bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of Hippocampal-Thalamic-Cortical Morphometric Reorganization in Temporal Lobe Epilepsy
Authors: Tung Hsin , Pan Szu-Yen , Lan Tsuo-Hung , Lin Yung-Yang , Peng Syu-Jyun 
Published: February 2022

IntroductionBrain cortico-subcortical connectivity has been investigated in epilepsy using the functional MRI (MRI). Although structural images cannot demonstrate dynamic changes, they provide higher spatial resolution, which allows exploration of the organization of brain in greater detail.MethodsWe used high-resolution brain MRI to study the hippocampal-thalamic-cortical networks in temporal lobe epilepsy (TLE) using a volume-based morphometric method. We enrolled 22 right-TLE, 33 left-TLE, and 28 age/gender-matched controls retrospectively. FreeSurfer software was used for the thalamus segmentation.ResultsAmong the 50 subfields, ipsilateral anterior, lateral, and parts of the intralaminar and medial nuclei, as well as the contralateral parts of lateral nuclei had significant volume loss in both TLE. The anteroventral nucleus was most vulnerable. Most thalamic subfields were susceptible to seizure burden, especially the left-TLE. SPM12 was used to conduct an analysis of the gray matter density (GMD) maps. Decreased extratemporal GMD occurred bilaterally. Both TLE demonstrated significant GMD loss over the ipsilateral inferior frontal gyrus, precentral gyrus, and medial orbital cortices.SignificanceThalamic subfield atrophy was related to the ipsilateral inferior frontal GMD changes, which presented positively in left-TLE and negatively in right-TLE. These findings suggest prefrontal-thalamo-hippocampal network disruption in TLE.
Functional Network Changes After High-Frequency rTMS Over the Most Activated Speech-Related Area Combined With Speech Therapy in Chronic Stroke With Non-fluent Aphasia
Authors: Chang Won Kee , Park Jihong , Lee Ji-Young , Cho Sungmin , Lee Jongseung , Kim Won-Seok , Paik Nam-Jong 
Published: February 2022

ObjectiveHigh-frequency repetitive transcranial magnetic stimulation (HF-rTMS) to the lesional hemisphere requires prudence in selecting the appropriate stimulation spot. Functional near-IR spectroscopy (fNIRS) can be used in both selecting the stimulation spot and assessing the changes of the brain network. This study aimed to evaluate the effect of HF-rTMS on the most activated spot identified with fNIRS and assess the changes of brain functional network in the patients with poststroke aphasia.MethodsA total of five patients received HF-rTMS to the most activated area on the lesional hemisphere, followed by 30 min of speech therapy for 10 days. The Korean version of the Western aphasia battery (K-WAB) and fNIRS evaluation were done 1 day before the treatment, 1 day and 1 month after the last treatment session. Changes of K-WAB and paired cortical interaction and brain network analysis using graph theory were assessed.ResultsAphasia quotient in K-WAB significantly increased after the treatment (P = 0.043). The correlation analysis of cortical interactions showed increased connectivity between language production and processing areas. Clustering coefficients of the left hemisphere were increased over a sparsity range between 0.45 and 0.58 (0.015 &lt; p &lt; 0.031), whereas the clustering coefficients of the right hemisphere, decreased over a sparsity range 0.15–0.87 (0.063 &lt; p &lt; 0.095). The global efficiency became lower over a network sparsity range between 0.47 and 0.75 (0.015 &lt; p &lt; 0.063).ConclusionImprovement of language function and changes of corticocortical interaction between language-related cortical areas were observed after HF-rTMS on the most activated area identified by fNIRS with combined speech therapy in the patients with poststroke aphasia.
Functional Independence and Disability Evaluation in Stroke Patients: Optimal Cutoff Scores for a Pictorial-Based Longshi Scale, Barthel Index, and Modified Rankin Scale
Authors: Liu Xiangxiang , Zhou Mingchao , Zhao Jingpu , Gao Yan , Wang Yao , Zhou Jing , Wan Li , Nie Guohui , Wang Yulong 
Published: February 2022

IntroductionThe modified Rankin Scale (mRS) and Barthel Index (BI) are widely used to measure functional outcomes worldwide. The Longshi Scale (LS), a novel pictorial-based instrument, was designed to improve the simplicity and convenience of measuring functional outcomes in the Chinese context. However, the disagreements in functional outcomes assessed by the mRS, BI, and LS are misleading, particularly in stroke patients. This study aimed to identify the optimal cutoff scores of LS and BI according to the mRS in Chinese stroke patients with different levels of functional disability.MethodsThe mRS, BI, and LS were applied to evaluate functional independence and disability in 7364 stroke patients in a multi-center cross-sectional study. Stroke patients were categorized into bedridden, domestic, and community groups in advance using the LS, indicating severe, moderate, and mild functional disability, respectively. The optimal cut-off scores of the LS and BI according to the mRS were identified via sensitivity, specificity, and Youden's index and stratified by different levels of functional disability determined by LS. We also plotted the receiver operator characteristic (ROC) curves of sensitivity and specificity and determined the area under the curve (AUC).ResultsIn the bedridden group, LS and BI cutoff scores with the highest Youden's index were 5 and 10 for mRS 4, and the AUCs for the ROC curve were 0.848 and 0.863 for mRS 4. In the domestic group, LS and BI cutoff scores with the highest Youden's index were 5 and 65 for mRS 3, and the AUCs for the ROC curve were 0.796 and 0.826 for mRS 3. In the community group, LS cutoff scores with the highest sum of sensitivity and specificity were 9, 9, and 8 for mRS grades 0, 1, and 2, respectively, while the BI cutoff scores with the highest sum of sensitivity and specificity were 100, 100, and 95, respectively, while the AUCs for the ROC curve were 0.697 and 0.735 for mRS 2, 0.694 and 0.716 for mRS 1, and 0.628, and 0.660 for mRS 0.ConclusionsThe mRS is more precise to determine mild functional disability, whereas BI can provide more specific information on moderate and severe levels in stroke patients. Although LS was a less precise was to determine moderate and severe levels than BI, it is much simpler and more convenient to be applied to a large-scale population.
Episodic Memory Dysfunction and Effective Connectivity in Adult Patients With Newly Diagnosed Nonlesional Temporal Lobe Epilepsy
Authors: Bakhtiari Aftab , Bjørke Agnes Balint , Larsson Pål Gunnar , Olsen Ketil Berg , Nævra Marianne C. Johansen , Taubøll Erik , Heuser Kjell , Østby Ylva 
Published: February 2022

ObjectiveEpilepsy is associated with both changes in brain connectivity and memory function, usually studied in the chronic patients. The aim of this study was to explore the presence of connectivity alterations measured by EEG in the parietofrontal network in patients with temporal lobe epilepsy (TLE), and to examine episodic memory, at the time point of diagnosis.MethodsThe parietofrontal network of newly diagnosed patients with TLE (N = 21) was assessed through electroencephalography (EEG) effective connectivity and compared with that of matched controls (N = 21). Furthermore, we assessed phenomenological aspects of episodic memory in both groups. Association between effective connectivity and episodic memory were assessed through correlation.ResultsPatients with TLE displayed decreased episodic (p ≤ 0.001, t = −5.18) memory scores compared with controls at the time point of diagnosis. The patients showed a decreased right parietofrontal connectivity (p = 0.03, F = 4.94) compared with controls, and significantly weaker connectivity in their right compared with their left hemisphere (p = 0.008, t = −2.93). There were no significant associations between effective connectivity and episodic memory scores.ConclusionsWe found changes in both memory function and connectivity at the time point of diagnosis, supporting the notion that TLE involves complex memory functions and brain networks beyond the seizure focus to strongly interconnected brain regions, already early in the disease course. Whether the observed connectivity changes can be interpreted as functionally important to the alterations in memory function, it remains speculative.
Carbohydrate Mouth-Rinsing Improves Overtime Physical Performance in Male Ice Hockey Players During On-Ice Scrimmages
Authors: Nyman Danielle L. E. , Gamble Alexander S. D. , Bigg Jessica L. , Boyd Logan A. , Vanderheyden Alexander J. , Spriet Lawrence L. 
Published: February 2022

PurposeThis randomized, double-blind, crossover study examined the effects of mouth-rinsing (MR) with a carbohydrate (CHO) vs. a placebo (PLA) solution on external and internal loads in hydrated ice hockey players during regulation and overtime (OT) periods of an on-ice scrimmage.MethodsTwelve skilled male hockey players (22.6 [3.4] years, 178.9 [4.7] cm, 84.0 [6.5] kg) played three 20-min regulation periods and one 12-min OT period of small-sided 3-on-3 scrimmage. Skaters repeated 2 min shift and rest intervals. Participants mouth rinsed with 25 mL of CHO or PLA solution approximately every 10 min for a total of 7 rinses. A local positioning system (LPS) tracked external load variables including speed, distance, acceleration, and deceleration. Internal load was monitored with heart rate (HR) sensors and a rating of perceived exertion (RPE).ResultsDuring regulation play, both the conditions developed similar fatigue, with significantly decreased high-intensity distance, average speed and decelerations, and increased RPE, from period 1 to 2 and 3. In OT, CHO MR increased the distance skated at high-intensity (224 [77], 185 [66] m, p = 0.042), peak speed (24.6 [1.6], 23.7 [1.3] km·h−1, p = 0.016), number of sprints (1.9 [1.2], 1.2 [0.9], p = 0.011), and decreased distance skated at slow speed (300 [33], 336 [47], p = 0.034) vs. PLA MR. OT RPE was similar between the two conditions in spite of more work done in CHO MR.ConclusionsCHO MR may be a valuable practice to protect against decrements in external load with increased playing time in ice hockey, and possibly allows athletes to perform more work relative to perceived levels of exertion.
Caffeine, Coffee, Tea and Risk of Rheumatoid Arthritis: Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies
Authors: Asoudeh Farzaneh , Dashti Fatemeh , Jayedi Ahmad , Hemmati Amirhossein , Fadel Abdulmannan , Mohammadi Hamed 
Published: February 2022

ObjectiveProspective cohort studies on coffee, tea and caffeine in relation to the risk of rheumatoid arthritis (RA) have shown conflicting results. The aim of this study was to conduct a dose–response meta-analysis of cohort studies on the association between dietary caffeine, different types of coffee and tea consumption and the risk of RA.MethodsPubMed/Medline, Scopus and EMBASE were searched up to July 2021 to identify relevant studies that had considered different types of coffee (caffeinated or decaffeinated), tea or caffeine exposure with RA as the main, or one of the, outcome(s). Two authors independently screened 742 publications. Finally, five prospective cohort studies were included in our meta-analysis. Pooled relative risks (RRs) were calculated by using a fixed-effects model. We also performed linear and non-linear dose-response analyses to examine the dose-response relations.ResultsComparing extreme categories, we found a positive, significant association between coffee (RR: 1.30; 95% CI: 1.04–1.62; I2 = 0%, n = 5) and decaffeinated coffee (RR: 1.89; 95% CI: 1.35–2.65; I2 = 38.1%, n =3) consumption and risk of RA. One additional cup of coffee consumed per day was associated with an increased risk of RA by 6% (95% CI: 1.02–1.10; I2 = 0%). This increase in the risk of RA for one cup/d of decaffeinated coffee was 11% (95% CI: 1.05–1.18; I2 = 38). No significant association was observed between caffeinated coffee, tea or caffeine intake and the risk of RA.ConclusionWe found that a higher intake of coffee and decaffeinated coffee was associated with increased risk of RA. No significant association between caffeinated coffee, tea or caffeine intake and the risk of RA was observed.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227665, identifier: CRD42021227665.
Abemaciclib in Combination With Endocrine Therapy for Patients With Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer: A Phase 1b Study
Authors: Tolaney Sara M. , Beeram Muralidhar , Beck J. Thaddeus , Conlin Alison , Dees E. Claire , Puhalla Shannon L. , Rexer Brent N. , Burris Howard A. , Jhaveri Komal , Helsten Teresa , Becerra Carlos , Kalinsky Kevin , Moore Kathleen N. , Manuel Allison M. , Lithio Andrew , Price Gregory L. , Chapman Sonya C. , Litchfield Lacey M. , Goetz Matthew P. 
Published: February 2022

BackgroundCyclin-dependent kinases (CDK) 4 and 6 regulate G1 to S cell cycle progression and are often altered in cancers. Abemaciclib is a selective inhibitor of CDK4 and CDK6 approved for administration on a continuous dosing schedule as monotherapy or as combination therapy with an aromatase inhibitor or fulvestrant in patients with advanced or metastatic breast cancer. This Phase 1b study evaluated the safety and tolerability, pharmacokinetics, and antitumor activity of abemaciclib in combination with endocrine therapy for metastatic breast cancer (MBC), including aromatase inhibitors (letrozole, anastrozole, or exemestane) or tamoxifen.Patients and MethodsWomen ≥18 years old with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) MBC were eligible for enrollment. Eligibility included measurable disease or non-measurable but evaluable bone disease by Response Evaluation Criteria in Solid Tumours (RECIST) v1.1, Eastern Cooperative Oncology Group performance status 0–1, and no prior chemotherapy for metastatic disease. Adverse events were graded by the National Cancer Institute Common Terminology Criteria for Adverse Events v4.0 and tumor response were assessed by RECIST v1.1.ResultsSixty-seven patients were enrolled and received abemaciclib 200 mg every 12 hours in combination with letrozole (Part A, n=20), anastrozole (Part B, n=16), tamoxifen (Part C, n=16), or exemestane (Part D, n=15). The most common treatment-emergent adverse events (TEAE) were diarrhea, fatigue, nausea, and abdominal pain. Grade 4 TEAEs were reported in five patients (one each with hyperglycemia, hypertension, neutropenia, procedural hemorrhage, and sepsis). There was no effect of abemaciclib or endocrine therapy on the pharmacokinetics of any combination study drug. Across all treated patients, the median progression-free survival was 25.4 months (95% confidence interval: 18.0, 35.8). The objective response rate was 38.9% in 36 patients with measurable disease.ConclusionsAbemaciclib in combination with multiple endocrine therapy options exhibited manageable safety and promising antitumor activity in patients with HR+, HER2- MBC.Clinical Trial Registrationhttps://clinicaltrials.gov/, identifier NCT02057133
Robot-Assisted Totally Intracorporeal Resection of Cutaneous Ureterostomy Tumor and Ileal Conduit Surgery: A Rare Case Report
Authors: Cai Lingkai , Zhuang Juntao , Cao Qiang , Yuan Baorui , Wu Qikai , Li Kai , Han Jie , Yu Hao , Lv JianCheng , Feng Dexiang , Liu Peikun , Yu Ruixi , Li Pengchao , Yang Xiao , Lu Qiang 
Published: February 2022

BackgroundRadical cystectomy (RC) is the standard treatment for muscular invasive bladder cancer (MIBC) and some high-risk non-muscular invasive bladder cancer (NMIBC). Cutaneous ureterostomy is a common form of urinary diversion. However, after radical cystectomy, recurrence of upper urinary tract malignancies is possible. There is no relevant report on how to improve this situation’s management.Case PresentationThis case is a 56-year-old male patient hospitalized due to the development of a new tumor in the ureteral cutaneous stoma following radical cystectomy for more than five years. A biopsy of the tumor revealed high-grade urothelial carcinoma. Computed tomography (CT) revealed that the local soft tissue around the cutaneous stoma was thickened, but no other lesions were visible. After evaluating the case, we chose robot-assisted completely intracorporeal resection of cutaneous ureterostomy tumor and ileal conduit surgery. The total time for the operation and the blood loss were 400 minutes and 150 ml, respectively. Following surgery, the patient got standard chemotherapy in combination with immunotherapy. Additionally, ten months following the surgery, the patient did not experience disease progression or complications.ConclusionThe robot-assisted operation is safe and feasible for upper urinary tract tumor recurrence following radical cystectomy with cutaneous ureterostomy.
Enhancing Performance of Breast Ultrasound in Opportunistic Screening Women by a Deep Learning-Based System: A Multicenter Prospective Study
Authors: Zhao Chenyang , Xiao Mengsu , Ma Li , Ye Xinhua , Deng Jing , Cui Ligang , Guo Fajin , Wu Min , Luo Baoming , Chen Qin , Chen Wu , Guo Jun , Li Qian , Zhang Qing , Li Jianchu , Jiang Yuxin , Zhu Qingli 
Published: February 2022

PurposeTo validate the feasibility of S-Detect, an ultrasound computer-aided diagnosis (CAD) system using deep learning, in enhancing the diagnostic performance of breast ultrasound (US) for patients with opportunistic screening-detected breast lesions.MethodsNine medical centers throughout China participated in this prospective study. Asymptomatic patients with US-detected breast masses were enrolled and received conventional US, S-Detect, and strain elastography subsequently. The final pathological results are referred to as the gold standard for classifying breast mass. The diagnostic performances of the three methods and the combination of S-Detect and elastography were evaluated and compared, including sensitivity, specificity, and area under the receiver operating characteristics (AUC) curve. We also compared the diagnostic performances of S-Detect among different study sites.ResultsA total of 757 patients were enrolled, including 460 benign and 297 malignant cases. S-Detect exhibited significantly higher AUC and specificity than conventional US (AUC, S-Detect 0.83 [0.80–0.85] vs. US 0.74 [0.70–0.77], p &lt; 0.0001; specificity, S-Detect 74.35% [70.10%–78.28%] vs. US 54.13% [51.42%–60.29%], p &lt; 0.0001), with no decrease in sensitivity. In comparison to that of S-Detect alone, the AUC value significantly was enhanced after combining elastography and S-Detect (0.87 [0.84–0.90]), without compromising specificity (73.93% [68.60%–78.78%]). Significant differences in the S-Detect’s performance were also observed across different study sites (AUC of S-Detect in Groups 1–4: 0.89 [0.84–0.93], 0.84 [0.77–0.89], 0.85 [0.76–0.92], 0.75 [0.69–0.80]; p [1 vs. 4] &lt; 0.0001, p [2 vs. 4] = 0.0165, p [3 vs. 4] = 0.0157).ConclusionsCompared with the conventional US, S-Detect presented higher overall accuracy and specificity. After S-Detect and strain elastography were combined, the performance could be further enhanced. The performances of S-Detect also varied among different centers.
Epidemiologic Characteristics, Prognostic Factors, and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study
Authors: Tang Dongsheng , Chen Yue , Shi Yuye , Tao Hong , Tao Shandong , Zhang Quan’e , Ding Banghe , He Zhengmei , Yu Liang , Wang Chunling 
Published: February 2022

ObjectiveThis study was conducted in order to study the clinical characteristics, prognostic factors, and treatment outcomes in patients with primary central nervous system lymphoma (PCNSL).Materials and MethodsThe data of a total of 5,166 PCNSL patients diagnosed between 2000 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database were obtained.ResultsThe mean age was 63.1 ± 14.9 years, with a male to female ratio of 1.1:1.0. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL) (84.6%). The 1-, 3-, and 5-year overall survival (OS) rates were 50.1%, 36.0%, and 27.2%, respectively, and the corresponding disease-specific survival (DSS) rates were 54.4%, 41.3%, and 33.5%, respectively. Multivariate analysis with Cox regression showed that race, sex, age, marital status, surgical resection, and chemotherapy were independent prognostic factors for OS and DSS, but radiotherapy was only for OS. Nomograms specially for DLBCL were established to predict the possibility of OS and DSS. The concordance index (C-index) values of OS and DSS were 0.704 (95% CI 0.687–0.721) and 0.698 (95% CI 0.679–0.717), suggesting the high discrimination ability of the nomograms.ConclusionSurgical resection and/or chemotherapy was favorably associated with better OS and DSS. However, radiotherapy was not beneficial for OS and DSS in the long term. A new predictive nomogram and a web-based survival rate calculator we developed showed favorable applicability and accuracy to predict the long-term OS for DLBCL patients specifically.
Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease
Authors: Yang Aram , Jung Nayoung , Kim Sinae , Lee Ji-Eun 
Published: February 2022

Background and PurposeThe prevalence of non-alcoholic fatty liver disease (NAFLD) in children has been increasing associated with insulin resistance. However, there is a scarcity of related studies in children with NAFLD with type 2 diabetes mellitus (T2DM) compared to adults. We conducted this study to investigate the association between non-invasive diagnostic methods of liver fibrosis and T2DM in pediatric patients with NAFLD.MethodsWe enrolled a total of 152 patients aged &lt;18 years with NAFLD, and compared their data according to the presence of T2DM. We evaluated fibrosis by transient elastography (TE, FibroScan®), and calculated the following fibrosis scores for each patient: NAFLD fibrosis score (NFS), AST: platelet ratio index (APRI), Fibrosis-4 (FIB-4) index, and pediatric NAFLD fibrosis index (PNFI).ResultsIn the NAFLD–T2DM group, the NFS and mean controlled attenuation parameter in FibroScan were significantly higher than those in the nondiabetic group. The receiver operating characteristic (ROC) curve values for predicting the presence of T2DM were 0.78 for NFS, 0.64 for FIB-4, 0.62 for PNFI, and 0.61 for APRI. The cutoff HbA1c levels for predicting fibrosis progression in APRI, NFS, and PNFI were 5.7% [area under the curve (AUC) 0.74], 6.4% (AUC 0.71), and 6.4% (AUC 0.55), respectively. In the multivariate analysis, hepatosteatosis on abdomen sonography, NFS, FibroScan F, and APRI were independently associated with T2DM risk.ConclusionsWe significantly characterized non-invasive fibrosis markers and elastography in pediatric NAFLD with T2DM compared with the nondiabetic group. We suggest evaluating the progression of fibrosis in the prediabetic stage in children using a combination of these non-invasive methods.