bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modulation of Brain Activity and Functional Connectivity by Acupuncture Combined With Donepezil on Mild-to-Moderate Alzheimer's Disease: A Neuroimaging Pilot Study
Authors: Zhan Yijun , Fu Qinhui , Pei Jian , Fan Mingxia , Yu Qiurong , Guo Miao , Zhou Houguang , Wang Tao , Wang Liaoyao , Chen Yaoxin 
Published: July 2022

BackgroundFunctional brain imaging changes have been proven as potential pathophysiological targets in early-stage AD. Current longitudinal neuroimaging studies of AD treated by acupuncture, which is one of the growingly acknowledged non-pharmacological interventions, have neither adopted comprehensive acupuncture protocols, nor explored the changes after a complete treatment duration. Thus, the mechanisms of acupuncture effects remain not fully investigated.ObjectiveThis study aimed to investigate the changes in spontaneous brain activity and functional connectivity and provide evidence for central mechanism of a 12-week acupuncture program on mild-to-moderate AD.MethodsA total of forty-four patients with mild-to-moderate AD and twenty-two age- and education-level-matched healthy subjects were enrolled in this study. The forty-four patients with AD received a 12-week intervention of either acupuncture combined with Donepezil (the treatment group) or Donepezil alone (the control group). The two groups received two functional magnetic resonance imaging (fMRI) scans before and after treatment. The healthy subject group underwent no intervention, and only one fMRI scan was performed after enrollment. The fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) were applied to analyze the imaging data. The correlations between the imaging indicators and the changed score of Alzheimer's Disease Assessment Scale-Cognitive Section (ADAS-cog) were also explored.ResultsAfter the 12-week intervention, compared to those in the control group, patients with AD in the treatment group scored significantly lower on ADAS-cog value. Moreover, compared to healthy subjects, the areas where the fALFF value decreased in patients with AD were mainly located in the right inferior temporal gyrus, middle/inferior frontal gyrus, middle occipital gyrus, left precuneus, and bilateral superior temporal gyrus. Compared with the control group, the right precuneus demonstrated the greatest changed value of fALFF after the intervention in the treatment group. The difference in ADAS-cog after interventions was positively correlated with the difference in fALFF value in the left temporal lobe. Right precuneus-based FC analysis showed that the altered FC by the treatment group compared to the control group was mainly located in the bilateral middle temporal gyrus.ConclusionThe study revealed the key role of precuneus in the effect of the combination of acupuncture and Donepezil on mild-to-moderate AD for cognitive function, as well as its connection with middle temporal gyrus, which provided a potential treating target for AD.Trial Registration Number:NCT03810794 (http://www.clinicaltrials.gov).
An Activation Likelihood Estimation Meta-Analysis of Specific Functional Alterations in Dorsal Attention Network in Mild Cognitive Impairment
Authors: Wu Huimin , Song Yu , Chen Shanshan , Ge Honglin , Yan Zheng , Qi Wenzhang , Yuan Qianqian , Liang Xuhong , Lin Xingjian , Chen Jiu 
Published: July 2022

BackgroundMild cognitive impairment (MCI) is known as the prodromal stage of the Alzheimer’s disease (AD) spectrum. The recent studies have advised that functional alterations in the dorsal attention network (DAN) could be used as a sensitive marker to forecast the progression from MCI to AD. Therefore, our aim was to investigate specific functional alterations in the DAN in MCI.MethodsWe systematically searched PubMed, EMBASE, and Web of Science and chose relevant articles based on the three functional indicators, the amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and functional connectivity (FC) in the DAN in MCI. Based on the activation likelihood estimation, we accomplished the aggregation of specific coordinates and the analysis of functional alterations.ResultsA total of 38 studies were involved in our meta-analysis. By summing up included articles, we acquired specific brain region alterations in the DAN mainly in the superior temporal gyrus (STG), middle temporal gyrus (MTG), superior frontal gyrus (SFG), middle frontal gyrus (MFG), inferior frontal gyrus (IFG), precentral gyrus (preCG), inferior parietal lobule (IPL), superior parietal lobule (SPL). At the same time, the key area that shows anti-interaction with default mode network included the IPL in the DAN. The one showing interactions with executive control network was mainly in the MFG. Finally, the frontoparietal network showed a close connection with DAN especially in the IPL and IFG.ConclusionThis study demonstrated abnormal functional markers in the DAN and its interactions with other networks in MCI group, respectively. It provided the foundation for future targeted interventions in preventing the progression of AD.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021287958].
Complex Interactions Between Circulating Fatty Acid Levels, Desaturase Activities, and the Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study
Authors: Liu Yue , Xia Yin-Yin , Zhang Ting , Yang Yang , Cannon Richard D. , Mansell Toby , Novakovic Boris , Saffery Richard , Han Ting-Li , Zhang Hua , Baker Philip N. 
Published: July 2022

ObjectiveMaternal abnormal fatty acid desaturation has previously been linked to gestational diabetes mellitus (GDM). However, few studies have investigated this relationship longitudinally throughout pregnancy. In this study, we investigated the relationship between GDM and desaturase activities across the pregnancy trimesters.MethodsA total of 661 women (GDM = 189, non-GDM = 472) were selected from the Complex Lipids in Mothers and Babies (CLIMB) cohort study. Clinical information and maternal serum were collected at 11–14, 22–28, and 32–34 weeks of gestation. Totally, 20 serum fatty acids were quantified using gas chromatography–mass spectrometry (GC-MS) analysis at each timepoint. Polyunsaturated fatty acid (PUFA) product-to-precursor ratios were used to estimate desaturase and elongase activities including delta-5 desaturase, delta-6 desaturase, stearoyl-CoA desaturase, and elongase.ResultsAfter adjusting for major potential confounders including maternal age, BMI, primiparity, smoking, and alcohol consumption, we observed a significant increase in the levels of γ-linolenic acid (GLA) and eicosatrienoic acid (DGLA) in the first trimester of women with GDM, whereas GLA and DGLA were reduced in the third trimester, when compared to the non-GDM group. Arachidonic acid (AA) showed an upward trend in the GDM group throughout pregnancy. Estimated delta-6 desaturase and delta-5 desaturase activity were elevated in the first trimester (OR = 1.40, 95% CI 1.03–1.91; OR = 0.56, 95% CI 0.32–0.96) but attenuated in the third trimester (OR = 0.78, 95% CI 0.58–1.07; OR = 2.64, 95% CI 1.46–4.78) in GDM pregnancies, respective to controls. Estimated delta-9–18 desaturase activity (OR = 3.70, 95% CI 1.49–9.19) was increased in women with GDM in later pregnancy.ConclusionsOur study highlights the potential importance of fatty acid desaturase activities, particularly estimated delta-5 desaturase and delta-9–18 desaturase in the pathophysiology of GDM. These findings may have applications for the early diagnosis and management of GDM.
Novel Diagnostic and Prognostic Tools for Lung Cancer Cachexia: Based on Nutritional and Inflammatory Status
Authors: Liu Chen-An , Zhang Qi , Ruan Guo-Tian , Shen Liu-Yi , Xie Hai-Lun , Liu Tong , Tang Meng , Zhang Xi , Yang Ming , Hu Chun-Lei , Zhang Kang-Ping , Liu Xiao-Yue , Shi Han-Ping 
Published: July 2022

BackgroundCachexia is one of the most common complications affecting lung cancer patients that seriously affects their quality-of-life and survival time. This study aimed to analyze the predictors and prognostic factors of lung cancer cachexia as well as to develop a convenient and accurate clinical prediction tool for oncologists.MethodsIn this multicenter cohort study, 4022 patients with lung cancer were retrospectively analyzed. The patients were randomly categorized into training and verification sets (7:3 ratio). Univariate and multivariate logistic regression analyses were performed to determine the risk factors of cachexia in patients with lung cancer. Cox regression analysis was applied to determine independent prognostic factors in the patients with lung cancer cachexia. Meanwhile, two nomograms were established and evaluated by time-dependent receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA).ResultsStage, serum albumin, ALI, anemia, and surgery were independent risk factors for cachexia in patients with lung cancer. Patients with lung cancer cachexia have a shorter survival time. Sex, stage, serum albumin, ALI, KPS score, and surgery served as independent prognostic factors for patients with lung cancer cachexia. The area under the curves (AUCs) of diagnostic nomogram in the training and validation sets were 0.702 and 0.688, respectively, the AUCs of prognostic nomogram in the training set for 1-, 3-, and 5-year were 0.70, 0.72, and 0.75, respectively, while in the validation set the AUCs were 0.71, 0.75, and 0.79, respectively. The calibration curves and DCA of the two nomograms were consistent and the clinical benefit rate was high.ConclusionCachexia brings an additional economic burden and worsens the prognosis of lung cancer patients. The two nomograms can accurately screen and predict the probability of occurrence of cachexia in lung cancer and the prognosis of patients with lung cancer cachexia, and guide clinical work.
The Role of SETBP1 in Gastric Cancer: Friend or Foe
Authors: Fang Fujin , Liu Chengyou , Li Qiong , Xu Rui , Zhang Tiantian , Shen Xiaobing 
Published: July 2022

BackgroundGastric cancer (GC) remains a common disease with a poor prognosis worldwide. The SET binding protein 1 (SETBP1) has been implicated in the pathogenesis of several cancers and plays a dual role as an oncogene and a tumor suppressor gene. However, the role and underlying mechanism of SETBP1 in GC remain unclear.Materials and MethodsWe used next-generation RNA sequencing (RNA-seq) data from The Cancer Genome Atlas (TCGA) to explore the correlation between SETBP1 expression and tumor progression. We then quantified SETBP1 expression in GC cells with real-time quantitative polymerase chain reactions (RT-qPCR). The chi-square test and logistic regression were used to assess the correlation between SETBP1 expression and clinicopathological features. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to assess the relationship between SETBP1 expression and survival. Finally, gene set enrichment analyses (GSEA) were used to examine GC-related signaling pathways in low and high SETBP1 expressing samples.ResultsWe found SETBP1 expression levels in GC tissues to be significantly lower than in adjacent non-tumor tissues in the TCGA database. In addition, SETBP1 expression differed significantly between groups classified by tumor differentiation. Furthermore, SETBP1 expression in diffuse-type GC was significantly higher than in intestinal-type GC. However, it did not differ significantly across pathological- or T-stage groups. RT-qPCR and comprehensive meta-analysis showed that SETBP1 expression is downregulated in GC cells and tissues. Interestingly, SETBP1 expression in poorly- or un-differentiated GC cells was higher than in well-differentiated GC cells. Moreover, the chi-square test and logistic regression analyses showed that SETBP1 expression correlates significantly with tumor differentiation. Kaplan–Meier curves indicated that patients with relatively high SETBP1 expression had a poor prognosis. Multivariate analyses indicated that SETBP1 expression might be an important predictor of poor overall survival in GC patients. GSEA indicated that 20 signaling pathways were significantly enriched in samples with high and low SETBP1 expression.ConclusionSETBP1 may play a dual role in GC progression.
Learning Curve of Robotic-Assisted Total Mesorectal Excision for Rectal Cancer
Authors: Tang Bo , Li Tao , Gao Gengmei , Shi Jun , Li Taiyuan 
Published: July 2022

BackgroundAlthough some studies have assessed the learning curve of robotic-assisted total mesorectal excision for rectal cancer, most studies included limited sample sizes, no study used postoperative complications as an independent variable to analyze the learning curve of robotic rectal surgery, and no study evaluated the influence of the learning curve on long-term oncologic outcomes.MethodsClinical data on consecutive patients who underwent robotic-assisted total mesorectal excision for rectal cancer by a single surgeon between January 2015 and December 2018 at the First Affiliated Hospital of Nanchang University were retrospectively collected. The cumulative sum (CUSUM) and risk-adjusted cumulative sum (RA-CUSUM) were used to visualize the learning curve of operation time and postoperative complications (CD ≥ grade II). Comparisons of clinical outcomes at different learning phases analyzed by RA-CUSUM were performed after propensity score matching.ResultsA total of 389 consecutive patients were included in the analysis. The numbers of patients needed to overcome the learning curves of operation time and postoperative complications of robotic-assisted laparoscopic surgery for rectal cancer were 34 and 36, respectively. The learning process was divided into two phases based on RA-CUSUM: the learning phase (1st-36th cases) and the mastery phase (37th-389th cases). Before matching, the mastery phase had more patients with older age, lower tumor location, and neoadjuvant therapy. After matching, the two phases exhibited similar characteristics. The operation time, intraoperative blood loss, postoperative hospital stay, and postoperative complications in the mastery phase were reduced compared with the learning phase, with a median follow-up of 35 months, and the long-term oncologic outcomes were not significantly different between the two phases.ConclusionsAn experienced laparoscopic surgeon initially implements robotic-assisted total mesorectal excision for rectal cancer, surgical outcomes improved after 36 cases, and the learning curve seemingly did not have an obvious impact on long-term oncologic outcomes.
The Spectrum of Parenchymal Changes in Kidneys Affected by Intrarenal Reflux, Diagnosed by Contrast-Enhanced Voiding Urosonography and DMSA Scan
Authors: Simičić Majce Ana , Arapović Adela , Čapkun Vesna , Brdar Dubravka , Brekalo Marko , Zebić Ileana , Barić Ana , Punda Ante , Saraga-Babić Mirna , Vukojević Katarina , Saraga Marijan 
Published: July 2022

PurposeTo describe the parenchymal defects in kidneys with intrarenal reflux (IRR) diagnosed using contrast-enhanced voiding urosonography (ceVUS) and 99mTc-DMSA scintigraphy (DMSA scan).Materials and MethodsA group of 186 uretero-renal units (URUs) was analyzed using ceVUS and DMSA scans: 47 without vesicoureteral reflux (VUR) (group A) and 139 with VURs, comprising 73 VURs without (group B), and 66 with IRR (group C). VURs included non-dilating (grades I–II), mildly non-dilating (grade III), and non-dilating (grades IV–V) grades. The parenchymal changes were analyzed using a DMSA scan.ResultsThe median age for VUR diagnosis was 16.5 months in girls, and 8.5 months in boys (Z = 3.9; p = 0.001). IRR occurred in 51.4% of boys and in 25.9% of girls (χ2 = 12.4; p &lt; 0.001). The non-dilating VUR occurred in 44% of boys and 24.1% of girls (χ2 = 7.7; p = 0.005). IRRs characterized upper and lower renal segments (81.8 and 63.6%) and middle segments (33.3%). Both incidence and increase in IRR correlated with the grade of VUR (p &lt; 0.001). The incidence of reduced DMSA signal was statistically different among groups A + B and C, but not between groups A and B (χ2 = 32.2; p &lt; 0.001). No statistically significant relationship existed between the reduced DMSA signal and the grade of VUR in group C. The reduced DMSA signal appeared in 9.9% positions in kidneys from group A, 14% from group B, and 32% from group C. Out of all 118 IRRs, 38.1% had reduced and 61.9% had normal DMSA signal. Among 11 parenchymal scars found in all three groups, 2 belonged to group B, 9 to group C, while group A had no scars.ConclusionThe parenchymal changes are the most prominent in the group with IRR, but they do not significantly differ among kidneys with different grades of VUR. VURs of higher grades are associated with a higher incidence of IRR and early clinical presentation. Scars can also appear in lower-grade VURs accompanied by IRR. Boys with VUR have earlier clinical presentation than girls, as they have significantly higher grades of VUR with a higher proportion of IRRs. Therefore, we suggest a subdivision of VURs into those with IRR and abundant parenchymal damage, and those without IRR and less parenchymal damage.
The Associations Among Physical Activity, Quality of Life, and Self-Concept in Children and Adolescents With Disabilities: A Moderated Mediation Model
Authors: Yang Wen , Yu Jane Jie , Wong Stephen Heung-Sang , Sum Raymond Kim-Wai , Li Ming Hui , Sit Cindy Hui-Ping 
Published: July 2022

ObjectivesThis study aimed to examine a moderated mediation model of the associations among physical activity (PA), quality of life (QoL), and self-concept (SC) in children and adolescents with physical disabilities (PDs) and intellectual disabilities (IDs).Materials and MethodsA total of 288 children and adolescents with PDs and IDs, aged between 6 and 17 years, were recruited from 16 special schools in Hong Kong. PA, QoL, and SC were measured using the Physical Activity Questionnaire for Older Children (PAQ-C), Paediatric Quality of Life Inventory (PedsQL), and Physical Self-Description Questionnaire Short Form, respectively. Mediation (i.e., PA, QoL, and SC) and moderation analyses (i.e., age, sex, and parental education level) were conducted by structural equation modelling (SEM) using the M plus and PROCESS macro for SPSS.ResultsPhysical activity (PA) was positively associated with SC (PDs: β = 0.373; IDs: β = 0.343), and SC significantly mediated the associations between PA and QoL in children and adolescents with PDs (parent proxy-report QoL: β = 0.114; self-report QoL: β = 0.141) and IDs (self-report QoL: β = 0.204). The mediating effects of SC accounted for 16 and 15% of the total effects of PA on QoL (parent proxy-report and self-report) respectively, in participants with PDs, and 8 and 4%, respectively, in those with IDs. Males and participants with higher parental education levels reported stronger associations among PA, QoL, and SC than their counterparts.ConclusionThis study supports mediating and moderating effects on the associations among PA, QoL, and SC in children and adolescents with PDs and IDs. Future researchers should consider PA intervention in mental health services and provide tailor-made PA programmes based on personal and environmental factors for children and adolescents with disabilities.
Successful Application of Argatroban During VV-ECMO in a Pregnant Patient Complicated With ARDS due to Severe Tuberculosis: A Case Report and Literature Review
Authors: Wu Hongxia , Tang Yongjiang , Xiong Xiaofeng , Zhu Min , Yu He , Cheng Deyun 
Published: July 2022

Severe tuberculosis during pregnancy may progress to acute respiratory distress syndrome (ARDS), and venovenous (VV) extracorporeal membrane oxygenation (ECMO) should be considered if conventional lung-protective mechanical ventilation fails. However, thrombocytopenia often occurs with ECMO, and there are limited reports of alternative anticoagulant therapies for pregnant patients with thrombocytopenia during ECMO. This report describes the first case of a pregnant patient who received argatroban during ECMO and recovered. Furthermore, we summarized the existing literature on VV-ECMO and argatroban in pregnant patients. A 31-year-old woman at 17 weeks of gestation was transferred to our hospital with ARDS secondary to severe tuberculosis. We initiated VV-ECMO after implementing a protective ventilation strategy and other conventional therapies. Initially, we selected unfractionated heparin anticoagulant therapy. However, on ECMO day 3, the patient’s platelet count and antithrombin III (AT-III) level declined to 27 × 103 cells/μL and 26.9%, respectively. Thus, we started the patient on a 0.06 μg/kg/min argatroban infusion. The argatroban infusion maintenance dose ranged between 0.9 and 1.2 μg/kg/min. The actual activated partial thromboplastin clotting time and activated clotting time ranged from 43 to 58 s and 220–260 s, respectively, without clinically significant bleeding and thrombosis. On day 27, the patient was weaned off VV-ECMO and eventually discharged. VV-ECMO may benefit pregnant women with refractory ARDS, and argatroban may be an alternative anticoagulant for pregnant patients with thrombocytopenia and AT-III deficiency during ECMO.
You Were Better Than Expected–An Experimental Study to Examine Expectation Change in a Non-clinical Sample
Authors: Groth Rosa-Marie , Rief Winfried 
Published: July 2022

BackgroundReduced sensitivity to rewards as well as the tendency to maintain dysfunctional expectations despite expectation-disconfirming evidence (cognitive immunization) are considered core features of various mental disorders. It is therefore important for clinical research to have paradigms that are suitable to study these phenomena. We developed a new experimental paradigm to study explicit expectation change after prior expectation induction and violation. Its validity is tested by applying the paradigm to healthy individuals.Materials and MethodsIn the main part of the study (experiment 1) we examined whether it is possible to change healthy individuals’ (Sample size 56) task-specific and generalized performance expectations through expectation-disconfirming experiences. We used a high-difficulty performance task to induce initially negative expectations regarding participants’ ability to successfully work on that unknown task. In the second part of the study, the difficulty of the test was lowered in one experimental condition, in order to disconfirm the negative expectations of the first part, while the other group continued with high test difficulty to confirm the negative expectations. We measured the participant’s explicit performance expectations before and after completing the tests. In experiment 2 (Sample size 57), we investigated the impact of different test instructions on expectation change. Using the same paradigm as in experiment 1, we added an “immunization-inhibiting” manipulation for one group and an “immunization-enhancing” manipulation for the other group.ResultsIn experiment 1, we were able to show that individuals changed their expectations according to variations of task difficulty. Adding instructions to manipulate cognitive immunization inhibited expectation change regardless of condition (experiment 2).ConclusionOur approach allowed us to examine the effects of implicitly acquired performance expectations on explicit, verbalized expectation change. The new experimental paradigm used in this study is suitable to induce performance expectations, and to examine expectation-change among healthy individuals (experiment 1). Instructions to enhance or inhibit cognitive immunization processes both inhibited expectation change (experiment 2). The results are discussed within the context of current models of expectation change, cognitive immunization, and reward sensitivity.