kcal). In addition, the SEE values for PLA-PRO was also significantly higher by 11.6 kcal than that for PRO-PLA. Further, the fullness the next morning was significantly higher by 30.8% in PLA-PRO (43.9 ± 23.5 mm) than in PLA (33.5 ± 26.6 mm). These effects remained after adjustment for 24-h energy intake.ConclusionPre-sleep protein supplementation combined with resistance exercise can significantly increase the SEE and fullness in the next morning, indicating a possible strategy to improve sleep energy metabolism in the sedentary population.
Preoperative Pectoralis Muscle Index Predicts Distant Metastasis-Free Survival in Breast Cancer Patients
Authors: Huang Wen-juan , Zhang Meng-lin , Wang Wen , Jia Qing-chun , Yuan Jia-rui , Zhang Xin , Fu Shuang , Liu Yu-xi , Miao Shi-di , Wang Rui-tao 
Published: April 2022

BackgroundBreast cancer is one of the most commonly diagnosed cancers, and the fourth leading cause of cancer deaths in females worldwide. Sarcopenia is related to adverse clinical outcomes in patients with malignancies. Muscle index is a key parameter in evaluating sarcopenia. However, there is no data investigating the association between muscle index and distant metastasis in breast cancer. The aim of this study was to explore whether muscle index can effectively predict distant metastasis and death outcomes in breast cancer patients.Study DesignThe clinical data of 493 breast cancer patients at the Harbin Medical University Cancer Hospital between January 2014 and December 2015 were retrospectively analyzed. Quantitative measurements of pectoralis muscle area and skeletal muscle area were performed at the level of the fourth thoracic vertebra (T4) and the eleventh thoracic vertebra (T11) of the chest computed tomography image, respectively. The pectoralis muscle index (PMI) and skeletal muscle index (SMI) were assessed by the normalized muscle area (area/the square of height). Survival analysis was performed using the log-rank test and Cox proportional hazards regression analysis.ResultThe patients with metastases had lower PMI at T4 level (PMI/T4) and SMI at T11 level (SMI/T11) compared with the patients without metastases. Moreover, there were significant correlations between PMI/T4 and lymphovascular invasion, Ki67 expression, multifocal disease, and molecular subtype. In addition, multivariate analysis revealed that PMI/T4, not SMI/T11, was an independent prognostic factor for distant metastasis-free survival (DMFS) and overall survival (OS) in breast cancer patients.ConclusionsLow PMI/T4 is associated with worse DMFS and OS in breast cancer patients. Future prospective studies are needed.
Family Size and the Age at Infancy-Childhood Transition Determine a Child’s Compromised Growth in Large Families
Authors: German Alina , Rubin Lisa , Raisin Galiya , Hochberg Ze’ev 
Published: April 2022

BackgroundData on growth of Israeli school children show that children from Jewish ultra-orthodox Haredi and Bedouin Arab families have a higher prevalence of stature below the 3rd percentile. While these populations are usually from lower socioeconomic strata, they also have larger families. This study aimed to evaluate if family structure and the timing of a child’s infancy–childhood transition (ICT) are central to variations in stature.Study DesignWe analyzed the association between family size, birth order and inter-birth interval with child growth and the age at ICT in 3 groups of children, 148 high birth order children from large families (LF ≥ 6), 118 low birth order children from large families (LF ≤ 3) and 150 children from small families (SF).ResultsHigh birth order children from large families were shorter in childhood than children from small families with a difference of 0.5 SDS in length. We found that birth length and birth order explained 35% of the total variance in infancy length whereas ICT age and infancy length explained 72% of the total variance in childhood length.ConclusionInfancy and childhood length are compromised in children from large families. As the family grows larger the younger children tend to be shorter. Reduced length gain in the period between infancy to childhood is when growth is most affected.
Comparative Study of the Perspectives on the Impact of a Culturally Responsive Picture Exchange Communication System for Children With Autism Spectrum Disorder in the United Arab Emirates
Authors: Safi Mohammed , Opoku Maxwell Peprah , Alshamsi Mariam , Abu-shariha Ahmad Hassan 
Published: April 2022

BackgroundThe Picture Exchange Communication System (PECS) is a widely accepted way to develop the communication skills of children with developmental disabilities such as autism spectrum disorder (ASD). However, the efficacy of PECS has been largely studied in Western societies and little research is available regarding its role in the development of children with ASD in a non-Western cultural context. The purpose of this study was to compare the parent and the practitioner perceptions of the use of PECS for children with ASD in the United Arab Emirates.MethodA new scale made up of three subscales was used to collect the data from the parents and the practitioners who were either related to or working with a cohort of children with ASD. The data were analyzed using Statistical Package for the Social Sciences (SPSS) and subjected to the computation of means, t-tests, analysis of variance (ANOVA), binary logistical regression, and two-way factorial ANOVA.ResultsThe results showed uncertainty or neutrality among the parents and the practitioners toward the use of PECS. Variables such as age, years of experience using PECS, and gender were noted to influence perceptions of PECS.ConclusionThe need for policymakers to consider developing regular training for parents and practitioners on the use of PECS and other implications are discussed.
A Phenotypic-Driven Approach for the Diagnosis of WOREE Syndrome
Authors: Riva Antonella , Nobile Giulia , Giacomini Thea , Ognibene Marzia , Scala Marcello , Balagura Ganna , Madia Francesca , Accogli Andrea , Romano Ferruccio , Tortora Domenico , Severino Mariasavina , Scudieri Paolo , Baldassari Simona , Musante Ilaria , Uva Paolo , Salpietro Vincenzo , Torella Annalaura , Nigro Vincenzo , Capra Valeria , Nobili Lino , Striano Pasquale , Mancardi Maria Margherita , Zara Federico , Iacomino Michele 
Published: April 2022

BackgroundWOREE syndrome is a rare neurodevelopmental disorder featuring drug-resistant epilepsy and global developmental delay. The disease, caused by biallelic pathogenic variants in the WWOX gene, usually leads to severe disability or death within the first years of life. Clinicians have become more confident with the phenotypic picture of WOREE syndrome, allowing earlier clinical diagnosis. We report a boy with a peculiar clinic-radiological pattern supporting the diagnosis of WOREE syndrome.MethodsDNA was extracted from blood samples of the proband and his parents and subjected to Exome Sequencing (ES). Agarose gel electrophoresis, real-time quantitative PCR (Q-PCR), and array-CGH 180K were also performed.ResultsES detected a pathogenic stop variant (c.790C &gt; T, p.Arg264*) in one allele of WWOX in the proband and his unaffected mother. A 180K array-CGH analysis revealed a 84,828-bp (g.chr16:78,360,803–78,445,630) deletion encompassing exon 6. The Q-PCR product showed that the proband and his father harbored the same deleted fragment, fusing exons 5 and 7 of WWOX.ConclusionsGenetic testing remains crucial in establishing the definitive diagnosis of WOREE syndrome and allows prenatal interventions/parental counseling. However, our findings suggest that targeted Next Generation Sequencing-based testing may occasionally show technical pitfalls, prompting further genetic investigation in selected cases with high clinical suspicion.
Enhanced Terahertz Generation From the Lithium Niobate Metasurface
Authors: Tu Yanyun , Sun Xu , Wu Haizhong , Zan Xiaolei , Yang Yan , Liu Ning , Wang Xiaowei , Meng Congsen , Lyu Zhihui , Zhu Zhihong , Liu Ken , Zhang Dongwen , Zhao Zengxiu 
Published: April 2022

The lithium niobate (LiNbO3) metasurface is an attractive platform for nonlinear frequency conversion due to its excellent nonlinearity, high damage threshold, and strong enhancement of the driving field. Here, we demonstrated the nonlinear metasurface for terahertz (THz) generation from LiNbO3on an insulator. The THz electric field from the LiNbO3metasurface of 300 nm thickness is enhanced by more than one order of magnitude compared to the unstructured sample. The enhanced terahertz electric field is very selective in the excitation wavelength due to its resonant feature and is highly anisotropic with respect to the excitation polarization. The polarization direction of the THz electric field can be controlled by rotating the optical axis of the LiNbO3metasurface. By combining the nanofabrication technology of the LiNbO3metasurface and ultrafast nonlinear optics, our work paves the way for the design of new compact terahertz photonic devices that integrate THz emitters into LiNbO3-based chips with multifaceted capabilities.
Portal Vein Pulsatility Index as a Potential Risk of Venous Congestion Assessed by Magnetic Resonance Imaging: A Prospective Study on Healthy Volunteers
Authors: Abou-Arab Osama , Beyls Christophe , Moussa Mouhamed Djahoum , Huette Pierre , Beaudelot Elodie , Guilbart Mathieu , De Broca Bruno , Yzet Thierry , Dupont Hervé , Bouzerar Roger , Mahjoub Yazine 
Published: April 2022

High values of the portal vein pulsatility index (PI) have been associated with adverse outcomes in perioperative or critically ill patients. However, data on dynamic changes of PI related to fluid infusion are scarce. We aimed to determine if dynamic changes in PI are associated with the fluid challenge (FC). To address this challenge, we conducted a prospective single-center study. The population study included healthy subjects. FC consisted in the administration of 500 ml of Ringer lactate infusion over 5 min. The portal blood flow and PI were assessed by magnetic resonance imaging. The responsiveness to FC was defined as an increase in the cardiac stroke volume of at least 10% as assessed by echocardiography. We included 24 healthy volunteers. A total of fourteen (58%) subjects were responders, and 10 (42%) were non-responders. In the responder group, FC induced a significant increase in portal blood flow from 881 (762–1,001) at the baseline to 1,010 (778–1,106) ml min−1 (p = 0.005), whilst PI remained stable (from 31 [25–41] to 35 (25–42) %; p = 0.12). In the non-responder group, portal blood flow remained stable after FC (from 1,042 to 1,034 ml min−1; p = 0.084), whereas PI significantly increased from 32 (22–40) to 48% *(25–85) after FC (p = 0.027). PI was negatively correlated to portal blood flow (Rho coefficient = −0.611; p = 0.002). To conclude, PI might be a sensitive marker of early congestion in healthy subjects that did not respond to FC. This finding requires further validation in clinical settings with a larger sample size.
Sex-Based Differences in the Myogenic Response and Inflammatory Gene Expression Following Eccentric Contractions in Humans
Authors: Fortino Stephen A. , Wageh Mai , Pontello Riley , McGlory Chris , Kumbhare Dinesh , Phillips Stuart M. , Parise Gianni 
Published: April 2022

After muscle injury, the interaction between muscle satellite cells (SC) and the immune response is instrumental for the repair and regeneration of skeletal muscle tissue. Studies have reported sex-based differences in the skeletal muscle inflammatory and regenerative response following injury. However, many of these studies investigated such differences by manipulating the concentration of estradiol, in rodents and humans, without directly comparing males to females. We sought to explore differences in the myogenic and inflammatory response following unaccustomed eccentric exercise in males and females. We hypothesized that females would have a blunted myogenic and inflammatory response as compared to males.Methods: 26 (13 male, 13 female) healthy young adults (22 ± 0.4 years [mean ± SEM]) performed 300 maximal eccentric contractions (180°/s) of the knee extensors. Muscle biopsies were taken before (pre) and 48 h (post) following eccentric damage. SC content and activation were determined by immunohistochemical and real time-polymerase chain reaction (rt-PCR) analysis. Inflammatory markers were analyzed using rt-PCR.Results: Following eccentric damage, males had a greater expansion of type I-associated SC (p &lt; 0.05), and there was a trend for a greater expansion in total SC (type I + II fibers) (p = 0.06) compared to females. There was a trend for a greater increase in Pax7 and CCL2 gene expression in males compared to females (p = 0.09).Conclusion: We conclude that there are sex-based differences in the myogenic and inflammatory response, where females have a blunted SC and inflammatory response.
Frequency Nesting Interactions in the Subthalamic Nucleus Correlate With the Step Phases for Parkinson’s Disease
Authors: Jin Luyao , Shi Wenbin , Zhang Chuting , Yeh Chien-Hung 
Published: April 2022

Gait disturbance in Parkinson’s disease (PD) can be ameliorated by sound stimulation. Given that excessive β synchronization in basal ganglia is linked to motor impairment in PD, whether the frequency nesting interactions are associated with the gait problem is far from clear. To this end, the masking phase-amplitude coupling (PAC) method was proposed to overcome the trade-off between intrinsic nonlinearity/non-stationarity and demand for predetermined frequencies, normally extracted by the filter. In this study, we analyzed LFPs recorded from 13 patients (one female) with PD during stepping with bilateral deep brain electrodes implanted in the subthalamic nucleus (STN). We found that not only high-frequency oscillation (100–300 Hz) was modulated by β (13–30 Hz) but also β and γ amplitude were modulated by their low-frequency components in δ/θ/α and δ/θ/α/β bands. These PAC values were suppressed by sound stimulation, along with an improvement in gait. We also showed that gait-related high-β (Hβ) modulation in the STN was sensitive to auditory cues, and Hβ gait-phase modulation increased with a metronome. Meanwhile, phase-locking values (PLVs) across all frequencies were significantly suppressed around contralateral heel strikes, manifesting the contralateral step as a critical gait phase in gait initiation for PD. Only the PLVs around contralateral steps were sensitive to auditory cues. Our results support masking PAC as an effective method in exploring frequency nesting interactions in LFPs and reveal the linkages between sound stimulation and couplings related to gait phases in the STN. These findings raise the possibility that nesting interactions in the STN work as feasible biomarkers in alleviating gait disorders.
Enhanced Blood Clotting After Rewarming From Experimental Hypothermia in an Intact Porcine Model
Authors: Schanche Torstein , Filseth Ole Magnus , Østerud Bjarne , Kondratiev Timofei V. , Sieck Gary C. , Tveita Torkjel 
Published: April 2022

Introduction: Due to functional alterations of blood platelets and coagulation enzymes at low temperatures, excessive bleeding is a well-recognized complication in victims of accidental hypothermia and may present a great clinical challenge. Still, it remains largely unknown if hemostatic function normalizes upon rewarming. The aim of this study was to investigate effects of hypothermia and rewarming on blood coagulation in an intact porcine model.Methods: The animals were randomized to cooling and rewarming (n = 10), or to serve as normothermic, time-matched controls (n = 3). Animals in the hypothermic group were immersion cooled in ice water to 25°C, maintained at 25°C for 1 h, and rewarmed to 38°C (normal temperature in pigs) using warm water. Clotting time was assessed indirectly at different temperatures during cooling and rewarming using a whole blood coagulometer, which measures clotting time at 38°C.Results: Cooling to 25°C led to a significant increase in hemoglobin, hematocrit and red blood cell count, which persisted throughout rewarming. Cooling also caused a transiently decreased white blood cell count that returned to baseline levels upon rewarming. After rewarming from hypothermia, clotting time was significantly shortened compared to pre-hypothermic baseline values. In addition, platelet count was significantly increased.Discussion/Conclusion: We found that clotting time was significantly reduced after rewarming from hypothermia. This may indicate that rewarming from severe hypothermia induces a hypercoagulable state, in which thrombus formation is more likely to occur.