bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in arm kinematics of chronic stroke individuals following “Assist-As-Asked” robot-assisted training in virtual and physical environments: A proof-of-concept study
Authors: Norouzi-Gheidari Nahid , Archambault Philippe S , Fung Joyce 
Published: June 2020

Introduction In this proof-of-concept study, we introduce a custom-developed robot-assisted training protocol, named “Assist-As-Asked”, aiming at improving arm function of chronic stroke subjects with moderate-to-severe upper extremity motor impairment. The study goals were to investigate the feasibility and potential adverse effects of this training protocol in both physical and virtual environments. Methods A sample of convenience of four chronic stroke subjects participated in 10 half-hour sessions. The task was to practice reaching six targets in both virtual and physical environments. The robotic arm used the Assist-As-Asked paradigm in which it helped subjects to complete movements when asked by them. Changes in the kinematics of the reaching movements and the participants’ perception of the reaching practice in both environments were the outcome measures of interest. Results Subjects improved their reaching performance and none of them reported any adverse events. There were no differences between the two environments in terms of kinematic measures even though subjects had different opinions about the environment preference. Conclusions Using the Assist-As-Asked protocol in moderate-to-severe chronic stroke survivors is feasible and it can be used with both physical and virtual environments with no evidence of one of them to be superior to the other based on users’ perspectives and movement kinematics.
Cotargeting BCL-2 and MCL-1 in high-risk B-ALL
Authors: Moujalled Donia M. , Hanna Diane T. , Hediyeh-zadeh Soroor , Pomilio Giovanna , Brown Lauren , Litalien Veronique , Bartolo Ray , Fleming Shaun , Chanrion Maïa , Banquet Sébastien , Maragno Ana-Leticia , Kraus-Berthier Laurence , Schoumacher Marie , Mullighan Charles G. , Georgiou Angela , White Christine A. , Lessene Guillaume , Huang David C. S. , Roberts Andrew W. , Geneste Olivier , Rasmussen Lorna , Davis Melissa J. , Ekert Paul G. , Wei Andrew , Ng Ashley P. , Khaw Seong L. 
Published: June 2020

Abstract
Improving survival outcomes in adult B-cell acute lymphoblastic leukemia (B-ALL) remains a clinical challenge. Relapsed disease has a poor prognosis despite the use of tyrosine kinase inhibitors (TKIs) for Philadelphia chromosome positive (Ph+ ALL) cases and immunotherapeutic approaches, including blinatumomab and chimeric antigen receptor T cells. Targeting aberrant cell survival pathways with selective small molecule BH3-mimetic inhibitors of BCL-2 (venetoclax, S55746), BCL-XL (A1331852), or MCL1 (S63845) is an emerging therapeutic option. We report that combined targeting of BCL-2 and MCL1 is synergistic in B-ALL in vitro. The combination demonstrated greater efficacy than standard chemotherapeutics and TKIs in primary samples from adult B-ALL with Ph+ ALL, Ph-like ALL, and other B-ALL. Moreover, combined BCL-2 or MCL1 inhibition with dasatinib showed potent killing in primary Ph+ B-ALL cases, but the BH3-mimetic combination appeared superior in vitro in a variety of Ph-like ALL samples. In PDX models, combined BCL-2 and MCL1 targeting eradicated ALL from Ph− and Ph+ B-ALL cases, although fatal tumor lysis was observed in some instances of high tumor burden. We conclude that a dual BH3-mimetic approach is highly effective in diverse models of high-risk human B-ALL and warrants assessment in clinical trials that incorporate tumor lysis precautions.
Systematic review and meta-analysis of outcomes in patients with suspected deep vein thrombosis
Authors: Patel Payal , Patel Parth , Bhatt Meha , Braun Cody , Begum Housne , Nieuwlaat Robby , Khatib Rasha , Martins Carolina C. , Zhang Yuan , Etxeandia-Ikobaltzeta Itziar , Varghese Jamie , Alturkmani Hani , Bahaj Waled , Baig Mariam , Kehar Rohan , Mustafa Ahmad , Ponnapureddy Rakesh , Sethi Anchal , Thomas Merrill , Wooldridge David , Lim Wendy , Bates Shannon M. , Lang Eddy , Le Gal Grégoire , Righini Marc , Wiercioch Wojtek , Schünemann Holger J. , Mustafa Reem A. 
Published: June 2020

Abstract
After deep vein thrombosis (DVT) is diagnosed, prompt evaluation and therapeutic intervention are of paramount importance for improvement in patient-important outcomes. We systematically reviewed patient-important outcomes in patients with suspected DVT, including mortality, incidence of pulmonary embolism (PE) and DVT, major bleeding, intracranial hemorrhage, and postthrombotic sequelae. We searched the Cochrane Central Register of Controlled Trials, Ovid Medline, Embase for eligible studies, references lists of relevant reviews, registered trials, and relevant conference proceedings. Two investigators screened and abstracted data. Nine studies with 5126 patients were included for lower extremity DVT. Three studies with 500 patients were included for upper extremity DVT. Among patients with lower extremity DVT, 0.85% (95% confidence interval [CI], 0% to 2.10%) and 0% developed recurrent DVT and PE, respectively, at 3 months. Among patients with upper extremity DVT, 0.49% (95% CI, 0% to 1.16%) and 1.98% (95% CI, 0.62% to 3.33%) developed recurrent DVT and PE, respectively, at 3 months. No major bleeding events were reported for those anticoagulated, which is lower than in other systematic reviews. For both upper and lower extremity DVT, low pretest probability patients with a negative D-dimer had a comparable incidence of VTE at 3 months (∼1%) as patients with a negative ultrasound (US). At higher pretest probabilities, negative US testing with or without serial US appears to be the safer option. In this review, we summarized the outcomes of patients evaluated by various diagnostic pathways. In most instances, there was significant limitation due to small population size or lack of direct evidence of effects of using a specific pathway. This systematic review was registered at PROSPERO as CRD42018100502.
The impact of a heat and moisture exchange mask on respiratory symptoms and airway response to exercise in asthma
Authors: Jackson Anna R. , Hull James H. , Hopker James G. , Fletcher Hannah , Gowers William , Birring Surinder S. , Dickinson John W. 
Published: June 2020

Respiratory symptoms, including cough, are prevalent in individuals with asthma when exercising. This study investigates whether a heat and moisture exchanger (HME) face mask is effective in modulating exercise-induced bronchoconstriction (EIB) and post-exercise cough in a cold, dry environment in individuals with asthma.Twenty-six participants diagnosed with asthma (20 males, 6 females) completed three cycling exercise challenges at 8°C and 24% relative humidity in a randomised order. Participants wore either an HME mask (MASK), sham mask (SHAM), or no mask (CONT). Following a 3-min warm-up, participants completed 6-min cycling at 80% peak power output. Before and after exercise, maximal flow-volume loops were recorded. Post-exercise cough was monitored with a Leicester Cough Monitor (LCM) for 24 h. Results were analysed using repeated-measures ANOVA and Friedman's tests and data were presented as the mean±sdor median (interquartile range (IQR)).Eleven participants failed to demonstrate EIB (i.e.>10% fall in forced expiratory volume in 1 s after exercise) and were removed from analysis. The percentage fall in forced expiratory volume in 1 s following exercise in CONT was greater than MASK (MASK: −6% (7%), SHAM: −11% (11%), CONT: −13% (9%); p<0.01). No difference was found between exercise in cough count per hour over the 24-h monitoring period or the number of coughs in the first hour after exercise.HME masks can attenuate EIB when exercising in cold, dry environments. The SHAM mask may not have been entirely inert, demonstrating the challenges of running randomised control trials utilising control and sham conditions.
Prevalence and risk factors of nocturnal enuresis among children ages 5–12 years in Xi’an, China: a cross-sectional study
Authors: Huang Hui-Mei , Wei Jing , Sharma Shristi , Bao Ying , Li Fei , Song Jian-Wen , Wu Hai-Bin , Sun Hong-Li , Li Zhi-Juan , Liu Huan-Nan , Wu Qian , Jiang Hong-Li 
Published: June 2020

Abstract
Background
Nocturnal enuresis (NE) has a negative impact on children’s health and imposes a long-term burden on families. With economic development and cultural improvements, parents and medical professionals pay more attention to NE. The aim of this study was to investigate the prevalence and risk factors of NE among children ages 5–12 years in Xi’an, China.

Methods
A stratified cluster sampling method was used to conduct a cross-sectional study of NE in 10 kindergartens and 20 primary schools in Xi’an. We used univariate analysis to compare the prevalences of characteristics such as gender, duration of disposable diaper (DD) use, toilet training onset time, daily living habits, academic performance, and family history of NE. Logistic regression analysis was used to calculate odds ratio and to determine risk factors of NE.

Results
The study included 6568 children ages 5–12 years, of which 262 (3.99%) had NE. The prevalence rates of NE decreased with age, with the highest prevalence at age 5 (9.09% for boys; 6.03% for girls). However, the prevalence increased with duration of DD use. Children experienced more NE if they never accepted toilet training (7.83%) or if they drank sugary beverages during the day (5.36%). Sleep disorders, sweets intake, drinking low amounts of plain water during the day, and family history of NE, were statistically associated with NE.

Conclusion
NE was closely associated with a family history of NE, being male, long-term use of DD, delayed toilet training, drinking sugary beverages and/or consuming little plain water, and sleep disorders. A supportive parental attitude towards NE and timely medical treatment can improve the quality of life of enuretic children.
RETRACTED ARTICLE: Angelica sinensis polysaccharide prevents mitochondrial apoptosis by regulating the Treg/Th17 ratio in aplastic anemia
Authors: Chen Zetao , Cheng Li , Zhang Jing , Cui Xing 
Published: June 2020

AbstractBackgroundAngelica sinensis polysaccharide (ASP) is an effective medicine for aplastic anemia (AA). The present study aims to investigate whether mitochondrial apoptosis in aplastic anemia could be corrected by ASP by adjusting an abnormal level of regulatory T cell (Treg)/ IL-17 secreting CD4 T cell (Th17) ratio.MethodsBALB/c mice were treated with 5.0 Gy Co60 γ -radiation. Then 2 × 106lymph node cells from DBA/2 donor mice were transplanted within 4 h after radiation. The mice in the various groups were fed saline or ASP for 2 weeks. For the in vitro experiment, bone marrow nucleated cells (BMNCs) and Treg cells were sorted from the mice on the 2nd day of modeling, and then cultured with or without ASP.ResultsThe mice treated with the medium dose of ASP for 14 days showed increased white blood cell (WBC), red blood cell (RBC), platelet (PLT), BMNC counts and Lin–Sca-1 + c-Kit+ (LSK) populations viability compared with the mice in the AA group mice. The data showed that ASP decreased damage to the mitochondrial outer membrane, improved the stabilization of the mitochondrial membrane, and corrected the abnormal levels of ROS and mitochondrial-associated apoptosis proteins, including the Bcl-2/Bax ratio and caspase-3 and caspase-9 expression, in BMNCs which were sorted from the bone marrow cells of AA mice. The changes to the p-P38/P38 and Treg/Th17 ratios induced by AA were also reversed by the medium dose of ASP. The same ASP effect including the Bcl-2/Bax and p-P38/P38 ratio, caspase-3 and caspase-9 expression of BMNCs were observed in vivo. The viability of Treg cells were increased by treatment of ASP in vivo.ConclusionsASP might prevent mitochondrial apoptosis to restore the function of hematopoietic stem cells by suppressing abnormal T-cell immunity in AA.
Veterinarians’ attitudes and practices regarding opioid-related vet shopping practices in tri-state Appalachian counties: an exploratory study
Authors: Patel Falguni C. , Raines Jeffrey A. , Kim Richard W. , Gruszynski Karen , Davis Robert E. , Sharma Manoj , Patterson Gilbert , Johnson Jason W. , Nahar Vinayak K. 
Published: June 2020

Abstract
Background
The opioid crisis continues to grow in the United States with 46,700 drug overdose deaths due to opioids in 2017 alone. Vet shopping, the practice of soliciting veterinarians for prescription medications, has been receiving national media attention in recent years. A 2014 review of Prescription Monitoring Drug Programs found less than 10 veterinary shoppers nationwide. Still much is unknown about the role of vet shopping and the opioid crisis. This study sought to understand the practice of vet shopping through the eyes of veterinarians practicing in Appalachian counties within the states of Kentucky, Tennessee, and Virginia, United States.

Results
Fourteen veterinarians were asked a set of 13 questions related to vet shopping. Results indicated that 13 veterinarians in the study had heard of the phenomenon of vet shopping and eight veterinarians had personally encountered vet shopping in their practices. Qualitative analysis of the interviews identified six key themes including a need for interprofessional communication and how important a valid veterinary-client-patient-relationship is within the profession.

Conclusions
The study hopefully sheds some light on the how often vet shopping is encountered in practice, concerns of veterinarians regarding vet shopping, and potential areas for improvement.
Performance of brief ICF-sleep disorders and obesity core set in obstructive sleep apnea patients
Authors: Xie Liang , Wu Qinhan , Hu Weiping , Li Wenjing , Xiang Guiling , Hao Shengyu , Guo Chengyao , Jiang Hong , Wu Xiaodan , Wu Xu , Li Shanqun 
Published: June 2020

Abstract
Background
Clinical questionnaires are mainly applied as screening tools for identification of the Obstructive sleep apnea (OSA) patients. Little attention has been paid to assess the body functions and health status of the patients. International Classification of Functioning, Disability and Health (ICF) was designed for better understanding and describing functioning and disability of patients. This study adopted the Brief ICF-Sleep Disorders and Obesity Core Set to evaluate the impairment of functioning and health status of OSA patients.

Methods
Five hundred ninety-two participants were enrolled in this cross-sectional study. Data were collected using Brief ICF-Sleep Disorders and Obesity Core Set Polysomnography was performed and basic characteristics of the patients were recorded.

Results
The scores for the component Body Functions and Code b130, b134, b140, b440, b530, s330, d160, d240, d450 of the two core sets were significantly different among the patients divided by apnea-hypopnea index (AHI) or oxygen saturation (SaO2) nadir, but the frequency of code s330, d160, d240, d450 was low. The Body Functions component of the both sets were closely related to neck circumference (NC), body mass index (BMI), apnea-hypopnea index (AHI) of the OSA patients. Body Functions of the Brief ICF-Sleep Disorders performed better with a threshold of 4 with sensitivity, specificity and area under the receiver operating characteristic curve (AUC) as 0.62, 0.74, 0.68(AHI ≥ 5), 0.69, 0.63, 0.66 (AHI ≥ 15), 0.75, 0.56, 0.66 (AHI ≥ 30), 0.56, 0.70, 0.63 (SaO2 nadir≤90%), 0.67, 0.66, 0.66 (SaO2 nadir<85%), 0.71, 0.59, 0.65 (SaO2 nadir<80%), separately.

Conclusion
The Body Functions component of both two sets could be an evaluation tool of impairment of body functions for OSA patients. The Brief ICF-Sleep Disorders Body Functions component performed better with a threshold of 4 and might provide a new insight for physicians to assess OSA patients.
Improving the evaluation of COPD exacerbation treatment effects by accounting for early treatment discontinuations: a post-hoc analysis of randomized clinical trials
Authors: Król Agnieszka , Palmér Robert , Rondeau Virginie , Rennard Stephen , Eriksson Ulf G. , Jauhiainen Alexandra 
Published: June 2020

Abstract
Background
Chronic obstructive pulmonary disease (COPD) clinical trials aimed at evaluating treatment effects on exacerbations often suffer from early discontinuations of randomized treatment. Treatment discontinuations imply a loss of information and should ideally be considered in the statistical analysis of trial results, particularly if the discontinuations are related to the disease or treatment itself. Here, we explore this issue by investigating (1) whether there exists an association between the risks of exacerbation and treatment discontinuation in COPD clinical trials and (2) whether disregarding this association can cause bias in exacerbation treatment effect estimates. We focus on the hypothetical estimand, i.e. the treatment effect that would have been observed had all subjects completed the trial as planned.

Methods
The association between exacerbation and discontinuation risks was analysed by applying a joint frailty (random effect) model – allowing for the simultaneous analysis of multiple types of correlated events – to data from five Phase III-IV COPD clinical trials. Specifically, the impact of the association on exacerbation treatment effect estimates was assessed by comparing the treatment hazard ratios of the joint frailty model to the rate/hazard ratios of two related statistical models (the negative binomial and shared frailty models), which both assume discontinuations to be unrelated to the trial outcome. The models were also compared using simulated data.

Results
A statistically significant (p < 0.0001), positive association between exacerbation and discontinuation risks was found in all trials. Importantly, simulations confirmed that – with such an association – models disregarding the association risk producing biased results (> 5 percentage point difference in hazard/rate ratio). For some treatment comparisons in the clinical trials, the difference in treatment effect estimates between the joint frailty and the other models was as high as 10–15 percentage points. The difference was affected by the strength of the exacerbation-discontinuation association, the population heterogeneity in exacerbation risk, and the difference in discontinuation rates between treatment arms.

Conclusions
We have identified an association between the risks of exacerbation and treatment discontinuation in five COPD clinical trials. We recommend using the joint frailty model to account for this association when estimating exacerbation treatment effects, particularly when targeting the hypothetical estimand.
Adoption of a dedicated multidisciplinary team is associated with improved survival in acute pulmonary embolism
Authors: Myc Lukasz A. , Solanki Jigna N. , Barros Andrew J. , Nuradin Nebil , Nevulis Matthew G. , Earasi Kranthikiran , Richardson Emily D. , Tsutsui Shawn C. , Enfield Kyle B. , Teman Nicholas R. , Haskal Ziv J. , Mazimba Sula , Kennedy Jamie L. W. , Mihalek Andrew D. , Sharma Aditya M. , Kadl Alexandra 
Published: June 2020

AbstractBackgroundAcute pulmonary embolism remains a significant cause of mortality and morbidity worldwide. Benefit of recently developed multidisciplinary PE response teams (PERT) with higher utilization of advanced therapies has not been established.MethodsTo evaluate patient-centered outcomes and cost-effectiveness of a multidisciplinary PERT we performed a retrospective analysis of 554 patients with acute PE at the university of Virginia between July 2014 and June 2015 (pre-PERT era) and between April 2017 through October 2018 (PERT era). Six-month survival, hospital length-of-stay (LOS), type of PE therapy, and in-hospital bleeding were assessed upon collected data.Results317 consecutive patients were treated for acute PE during an 18-month period following institution of a multidisciplinary PE program; for 120 patients PERT was activated (PA), the remaining 197 patients with acute PE were considered as a separate, contemporary group (NPA). The historical, comparator cohort (PP) was composed of 237 patients. These 3 groups were similar in terms of baseline demographics, comorbidities and risk, as assessed by the Pulmonary Embolism Severity Index (PESI). Patients in the historical cohort demonstrated worsened survival when compared with patients treated during the PERT era. During the PERT era no statistically significant difference in survival was observed in the PA group when compared to the NPA group despite significantly higher severity of illness among PA patients. Hospital LOS was not different in the PA group when compared to either the NPA or PP group. Hospital costs did not differ among the 3 cohorts. 30-day re-admission rates were significantly lower during the PERT era. Rates of advanced therapies were significantly higher during the PERT era (9.1% vs. 2%) and were concentrated in the PA group (21.7% vs. 1.5%) without any significant rise in in-hospital bleeding complications.ConclusionsAt our institution, all-cause mortality in patients with acute PE has significantly and durably decreased with the adoption of a PERT program without incurring additional hospital costs or protracting hospital LOS. Our data suggest that the adoption of a multidisciplinary approach at some institutions may provide benefit to select patients with acute PE.
Decreased detection of ESBL- or pAmpC-producing Escherichia coli in broiler breeders imported into Sweden
Authors: Nilsson Oskar , Börjesson Stefan , Landén Annica , Greko Christina , Bengtsson Björn 
Published: June 2020

AbstractIn the spring of 2010, it was discovered that a large proportion of broilers in Sweden were colonized with Escherichia coli producing extended-spectrum beta-lactamases (ESBL) or plasmid mediated AmpC (pAmpC). It was hypothesized that the high prevalence was due to transfer from an upper level in the production pyramid and sampling upwards in the production pyramid was initiated. From 2010 to 2019, all shipments (n = 122) of broiler breeders were screened on arrival to Sweden for the occurrence of ESBL- or pAmpC-producing E. coli using selective methods. Samples of paper linings from shipments of breeders were cultured on MacConkey agar supplemented with cefotaxime (1 mg/L) after pre-enrichment in either MacConkey broth with cefotaxime (1 mg/L), or from late June 2015 in buffered peptone water without antibiotics. ESBL- or pAmpC-producing E. coli was isolated from 43 (35%) of these. Over the years, the proportion of positive imports have decreased and during 2018 and 2019 all imports were negative. In conclusion, the occurrence of ESBL- or pAmpC-producing E. coli in broiler breeders on arrival to Sweden has decreased. Such bacteria have not been detected in any shipments since 2017.