bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired dynamic cerebral autoregulation: A potential mechanism of orthostatic hypotension and dementia in Parkinson’s disease
Authors: Chen Hongxiu , Xu Erhe , Zhou Fubo , Li Qiuping , Zeng Jingrong , Mei Shanshan , Xing Yingqi 
Published: September 2022

BackgroundOrthostatic hypotension (OH) and cognitive impairment are common non-motor symptoms of Parkinson’s disease (PD). This study aimed to investigate whether impaired dynamic cerebral autoregulation (dCA) is associated with OH and Parkinson’s disease dementia (PDD), and analyze the related risk factors in patients with PDD.Materials and methodsWe enrolled 89 patients with PD and 20 age- and sex-matched healthy controls (HCs). Cognition and different cognitive domains were assessed by the Montreal Cognitive Assessment scale. Non-invasive continuous beat-to-beat blood pressure and cerebral blood flow velocity were assessed using a servo-controlled finger plethysmograph and transcranial Doppler, respectively. dCA was examined using supine and orthostatic changes with transfer function analysis to derive the autoregulatory parameters of phase, gain, and coherence. Logistic regression analysis was performed to determine the risk factors for PDD.ResultsWe found that 21 (23.6%) patients with PD had OH. These patients showed worse cognitive performance in specific cognitive tasks, such as language and orientation. The patients with OH also had poorer dCA; the very low frequency (VLF) phase in two different postures was lower than that in patients without OH as well as HCs (both P &lt; 0.05). And the normalized gain in the VLF and low frequency (LF) in standing position was higher in PD patients with and without OH than in HCs. PDD patients also had significantly higher LF normalized gain when standing than patients without dementia (P = 0.015), indicating impaired dCA. LF normalized gain in standing (odds ratio: 3.756, 95% confidence interval: 1.241–11.367) and education were significantly associated with PDD.ConclusionDiminished dCA may represent a potential mechanism for OH and cognitive impairment and low educational level might be a significant factor contributing to the increased risk of PDD.
Reduced phonemic fluency in progressive supranuclear palsy is due to dysfunction of dominant BA6
Authors: Isella Valeria , Licciardo Daniele , Ferri Francesca , Crivellaro Cinzia , Morzenti Sabrina , Appollonio Ildebrando , Ferrarese Carlo 
Published: September 2022

BackgroundReduced phonemic fluency is extremely frequent in progressive supranuclear palsy (PSP), but its neural correlate is yet to be defined.ObjectiveWe explored the hypothesis that poor fluency in PSP might be due to neurodegeneration within a dominant frontal circuit known to be involved in speech fluency, including the opercular area, the superior frontal cortex (BA6), and the frontal aslant tract connecting these two regions.MethodsWe correlated performance on a letter fluency task (F, A, and S, 60 s for each letter) with brain metabolism as measured with Fluoro-deoxy-glucose Positron Emission Tomography, using Statistical Parametric Mapping, in 31 patients with PSP.ResultsReduced letter fluency was associated with significant hypometabolism at the level of left BA6.ConclusionOur finding is the first evidence that in PSP, as in other neurogical disorders, poor self-initiated, effortful verbal retrieval appears to be linked to dysfunction of the dominant opercular-aslant-BA6 circuit.
Effects of rTMS treatment on global cognitive function in Alzheimer's disease: A systematic review and meta-analysis
Authors: Zhang Tianjiao , Sui Youxin , Lu Qian , Xu Xingjun , Zhu Yi , Dai Wenjun , Shen Ying , Wang Tong 
Published: September 2022

BackgroundAlthough repetitive transcranial magnetic stimulation (rTMS) has been extensively studied in patients with Alzheimer's disease (AD), the clinical evidence remains inconsistent. The purpose of this meta-analysis was to evaluate the effects of rTMS on global cognitive function in patients with AD.MethodsAn integrated literature search using 4 databases (PubMed, Web of Science, Embase, and Cochrane Library) was performed to identify English language articles published up to October 6, 2021. We pooled Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog) scores using a random-effects model via RevMan 5.4 software. We calculated estimates of mean differences (MD) with 95% confidence intervals (CI). The primary outcomes were pre-post treatment changes in global cognition as measured using MMSE and ADAS-Cog immediately after rTMS treatment, and the secondary outcome was duration of cognitive improvement (1–1.5 and ≥3 months).ResultsNine studies with 361 patients were included in this meta-analysis. The results showed that rTMS significantly improved global cognitive function immediately following rTMS treatment [(MD) 1.82, 95% confidence interval (CI) 1.41–2.22, p &lt; 0.00001, MMSE; 2.72, 95% CI, 1.77–3.67, p &lt; 0.00001, ADAS-Cog], and the therapeutic effects persisted for an extended duration (2.20, 95% CI, 0.93–3.47, p =0.0007, MMSE; 1.96, 95% CI, 0.96–2.95, p = 0.0001, ADAS-Cog). Subgroup analyses showed that high frequency rTMS targeted to the left dorsolateral prefrontal cortex (DLPFC) for over 20 sessions induced the greatest cognitive improvement, with effects lasting for more than 1 month after the final treatment. There were no significant differences in dropout rate (p &gt; 0.05) or adverse effect rate (p &gt; 0.05) between the rTMS and control groups.ConclusionsRepetitive TMS is a potentially effective treatment for cognitive impairment in AD that is safe and can induce long-lasting effects. Our results also showed that ADAS-cog and MMSE differed in determination of global cognitive impairment.Systematic review registrationhttp://www.crd.york.ac.uk/PROSPERO, PROSPERO CRD42022315545.
Catheter ablation and cognitive function in atrial fibrillation: A systematic review and meta-analysis
Authors: Chen Pengfei , Chen Zhuhong , Pan Deng , Miao Lina , Shi Yujiao , Guo Ming , Du Jianpeng 
Published: September 2022

BackgroundAtrial fibrillation (AF) is a risk factor for cognitive dysfunction. Although catheter ablation (CA) is one of the main treatments for AF, whether it can improve cognitive function in patients with AF remains unclear. We conducted a systematic review and meta-analysis to evaluate the cognitive outcome post-CA procedure.MethodsTwo investigators independently searched the PubMed, EMBASE, Web of Science, CNKI, WanFang, and VIP databases from inception to September 2021 for all the potentially eligible studies. The outcomes of interest included dementia or cognitive disorder through scoring or recognized classification criteria. Heterogeneity was determined by using Cochrane's Q test and calculating the I2. A random-effects model was used to incorporate the potential effects of heterogeneity. The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of each included study, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was adopted to evaluate the quality of evidence.ResultThirteen studies including 40,868 patients were included, among which 12,086 patients received AF ablation. Meta-analysis indicated that patients with AF ablation had a lower risk of dementia incidence in comparison to patients with AF without ablation [hazard ratio (HR): 0.60, 95% CI: 0.43 to 0.84, p = 0.003 I2 = 40%]. Significant differences were observed in the incidence of new-onset dementia [risk ratio (RR): 0.43, 95% CI: 0.28 to 0.65, p &lt; 0.0001 I2 = 84%]; the changes in the Montreal Cognitive Assessment (MoCA) score [weighted mean difference (WMD): 1.00, 95% CI: 0.36 to 1.64, p &lt; 0.005 I2 = 0%] and Mini-Mental State Examination (MMSE) score (WMD: 0.98, 95% CI: 0.69 to 1.26, p &lt; 0.00001 I2 = 0%]. However, in subgroup analysis, we did not observe significant changes in MoCA score at &lt; 3 months (WMD: 1.20, 95% CI: −0.19 to 2.58, p = 0.09 I2 = 50%) and changes in cognitive function scores between the radiofrequency group and cryoballoon group [standard mean difference (SMD): 0.39, 95% CI: −0.47 to 1.24, p = 0.38 I2 = 87%]. The NOS indicated that included studies were moderate to high quality, while the quality of evidence assessed by GRADE was low in 2 and very low in 2.ConclusionWe analyzed the related cognitive outcomes after AF ablation. In the overall population, AF ablation had a positive trend for improving cognitive function at &gt;3 months post-procedure. However, AF ablation might not be related to the improvement of cognitive function at &lt; 3 months.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021285198.
Early predictors of visual and axonal outcomes after acute optic neuritis
Authors: Nguyen Minh N. L. , Zhu Chao , Kolbe Scott C. , Butzkueven Helmut , White Owen B. , Fielding Joanne , Kilpatrick Trevor J. , Egan Gary F. , Klistorner Alexander , van der Walt Anneke 
Published: September 2022

BackgroundPredicting long-term visual outcomes and axonal loss following acute optic neuritis (ON) is critical for choosing treatment. Predictive models including all clinical and paraclinical measures of optic nerve dysfunction following ON are lacking.ObjectivesUsing a prospective study method, to identify 1 and 3 months predictors of 6 and 12 months visual outcome (low contrast letter acuity 2.5%) and axonal loss [retinal nerve fiber layer thickness and multifocal evoked potential (mfVEP) amplitude] following acute ON.MethodsIn total, 37 patients of acute ON onset were evaluated within 14 days using between-eye asymmetry of visual acuity, color vision (Ishihara plates), optical coherence tomography, mfVEP, and optic nerve magnetic resonance imaging [magnetic transfer ratio (MTR) and diffusion tensor imaging (DTI)].ResultsVisual outcome at 6 and 12 months was best predicted by Ishihara asymmetry at 1 and 3 months following ON onset. Axonal loss at 6 and 12 months was reliably predicted by Ishihara asymmetry at 1 month. Optic nerve MTR and DTI at 3 months post-acute ON could predict axonal loss at 6 and 12 months.ConclusionsSimple Ishihara asymmetry testing 1 month after acute ON onset can best predict visual outcome and axonal loss at 6 and 12 months in a clinical or research setting.
Pain assessment during physiotherapy and noxious stimuli in patients with disorders of consciousness: A preliminary study
Authors: Shen Jianzhong , Tang Shanchun , Yan Bingyang , Xie Donghua , Fang Tingting , Chen Lidan , Li Guoyun 
Published: September 2022

ObjectivesThe primary purpose of this study is to determine whether patients with disorders of consciousness (DOC) (unresponsive wakefulness syndrome, UWS; minimally conscious state, MCS) experience pain during physiotherapy and noxious stimuli in a larger patient population.Materials and methodsThe patients’ level of consciousness was measured with the Coma Recovery Scale-Revised (CRS-R). Additionally, the Nociception Coma Scale-revised (NCS-R) was used to assess their pain response. The NCS-R total scores between UWS and MCS at baseline, physiotherapy and noxious stimulus were compared using the Mann-Whitney U test (Wilcoxon rank-sum test) and the Kruskal-Wallis H test with Bonferroni correction.ResultsThe study enrolled 93 participants. There was a statistically significant difference in NCS-R total scores between the three conditions (H = 215.25, p &lt; 0.001). At baseline, there was no statistically significant difference between MCS and UWS (U = 378, z = –1.35, p = 0.178). While there was a statistically significant difference between MCS and UWS during physiotherapy (U = 1,362, z = –3.06, p &lt; 0.01) and under noxious stimuli (U = 5142.5, z = –11.22, p &lt; 0.001).ConclusionPhysiotherapy improved the activity responsiveness of DOC patients, and patients experienced less potential pain. However, some DOC patients, especially MCS patients, perceived pain under the noxious stimuli.
VISTA is associated with immune infiltration and predicts favorable prognosis in TNBC
Authors: Zhang Mi , Zhang Juan , Liu Na , Wang Biyuan , Zhou Yan , Yang Jin 
Published: September 2022

BackgroundV-domain Ig-containing suppressor of T cell activation (VISTA), a critical immune checkpoint protein, can regulate the immune system. Nevertheless, little information is available on the expression level of VISTA and its clinical significance as well. The immunological and prognostic role of VISTA in triple-negative breast cancer (TNBC) still remains unclear.MethodsThe clinical significance and expression of VISTA in TNBC were examined using RNA sequencing and clinical data. Cancer single-cell state atlas (CancerSEA), gene set enrichment analyses (GSEA), single sample GSEA, ESTIMATE algorithm, immunohistochemistry (IHC) were utilized to assess the functions of VISTA.ResultsVISTA was down-regulated and closely associated with good prognosis in TNBC. The expression of VISTA was higher in Immunity-H group and immunomodulatory (IM) subtype. The level of VISTA expression in TNBC gradually increased with the degree of stromal tumor infiltrating lymphocytes (sTILs) infiltration. In addition, the high expression of VISTA was strongly linked to higher proportion of CD8 (+) T cell and M1 macrophages.ConclusionVISTA was remarkably correlated with a favorable prognosis and high immune infiltration in patients with TNBC.
Identification of macrophage correlated biomarkers to predict the prognosis in patients with intrahepatic cholangiocarcinoma
Authors: Xu Linping , Yan Meimei , Long Jianpeng , liu Mengmeng , Yang Hui , Li Wei 
Published: September 2022

BackgroundIt has been shown that tumor-associated immune cells, particularly macrophages, play a fundamental role in the development and treatment response of intrahepatic cholangiocarcinoma (ICC). However, little is known about macrophages at the single cellular level of ICC patients.MethodsScRNA-seq from Zhang et al. was used in the present study to identify the genes differentially expressed in ICCs. Furthermore, transcriptomic data from TCGA datasets, IHC and flowcytometry from our cohort were used to confirm the findings. Kaplan-Meier and TIDE scores were also used for prognostic analysis and ICB responses.ResultsA significant number of macrophages were found in ICCs as compared to adjacent tissues. We then extracted, processed, and classified the macrophages from the ICCs and adjacent tissues into 12 clusters. Significantly, the macrophages from the ICC exhibited an immunosuppressed state in terms of both signature gene expression and functional enrichment. Furthermore, our results indicate that, of the 10 selective tumor-promoting genes of macrophages, only MMP19 and SIRPα can predict ICB responses in ICCs. Although a higher expression of MMP19 and SIRPα predict a poor prognosis for ICCs without immunotherapy after surgery, patients with high SIRPα expression were more sensitive to immunotherapy, whereas those with high MMP19 expression were not sensitive to immunotherapy. To define the mechanisms, we found that SIRPαhi ICCs exhibited an increased enrichment KEGG pathway of leukocyte transendothelial migration and neutrophil extracellular trap formation. The increased immune cell infiltration will increase sensitivity to immunotherapy.ConclusionCollectively, macrophages are critical to the immune status of ICCs, and MMP19 and SIRPα can predict prognosis and ICB responses for ICCs.
Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®)
Authors: Costa Suzete , Guerreiro José , Teixeira Inês , Helling Dennis K. , Pereira João , Mateus Céu 
Published: September 2022

Background:There is little experience in the economic evaluation of pharmacy/primary care collaborative health interventions using interprofessional technology-driven communication under real-world conditions. This study aimed to conduct cost-effectiveness and cost-utility analyses of a collaborative care intervention in hypertension and hyperlipidemia management between pharmacies and primary care versus usual (fragmented) care alongside a trial.Methods:An economic evaluation was conducted alongside a 6-month pragmatic quasi-experimental controlled trial. Data sources included primary care clinical software; pharmacy dispensing software; patient telephone surveys; and published literature. The target population was adult patients on hypertension and/or lipid-lowering medication. The perspective was societal. We collected patient-level data on resource use to estimate trial costs. Effect outcomes included blood pressure (BP) and quality-adjusted life years (QALYs). Bootstrapping was used to estimate uncertainty around the incremental cost-effectiveness and cost-utility ratios. Cost-effectiveness planes and acceptability curves were estimated.Results:The intervention was not shown to have reasonable levels of cost-effectiveness or cost-utility when compared to usual care as denoted by the levels of uncertainty expressed in wide confidence intervals. The probability of the intervention being cost-effective is 28% at the threshold of €20,000 per QALY gained and 57% at the threshold of €500 per mmHg systolic BP decrease.Conclusion:Considering the limitations of the trial which affected effectiveness and economic outcomes, our results are not generalizable for community pharmacy and primary care in Portugal. This research offers, however, valuable lessons on methods and strategies that can be used in future economic evaluations of collaborative public health interventions with the potential for reimbursement.Clinical trial registration:https://www.isrctn.com/ISRCTN13410498, identifier ISRCTN13410498
Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysis
Authors: Ma Qin , Li Hancong , Liao Jing , Cai Zhaolun , Zhang Bo 
Published: September 2022

Background: Due to an increase in drug resistance, the eradication rate of H. pylori with empirical therapy has declined. Tailored therapy has been proposed as an alternative to standard empirical treatments. The necessity of personalized eradication therapy remains unclear. The aim of this study was to determine whether tailored therapy is superior to empirical therapy for H. pylori infection.Methods: We searched for eligible randomized controlled trials in the PubMed, Embase (Ovid), Wanfang, and Cochrane Central Register of Controlled Trials databases up to 10 December 2021. A random effects model comparing pooled relative risks (RRs) with 95% confidence intervals (CIs) was applied in the meta-analysis.Results: Twenty-one studies were included in the meta-analysis. In the first-line treatment, tailored therapy was more effective than empirical therapy (RR, 1.14 [95% CI, 1.08–1.21], I2 = 72.2%). In the second-line therapy setting, the results did not reveal significant differences between the two treatments (RR, 1.05 [95% CI, 0.84–1.30], I2 = 80.6%). A similar result was observed in mixed second- and third-line treatments (RR, 1.03 [95% CI, 0.96–1.11], I2 = 0.0%). Regarding adverse events, no significant differences were found between the two treatments (RR, 0.90 [95% CI, 0.80–1.01], I2 = 35.7%). Most of the results were highly heterogeneous.Conclusion: A tailored approach might provide a better eradication rate than empirical methods in first-line treatment. There might be no obvious advantage in second-line or mixed second- and third-line treatments third-line treatment. Due to the high heterogeneity, the results should be interpreted with caution. Further clinical studies are needed and justified.
Advances on aerodynamic actuation induced by surface dielectric barrier discharges
Authors: Portugal Sherlie , Choudhury Bhaswati , Cardenas Dorindo 
Published: September 2022

Surface Dielectric Barrier Discharge (SDBD) is a well-known technology for active aerodynamic flow control with low power consumption. It is a type of plasma actuation for flow control with no moving parts and very fast response times. Research on SDBD flow control over the years has shown great potential for flow separation, boundary layer transition, drag reductions and suppression of local heating. A major area of research on SDBD flow control lies in increasing the effectiveness of SDBD actuators with new electrode configurations, surface materials, and plasma array designs. This review aims to provide a comprehensive report of research performed on SDBD flow control over the last 2 decades with a focus on SDBD reactor designs. Aspects of SDBD flow control including discharge morphology and actuation mechanism through momentum and energy transfer have been discussed in depth. Additionally, the future of research in SDBD actuated flow control has been explored. This review can serve as the baseline to develop new SDBD reactor designs for specific applications with improved effectiveness and advanced systems.
Evaluating behavior change factors over time for a simple vs. complex health behavior
Authors: Phillips L. Alison , More Kimberly R. 
Published: September 2022

BackgroundResearchers are working to identify dynamic factors involved in the shift from behavioral initiation to maintenance—factors which may depend on behavioral complexity. We test hypotheses regarding changes in factors involved in behavioral initiation and maintenance and their relationships to behavioral frequency over time, for a simple (taking a supplement) vs. complex (exercise) behavior.MethodsData are secondary analyses from a larger RCT, in which young adult women, new to both behaviors, were randomly assigned to take daily calcium (N = 161) or to go for a daily, brisk walk (N = 171), for 4-weeks. Factors (intentions, self-efficacy, intrinsic motivation, self-identity, habit strength) were measured weekly. Multi-level modeling evaluated their change over time. Bivariate correlations and multiple regression determined the relationships between factors and the subsequent-week behavioral frequency (self-report and objective).FindingResults were partly in-line with expectations, in that individuals’ intentions and self-efficacy predicted initial behavioral engagement for both behaviors, and habit strength increased for both behaviors, becoming a significant predictor of behavioral frequency in later weeks of the study in some analyses. However, results depended on whether the outcome was self-reported or objectively measured and whether analyses were bivariate or multivariate (regression).DiscussionThe factors theorized to play a role in behavioral maintenance (intrinsic motivation, self-identity, and habit strength) started to develop, but only habit strength predicted behavioral frequency by study-end, for both behaviors. Differences in initiation and maintenance between behaviors of differing complexity may not be as stark as theorized, but longer follow-up times are required to evaluate maintenance factors.