bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cortical Thickness Changes After Computerized Working Memory Training in Patients With Mild Cognitive Impairment
Authors: Hol Haakon R. , Flak Marianne M. , Chang Linda , Løhaugen Gro Christine Christensen , Bjuland Knut Jørgen , Rimol Lars M. , Engvig Andreas , Skranes Jon , Ernst Thomas , Madsen Bengt-Ove , Hernes Susanne S. 
Published: April 2022

BackgroundAdaptive computerized working memory (WM) training has shown favorable effects on cerebral cortical thickness as compared to non-adaptive training in healthy individuals. However, knowledge of WM training-related morphological changes in mild cognitive impairment (MCI) is limited.ObjectiveThe primary objective of this double-blind randomized study was to investigate differences in longitudinal cortical thickness trajectories after adaptive and non-adaptive WM training in patients with MCI. We also investigated the genotype effects on cortical thickness trajectories after WM training combining these two training groups using longitudinal structural magnetic resonance imaging (MRI) analysis in Freesurfer.MethodMagnetic resonance imaging acquisition at 1.5 T were performed at baseline, and after four- and 16-weeks post training. A total of 81 individuals with MCI accepted invitations to undergo 25 training sessions over 5 weeks. Longitudinal Linear Mixed effect models investigated the effect of adaptive vs. non-adaptive WM training. The LME model was fitted for each location (vertex). On all statistical analyzes, a threshold was applied to yield an expected false discovery rate (FDR) of 5%. A secondary LME model investigated the effects of LMX1A and APOE-ε4 on cortical thickness trajectories after WM training.ResultsA total of 62 participants/patients completed the 25 training sessions. Structural MRI showed no group difference between the two training regimes in our MCI patients, contrary to previous reports in cognitively healthy adults. No significant structural cortical changes were found after training, regardless of training type, across all participants. However, LMX1A-AA carriers displayed increased cortical thickness trajectories or lack of decrease in two regions post-training compared to those with LMX1A-GG/GA. No training or training type effects were found in relation to the APOE-ε4 gene variants.ConclusionThe MCI patients in our study, did not have improved cortical thickness after WM training with either adaptive or non-adaptive training. These results were derived from a heterogeneous population of MCI participants. The lack of changes in the cortical thickness trajectory after WM training may also suggest the lack of atrophy during this follow-up period. Our promising results of increased cortical thickness trajectory, suggesting greater neuroplasticity, in those with LMX1A-AA genotype need to be validated in future trials.
Mechanical Bowel Preparation Is a Risk Factor for Postoperative Delirium as It Alters the Gut Microbiota Composition: A Prospective Randomized Single-Center Study
Authors: Yang Zhoujing , Tong Chuandi , Qian Xinye , Wang Hailian , Wang Yingwei 
Published: April 2022

Background and ObjectivePostoperative delirium (POD) is a frequent complication in patients undergoing gastrectomy. Increasing evidence suggests that abnormal gut microbiota composition may contribute to its morbidity. However, it is unclear whether mechanical bowel preparation would cause postoperative delirium by altering the gut microbiota of patients. This study aimed to investigate the association between mechanical bowel preparation and postoperative delirium in patients undergoing gastrectomy.MethodsA prospective randomized single-center study was performed. A total of 81 patients with gastric cancer were enrolled and randomly assigned to two groups: preparation group and non-preparation group according to whether the patient received MBP before surgery. To diagnose postoperative delirium, we used the 3-Min Diagnostic Interview for Confusion Assessment Method-defined delirium for five successive days after surgery. 16s rRNA gene sequencing was used to investigate changes in the intestinal bacteria. The linear discriminant analysis and effect size (LefSe) analysis were also used to identify the different taxa of fecal microbiota between the postoperative delirium and non-postoperative delirium groups.ResultsWe found that there was a significant difference in β-diversity of the gut microbiota between the preparation group and non-preparation group (P = 0.048). Furthermore, patients in the preparation group had a much higher rate of postoperative delirium (13/40, 32.5%) compared with that in non-preparation groups (4/41, 9.8%). Multivariate regression analysis adjusted by other risk factors indicated that mechanical bowel preparation was associated with the occurrence of delirium (odds ratio = 4.792; 95% confidence interval: 1.274–18.028; P = 0.020). When comparing the gut microbiota of patients with and without POD, Bacteroides and Veillonella (genus), which were higher in the preparation group, were also higher in delirium patients (P &lt; 0.05). Genus Olsenella was both relatively higher in the non-preparation group and non-POD group (P &lt; 0.05).ConclusionMechanical bowel preparation not only altered the gut microbiota composition of patients with gastric cancer but also increased the incidence of postoperative delirium. Among all the gut microbiota altered by mechanical bowel preparation, Bacteroides and Veillonella genus might be a risk factor of POD. Genus Olsenella might be a beneficial bacteria to reduce the incidence of POD.
Intake of Ultra-Processed Food and Ectopic-, Visceral- and Other Fat Depots: A Cross-Sectional Study
Authors: Fridén Michael , Kullberg Joel , Ahlström Håkan , Lind Lars , Rosqvist Fredrik 
Published: April 2022

IntroductionThe purpose of this study was to investigate associations between intake of ultra-processed food (UPF) and liver fat, pancreas fat and visceral adipose tissue (VAT) but also subcutaneous adipose tissue (SAT), VAT/SAT ratio and total fat mass.Materials and MethodsCross-sectional analysis of n = 286 50-year old men and women. Energy percentage (%E) from UPF was calculated from a semi-quantitative food frequency questionnaire. Food items were categorized according to the NOVA-classification system and fat depots were assessed using magnetic resonance imaging (MRI) and bioelectrical impedance analysis (BIA). Associations were analyzed using linear regression, adjusted for sex, education, physical activity, smoking, dietary factors and BMI.ResultsMean intake of UPF was 37.8 ± 10.2 %E and the three largest contributors to this were crisp- and wholegrain breads and spreads, indicating overall healthy food choices. Consumption of UPF was associated with higher intake of energy, carbohydrates and fiber and lower intake of protein and polyunsaturated fat but no differences were observed for total fat, saturated fat (SFA), monounsaturated fat, sugar or alcohol between tertiles of UPF. Intake of UPF was positively associated with liver- and pancreas fat, VAT, VAT/SAT and inversely associated with total fat mass in crude models. The association for VAT remained after full adjustment (β = 0.01 (95% CI: 0.002, 0.02), P = 0.02) and was driven by women.ConclusionEnergy intake from UPF is not associated with ectopic fat, SAT or total fat after adjustment for multiple confounders in this population having overall healthy food habits. However, a positive association between UPF and VAT was observed which was driven by women.
Probiotics, Prebiotics, and Synbiotics Improve Uremic, Inflammatory, and Gastrointestinal Symptoms in End-Stage Renal Disease With Dialysis: A Network Meta-Analysis of Randomized Controlled Trials
Authors: Yu Zixian , Zhao Jin , Qin Yunlong , Wang Yuwei , Zhang Yumeng , Sun Shiren 
Published: April 2022

BackgroundProbiotics, prebiotics, and synbiotics are three different supplements to treat end stage renal disease (ESRD) patients by targeting gut bacteria. The comprehensive comparison of the effectiveness of different supplements are lacking.ObjectivesThe purpose of this network meta-analysis (NMA) is to assess and rank the efficacy of probiotics, prebiotics, and synbiotics on inflammatory factors, uremic toxins, and gastrointestinal symptoms (GI symptoms) in ESRD patients undergoing dialysis.MethodsRandomized clinical trials were searched from the PubMed, Embase, and Cochrane Register of Controlled Trials databases, from their inception until 4 September 2021. Random-effect model were used to obtain all estimated outcomes in network meta-analysis (NMA). Effect estimates were presented as mean differences (Mean ± SD) with 95% confidence interval (CI). The comprehensive effects of all treatments were ranked by the surface under the cumulative ranking (SUCRA) probabilities.ResultsTwenty-five studies involved 1,106 participants were included. Prebiotics were superior in decreasing Interleukin-6 (IL-6; SMD –0.74, 95% CI [–1.32, –0.16]) and tumor-necrosis factor-α (TNF-α; SMD –0.59, 95% CI [–1.09, –0.08]), synbiotics were more effective in declining C-reactive protein (CRP; SMD –0.69, 95% CI [–1.14, –0.24]) and endotoxin (SMD –0.83, 95% CI [–1.38, –0.27]). Regarding uremic toxins, prebiotics ranked highest in reducing indoxyl sulfate (IS; SMD –0.43, 95% CI [–0.81, –0.05]), blood urea nitrogen (BUN; SMD –0.42, 95% CI [–0.78, –0.06]), and malondialdehyde (MDA; SMD –1.88, 95% CI [–3.02, –0.75]). Probiotics were rated as best in alleviating GI symptoms (SMD: –0.52, 95% CI [–0.93, –0.1]).ConclusionOur research indicated prebiotics were more effective in declining IL-6, TNF-α, IS, MDA, and BUN, synbiotics lowering CRP and endotoxin significantly, and probiotics were beneficial for alleviating GI symptoms, which may contribute to better clinical decisions. This study was registered in PROSPERO (Number: CRD42021277056).Systematic Review Registration[http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42021277056].
Health-Related Quality of Life in Patients With Locally Advanced Gastric Cancer Undergoing Perioperative or Postoperative Adjuvant S-1 Plus Oxaliplatin With D2 Gastrectomy: A Propensity Score-Matched Cohort Study
Authors: Yu Jianhong , Wang Zaozao , Li Zhexuan , Liu Ying , Fan Yingcong , Di Jiabo , Cui Ming , Xing Jiadi , Zhang Chenghai , Yang Hong , Yao Zhendan , Zhang Nan , Chen Lei , Liu Maoxing , Xu Kai , Tan Fei , Gao Pin , Su Xiangqian 
Published: April 2022

BackgroundSome high-quality clinical trials have proven the efficacy and safety of perioperative and postoperative S-1 with oxaliplatin (peri-SOX and post-SOX) for patients with locally advanced gastric cancer (LAGC) undergoing D2 gastrectomy. However, little is known about how health-related quality of life (HRQOL) changes over time in patients receiving peri-SOX or post-SOX chemotherapy.MethodsA prospective observational cohort (NCT04408859) identified 151 eligible patients with LAGC who underwent D2 gastrectomy with at least six cycles of peri-SOX or post-SOX chemotherapy from 2018 to 2020. HRQOL was assessed using the EROTC QLQ-C30 and its gastric module, QLQ-STO22, at indicated measurements, including the baseline, 1st, 3rd, 6th and 12th month after initiation of therapy. Baseline characteristics, therapeutic effects, and longitudinal HRQOL were compared between the peri-SOX and post-SOX groups after propensity score matching. HRQOL changes over time and the risk factors for scales with severe deterioration were further analyzed.ResultsNo statistically significant differences in longitudinal HRQOL were observed between patients in the peri-SOX and post-SOX groups, with comparable surgical outcomes and adverse chemotherapy events. Scales of social functioning, abnormal taste, and anxiety improved earlier in the peri-SOX group than in the post-SOX group. Score changes in both groups indicated that general deterioration and slower recovery usually occurred in the scales of physical, social, and role functioning, as well as symptoms of fatigue, reflux, diarrhea, and anxiety.ConclusionPeri-SOX showed a longitudinal HRQOL comparable to post-SOX in patients with LAGC who underwent D2 gastrectomy. The peri-SOX group had better performance in social functioning, abnormal taste, and anxiety at some measurements.
A Potential Prognostic Marker for Recognizing VEGF-Positive Hepatocellular Carcinoma Based on Magnetic Resonance Radiomics Signature
Authors: Fan Tingting , Li Shijie , Li Kai , Xu Jingxu , Zhao Sheng , Li Jinping , Zhou Xinglu , Jiang Huijie 
Published: April 2022

ObjectivesThe objective of our project is to explore a noninvasive radiomics model based on magnetic resonance imaging (MRI) that could recognize the expression of vascular endothelial growth factor (VEGF) in hepatocellular carcinoma before operation.Methods202 patients with proven single HCC were enlisted and stochastically distributed into a training set (n = 142) and a test set (n = 60). Arterial phase, portal venous phase, balanced phase, delayed phase, and hepatobiliary phase images were used to radiomics features extraction. We retrieved 1906 radiomic features from each phase of every participant’s MRI images. The F-test was applied to choose the crucial features. A logistic regression model was adopted to generate a radiomics signature. By combining independent risk indicators from the fusion radiomics signature and clinico-radiological features, we developed a multivariable logistic regression model that could predict the VEGF status preoperatively through calculating the area under the curve (AUC).ResultsThe entire group comprised 108 VEGF-positive individuals and 94 VEGF-negative patients. AUCs of 0.892 (95% confidence interval [CI]: 0.839 - 0.945) in the training dataset and 0.800 (95% CI: 0.682 - 0.918) in the test dataset were achieved by utilizing radiomics features from two phase images (8 features from the portal venous phase and 5 features from the hepatobiliary phase). Furthermore, the nomogram relying on a combined model that included the clinical factors α-fetoprotein (AFP), irregular tumor margin, and the fusion radiomics signature performed well in both the training (AUC = 0.936, 95% CI: 0.898-0.974) and test (AUC = 0.836, 95% CI: 0.728-0.944) datasets.ConclusionsThe combined model acquired from two phase (portal venous and hepatobiliary phase) pictures of gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI could be considered as a credible prognostic marker for the level of VEGF in HCC.
Breast Metastasis From Rectal Signet-Ring Cell Carcinoma: A Case Report and Review of Literature
Authors: Dai Yuran , Jin Yudi , Lan Ailin , Ding Nan , Jiang Linshan , Liu Shengchun 
Published: April 2022

BackgroundMetastatic rectal cancer (mRC) of the breast is an extremely rare clinical situation. There are few reported cases in domestic or foreign literature. The clinicopathologic characteristics along with the diagnostic and therapeutic strategies of such cases remain relatively unclear. Here, we would like to provide our comprehensive insights into this rare entity.MethodsWe present a case that till now is the first reported breast metastasis from rectal cancer pathologically diagnosed as a signet-ring cell carcinoma, and we review the current literature on this rare event. The detailed clinical data, histopathology, management, and follow-up aspects were gathered for analysis.ResultsA total of 15 cases were collected including the current case. Breast metastases from rectal cancer present at an average age of 47.7 years (range, 28 to 69 years) and appear with an average interval of 28.4 months (range, 5 months to 18 years) following primary tumor diagnoses. Of the 15 cases, 8 and 5 are pathologically diagnosed as adenocarcinomas and mucinous adenocarcinomas, respectively. Most cases (11/15) are accompanied by extramammary metastases. About half of the breast metastases (7/15) were to the left. In all cases, the main complaints were palpable mass. The average maximum diameter of the metastatic mass is 2.7 cm (range, 1–11 cm). The majority (8/12) of cases with accessible therapy information exclude the option of local surgery.ConclusionPrevious cancer history and accurate immunohistochemistry data play critical roles to distinguish mammary metastasis from a primary neoplasm of the breast. Mastectomy and molecular-targeted drugs should be considered with priority if systemic condition supports them.
Posterior Percutaneous Pedicle Screws Fixation Versus Open Surgical Instrumented Fusion for Thoraco-Lumbar Spinal Metastases Palliative Management: A Systematic Review and Meta-analysis
Authors: Perna Andrea , Smakaj Amarildo , Vitiello Raffaele , Velluto Calogero , Proietti Luca , Tamburrelli Francesco Ciro , Maccauro Giulio 
Published: April 2022

BackgroundSurgical palliative treatment of spinal metastases (SM) could influence the quality of life (QoL) in cancer patients, since the spine represents the most common site of secondary bony localization. Traditional open posterior instrumented fusion (OPIF) and Percutaneous pedicle screw fixation (PPSF) became the main surgical treatment alternatives for SM, but in Literature there is no evidence that describes the absolute superiority of one treatment over the other.Materials and MethodsThis is a systematic review and meta-analysis of comparative studies on PPSF versus OPIF in patients with SM, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The outcomes of interest were: complications, blood loss, infections, mortality, pain and also the Quality of Life (QoL).ResultsThere were a total of 8 studies with 448 patients included in the meta-analyses. Postoperative complications were more frequent in OPIF (odds ratio of 0.48. 95% CI, 0.27 to 0.83; p= 0.01), PPFS was associated with blood loss (odds ratio -585.70. 95% IC, -848.28 to -323.13.69; p&lt; 0.0001) and a mean hospital stay (odds ratio -3.77. 95% IC, -5.92 to -1.61; p= 0.0006) decrease. The rate of infections was minor in PPFS (odds ratio of 0.31. 95% CI, 0.12 to 0.81; p= 0.02) whereas the occurrence of reinterventions (0.76. 95% CI, 0.25 to 2.27; p= 0.62) and the mortality rate was similar in both groups (odds ratio of 0.79. 95% CI, 0.40 to 1.58; p= 0.51). Finally, we also evaluated pre and post-operative VAS and the meta-analysis suggested that both techniques have a similar effect on pain.Discussion and ConclusionThe PPSF treatment is related with less complications, a lower rate of infections, a reduction in intraoperative blood loss and a shorter hospital stay compared to the OPIF treatment. However, further randomized clinical trials could confirm the results of this meta-analysis and provide a superior quality of scientific evidence.
Effects of Umbilical Cord Management Strategies on Stem Cell Transfusion, Delivery Room Adaptation, and Cerebral Oxygenation in Term and Late Preterm Infants
Authors: Okulu Emel , Haskologlu Sule , Guloglu Deniz , Kostekci Ezgi , Erdeve Omer , Atasay Begum , Koc Acar , Soylemez Feride , Dogu Figen , Ikinciogullari Aydan , Arsan Saadet 
Published: April 2022

Background:The umbilical cord blood contains a high concentration of stem cells. There is not any published study evaluating the amount of stem cells that have the potential to be transferred to the infant through placental transfusion methods as delayed cord clamping (DCC) and umbilical cord milking (UCM). The aim of this study is to measure the concentrations of endothelial progenitor cell (EPC) and CD34+ hematopoietic stem cell (HSC) in the placental residual blood volume (PRBV), and evaluate the delivery room adaptation and cerebral oxygenation of these infants.MethodsInfants with ≥36 gestational weeks were randomized to receive DCC (120 s), UCM, or immediate cord clamping (ICC). EPC and CD34+ HSC were measured by flow cytometry from the cord blood. PRBV was collected in the setup. The cord blood gas analysis and complete blood count were performed. The heart rate (HR), oxygen saturation (SpO2), and cerebral regional oxygen saturation (crSO2) were recorded.ResultsA total of 103 infants were evaluated. The amount of PRBV (in ml and ml/kg) was higher in the ICC group (p &lt; 0.001). The number of EPCs in the PRBV content (both ml and ml/kg) were the highest in the ICC group (p = 0.002 and p = 0.001, respectively). The number of CD34+ HSCs in PRBV content (ml and ml/kg) was similar in all groups, but nonsignificantly higher in the ICC group. The APGAR scores at the first and fifth min were lower in the ICC group (p &lt; 0.05). The mean crSO2 values were higher at the 3rd and 10th min in the DCC group (p = 0.042 and p = 0.045, respectively). cFOE values were higher at the 3rd and 10th min in the ICC group (p = 0.011 and p &lt; 0.001, respectively).ConclusionThis study showed that placental transfusion methods, such as DCC and UCM, provide both higher blood volume, more stem cells transfer to the infant, and better cerebral oxygenation in the first minutes of life, whereas many lineages of stem cells is lost to the placenta by ICC with higher residual blood volume. These cord management methods rather than ICC do not require any cost or technology, and may be a preemptive therapeutic source for diseases of the neonatal period.
Respiratory Oscillometry in Newborn Infants: Conventional and Intra-Breath Approaches
Authors: Radics Bence L. , Gyurkovits Zita , Makan Gergely , Gingl Zoltán , Czövek Dorottya , Hantos Zoltán 
Published: April 2022

BackgroundOscillometry has been employed widely as a non-invasive and standardized measurement of respiratory function in children and adults; however, limited information is available on infants.AimsTo establish the within-session variability of respiratory impedance (Zrs), to characterize the degree and profile of intra-breath changes in Zrs and to assess their impact on conventional oscillometry in newborns.Methods109 healthy newborns were enrolled in the study conducted in the first 5 postpartum days during natural sleep. A custom-made wave-tube oscillometry setup was used, with an 8–48 Hz pseudorandom and a 16 Hz sinusoidal signal used for spectral and intra-breath oscillometry, respectively. A resistance-compliance-inertance (R-C-L) model was fitted to average Zrs spectra obtained from successive 30-s recordings. Intra-breath measures, such as resistance (Rrs) and reactance (Xrs) at the end-expiratory, end-inspiratory and maximum-flow points were estimated from three 90-s recordings. All natural and artifact-free breaths were included in the analysis.ResultsWithin-session changes in the mean R, C and L values, respectively, were large (mean coefficients of variation: 10.3, 20.3, and 26.6%); the fluctuations of the intra-breath measures were of similar degree (20–24%). Intra-breath analysis also revealed large swings in Rrs and Xrs within the breathing cycle: the peak-to-peak changes amounted to 93% (range: 32–218%) and 41% (9–212%), respectively, of the zero-flow Zrs magnitude.DiscussionIntra-breath tracking of Zrs provides new insight into the determinants of the dynamics of respiratory system, and highlights the biasing effects of mechanical non-linearities on the average Zrs data obtained from the conventional spectral oscillometry.