bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine Learning-Based Personalized Risk Prediction Model for Mortality of Patients Undergoing Mitral Valve Surgery: The PRIME Score
Authors: Zhou Ning , Ji Zhili , Li Fengjuan , Qiao Bokang , Lin Rui , Jiang Wenxi , Zhu Yuexin , Lin Yuwei , Zhang Kui , Li Shuanglei , You Bin , Gao Pei , Dong Ran , Wang Yuan , Du Jie 
Published: April 2022

BackgroundMitral valve surgery (MVS) is an effective treatment for mitral valve diseases. There is a lack of reliable personalized risk prediction models for mortality in patients undergoing mitral valve surgery. Our aim was to develop a risk stratification system to predict all-cause mortality in patients after mitral valve surgery.MethodsDifferent machine learning models for the prediction of all-cause mortality were trained on a derivation cohort of 1,883 patients undergoing mitral valve surgery [split into a training cohort (70%) and internal validation cohort (30%)] to predict all-cause mortality. Forty-five clinical variables routinely evaluated at discharge were used to train the models. The best performance model (PRIME score) was tested in an externally validated cohort of 220 patients undergoing mitral valve surgery. The model performance was evaluated according to the area under the curve (AUC). Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were compared with existing risk strategies.ResultsAfter a median follow-up of 2 years, there were 133 (7.063%) deaths in the derivation cohort and 17 (7.727%) deaths in the validation cohort. The PRIME score showed an AUC of 0.902 (95% confidence interval [CI], 0.849–0.956) in the internal validation cohort and 0.873 (95% CI: 0.769–0.977) in the external validation cohort. In the external validation cohort, the performance of the PRIME score was significantly improved compared with that of the existing EuroSCORE II (NRI = 0.550, [95% CI 0.001–1.099], P = 0.049, IDI = 0.485, [95% CI 0.230–0.741], P &lt; 0.001).ConclusionMachine learning-based model (the PRIME score) that integrate clinical, demographic, imaging, and laboratory features demonstrated superior performance for the prediction of mortality patients after mitral valve surgery compared with the traditional risk model EuroSCORE II.Clinical Trial Registration[http://www.clinicaltrials.gov], identifier [NCT05141292].
Reduction in Volume of Nucleus Basalis of Meynert Is Specific to Parkinson’s Disease and Progressive Supranuclear Palsy but Not to Multiple System Atrophy
Authors: Rogozinski Sophia , Klietz Martin , Respondek Gesine , Oertel Wolfgang H. , Grothe Michel J. , Pereira Joana B. , Höglinger Günter U. 
Published: April 2022

ObjectivesTo study in vivo gray matter (GM) volumes of the nucleus basalis of Meynert (nbM) in different parkinsonian syndromes and assess their relationship with clinical variables.MethodsT1-weighted magnetic resonance images from patients with progressive supranuclear palsy (PSP, N = 43), multiple system atrophy (MSA, N = 23), Parkinson’s disease (PD, N = 26), and healthy controls (HC, N = 29) were included. T1-weighted images were analyzed using a voxel-based morphometry approach implemented in the VBM8 toolbox, and nbM volumes were extracted from the spatially normalized GM images using a cyto-architectonically-defined nbM mask in stereotactic standard space. NbM volumes were compared between groups, while controlling for intracranial volume. Further, within each group correlation analyses between nbM volumes and the Mini Mental Status Examination (MMSE), Hoehn and Yahr stage, PSP Rating Scale, Unified Parkinson’s Disease Rating Scale part III and Frontal Assessment Battery scores were performed.ResultsSignificantly lower nbM volumes in patients with PSP and PD compared to HC or patients with MSA were found. No significant correlations between MMSE and nbM volumes were detected in any of the subgroups. No significant correlations were found between clinical scores and nbM volumes in PSP or other groups.ConclusionnbM volumes were reduced both in PD and PSP but not in MSA. The lack of significant correlations between nbM and cognitive measures suggests that other factors, such as frontal atrophy, may play a more important role than subcortical cholinergic atrophy in PSP patients. These results may indicate that other drug-targets are needed to improve cognitive function in PSP patients.
Inter-Observer and Intra-Observer Variability in Gross Tumor Volume Delineation of Primary Esophageal Carcinomas Based on Different Combinations of Diagnostic Multimodal Images
Authors: Li Fengxiang , Li Yankang , Wang Xue , Zhang Yingjie , Liu Xijun , Liu Shanshan , Wang Wei , Wang Jinzhi , Guo Yanluan , Xu Min , Li Jianbin 
Published: April 2022

Background and PurposeThis study aimed to investigate inter-/intra-observer delineation variability in GTVs of primary esophageal carcinomas (ECs) based on planning CT with reference to different combinations of diagnostic multimodal images from endoscopy/EUS, esophagography and FDG-PET/CT.Materials and MethodsFifty patients with pathologically proven thoracic EC who underwent diagnostic multimodal images before concurrent chemoradiotherapy were enrolled. Five radiation oncologist independently delineated the GTVs based on planning CT only (GTVC), CT combined with endoscopy/EUS (GTVCE), CT combined with endoscopy/EUS and esophagography (X-ray) (GTVCEX), and CT combined with endoscopy/EUS, esophagography, and FDG-PET/CT (GTVCEXP). The intra-/inter-observer variability in the volume, longitudinal length, generalized CI (CIgen), and position of the GTVs were assessed.ResultsThe intra-/inter-observer variability in the volume and longitudinal length of the GTVs showed no significant differences (p&gt;0.05). The mean intra-observer CIgen values for all observers was 0.73 ± 0.15. The mean inter-observer CIgen values for the four multimodal image combinations was 0.67 ± 0.11. The inter-observer CIgen for the four combined images was the largest, showing significant differences with those for the other three combinations. The intra-observer CIgen among different observers and inter-observer CIgen among different combinations of multimodal images showed significant differences (p&lt;0.001). The intra-observer CIgen for the senior radiotherapists was larger than that for the junior radiotherapists (p&lt;0.001).ConclusionFor radiation oncologists with advanced medical imaging training and clinical experience, using diagnostic multimodal images from endoscopy/EUS, esophagography, and FDG-PET/CT could reduce the intra-/inter-observer variability and increase the accuracy of target delineation in primary esophageal carcinomas.
Prognostic Impact of Platelet-Large Cell Ratio In Myelodysplastic Syndromes
Authors: Chen Qiuni , Chen Yue , Zhang Yijing , Zhang Lijuan , Chen Kankan , He Zhengmei , Wang Chunling , Yu Liang 
Published: April 2022

BackgroundMyelodysplastic syndromes (MDSs) are a very heterogeneous group of myeloid disorders with high prevalence and risk of developing acute myeloid leukemia. The more accurate risk stratification can provide a better guidance of treatment. The platelet–large cell ratio (P-LCR) is a parameter reported in complete blood cell count tests, and was associated with many diseases, but its role in MDS is not clear.PurposeThis study aims to explore the impact of the P-LCR on the prognosis of patients with MDS, which is of great significance for clinical treatment.MethodsIn the retrospective study, 122 newly diagnosed MDS patients were enrolled. We used the bioinformatics tool X-tile to define a P-LCR threshold of 36.7% to predict prognosis. Patients were divided into P-LCRlow and P-LCRhigh groups, and their characteristics were compared between the two groups.ResultsResults show that the P-LCRlow was associated with worse overall survival (OS) than the P-LCRhigh patients (median OS, 18.53 months versus 25.77 months, p=0.0057), but there were no statistical differences in progression-free survival (PFS) between the two groups (p=0.2001). The results of univariate and multivariate Cox proportional hazard analyses adjusted for gender, bone marrow blast level, platelet count, and International Prognostic Scoring System scores showed that the P-LCR was useful in the evaluation of PFS [hazard ratio (HR) 0.212, 95%CI 0.064–0.702, p=0.011] and OS of MDS (HR 0.464, 95%CI 0.284–0.757, p=0.002).ConclusionThis study is the first report showing that the P-LCR would be a simple and immediately available biomarker for predicting the prognosis of MDS.
Paraquat Induces Lung Injury via miR-199-Mediated SET in a Mouse Model
Authors: Cai Quan , Jin Yan , Jia Ziyi , Liu Zhi 
Published: April 2022

Objective: To explore the molecular mechanism of lung injury caused by paraquat (PQ) poisoning by investigating miR-199-mediated SET.Methods: A paraquat poisoning model was established in C57BL/6 male mice via intraperitoneal injection of paraquat. The mice were transfected with miR-199 siRNA and or mimic. After 14 days of treatment, pathophysiological changes of the lung were observed and lung tissue was analyzed via Hematoxylin-Eosin staining. The levels of miR-199, SETs, surfactant protein SP-A and SP-B, and inflammatory and oxidative factors were analyzed by qPCR, Western Blot, and ELISA kits.Results: A acute lung-injury (ALI) model was established using PQ treatment and confirmed with edema of pulmonary endothelium with low electronic density of endothelial cytoplasm, presence of protein-rich fluid, and numerous erythrocytes in alveolar space, concentric figures of damaged tubular myelin, alveolar destruction, and increase in inflammatory cell numbers. Compared with the control group, miR-199 and SET levels were reduced in the PQ-treated group. miR-199 siRNA increased the SET level, inflammatory and oxidative levels, and reduced the levels of SP-A and SP-B, and miR-199 mimic reduced the SET level, inflammatory and oxidative levels, and increased the levels of SP-A and SP-B. PQ treatment reduced miR-199 level.Conclusion: Paraquat induces ALI by affecting miR-199-mediated SET.
MMP9 Expression Correlates With Cisplatin Resistance in Small Cell Lung Cancer Patients
Authors: Wu Longqiu , Wang Xiangcai , He Xin , Li Qiang , Hua Qian , Liu Rongrong , Qiu Zhengang 
Published: April 2022

Background: Cisplatin is the basis of the primary treatment for SCLC chemotherapy. However, the limited objective response rate and definite drug resistance greatly restrict the clinical potential and therapeutic benefits of cisplatin use. Therefore, it is essential to identify biomarkers that can discern the sensitivity of SCLC patients to cisplatin treatment.Methods: We collected two SCLC cohorts treated with cisplatin that included mutation data, prognosis data and expression data. The sensitivity of cisplatin was evaluated by the pRRophetic algorithm. MCPcounter, quanTIseq, and xCell algorithms were used to evaluate immune cell score. GSEA and ssGSEA algorithms were used to calculate immune-related pathway scores. Univariate and multivariate Cox regression models were employed, and survival analysis was used to evaluate the prognostic value of the candidate genes.Results: MMP9-High is related to improved clinical prognoses of patients with SCLC (HR = 0.425, p = 0.0085; HR = 0.365, p = 0.0219). Multivariate results showed that MMP-High could be used as an independent predictor of the prognosis of SCLC after cisplatin treatment (HR = 0.216, p = 0.00153; HR = 0.352; p = 0.0199). In addition, MMP9-High displayed a significantly lower IC50 value of cisplatin and higher immunogenicity than MMP9-Low SCLC. Compared with MMP9-Low SCLC, MMP9-High included significantly increased levels of T-cells, cytoxic lymphocytes, B-cells, NK-cells, and dense cells (DCS). Similarly, the activity of cytokine binding, B-cell, NK-cell mediated immune response chemokine binding, and antigen presentation pathways in MMP9-High was significantly higher than that in MMP9-Low.Conclusion: In this study, we identified that MMP9-High could be potentially considered a novel biomarker used to ascertain the improved prognosis of SCLC patients after cisplatin treatment. Furthermore, we indicated that the tumor immune microenvironment of MMP9-High SCLC is mainly characterized by a large number of infiltrated activated immune cells as well as activated immune-related pathways.
Mental Health in Australia: Psychological Distress Reported in Six Consecutive Cross-Sectional National Surveys From 2001 to 2018
Authors: Enticott Joanne , Dawadi Shrinkhala , Shawyer Frances , Inder Brett , Fossey Ellie , Teede Helena , Rosenberg Sebastian , Ozols AM Ingrid , Meadows Graham 
Published: April 2022

PurposeTo examine Australian psychological distress trends from 2001 to 2017/18, including analysis by age, sex, location, and household income.MethodsSecondary analysis of the working age population (18–64 years) in six successive representative national health surveys. Measures were prevalence of psychological distress at very-high symptom level (defined by a Kessler Psychological Distress Scale (K10) score of 30 or more) and combined high/very-high level (K10 score of 22 or more). Very-high K10 scores are associated with mental health problems meeting diagnostic thresholds in past year.ResultsFrom 2001 to 2017/18 Australian rates of K10 very-high distress rose significantly from 3.8 to 5.1% and combined high/very-high from 13.2 to 14.8%. In women aged 55–64, very-high distress rose significantly and substantially from 3.5 to 7.2% and high/very-high distress from 12.4 to 18.7%. In men aged 25–34, very-high distress increased from 2.1 to 4.0% and high/very-high from 10.6 to 11.5%. Income was strongly and inversely associated with distress (lowest vs. highest quintile adjusted OR 11.4). An apparent association of increased distress with regional location disappeared with adjustment for income.ConclusionAustralia’s population level of psychological distress increased significantly from 2001–2017/18, with levels highest in women and with rates inversely associated with income. This is likely to be indicative of increased community rates of mental disorders. Given that this has occurred whilst mental healthcare expenditure has increased, there is an urgent need to reconsider how best to respond to mental illness, including targeting the most vulnerable based on social determinants such as age, gender, and lower incomes.
The Correlation Between Probiotics and Anxiety and Depression Levels in Cancer Patients: A Retrospective Cohort Study
Authors: Ye Ziqi , Zhang Yanfang , Du Mengfei , Lu Shaojia , Zhao Qingwei , Yang Si 
Published: April 2022

ObjectiveStudies have shown a correlation between gut microbiota and anxiety and depression levels. However, these studies are mainly animal studies or clinical studies of non-cancer patients, there is still a lack of relevant studies in cancer patients. The main objective of this trial was to analyze the correlation between probiotics and anxiety and depression levels in cancer patients.MethodsWe screened all cancer patients consecutively admitted to the inpatient department of the First Affiliated Hospital, Zhejiang University School of Medicine in May 2020. A total of 292 cancer patients met our inclusion criteria. Then, we followed up all patients for 24 weeks. Patients who had incomplete data or loss of follow-up were excluded. In addition, in patients who took probiotics, those did not take probiotics consistently or did not take specific probiotics were excluded. Ultimately, the number of patients enrolled was 82 in probiotics cohort and 100 in non-probiotics cohort. The 17-item Hamilton Depression Scale (HAMD-17) questionnaire was used to measure the depression levels of the patients, and we also used Hamilton Anxiety Scale (HAMA) questionnaire to assess the patients’ anxiety levels. A logistic regression model was used to analyze whether the difference in baseline data of two cohorts would affect the final result.ResultsDemographic and clinical characteristics of all cancer patients enrolled in probiotics cohort and non-probiotics cohort were similar except the cancer therapy (P = 0.004). According to the HAMA score, we divided cancer patients into non-anxiety group (HAMA score &lt; 14) and anxiety group (HAMA score ≥ 14). Similarly, cancer patients were also divided into non-depression group (HAMD-17 score ≤ 7) and depression group (HAMD-17 score &gt; 7). The results demonstrated that there was no statistical difference in the proportion of patients with anxiety (6.1 and 13.0%, respectively, P = 0.121) and depression (30.5 and 23.0%, respectively, P = 0.254) between probiotics and non-probiotics cohorts. The results of logistic regression model analysis further proved that the baseline difference in cancer therapy did not affect the conclusions.ConclusionOur results still suggest that there is no significant correlation between probiotics and anxiety and depression levels in cancer patients. Therefore, we do not recommend supplementing probiotics for cancer patients to prevent anxiety and depression. Moreover, high-quality RCTs are also needed to further confirm the conclusions of this study.
A Network Analysis of the Relationships Between Behavioral Inhibition/Activation Systems and Problematic Mobile Phone Use
Authors: Gao Lingfeng , Zhao Wan , Chu Xiaowei , Chen Haide , Li Weijian 
Published: April 2022

BackgroundIt is of great concern to society that individuals can be vulnerable to problematic mobile phone use (PMPU). However, there are a few studies in the field evaluating associations between behavioral inhibition/activation systems (BIS/BAS) and PMPU, and the results have been inconsistent. This study aimed to explore the relationships between BIS/BAS and PMPU by network analysis.MethodsA total of 891 young adults participated in the study. BIS/BAS and PMPU were assessed by using the behavioral inhibition and activation systems scale and smartphone application-based addiction scale, respectively. The structure of the BIS/BAS-PMPU network was characterized using “strength,” “closeness” and “betweenness” as centrality indices. Edge-weight accuracy and centrality stability were tested using a bootstrap procedure.ResultsThe network analysis showed that “mood modification,” “tolerance” and “withdrawal symptoms” had high centrality. In addition, the positive connection between BIS and “mood modification” or “tolerance” and between BAS-fun seeking and “mood modification” or “conflict” were also shown in the BIS/BAS-PMPU network.ConclusionThese findings shed light on the central and bridge components between the BIS/BAS and PMPU communities, providing new evidence relevant to potential mechanisms that account for how high-BIS or high-BAS individuals develop PMPU, and inspiring component-based PMPU prevention or interventions.
Amplitude of Low-Frequency Fluctuation With Different Clinical Outcomes in Patients With Generalized Tonic–Clonic Seizures
Authors: Zu Meidan , Fu Lulan , Hu Mingwei , Cao Xiaoyan , Wang Long , Zhang Juan , Deng Ziru , Qiu Bensheng , Wang Yu 
Published: April 2022

BackgroundGeneralized tonic–clonic seizures (GTCS) are associated with significant disability and sudden unexpected death when they cannot be controlled. We aimed to explore the underlying neural substrate of the different responses to antiseizure drugs between the seizure-free (SF) and non-seizure-free (NSF) patients with GTCS through the amplitude of low-frequency fluctuation (ALFF) method.MethodsWe calculated ALFF among the SF group, NSF group, and healthy controls (HCs) by collecting resting-state functional magnetic resonance imaging (rs-fMRI) data. One-way ANOVA was used to compare the ALFF of the three groups, and post-hoc analysis was done at the same time. Pearson's correlation analysis between ALFF in the discrepant brain areas and the clinical characteristics (disease course and age of onset of GTCS) was calculated after then.ResultsA significant group effect was found in the right fusiform gyrus (R.FG), left fusiform gyrus (L.FG), left middle occipital gyrus (L.MOG), right inferior frontal gyrus (R.IFG), right precentral gyrus (R.PreG), right postcentral gyrus (R.PostG), and left calcarine sulcus (L.CS). The SF and NSF groups both showed increased ALFF in all discrepant brain areas compared to HCs except the R.IFG in the NSF group. Significantly higher ALFF in the bilateral FG and lower ALFF in the R.IFG were found in the NSF group compared to the SF group.ConclusionsHigher ALFF in the bilateral FG were found in the NSF group compared to the SF and HC groups. Our findings indicate that abnormal brain activity in the FG may be one potential neural substrate to interpret the failure of seizure control in patients with GTCS.
Cannabis Use Is Associated With Lower COVID-19 Susceptibility but Poorer Survival
Authors: Huang Da , Xu Roubing , Na Rong 
Published: April 2022

ObjectivesTo investigate the impact of cannabis use on the infection and survival outcomes of COVID-19.Study DesignCross-sectional study based on the UK Biobank (UKB) dataset.MethodsWe identified 13,099 individuals with cannabis smoking history in the UKB COVID-19 Serology Study. The Charlson-Quan Comorbidity Index was estimated using inpatient ICD-10 records. Multivariable logistic regression characterized features associated with COVID-19 infection. Cox models determined the hazard ratios (HR) for COVID-19-related survival.ResultsCannabis users were more likely to getting COVID-19 (odds ratio: 1.22, P = 0.001) but multivariable analysis showed that cannabis use was a protective factor of COVID-19 infection (adjusted odds ratio: 0.81, P = 0.001). Regular cannabis users, who smoked more than once per month, had a significantly poorer COVID-19-related survival, after adjusting for known risk factors including age, gender, smoking history, and comorbidity (adjusted hazard ratio: 2.81, P = 0.041).ConclusionsThe frequency of cannabis use could be considered as a candidate predictor for mortality risk of COVID-19.
Cardiovascular/Stroke Risk Stratification in Parkinson’s Disease Patients Using Atherosclerosis Pathway and Artificial Intelligence Paradigm: A Systematic Review
Authors: Suri Jasjit S. , Paul Sudip , Maindarkar Maheshrao A. , Puvvula Anudeep , Saxena Sanjay , Saba Luca , Turk Monika , Laird John R. , Khanna Narendra N. , Viskovic Klaudija , Singh Inder M. , Kalra Mannudeep , Krishnan Padukode R. , Johri Amer , Paraskevas Kosmas I. 
Published: April 2022

Parkinson’s disease (PD) is a severe, incurable, and costly condition leading to heart failure. The link between PD and cardiovascular disease (CVD) is not available, leading to controversies and poor prognosis. Artificial Intelligence (AI) has already shown promise for CVD/stroke risk stratification. However, due to a lack of sample size, comorbidity, insufficient validation, clinical examination, and a lack of big data configuration, there have been no well-explained bias-free AI investigations to establish the CVD/Stroke risk stratification in the PD framework. The study has two objectives: (i) to establish a solid link between PD and CVD/stroke; and (ii) to use the AI paradigm to examine a well-defined CVD/stroke risk stratification in the PD framework. The PRISMA search strategy selected 223 studies for CVD/stroke risk, of which 54 and 44 studies were related to the link between PD-CVD, and PD-stroke, respectively, 59 studies for joint PD-CVD-Stroke framework, and 66 studies were only for the early PD diagnosis without CVD/stroke link. Sequential biological links were used for establishing the hypothesis. For AI design, PD risk factors as covariates along with CVD/stroke as the gold standard were used for predicting the CVD/stroke risk. The most fundamental cause of CVD/stroke damage due to PD is cardiac autonomic dysfunction due to neurodegeneration that leads to heart failure and its edema, and this validated our hypothesis. Finally, we present the novel AI solutions for CVD/stroke risk prediction in the PD framework. The study also recommends strategies for removing the bias in AI for CVD/stroke risk prediction using the PD framework.