bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Individualized Prognostic Signature for Clinically Predicting the Survival of Patients With Bladder Cancer
Authors: Liu Qing , Wang Yunchao , Gao Huayu , Sun Fahai , Wang Xuan , Zhang Huawei , Wang Jianning 
Published: March 2022

Background:The tumor immune microenvironment (TIME) plays an important role in the development and prognosis of bladder cancer. It is essential to conduct a risk model to explore the prognostic value of the immunologic genes and establish an individualized prognostic signature for predicting the survival of patients with bladder cancer.Method:The differentially expressed immunologic genes (DEGs) are identified in The Cancer Genome Atlas (TCGA). The nonnegative matrix factorization (NMF) was used to stratify the DEGs in TCGA. We used the least absolute shrinkage and selection operator (LASSO) Cox regression and univariate Cox analysis to establish a prognostic risk model. A nomogram was used to establish an individualized prognostic signature for predicting survival. The potential pathways underlying the model were explored.Results:A total of 1,018 DEGs were screened. All samples were divided into two clusters (C1 and C2) by NMF with different immune cell infiltration, and the C2 subtype had poor prognosis. We constructed a 15-gene prognostic risk model from TCGA cohort. The patients from the high-risk group had a poor overall survival rate compared with the low-risk group. Time-dependent ROC curves demonstrated good predictive ability of the signature (0.827, 0.802, and 0.812 for 1-, 3-, and 5-year survival, respectively). Univariate and multivariate Cox regression analyses showed that the immunologic prognostic risk model was an independent factor. The decision curve demonstrated a relatively good performance of the risk model and individualized prognostic signature, showing the best net benefit for 1-, 3-, and 5-year OS. Gene aggregation analysis showed that the high-risk group was mainly concentrated in tumorigenesis and migration and immune signaling pathways.Conclusion:We established a risk model and an individualized prognostic signature, and these may be useful biomarkers for prognostic prediction of patients with bladder cancer.
Central Venous Pressure Measurement Is Associated With Improved Outcomes in Patients With or at Risk for Acute Respiratory Distress Syndrome: An Analysis of the Medical Information Mart for Intensive Care IV Database
Authors: Tang Rui , Peng Junnan , Wang Daoxin 
Published: March 2022

BackgroundCentral venous pressure (CVP) monitoring is widely used in the intensive care unit (ICU). However, the formal utility of CVP measurement to altering patient outcomes among ICU patients with or at risk for acute respiratory distress syndrome (ARDS) has never been investigated. Our study aimed to explore the association of CVP measurement with 28-day mortality specifically in that population.MethodsThis study was based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were divided into CVP and no CVP groups according to whether they had CVP measurement within 24 h of admission to the ICU. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the association between CVP measurement and 28-day mortality, and propensity score matching (PSM) and propensity score-based overlap weighting (OW) were employed to verify the stability of our results.ResultsA total of 10,198 patients with or at risk for ARDS were included in our study, of which 4,647 patients (45.6%) belonged to the CVP group. Multivariate logistic regression showed that the early measurement of CVP was independently associated with lower 28-day mortality (OR: 0.49; 95% CI: 0.42–0.57; p &lt; 0.001). This association remained robust after PSM and OW (both p &lt; 0.001). Patients in the CVP group had shorter ICU stay, lower in-hospital mortality, more fluid on day 1 and higher clearance of blood lactate than those in the no CVP group.ConclusionEarly CVP measurement is associated with an improvement in 28-day mortality among a general population of critically ill patients with or at risk for ARDS.
Altered Structural Brain Network Topology in Patients With Primary Craniocervical Dystonia
Authors: Wang Xiu , Hu Wenhan , Wang Huimin , Gao Dongmei , Liu Yuye , Zhang Xin , Jiang Yin , Mo Jiajie , Meng Fangang , Zhang Kai , Zhang Jian-guo 
Published: March 2022

PurposeRegional cortical thickness or volume analyses based upon structural MRI scans have been employed to study the pathophysiology of primary craniocervical dystonia (CCD). In the present study, brain connectivity network analyses based upon morphological distribution similarities among different brain areas were used to study the network disruption in individuals affected by CCD.MethodsThe T1 MRI scans were completed for 37 patients with CCD and 30 healthy controls, with individual brain structural networks being constructed based upon gray matter (GM) similarities in 90 regions within the brain. Area under the curve (AUC) values for each network parameter were determined, and the GRETNA program was used to conduct a graph theory-based measurement of nodal and global network properties. These properties were then compared between healthy controls and those with CCD. In addition, relationships between nodal properties and the severity of clinical dystonia were assessed through Spearman's correlation analyses.ResultsRelative to individuals in the control group, patients with CCD exhibited decreased local nodal properties in the right globus pallidus, right middle frontal gyrus, and right superior temporal pole. The degree of centrality as well as the node efficiency of the right globus pallidus were found to be significantly correlated with ocular dystonic symptom. The node efficiency of right middle frontal gyrus was significantly related to the total motor severity. No nodal properties were significantly correlated with oral dystonic motor scores. Among CCD patients, the right hemisphere exhibited more widespread decreases in connectivity associated with the motor related brain areas, associative cortex, and limbic system, particularly in the middle frontal gyrus, globus pallidus, and cingulate gyrus.ConclusionsThe assessment of morphological correlations between different areas in the brain may represent a sensitive approach for detecting alterations in brain structures and to understand the mechanistic basis for CCD at the network level. Based on the nodal properties identified in this study, the right middle frontal gyrus and globus pallidus were the most severely affected in patients with CCD. The widespread alterations in morphological connectivity, such as the cortico-cortical and cortico-subcortical networks, further support the network mechanism as a basis for CCD.
A New Scoring System to Differentially Diagnose and Distinguish Tuberculous Meningitis and Bacterial Meningitis in South China
Authors: Wen An , Liu Shi-Min , Cao Wen-Feng , Zhou Yong-Liang , Luo Chao-Qun , Xiang Zheng-bing , Hu Fan , Zhang Ping , Leng Er-Ling 
Published: March 2022

BackgroundTuberculous meningitis (TBM) is the most serious form of extrapulmonary tuberculosis caused by Mycobacterium tuberculosis, and is characterized by high morbidity and mortality. Unfortunately, it is difficult to distinguish TBM from bacterial meningitis (BM) based on clinical features alone. The latest diagnostic tests and neuroimaging methods are still not available in many developing countries. This study aimed to develop a simple diagnostic algorithm based on clinical and laboratory test results as an early predictor of TBM in South China.MethodsA retrospective study was conducted to compare the clinical and laboratory characteristics of 114 patients with TBM and 47 with BM. Multivariate logistic regression analysis was performed on the characteristics of independently predicted TBM to develop a new diagnostic rule.ResultsFive characteristics were predictive of a diagnosis of TBM: duration of symptoms before admission; tuberculous symptoms; white blood cell (WBC) count, total cerebrospinal fluid WBC count, and cerebrospinal fluid chloride concentration. The sensitivity and specificity of the new scoring system developed in this study were 81.6 and 93.6%, respectively.ConclusionThe new scoring system proposed in this study can help physicians empirically diagnose TBM and can be used in countries and regions with limited microbial and radiological resources.
The MMT of Elbow Flexion and the AFE Predict Impairment and Disability at 3 Weeks in Patients With Acute Stroke
Authors: Ueda Shujiro , Aoki Hiroko , Yasuda Yumiko , Nishiyama Ayumi , Hayashi Yusuke , Honaga Kaoru , Tanuma Akira , Takakura Tomokazu , Kurosu Akihiro , Hatori Kozo , Hayashi Akito , Fujiwara Toshiyuki 
Published: March 2022

ObjectiveThis study aimed to investigate whether upper extremity motor function assessment within 72 h from stroke onset can predict the functional outcomes of the upper extremity.DesignThis was a prospective, cohort study of patients with a first unilateral hemispheric stroke between May 2018 and March 2020. The motor arm item of the National Institutes of Health Stroke Scale, manual muscle testing of the elbow and forearm, and active finger extension scale were assessed within 72 h after stroke onset. The Fugl-Meyer assessment upper extremity motor score and action research arm test were assessed at discharge from the acute hospital. Multiple regression analysis was used to study predictors of upper extremity motor function at discharge from the acute hospital. The adjustment variables included age, sex, thumb localizing test, and visuospatial function.ResultsSixty acute stroke patients were recruited. The model with the highest coefficient of determination for the Fugl-Meyer assessment upper extremity motor score at discharge was the elbow flexion model (R2= 0.76), followed by the active finger extension model (R2= 0.69). For the action research arm test, the highest model was the active finger extension model (R2= 0.64), followed by the elbow flexion model (R2= 0.63).ConclusionThe manual muscle testing of elbow flexion and the active finger extension may be useful for predicting impairment and disability at 3 weeks in patients with acute stroke.
Requirements for Eliciting a Spastic Response With Passive Joint Movements and the Influence of Velocity on Response Patterns: An Experimental Study of Velocity-Response Relationships in Mild Spasticity With Repeated-Measures Analysis
Authors: Fujimura Kenta , Mukaino Masahiko , Itoh Shota , Miwa Haruna , Itoh Ryoka , Narukawa Daisuke , Tanikawa Hiroki , Kanada Yoshikiyo , Saitoh Eiichi , Otaka Yohei 
Published: March 2022

BackgroundSpasticity is defined as a velocity-dependent increase in tonic stretch reflexes and is manually assessed in clinical practice. However, the best method for the clinical assessment of spasticity has not been objectively described. This study analyzed the clinical procedure to assess spasticity of the elbow joint using an electrogoniometer and investigated the appropriate velocity required to elicit a spastic response and the influence of velocity on the kinematic response pattern.MethodsThis study included eight healthy individuals and 15 patients with spasticity who scored 1 or 1+ on the modified Ashworth Scale (MAS). Examiners were instructed to manually assess spasticity twice at two different velocities (slow and fast velocity conditions). During the assessment, velocity, deceleration value, and angle [described as the % range of motion (%ROM)] at the moment of resistance were measured using an electrogoniometer. Differences between the slow and fast conditions were evaluated. In addition, variations among the fast condition such as the responses against passive elbow extension at &lt;200, 200–300, 300–400, 400°/s velocities were compared between the MAS 1+, MAS 1, and control groups.ResultsSignificant differences were observed in the angular deceleration value and %ROM in the fast velocity condition (417 ± 80°/s) between patients and healthy individuals, but there was no difference in the slow velocity condition (103 ± 29°/s). In addition, the deceleration values were significantly different between the MAS 1 and MAS 1+ groups in velocity conditions faster than 300°/s. In contrast, the value of %ROM plateaued when the velocity was faster than 200°/s.ConclusionThe velocity of the passive motion had a significant effect on the response pattern of the elbow joint. The velocity-response pattern differed between deceleration and the angle at which the catch occurred; the value of deceleration value for passive motion was highly dependent on the velocity, while the %ROM was relatively stable above a certain velocity threshold. These results provide clues for accurate assessment of spasticity in clinical practice.
Causal Association Between Tea Consumption and Kidney Function: A Mendelian Randomization Study
Authors: Zhang Yangchang , Xiong Yang , Shen Shisi , Yang Jialu , Wang Wei , Wu Tingting , Chen Li , Yu Qiuhua , Zuo Hangjia , Wang Xu , Lei Xun 
Published: March 2022

BackgroundCausal research concerning the consumption of tea and the risk of chronic kidney disease (CKD) is limited. This study identified the potential causal effects of tea intake on CKD, the estimated glomerular filtration rate (eGFR), and albuminuria.MethodsGenome-wide association studies (GWASs) from UK Biobank were able to identify single-nucleotide polymorphisms (SNPs) associated with an extra cup of tea each day. The summary statistics for the kidney function from the CKDGen consortium include 11,765 participants (12,385 cases of CKD) and 54,116 participants for the urinary albumin-to-creatinine ratio who were mostly of European descent. A two-sample Mendelian randomization (MR) analysis was performed to test the relationship between the selected SNPs and the risk of CKD.ResultsA total of 2,672 SNPs associated with tea consumption (p &lt; 5 × 10–8) were found, 45 of which were independent and usable in CKDGen. Drinking more cups of tea per day indicates a protective effect for CKD G3-G5 [odds ratio (OR) = 0.803; p = 0.004] and increases eGFR (β = 0.019 log ml/min/1.73 m2 per cup per day; p = 2.21 × 10–5). Excluding two SNPs responsible for directional heterogeneity (Cochran Q p = 0.02), a high consumption of tea was also negatively correlated with a lower risk of albuminuria (OR = 0.758; p = 0.002).ConclusionFrom the perspective of genes, causal relationships exist between daily extra cup of tea and the reduced risk of CKD and albuminuria and increased eGFR.
The Effect of Post-Mastectomy Radiotherapy in Patients With Metaplastic Breast Cancer: A Propensity Score-Matched Analysis of the SEER Database
Authors: Hu Jin , Tan Jie , Dong Fang , Zhang Ximeng , Ming Jie , Huang Tao 
Published: March 2022

BackgroundMetaplastic breast cancer (MBC) is a rare tumor with aggressive biological behavior. This study aimed to evaluate the efficacy of post-mastectomy radiotherapy (PMRT) on patients with low-risk (T1N0M0), intermediate-risk (T1-2N1M0 and T3N0M0), and high-risk (T1-4N2-3M0 and T4N0-1M0) MBC via propensity-score matching (PSM).MethodsWe analyzed information from the Surveillance, Epidemiology, and End Results (SEER) public-use database from 1975 to 2016 for MBC incidence trends and compared overall survival (OS) and breast cancer-specific survival (BCSS) between groups of MBC women diagnosed from 2001 to 2016 using Kaplan–Meier analysis and the multivariate Cox proportional model. PSM was used to make 1:1 case–control matching.ResultsJoinpoint analyses identified 1984 and 2003 as the inflection points among 4,672 patients. 1,588 (42.4%) of the 3,748 patients diagnosed with MBC between 2001 and 2016 received PMRT. According to multivariate analyses, PMRT provided better OS (p &lt; 0.001) and BCSS (p &lt; 0.001) before PSM, and better prognosis after PSM (n = 2528) for patients receiving PMRT (n = 1264) compared to those without PMRT (OS, p &lt; 0.001 and BCSS, p &lt; 0.001). When stratifying the case–control matching patients into low-risk, intermediate-risk, and high-risk groups, PMRT could improve BCSS compared with that in non-PMRT patients in the high-risk groups; it also improved OS in both the intermediate- and high-risk groups.ConclusionsPer findings of the PSM analysis, PMRT could provide better BCSS in high-risk groups, and better OS in intermediate- and high-risk groups.
Anatomical Study of Arachnoid Granulation in Superior Sagittal Sinus Correlated to Growth Patterns of Meningiomas
Authors: Ye Yuanliang , Gao Wen , Xu Weilin , Gong Jiangu , Qiu Minxing , Long Lang , Ding Jiuyang 
Published: March 2022

Meningiomas in the parasagittal region were formed by arachnoidal cells disseminated among arachnoid granulations. The purpose of this study was to characterize the morphology of chordae willisii, and AGs found in the superior sagittal sinus. This study used 20 anatomical specimens. Rigid endoscopes were introduced via torcula herophili into the sinus lumen. The morphological features of arachnoid granulation and chordae willisii were analyzed, and then arachnoid granulations and chordae willisii were assessed by elastic fiber stains, Masson’s stains, and imaging analysis. Three types of arachnoid granulations were present in the examined sinuses. There were 365 counts of arachnoid granulations in examined sinuses by imaging analysis, averaging 1.36 ± 2.58 per sinus. Types I, II, and III made up 20.27, 45.20, and 34.52% of 268 patients, respectively. Microscopy of chordae willisii transverse sections indicated the existence of a single layer and a multiple-layered dura sinus wall. The dural sinus wall was the thickest one in the superior sagittal sinus. The thickness of longitudinal lamellae was significantly greater than trabeculae. This study reveals the anatomical differences between arachnoid granulations in the superior sagittal sinus. The arachnoid granulations classification enables surgeons to predict preoperatively growth patterns, followed by safely achieving the optimal range of parasagittal meningioma resection.
Associations Between Eczema and Attention Deficit Hyperactivity Disorder Symptoms in Children
Authors: Loo Evelyn Xiu Ling , Ooi Delicia Shu Qin , Ong Minyee , Ta Le Duc Huy , Lau Hui Xing , Tay Michelle Jia Yu , Yap Qai Ven , Chan Yiong Huak , Tham Elizabeth Huiwen , Goh Anne Eng Neo , Van Bever Hugo , Teoh Oon Hoe , Eriksson Johan Gunnar , Chong Yap Seng , Gluckman Peter , Yap Fabian Kok Peng , Karnani Neerja , Xu Jia , Tan Karen Mei Ling , Tan Kok Hian , Lee Bee Wah , Kramer Michael , Shek Lynette Pei-chi , Meaney Michael J. , Broekman Birit F. P. 
Published: March 2022

BackgroundEpidemiological studies suggest a link between eczema and attention deficit hyperactivity disorder (ADHD), but underlying mechanisms have not been examined.ObjectiveWe aim to investigate the association between eczema and subsequent ADHD symptoms in the Growing Up in Singapore Towards healthy Outcomes cohort and explore the role of pro-inflammatory cytokines and gut microbiome.MethodsThe modified International Study of Asthma and Allergies in Childhood questionnaire and Computerized Diagnostic Interview Schedule for Children Version IV were administered to assess reported eczema within the first 18 months and presence of ADHD symptoms at 54 months, respectively. Skin prick testing at 18 months, cytokines in maternal blood during pregnancy and cord blood and the mediating role of the gut microbiome at 24 months were assessed.ResultsAfter adjusting for confounders, eczema with or without a positive skin prick test was associated with doubling the risk of ADHD symptoms. No differences in maternal and cord blood cytokines were observed in children with and without eczema, or children with and without ADHD. Gut microbiome dysbiosis was observed in children with eczema and children with ADHD. Children with eczema also had lower gut bacterial Shannon diversity. However, the relationship between eczema and ADHD was not mediated by gut microbiome.ConclusionEarly life eczema diagnosis is associated with a higher risk of subsequent ADHD symptoms in children. We found no evidence for underlying inflammatory mechanism or mediation by gut microbiome dysbiosis. Further research should evaluate other mechanisms underlying the link between eczema and ADHD.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT01174875], identifier [NCT01174875].
Predictive Value of Diaphragmatic Ultrasonography for the Weaning Outcome in Mechanically Ventilated Children Aged 1–3 Years
Authors: Yao Yelin , He Liming , Chen Weiming , Zhou Hao , Lu Guoping , Tao Jinhao , Wang SuJuan 
Published: March 2022

BackgroundThere are estimated 20% of mechanically ventilated patients having difficulty in weaning from the ventilators, and the weaning process accounts for 40% of the whole ventilation time. Reliable tools are urgently needed to estimate the weaning outcome. Diaphragmatic ultrasonography, as a relatively good predictive method for the adults, was measured in this study, assessing the value of each indicator of diaphragmatic ultrasonography to predict the outcomes of ventilator weaning from mechanically ventilated children of 1–3 years old.MethodsBetween November 2018 and November 2019, children who were mechanically ventilated and ready for weaning in the pediatric intensive care unit (PICU) were enrolled in the study. Diaphragmatic ultrasonography was performed to the children to measure the right diaphragm excursion (DE), contraction velocity, thickness, and diaphragm thickening fraction (DTF), which were recorded followed by spontaneous breathing trial (SBT). The receiver operator characteristic (ROC) curves were also used to assess the value of each indicator to predict the weaning outcome.ResultsDuring this study period, a total of 72 children were enrolled, and of them, 56 children passed the weaning process, while 16 children failed. There were significant differences in DE, contraction velocity, thickness, and DTF parameters between the weaning success group and the failure group. The areas under the ROC curves (AUC) and the optimal threshold of the above indicators were as follows: 0.72 and 8.08 mm for DE, 0.71 and 26.1% for right DTF (DTFR), 0.71 and 20.7% for left DTF (DTFL), 0.78 and 14.8% for minimum DTF (DTFMIN), 0.79 and 26.1% for maximum DTF (DTFMAX), 0.71 and 1.24 mm for maximum diaphragm thickness at the end of inspiration (DteiMAX), and 0.65 and 10.0 mm/s for contraction velocity.ConclusionDiaphragmatic ultrasonography is feasible in guiding ventilator weaning, and the indicators of DE, DTF, and DteiMAX guide the weaning more accurately. Among them, DTF may act as a more reliable predictor of weaning by avoiding the influence of diaphragm development in children.