cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.29514806
title: Robot-assisted technique versus freehand technique for spine surgery: an umbrella review

description: Pedicle screw internal fixation is a significant method for maintaining spinal stability. Despite the existence of numerous systematic reviews and meta-analyses that have evaluated the efficacy and safety of robotic-assisted compared to freehand technique, a comprehensive evaluation of the evidence’s strength and quality remains to be conducted. A comprehensive search of five major databases (i.e. PubMed, Embase, Cochrane, Web of Science, and Scopus) was conducted up to May 2024. The present umbrella review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The quality of the included meta-analysis was evaluated by AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews). The quality of the evidence for each association was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. The present study incorporated a total of 22 meta-analyses, encompassing randomized clinical trials, cohort studies, and observational studies. A total of 14 associations with ‘perfect’ pedicle screw, ‘clinically acceptable’ pedicle screw, complications, facet joint violation, intraoperative radiation dose, intraoperative radiation time, and other related outcomes were evaluated in this umbrella review. Robot-assisted techniques in spine surgery have been found to be beneficial. The quality of the majority of the associations ranged from low to very low, indicating that flaws were certain in the current meta-analyses. This umbrella review indicated potential advantages of robotic-assisted technique for spine surgery, despite these findings with low certainty of the evidence, and cautious interpretation and application in clinical practice are needed.
DOI: 10.6084/m9.figshare.29514806.v1
title: Robot-assisted technique versus freehand technique for spine surgery: an umbrella review

description: Pedicle screw internal fixation is a significant method for maintaining spinal stability. Despite the existence of numerous systematic reviews and meta-analyses that have evaluated the efficacy and safety of robotic-assisted compared to freehand technique, a comprehensive evaluation of the evidence’s strength and quality remains to be conducted. A comprehensive search of five major databases (i.e. PubMed, Embase, Cochrane, Web of Science, and Scopus) was conducted up to May 2024. The present umbrella review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The quality of the included meta-analysis was evaluated by AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews). The quality of the evidence for each association was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. The present study incorporated a total of 22 meta-analyses, encompassing randomized clinical trials, cohort studies, and observational studies. A total of 14 associations with ‘perfect’ pedicle screw, ‘clinically acceptable’ pedicle screw, complications, facet joint violation, intraoperative radiation dose, intraoperative radiation time, and other related outcomes were evaluated in this umbrella review. Robot-assisted techniques in spine surgery have been found to be beneficial. The quality of the majority of the associations ranged from low to very low, indicating that flaws were certain in the current meta-analyses. This umbrella review indicated potential advantages of robotic-assisted technique for spine surgery, despite these findings with low certainty of the evidence, and cautious interpretation and application in clinical practice are needed.
DOI: 10.6084/m9.figshare.29646662
title: Association of transfer time and delays with outcomes for patients with acute pulmonary embolism requiring interhospital transfer: a retrospective observational study

description: Interhospital transfer (IHT) for pulmonary embolism (PE) is increasingly performed to improve access to advanced reperfusion therapies, but it is unclear if IHT times influence overall outcomes. We studied the association between transfer times and outcomes of patients with acute PE requiring IHT. 139 patients with acute PE undergoing IHT to the Mount Sinai Health System between September 2021 and June 2023 were retrospectively studied. Primary outcomes were 30-day mortality and 30-day major bleeding. ‘Door to IHT’ time was defined as the time from diagnosis of acute PE to the time patient physically arrived in the receiving hospital. Patients were divided into groups based on quartiles of ‘door to IHT’ time; those within the first and fourth quartiles of ‘door to IHT’ time were compared using propensity score-weighted analyses. The propensity score was calculated from six variables: age, sex, BMI [Body Mass Index], PESI [PE Severity Index] score, ESC [European Society of Cardiology] risk class and presence of a central PE. Multivariable regression models were fitted within the propensity score-matched sample to assess the association of ‘door to IHT’ time with primary outcomes. Median age of included patients was 61 years and 76 (54.7%) were women. Median PESI score was 88 points. Median ‘door to IHT’ time was 10.8 (IQR: 7.3–19.4) hours. Rates of 30-day mortality and 30-day major bleeding were 7.2% and 2.2%. Within propensity score-weighted analyses, no significant associations were found between ‘door to IHT’ time and any of the primary outcomes (30-day mortality or 30-day major bleeding). In this retrospective study of patients with acute PE undergoing IHT, differences in ‘door to IHT’ time were not significantly associated with 30-day mortality or 30-day major bleeding. This suggests that delays in IHT do not adversely influence outcomes of patients with acute PE undergoing IHT.
DOI: 10.6084/m9.figshare.29646662.v1
title: Association of transfer time and delays with outcomes for patients with acute pulmonary embolism requiring interhospital transfer: a retrospective observational study

description: Interhospital transfer (IHT) for pulmonary embolism (PE) is increasingly performed to improve access to advanced reperfusion therapies, but it is unclear if IHT times influence overall outcomes. We studied the association between transfer times and outcomes of patients with acute PE requiring IHT. 139 patients with acute PE undergoing IHT to the Mount Sinai Health System between September 2021 and June 2023 were retrospectively studied. Primary outcomes were 30-day mortality and 30-day major bleeding. ‘Door to IHT’ time was defined as the time from diagnosis of acute PE to the time patient physically arrived in the receiving hospital. Patients were divided into groups based on quartiles of ‘door to IHT’ time; those within the first and fourth quartiles of ‘door to IHT’ time were compared using propensity score-weighted analyses. The propensity score was calculated from six variables: age, sex, BMI [Body Mass Index], PESI [PE Severity Index] score, ESC [European Society of Cardiology] risk class and presence of a central PE. Multivariable regression models were fitted within the propensity score-matched sample to assess the association of ‘door to IHT’ time with primary outcomes. Median age of included patients was 61 years and 76 (54.7%) were women. Median PESI score was 88 points. Median ‘door to IHT’ time was 10.8 (IQR: 7.3–19.4) hours. Rates of 30-day mortality and 30-day major bleeding were 7.2% and 2.2%. Within propensity score-weighted analyses, no significant associations were found between ‘door to IHT’ time and any of the primary outcomes (30-day mortality or 30-day major bleeding). In this retrospective study of patients with acute PE undergoing IHT, differences in ‘door to IHT’ time were not significantly associated with 30-day mortality or 30-day major bleeding. This suggests that delays in IHT do not adversely influence outcomes of patients with acute PE undergoing IHT.
DOI: 10.6084/m9.figshare.30928037
title: Unveiling structural damage of the corpus callosum in amyotrophic lateral sclerosis through diffusion tensor imaging and spread direction perspectives

description: Damage to the corpus callosum (CC) in amyotrophic lateral sclerosis (ALS) patients has been confirmed <i>via</i> electrophysiological, neuroimaging, and autopsy studies. Additionally, the CC is hypothesized to serve as a pathway for the spread of pathological information. This study aimed to investigate whether the CC plays a mediating role in the symptomatic spread of ALS. In this observational study, diffusion tensor imaging (DTI) data were acquired from 45 individuals with the upper motor neuron-dominant (UMN-D) phenotype of ALS. The UMN-D ALS patients were categorized into two groups based on the direction of symptom spread, including 25 patients with horizontal spread (group H) and 20 patients with vertical spread (group V). Diffusivity indices were derived through whole-brain analysis and probabilistic fiber tracking. According to the voxel-based analysis and tract-based spatial statistics, differences in axial diffusivity (AD) in the CC were observed between disease subgroups, with patients in group H showing higher AD values than those in group V. Fiber tracking analysis revealed persistent differences in the AD indices of CC-primary motor cortex (PMC) fibers between the two disease subgroups. In UMN-D ALS patients, the direction of symptom spread may be related to the degree of CC involvement. The AD metric may be a more specific indicator of CC damage.
DOI: 10.6084/m9.figshare.30928037.v1
title: Unveiling structural damage of the corpus callosum in amyotrophic lateral sclerosis through diffusion tensor imaging and spread direction perspectives

description: Damage to the corpus callosum (CC) in amyotrophic lateral sclerosis (ALS) patients has been confirmed <i>via</i> electrophysiological, neuroimaging, and autopsy studies. Additionally, the CC is hypothesized to serve as a pathway for the spread of pathological information. This study aimed to investigate whether the CC plays a mediating role in the symptomatic spread of ALS. In this observational study, diffusion tensor imaging (DTI) data were acquired from 45 individuals with the upper motor neuron-dominant (UMN-D) phenotype of ALS. The UMN-D ALS patients were categorized into two groups based on the direction of symptom spread, including 25 patients with horizontal spread (group H) and 20 patients with vertical spread (group V). Diffusivity indices were derived through whole-brain analysis and probabilistic fiber tracking. According to the voxel-based analysis and tract-based spatial statistics, differences in axial diffusivity (AD) in the CC were observed between disease subgroups, with patients in group H showing higher AD values than those in group V. Fiber tracking analysis revealed persistent differences in the AD indices of CC-primary motor cortex (PMC) fibers between the two disease subgroups. In UMN-D ALS patients, the direction of symptom spread may be related to the degree of CC involvement. The AD metric may be a more specific indicator of CC damage.
DOI: 10.6084/m9.figshare.28637841
title: A score prediction model for predicting the heterogeneity symptom trajectories among lung cancer patients during perioperative period: a longitudinal observational study

description: Patients undergoing video-assisted thoracoscopic surgery (VATs) for lung cancer (LC) frequently experience prolonged symptoms that can significantly affect their quality of life (QoL). This study employed a longitudinal observational design. The MDASI and QLQ-C30 were utilized to evaluate symptoms and QoL one day before surgery, as well as at 1 day, 2 weeks, and 1, 2, and 3 months post-surgery. Latent class growth modeling (LCGM) was employed to identify heterogeneous trajectories. By Logistic regression analysis, a score prediction model was developed based on predictive factors, which was internally validated utilizing 1000 bootstrap samples. The SHaply Additive Explanations (SHAP) was used to calculating the contribution of each factor. 205 participants participated in this study. The predominant postoperative complaints included fatigue, shortness of breath, pain, and coughing. Two distinct classes of symptom trajectories were identified: ‘severe group’ and ‘mild group’. Four independent predictors of heterogeneous symptom trajectories were used to develop a scoring model. The area under the receiver operating characteristic curve for this model was 0.742 (95% CI: 0.651–0.832). And the calibration curves demonstrated strong concordance between anticipated probability and actual data (mean absolute error: 0.033). Furthermore, the decision curve analysis (DCA) indicated higher net benefit than other four single factors. SHAP highlighted WBC and surgical duration time as the most influential features. We established a score model to predict the occurrence of severe symptom trajectories 3 months postoperatively, promoting recovery by advancing rehabilitation plan based on preoperative and surgical situation. ClinicalTrials.gov (ChiCTR2100044776).
DOI: 10.6084/m9.figshare.28081943
title: Identification of ALDH7A1 as a DNA-methylation-driven gene in lung squamous cell carcinoma

description: Deoxyribose nucleic acid (DNA) methylation is an important epigenetic modification that plays an important role in the occurrence and development of tumors. Identifying key methylation-driven genes that affect the prognosis of lung squamous cell carcinoma (LUSC) can provide direction for targeted therapy research. Methylation and RNA-seq data were downloaded from The Cancer Genome Atlas (TCGA). The MethylMix package was used to integrate and analyze the methylation and gene expression data from TCGA, and the LUSC dataset (GSE37745) was downloaded from GEO for validation. Forty-five DNA-methylation-driven genes (MDGs) were obtained, and 3 genes (TRIM61, SMIM22, and ALDH7A1) were significantly associated with survival by using univariate and multivariate Cox regression. A risk model was constructed. KM analysis showed that patients with high-risk scores had poor survival. A nomination plot for prognosis prediction of LUSC patients was constructed, which showed a good predictive efficiency for tumor prognosis. The high expression of ALDH7A1 was an independent risk factor for poor prognosis in LUSC. The expression of ALDH7A1 in LUSC was negatively correlated with its methylation status (COR = −0.655). GSEA analysis showed that high expression of ALDH7A1 could activate multiple signaling pathways (JAK-STAT signaling pathway and mTOR signaling pathway). <i>In vitro</i> cell experiments confirmed that in LUSC, silencing ALDH7A1 could inhibit tumor progression, while overexpression of ALDH7A1 could promote tumor progression. Our results indicated that ALDH7A1, a newly discovered MDG in LUSC, could act as an independent prognostic factor for OS in LUSC, with the potential to become a potential target for LUSC diagnosis and treatment. High expression of ALDH7A1 in LUSC could promote the occurrence and development of tumors. Signaling pathways, such as JAK-STAT and mTOR signaling pathways, might regulate the high expression of ALDH7A1.
DOI: 10.6084/m9.figshare.28081943.v1
title: Identification of ALDH7A1 as a DNA-methylation-driven gene in lung squamous cell carcinoma

description: Deoxyribose nucleic acid (DNA) methylation is an important epigenetic modification that plays an important role in the occurrence and development of tumors. Identifying key methylation-driven genes that affect the prognosis of lung squamous cell carcinoma (LUSC) can provide direction for targeted therapy research. Methylation and RNA-seq data were downloaded from The Cancer Genome Atlas (TCGA). The MethylMix package was used to integrate and analyze the methylation and gene expression data from TCGA, and the LUSC dataset (GSE37745) was downloaded from GEO for validation. Forty-five DNA-methylation-driven genes (MDGs) were obtained, and 3 genes (TRIM61, SMIM22, and ALDH7A1) were significantly associated with survival by using univariate and multivariate Cox regression. A risk model was constructed. KM analysis showed that patients with high-risk scores had poor survival. A nomination plot for prognosis prediction of LUSC patients was constructed, which showed a good predictive efficiency for tumor prognosis. The high expression of ALDH7A1 was an independent risk factor for poor prognosis in LUSC. The expression of ALDH7A1 in LUSC was negatively correlated with its methylation status (COR = −0.655). GSEA analysis showed that high expression of ALDH7A1 could activate multiple signaling pathways (JAK-STAT signaling pathway and mTOR signaling pathway). <i>In vitro</i> cell experiments confirmed that in LUSC, silencing ALDH7A1 could inhibit tumor progression, while overexpression of ALDH7A1 could promote tumor progression. Our results indicated that ALDH7A1, a newly discovered MDG in LUSC, could act as an independent prognostic factor for OS in LUSC, with the potential to become a potential target for LUSC diagnosis and treatment. High expression of ALDH7A1 in LUSC could promote the occurrence and development of tumors. Signaling pathways, such as JAK-STAT and mTOR signaling pathways, might regulate the high expression of ALDH7A1.
DOI: 10.6084/m9.figshare.28637841.v1
title: A score prediction model for predicting the heterogeneity symptom trajectories among lung cancer patients during perioperative period: a longitudinal observational study

description: Patients undergoing video-assisted thoracoscopic surgery (VATs) for lung cancer (LC) frequently experience prolonged symptoms that can significantly affect their quality of life (QoL). This study employed a longitudinal observational design. The MDASI and QLQ-C30 were utilized to evaluate symptoms and QoL one day before surgery, as well as at 1 day, 2 weeks, and 1, 2, and 3 months post-surgery. Latent class growth modeling (LCGM) was employed to identify heterogeneous trajectories. By Logistic regression analysis, a score prediction model was developed based on predictive factors, which was internally validated utilizing 1000 bootstrap samples. The SHaply Additive Explanations (SHAP) was used to calculating the contribution of each factor. 205 participants participated in this study. The predominant postoperative complaints included fatigue, shortness of breath, pain, and coughing. Two distinct classes of symptom trajectories were identified: ‘severe group’ and ‘mild group’. Four independent predictors of heterogeneous symptom trajectories were used to develop a scoring model. The area under the receiver operating characteristic curve for this model was 0.742 (95% CI: 0.651–0.832). And the calibration curves demonstrated strong concordance between anticipated probability and actual data (mean absolute error: 0.033). Furthermore, the decision curve analysis (DCA) indicated higher net benefit than other four single factors. SHAP highlighted WBC and surgical duration time as the most influential features. We established a score model to predict the occurrence of severe symptom trajectories 3 months postoperatively, promoting recovery by advancing rehabilitation plan based on preoperative and surgical situation. ClinicalTrials.gov (ChiCTR2100044776).
DOI: 10.6084/m9.figshare.30691943
title: Study protocol for low-dose evaluation of aspirin in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention (LEAST): a multicenter, double-blind, randomized controlled clinical trial

description: Dual antiplatelet therapy (DAPT) with aspirin and ticagrelor is standard treatment for ST-elevation myocardial infarction (STEMI). While the optimal ticagrelor dose is established, the ideal aspirin maintenance dose remains debatable, particularly in East Asian populations who demonstrate enhanced bleeding sensitivity with standard antiplatelet regimens compared to Western populations. The Low-dose Evaluation of Aspirin in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention (LEAST) trial is a multicenter, randomized, double-blind, placebo-controlled trial comparing low-dose (50 mg/d) versus standard-dose (100 mg/d) aspirin combined with ticagrelor (90 mg twice daily) in Chinese STEMI patients post-percutaneous coronary intervention. A total of 3612 patients will be enrolled from 34 centers across China using stratified randomization by age and multivessel disease status. The primary endpoint is 12-month composite of cardiac death, non-fatal myocardial infarction, non-fatal stroke, and ischemia-driven target vessel revascularization (non-inferiority testing with 1.5% absolute difference margin). The key secondary endpoint is Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding (superiority testing). A hierarchical testing strategy ensures bleeding benefits are only claimed when ischemic safety has been established. This trial will provide evidence regarding optimal aspirin maintenance dose in Chinese STEMI patients receiving DAPT with ticagrelor. The findings may support development of population-specific antithrombotic strategies that better balance efficacy and safety in East Asian populations. The LEAST trial addresses an important knowledge gap regarding optimal aspirin dosing in Chinese STEMI patients and may influence future guideline recommendations for acute coronary syndrome management in Asian populations. ClinicalTrials.gov (NCT06756945)
DOI: 10.6084/m9.figshare.30691943.v1
title: Study protocol for low-dose evaluation of aspirin in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention (LEAST): a multicenter, double-blind, randomized controlled clinical trial

description: Dual antiplatelet therapy (DAPT) with aspirin and ticagrelor is standard treatment for ST-elevation myocardial infarction (STEMI). While the optimal ticagrelor dose is established, the ideal aspirin maintenance dose remains debatable, particularly in East Asian populations who demonstrate enhanced bleeding sensitivity with standard antiplatelet regimens compared to Western populations. The Low-dose Evaluation of Aspirin in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention (LEAST) trial is a multicenter, randomized, double-blind, placebo-controlled trial comparing low-dose (50 mg/d) versus standard-dose (100 mg/d) aspirin combined with ticagrelor (90 mg twice daily) in Chinese STEMI patients post-percutaneous coronary intervention. A total of 3612 patients will be enrolled from 34 centers across China using stratified randomization by age and multivessel disease status. The primary endpoint is 12-month composite of cardiac death, non-fatal myocardial infarction, non-fatal stroke, and ischemia-driven target vessel revascularization (non-inferiority testing with 1.5% absolute difference margin). The key secondary endpoint is Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding (superiority testing). A hierarchical testing strategy ensures bleeding benefits are only claimed when ischemic safety has been established. This trial will provide evidence regarding optimal aspirin maintenance dose in Chinese STEMI patients receiving DAPT with ticagrelor. The findings may support development of population-specific antithrombotic strategies that better balance efficacy and safety in East Asian populations. The LEAST trial addresses an important knowledge gap regarding optimal aspirin dosing in Chinese STEMI patients and may influence future guideline recommendations for acute coronary syndrome management in Asian populations. ClinicalTrials.gov (NCT06756945)