bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional Remodeling Associated With Language Recovery After Repetitive Transcranial Magnetic Stimulation in Chronic Aphasic Stroke
Authors: Lin Bing-Fong , Yeh Shih-Ching , Kao Yu-Chieh Jill , Lu Chia-Feng , Tsai Po-Yi 
Published: March 2022

BackgroundRepetitive transcranial magnetic stimulation (rTMS) has shown promising efficacy in improving the language functions in poststroke aphasia. However, randomized controlled trials were lacking to investigate the rTMS-related neuroimaging changes underlying the therapeutic effects on language improvement in chronic aphasia.ObjectiveIn this study, we aimed to evaluate the effects of low-frequency rTMS (LF-rTMS) on chronic poststroke aphasia. We hypothesized that the deactivation of the right pars triangularis could restore the balance of interhemispheric inhibition and, hence, facilitated the functional remodeling of language networks in both the hemispheres. Furthermore, the rTMS-induced functional reorganization should underpin the language recovery after rTMS.MethodsA total of 33 patients (22 males; age: 58.70 ± 13.77 years) with chronic stroke in the left hemisphere and nonfluent aphasia were recruited in this randomized double-blinded study. The ratio of randomization between the rTMS and sham groups is 17:16. All the patients received real 1-Hz rTMS or sham stimulation (placebo coil delivered &lt; 5% of magnetic output with similar audible click-on discharge) at the right posterior pars triangularis for 10 consecutive weekdays (stroke onset to the first stimulation: 10.97 ± 10.35 months). Functional connectivity of language networks measured by resting-state fMRI was calculated and correlated to the scores of the Concise Chinese Aphasia Test by using the stepwise regression analysis.ResultsAfter LF-rTMS intervention, significant improvement in language functions in terms of comprehension and expression abilities was observed compared with the sham group. The rTMS group showed a significant decrease of coupling strength between right pars triangularis and pars opercularis with a strengthened connection between right pars orbitalis and angular gyrus. Furthermore, the LF-rTMS significantly enhanced the coupling strength associated with left Wernicke area. Results of regression analysis showed that the identified functional remodeling involving both the hemispheres could support and predict the language recovery after LF-rTMS treatment.ConclusionWe reported the therapeutic effects of LF-rTMS and corresponding functional remodeling in chronic poststroke aphasia. Our results provided neuroimage evidence reflecting the rebalance of interhemispheric inhibition induced by LF-rTMS, which could facilitate future research in the refinement of rTMS protocol to optimize the neuromodulation efficacy and benefit the clinical management of patients with stroke.
The Significance of Atrial Fibrillation in Patients With Transient Global Amnesia
Authors: Simaan Naaem , Honig Asaf , Filioglo Andrei , Jeremy Molad , Leker Ronen R. 
Published: March 2022

Background and PurposeThe etiology of transient global amnesia (TGA) remains unclear in a large subset of patients. We aimed to determine the clinical and radiological characteristics of TGA-patients with suspected acute micro-embolic stroke on diffusion-weighted imaging (DWI).MethodsTGA-patients that had new DWI hippocampal lesions (DWI+) were compared to DWI negative TGA-patients (DWI–). Demographics, risk factors, clinical data, radiological data, and mortality were analyzed.ResultsOut of 83 patients diagnosed with TGA, 56 (65%) underwent MRI during the acute hospitalization and 26 (46%) had new hippocampal DWI lesions. DWI+ patients more often had a history of atrial fibrillation (AF, 26 vs. 7%, p = 0.04) but the frequency of other risk factors did not differ. None of the patients died, however, two DWI+ patients had subsequent stroke during a 2-year follow up and both had AF. In contrast, none of the DWI- patients had recurrent events.ConclusionAF is common among DWI+ TGA-patients. The presence of AF in patients with TGA could suggest an increased risk of subsequent stroke.
Recurrence of Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Cohort Study in Central China
Authors: Feng Jilun , Yang Mu , Cui Dingge , Huang Zhi , Ji Tuo , Lian Yajun 
Published: March 2022

ObjectiveTo investigate factors that could impact or predict the probability of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis recurrence in central China.MethodsFrom November 2014 to October 2020, observational data of anti-NMDAR encephalitis inpatients in our institution were collected and analyzed prospectively. The demographics, clinical characteristics, tumor status, lesion locations on MRI and immunotherapies, etc. had entered into a Cox regression model for the identification of the factors associated with relapse-free survival.ResultsWe enrolled 113 patients in a row (median age: 28 years, range: 1–61 years). The gender distribution was not statistically significant (p = 0.158), with 49 people (43.4%) being female. The median follow-up time was 16 (4–77) months. Among them, 16.8% of patients relapsed. The average interval between recurrences was 8 months (range 3–54 mo). The severity of the initial relapse was less severe than it had been at the start. The first relapse had considerably fewer symptoms (median 2, range 1–6) than the first episode (median 4, range 1–8, p = 0.005). The mRS at first relapse (median 3, mean 2.84, range 1–5) had been significantly lower than that at onset (median 4, mean 3.89, range 3–5, p = 0.004). The length of hospitalization at first relapse (median 17 days, range 5–46) was significantly shorter than the first episode (median 35 days, range 14–102, p = 0.002). In the survival analysis, the risk of recurrence was significantly higher for patients with a brainstem lesion (HR: 4.112, 95% CI: 1.205–14.030; p = 0.024) or ≥3 abnormal sites (HR: 2.926, 95% CI: 1.085–7.896; p = 0.034) on brain MRI at the first episode. There was no significant difference in neurological outcomes between the recurrent and monophasic groups at the most recent follow-up (mRS 0–2 in 17/19 vs. 86/94; p = 0.674).ConclusionsAnti-NMDAR encephalitis can recur in around one out of every six cases, and symptoms are generally milder than when it first appears. Recurrence is not related to the severity in the acute phase or the prognosis at follow-up. Patients with ≥3 abnormal sites on MRI or lesions located in the brainstem at onset must be alert to the possibility of recurrence.
RETRACTED: Dietary Patterns in Adults Following the Christian Orthodox Fasting Regime in Greece
Authors: Kokkinopoulou Anna , Pagkalos Ioannis , Hassapidou Maria , Kafatos Anthony 
Published: March 2022

ObjectiveThe aim of the study was to identify and describe the dietary patterns seen in a carefully selected sample that follows the Christian Orthodox Church (COC) fasting regime in Greece.MethodsA number of 361 individuals from Northern Greece participated in this cross-sectional study. A number of 176 subjects have been fasting according to the COC recommendations since childhood and 185 non-fasters acted as the control group. Dietary data from a validated food frequency questionnaire were used to derive dietary patterns by principal component analysis (PCA).ResultsThree distinct dietary patterns were identified in the fasting population, the “COC Fasting,” the “Western,” and the “Traditional” dietary pattern, whereas in the non-fasting population, two dietary patterns were found the “Western” and the “Traditional.” The dietary patterns in the fasting population were associated with healthier lifestyle choices, such as abstaining from alcohol and smoke and reduced red and processed meats consumption.ConclusionFindings from the study revealed that people who adhere to the COC fasting recommendations since childhood tend to follow this dietary pattern throughout the year. By gaining insights into the energy and nutrient intake of this unique dietary pattern, public health stakeholders could promote healthier eating behaviors to prevent non-communicable chronic diseases, such as obesity and metabolic syndrome.
Priority Micronutrient Density in Foods
Authors: Beal Ty , Ortenzi Flaminia 
Published: March 2022

BackgroundDespite concerted efforts to improve diet quality and reduce malnutrition, micronutrient deficiencies remain widespread globally, especially in low- and middle-income countries and among population groups with increased needs, where diets are often inadequate in iron, zinc, folate, vitamin A, calcium, and vitamin B12. There is a need to understand the density of these micronutrients and their bioavailability across diverse foods and the suitability of these foods to help meet requirements for populations with high burdens of micronutrient malnutrition.ObjectiveWe aimed to identify the top food sources of these commonly lacking micronutrients, which are essential for optimal health, to support efforts to reduce micronutrient malnutrition among various populations globally.MethodsWe built an aggregated global food composition database and calculated recommended nutrient intakes for five population groups with varying requirements. An approach was developed to rate foods according to their density in each and all priority micronutrients for various population groups with different nutrient requirements.ResultsWe find that the top sources of priority micronutrients are organs, small fish, dark green leafy vegetables, bivalves, crustaceans, goat, beef, eggs, milk, canned fish with bones, mutton, and lamb. Cheese, goat milk, and pork are also good sources, and to a lesser extent, yogurt, fresh fish, pulses, teff, and canned fish without bones.ConclusionThe results provide insight into which foods to prioritize to fill common micronutrient gaps and reduce undernutrition.
Dietary Customs and Social Deprivation in an Aging Population From Southern Italy: A Machine Learning Approach
Authors: Tatoli Rossella , Lampignano Luisa , Donghia Rossella , Castellana Fabio , Zupo Roberta , Bortone Ilaria , De Nucci Sara , Campanile Giuseppe , Lofù Domenico , Vimercati Luigi , Lozupone Madia , De Pergola Giovanni , Panza Francesco , Giannelli Gianluigi , Di Noia Tommaso , Boeing Heiner , Sardone Rodolfo 
Published: March 2022

BackgroundDiet and social determinants influence the state of human health. In older adults, the presence of social, physical and psychological barriers increases the probability of deprivation. This study investigated the relationship between social deprivation and eating habits in non-institutionalized older adults from Southern Italy, and identified foods and dietary habits associated with social deprivation.MethodsWe recruited 1,002 subjects, mean age 74 years, from the large population based Salus in Apulia Study. In this cross-sectional study, eating habits and the level of deprivation were assessed with FFQ and DiPCare-Q, respectively.ResultsDeprived subjects (n = 441) included slightly more females, who were slightly older and with a lower level of education. They consumed less fish (23 vs. 26 g), fruiting vegetables (87 vs. 102 g), nuts (6 vs. 9 g) and less “ready to eat” dishes (29 vs. 33 g). A Random Forest (RF) model was used to identify a dietary pattern associated with social deprivation. This pattern included an increased consumption of low-fat dairy products and white meat, and a decreased consumption of wine, leafy vegetables, seafood/shellfish, processed meat, red meat, dairy products, and eggs.ConclusionThe present study showed that social factors also define diet and eating habits. Subjects with higher levels of deprivation consume cheaper and more readily available food.
The Joint Association Between Multiple Dietary Patterns and Depressive Symptoms in Adults Aged 55 and Over in Northern China
Authors: Ma Yuxia , Li Ruiqiang , Zhan Wenqiang , Huang Xin , Zhang Limin , Liu Zhan 
Published: March 2022

BackgroundDepression is a common psychiatric disorder in older adults that affects their health-related quality of life. Two percent of adults over the age of 55 suffer from major depression, and the prevalence of depression increases with age. Even in the absence of major depressive disorder, 10–15% of older adults have clinically significant depressive symptoms.ObjectivesEpidemiological studies on the association between different gender eating patterns and depression show inconsistent associations. Our study examined whether different gender eating patterns are related to depression. We consider eating patterns individually and as a joint exposure to predefined eating patterns.MethodsPrincipal component analysis (PCA) was performed on the data of the 24-h diet recall dietary intake, and the dietary pattern was determined. Linear regression models are used to explore the relationship between different diets and depression of men and women; weighted quantile sum (WQS) regression, quantile g calculation (qgcomp) and Bayesian kernel machine regression (BKMR) are performed as Secondary analysis.ResultsIn the dietary patterns model, we found that the vegetable and fruit-based diet has a significant inhibitory effect in women, and the egg-milk-based diet has a significant inhibitory effect in men. We found that when all dietary factors are above the 55th percentile, there is a significant positive correlation between multiple dietary patterns and depression risk. We also determined a positive correlation between meat and obesity risk and a negative correlation between egg and milk and vegetables and fruits.ConclusionsIn the study population, after controlling for other baseline indicators and predictors of dietary pattern exposure, a fruit and vegetable-based diet was associated with a slightly healthier and lower risk of depression, while a meat-based dietary pattern associated with a higher risk of depression, and this association effect varies between genders.
Is There a Role for Large Exome Sequencing in the Management of Metastatic Non-Small Cell Lung Cancer: A Brief Report of Real Life
Authors: Dalens Lorraine , Niogret Julie , Kaderbhai Courèche Guillaume , Boidot Romain 
Published: March 2022

IntroductionNon-small-cell lung cancer (NSCLC) is one of the main causes of death by cancer worldwide. With the rise of targeted therapies, the search for molecular abnormalities is becoming a crucial step in the management of lung cancer. Whole exome sequencing (WES) is developing rapidly and is now accessible in routine care. However, its value, compared to smaller gene panels, remains unclear.MethodsWe conducted a retrospective analysis of all 281 patients with lung carcinoma referred to the Molecular Tumor Board of the Georges-François Leclerc Cancer Center (CGFL) between March 2015 and January 2018. We compared the results of standard molecular testing with the results of WES performed on every patient.ResultsWES highlighted many more mutations than smaller panels (mutations were found in 82 genes, while smaller panels found, at the most, mutations in 12 genes). Most of these mutations were class III or IV according to the ESCAT classification. The exome sensitivity also showed limitations, notably a slightly lower efficiency for common mutations, including classical EGFR mutations.ConclusionSmall, targeted panels could be preferred over WES at the initial diagnosis of metastatic NSCLC. They are more sensitive for the identification of mutations on the most frequently mutated genes, such as ALK, BRAF, EGFR, ERBB2, KRAS or MET. Larger panels or WES could be useful at disease progression, to enlarge treatment possibilities by highlighting uncommon but potentially targetable mutations that are not covered by smaller, targeted panels.
Evaluation of Growth Hormone Therapy in Seven Chinese Children With Familial Short Stature Caused by Novel ACAN Variants
Authors: Sun Jie , Jiang Lihong , Liu Geli , Ma Chen , Zheng Jiaqi , Niu Lele 
Published: March 2022

ObjectiveACAN gene variants are an important cause of familial short stature (FSS). Appropriate growth-promoting therapies effectively improve the patient height. Here, we report a therapeutic assessment of cases of seven families of FSS patients with heterozygous ACAN variants. Our findings provide a valuable theoretical basis for the clinical diagnosis and treatment of this disease.MethodsFrom December 2020 to June 2021, 32 FSS patients were examined in Tianjin Medical University General Hospital (Tianjin, China) by whole-exome sequencing to determine whether ACAN variants were present. Their clinical data were summarized and scrupulously analyzed.ResultsWe found seven novel heterozygous ACAN variants: c.1051 + 2T &gt; A, c.313T &gt; C (p.S105P), c.2660C &gt; G (p.S887X), c.2153C &gt; A (p. T718K), c.7243delG (p.D2415Tfs*4), c.2911G &gt; T (p.G971X), c.758-7T &gt; C. All seven patients had proportionate short stature and mild skeletal dysplasia. Endocrine examination results were normal. Only one of the patients had an advanced bone age (1.1 years older than chronological age), whereas the other patients had normal bone ages. All of them had a family history of short stature, with or without osteoarthritis or intervertebral disc disease. All seven patients accepted treatment with recombinant human growth hormone (rhGH) and were regularly followed up. One patient did not come at the follow-up visit. The height of the remaining six patients before and after the treatment was −2.89 ± 0.68 SDS, −1.91 ± 0.93 SDS, respectively, with a treatment course of 1.85 ± 1.91 years. A good therapeutic response was observed in all of them.ConclusionsIn this study, seven novel heterozygous variants in ACAN were discovered, which expanded the spectrum of the already established ACAN pathogenic variants. In FSS cohort, the proportion of ACAN variants accounted was large. The treatment with rhGH effectively increased the patient height, but further studies with longer follow-up periods and more extensive observations are required to elucidate the long-term effect.
Familial Experience With Hirschsprung's Disease Improves the Patient's Ability to Cope
Authors: Verkuijl Sanne J. , Meinds Rob J. , van der Steeg Alida F. W. , Sloots Cornelius E. J. , van Heurn Ernst , de Blaauw Ivo , van Gemert Wim G. , Witvliet Marieke J. , Vermeulen Karin M. , Trzpis Monika , Broens Paul M. A. 
Published: March 2022

IntroductionFamilial occurrence of Hirschsprung's disease may have a positive effect on patients' ability to cope with the disease. The aim was to compare long-term bowel function and generic quality of life between patients with familial and non-familial Hirschsprung's disease.MethodsThis was a nationwide, cross-sectional study in which we included all 830 Hirschsprung patients of 8 years and older who had undergone surgery between 1957 and 2015. We excluded patients with a permanent stoma, intellectual disability, or an unknown or foreign address. We requested patients to complete the validated pediatric or adult Defecation and Fecal Continence questionnaire and the Child Health Questionnaire Child Form-87, or the World Health Organization Quality of Life-100 Assessment Instrument.ResultsWe analyzed 336 Hirschsprung patients, 15.8% of whom were familial cases and 84.2% were non-familial cases. After adjusting for aganglionic length, sex, and age, patients with familial Hirschsprung's disease were twice more likely to suffer from constipation (OR = 2.47, 95% CI, 1.21–5.05, p = 0.013). The quality of life of the pediatric patients was comparable, but in adult patients the energy/fatigue, thinking/learning/concentration, and work capacity facets showed better scores in the familial patients with Hirschsprung's disease of the rectosigmoid (p = 0.029, p = 0.024, p = 0.036, respectively).ConclusionsDifferent facets of generic quality of life are better in adult patients with familial Hirschsprung's disease of the rectosigmoid. It seems that familial experience with the disease influences patients' coping abilities positively.
Anakinra in Paediatric Rheumatology and Periodic Fever Clinics: Is the Higher Dose Safe?
Authors: Fingerhutová Šárka , Jančová Eva , Doležalová Pavla 
Published: March 2022

ObjectiveAnakinra has been increasingly used in off-label indications as well as dosing and mode of administration in a variety of inflammatory conditions. We aimed to review our clinical practice and compare treatment outcomes with published data.MethodsClinical data from electronic records were retrospectively reviewed for patients treated with anakinra over the past 6 years for autoinflammatory diseases (AID).ResultsFrom 47 eligible patients (27 female patients), 32 were children. Macrophage activation syndrome (MAS) was the indication for anakinra therapy in 42.6% of patients. Systemic juvenile idiopathic arthritis (SJIA) was the most common underlying diagnosis (19/47) followed by the spectrum of AID. Off-label use was noted in 38.3% patients. Recommended dose was exceeded in 21 children (mean induction dose 5.1, highest dose 29.4 mg/kg/day) and two adults; five patients were treated intravenously. The mean treatment duration for SJIA was 1.4 years, that for AID was 2.2 years, and that for patients with higher anakinra dose was 9.7 (19.3) months. The mean follow-up duration was 2.7 (1.7) years. Treatment was effective in the majority of SJIA and cryopyrinopathy patients as well as those with MAS. Anakinra was well-tolerated without any major adverse effects even in patients with long-term administration of higher than recommended doses including two infants treated with a dose of over 20 mg/kg/day.ConclusionOur results support early use of anakinra in the individually tailored dosing. In patients with hyperinflammation, anakinra may be lifesaving and may even allow for corticosteroid avoidance. Further studies are needed in order to set up generally accepted response parameters and define condition-specific optimal dosing regimen.