bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep learning for screening primary osteopenia and osteoporosis using spine radiographs and patient clinical covariates in a Chinese population
Authors: Mao Liting , Xia Ziqiang , Pan Liang , Chen Jun , Liu Xian , Li Zhiqiang , Yan Zhaoxian , Lin Gengbin , Wen Huisen , Liu Bo 
Published: September 2022

PurposeMany high-risk osteopenia and osteoporosis patients remain undiagnosed. We proposed to construct a convolutional neural network model for screening primary osteopenia and osteoporosis based on the lumbar radiographs, and to compare the diagnostic performance of the CNN model adding the clinical covariates with the image model alone.MethodsA total of 6,908 participants were collected for analysis, including postmenopausal women and men aged 50–95 years, who performed conventional lumbar x-ray examinations and dual-energy x-ray absorptiometry (DXA) examinations within 3 months. All participants were divided into a training set, a validation set, test set 1, and test set 2 at a ratio of 8:1:1:1. The bone mineral density (BMD) values derived from DXA were applied as the reference standard. A three-class CNN model was developed to classify the patients into normal BMD, osteopenia, and osteoporosis. Moreover, we developed the models integrating the images with clinical covariates (age, gender, and BMI), and explored whether adding clinical data improves diagnostic performance over the image mode alone. The receiver operating characteristic curve analysis was performed for assessing the model performance.ResultsAs for classifying osteoporosis, the model based on the anteroposterior+lateral channel performed best, with the area under the curve (AUC) range from 0.909 to 0.937 in three test cohorts. The models with images alone achieved moderate sensitivity in classifying osteopenia, in which the highest AUC achieved 0.785. The performance of models integrating images with clinical data shows a slight improvement over models with anteroposterior or lateral images input alone for diagnosing osteoporosis, in which the AUC increased about 2%–4%. Regarding categorizing osteopenia and the normal BMD, the proposed models integrating images with clinical data also outperformed the models with images solely.ConclusionThe deep learning-based approach could screen osteoporosis and osteopenia based on lumbar radiographs.
Contraceptive method use trajectories among young women in Kenya: A qualitative study
Authors: Calhoun Lisa M. , Mandal Mahua , Onyango Bernard , Waga Erick , McGuire Courtney , Zulu Eliya M. , van den Akker Thomas , Benova Lenka , Delvaux Thérèse , Speizer Ilene S. 
Published: September 2022

BackgroundMany young women experience important key life transitions during adolescence and early adulthood, such as initiation of sexual activity, first use of contraceptives, marriage, and childbirth. For young women to be able to plan and manage their lives, it is critical to understand how these life events intersect and shape their contraceptive decision-making. This study aims to explore young women's contraceptive method use trajectories, including the factors that influence contraceptive decision-making throughout adolescence and youth.MethodologyIn 2019, the Full Access, Full Choice project (FAFC), implemented by the University of North Carolina at Chapel Hill and the African Institute for Development Policy, conducted 30 in-depth interviews with young women aged 18–24 years in three counties in Kenya (Nairobi, Mombasa and Migori). Eligible respondents had used two or more modern contraceptive methods. Interview guides utilized a modified life history approach to capture details about respondents' contraceptive use and life experiences from the time they first used contraception until the time of interview.ResultsWe identified five separate contraceptive use trajectories based on the occurrence and timing of marriage, childbirth, and contraceptive method choice as well as various influences on contraceptive decision-making. The majority of respondents began their contraceptive journey by using male condoms or emergency contraception, but subsequent contraceptive decisions were varied across trajectories and influenced by different factors. For many women, the initiation of a non-coitally dependent method occurred after the birth of a child; for some, this was the first method used. Once women transitioned to using a non-coitally dependent method such as injectables or implants, many cycled through different methods to find one that had fewer side effects or provided the desired duration of protection.DiscussionThis study highlights the nuanced needs of young women throughout their adolescent and youth years in Kenya. This suggests that programs and policies need to encompass young women's diversity of experiences and motivations to best serve them.
Combining autophagy and immune characterizations to predict prognosis and therapeutic response in lung adenocarcinoma
Authors: Li Qiaxuan , Xie Daipeng , Yao Lintong , Qiu Hongrui , You Peimeng , Deng Jialong , Li Congsen , Zhan Weijie , Weng Maotao , Wu Shaowei , Li Fasheng , Zhou Yubo , Zeng Fanjun , Zheng Yong , Zhou Haiyu 
Published: September 2022

BackgroundAutophagy, a key regulator of programmed cell death, is critical for maintaining the stability of the intracellular environment. Increasing evidence has revealed the clinical importance of interactions between autophagy and immune status in lung adenocarcinoma. The present study evaluated the potential of autophagy-immune-derived biomarkers to predict prognosis and therapeutic response in patients with lung adenocarcinoma.MethodsPatients from the GSE72094 dataset were randomized 7:3 to a training set and an internal validation set. Three independent cohorts, TCGA, GSE31210, and GSE37745, were used for external verification. Unsupervised hierarchical clustering based on autophagy- and immune-associated genes was used to identify autophagy- and immune-associated molecular patterns, respectively. Significantly prognostic autophagy-immune genes were identified by LASSO analysis and by univariate and multivariate Cox regression analyses. Differences in tumor immune microenvironments, functional pathways, and potential therapeutic responses were investigated to differentiate high-risk and low-risk groups.ResultsHigh autophagy status and high immune status were associated with improved overall survival. Autophagy and immune subtypes were merged into a two-dimensional index to characterize the combined prognostic classifier, with 535 genes defined as autophagy-immune-related differentially expressed genes (DEGs). Four genes (C4BPA, CD300LG, CD96, and S100P) were identified to construct an autophagy-immune-related prognostic risk model. Survival and receiver operating characteristic (ROC) curve analyses showed that this model was significantly prognostic of survival. Patterns of autophagy and immune genes differed in low- and high-risk patients. Enrichment of most immune infiltrating cells was greater, and the expression of crucial immune checkpoint molecules was higher, in the low-risk group. TIDE and immunotherapy clinical cohort analysis predicted that the low-risk group had more potential responders to immunotherapy. GO, KEGG, and GSEA function analysis identified immune- and autophagy-related pathways. Autophagy inducers were observed in patients in the low-risk group, whereas the high-risk group was sensitive to autophagy inhibitors. The expression of the four genes was assessed in clinical specimens and cell lines.ConclusionsThe autophagy-immune-based gene signature represents a promising tool for risk stratification in patients with lung adenocarcinoma, guiding individualized targeted therapy or immunotherapy.
M2-like tumor-associated macrophage-related biomarkers to construct a novel prognostic signature, reveal the immune landscape, and screen drugs in hepatocellular carcinoma
Authors: Qu Xiaodong , Zhao Xingyu , Lin Kexin , Wang Na , Li Xuezhi , Li Songbo , Zhang Luyao , Shi Yongquan 
Published: September 2022

BackgroundM2-like tumor-associated macrophages (M2-like TAMs) have important roles in the progression and therapeutics of cancers. We aimed to detect novel M2-like TAM-related biomarkers in hepatocellular carcinoma (HCC) via integrative analysis of single-cell RNA-seq (scRNA-seq) and bulk RNA-seq data to construct a novel prognostic signature, reveal the “immune landscape”, and screen drugs in HCC.MethodsM2-like TAM-related genes were obtained by overlapping the marker genes of TAM identified from scRNA-seq data and M2 macrophage modular genes identified by weighted gene co-expression network analysis (WGCNA) using bulk RNA-seq data. Univariate Cox regression and least absolute shrinkage and selection operator (LASSO) regression analyses were carried out to screen prognostic genes from M2-like TAM-related genes, followed by a construction of a prognostic signature, delineation of risk groups, and external validation of the prognostic signature. Analyses of immune cells, immune function, immune evasion scores, and immune-checkpoint genes between high- and low-risk groups were done to further reveal the immune landscape of HCC patients. To screen potential HCC therapeutic agents, analyses of gene–drug correlation and sensitivity to anti-cancer drugs were conducted.ResultsA total of 127 M2-like TAM-related genes were identified by integrative analysis of scRNA-seq and bulk-seq data. PDLIM3, PAM, PDLIM7, FSCN1, DPYSL2, ARID5B, LGALS3, and KLF2 were screened as prognostic genes in HCC by univariate Cox regression and LASSO regression analyses. Then, a prognostic signature was constructed and validated based on those genes for predicting the survival of HCC patients. In terms of drug screening, expression of PAM and LGALS3 was correlated positively with sensitivity to simvastatin and ARRY-162, respectively. Based on risk grouping, we predicted 10 anticancer drugs with high sensitivity in the high-risk group, with epothilone B having the lowest half-maximal inhibitory concentration among all drugs tested.ConclusionsOur findings enhance understanding of the M2-like TAM-related molecular mechanisms involved in HCC, reveal the immune landscape of HCC, and provide potential targets for HCC treatment.
Pulse pressure and the risk of renal hyperfiltration in young adults: Results from Korea National Health and Nutrition Examination Survey (2010–2019)
Authors: Yang Eunji , Park Sang Ho , Lee Seoyoung , Oh Donghwan , Choi Hoon Young , Park Hyeong Cheon , Jhee Jong Hyun 
Published: September 2022

BackgroundHigh pulse pressure (PP) is associated with increased risk of decline of kidney function. However, little is known about the association between PP and RHF in young adults. This study aimed to evaluate the association between PP and RHF in healthy young adults.MethodsData were retrieved from the Korea National Health and Nutrition Examination Survey from 2010 to 2019. A total of 10,365 participants aged 19–39 years with no hypertension and normal kidney function were analyzed. RHF was defined as logarithm transformed estimated glomerular filtration rate (eGFR) with residuals &gt;90th percentile after adjustment for sex, logarithm transformed age, weight, and height. Participants were divided into tertile based on PP levels.ResultsThe prevalence of RHF was higher in higher PP tertile group (6.6, 10.5, and 12.7% in T1, T2, and T3; P for trend &lt; 0.001). In multivariable logistic regression analyses, the risk for RHF was increased in higher PP tertiles compared to the lowest tertile [odds ratio (OR), 1.42; 95% confidence interval (CI), 1.19–1.69 in T2; OR, 1.44; 95% CI, 1.20–1.73 in T3]. When PP levels were treated as continuous variable, the risk of RHF was increased 2.36 per 1.0 increase of PP (P &lt; 0.001). In subgroup analyses stratified sex, histories of diabetes or dyslipidemia, and isolated systolic hypertension or isolated diastolic hypertension, there were no significant interactions with PP for the risk for RHF, suggesting that high PP was associated with increased risk of RHF regardless of subgroups. However, the subgroup with BMI showed significant interaction with PP for the risk of RHF, indicating that participants with BMI ≥ 25 kg/m2 were at higher risk of RHF with increasing PP levels than those with BMI &lt; 25 kg/m2 (OR, 1.89; 95% CI, 1.25–2.87 in BMI &lt; 25 kg/m2; OR, 3.16; 95% CI, 1.74–5.73 in BMI ≥ 25 kg/m2; P for interaction = 0.01).ConclusionHigh PP is associated with an increased risk of RHF in healthy young adults and this association is prominent in obese young adults. The assessment of PP and associated RHF may give benefit to early detect the potential risk of CKD development in young adults.
Receptor-binding domain-anchored peptides block binding of severe acute respiratory syndrome coronavirus 2 spike proteins with cell surface angiotensin-converting enzyme 2
Authors: Wang Ting , Xu Jie , Wang Beibei , Wang Yulian , Zhao Wei , Xiang Bin , Xue Yuhua , Yuan Quan , Wang Yiqiang 
Published: September 2022

BackgroundThe COVID-19 pandemic has killed over 6 million people worldwide. Despite the accumulation of knowledge about the causative pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the pathogenesis of this disease, cures remain to be discovered. We searched for certain peptides that might interfere with spike protein (S protein)-angiotensin-converting enzyme 2 (ACE2) interactions.MethodsPhage display (PhD)-12 peptide library was screened against recombinant spike trimer (S-trimer) or receptor-binding domain (S-RBD) proteins. The resulting enriched peptide sequences were obtained, and their potential binding sites on S-trimer and S-RBD 3D structure models were searched. Synthetic peptides corresponding to these and other reference sequences were tested for their efficacy in blocking the binding of S-trimer protein onto recombinant ACE2 proteins or ACE2-overexpressing cells.ResultsAfter three rounds of phage selections, two peptide sequences (C2, DHAQRYGAGHSG; C6, HWKAVNWLKPWT) were enriched by S-RBD, but only C2 was present in S-trimer selected phages. When the 3D structures of static monomeric S-RBD (6M17) and S-trimer (6ZGE, 6ZGG, 7CAI, and 7CAK, each with different status of S-RBDs in the three monomer S proteins) were scanned for potential binding sites of C2 and C6 peptides, C6 opt to bind the saddle of S-RBD in both 6M17 and erected S-RBD in S-trimers, but C2 failed to cluster there in the S-trimers. In the competitive S-trimer-ACE2-binding experiments, synthetic C2 and C6 peptides inhibited S-trimer binding onto 293T-ACE2hR cells at high concentrations (50 μM) but not at lower concentrations (10 μM and below), neither for the settings of S-trimer binding onto recombinant ACE2 proteins.ConclusionUsing PhD methodology, two peptides were generated bearing potentials to interfere with S protein-ACE2 interaction, which might be further exploited to produce peptidomimetics that block the attachment of SARS-CoV-2 virus onto host cells, hence diminishing the pathogenesis of COVID-19.
Case report: Dueling etiologies: Longitudinally extensive spinal cord lesion mimicking spinal cord infarct with simultaneous positive Lyme serology and amphiphysin antibody
Authors: Kalaszi Marianna , Donlon Eoghan , Ahmad Marzuki Wan , Mohamed Abdirahman Sheikh , Boers Peter 
Published: September 2022

BackgroundLongitudinally extensive spinal cord lesions are challenging diagnostic entities as they are uncommon, but various etiologies can cause them.Case reportWe report a case of a 55-year-old man with a past medical history of hypertension. He is an ex-smoker. He presented with chest pain, followed by right lower limb weakness, preceded by 2 weeks of constipation and voiding dysfunction. The examination revealed right lower limb mild flaccid paresis, absent reflexes, reduced anal tone, and urinary retention. His symptoms deteriorated over 24 h, and he developed severe flaccid paraparesis with impaired pinprick sensation below the T4 level. MRI spine showed an abnormal, non-enhancing signal in the anterior aspect of the spinal cord extending from the T4 level to the conus without associated edema. He was commenced on intravenous steroids and had significant improvement after one dose. The imaging was felt to be consistent with spinal cord infarction, and aspirin was started. The cerebrospinal fluid analysis showed elevated protein (0.8 mg/ml). Investigations for stroke and autoimmune pathologies were negative. The Lyme immunoblot confirmed intrathecal production of IgG to Borrelia antigens. The patient was started on ceftriaxone. The paraneoplastic screen identified amphiphysin antibodies. CT-TAP and PET-CT did not identify occult malignancy. The patient had a significant improvement over 2 months, strength was almost fully recovered, and autonomic functions returned to normal.ConclusionWe describe an unusual steroid-responsive, longitudinally extensive spinal cord lesion with radiological features of spinal cord infarct and a simultaneous finding of intrathecal Lyme antibodies and serum amphiphysin antibodies.
The efficacy of intravaginal electrical stimulation (IVES) in treating female with urinary incontinence symptom from meta-analysis of nine randomized controlled trials
Authors: Yao Huibao , Zhang Xiaofei , Sun Fengze , Tang Gonglin , Wu Jitao , Zhou Zhongbao 
Published: September 2022

BackgroundUrinary incontinence (UI) is a common disease in the middle-aged and elderly women, and physical therapy has gradually become the mainstream treatment of UI. We conducted a meta-analysis to evaluate the efficacy of intravaginal electrical stimulation (IVES) in the treatment of UI.MethodsFrom January 2006 to December 2021, we finally selected nine randomized controlled trials (RCTs) including 657 participants from PubMed, EMBASE, and Cochrane databases to evaluate the efficacy of IVES in the treatment of female UI. Continuous data were represented by mean difference and 95% CI, while dichotomous data were represented by odds ratio and 95% CI. All the data were analyzed by the Review Manager Version 5.4.ResultsCompared with the control group, there were significant improvements in urine pad test (P = 0.01), urinary incontinence frequency (P = 0.04), some indicators in the incontinence quality of life questionnaire and King's health questionnaires, and subjective feeling of cure (P = 0.009) in the IVES group. However, in other indicators reflecting UI, there was no significant difference between the IVES group and the control group. In addition, subgroup analysis showed that IVES and IVES combined with training could significantly reduce the weight of the urine pad, which reflected the improvement of urine leakage.ConclusionThis meta-analysis proved that IVES can partially improve the symptoms of female patients with UI compared with the control group. However, it still needs to be further evaluated through more high-quality research in the future.
Case report: Multiple brain tuberculomas after in vitro fertilization, embryo transfer, and abortion
Authors: Shi Zhaobo , Sun Yong 
Published: September 2022

BackgroundMultiple brain tuberculomas (MBT), characterized by disseminated tuberculous granulomas in the brain, is a rare disease like tuberculosis encountered after in vitro fertilization, embryo transfer (IVF-ET), and abortion. This study aimed to investigate the clinical characteristics, diagnostic methods, and therapeutic strategies of MBT after IVF-ET and abortion.MethodsA retrospective analysis was performed on the data of two patients who suffered from MBT after IVF-ET and abortion.ResultsBoth patients manifested headache and vomiting, which are the common symptoms of intracranial hypertension, accompanied by tuberculous meningitis. Besides, case 1 was affected by fever and epilepsy. In terms of imaging characteristics, T2-weighted imaging (T2WI) displayed multiple intracranial punctate or patchy high-intensity signals, some of which were presented as “target sign” or enhanced-like disseminated nodules, similar to miliary tuberculosis. Regular anti-tuberculosis therapy with isoniazid, rifampicin, pyrazinamide, and ethambutol was administered but failed to achieve a significant effect in the initial stage. The symptoms were gradually relieved, and the brain lesions in MRI were significantly alleviated after combining with intrathecal injections of isoniazid, dexamethasone, and chymotrypsin.ConclusionsIn vitro fertilization, embryo transfer (IVF-ET) may be a risk factor for MBT, the common manifestations of which are intracranial hypertension. In addition to multiple nodular enhancement on brain MRI, the “target sign” on T2WI is likely to be another typical feature of MBT. Provided that there is no obvious effect of regular anti-tuberculosis therapy (ATT), intrathecal injections of isoniazid, dexamethasone, and chymotrypsin are considered to produce a favorable prognosis, but further studies are still needed to confirm the efficacy.
Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study
Authors: Zhu Ganggui , Fu Zaixiang , Jin Taian , Xu Xiaohui , Wei Jie , Cai Lingxin , Yu Wenhua 
Published: September 2022

BackgroundThis study sought to develop and validate a dynamic nomogram chart to assess the risk of acute kidney injury (AKI) in patients with acute ischemic stroke (AIS).MethodsThese data were drawn from the Medical Information Mart for Intensive Care III (MIMIC-III) database, which collects 47 clinical indicators of patients after admission to the hospital. The primary outcome indicator was the occurrence of AKI within 48 h of intensive care unit (ICU) admission. Independent risk factors for AKI were screened from the training set using univariate and multifactorial logistic regression analyses. Multiple logistic regression models were developed, and nomograms were plotted and validated in an internal validation set. Based on the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) to estimate the performance of this nomogram.ResultsNomogram indicators include blood urea nitrogen (BUN), creatinine, red blood cell distribution width (RDW), heart rate (HR), Oxford Acute Severity of Illness Score (OASIS), the history of congestive heart failure (CHF), the use of vancomycin, contrast agent, and mannitol. The predictive model displayed well discrimination with the area under the ROC curve values of 0.8529 and 0.8598 for the training set and the validator, respectively. Calibration curves revealed favorable concordance between the actual and predicted incidence of AKI (p &gt; 0.05). DCA indicates the excellent net clinical benefit of nomogram in predicting AKI.ConclusionIn summary, we explored the incidence of AKI in patients with AIS during ICU stay and developed a predictive model to help clinical decision-making.