bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroimaging markers of dual impairment in cognition and physical performance following stroke: The Nor-COAST study
Authors: Einstad Marte Stine , Schellhorn Till , Thingstad Pernille , Lydersen Stian , Aamodt Eva Birgitte , Beyer Mona Kristiansen , Saltvedt Ingvild , Askim Torunn 
Published: December 2022

BackgroundCognitive decline and decline in physical performance are common after stroke. Concurrent impairments in the two domains are reported to give increased risk of dementia and functional decline. The concept of dual impairment of physical performance and cognition after stroke is poorly investigated. Clinically accessible imaging markers of stroke and pre-existing brain pathology might help identify patients at risk.ObjectiveThe primary aim of this study was to investigate to which extent pre-stroke cerebral pathology was associated with dual impairment in cognition and physical performance at time of stroke. Secondary aims were to examine whether white matter hyperintensities, medial temporal lobe atrophy, and stroke lesion volume and location were associated with dual impairment.MethodsParticipants from the Norwegian Cognitive Impairment After Stroke (Nor-COAST) study with available MRI data at baseline were included in this cross-sectional study. Logistic regression analyses were conducted, with impairment status (no impairment, impaired cognition, impaired physical performance, and dual impairment) as the dependent variable and MRI markers as covariates. Pre-existing brain pathologies were classified into neurodegenerative, cerebrovascular, or mixed pathology. In addition, white matter hyperintensities and medial temporal lobe atrophy were included as independent covariates. Stroke volume and location were also ascertained from study-specific MRI scans.ResultsParticipants’ (n = 348) mean (SD) age was 72.3 (11.3) years; 148 (42.5%) were women. Participants with dual impairment (n = 99) were significantly older, had experienced a more severe stroke, and had a higher comorbidity burden and poorer pre-stroke function. Stroke lesion volume (odds ratio 1.03, 95%, confidence interval 1.00 to 1.05, p = 0.035), but not stroke location or pre-existing brain pathology, was associated with dual impairment, after adjusting for age and sex.ConclusionIn this large cohort of stroke survivors having suffered mainly mild to moderate stroke, stroke lesion volume—but not pre-existing brain pathology—was associated with dual impairment early after stroke, confirming the role of stroke severity in functional decline.
Systematic review of Kaixinsan in treating depression: Efficacy and pharmacological mechanisms
Authors: Bo Menghan , Zhang Hongjing , Xu Jia , Zhao Hong , Jia Xinglei , Wang Guangdong , Lu Zhengyu 
Published: December 2022

IntroductionKaixinsan (KXS) has been in use as an effective classic formulation of traditional Chinese medicine for depression. However, its active components and action mechanism against depression remain elusive. The purpose of this study was to summarize and evaluate the efficacy and potential pharmacological mechanisms of KXS in antidepressant treatment.Materials and methodsReports on the use of KXS in the treatment of depression were systematically collected from PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang Data from the establishment to July 2022, including those on mood disorders in neurological diseases such as Alzheimer’s disease. Meta-analysis was conducted with the Review Manager 5.3 software. Online datasets, traditional Chinese medicine system pharmacological analysis platform, GeneCards, online Mendelian inheritance in man, and DisGeNET were used to investigate the depression-related genes. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichments were performed to construct the ‘component-target-pathways’ network using Metascape online analyses.ResultTen studies were included in the analysis. Meta-analysis showed that both low-dose KXS (SMD = 19.66, Z = 7.96, and I2 = 42%) and high-dose KXS (SMD = 23.84, Z = 8.46, and I2 = 13%) could increase the sucrose preference in depression models. In addition, 5-hydroxytryptamine (5-HT) (SMD = 10.91, Z = 2.95, and I2 = 50%) returned to normal level after the treatment at low dose KXS. In network pharmacology, 50 active components and 376 gene targets were screened out. AKT1, GAPDH, ALB, TNF, and TP53 were the core target proteins. GO analysis showed that KXS mainly treats depression in biological processes such as response to drugs, cellular calcium ion homeostasis, and regulation of chemical synaptic signal transmission. KEGG results show that the mechanism of action of KXS in treating depression is through neural activity ligand-receptor interaction, the calcium signaling and CAMP signaling pathways.DiscussionThe study reveals the active components and potential molecular mechanism of KXS in the treatment of depression and provides evidence for future basic research.
Clinical characteristics and management of headache in patients with myeloproliferative neoplasms
Authors: Shimoyama Takashi , Yamaguchi Hiroki , Kimura Kazumi , Suzuki Fumiaki , Hayashi Toshiyuki , Wakita Satoshi 
Published: December 2022

BackgroundHeadache is frequently reported as a neurological manifestation of myeloproliferative neoplasms (MPNs), including polycythemia vera and essential thrombocythaemia. This study sought to clarify the clinical characteristics and response to treatment of headaches in patients with MPNs.MethodsWe prospectively studied 137 patients with MPNs. The following information was gathered to assess the features of headache at baseline and at follow-up (&gt;6 months): (1) average duration of headache attacks, (2) number of headache days per month, (3) numerical rating scale (NRS), (4) Headache Impact Test-6 (HIT-6), and (5) Migraine Disability Assessment (MIDAS). We compared those parameters for headaches between the baseline and follow-up interviews according to the management.ResultsThirty-seven (27.0%) patients had headache. The prevalence of headaches gradually decreased with increasing age (Age ≤ 49 years: 61.0%, 50–59 years: 38.5%, 60–69 years: 17.2%, 70–79 years: 5.1%, and ≥80 years: 0.0%, P &lt; 0.001). Multiple logistic regression analysis showed that younger age, but not platelet counts or the JAK2 V617F mutation, was independently associated with headaches (Odds Ratios 2.004, 95% confidence intervals 1.293–3.108, P = 0.002). Scintillating scotomas were present in 22 (59.5%) of 37 patients with headaches, while four patients developed sudden headaches that lasted for only 0–10 min. Follow-up interviews were available for 31 (83.8%) of 37 patients with headaches. Twenty-one (67.7%) patients were treated with low-dose aspirin (100 mg once daily) [low-dose aspirin alone: n = 9; combined cytoreductive therapy: n = 12] for headache management. All parameters for headache [average duration of headache attacks, number of headache days per month, NRS score, HIT-6 score, and MIDAS score (all P &lt; 0.001)] were significantly improved at follow-up in patients taking low-dose aspirin. However, there were no significant differences in these parameters of headaches in patients who did not receive low-dose aspirin.ConclusionHeadaches is common in patients with MPNs, particularly in younger patients. MPN-related headaches may be managed by using low-dose aspirin and controlling MPNs.
Risk factors for neuromuscular complications in lower limbs after lung transplantation
Authors: Cho Soomi , Lee Jee Eun , Choi Byeong Joo , Kim Song Yee , Park Moo Suk , Kim Hyo-Hyun , Lee Jin Gu , Paik Hyo Chae , Shin Ha Young , Kim Seung Woo 
Published: December 2022

ObjectiveThis study aimed to analyze the prevalence and risk factors of neuromuscular complications after lung transplantation (LT), as well as the association between neuromuscular complications and extracorporeal membrane oxygenation (ECMO) support.MethodsWe retrospectively included 201 patients who underwent LT between 2013 and 2020. Patients were classified into three groups based on the presence and the pattern of postoperative leg weakness: no weakness group, asymmetric weakness group, and symmetric weakness group. Comorbidities, duration of ECMO therapy, and postoperative complications were compared between the three groups.ResultsOf the 201 recipients, 16 (8.0%) and 29 (14.4%) patients developed asymmetric and symmetric leg weakness, respectively. Foot drop was the main complaint in patients with asymmetric weakness. The presumed site of nerve injury in the asymmetric weakness group was the lumbosacral plexus in 8 (50%), peroneal nerve in 4 (25%), sciatic nerve in 2 (12.5%), and femoral nerve in 2 (12.5%) patients. In multivariate analysis, the use of preoperative ECMO was found to be independently associated with asymmetric weakness (OR, 3.590; 95% CI [1.227–10.502]). Symmetric leg weakness was associated with age at LT (1.062 [1.002–1.125]), diabetes mellitus (2.873 [1.037–7.965]), myositis (13.250 [2.179–80.584]), postoperative continuous renal replacement therapy (4.858 [1.538–15.350]), and duration of stay in the intensive care unit (1.052 [1.015–1.090]).ConclusionMore than 20% of patients developed leg weakness after LT. Early suspicion for peripheral neuropathy is required in patients after LT who used ECMO preoperatively, and who suffered from medical complications after LT.
Stent-assisted coiling vs. coiling alone of ruptured tiny intracranial aneurysms: A contemporary cohort study in a high-volume center
Authors: Zhang Guanghao , Wu Yina , Wei Yanpeng , Xue Gaici , Chen Rundong , Lv Nan , Zhang Xiaoxi , Duan Guoli , Yu Ying , Li Qiang , Xu Yi , Huang Qinghai , Yang Pengfei , Zuo Qiao , Liu Jianmin 
Published: December 2022

ObjectiveThis study aims to compare the safety and efficacy of stent-assisted coiling (SAC) with those of coiling alone (CA) for the treatment of ruptured tiny intracranial aneurysms.MethodsWe enrolled 245 patients with ruptured tiny intracranial aneurysms treated with coil embolization. Patients were grouped into SAC and CA groups. Baseline characteristics, periprocedural complications, clinical outcomes, and angiographic results were compared between the two groups. In addition, a subgroup analysis was conducted in the SAC group, and patients were regrouped into low-profile visualized intraluminal support (LVIS) and laser-cut groups to compare the perioperative procedure-related complications and clinical and angiographic follow-up outcomes.ResultsAll baseline characteristics were equivalent between the two groups except for aneurysm size and dome-to-neck aspect ratio. The rates of overall procedure-related complications, intraprocedural rupture, postoperative early rebleeding, intraprocedural thrombosis, postprocedural thrombosis, and procedure-related mortality were comparable between the two groups (P = 0.105, 0.145, 0.308, 1.000, 1.000, 0.160, respectively). Nevertheless, the rate of hemorrhagic complication in the SAC group was significantly higher (P = 0.023). The angiographic follow-up outcomes showed that the SAC group had a higher complete occlusion rate and lower recurrence rate (88.2 vs. 67.1%, 5.4 vs. 15.2%, P = 0.001). The clinical outcomes at discharge and follow-up between the two groups demonstrated no significant differences (P = 0.192 and P = 0.085, respectively). For subgroup analysis, LVIS stents were associated with a significantly higher rate of complete occlusion (P = 0.014) and a lower rate of intraprocedural rupture (p = 0.021). Moreover, multivariate analysis showed that there were no predictors for the overall, hemorrhagic, and ischemic procedure-related complications, while Raymond class was an independent predictor of retreatment (OR = 3.508, 95% CI 1.168–11.603; P = 0.029).ConclusionStent-assisted coiling may increase the incidence of hemorrhagic events with favorable angiographic results and comparable clinical outcomes compared with stand-alone coiling. Nevertheless, LVIS stent could improve the safety compared with lazer-cut stent. Simultaneously, considering the better long-term effect, LVIS stent-assisted coiling may be a preferable choice for ruptured tiny intracranial aneurysms.
Case report: Conservative treatment for fertility preservation in a woman with hemoperitoneum due to an invasive mole
Authors: Xu Linjuan , Feng Min , Cai Jing , Li Hongmei 
Published: December 2022

BackgroundInvasive moles are a subtype of gestational trophoblastic neoplasia (GTN) that usually develops after hydatidiform molar pregnancies. Uterine rupture in high-risk GTN is a rare and potentially catastrophic event. The treatment of invasive mole perforation with uterine rupture is particularly challenging in young women who desire fertility preservation.Case presentationWe present the case of a 22-year-old woman with a rapidly transformed invasive mole after two evacuations for a complete molar pregnancy. Within 21 days of the second molar evacuation, the serum β-hCG level surged from 5,718 mIU/ml to 444,617 mIU/ml. An ultrasonography examination showed the uterus was 9.2×8.9×7.8 cm in size with an uneven echo area of 6.9×5.2 cm near the fundus of the uterine cavity; the convex anterior wall had no normal muscle layer, and the outer margin was about 0.24 cm from the serosal layer. The patient was diagnosed with an invasive mole. Since she desired fertility preservation, we proposed a methotrexate (MTX) chemotherapy regimen. Before the planned chemotherapy, she experienced sudden abdominal pain accompanied by a blood pressure of 76/48 mmHg and a pulse rate of 116 bpm. An emergency abdominal ultrasound scan showed acute intra-abdominal bleeding (approximately 2,000 ml), and blood tests showed a hemoglobin concentration of 7.9 g/dL. Immediate uterine artery embolization was performed, and 35 mg MTX was administered bilaterally through the uterine arteries. The next day, the serum β-hCG decreased to 83,530 mIU/ml, and the vital signs remained stable. Seven days later, the patient received a combination of etoposide, methotrexate, dactinomycin, cyclophosphamide, and vincristine (EMACO), and the serum β-hCG level normalized after cycle five. At the 13-month follow-up after therapy completion, the woman was disease-free with a normal β-hCG level.ConclusionOur experience highlights the potential feasibility and efficacy of conservative treatment for fertility preservation in such scenarios.
Diagnostic value of circulating lncRNAs for gastric cancer: A systematic review and meta-analysis
Authors: Li Jian , Zhang Yanyan , Xu Qingyu , Zhang Yaqiong , Bei Songhua , Ding Ying , Zhang Xiaohong , Feng Li 
Published: December 2022

ObjectiveWith the prevalence of next-generation sequencing (NGS) technology, a large number of long non-coding RNAs (lncRNAs) have attracted tremendous attention and have been the topic of extensive research on gastric cancer (GC). It was revealed that lncRNAs not only participate in the transduction of various signaling pathways, thus influencing GC genesis and development, but also have the potential for GC diagnosis. Therefore, we aimed to conduct a meta-analysis of previous studies on GC.Materials and methodsAn electronic search was made before August 2021 on databases including PubMed, Embase, and Web of Science. Relevant articles that compare lncRNA expression in GC patients and healthy controls were summarized. We conducted a meta-analysis with the objective of evaluating the ability of lncRNAs in diagnosing GC.ResultsA total of 40 original research studies including 6,772 participants were discussed in this meta-analysis. The overall sensitivity, specificity, and the area under the curve (AUC) were 0.78 (95% CI: 0.75–0.81), 0.79 (95% CI: 0.74–0.83), and 0.85 (95% CI: 0.81–0.87), respectively. The value of pooled diagnostic odds ratios (DORs) was 13.00 (95% CI: 10.00–17.00).ConclusionsThis meta-analysis revealed that serum or plasma lncRNAs have high sensitivity and specificity, which makes lncRNAs clinically feasible in diagnosing GC. The results from this meta-analysis demonstrated that peripheral blood lncRNAs may become novel noninvasive biomarkers in the foreseeable future. At the same time, it should be noted that a greater number of blood samples and more evidence from rigorous multicenter clinical studies are necessary to justify their applicability as cancer biomarkers.
Genetically predicted iron status was associated with the risk of prostate cancer
Authors: Ying Jiacheng , Wang Binyan , Han Shuyang , Song Jie , Liu Ke , Chen Weiwei , Sun Xiaohui , Mao Yingying , Ye Ding 
Published: December 2022

IntroductionObservational studies have reported a relationship between iron status and the risk of prostate cancer. However, it remains uncertain whether the association is causal or due to confounding or reverse causality. To further clarify the underlying causal relationship, we conducted a Mendelian randomization (MR) analysis.MethodsWe selected three genetic variants (rs1800562, rs1799945, and rs855791) closely correlated with four iron status biomarkers (serum iron, log-transformed ferritin, transferrin saturation, and transferrin) as instrumental variables. Summary statistics for prostate cancer were obtained from the Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome consortium including 79,148 cases and 61,106 controls of European ancestry. The inverse-variance weighted (IVW) method was conducted primarily to estimate the association of genetically predicted iron status and the risk of prostate cancer, supplemented with simple-median, weighted-median and maximum-likelihood methods as sensitivity analysis. MR-Egger regression was used to detect directional pleiotropy. We also conducted a meta-analysis of observational studies to assess the associations between iron status and the risk of prostate cancer.ResultsGenetically predicted increased iron status was associated with the decreased risk of prostate cancer, with odds ratio of 0.91 [95% confidence interval (CI): 0.84, 0.99; P = 0.035] for serum iron, 0.81 (95% CI: 0.65, 1.00; P = 0.046) for log- transformed ferritin, 0.94 (95% CI: 0.88, 0.99; P = 0.029) for transferrin saturation, and 1.15 (95% CI: 0.98, 1.35; P = 0.084) for transferrin (with higher transferrin levels representing lower systemic iron status), using the inverse-variance weighted method. Sensitivity analyses produced consistent associations, and MR-Egger regression indicated no potential pleiotropy. Our replication analysis based on FinnGen research project showed compatible results with our main analysis. Results from our meta-analysis similarly showed that serum ferritin [standardized mean difference (SMD): −1.25; 95% CI: −2.34, −0.16; P = 0.024] and transferrin saturation (SMD: −1.19; 95% CI: −2.34, −0.05; P = 0.042) were lower in patients with prostate cancer compared with that in controls.DiscussionOur study suggests a protective role of iron in the risk of prostate cancer, further investigations are required to clarify the underlying mechanisms.
Expected small left heart size in the presence of congenital diaphragmatic hernia: Fetal values and Z-scores for infants confirmed to have no heart disease postnatally
Authors: Moon-Grady Anita J. , Byrne Francesca A. , Lusk Leslie A. , Keller Roberta L. 
Published: December 2022

ObjectivesIn fetuses with left-sided congenital diaphragmatic hernia (CDH), left heart structures may appear small, but usually normalize after birth in the absence of structural cardiac anomalies. To decrease the possibility of an erroneous diagnosis of structural heart disease, we identify normal values for left heart structures in the presence of left CDH and secondarily investigate the relationship of left heart size and survival to neonatal hospital discharge.MethodsLeft heart structures [mitral valve (MV) and aortic valve (AoV) annulus diameter, left ventricle (LV) length and width] were measured by fetal echocardiogram in fetuses with left CDH and no congenital heart disease. We generated linear regression models to establish the relationship of gestational age for each left heart structure using data from fetuses who survived after birth. We calculated z-scores (normalized to gestational age), and assessed the relationship of survival to the size of each structure.ResultsOne hundred forty-two fetuses underwent fetal echocardiogram (median 25 weeks' gestation, IQR 23, 27 weeks). Left heart structures were deemed small when using published normative data from unaffected fetuses (z-scores: MV −1.09 ± 1.35, AoV −2.12 ± 1.16, LV length −1.36 ± 1.24, LV width −4.79 ± 0.79). CDH-specific models derived from log-transformed values yielded left-shifted distributions, reflecting the small structures (mean z-score lower by: MV 0.99 ± 0.30, AoV 2.04 ± 0.38, LV length 1.30 ± 0.36, and LV width 4.69 ± 0.28; p &lt; 0.0001 for all comparisons). Non-survivors had worse z-scores than survivors for all measurements, but this did not reach statistical significance.ConclusionsLog-transformed linear models generated new normative data for fetal left heart structures in left CDH, which may be used to allay antenatal concerns regarding structural left heart anomalies. There were no significant differences in z-scores between survivors and non-survivors, suggesting that in the absence of true structural disease, cardiac evaluation is not predictive in isolation and that causes of mortality are likely multifactorial in this population.
Discovery of pyrrole derivatives as acetylcholinesterase-sparing butyrylcholinesterase inhibitor
Authors: Sun Shouyuan , Shi Tao , Peng Yan , Zhang Honghua , Zhuo Linsheng , Peng Xue , Li Qien , Wang Manxia , Wang Shuzhi , Wang Zhen 
Published: December 2022

Inspired by the crucial roles of (hetero)aryl rings in cholinesterase inhibitors and the pyrrole ring in new drug discovery, we synthesized 19 pyrrole derivatives and investigated their cholinesterase inhibitory activity. As a result, compounds 3o, 3p, and 3s with a 1,3-diaryl-pyrrole skeleton showed high selectivity toward BChE over AChE with a best IC50 value of 1.71 ± 0.087 µM, which were comparable to donepezil. The pharmaceutical potential of these structures was further predicted and compounds 3o and 3p were proved to meet well with the Lipinsky’s five rules. In combination of the inhibition kinetic studies with the results of molecular docking, we concluded that compound 3p inhibited BChE in a mixed competitive mode. This research has proved the potential of the 1,3-diaryl-pyrrole skeleton as a kind of selective BChE inhibitor.
Collimated terahertz radiation through a laser irradiating on a T-type target
Authors: Lv Chong , Sun Wei , Ban Xiaona , Wan Feng , Wang Zhao 
Published: December 2022

A scheme, applying a linearly polarized laser irradiating on a T-type target which contains a longitudinal target followed by a transverse target, is proposed to collimate the terahertz radiation. The results show that the interaction between the laser and the longitudinal target can effectively reduce the electron transverse divergence while increasing the electron maximum cut-off energy. In this way, the terahertz radiation can be well collimated while enhancing its intensity. By using two-dimensional particle-in-cell simulations, we show that the pointing angle is about −13.6° and 17.5° when the length and thickness of the longitudianl target are 90.0 μm and 4.0 μm, respectively. In addition, the impact of the laser and target parameters on the collimation of terahertz radiation are also investigated separately. Such a scheme may pave a new way for enhancing and collimating the terahertz radiation via laser-solid interactions.