bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-Analysis
Authors: Bioletto Fabio , Prencipe Nunzia , Berton Alessandro Maria , Bona Chiara , Parasiliti-Caprino Mirko , Faletti Riccardo , Ghigo Ezio , Grottoli Silvia , Gasco Valentina 
Published: June 2022

BackgroundAdult GH deficiency (GHD) has been described as a heterogeneous condition characterized by many clinical modifications, such as metabolic alterations, impaired quality of life, and increased mortality. The clinical relevance of cardiac involvement remains, however, only partially elucidated.MethodsPubMed/Medline, EMBASE, Cochrane library, OVID and CINAHL databases were systematically searched until February 2022 for studies evaluating cardiac function and morphology by magnetic resonance imaging in adult patients with GHD. Effect sizes were pooled through a random-effect model.ResultsFour studies were considered in the meta-analysis. With respect to the left ventricle, GHD patients were characterized by a lower stroke-volume-index (-3.6 ml/m2, standardized mean difference (SMD) -0.60, 95%CI [-1.15,-0.05], p=0.03), lower end-diastolic-volume-index (-6.2 ml/m2, SMD -0.54, 95%CI [-0.97,-0.10], p=0.02) and, after accounting for possible biases, lower mass-index (-15.0 g/m2, SMD -1.03, 95%CI [-1.89,-0.16], p=0.02). With respect to the right ventricle, a lower end-diastolic-volume-index (-16.6 ml/m2, SMD -1.04, 95%CI [-2.04,-0.03], p=0.04) and a borderline-significant lower stroke-volume-index (-5.0 ml/m2, SMD -0.84, 95%CI [-1.77,0.08], p=0.07) could be observed. Data about the effect of GH replacement therapy highlighted a significant increase in left ventricular mass-index after treatment initiation (+3.7 g/m2, 95%CI [1.6,5.7], p&lt;0.01).ConclusionWith respect to the left ventricle, our results confirmed those retrieved by echocardiographic studies. In addition, significant alterations were demonstrated also for the right ventricle, for which echocardiographic data are nearly absent. This supports the thesis of a biventricular cardiac involvement in patients with GHD, with a similar pattern of morphological and functional alterations in both ventricles.
Analysis of lncRNA and mRNA Repertoires in Lung From BAFF-R-Deficient Pneumocystis-Infected Mice
Authors: Rong Heng-Mo , Zhang Chao , Rong Guang-Sheng , Li Ting , Qian Xiao-Jun , Wang Dong , Tong Zhao-Hui 
Published: June 2022

BackgroundPneumocystis pneumonia (PCP) is a common medical issue in immunosuppressive patients. Increasing evidence supports that B cells may play an essential role in PCP individuals. The present study aims to integrate lncRNA and mRNA expression profiles and further investigate the molecular function of mature B cells in PCP.MethodsThe lung tissue of wild-type (WT) mice and B-cell-activating factor receptor–deficient (mature B-cell deficiency, BAFF-R–/–) mice were harvested at 3 weeks after being infected with pneumocystis. After total RNAs were extracted, transcriptome profiling was performed following the Illumina HiSeq 3000 protocol. lncRNA-targeted miRNA pairs were predicted using the online databases. The Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment pathways were analyzed to functionally annotate these differentially expressed genes. Additionally, the immune-related lncRNA–miRNA–mRNA–ceRNA network was subsequently performed. The quantitative real-time PCR (RT-PCR) analysis was conducted to evaluate the lncRNA and mRNA expression profiles in WT-PCP mice and BAFF-R–/– PCP mice.ResultsCompared with the control group, 166 mRNAs were observed to be aberrantly expressed (fold change value ≥2; P &lt;0.05) in the BAFF-R–/– PCP group, including 39 upregulated and 127 downregulated genes, while there were 69 lncRNAs differently expressed in the BAFF-R–/– PCP group, including 15 upregulated and 54 downregulated genes. In addition, GO and KEGG pathway analyses showed that BAFF-R deficiency played an important role in the primary and adaptive immune responses in PCP. Furthermore, the lncRNA and mRNA co-expression network was established. We noted that the core network of lncRNA-TF (transcription factor) pairs could be classified into the categories including infection and immunity pathways.ConclusionIn summary, in this study, we further explored the role of mature B cells in the pathogenesis and progression of PCP and the data demonstrated that BAFF-R deficiency could play a significant role in immune regulation in the PCP population.
Comprehensive Analysis of m5C Methylation Regulatory Genes and Tumor Microenvironment in Prostate Cancer
Authors: Yu Guopeng , Bao Jiahao , Zhan Ming , Wang Jiangyi , Li Xinjuan , Gu Xin , Song Shangqing , Yang Qing , Liu Yushan , Wang Zhong , Xu Bin 
Published: June 2022

Background5-Methylcytidine (m5C) methylation is an emerging epigenetic modification in recent years, which is associated with the development and progression of various cancers. However, the prognostic value of m5C regulatory genes and the correlation between m5C methylation and the tumor microenvironment (TME) in prostate cancer remain unknown.MethodsIn the current study, the genetic and transcriptional alterations and prognostic value of m5C regulatory genes were investigated in The Cancer Genome Atlas and Gene Expression Omnibus datasets. Then, an m5C prognostic model was established by LASSO Cox regression analysis. Gene set variation analyses (GSVA), gene set enrichment analysis (GSEA), clinical relevance, and TME analyses were conducted to explain the biological functions and quantify the TME scores between high-risk and low-risk subgroups. m5C regulatory gene clusters and m5C immune subtypes were identified using consensus unsupervised clustering analysis. The Cell-type Identification By Estimating Relative Subsets of RNA Transcripts algorithm was used to calculate the contents of immune cells.ResultsTET3 was upregulated at transcriptional levels in PCa compared with normal tissues, and a high TET3 expression was associated with poor prognosis. An m5C prognostic model consisting of 3 genes (NSUN2, TET3, and YBX1) was developed and a nomogram was constructed for improving the clinical applicability of the model. Functional analysis revealed the enrichment of pathways and the biological processes associated with RNA regulation and immune function. Significant differences were also found in the expression levels of m5C regulatory genes, TME scores, and immune cell infiltration levels between different risk subgroups. We identified two distinct m5C gene clusters and found their correlation with patient prognosis and immune cell infiltration characteristics. Naive B cells, CD8+ T cells, M1 macrophages and M2 macrophages were obtained and 2 m5C immune subtypes were identified. CTLA4, NSUN6, TET1, and TET3 were differentially expressed between immune subtypes. The expression of CTLA4 was found to be correlated with the degree of immune cell infiltration.ConclusionsOur comprehensive analysis of m5C regulatory genes in PCa demonstrated their potential roles in the prognosis, clinical features, and TME. These findings may improve our understanding of m5C regulatory genes in the tumor biology of PCa.
Risk Prediction Models for Early ICU Admission in Patients With Autoimmune Encephalitis: Integrating Scale-Based Assessments of the Disease Severity
Authors: Wu Chunmei , Fang Yongkang , Zhou Yingying , Wu Huiting , Huang Shanshan , Zhu Suiqiang 
Published: June 2022

BackgroundIn patients with autoimmune encephalitis (AE), the prediction of progression to a critically ill status is challenging but essential. However, there is currently no standard prediction model that comprehensively integrates the disease severity and other clinical features. The clinical assessment scale in autoimmune encephalitis (CASE) and the modified Rankin Scale (mRS) have both been applied for evaluating the severity of AE. Here, by combining the two scales and other clinical characteristics, we aimed to investigate risk factors and construct prediction models for early critical care needs of AE patients.MethodsDefinite and probable AE patients who were admitted to the neurology department of Tongji Hospital between 2013 and 2021 were consecutively enrolled. The CASE and mRS scores were used to evaluate the overall symptom severity at the time of hospital admission. Using logistic regression analysis, we analyzed the association between the total scores of the two scales and critical illness individually and then we evaluated this association in combination with other clinical features to predict early intensive care unit (ICU) admission. Finally, we constructed four prediction models and compared their performances.ResultsOf 234 patients enrolled, forty developed critical illness and were early admitted to the ICU (within 14 days of hospitalization). Four prediction models were generated; the models were named CASE, CASE-plus (CASE + prodromal symptoms + elevated fasting blood glucose + elevated cerebrospinal fluid (CSF) white blood cell (WBC) count), mRS and mRS-plus (mRS + prodromal symptoms + abnormal EEG results + elevated fasting blood glucose + elevated CSF WBC count) and had areas under the ROC curve of 0.850, 0.897, 0.695 and 0.833, respectively. All four models had good calibrations. In general, the models containing “CASE” performed better than those including “mRS”, and the CASE-plus model demonstrated the best performance.ConclusionOverall, the symptom severity at hospital admission, as defined by CASE or mRS, could predict early ICU admission, especially when assessed by CASE. Adding other clinical findings, such as prodromal symptoms, an increased fasting blood glucose level and an increased CSF WBC count, could improve the predictive efficacy.
Idiopathic Hypersomnia—A Dynamic Simulation Model
Authors: Susta Marek , Šonka Karel , Bizik Gustav , Petranek Svojmil , Nevsimalova Sona 
Published: June 2022

Aims of the study:Commonly used approach to illness assessment focuses on the patient's actual state supplemented by binary records of past events and conditions. This research project was designed to explain subjective experience in idiopathic hypersomnia (IH) patients influenced by their clinical symptoms and comorbidities.Material and MethodsForty-three IH patients of both sexes (female 60.5%, male 39.5%) were assessed using a detailed structured examination. The interview covered neurologic, psychiatric, and internal medicine anamnesis, medication past and current, substance abuse, work impairment, detailed sleep-related data, specific sleep medication, and a full-length set of questionnaires including depression, quality of life, sleepiness, anxiety, fatigue, insomnia, and sleep inertia. The data were digitized and imported into statistical software (SPSS by IBM), and dynamic simulation software (Vensim by Ventana Systems Inc.) was used to build a causal loop diagram and stocks and flows diagram as a simulation structure.ResultsThe overall raw data and simulation-based patterns fit at 76.1%. The simulation results also identified the parameters that contribute the most to patients' subjective experience. These included sleep inertia, the refreshing potential of naps, the quality of nocturnal sleep, and the social aspects of the patient's life. Psychiatric disorders influence the overall pattern at a surprisingly low level. The influence of medication has been studied in detail. Although its contribution to the dynamics looks marginal at first sight, it significantly influences the contribution of other variables to the overall patient experience of the disease.ConclusionEven the simplified dynamic structure designed by the research team reflects the real-life events in patients with IH at the acceptable level of 76.1% and suggests that a similar structure plays an important role in the course of the disease. Therapeutic focus on the parameters identified by the model should enhance the patients' subjective experience throughout illness duration and might even turn the progress from negative into positive. Further research is needed to understand the dynamics of idiopathic hypersomnia in greater detail to better understand the causes and design therapeutic approaches to improve patients' quality of life.
Case Report: New Application of a Gufoni Maneuver Variation for Apogeotropic Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo
Authors: Dong Jiaoxuan , Li Ling , He Songbin , Liu Haipeng , Dai Fangyu 
Published: June 2022

BackgroundSeveral canalith repositioning procedures (CRPs) such as Gufoni maneuver have been proposed to treat the apogeotropic lateral semicircular canal variant of BPPV (LC-BPPV). The reported success rate varied widely in different studies. Research showed that there was a risk of treatment failure due to insufficient repositioning of the debris. So far, there is insufficient evidence to recommend a preferable CRP for apogeotropic LC-BPPV.Case descriptionA 49-year-old woman and a 48-year-old man diagnosed with apogeotropic LC-BPPV relapse were treated with original Gufoni maneuver for apogeotropic variant but no satisfactory result was obtained. A variation of Gufoni maneuver originally proposed for the geotropic variant was applied to detach otoconia toward the utricle or the non-ampullary arm. Apogeotropic nystagmus was successfully transformed into the geotropic variant. The subsequent Gufoni maneuver was successful. On a 64-year-old male with untreated apogeotropic LC-BPPV, we performed the Gufoni maneuver variation and observed a change in nystagmus direction. In all the three cases, no relapse of vertigo was reported after 1 month.ConclusionThe new application of Gufoni maneuver variation may improve the treatment of apogeotropic LC-BPPV. Treatment efficacy and patient-specific optimization such as head rotation angle deserve a large-scale validation and further investigation.
Integrating a Group-Based, Early Childhood Parenting Intervention Into Primary Health Care Services in Rural Bangladesh: A Cluster-Randomized Controlled Trial
Authors: Mehrin Syeda Fardina , Hasan Mohammed Imrul , Tofail Fahmida , Shiraji Shamima , Ridout Deborah , Grantham-McGregor Sally , Hamadani Jena D. , Baker-Henningham Helen 
Published: June 2022

BackgroundOver 250 million children globally do not reach their developmental potential. We tested whether integrating a group-based, early childhood parenting program into government healthcare clinics improved children’s development, growth, and behavior.MethodsWe conducted a cluster-randomized controlled trial in 40 community clinics in the Kishorganj district of Bangladesh. We randomly assigned clinics (1:1) to deliver a group-based parenting interventions or to a comparison group that received no intervention. Participants were children aged 5–24 months, with weight-for-age z-score of ≤ −1.5 SDs of the WHO standards, living within a thirty-minute walking distance from the clinic (n = 419 intervention, 366 control). Government health staff facilitated parenting sessions in the clinic with groups of four mother/child dyads fortnightly for one year as part of their routine duties. Primary outcomes measured at baseline and endline were child development assessed using the Bayley scales, child behaviors during the test by tester ratings, and child growth. The trial is registered at ClinicalTrials.gov, NCT02208531.Findings:91% of children were tested at endline (396 intervention, 319 control). Multilevel analyses showed significant benefits of intervention to child cognition (effect size 0.85 SDs, 95% CI: 0.59, 1.11), language (0.69 SDs, 0.43, 0.94), and motor development (0.52 SDs, 0.31, 0.73), and to child behaviors during the test (ranging from 0.36 SDs, 0.14, 0.58, to 0.53 SDs, 0.35, 0.71). There were no significant effects on growth.ConclusionA scalable parenting intervention, integrated into existing government health services and implemented by government health staff, led to significant benefits to child development and behavior.
Breast Cancer Stigma Scale: A Reliable and Valid Stigma Measure for Patients With Breast Cancer
Authors: Bu Xiaofan , Li Shuangshuang , Cheng Andy S. K. , Ng Peter H. F. , Xu Xianghua , Xia Yimin , Liu Xiangyu 
Published: June 2022

PurposeThis study aims to develop and validate a stigma scale for Chinese patients with breast cancer.MethodsPatients admitted to the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, for breast cancer treatment participated in this study. Development of the Breast Cancer Stigma Scale involved the following procedures: literature review, interview, and applying a theoretical model to generate items; the Breast Cancer Stigma Scale’s content validity was assessed by a Delphi study (n = 15) and feedback from patients with breast cancer (n = 10); exploratory factor analysis (n = 200) was used to assess the construct validity; convergent validity was assessed with the Social Impact Scale (n = 50); internal consistency Cronbach’s α (n = 200), split-half reliability (n = 200), and test–retest reliability (N = 50) were used to identify the reliability of the scale.ResultsThe final version of the Breast Cancer Stigma Scale consisted of 15 items and showed positive correlations with the Social Impact Scale (ρ = 0.641, P &lt; 0.001). Exploratory factor analysis (EFA) revealed four components of the Breast Cancer Stigma Scale: self-image impairment, social isolation, discrimination, and internalized stigma, which were strongly related to our perceived breast cancer stigma model and accounted for 69.443% of the total variance. Cronbach’s α for the total scale was 0.86, and each subscale was 0.75–0.882. The test–retest reliability with intra-class correlation coefficients of the total scale was 0.947 (P &lt; 0.001), and split-half reliability with intra-class correlation coefficients of the total scale was 0.911 (P &lt; 0.001). The content validity index (CVI) was 0.73–1.0.ConclusionThe newly developed Breast Cancer Stigma Scale offers a valid and reliable instrument for assessing the perceived stigma of patients with breast cancer in clinical and research settings. It may be helpful for stigma prevention in China.
Configurational Paths to Higher Efficiency in County Hospital: Evidence From Qualitative Comparative Analysis
Authors: Yin Gang , Ning Jie , Peng Yarui , Yue Jingkai , Tao Hongbing 
Published: June 2022

BackgroundThe efficient operation of county-level medical institutions is a significant guarantee in constructing Chinese rural tertiary care service networks. However, it is still unclear how to increase the efficiency of county hospitals under the interaction of multiple factors. In this study, 35 county general hospitals in China were selected to explore the configuration paths of county hospitals' high and poor efficiency status under the Environment-Structure-Behavior (ESB) framework and provide evidence-based recommendations for measures to enhance its efficiency.MethodsData envelopment analysis with the bootstrapping procedure was used to estimate the technical efficiency value of case hospitals. A fuzzy-set qualitative comparative analysis approach was carried out to explore the configuration of conditions to the efficiency status.ResultsAntecedent configurations affecting the efficiency status of county hospitals were identified based on the ESB analytical framework. Three high-efficiency configuration paths can be summarized as structural optimization, capacity enhancement, and government support. Another three types of paths, namely insufficient capacity, aggressive expansion, and poor decision-making, will lead to inefficient configurations.ConclusionQualitative comparative analysis is necessary when exploring complex causality. The efficiency situation of county hospitals results from a combination of influencing factors instead of the effect of a single one. There is no solitary configuration for high efficiency that applies to all healthcare units. Any measures aimed at efficiency promotion should be discussed within the framework of a case-specific analysis.
Osteoprotegerin Gene Polymorphisms Are Associated with Subclinical Atherosclerosis in the Mexican Mestizo Population
Authors: Cazarín-Santos Benny Giovanni , Pérez-Hernández Nonanzit , Posadas-Sánchez Rosalinda , Vargas-Alarcón Gilberto , Pérez-Méndez Óscar , Rodríguez-Silverio Juan , Roque-Ramírez Bladimir , Borgonio-Cuadra Verónica Marusa , Rodríguez-Pérez José Manuel 
Published: June 2022

Subclinical atherosclerosis (SA) is the presence of coronary calcification in the absence of cardiovascular symptoms, and it usually progresses to atherosclerotic disease. Studies have shown an association of osteoprotegerin gene (OPG) variants with calcification process in cardiovascular diseases; however, to this day there are no studies that evaluate individuals in the asymptomatic stage of atherosclerotic disease. Therefore, the purpose of this study was to analyze the association of four genetic variants and haplotypes of the OPG gene with the development of SA, through TaqMan genotyping assays. We also aimed to identify potential response elements for transcription factors in these genetic variants. The study included 1413 asymptomatic participants (1041 were controls and 372 were individuals with SA). The rs3102735 polymorphism appeared as a protective marker (OR = 0.693; 95% CI = 0.493–0.974; pheterozygote = 0.035; OR = 0.699; 95% CI = 0.496–0.985; pcodominant 1 = 0.040) and two haplotypes were associated with SA, one as a decreased risk: GACC (OR = 0.641, 95% CI = 0.414–0.990, p = 0.045) and another as an increased risk: GACT (OR = 1.208, 95% CI = 1.020–1.431, p = 0.029). Our data suggest a lower risk of SA in rs3102735 C carriers in a representative sample of Mexican mestizo population.
Toward Semi-Supervised Graphical Object Detection in Document Images
Authors: Kallempudi Goutham , Hashmi Khurram Azeem , Pagani Alain , Liwicki Marcus , Stricker Didier , Afzal Muhammad Zeshan 
Published: June 2022

The graphical page object detection classifies and localizes objects such as Tables and Figures in a document. As deep learning techniques for object detection become increasingly successful, many supervised deep neural network-based methods have been introduced to recognize graphical objects in documents. However, these models necessitate a substantial amount of labeled data for the training process. This paper presents an end-to-end semi-supervised framework for graphical object detection in scanned document images to address this limitation. Our method is based on a recently proposed Soft Teacher mechanism that examines the effects of small percentage-labeled data on the classification and localization of graphical objects. On both the PubLayNet and the IIIT-AR-13K datasets, the proposed approach outperforms the supervised models by a significant margin in all labeling ratios (1%, 5%, and 10%). Furthermore, the 10% PubLayNet Soft Teacher model improves the average precision of Table, Figure, and List by +5.4,+1.2, and +3.2 points, respectively, with a similar total mAP as the Faster-RCNN baseline. Moreover, our model trained on 10% of IIIT-AR-13K labeled data beats the previous fully supervised method +4.5 points.