bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of a Predictive Nomogram for Possible REM Sleep Behavior Disorders
Authors: Lai Hong , Li Xu-Ying , Hu Junya , Li Wei , Xu Fanxi , Zhu Junge , He Raoli , Weng Huidan , Chen Lina , Yu Jiao , Li Xian , Song Yang , Wang Xianling , Wang Zhanjun , Li Wei , Kang Rong , Li Yuling , Xu Junjie , Deng Yuanfei , Ye Qinyong , Wang Chaodong 
Published: June 2022

ObjectivesTo develop and validate a predictive nomogram for idiopathic rapid eye movement (REM) sleep behavior disorder (RBD) in a community population in Beijing, China.MethodsBased on the validated RBD questionnaire-Hong Kong (RBDQ-HK), we identified 78 individuals with possible RBD (pRBD) in 1,030 community residents from two communities in Beijing. The least absolute shrinkage and selection operator (LASSO) regression was applied to identify candidate features and develop the nomogram. Internal validation was performed using bootstrap resampling. The discrimination of the nomogram was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve, and the predictive accuracy was assessed via a calibration curve. Decision curve analysis (DCA) was performed to evaluate the clinical value of the model.ResultsFrom 31 potential predictors, 7 variables were identified as the independent predictive factors and assembled into the nomogram: family history of Parkinson's disease (PD) or dementia [odds ratio (OR), 4.59; 95% confidence interval (CI), 1.35–14.45; p = 0.011], smoking (OR, 3.24; 95% CI, 1.84–5.81; p &lt; 0.001), physical activity (≥4 times/week) (OR, 0.23; 95% CI, 0.12–0.42; p &lt; 0.001), exposure to pesticides (OR, 3.73; 95%CI, 2.08–6.65; p &lt; 0.001), constipation (OR, 6.25; 95% CI, 3.58–11.07; p &lt; 0.001), depression (OR, 3.66; 95% CI, 1.96–6.75; p &lt; 0.001), and daytime somnolence (OR, 3.28; 95% CI, 1.65–6.38; p = 0.001). The nomogram displayed good discrimination, with original AUC of 0.885 (95% CI, 0.845–0.925), while the bias-corrected concordance index (C-index) with 1,000 bootstraps was 0.876. The calibration curve and DCA indicated the high accuracy and clinical usefulness of the nomogram.ConclusionsThis study proposed an effective nomogram with potential application in the individualized prediction for pRBD.
Peripheral Hemolysis in Relation to Iron Rim Presence and Brain Volume in Multiple Sclerosis
Authors: Krajnc Nik , Bsteh Gabriel , Kasprian Gregor , Zrzavy Tobias , Kornek Barbara , Berger Thomas , Leutmezer Fritz , Rommer Paulus , Lassmann Hans , Hametner Simon , Dal-Bianco Assunta 
Published: June 2022

Background:Iron rim lesions (IRLs) represent chronic lesion activity and are associated with a more severe disease course in multiple sclerosis (MS). How the iron rims around the lesions arise in patients with MS (pwMS), and whether peripheral hemolysis may be a source of iron in rim associated macrophages, is unclear.ObjectiveTo determine a potential correlation between peripheral hemolysis parameters and IRL presence in pwMS.MethodsThis retrospective study included pwMS, who underwent a 3T brain MRI between 2015 and 2020 and had a blood sample drawn at ± 2 weeks. Patients with vertigo served as a control group.ResultsWe analyzed 75 pwMS (mean age 37.0 years [SD 9.0], 53.3% female) and 43 controls (mean age 38.3 years [SD 9.8], 51.2% female). Median number of IRLs was 1 (IQR 4), 28 (37.3%) pwMS had no IRLs. IRL patients showed significantly higher Expanded Disability Status Scale (EDSS) compared to non-IRL patients (median EDSS 2.3 [IQR 2.9] vs. 1.3 [IQR 2.9], p = 0.017). Number of IRLs correlated significantly with disease duration (rs = 0.239, p = 0.039), EDSS (rs = 0.387, p &lt; 0.001) and Multiple Sclerosis Severity Scale (MSSS) (rs = 0.289, p = 0.014). There was no significant difference in hemolysis parameters between non-IRL, IRL patients (regardless of gender and/or disease type) and controls, nor between hemolysis parameters and the number of IRLs. Total brain volume was associated with fibrinogen (β= −0.34, 95% CI −1.32 to −0.145, p = 0.016), and absolute cortical and total gray matter volumes were associated with hemoglobin (β = 0.34, 95% CI 3.39–24.68, p = 0.011; β = 0.33, 95% CI 3.29–28.95, p = 0.015; respectively).ConclusionOur data do not suggest an association between hemolysis parameters and IRL presence despite a significant association between these parameters and markers for neurodegeneration.
Structural and Functional Brain Changes in Patients With Classic Trigeminal Neuralgia: A Combination of Voxel-Based Morphometry and Resting-State Functional MRI Study
Authors: Liu Hao , Hou Haiman , Li Fangfang , Zheng Ruiping , Zhang Yong , Cheng Jingliang , Han Shaoqiang 
Published: June 2022

ObjectivesBrain structural and functional abnormalities have been separately reported in patients with classic trigeminal neuralgia (CTN). However, whether and how the functional deficits are related to the structural alterations remains unclear. This study aims to investigate the anatomical and functional deficits in patients with CTN and explore their association.MethodsA total of 34 patients with CTN and 29 healthy controls (HCs) with age- and gender-matched were recruited. All subjects underwent structural and resting-state functional magnetic resonance imaging (fMRI) scanning and neuropsychological assessments. Voxel-based morphometry (VBM) was applied to characterize the alterations of gray matter volume (GMV). The amplitude of low-frequency fluctuation (ALFF) method was used to evaluate regional intrinsic spontaneous neural activity. Further correlation analyses were performed between the structural and functional changes and neuropsychological assessments.ResultsCompared to the HCs, significantly reduced GMV was revealed in the right hippocampus, right fusiform gyrus (FFG), and temporal-parietal regions (the left superior/middle temporal gyrus, left operculo-insular gyrus, left inferior parietal lobule, and right inferior temporal gyrus) in patients with CTN. Increased functional activity measured by zALFF was observed mainly in the limbic system (the bilateral hippocampus and bilateral parahippocampal gyrus), bilateral FFG, basal ganglia system (the bilateral putamen, bilateral caudate, and right pallidum), left thalamus, left cerebellum, midbrain, and pons. Moreover, the right hippocampus and FFG were the overlapped regions with both functional and anatomical deficits. Furthermore, GMV in the right hippocampus was negatively correlated with pain intensity, anxiety, and depression. GMV in the right FFG was negatively correlated with illness duration. The zALFF value in the right FFG was positively correlated with anxiety.ConclusionOur results revealed concurrent structural and functional changes in patients with CTN, indicating that the CTN is a brain disorder with structural and functional abnormalities. Moreover, the overlapping structural and functional changes in the right hippocampus and FFG suggested that anatomical and functional changes might alter dependently in patients with CTN. These findings highlight the vital role of hippocampus and FFG in the pathophysiology of CTN.
Patterns of Treatment and Outcomes in Older Men With Penile Cancer: A SEER Dataset Analysis
Authors: Bourlon Maria T. , Verduzco-Aguirre Haydee , Molina Elizabeth , Meyer Elisabeth , Kessler Elizabeth , Kim Simon P. , Spiess Philippe E. , Flaig Thomas 
Published: June 2022

PurposeTo evaluate clinicopathologic and treatment characteristics from a population-based cohort of penile cancer, with an emphasis in older adults, due to incomplete evidence to guide therapy in this age subgroup.Materials and MethodsPatients with malignant penile tumors diagnosed 2004-2016 were identified in the Surveillance, Epidemiology and End Results Program (SEER)-18 dataset. Demographic and treatment characteristics were obtained. Population was analyzed by age at diagnosis (&lt;65 vs ≥65 years). We examined univariate associations between age groups with Chi-square analysis. To study survival, we calculated Kaplan-Meier survival curves, but due to the high number of competing events, we also performed a univariate competing risk analysis using the cumulative incidence function, and a multivariate analysis using the Fine-Gray method. We also described competing mortality due to penile cancer and other causes of death.ResultsWe included 3,784 patients. Median age was 68 years, 58.7% were aged ≥65. Older patients were less likely to have received chemotherapy (p&lt;0.001), primary site surgery (p = 0.002), or therapeutic regional surgery (p &lt;0.001). Median overall survival (OS) in patients &lt;65 years was not reached (95% CI incalculable) vs 49 months in those ≥65 years (95% CI 45-53, p &lt;0.0001). On univariate analysis, age was associated with a lower incidence of penile cancer death. On multivariate analysis, stage at diagnosis, and receipt of primary site surgery were associated with a higher incidence of penile cancer death. Estimated penile cancer-specific mortality was higher in patients &lt;65 years in stages II-IV. Estimated mortality due to other causes was higher in older patients across all stages.ConclusionsOlder patients are less likely to receive surgery, chemotherapy and radiotherapy for penile cancer. Primary surgical resection was associated with better penile cancer-specific mortality on multivariate analysis. Competing mortality risks are highly relevant when considering OS in older adults with penile cancer. Factors associated with undertreatment of older patients with penile cancer need to be studied, in order to develop treatment strategies tailored for this population.
Association Between Methylmalonic Acid and Cognition: A Systematic Review and Meta-Analysis
Authors: Wang Chao , Zhang Ying , Shu Jianbo , Gu Chunyu , Yu Yuping , Liu Wei 
Published: June 2022

BackgroundMethylmalonic acid (MMA) is an intermediate metabolite of human body. The content of MMA in the blood of healthy people is very low, and its concentration will increase in some diseases and elderly people. Recent studies have shown that MMA has a variety of biological functions. The correlation between MMA and cognition, one of the important functions of the nervous system, is still uncertain.ObjectiveMeta-analyses were performed to assess whether elevated MMA was associated with the risk of cognitive decline.Materials and MethodsCross-sectional studies, randomized controlled studies, and case-control studies on the relationship between MMA and cognition were obtained by searching PubMed, Web of Science, EMBASE, ProQuest, WANFANG MED ONLINE, China National Knowledge Infrastructure (CNKI) and Chongqing VIP until May 2022. Two researchers independently selected studies according to inclusion and exclusion criteria, evaluated study quality and extracted data. Meta-analyses were performed using Review Manager 5.4 software. The sensitivity analysis of meta-analysis was performed by One by one exclusion method.ResultsA total of 11 studies were included, including six cross-sectional studies, two randomized controlled studies, and three case-control studies, with a sample of 16,533 subjects. Meta-analysis showed that there was no significant difference in cognitive level between high-level MMA subjects and low-level MMA subjects in the general population [SMD = −2.19, 95% CI (−4.76 ∼ 0.38), Z = 1.67, P = 0.09]. In the population supplemented with VitB12, the increase of MMA level caused by VitB12 supplementation was not related to the change of cognition [SMD = 0.32, 95% CI (−0.19 ∼ 0.84) z = 1.22, P = 0.22]. There was also no significant difference in MMA levels between patients with dementia and the control group [WMD = 20.89, 95% CI (−5.13 ∼ 46.92), z = 1.57, P = 0.12].ConclusionIn the general population, whether VitB12 is supplemented or not, there is no correlation between the increase of MMA level and the decrease of cognitive level. In dementia diseases, the level of MMA did not change significantly. High levels of MMA may not be a risk factor for cognitive impairment. The exact relationship between MMA and cognition needs further research.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021266310], identifier [CRD42021266310].
Effectiveness and Safety of Cystic Fibrosis Transmembrane Conductance Regulator Modulators in Children With Cystic Fibrosis: A Meta-Analysis
Authors: Li Qiyu , Liu Siyuan , Ma Xuemei , Yu Jiaping 
Published: June 2022

Background and AimCystic fibrosis (CF) is a genetic disease that is difficult to treat and caused by dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Small molecules have been used to treat the symptom caused by CFTR mutations by restoring CFTR protein function. However, the data on children with CF are scarce. This meta-analysis aimed to evaluate the effectiveness and safety of this therapy in children diagnosed with CF.Materials and MethodsRelevant studies were identified through searching medical databases before April 1, 2022. The primary outcomes of ppFEV1, lung clearance index2.5 (LCI2.5), sweat chloride concentration (SwCI), and Cystic Fibrosis Questionnaire-Revised (CFQ-R) score were pooled and analyzed. The secondary outcomes were nutritional status (weight, BMI, stature, and their z-score) and adverse events under therapy.ResultsA total of twelve studies were included. Compared with the placebo group, the pooled outcome of the ppFEV1, LCI2.5, SwCI, and CFQ-R score were improved by 7.91 {[95% confidence interval (CI), 3.71–12.12], –1.00 (95% CI, –1.38 to –0.63), –35.22 (95% CI, –55.51 to –14.92), and 4.45 (95% CI, 2.31–6.59), respectively}. Compared with the placebo group, the pooled result of the change in weight was improved by 1.53 (95% CI, 0.42–2.63). All the aforementioned results were also improved in single-arm studies. No clear differences in adverse events were found between CFTR modulator therapy and the placebo group.ConclusionCFTR modulators could improve multiaspect function in children with CF and result in comparable adverse events.
Analysis of Worldwide Time-Series Data Reveals Some Universal Patterns of Evolution of the SARS-CoV-2 Pandemic
Authors: Mitrović Dankulov Marija , Tadić Bosiljka , Melnik Roderick 
Published: June 2022

Predicting the evolution of the current epidemic depends significantly on understanding the nature of the underlying stochastic processes. To unravel the global features of these processes, we analyse the world data of SARS-CoV-2 infection events, scrutinising two 8-month periods associated with the epidemic’s outbreak and initial immunisation phase. Based on the correlation-network mapping, K-means clustering, and multifractal time series analysis, our results reveal several universal patterns of infection dynamics, suggesting potential predominant drivers of the pandemic. More precisely, the Laplacian eigenvectors localisation has revealed robust communities of different countries and regions that break into clusters according to similar profiles of infection fluctuations. Apart from quantitative measures, the immunisation phase differs significantly from the epidemic outbreak by the countries and regions constituting each cluster. While the similarity grouping possesses some regional components, the appearance of large clusters spanning different geographic locations is persevering. Furthermore, characteristic cyclic trends are related to these clusters; they dominate large temporal fluctuations of infection evolution, which are prominent in the immunisation phase. Meanwhile, persistent fluctuations around the local trend occur in intervals smaller than 14 days. These results provide a basis for further research into the interplay between biological and social factors as the primary cause of infection cycles and a better understanding of the impact of socio-economical and environmental factors at different phases of the pandemic.
Vortioxetine Modulates the Regional Signal in First-Episode Drug-Free Major Depressive Disorder at Rest
Authors: Xiong Shihong , Li Wei , Zhou Yang , Ren Hongwei , Lin Guorong , Zhang Sheng , Xiang Xi 
Published: June 2022

BackgroundPrevious studies on brain functional alterations associated with antidepressants for major depressive disorder (MDD) have produced conflicting results because they involved short treatment periods and a variety of compounds.MethodsResting-state functional magnetic resonance imaging scans were obtained from 25 first-episode drug-free patients with MDD and 25 healthy controls. The patients, who were treated with vortioxetine for 8 weeks, were scanned at two-time points (baseline and week 8 of treatment). The amplitude of low-frequency fluctuation (ALFF) in the imaging data was used to analyze local brain signal alterations associated with antidepressant treatment.ResultsCompared with the controls, the patients at baseline showed decreased ALFF values in the right inferior temporal gyrus and increased ALFF values in the left inferior cerebellum, right cingulate gyrus and postcentral gyrus. After 8 weeks of vortioxetine treatment, patients showed increased ALFF values in the bilateral cingulate gyrus, middle temporal gyrus, medial superior frontal gyrus, and inferior cerebellum.ConclusionThis study provided evidence that vortioxetine modulates brain signals in MDD sufferers. These findings contribute to the understanding of how antidepressants effect brain function.
Roles and Challenges for Village Doctors in COVID-19 Pandemic Prevention and Control in Rural Beijing, China: A Qualitative Study
Authors: Li Jin , Zhao Ning , Zhang Haiyan , Yang Hui , Yang Jia 
Published: June 2022

ObjectivesRural areas in China are more vulnerable to COVID-19 pandemic than urban areas, due to their far fewer health care resources. Village doctors, as rural grassroots health workers in China, have been actively engaged in the pandemic prevention and control. This study aims to describe the roles of village doctors in rural China, and the challenges they have faced during the prevention and control of the COVID-19 pandemic.SettingThis study was conducted in three towns in Huairou District, Beijing, China.DesignWe carried out semi-structured interviews with 75 key informants. All the interviews were audio-recorded and transcribed verbatim. We employed thematic analysis to define themes and sub-themes from the qualitative data.ResultsWe reported four themes. First, the village doctor guided the village committee to carry out decontamination, monitored home-isolated residents, and disseminated knowledge on prevention of the COVID-19 pandemic during the rural pandemic prevention and control. Second, they took pandemic prevention measures in village clinics, distributed pandemic prevention materials, and undertook pre-screening triage. Third, village doctors provided basic medical care, including treatment of common diseases as well as the purchase and delivery of medicines to villagers. Fourth, village doctors faced difficulties and challenges, such as inadequate medical skills, aging staff structure, and lack of pandemic prevention materials.ConclusionsDespite many difficulties and challenges, village doctors have actively participated in rural pandemic prevention and control, and made outstanding contributions to curbing spread of COVID-19 pandemic in rural areas. Village doctors provide basic health care while participating in various non-medical tasks.
Surgical Correction of Kyphosis in Patients With Camptocormia Associated With Parkinson’s Disease: A Case Report and Review of the Literature
Authors: Mei Guo-long , Wei Hui-ting , Ma Yue-rong , Wan Dun 
Published: June 2022

BackgroundCamptocormia is a postural deformity that is characterized by a markedly flexed lumbar spine, with symptoms that worsen with walking and standing. Here, we report a case of camptocormia associated with Parkinson’s disease.Case descriptionA 70-year-old man with a 7-year history of Parkinson’s disease presented with a fall injury that caused lower back pain for 3 months and was aggravated for 2 months. He had been diagnosed with a compression fracture after the fall and had undergone percutaneous kyphoplasty at a local hospital. MRI showed non-union of the L1 vertebra and compression fracture of L2. The patient underwent posterior osteotomy, canal decompression, and internal fixation of the T10-L3 intervertebral plate with bone graft fusion. Postoperative examination showed that the lumbar lordosis was corrected and sensation was restored in both lower extremities. However, after 1 month, the fixation was loosened and a correction surgery was performed at our hospital. At the most recent follow-up at 1.5 years, the patient was found to be in good general health and did not complain of lower back discomfort. He was also actively exercising according to the rehabilitation regimen and had resumed social life.ConclusionThis is a rare case of camptocormia in a Parkinson’s patient that highlights the need for careful evaluation of whether internal spinal fixation surgery is beneficial in such patients.
MRI-Based Optimization Design of the Pre-Spinal Route of Contralateral C7 Nerve Transfer for Spastic Arm Paralysis
Authors: Zhao Hua-Li , Gao Yun , Yu Ai-Ping , Wei Yi-Min , Shen Yun-Dong , Jiang Su , Qiu Yan-Qun , Yu Jing , Liang Zong-Hui 
Published: June 2022

PurposeThe prespinal route of contralateral cervical 7 nerve transfer developed by Prof. Wendong Xu helps realize the direct anastomosis of the bilateral cervical 7 nerves. However, 20% of operations still require a nerve graft, which leads to an unfavorable prognosis. This study aims to explore the optimized prespinal route with MRI to further improve the prognosis.MethodsThe current study enrolled 30 patients who suffered from central spastic paralysis of an upper limb and who underwent contralateral cervical 7 nerve transfer via Prof. Xu’s prespinal route through the anterior edge of the contralateral longus colli. MRI images were used to analyze the route length, vertebral artery exposure, and contralateral cervical 7 nerve included angle. Three prespinal routes were virtually designed and analyzed. The selected optimal route was applied to another 50 patients with central spastic paralysis of an upper limb for contralateral cervical 7 nerve transfer.ResultsBy the interventions on the 30 patients, the middle and posterior routes were shorter than the anterior route in length, but with no statistical difference between the two routes. Of 30 contralateral vertebral arteries, 26 were located at the posterior medial edge of the longus colli. The average included angles of the anterior, middle, and posterior routes were 108.02 ± 7.89°, 95.51 ± 6.52°, and 72.48 ± 4.65°, respectively. According to these data, the middle route was optimally applied to 50 patients, in whom the rate of nerve transplantation was only 4%, and no serious complications such as vertebral artery or brachial plexus injury occurred.ConclusionThe low rate of nerve transplantation in 50 patients and the absence of any serious complications in these cases suggests that the middle route is the optimal one.