bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Risk for Dementia in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Population-Based Studies
Authors: Liu Mengsi , Li Dongxiu , Hong Xia , Sun Zhen 
Published: May 2022

BackgroundMounting evidence suggests that there may be a causal relationship or common pathogenic pathway between inflammatory bowel disease (IBD) and dementia. However, inconsistent results have emerged from epidemiological studies. We therefore conducted this review to clarify the relationship between IBD and dementia.MethodsWe systematically searched PubMed, Web of Science, Embase, and Cochrane library to identify all studies exploring the relationship between IBD and dementia published as of September 2021. Risk estimates were pooled using both fixed and random-effects models.ResultsSix studies involving 2,334,472 subjects were included. Pooled results suggested that the risk of developing dementia significantly increased after IBD diagnosis (HR = 1.27, 95% CI: 1.10–1.47, P = 0.001), which did not vary by age, gender, dementia subtype, or IBD subtype. Whereas, the dementia incidence before IBD diagnosis and the comorbidity rate of dementia in IBD patients were similar to those without IBD (HR = 0.92, 95% CI: 0.68–1.25; 0.82, 95% CI: 0.64–1.06, respectively). However, current evidence was insufficient to establish a causal relationship.ConclusionThis study shows an unidirectional association between IBD and dementia; patients with IBD have an increased risk of dementia, and it may be beneficial to develop individualized dementia screening strategies for this population. Future research needs to further investigate whether effective therapies of IBD can reduce this risk and pathophysiological mechanisms of the association.
Bifurcated Aneurysm Location Predicts In-Stent Stenosis After Neuroform-EZ Stent-Assisted Coiling for Intracranial Aneurysm
Authors: You Wei , Feng Junqiang , Ge Huijian , Jin Hengwei , Liu Peng , Li Youxiang , Jiang Yuhua , Liu Xinke 
Published: May 2022

Background and PurposeThe Neuroform EZ stent system (Boston Scientific Corporation, Fremont, CA, United States) is a fourth-generation intracranial aneurysm stent designed specifically for the cerebrovasculature to support aneurysm treatment. In this study, we analyzed our consecutive series of patients with aneurysm treated with the Neuroform EZ stent, with special attention to the occurrence of in-stent stenosis (ISS).MethodsA retrospective review of our center's electronic database was conducted to identify all patients with intracranial aneurysms who underwent aneurysm treatment with the Neuroform EZ stent between January 2016 and October 2018. Patients with at least one digital subtraction angiography (DSA) follow-up in our hospital were enrolled in this study. In-stent stenosis (ISS) was graded as mild (&lt;2–5%), moderate (25–50%), or severe (&gt;50%).ResultsThe study included 114 patients (78 women, 68.4%; median age 57.2 ± 9 years) with a total of 116 aneurysms. Of the 116 lesions, 20 were identified with ISS (17.2%) at a mean follow-up of 6.9 ± 1.7 months, and ISS was mild in 30% (6/20), moderate in 50% (10/20), and severe in 20% (4/20). No patients were symptomatic or required further intervention. Patients who developed ISS were younger than those without ISS (52.6 ± 7.8 vs. 57.9 ± 9; p = 0.016). The proportion of aneurysms located at the artery bifurcation was significantly higher in patients with stenosis than located at the sidewall artery (37.9 vs. 10.3%; p = 0.002). In the multivariable analysis, the patients' age (OR = 0.94; 95% CI 0.88–0.998; p = 0.02) and bifurcated aneurysm location (OR = 4.59; 95% CI 1.54–13.67; p = 0.006) were independent predictors of ISS.ConclusionsIn this retrospective study, the incidence of ISS after Neuroform EZ stent placement was 17.2%, and all the ISS cases were asymptomatic. Patients with younger age and bifurcated aneurysm location are more likely to develop ISS. Although Neuroform EZ stent is particularly suitable for bifurcated aneurysms, the ISS for this location should be focused upon.
Improving Visualization Methods of Utility-Weighted Disability Outcomes for Stroke Trials
Authors: Tokunboh Ivie , Sung Eleanor Mina , Chatfield Fiona , Gaines Nathan , Nour May , Starkman Sidney , Saver Jeffrey L. 
Published: May 2022

BackgroundThe modified Rankin Scale (mRS) is the most common endpoint in acute stroke trials, but its power is limited when analyzed dichotomously and its indication of effect size is challenging to interpret when analyzed ordinally. To address these issues, the utility-weighted-mRS (UW-mRS) has been developed as a patient-centered, linear scale. However, appropriate data visualizations of UW-mRS results are needed, as current stacked bar chart displays do not convey crucial utility-weighting information.Design/MethodsTwo UW-mRS display formats were devised: (1) Utility Staircase charts, and (2) choropleth-stacked-bar-charts (CSBCs). In Utility Staircase displays, mRS segment height reflects the utility value of each mRS level. In CSBCs, mRS segment color intensity reflects the utility of each mRS level. Utility Staircase and CSBC figures were generated for 15 randomized comparisons of acute ischemic/hemorrhagic stroke therapies, including fibrinolysis, endovascular reperfusion, blood pressure moderation, and hemicraniectomy. Display accuracy in showing utility outcomes was assessed with the Tufte-lie-factor and ease-of-use assessed by formal ratings completed by a panel of 4 neurologists and emergency physicians and one nurse-coordinator.ResultsThe Utility Staircase and CSBC displays rapidly conveyed patient-centered valuation of trial outcome distributions not available in conventional ordinal stacked bar charts. Tufte-lie-factor (LF) scores indicated “substantial distortion” of utility-valued outcomes for 93% (14/15) of conventional stacked bar charts, vs. “no distortion” for all Utility Staircase and CSBC displays. Clinician ratings on the Figural Display Questionnaire indicated that utility information encoded in row height (Utility Staircase display) was more readily assimilated than that conveyed in segment hue intensity (CSBC), both superior to conventional stacked bar charts.ConclusionsUtility Staircase displays are an efficient graphical format for conveying utility weighted–modified Rankin Scale primary endpoint results of acute stroke trials, and choropleth-stacked-bar-charts a good alternative. Both are more accurate in depicting quantitative, health-related quality of life results and preferred by clinician users for utility results visualization, compared with conventional stacked bar charts.
Total Dairy Consumption Is Not Associated With Likelihood of a First Clinical Diagnosis of Central Nervous System Demyelination
Authors: Dieu Dao Ying Rachel , Dunlop Eleanor , Daly Alison , Lucas Robyn M. , Probst Yasmine , Black Lucinda J. 
Published: May 2022

BackgroundThe evidence associating consumption of dairy products and risk of MS is contradictory and inconclusive.ObjectiveTo test associations between dairy consumption and the likelihood of a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS.MethodsWe used data from the 2003–2006 Ausimmune Study, a population-based Australian, multicentre, matched case-control study (272 cases, 519 controls). Total dairy consumption (servings/day) was calculated by summing consumption of milk, cheese and yogurt. Covariate-adjusted treatment effects using augmented inverse probability weighting was used to test for associations with FCD. We conducted sensitivity analyses in the subset of participants who had had a classic first demyelinating event (FDE), defined as a single, first episode of symptoms suggestive of CNS demyelination.ResultsThere were no statistically significant associations between total dairy consumption (per one serving/day) and FCD (adjusted OR 1.00; 95% CI 0.93, 1.07; p = 0.979). However, yogurt consumption (vs. no yogurt consumption) was associated with an 11% decreased likelihood of FDE (adjusted OR 0.89; 95% CI 0.89, 0.79; p = 0.046).ConclusionWhile total dairy consumption was not associated with FCD in this Australian case-control study, yogurt consumption was associated with reduced likelihood of FDE.
Association of Dietary Protein Intake and Grip Strength Among Adults Aged 19+ Years: NHANES 2011–2014 Analysis
Authors: Pikosky Matthew A. , Cifelli Christopher J. , Agarwal Sanjiv , Fulgoni Victor L. 
Published: May 2022

BackgroundResearch on the role of protein in the diet has evolved beyond a focus on quantity to include the impact of its quality and distribution across meal times in an effort to optimize dietary protein recommendations.ObjectiveTo determine the association of dietary protein amount, type, and intake pattern with grip strength in adults.DesignData from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 for adults 19 + years (N = 9,214) were used with exclusions for pregnant and lactating women. Intakes of dietary total protein (TP), animal protein (AP, including dairy), plant protein (PP), and leucine (Leu) were determined using day 1 24 h dietary recall data after adjusting for the complex sample design of NHANES. Regression analyses were used to assess the association of dietary protein and leucine intake quartiles, and whether consuming &gt; 20 g of dietary protein at one or more meals was related to grip strength with adjustment for age, gender, and ethnicity.ResultsMean intake of TP among adults aged 19 + years was 83.6 ± 0.5 g/day, and 2/3rd of this was from animal sources (including dairy). Grip strength increased (p &lt; 0.05) with increasing quartiles of TP, AP, PP, and leucine among all adults 19 + years (β = 1.340.19, 1.27 ± 0.19, 0.76 ± 0.20, and 1.33 ± 0.23, respectively), 19–50 years (β = 1.14 ± 0.27, 1.06 ± 0.25, 0.77 ± 0.30, and 1.18 ± 0.27, respectively), and 51 + years (β = 0.95 ± 0.26, 1.08 ± 0.27, and 1.05 ± 0.27, respectively, for TP, AP, and Leu); however, the increase was more pronounced for AP than PP. Grip strength also increased (p &lt; 0.05) with increasing the number of meal occasions containing &gt; 20 g of dietary protein (β = 1.50 ± 0.20, 1.41 ± 0.25, and 0.91 ± 0.37 for 19+, 19–50, and 51 + years, respectively), and significant increases were detected for two meals compared to zero meals.ConclusionDietary protein quantity, quality, and distribution should be considered collectively when looking to optimize protein intake to support muscle strength and function.
Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging for Monitoring the Immune Response of Immunogenic Chemotherapy
Authors: Hu Junjiao , Yu Xin , Yin Peidi , Du Bin , Cai Xiangran 
Published: May 2022

ObjectiveTo evaluate the predictive value of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) in the quantitative assessment of conventional chemotherapy-activated immune responses in mouse tumor models and clinics.MethodsA total of 19 subcutaneous tumor-bearing mice were randomly divided into treated and control groups. Both groups had orderly IVIM DWI examinations before and on days 6 and 12 after the administration of cyclophosphamide (CPA) or saline. Pathologic examinations were performed, including HE staining and immunohistochemistry (IHC). The expressions of immune-related genes in the tumor were measured by qPCR. In addition, six patients with breast cancer requiring neoadjuvant chemotherapy (NACT) also underwent functional MRI examinations and IHC to determine potential antitumor immune response.ResultsAt the end of the study, the CPA treatment group showed the lowest tumor volume compared to the control group. For pathological examinations, the CPA treatment group showed a lower percentage of CD31 staining (P &lt; 0.01) and Ki-67 staining (P&lt;0.01), and a higher percentage of TUNEL staining (P &lt; 0.01). The tumoral pseudodiffusion coefficient (D*) value showed a positive correlation with the CD31-positive staining rate (r = 0.729, P &lt; 0.0001). The diffusion related parameters (D) value was positively correlated with TUNEL (r = 0.858, P &lt; 0.0001) and negatively correlated with Ki-67 (r = -0.904, P &lt; 0.0001). Moreover, a strong induction of the expression of the immune responses in the CPA treatment group was observed on day 12. D values showed a positive correlation with the Ifnb1-, CD8a-, Mx1-, Cxcl10- (r = 0.868, 0.864, 0.874, and 0.885, respectively, P &lt; 0.0001 for all). Additionally, the functional MRI parameters and IHC results in patients with breast cancer after NACT also showed a close correlation between D value and CD8a (r = 0.631, P = 0.028).ConclusionsThe treatment response induced by immunogenic chemotherapy could be effectively evaluated using IVIM-DWI. The D values could be potential, sensitive imaging marker for identifying the antitumor immune response initiated by immunogenic chemotherapy.
S-1 Maintenance Therapy After First-Line Treatment With Nab-Paclitaxel Plus S-1 for Advanced Pancreatic Adenocarcinoma: A Real-World Study
Authors: Shi Yan , Han Quanli , Yan Huan , Lv Yao , Yuan Jing , Li Jie , Guan Shasha , Wang Zhikuan , Huang Lei , Dai Guanghai 
Published: May 2022

BackgroundIn our previous phase II study, nab-paclitaxel plus S-1 (NPS) showed encouraging objective response rate (ORR) as first-line treatment for advanced pancreatic adenocarcinoma (APAC). This study aimed to evaluate the effectiveness and safety of S-1 maintenance after NPS in APAC and to explore factors predicting survival benefits when using S-1 maintenance.MethodsBetween 2014 and 2018 a total of 182 patients with APAC, who were primarily treated with NPS, were included. For patients without progression or with treatment discontinuation due to any reasons within 4 months during NPS treatment, S-1 monotherapy was administrable as maintenance therapy at the physicians’ discretion based on the patients’ preference and performance status. Efficacy and safety of S-1 maintenance were investigated.ResultsIn 123 patients without progression within 4 months during NPS treatment, 74 received S-1 maintenance and had median progression-free survival of 9.6 months and median overall survival of 16.7 months. Multivariable analysis showed that in patients receiving S-1 maintenance after first-line NPS therapy, an Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0, non-metastatic disease, and complete or partial response as best response to NPS chemotherapy were independently associated with better survival. The most common all-grade hematological and non-hematological adverse events were neutropenia (82.4%) and peripheral neurotoxicity (66.2%), respectively, and the most common ≥Grade 3 hematological and non-hematological adverse events were neutropenia (40.5%) and peripheral neurotoxicity (6.8%), respectively in patients who received S-1 maintenance.ConclusionsOur real-world study showed that S-1 maintenance after tumor response or stable disease induced by first-line NPS treatment was effective and well-tolerated for some patients with APAC, which offers a promising alternative treatment strategy with encouraging survival for APAC.
Computed Tomography-Based Radiomics for Differentiation of Thymic Epithelial Tumors and Lymphomas in Anterior Mediastinum
Authors: He Wenzhang , Xia Chunchao , Chen Xiaoyi , Yu Jianqun , Liu Jing , Pu Huaxia , Li Xue , Liu Shengmei , Chen Xinyue , Peng Liqing 
Published: May 2022

ObjectiveTo investigate the differential diagnostic performance of computed tomography (CT)-based radiomics in thymic epithelial tumors (TETs) and lymphomas in anterior mediastinum.MethodsThere were 149 patients with TETs and 93 patients with lymphomas enrolled. These patients were assigned to a training set (n = 171) and an external validation set (n = 71). Dedicated radiomics prototype software was used to segment lesions on preoperative chest enhanced CT images and extract features. The multivariable logistic regression algorithm was used to construct three models according to clinico-radiologic features, radiomics features, and combined features, respectively. Performance of the three models was compared by using the area under the receiver operating characteristic curves (AUCs). Decision curve analysis was used to evaluate clinical utility of the three models.ResultsFor clinico-radiologic model, radiomics signature model, and combined model, the AUCs were 0.860, 0.965, 0.975 and 0.843, 0.961, 0.955 in the training cohort and the test cohort, respectively (all P&lt;0.05). The accuracies of each model were 0.836, 0.895, 0.918 and 0.845, 0.901, 0.859 in the two cohorts, respectively (all P&lt;0.05). Compared with the clinico-radiologic model, better diagnostic performances were found in the radiomics signature model and the combined model.ConclusionsRadiomics signature model and combined model exhibit outstanding and comparable differential diagnostic performances between TETs and lymphomas. The CT-based radiomics analysis might serve as an effective tool for accurately differentiating TETs from lymphomas before treatment.
Nutritional Risk Index as a Prognostic Factor Predicts the Clinical Outcomes in Patients With Stage III Gastric Cancer
Authors: Song Haibin , Sun Hongkai , Yang Laishou , Gao Hongyu , Cui Yongkang , Yu Chengping , Xu Haozhi , Li Linqiang 
Published: May 2022

ObjectiveThis study is aimed to determine the potential prognostic significance of nutritional risk index (NRI) in patients with stage III gastric cancer.MethodsA total of 202 patients with stage III gastric cancer were enrolled in this study. NRI was an index based on ideal body weight, present body weight, and serum albumin levels. All patients were divided into two groups by receiver operating characteristic curve: low NRI group (NRI&lt;99) and high NRI group (NRI≥99). The relationship between NRI and clinicopathologic characteristics was evaluated by Chi-square test. The clinical survival outcome was analyzed by Kaplan-Meier method and compared using log-rank test. The univariate and multivariate analyses were used to detect the potential prognostic factors. A nomogram for individualized assessment of disease-free survival (DFS) and overall survival (OS). The calibration curve was used to evaluate the performance of the nomogram for predicted and the actual probability of survival time. The decision curve analysis was performed to assess the clinical utility of the nomogram by quantifying the net benefits at different threshold probabilities.ResultsThe results indicated that NRI had prognostic significance by optimal cutoff value of 99. With regard to clinicopathologic characteristics, NRI showed significant relationship with age, weight, body mass index, total protein, albumin, albumin/globulin, prealbumin, glucose, white blood cell, neutrophils, lymphocyte, hemoglobin, red blood cell, hematocrit, total lymph nodes, and human epidermal growth factor receptor 2 (P&lt;0.05). Through the univariate and multivariate analyses, NRI, total lymph nodes, and tumor size were identified as the independent factor to predict the DFS and OS. The nomogram was used to predict the 1-, 3-, and 5-year survival probabilities, and the calibration curve showed that the prediction line matched the reference line well for 1-, 3-, and 5-year DFS and OS. Furthermore, the decision curve analysis also showed that the nomogram model yielded the best net benefit across the range of threshold probability for 1-, 3-, 5-year DFS and OS.ConclusionsNRI is described as the potential prognostic factor for patients with stage III gastric cancer and is used to predict the survival and prognosis.
Post-Radiotherapy PET Image Outcome Prediction by Deep Learning Under Biological Model Guidance: A Feasibility Study of Oropharyngeal Cancer Application
Authors: Ji Hangjie , Lafata Kyle , Mowery Yvonne , Brizel David , Bertozzi Andrea L. , Yin Fang-Fang , Wang Chunhao 
Published: May 2022

PurposeTo develop a method of biologically guided deep learning for post-radiation 18FDG-PET image outcome prediction based on pre-radiation images and radiotherapy dose information.MethodsBased on the classic reaction–diffusion mechanism, a novel biological model was proposed using a partial differential equation that incorporates spatial radiation dose distribution as a patient-specific treatment information variable. A 7-layer encoder–decoder-based convolutional neural network (CNN) was designed and trained to learn the proposed biological model. As such, the model could generate post-radiation 18FDG-PET image outcome predictions with breakdown biological components for enhanced explainability. The proposed method was developed using 64 oropharyngeal patients with paired 18FDG-PET studies before and after 20-Gy delivery (2 Gy/day fraction) by intensity-modulated radiotherapy (IMRT). In a two-branch deep learning execution, the proposed CNN learns specific terms in the biological model from paired 18FDG-PET images and spatial dose distribution in one branch, and the biological model generates post-20-Gy 18FDG-PET image prediction in the other branch. As in 2D execution, 718/233/230 axial slices from 38/13/13 patients were used for training/validation/independent test. The prediction image results in test cases were compared with the ground-truth results quantitatively.ResultsThe proposed method successfully generated post-20-Gy 18FDG-PET image outcome prediction with breakdown illustrations of biological model components. Standardized uptake value (SUV) mean values in 18FDG high-uptake regions of predicted images (2.45 ± 0.25) were similar to ground-truth results (2.51 ± 0.33). In 2D-based Gamma analysis, the median/mean Gamma Index (&lt;1) passing rate of test images was 96.5%/92.8% using the 5%/5 mm criterion; such result was improved to 99.9%/99.6% when 10%/10 mm was adopted.ConclusionThe developed biologically guided deep learning method achieved post-20-Gy 18FDG-PET image outcome predictions in good agreement with ground-truth results. With the breakdown biological modeling components, the outcome image predictions could be used in adaptive radiotherapy decision-making to optimize personalized plans for the best outcome in the future.
The Performance-Result Gap in Mixed-Reality Cycling – Evidence From the Virtual Tour de France 2020 on Zwift
Authors: Westmattelmann Daniel , Stoffers Benedikt , Sprenger Marius , Grotenhermen Jan-Gerrit , Schewe Gerhard 
Published: May 2022

Background: Mixed-reality sports are increasingly reaching the highest level of sport, exemplified by the first Virtual Tour de France, held in 2020. In road races, power output data are only sporadically available, which is why the effect of power output on race results is largely unknown. However, in mixed-reality competitions, measuring and comparing the power output data of all participants is a fundamental prerequisite for evaluating the athlete’s performance.Objective: This study investigates the influence of different power output parameters (absolute and relative peak power output) as well as body mass and height on the results in mixed-reality competitions.Methods: We scrape data from all six stages of the 2020 Virtual Tour de France of women and men and analyze it using regression analysis. Third-order polynomial regressions are performed as a cubic relationship between power output and competition result can be assumed.Results: Across all stages, relative power output over the entire distance explains most of the variance in the results, with maximum explanatory power between 77% and 98% for women and between 84% and 99% for men. Thus, power output is the most powerful predictor of success in mixed-reality sports. However, the identified performance-result gap reveals that other determinants have a subordinate role in success. Body mass and height can explain the results only in a few stages. The explanatory power of the determinants considered depends in particular on the stage profile and the progression of the race.Conclusion: By identifying this performance-result gap that needs to be addressed by considering additional factors like competition strategy or the specific use of equipment, important implications for the future of sports science and mixed-reality sports emerge.