bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of Urine Creatinine With Kidney Stone Prevalence in US Adults: Data From NHANES 2009–2018
Authors: Shen Xudong , Chen Yan , Zhang Yangyang , Xia Kaiguo , Chen Yang , Hao Zongyao 
Published: March 2022

BackgroundThe primary objective of this project is to explore the association of urine creatinine (UCR) with the prevalence rate of kidney stones.MethodThe National Health and Nutrition Examination Survey (NHANES) database was employed to conduct a cross-sectional study. The analysis samples included adults aged ≥20 years from five consecutive cycles of the NHANES 2009–2018. The association between UCR and kidney stones was detected using univariate and multivariate logistic regression analyses. Further, subgroup analyses were performed to evaluate the subgroup effects.ResultsAfter adjustment for all confounders, multiple logistic regression analysis revealed a weak positive relationship between UCR and kidney stone (OR = 1.015, 95% CI: 1.008–1.021). In the subgroup analysis stratified by sex, age, or race, the risk further increased in men (OR = 1.014, 95% CI: 1.005–1.023), women (OR = 1.015, 95% CI: 1.005–1.025), white race (OR = 1.022, 95% CI: 1.013–1.030), aged 40–59 years (OR = 1.017, 95% CI: 1.006–1.028), and aged 60–80 years (OR = 1.017, 95% CI: 1.006–1.028).ConclusionsOur results confirmed a moderately increased risk of kidney stone formation attributed to high levels of UCR, especially in middle-aged and older adults and the white race. However, because of the cross-sectional design of the study, causal inferences cannot be made.
Ionic Liquid Co-Catalyst Assisted Biodiesel Production From Waste Cooking Oil Using Heterogeneous Nanocatalyst: Optimization and Characterization
Authors: Baskar Gurunathan , Anita Nalathamalar T. , Jeehoon Han , Naveenkumar Rajendran 
Published: March 2022

In the present work, the biodiesel was produced from waste cooking oil (WCO) using heterogeneous zinc doped iron nanocatalyst and tetrabutylammonium iodide (TBAI) as co-catalyst. The heterogeneous zinc doped iron nanocatalyst was synthesized and characterized. The functional group in the heterogeneous nanocatalyst was confirmed using FTIR analysis, the crystalline nature was studied by XRD analysis, and the size and structure of the nanocatalyst were analyzed by SEM. The optimization of transesterification parameters like oil to methanol molar ratio, zinc doped iron concentration, TBAI concentration, temperature, and time were carried out for the maximum conversion of biodiesel from WCO. At 50 min the maximum biodiesel conversion of 90% was achieved at 55°C with 12% catalyst, 30% co-catalyst, and 1:11 WCO to methanol ratio. The presence of functional groups and the methyl ester composition of the biodiesel from WCO were confirmed by FTIR and GC-MS analysis. The use of zinc doped iron nanocatalyst with TBAI showed good catalytic activity to produce biodiesel from WCO.
Musculoskeletal Pain in Parkinson's Disease
Authors: Li Jun , Zhu Ben-Fan , Gu Zhu-Qin , Zhang Hui , Mei Shan-Shan , Ji Shao-Zhen , Liu Shu-Ying , Han Chao , Chen Huai-Zhen , Chan Piu 
Published: March 2022

BackgroundMusculoskeletal pain is commonly experienced in patients with Parkinson's disease (PD). Few studies have investigated the clinical characteristics and risk factors associated with musculoskeletal pain.ObjectivesTo investigate the distribution, clinical characteristics, and factors associated with musculoskeletal pain in a large sample of patients with PD.MethodsWe enrolled 452 patients from two clinics and used a standardized questionnaire to collect demographic and clinical information. Musculoskeletal pain was diagnosed based on the Ford Classification System, and pain severity was assessed with the numeric rating scale (NRS). Multivariate regression models explored the association between clinical features of PD and quality of life and pain.ResultsTwo hundred and six patients (45.58%) reported musculoskeletal pain, typically in their lower limbs and backs. Levodopa resulted in a ≥30% reduction in pain intensity scores in 170 subjects. Female sex (odds ratio [OR], 1.57; 95% CI, 1.07–2.29) and Levodopa-equivalent daily doses (LEDDs; OR, 3.35; 95% CI, 1.63–6.59) were associated with an increased risk for musculoskeletal pain. Pain duration (p = 0.017), motor symptoms (p &lt; 0.001), and depression (p &lt; 0.001) were significantly associated with quality of life.ConclusionsThe lower limbs and back are common sites of musculoskeletal pain in patients with PD, and up to 82.52% of patients were responsive to Levodopa. Female sex and LEDDs are associated with musculoskeletal pain, suggesting that dopamine deficiencies, and not the motor and non-motor impairment, might be the most critical baseline risk factor of musculoskeletal pain.
Diagnostic Yield and Complication Rate of Stereotactic Biopsies in Precision Medicine of Gliomas
Authors: Katzendobler Sophie , Do Anna , Weller Jonathan , Dorostkar Mario M. , Albert Nathalie L. , Forbrig Robert , Niyazi Maximilian , Egensperger Rupert , Thon Niklas , Tonn Joerg Christian , Quach Stefanie 
Published: March 2022

BackgroundAn integrated diagnosis consisting of histology and molecular markers is the basis of the current WHO classification system of gliomas. In patients with suspected newly diagnosed or recurrent glioma, stereotactic biopsy is an alternative in cases in which microsurgical resection is deemed to not be safely feasible or indicated. In this retrospective study, we aimed to analyze both the diagnostic yield and the safety of a standardized biopsy technique.Material and MethodsThe institutional database was screened for frame-based biopsy procedures (January 2016 until March 2021). Only patients with a suspected diagnosis of glioma based on imaging were included. All tumors were classified according to the current WHO grading system. The clinical parameters, procedural complications, histology, and molecular signature of the tissues obtained were assessed.ResultsBetween January 2016 and March 2021, 1,214 patients underwent a stereotactic biopsy: 617 (50.8%) for a newly diagnosed lesion and 597 (49.2%) for a suspected recurrence. The median age was 56.9 years (range 5 months−94.4 years). Magnetic resonance imaging (MRI)-guidance was used in 99.3% of cases and additional positron emission tomography (PET)-guidance in 34.3% of cases. In total, stereotactic serial biopsy provided an integrated diagnosis in 96.3% of all procedures. The most frequent diagnoses were isocitrate dehydrogenase (IDH) wildtype glioblastoma (n = 596; 49.2%), oligodendroglioma grade 2 (n = 109; 9%), astrocytoma grade 3 (n = 108; 8.9%), oligodendroglioma grade 3 (n = 76; 6.3%), and astrocytoma grade 2 (n = 66; 5.4%). A detailed determination was successful for IDH 1/2 mutation in 99.4% of cases, for 1p/19q codeletion in 97.4% of cases, for TERT mutation in 98.9% of cases, and for MGMT promoter methylation in 99.1% of cases. Next-generation sequencing was evaluable in 64/67 (95.5%) of cases and DNA methylome analysis in 41/44 (93.2%) of cases. Thirteen (1.1%) cases showed glial tumors that could not be further specified. Seventy-three tumors were different non-glioma entities, e.g., of infectious or inflammatory nature. Seventy-five out of 597 suspected recurrences turned out to be post-therapeutic changes only. The rate of post-procedural complications with clinical symptoms of the Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or higher was 1.2% in overall patients and 2.6% in the subgroup of brainstem biopsies. There was no fatal outcome in the entire series.ConclusionImage-guided stereotactic serial biopsy enables obtaining reliable histopathological and molecular diagnoses with a very low complication rate even in tumors with critical localization. Thus, in patients not undergoing microsurgical resection, this is a valuable tool for precision medicine of patients with glioma.
The LINC00452/miR-204/CHST4 Axis Regulating Thymic Tregs Might Be Involved in the Progression of Thymoma-Associated Myasthenia Gravis
Authors: Wang Fuqiang , Zhang Hanlu , Qiu Guanghao , Li Zhiyang , Wang Yun 
Published: March 2022

BackgroundMyasthenia gravis (MG) is an autoimmune disease that mainly affects neuromuscular junctions and is usually associated with immune disorders in the thymoma. The competitive endogenous RNA (ceRNA) hypothesis has been demonstrated to be an intrinsic mechanism regulating the development of several autoimmune diseases; however, the mechanism where the ceRNA network regulates immune cells in patients with thymoma-associated MG (TAMG) has rarely been explored.MethodsRNA-seq data and clinical information of 124 patients with thymoma were obtained from The Cancer Genome Atlas (TCGA) database. The patients were divided into two groups according to whether they were diagnosed with MG. We applied the propensity score matching method to reduce the incidence of baseline confounders. We then constructed a ceRNA network with differentially expressed RNAs between the groups based on four public databases. The expression of genes of interest was validated by qPCR. Moreover, we predicted the immune cells that infiltrated the thymoma and then analyzed the association between immune cells and RNA in the ceRNA network. To further determine the function of the mRNAs associated with immune cells in patients with TAMG, we performed gene set enrichment analysis in thymoma patients with MG.ResultsAfter matching, 94 patients were included in the following analysis. A total of 847 mRNAs, 409 lncRNAs, and 45 miRNAs were differentially expressed between the groups. The ceRNA network, including 18 lncRNAs, four miRNAs, and 13 mRNAs, was then constructed. We then confirmed that CHST4 and LINC00452, miR-204-3p and miR-204-5p were differentially expressed between patients with TAMG and thymoma patients without MG (NMG) by qPCR. Moreover, we found that the percentage of predicted regulatory T (Treg) cells was significantly decreased in patients with TAMG. Further analysis indicated that the LINC00452/miR-204/CHST4 axis might regulate thymic regulatory T cells (Tregs) in the progression of MG.ConclusionsIn this research, we constructed a ceRNA network involved in the progression of TAMG, discovered that thymic Tregs were significantly decreased in patients with TAMG, and assumed that the LINC00452/miR-204/CHST4 axis may regulate thymic Tregs in the development of TAMG. These findings may deepen our understanding of the roles of the ceRNA network in regulating TAMG and highlight the function of CHST4 in recruiting peripheral T cells in the progression of TAMG.
Efficacy and Safety of Tacrolimus Therapy for a Single Chinese Cohort With Very-Late-Onset Myasthenia Gravis
Authors: Zheng Yiming , Yuan Xiaoqiu , Zhang Caifeng , Liu Ran , Jin Haiqiang , Hao Hongjun , Li Fan , Zhao Yawen , Yuan Yun , Wang Zhaoxia , Gao Feng 
Published: March 2022

Background and PurposePrevious studies have found tacrolimus to be a favorable drug for treating different types of myasthenia gravis (MG), but few have focused on very-late-onset MG (VLOMG). This study evaluated the efficacy and safety of tacrolimus for VLOMG therapy.MethodsThis was a retrospective single-center cohort study of 70 patients with VLOMG (onset ≥65 years) who visited Peking University First Hospital in 2019. Participants were divided into the tacrolimus (Tac) group and the control group based on tacrolimus usage. We further divided the Tac group into patients treated without corticosteroids and with corticosteroids. Sociodemographic features, clinical profiles, and outcomes were compared between different therapies and further analyzed by multivariate regression. Details of tacrolimus treatment, comorbidities, and adverse drug reactions (ADRs) were described.ResultsAmong 70 patients, the median (interquartile range) age at onset was 71 (68–77) years, and the follow-up duration was 27 (27-29) months. Most patients were types I (28%) and III (40%) according to the MG Foundation of America (MGFA) classification. In the Tac group, tacrolimus treatment was maintained for 36 (27-38) months. The dosage at the final evaluation was 1.0 (1.0–1.75) mg/day, and the last blood concentration test was 4.25 (2.85–5.7) ng/ml. A total of 43% reached remission, and 37% improved based on MGFA postintervention status (MGFA-PIS). For the 9 patients, newly diagnosed at enrollment within this group, MG activities of daily living (MG-ADL) decreased significantly from 3 (2-5) to 2 (1-2) (p= 0.041). Regarding the 13 patients, coadministering Wuzhi capsules the tacrolimus concentration increased from 2.75 (1.4–3.8) ng/ml to 5.95 (5.1–7.0) ng/ml (p= 0.012). No significant differences in outcomes were observed between tacrolimus treatment without and with corticosteroids or between the Tac group and the control group. A total of 93% had at least one comorbidity. ADRs related to tacrolimus emerged in 25% (9/36) of patients, most of which were not serious and reversible.ConclusionsTacrolimus is effective and safe in treating VLOMG. Tacrolimus monotherapy without corticosteroids can be used as an initial and maintenance treatment for VLOMG. Wuzhi capsules work well in elevating tacrolimus concentrations in this population.
Physical Capacity and Activity in Patients With Idiopathic Normal Pressure Hydrocephalus
Authors: Rydja Johanna , Kollén Lena , Ulander Martin , Tullberg Mats , Lundin Fredrik 
Published: March 2022

IntroductionMost patients with idiopathic normal pressure hydrocephalus (iNPH) improve gait after surgery. However, knowledge on physical capacity and activity after shunt surgery is limited. One of the aims of this study was to evaluate the effect of shunt surgery in patients with iNPH on short-distance walking, functional exercise capacity, functional strength, and variables of activity and sleep, 3 and 6 months postoperatively. Another aim was to evaluate the effect of a physical exercise program. Additionally, we studied how changes in short-distance walking were correlated with functional exercise capacity and voluntary walking.MethodsIn total, 127 patients were consecutively included and randomized to the exercise group (n = 62) or the control group (n = 65). Participants in the exercise group underwent the supervision of a 12-week exercise program. All patients were assessed before surgery, at 3 and 6 months postoperatively with the 10-m walk test (10MWT), the 6-min walk test (6MWT), 30-s chair stand test (30sCST), and with the actigraphic recordings of activity variables measured for a total of 24 h/day for at least 3 days.ResultsAll patients improved at 3 months postoperatively in the 10MWT (p &lt; 0.001), 6MWT (p &lt; 0.001), and 30sCST (p &lt; 0.001). These results were maintained after 6 months. Actigraphic recordings for voluntary walking (steps per minute) were improved and nighttime sleep (%) increased after 6 months (p = 0.01, p = 0.04). There were no significant differences between the exercise group and the control group, except for the postoperative change in the proportion of daytime sleep after 3 months, which was slightly more reduced compared to baseline in the exercise group (p = 0.04). Changes after 3 months in the 10MWT and 6MWT were moderately correlated (ρ= −0.49, p = 0.01) whereas the correlation between the 10MWT and voluntary walking was weak (ρ = −0.34, p = 0.01).ConclusionShunt surgery improved short-distance walking, functional exercise capacity, functional strength, and voluntary walking. An exercise program did not affect these outcomes. Short-distance walking was weakly correlated with voluntary walking, indicating improved physical capacity does not directly translate to increased physical activity. Further research should address how interventions should be tailored to promote physical activity after shunt surgery.Trial Registrationclinicaltrials.gov, Id: NCT02659111.
Understanding Magnetic Resonance Imaging in Multiple Sclerosis (UMIMS): Development and Piloting of an Online Education Program About Magnetic Resonance Imaging for People With Multiple Sclerosis
Authors: Freund Magalie , Schiffmann Insa , Rahn Anne Christin , Chard Declan , Lukas Carsten , Scheiderbauer Jutta , Sippel Anna , Heesen Christoph 
Published: March 2022

BackgroundPeople with multiple sclerosis (pwMS) lack sufficient magnetic resonance imaging (MRI) knowledge to truly participate in frequently occurring MRI-related therapy decisions. An evidence-based patient information (EBPI) about MRI is currently lacking.ObjectiveThe aim of this study was to develop an evidence-based online education program about limitations and benefits of MRI for pwMS. Ultimately, our goal was to improve MRI risk-knowledge, empower pwMS, and promote shared decision-making.MethodsThe program's contents were based on literature research and a previous pilot study. It was revised following 2 evaluation rounds with pwMS, MRI experts and expert patients. In a pilot study, n = 92 pwMS received access to the program for 4 weeks. User experiences and acceptance, MRI knowledge (MRI-RIKNO 2.0 questionnaire) and emotions and attitudes toward MRI (MRI-EMA questionnaire) were assessed. Results were compared to a previous survey population of n = 508 pwMS without access to the program.ResultsParticipants rated the program as easy to understand, interesting, relevant, recommendable, and encouraging. In comparison to pwMS without access to the program, MRI risk-knowledge and perceived MRI competence were higher.ConclusionSatisfaction with the program and good MRI-risk knowledge after usage demonstrates the need and applicability of EBPI about MRI in MS.
Urethra Sparing With Target Motion Mitigation in Dose-Escalated Extreme Hypofractionated Prostate Cancer Radiotherapy: 7-Year Results From a Phase II Study
Authors: Greco Carlo , Pares Oriol , Pimentel Nuno , Louro Vasco , Nunes Beatriz , Kociolek Justyna , Stroom Joep , Vieira Sandra , Mateus Dalila , Cardoso Maria Joao , Soares Ana , Marques Joao , Freitas Elda , Coelho Graça , Fuks Zvi 
Published: March 2022

PurposeTo explore whether the rectal distension-mediated technique, harnessing human physiology to achieve intrafractional prostate motion mitigation, enables urethra sparing by inverse dose painting, thus promoting dose escalation with extreme hypofractionated stereotactic ablative radiotherapy (SABR) in prostate cancer.Materials and MethodsBetween June 2013 and December 2018, 444 patients received 5 × 9 Gy SABR over 5 consecutive days. Rectal distension-mediated SABR was employed via insertion of a 150-cm3 air-inflated endorectal balloon. A Foley catheter loaded with 3 beacon transponders was used for urethra visualization and online tracking. MRI-based planning using Volumetric Modulated Arc Therapy - Image Guided Radiotherapy (VMAT-IGRT) with inverse dose painting was employed in delivering the planning target volume (PTV) dose and in sculpting exposure of organs at risk (OARs). A 2-mm margin was used for PTV expansion, reduced to 0 mm at the interface with critical OARs. All plans fulfilled Dmean ≥45 Gy. Target motion ≥2 mm/5 s motions mandated treatment interruption and target realignment prior to completion of the planned dose delivery.ResultsPatient compliance to the rectal distension-mediated immobilization protocol was excellent, achieving reproducible daily prostate localization at a patient-specific retropubic niche. Online tracking recorded ≤1-mm intrafractional target deviations in 95% of treatment sessions, while target realignment in ≥2-mm deviations enabled treatment completion as scheduled in all cases. The cumulative incidence rates of late grade ≥2 genitourinary (GU) and gastrointestinal (GI) toxicities were 5.3% and 1.1%, respectively. The favorable toxicity profile was corroborated by patient-reported quality of life (QOL) outcomes. Median prostate-specific antigen (PSA) nadir by 5 years was 0.19 ng/ml. The cumulative incidence rate of biochemical failure using the Phoenix definition was 2%, 16.6%, and 27.2% for the combined low/favorable–intermediate, unfavorable intermediate, and high-risk categories, respectively. Patients with a PSA failure underwent a 68Ga-labeled prostate-specific membrane antigen (68Ga-PSMA) scan showing a 20.2% cumulative incidence of intraprostatic relapses in biopsy International Society of Urological Pathology (ISUP) grade ≥3.ConclusionThe rectal distension-mediated technique is feasible and well tolerated. Dose escalation to 45 Gy with urethra-sparing results in excellent toxicity profiles and PSA relapse rates similar to those reported by other dose-escalated regimens. The existence of intraprostatic recurrences in patients with high-risk features confirms the notion of a high α/β ratio in these phenotypes resulting in diminished effectiveness with hypofractionated dose escalation.
Bibliometric Analysis of Global Research on Perinatal Palliative Care
Authors: Wang Yiting , Shan Chunjian , Tian Yingying , Pu Congshan , Zhu Zhu 
Published: March 2022

ObjectivesThe aim of this study was to perform a bibliometric analysis of publications related to perinatal palliative care to identify scientific output and research trends at a global level.MethodsThe Web of Science Core Collection database was searched to retrieve publications focusing on perinatal palliative care published between 2001 and 2020. All retrieved publications were identified by title and abstract for their relevance to perinatal palliative care. These eligible publications were extracted from the following data: title, abstract, year, keywords, author, organization, journal and cited literature. VOSviewer software was used to conduct bibliographic coupling, coauthorship, and cooccurrence analyses and to detect publication trends in perinatal palliative care research.ResultsA total of 114 publications concerning perinatal palliative care were included. The annual number of publications has increased dramatically in recent years. The United States has made the largest contribution to this field with the majority of publications (68, 59.6%) and citations (1,091, 70.5%) and with close collaborations with researchers in Canada, Portugal and Australia. Wool C and her institution, York College of Pennsylvania, are the respectively, most prolific author and institution in this field, publishing 18 papers (15.8%). Journal of Palliative Medicine is the leading and main journal in this field. According to the cooccurrence network analysis, five main research topics were identified: the candidates for PPC, service models and forms, framework components, parental perspectives and satisfaction, and challenges and needs of health care providers.ConclusionThe findings of this bibliometric study illustrate the current state and global trends of perinatal palliative care for the past two decades, which will help researchers determine areas of research focus and explore new directions for future research in this field.