bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nomogram-Based Risk Model of Small (≤5 mm) Intracranial Aneurysm Rupture in an Eastern Asian Study
Authors: Lou Haiyan , Nie Kehui , Yang Jun , Zhang Tiesong , Wang Jincheng , Fan Weijian , Gu Chenjie , Yan Min , Chen Tao , Zhang Tingting , Min Junxia , Zhan Renya , Pan Jianwei 
Published: May 2022

Background and PurposeRisk stratification of small unruptured intracranial aneurysms (IAs) (&lt; =5 mm) is important for clinical decision-making and management. The aim of this study was to develop an individualized rupture risk model for small IAs in an eastern Asian population.MethodsThis study retrospectively enrolled 343 patients with ruptured (n = 96) and unruptured (n = 285) small IAs. Clinical data and aneurysmal morphology were taken into consideration, regression analysis was performed to identify significant variables, and these variables were then incorporated into a predictive nomogram. The diagnostic performance of the nomogram was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC) and calibration plot. Clinical effectiveness was validated by decision curve analysis (DCA). The PHASES score calculated for each case was used for comparison.ResultsThe nomogram achieved an AUC of 0.849 (95% CI: 0.805–0.893), with a sensitivity of 86.5%, a specificity of 70.9%, and accuracy of 74.7%, which was superior to PHASES score system (AUC = 0.693, sensitivity = 83.6%, specificity = 48.8%, and accuracy = 57.5%). A good agreement between predicted rupture risk and actual rupture status in the small aneurysms was observed, and DCA illustrated the benefit of using the nomogram when decisions needed to be made clinically.ConclusionsThe nomogram based on clinical and morphological risk factors can be useful in assisting clinicians with individualized assessments and benefit-risk balancing in patients with small IAs (&lt; =5 mm).
Nutritional Intake and Gut Microbiome Composition Predict Parkinson’s Disease
Authors: Lubomski Michal , Xu Xiangnan , Holmes Andrew J. , Muller Samuel , Yang Jean Y. H. , Davis Ryan L. , Sue Carolyn M. 
Published: May 2022

BackgroundModels to predict Parkinson’s disease (PD) incorporating alterations of gut microbiome (GM) composition have been reported with varying success.ObjectiveTo assess the utility of GM compositional changes combined with macronutrient intake to develop a predictive model of PD.MethodsWe performed a cross-sectional analysis of the GM and nutritional intake in 103 PD patients and 81 household controls (HCs). GM composition was determined by 16S amplicon sequencing of the V3-V4 region of bacterial ribosomal DNA isolated from stool. To determine multivariate disease-discriminant associations, we developed two models using Random Forest and support-vector machine (SVM) methodologies.ResultsUsing updated taxonomic reference, we identified significant compositional differences in the GM profiles of PD patients in association with a variety of clinical PD characteristics. Six genera were overrepresented and eight underrepresented in PD patients relative to HCs, with the largest difference being overrepresentation of Lactobacillaceae at family taxonomic level. Correlation analyses highlighted multiple associations between clinical characteristics and select taxa, whilst constipation severity, physical activity and pharmacological therapies associated with changes in beta diversity. The random forest model of PD, incorporating taxonomic data at the genus level and carbohydrate contribution to total energy demonstrated the best predictive capacity [Area under the ROC Curve (AUC) of 0.74].ConclusionThe notable differences in GM diversity and composition when combined with clinical measures and nutritional data enabled the development of a predictive model to identify PD. These findings support the combination of GM and nutritional data as a potentially useful biomarker of PD to improve diagnosis and guide clinical management.
Influence of Hearing Rehabilitation With Active Middle Ear and Bone Conduction Implants on Postural Control
Authors: Seiwerth Ingmar , Brylok Antonia , Schwesig René , Rahne Torsten , Fröhlich Laura , Lauenroth Andreas , Hullar Timothy E. , Plontke Stefan K. 
Published: May 2022

BackgroundAs audition also seems to contribute to balance control, additionally to visual, proprioceptive, and vestibular information, we hypothesize that hearing rehabilitation with active middle ear and bone conduction implants can influence postural control.MethodsIn a prospective explorative study, the impact of hearing rehabilitation with active middle ear [Vibrant Soundbrige (VSB), MED-EL, Innsbruck, Austria] and bone conduction implants [Bonebridge (BB), MED-EL, Innsbruck, Austria] on postural control in adults was examined in three experiments. Vestibulospinal control was measured by cranio-corpography (CCG), trunk sway velocity (°/s) by the Standard Balance Deficit Test (SBDT), and postural stability with a force plate system, each time in best aided (BA) and unaided (UA) condition with frontal-noise presentation (Fastl noise, 65 dB SPL), followed by subjective evaluation, respectively.ResultsIn 26 subjects [age 55.0 ± 12.8 years; unilateral VSB/BB: n = 15; bilateral VSB/BB: n = 3, bimodal (VSB/BB + hearing aid): n = 8], CCG-analysis showed no difference between BA and UA conditions for the means of distance, angle of displacement, and angle of rotation, respectively. Trunk sway measurements revealed a relevant increase of sway in standing on foam (p = 0.01, r = 0.51) and a relevant sway reduction in walking (p = 0.026, r = 0.44, roll plane) in BA condition. Selective postural subsystem analysis revealed a relevant increase of the vestibular component in BA condition (p = 0.017, r = 0.47). As measured with the Interactive Balance System (IBS), 42% of the subjects improved stability (ST) in BA condition, 31% showed no difference, and 27% deteriorated, while no difference was seen in comparison of means. Subjectively, 4–7% of participants felt that noise improved their balance, 73–85% felt no difference, and 7–23% reported deterioration by noise. Furthermore, 46–50% reported a better task performance in BA condition; 35–46% felt no difference and 4–15% found the UA situation more helpful.ConclusionsSubjectively, approximately half of the participants reported a benefit in task performance in BA condition. Objectively, this could only be shown in one mobile SBDT-task. Subsystem analysis of trunk sway provided insights in multisensory reweighting mechanisms.
Factors That Influence Susceptibility Vessel Sign in Patients With Acute Stroke Referred for Mechanical Thrombectomy
Authors: Dillmann Manon , Bonnet Louise , Vuillier Fabrice , Moulin Thierry , Biondi Alessandra , Charbonnier Guillaume 
Published: May 2022

Background and PurposeThe presence of a Susceptibility Vessel Sign (SVS) in the acute phase of proximal occlusion ischemic stroke indicates the presence of deoxyhemoglobin in the thrombus. Thrombi composition changes over time. The aim of this study was to investigate whether the absence of SVS is associated with a shorter symptom onset to imaging time.MethodsWe retrospectively analyzed all patients referred for mechanical thrombectomy at Besançon University Hospital between 1 January 2015 and 31 December 2020 for whom readable T2*-weighted imaging was available. We compared patient characteristics according to the presence or absence of an SVS. We also studied the subgroup for whom the exact symptom onset time was known. We performed a univariate statistical analysis, then a multivariate analysis on the variables that were statistically significant in the univariate analysis.ResultsOf the 389 patients included, 309 (79.4%) were SVS+. We found no significant relationship between SVS– and the time between symptom onset and imaging in the whole cohort. In the multivariate analysis, SVS– was associated with anticoagulant treatment (p &lt; 0.01), and SVS+ with age (p = 0.023) and carotid terminus occlusion (p = 0.042). In the known symptom onset subgroup, SVS– was significantly associated with a shorter symptom onset -imaging time (p &lt; 0.001), and this was confirmed in the multivariate analysis (p = 0.011; OR 0.911; 95% CI [0.844; 0.972]).ConclusionIn the acute phase of proximal occlusion ischemic stroke, absence of SVS was associated with a shorter symptom onset–imaging time for patients with a known symptom onset time.
Altered Brain Topological Property Associated With Anxiety in Experimental Orthodontic Pain
Authors: Zhang Feifei , Li Fei , Yang Hong , Jin Yu , Lai Wenli , Kemp Graham J. , Jia Zhiyun , Gong Qiyong 
Published: May 2022

BackgroundOrthodontic pain is orofacial pain caused by tooth movement. Anxiety is a strong predictor of the severity of such pain, but little is known about the underlying neuropsychological mechanisms of such effects. The purpose of this study was to investigate the effect of orthodontic pain on brain functional networks and to define the mediating role of anxiety in orthodontic pain and brain function.MethodsGraph theory-based network analyses were applied to brain functional magnetic resonance imaging data from 48 healthy participants exposed to 24 h orthodontic pain stimuli and 49 healthy controls without any stimulation.ResultsIn the experimental orthodontic pain stimulation, brain functional networks retained a small-world organization. At the regional level, the nodal centrality of ipsilateral brain nodes to the pain stimulus was enhanced; in contrast the nodal centrality of contralateral brain areas was decreased, especially the right mid-cingulate cortex, which is involved in pain intensity coding. Furthermore, anxiety mediated the relationship between nodal efficiency of mid-cingulate cortex and pain severity.ConclusionThe results illuminate the neural mechanisms of orthodontic pain by revealing unbalanced hemispherical brain function related to the unilateral pain stimulation, and reveal clinically exploitable evidence that anxiety mediates the relationship between nodal function of right mid-cingulate cortex and orthodontic pain.
Assessing Insulin Sensitivity and Postprandial Triglyceridemic Response Phenotypes With a Mixed Macronutrient Tolerance Test
Authors: Newman John W. , Krishnan Sridevi , Borkowski Kamil , Adams Sean H. , Stephensen Charles B. , Keim Nancy L. 
Published: May 2022

The use of meal challenge tests to assess postprandial responses in carbohydrate and fat metabolism is well established in clinical nutrition research. However, challenge meal compositions and protocols remain a variable. Here, we validated a mixed macronutrient tolerance test (MMTT), containing 56-g palm oil, 59-g sucrose, and 26-g egg white protein for the parallel determination of insulin sensitivity and postprandial triglyceridemia in clinically healthy subjects. The MMTT was administered in two study populations. In one, women with overweight/obese BMIs (n = 43) involved in an 8-week dietary intervention were administered oral glucose tolerance tests (OGTTs) and MMTTs within 2 days of each other after 0, 2, and 8 weeks of the dietary intervention. In the other, 340 men and women between 18 and 64 years of age, with BMI from 18–40 kg/m2, completed the MMTT as part of a broad nutritional phenotyping effort. Postprandial blood collected at 0, 0.5, 3, and 6 h was used to measure glucose, insulin, and clinical lipid panels. The MMTT postprandial insulin-dependent glucose disposal was evaluated by using the Matsuda Index algorithm and the 0- and 3 h blood insulin and glucose measures. The resulting MMTT insulin sensitivity index (ISIMMTT) was strongly correlated (r = 0.77, p &lt; 0.001) with the OGTT-dependent 2 h composite Matsuda index (ISIComposite), being related by the following equation: Log (ISIComposite) = [0.8751 x Log(ISIMMTT)] –0.2115. An area under the triglyceride excursion curve &gt;11.15 mg/mL h–1 calculated from the 0, 3, and 6 h blood draws established mild-to-moderate triglyceridemia in agreement with ∼20% greater prevalence of hypertriglyceridemia than fasting indications. We also demonstrated that the product of the 0 to 3 h and 3 to 6 h triglyceride rate of change as a function of the triglyceride incremental area under the curve optimally stratified subjects by postprandial response patterns. Notably, ∼2% of the population showed minimal triglyceride appearance by 6 h, while ∼25% had increasing triglycerides through 6 h. Ultimately, using three blood draws, the MMTT allowed for the simultaneous determination of insulin sensitivity and postprandial triglyceridemia in individuals without clinically diagnosed disease.Clinical Trial Registration[https://clinicaltrials.gov/], identifier [NCT02298725; NCT02367287].
DeepLN: A Multi-Task AI Tool to Predict the Imaging Characteristics, Malignancy and Pathological Subtypes in CT-Detected Pulmonary Nodules
Authors: Wang Chengdi , Shao Jun , Xu Xiuyuan , Yi Le , Wang Gang , Bai Congchen , Guo Jixiang , He Yanqi , Zhang Lei , Yi Zhang , Li Weimin 
Published: May 2022

ObjectivesDistinction of malignant pulmonary nodules from the benign ones based on computed tomography (CT) images can be time-consuming but significant in routine clinical management. The advent of artificial intelligence (AI) has provided an opportunity to improve the accuracy of cancer risk prediction.MethodsA total of 8950 detected pulmonary nodules with complete pathological results were retrospectively enrolled. The different radiological manifestations were identified mainly as various nodules densities and morphological features. Then, these nodules were classified into benign and malignant groups, both of which were subdivided into finer specific pathological types. Here, we proposed a deep convolutional neural network for the assessment of lung nodules named DeepLN to identify the radiological features and predict the pathologic subtypes of pulmonary nodules.ResultsIn terms of density, the area under the receiver operating characteristic curves (AUCs) of DeepLN were 0.9707 (95% confidence interval, CI: 0.9645-0.9765), 0.7789 (95%CI: 0.7569-0.7995), and 0.8950 (95%CI: 0.8822-0.9088) for the pure-ground glass opacity (pGGO), mixed-ground glass opacity (mGGO) and solid nodules. As for the morphological features, the AUCs were 0.8347 (95%CI: 0.8193-0.8499) and 0.9074 (95%CI: 0.8834-0.9314) for spiculation and lung cavity respectively. For the identification of malignant nodules, our DeepLN algorithm achieved an AUC of 0.8503 (95%CI: 0.8319-0.8681) in the test set. Pertaining to predicting the pathological subtypes in the test set, the multi-task AUCs were 0.8841 (95%CI: 0.8567-0.9083) for benign tumors, 0.8265 (95%CI: 0.8004-0.8499) for inflammation, and 0.8022 (95%CI: 0.7616-0.8445) for other benign ones, while AUCs were 0.8675 (95%CI: 0.8525-0.8813) for lung adenocarcinoma (LUAD), 0.8792 (95%CI: 0.8640-0.8950) for squamous cell carcinoma (LUSC), 0.7404 (95%CI: 0.7031-0.7782) for other malignant ones respectively in the malignant group.ConclusionsThe DeepLN based on deep learning algorithm represented a competitive performance to predict the imaging characteristics, malignancy and pathologic subtypes on the basis of non-invasive CT images, and thus had great possibility to be utilized in the routine clinical workflow.
Potential Treat-to-Target Approach for Methamphetamine Use Disorder: A Pilot Study of Adenosine 2A Receptor Antagonist With Positron Emission Tomography
Authors: Okita Kyoji , Matsumoto Toshihiko , Funada Daisuke , Murakami Maki , Kato Koichi , Shigemoto Yoko , Sato Noriko , Matsuda Hiroshi 
Published: May 2022

Introduction: The misuse of stimulant drugs such as methamphetamine is a global public health issue. One important neurochemical mechanism of methamphetamine use disorder may be altered dopaminergic neurotransmission. For instance, previous studies using positron emission tomography (PET) have consistently shown that striatal dopamine D2-type receptor availability (quantified as binding potential; BPND) is lower in methamphetamine use disorder. Further, methamphetamine use is known to induce chronic neuroinflammation through multiple physiological pathways. Upregulation of D2-type receptor and/or attenuation of neuroinflammation may therefore provide a therapeutic effect for this disorder. In vitro studies have shown that blockage of adenosine 2A (A2A) receptors may prevent D2-receptor downregulation and neuroinflammation-related brain damage. However, no study has examined this hypothesis yet.Methods and Analysis: Using a within-subject design, this trial will assess the effect of the selective A2A receptor antagonist, istradefylline, primarily on D2-type BPND in the striatum, and secondarily on neuroinflammation in the whole brain in individuals with methamphetamine use disorder. The research hypotheses are that istradefylline will increase striatal D2-type BPND and attenuate neuroinflammation. Twenty participants with methamphetamine use disorder, aged 20–65, will be recruited to undergo [11C]raclopride PET (for every participant) and [11C]DAA1106 PET (if applicable) once before and once after administration of 40 mg/day istradefylline for 2 weeks. Neuropsychological measurements will be performed on the same days of the PET scans.
Psychological Responses and Strategies Towards the COVID-19 Pandemic Among Higher Education Students in Portugal and Switzerland: A Mixed-Methods Study
Authors: Schwander-Maire Françoise , Querido Ana , Cara-Nova Tanya , Dixe Maria Anjos , Aissaoui Djamel , Charepe Zaida , Christie Derek , Laranjeira Carlos 
Published: May 2022

BackgroundThe COVID-19 pandemic has caused overwhelming changes in individual and community daily-life, resulting from the public health measures implemented to contain it, and also from its psychological and socio-economic consequences. These shifts and consequences impacted the entire population, but some groups are more likely to be affected by these changes, including higher education students.Objectivesa) to investigate mental health status and its determinants among higher-education students in Portugal and Switzerland; and b) to explore adjustment patterns used by these students to overcome the impact of the COVID-19 pandemic.MethodsA cross-sectional study with a mixed-methods sequential explanatory design was conducted in two phases. First, an online survey was conducted among higher education students in Portugal and Switzerland, in Portuguese and French respectively. A convenience sampling method was used. Second, some participants from the first phase were invited to participate in four online focus group discussions (two in each country) using a maximum variation sampling method.ResultsThe survey was answered by 1,880 students. Portuguese students revealed higher levels of stress and anxiety, but lower depression symptoms and less resilient coping compared to Swiss respondents. Hope was identified as an explanatory variable for mental health symptoms in students from both countries. In the focus groups (n = 27), 13 adjustment strategies were found, which were subdivided into three spheres: personal, social, and contextual.ConclusionsThe results suggest that the COVID-19 pandemic had a mild to moderate impact on most of the evaluated mental health variables. Nevertheless, the students reacted and mobilized positive short-term strategies, which need to be reinforced in order to prevent long-term psychological harm. In addition, our results can inform psychosocial interventions to minimize psychological impact, anxiety, depression, and stress due to sanitary crises or other population-wide problems or disasters.
Knowledge, Perception, and Willingness to Use Telepharmacy Among the General Population in Indonesia
Authors: Tjiptoatmadja Nesqi N. , Alfian Sofa D. 
Published: May 2022

IntroductionCOVID-19 emerged as a pandemic in early 2020. Various steps were taken in an attempt to decrease the spread, which resulted in limited mobility. As people were dissuaded from going out, multiple numbers of digitalized pharmacy services arose to fulfill people's needs for medicine. The objective of this study was to assess knowledge, perception, and willingness to use telepharmacy services and the affecting factors among the general population in Indonesia.Patients and MethodsA cross-sectional study was conducted with the inclusion criteria of Indonesian citizenship, living in Indonesia, and agreement to participate. Details of demographic characteristics, knowledge and perception of telepharmacy services and willingness to use them were collected using an online questionnaire that was adapted from a previous study. The results were analyzed using a descriptive analysis method. The associations between demographic characteristics and knowledge, perception, and willingness to use telepharmacy services were tested with the Mann–Whitney U Test.ResultsOf 203 participants participated in this study, 51% of them had heard about telepharmacy. Over 98% of the participants had a positive perception of telepharmacy services. The majority of those who had never used it were willing to try telepharmacy services in the future. Age and educational level were significantly associated with knowledge of telepharmacy services. No associations were observed between demographic characteristics and perception and willingness to use telepharmacy services.ConclusionsGeneral population in Indonesia had a fair knowledge, a positive perception, and were willing to use telepharmacy services. Interventions to increase knowledge of telepharmacy in Indonesia need to target older adults and people who are less educated.
“DOST” Model to Link and Support Drug Resistant TB Patients From Private Sector: An Experience From Delhi, India
Authors: Vatsyayan Vindhya , Pattery Theresa , Sayyad Khasim , Williams Jason , Pal Arnab , Panibatla Vikas , Khanna Ashwani 
Published: May 2022

BackgroundThe National TB Elimination Programme (NTEP) has quite successfully involved private sector for referral of presumptive drug resistant TB (DR-TB) patients for molecular testing and referral for DR-TB management. There was a challenge as all the referred patients were not reaching to the facilities. A “DOST” intervention model was implemented to strengthen the patient care pathway. We conducted this study to describe the patient care cascade, the clinico-demographic characteristics of patients linked to the treatment and to estimate the mean turn-around time for drug resistant TB care services.MethodsIt is a cross-sectional study conducted at New Delhi during the period July 2019-December 2020 under programmatic settings.ResultsA total of 9,331 patients were subjected to CB-NAAT test and 382 (4%) were found to be resistant for rifampicin and 231 (76%) were initiated on treatment in the public sector under NTEP.ConclusionThe DOST intervention model developed to link the DR-TB patients from private sector to the public sector DR-TB centers is found to be efficient and effective.