bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary myoadenylate deaminase deficiency is not a common feature of inflammatory myopathies: A descriptive study
Authors: Wilkinson Michael , Cash Kathy , Gutschmidt Bernice , Otto Sophia , Limaye Vidya 
Published: November 2022

BackgroundMyoadenylate deaminase (MAD) deficiency is a form of metabolic myopathy, which generally causes only mild symptoms in the primary inherited form. Inflammatory myopathies are a group of autoimmune diseases which result in skeletal muscle weakness. In addition to inflammatory pathology, it has been speculated that non-inflammatory mechanisms, and possibly secondary MAD-deficiency, may potentially contribute to weakness in these conditions.MethodsWe investigated for an association between these two myopathic processes through two complementary methods. Firstly, muscle biopsy records in South Australia over a 17-year period were retrospectively reviewed for diagnosis of myositis or MAD-deficiency, as well as associated clinical features. Secondly, a prospective arm histochemically tested all incident biopsy specimens over a 12-month period for MAD-deficiency.ResultsIn the retrospective arm, 30 MAD-deficient cases were identified (1.3% of all biopsies), with no significant difference observed in overall rates of myositis diagnosis between patients with intact and deficient MAD activity (21.3% vs 26.7%, P = 0.47). No cases of MAD-deficiency were detected in the prospective arm, despite 39 cases of myositis being identified over this period.ConclusionSecondary MAD deficiency is unlikely to be a major driver of symptoms in inflammatory myopathies.
Impact of unplanned peritoneal dialysis start on patients' outcomes—A multicenter cohort study
Authors: Hangai Kellen Thayanne , Pecoits-Filho Roberto , Blake Peter G. , da Silva Daniela Peruzzo , Barretti Pasqual , de Moraes Thyago Proença 
Published: November 2022

BackgroundPatients with end-stage kidney disease (ESKD) who start unplanned dialysis therapy are more likely to be treated with hemodialysis (HD) using a central venous catheter, which has been associated with a greater risk of infections and other complications, as well as with a higher long-term risk of death. Urgent-start PD is an alternative that has been suggested as an option for starting dialysis in these cases, with potentially better patient outcomes. However, the definition of urgent-start PD is not homogeneous, and no study, to our knowledge, has compared clinical outcomes among urgent start, early start, and conventional start of PD. In this study, we aimed to compare these types of initiation of dialysis therapy in terms of a composite outcome of patient survival and technique failure.MethodsThis is a retrospective, multicenter, cohort study, involving data from 122 PD clinics in Brazil. We used the following: Urgent-start groups refer to patients who initiated PD within 72 h after the PD catheter insertion; early-start groups are those starting PD from 72 h to 2 weeks after the catheter insertion; and conventional-start groups are those who used the PD catheter after 2 weeks from its insertion. We analyzed the composite endpoint of all causes of patient's mortality and technique failure (within the initial 90 days of PD therapy) using the following three different statistical models: multivariate Cox, Fine and Gay competing risk, and a multilevel model.ResultsWe included 509 patients with valid data across 68 PD clinics. There were 38 primary outcomes, comprising 25 deaths and 13 technique failures, with a total follow-up time of 1,393.3 months. Urgent-start PD had no association with the composite endpoint in all three models.ConclusionUnplanned PD seems to be a safe and feasible option for treatment for patients with non-dialysis ESKD in urgent need of dialysis.
Early-start antiplatelet therapy after operation in patients with spontaneous intracerebral hemorrhage and high risk of ischemic events (E-start): Protocol for a multi-centered, prospective, open-label, blinded endpoint randomized controlled trial
Authors: Wang Kaiwen , Mo Shaohua , Liu Qingyuan , Pu Jun , Huang Xiaobin , Kang Dezhi , Lin Fixin , Zou Dewei , Sun Xinguo , Ren Jinrui , Tong Xianzeng , Li Jiangan , Salman Rustam Al-Shahi , Wang Nuochuan , Guo Shuaiwei , Liu Yang , Zhang Yanan , Li Xiong , Wu Jun , Wang Shuo 
Published: November 2022

BackgroundFor severe spontaneous intracerebral hemorrhage (sSICH) patients with high risk of ischemic events, the incidence of postoperative major cardiovascular/cerebrovascular and peripheral vascular events (MACCPE) is notable. Although antiplatelet therapy is a potential way to benefit these patients, the severe hemorrhagic complications, e.g., intracranial re-hemorrhage, is a barrier for early starting antiplatelet therapy.ObjectivesThis randomized controlled trial aims to identify the benefit and safety of early starting antiplatelet therapy after operation for sSICH patients with high risk of ischemic events.MethodsThis study is a multicenter, prospective, randomized, open-label, blinded-endpoint trial. We will enroll 250 sSICH patients with a high risk of ischemic events (including cerebral infarcts, transient ischemic attack, myocardial infarction, pulmonary embolism, and deep venous thrombosis). The participants will be randomized in a 1:1 manner to early-start group (start antiplatelet therapy at 3 days after operation) and normal-start group (start antiplatelet therapy at 30 days after operation). The early-start group will receive aspirin 100 mg daily. The control group will not receive antithrombotic therapy until 30 days after operation. The efficacy endpoint is the incidence of MACCPE, and the safety endpoint is the incidence of intracranial re-hemorrhage.DiscussionThe Early-Start antiplatelet therapy after operation in patients with spontaneous intracerebral hemorrhage trial (E-start) is the first randomized trial about early start antiplatelet therapy for operated sSICH patients with a high risk of ischemic events. This study will provide a new strategy and evidence for postoperative management in the future.Clinical trial registrationClinicalTrials.gov, identifier NCT04820972; Available at: https://clinicaltrials.gov/ct2/show/NCT04820972?term=NCT04820972&amp;draw=2&amp;rank=1.Chinese Clinical Trial Registry, identifier ChiCTR2100044560; Available at: http://www.chictr.org.cn/showproj.aspx?proj=123277.
Discovery and validation of Ferroptosis-related molecular patterns and immune characteristics in Alzheimer’s disease
Authors: He Yi-Jie , Cong Lin , Liang Song-Lan , Ma Xu , Tian Jia-Nan , Li Hui , Wu Yun 
Published: November 2022

BackgroundTo date, the pathogenesis of Alzheimer’s disease is still not fully elucidated. Much evidence suggests that Ferroptosis plays a crucial role in the pathogenesis of AD, but little is known about its molecular immunological mechanisms. Therefore, this study aims to comprehensively analyse and explore the molecular mechanisms and immunological features of Ferroptosis-related genes in the pathogenesis of AD.Materials and methodsWe obtained the brain tissue dataset for AD from the GEO database and downloaded the Ferroptosis-related gene set from FerrDb for analysis. The most relevant Hub genes for AD were obtained using two machine learning algorithms (Least absolute shrinkage and selection operator (LASSO) and multiple support vector machine recursive feature elimination (mSVM-RFE)). The study of the Hub gene was divided into two parts. In the first part, AD patients were genotyped by unsupervised cluster analysis, and the different clusters’ immune characteristics were analysed. A PCA approach was used to quantify the FRGscore. In the second part: we elucidate the biological functions involved in the Hub genes and their role in the immune microenvironment by integrating algorithms (GSEA, GSVA and CIBERSORT). Analysis of Hub gene-based drug regulatory networks and mRNA-miRNA-lncRNA regulatory networks using Cytoscape. Hub genes were further analysed using logistic regression models.ResultsBased on two machine learning algorithms, we obtained a total of 10 Hub genes. Unsupervised clustering successfully identified two different clusters, and immune infiltration analysis showed a significantly higher degree of immune infiltration in type A than in type B, indicating that type A may be at the peak of AD neuroinflammation. Secondly, a Hub gene-based Gene-Drug regulatory network and a ceRNA regulatory network were successfully constructed. Finally, a logistic regression algorithm-based AD diagnosis model and Nomogram diagram were developed.ConclusionOur study provides new insights into the role of Ferroptosis-related molecular patterns and immune mechanisms in AD, as well as providing a theoretical basis for the addition of diagnostic markers for AD.
Estimated EEG functional connectivity and aperiodic component induced by vagal nerve stimulation in patients with drug-resistant epilepsy
Authors: Coa Roberta , La Cava Simone Maurizio , Baldazzi Giulia , Polizzi Lorenzo , Pinna Giovanni , Conti Carlo , Defazio Giovanni , Pani Danilo , Puligheddu Monica 
Published: November 2022

BackgroundVagal nerve stimulation (VNS) improves seizure frequency and quality of life in patients with drug-resistant epilepsy (DRE), although the exact mechanism is not fully understood. Previous studies have evaluated the effect of VNS on functional connectivity using the phase lag index (PLI), but none has analyzed its effect on EEG aperiodic parameters (offset and exponent), which are highly conserved and related to physiological functions.ObjectiveThis study aimed to evaluate the effect of VNS on PLI and aperiodic parameters and infer whether these changes correlate with clinical responses in subjects with DRE.Materials and methodsPLI, exponent, and offset were derived for each epoch (and each frequency band for PLI), on scalp-derived 64-channel EEG traces of 10 subjects with DRE, recorded before and 1 year after VNS. PLI, exponent, and offset were compared before and after VNS for each patient on a global basis, individual scalp regions, and channels and separately in responders and non-responders. A correlation analysis was performed between global changes in PLI and aperiodic parameters and clinical response.ResultsPLI (global and regional) decreased after VNS for gamma and delta bands and increased for an alpha band in responders, but it was not modified in non-responders. Aperiodic parameters after VNS showed an opposite trend in responders vs. non-responders: both were reduced in responders after VNS, but they were increased in non-responders. Changes in aperiodic parameters correlated with the clinical response.ConclusionThis study explored the action of VNS therapy from a new perspective and identified EEG aperiodic parameters as a new and promising method to analyze the efficacy of neuromodulation.
Sustainability of large-scale implementation of shared decision making with the SHARE TO CARE program
Authors: Stolz-Klingenberg Constanze , Bünzen Claudia , Coors Marie , Flüh Charlotte , Margraf Nils G. , Wehkamp Kai , Clayman Marla L. , Scheibler Fueloep , Wehking Felix , Rüffer Jens Ulrich , Schüttig Wiebke , Sundmacher Leonie , Synowitz Michael , Berg Daniela , Geiger Friedemann 
Published: November 2022

IntroductionSHARE TO CARE (S2C) is a comprehensive implementation program for shared decision making (SDM). It is run at the University Hospital Schleswig-Holstein (UKSH) in Kiel, Germany, and consists of four combined intervention modules addressing healthcare professionals and patients: (1) multimodal training of physicians (2) patient activation campaign including the ASK3 method, (3) online evidence-based patient decision aids (4) SDM support by nurses. This study examines the sustainability of the hospital wide SDM implementation by means of the Neuromedical Center comprising the Departments of Neurology and Neurosurgery.MethodsBetween 2018 and 2020, the S2C program was applied initially within the Neuromedical Center: We implemented the patient activation campaign, trained 89% of physicians (N = 56), developed 12 patient decision aids and educated two decision coaches. Physicians adjusted the patients' pathways to facilitate the use of decision aids. To maintain the initial implementation, the departments took care that new staff members received training and decision aids were updated. The patient activation campaign was continued. To determine the sustainability of the initial intervention, the SDM level after a maintenance phase of 6–18 months was compared to the baseline level before implementation. Therefore, in- and outpatients received a questionnaire via mail after discharge. The primary endpoint was the “Patient Decision Making” subscale of the Perceived Involvement in Care Scale (PICSPDM). Secondary endpoints were an additional scale measuring SDM (CollaboRATE), and the PrepDM scale, which determines patients' perceived health literacy while preparing for decision making. Mean scale scores were compared using t-tests.ResultsPatients reported a significantly increased SDM level (PICSPDMp = 0.02; Hedges' g = 0.33; CollaboRATE p = 0.05; Hedges' g = 0.26) and improved preparation for decision making (PrepDM p = 0.001; Hedges' g = 0.34) 6–18 months after initial implementation of S2C.DiscussionThe S2C program demonstrated its sustainability within the Neuromedical Center at UKSH Kiel in terms of increased SDM and health literacy. Maintaining the SDM implementation required a fraction of the initial intensity. The departments took on the responsibility for maintenance. Meanwhile, an additional health insurance-based reimbursement for S2C secures the continued application of the program.ConclusionSHARE TO CARE promises to be suitable for long-lasting implementation of SDM in hospitals.
Effect of doctor–patient news-induced moral judgments on pain empathy for doctors and patients in China
Authors: Li HuiLing , Zhao Dong , Yang BinJie , Zhao YuHui , Huang HanZhi , Jiang Huan , Chen MeiFen , Zhou Qiang , Ying Liang 
Published: November 2022

ObjectivePain empathy’s preferential nature tends to trigger prejudice and intergroup conflicts. Given the current degree of proliferation of doctor–patient conflict news in China, this study aims to determine whether readers of doctor–patient news-initiated moral judgments prefer pain empathy for doctors or patients.Materials and methodsThis study utilized localized doctor–patient news with high or low moral performance (based on morality ratings of patients’ behaviors) as moral-judgment-eliciting materials, and painful pictures as pain empathy-eliciting materials. The event-related potential (ERP) technique was utilized to assess moral judgment’s effect on the cognitive empathy component and to investigate electroencephalogram signals’ accuracy in classifying four brain response patterns when facing doctor or patient is experiencing or not experiencing pain.ResultsUnder low moral text material, participants exhibited smaller mean wave amplitude of positive 300 (P3) and late positive potential (LPP) to painful pictures than non-painful pictures when facing patients; under high moral text material, participants exhibited larger mean wave amplitude of P3 and LPP to painful pictures than non-painful pictures when facing doctors. Electroencephalogram (EEG) signals’ classification accuracy was significant in 0–1,000 ms in both high and low moral judgments, but the classification accuracy was higher in low moral judgments in some cognitive empathy stages (0.51, 0.53–0.55, 0.66–0.79, and 0.88–1 s).ConclusionUnder low moral judgment, individuals pay less attention to the patient’s (perpetrator’s) pain; under high moral judgment, individuals empathize with the doctor (the person praised), showing that news-induced moral judgment can sway readers’ empathy for different social groups. In cognitive empathy, individuals’ brain representations are more discriminatory under low than high moral judgments when confronted with pain by doctors and patients, which provides insight into objectively recognizing group bias.
Mapping white matter structural covariance connectivity for single subject using wavelet transform with T1-weighted anatomical brain MRI
Authors: Wang Xun-Heng , Zhao Bohan , Li Lihua 
Published: November 2022

IntroductionCurrent studies of structural covariance networks were focused on the gray matter in the human brain. The structural covariance connectivity in the white matter remains largely unexplored. This paper aimed to build novel metrics that can infer white matter structural covariance connectivity, and to explore the predictive power of the proposed features.MethodsTo this end, a cohort of 315 adult subjects with the anatomical brain MRI datasets were obtained from the publicly available Dallas Lifespan Brain Study (DLBS) project. The 3D wavelet transform was applied on the individual voxel-based morphology (VBM) volume to obtain the white matter structural covariance connectivity. The predictive models for cognitive functions were built using support vector regression (SVR).ResultsThe predictive models exhibited comparable performance with previous studies. The novel features successfully predicted the individual ability of digit comparison (DC) (r = 0.41 ± 0.01, p &lt; 0.01) and digit symbol (DSYM) (r = 0.5 ± 0.01, p &lt; 0.01). The sensorimotor-related white matter system exhibited as the most predictive network node. Furthermore, the node strengths of sensorimotor mode were significantly correlated to cognitive scores.DiscussionThe results suggested that the white matter structural covariance connectivity was informative and had potential for predictive tasks of brain-behavior research.
The associations of cerebrospinal fluid biomarkers with cognition, and rapid eye movement sleep behavior disorder in early Parkinson’s disease
Authors: Tao Mingzhu , Dou Kaixin , Xie Yijie , Hou Binghui , Xie Anmu 
Published: November 2022

BackgroundIn Parkinson’s disease (PD), levels of cerebrospinal fluid (CSF) biomarkers and progression of non-motor symptoms are associated, but the specifics are not yet clear.ObjectiveThe aim of this study was to investigate the associations of non-motor symptoms with CSF biomarkers in PD.Materials and methodsWe assessed 487 individuals from the Parkinson’s Progression Markers Initiative (PPMI), consisting of 155 healthy controls (HCs) and 332 individuals with PD. Patients with PD were grouped according to non-motor symptoms and compared CSF α-synuclein (α-syn), amyloid-beta 1-42 (Aβ1–42), and total tau (t-tau) levels. Multiple linear regressions were used in baseline analysis and linear mixed-effects models in longitudinal analysis. Analyses of mediating effects between cognition and CSF biomarkers were also performed.ResultsAt baseline, PD patients with cognitive impairment (PDCI) exhibited significantly lower CSF α-syn (β = −0.1244; P = 0.0469), Aβ (β = −0.1302; P = 0.0447), and t-tau (β = −0.1260; P = 0.0131) levels than PD patients without cognitive impairment (PDCU). Moreover, a faster decline of α-syn (β = −0.2152; P = 0.0374) and Aβ (β = −0.3114; P = 0.0023) and a faster rise of t-tau (β = −0.1534; P = 0.0274) have been found in longitudinal analysis. The Aβ positive group showed an earlier decline in cognitive performance (β = −0.5341; P = 0.0180) compared with the negative Aβ group in both analyses. In addition, we found that PD patients with probable rapid eye movement sleep behavior disorder (pRBD) showed decreased CSF α-syn (β = −0.1343; P = 0.0033) levels. Finally, mediation analysis demonstrated that olfactory function partially mediated the relationship between cognition and CSF biomarkers levels.ConclusionOur study shows that CSF biomarkers are associated with cognition at baseline and longitudinally. Cognitive impairment is more severe in patients with a heavier Aβ burden. CSF α-syn decreased in PD patients with pRBD. This study suggests that early recognition of the increased risk of non-motor symptoms is important for disease surveillance and may be associated with the pathological progression of CSF markers.
Prognostic value of the geriatric nutritional index in colorectal cancer patients undergoing surgical intervention: A systematic review and meta-analysis
Authors: Mao Yiqing , Lan Jiarong 
Published: November 2022

BackgroundWe reviewed the literature to assess the prognostic ability of the geriatric nutritional risk index (GNRI) for patients with colorectal cancer (CRC) undergoing curative surgery.MethodsThe online databases of PubMed, CENTRAL, ScienceDirect, Embase, and Google Scholar were searched for articles reporting the relationship between GNRI and outcomes in CRC patients. English language studies were searched up to 28th April 2022.ResultsTen studies with 3802 patients were included. Meta-analysis indicated that patients with low GNRI had significantly poor overall survival (HR: 2.41 95% CI: 1.72, 3.41 I2 = 68%) and disease-free survival (HR: 1.92 95% CI: 1.47, 2.49 I2 = 49%) as compared to those with high GNRI. The meta-analysis also indicated a significantly higher risk of complications with low GNRI as compared to high GNRI (HR: 1.98 95% CI: 1.40, 2.82 I2 = 0%). The results did not change on subgroup analysis based on study location, age group, GNRI cut-off, and sample size.ConclusionCurrent evidence indicates that GNRI can be a valuable prognostic indicator for CRC patients undergoing surgical intervention. Patients with low GNRI have poor overall and disease-free survival and a higher incidence of complications. Clinicians could use this simple indicator to stratify patients and formulate personalized treatment plans.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier (CRD42022328374).
The addition of radiotherapy to breast-conserving surgery improves survival for elderly patients with early breast cancer
Authors: Yang Shi-Ping , Tan Lu-Lu , Zhou Ping , Lian Chen-Lu , Wu San-Gang , He Zhen-Yu 
Published: November 2022

PurposeTo evaluate whether adjuvant radiotherapy (RT) after breast-conserving surgery (BCS) was associated with better survival among elderly (≥70 years) breast cancer patients with T1-2N0 and estrogen receptor (ER) positive disease.MethodsWe included patients who met the inclusion criteria between 2010 and 2014 from the Surveillance, Epidemiology, and End Results program. Patients were subdivided into three groups based on surgery and RT: BCS alone, BCS plus RT, and refusal of RT. The primary outcomes were breast cancer-specific survival (BCSS) and overall survival (OS). Chi-squared tests, Kaplan–Meier method, and Multivariate Cox regression analysis were used for statistical analysis. Propensity score matching (PSM) was performed to minimize the potential selection bias.ResultsA total of 26586 patients were included in this analysis. The median follow-up was 66 months. Of these patients, 15591 (58.6%) patients received RT, RT was recommended but not performed due to patient refusal for 1270 (4.8%) patients, and RT was not recommended for 9725 (36.6%) patients. The 5-year BCSS was 98.3% for patients receiving RT, 97.1% for patients refusal of RT, and 96.4% for patients not recommended RT (P&lt;0.001). The 5-year OS was 88.6% for patients receiving RT, 77.6% for patients who refused RT, and 72.1% for patients not recommended RT (P&lt;0.001). Multivariate Cox regression analyses showed that patients who received adjuvant RT after BCS had significantly better BCSS (hazard ratio [HR] 0.523, 95%confidence interval [CI] 0.447-0.612, P&lt;0.001) and OS (HR 0.589, 95%CI 0.558-0.622, P&lt;0.001) compared to those without RT. A total of 7721 pairs of patients were matched successfully between those with and without RT using PSM. The results also showed that patients who received RT after BCS had significantly better BCSS (HR 562, 95%CI 0.467-0.676, P&lt;0.001) and OS (HR 0.612, 95%CI 0.0.575-0.652, P&lt;0.001) compared to those without RT.ConclusionsThese data suggest that individual counseling is important for treatment decision-making in elderly breast cancer patients with T1-2N0 and ER-positive disease. Given the relatively lower toxicity of modern RT techniques, adjuvant RT should be recommended in patients with high life expectancy.