bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care coordination guidelines for the care of people with spina bifida
Authors: Van Speybroeck Alexander , Beierwaltes Patricia , Hopson Betsy , McKee Suzanne , Raman Lisa , Rao Ravindra , Sherlock Rebecca 
Published: December 2020

Care coordination is the deliberate organization of patient care activities between two or more participants (including the patient) involved in a person’s care to facilitate the appropriate delivery of health care services. Organizing care involves the marshalling of personnel and other resources needed to carry out all required patient care activities. It is often managed by the exchange of information among participants responsible for different aspects of care [1]. With an estimated 85% of individuals with Spina Bifida (SB) surviving to adulthood, SB specific care coordination guidelines are warranted. Care coordination (also described as case management services) is a process that links them to services and resources in a coordinated effort to maximize their potential by providing optimal health care. However, care can be complicated due to the medical complexities of the condition and the need for multidisciplinary care, as well as economic and sociocultural barriers. It is often a shared responsibility by the multidisciplinary Spina Bifida team [2]. For this reason, the Spina Bifida Care Coordinator has the primary responsibility for overseeing the overall treatment plan for the individual with Spina Bifida[3]. Care coordination includes communication with the primary care provider in a patient’s medical home. This article discusses the Spina Bifida Care Coordination Guideline from the 2018 Spina Bifida Association’s Fourth Edition of the Guidelines for the Care of People with Spina Bifida and explores care coordination goals for different age groups as well as further research topics in SB care coordination.
Comparison of active-assisted and active-unassisted robot-mediated upper limb therapy in subacute stroke
Authors: Pila Ophélie , Koeppel Typhaine , Grosmaire Anne-Gaëlle , Duret Christophe 
Published: December 2020

Background: Upper-limb robot-mediated therapy is usually carried out in active-assisted mode because it enables performance of many movements. However, assistance may reduce the patient’s own efforts which could limit motor recovery. Objective: The aim of this study was to compare the effects of active-assisted and active-unassisted robotic interactions on motor recovery in subacute stroke patients with moderate hemiparesis. Methods: Fourteen patients underwent a 6-week combined upper limb program of usual therapy and robotic therapy using either the active-unassisted ( n = 8) or active-assisted ( n = 6) modes. In the active-assisted group, assistance was only provided for the first 3 weeks (1st period) and was then switched off for the remaining 3 weeks (2nd period). The Fugl-Meyer Assessment (FMA) was carried out pre- and post-treatment. The mean number of movements performed and the mean working distance during the 1st and 2nd periods were compared between groups. Results: FMA score improved post-treatment in both groups with no between-group differences: active-assisted group: +8±6 pts vs active-unassisted group: +10±6 pts (ns). Between the 1st and 2nd periods, there was a statistical trend towards an improvement in the number of movements performed ( p = 0.06) in the active-unassisted group (526±253 to 783±434, p = 0.06) but not in the active-assisted group (882±211 to 880±297, ns). Another trend of improvement was found for the working distance in the active-unassisted group (8.7±4.5 to 9.9±4.7, p = 0.09) but not in the active-assisted group (14.0±0 to 13.5±1.1, ns). Conclusions: The superiority of the non-assistive over assistive robotic modes has not been demonstrated. However, the non-assistive mode did not appear to reduce motor recovery in this population, despite the performance of fewer movements on shorter working distance compared with the group who had assistance. It seems that the requirement of effort could be a determinant factor for recovery in neurorehabilitation however further well-design studies are needed to fully understand this phenomenon.
Pluricentric Languages Policy Features through the Example of French
Authors: Ivanova V. A. , Ulianitckaia L. A. 
Published: December 2020

Introduction.The paper reviews features of the French language policy inFrance,Belguim,Canada, andSwitzerland. The novelty of the study is implied by the fact that features of the language policy are analyzed with previously unknown circumstances taken into account: the circumstances that allow French to be seen as a pluricentric language. The relevance of the study is conditioned by the necessity of observing the sociopolitical space of language functioning, as well as the importance of both analyzing the dynamics of pluricentric languages spreading and identifying mechanisms of using a single language for either uniting disparate nations or countries manipulating.Methodology and sources.The method of the study is a comprehensive approach with a number of linguistic and social variables correlations. The study was conducted using official websites of Organisation international dela Francophonie describing official bodies and institutions responsible for language policy implementation, as well as articles of various publications (Le soir, The Guardian, Ethnologies), devoted to the discussion of French norm regulation problems as the material of the study.Resultsanddiscussion.The main result of the study is a review of the status of French as a pluricentric language worldwide, particularly in countries considered to be centres of French variants development and having French as an official language. Main features of a pluricentric language, as well as the factors that turn a monocentric language into a pluricentric one (through the example of French) are looked at. The actions taken by the Organisation internationale dela Francophonie and aimed at the strengthening of relations between French-speaking countries and the promoting of the French language worldwide are described. The study also illustrates the dependence of peripheral language centres fromFrance. An emphasis is put on the politics of the Académie Française aimed at the French language unification in all the countries having it as an official language. An assumption on the reasons of different deviation extent of French variants inCanada,Belgium, andSwitzerland from Standard French is made.Conclusion.It is impossible to consider language to be an independent and isolated phenomenon as it exists and evolves within society serving its needs. Institutions pursuing a language policy are in position to affect its development directly, yet in the context of pluricentric languages it is insufficient to have a single centre of linguistic regulation. Local institutions may have a policy that runs contrary to the language policy of the centre. Gender reforms can also become a new wave of linguistic changes leading to further distancing of different language variants.
THE CONUNDRUM OF INTERNET OF THINGS ADOPTION IN HIGHER EDUCATIONAL INSTITUTIONS
Authors: May Amy Yeo Chu , Tan Gim Guan , Carter Steve 
Published: December 2020

This study aims to extend the evaluation and understanding of an individuals’ adoption intention towards the Internet of Things (IoT) in a higher educational context and also to assess the relationship between Perceived Benefits, Digital Culture and Mindset, Technological Motivator, Technological Inhibitor and Attitude and how these factors relate to the adoption of Internet of Things (IoT) behavior. The research employed a quantitative and cross-sectional approach. A sample of 202 respondents from a Malaysian educational institution was collected through a self-designed questionnaire based on a snowball sampling technique. The data collected were analyzed using SmartPLS. The results indicate that attitude, technological motivator and digital mindset have a significant effect on the IoT adoption intention. Of these, attitude has the greatest influence with regard to the decision to adopt any IoT products or services. Digital mindset was a salient factor that explained user’s adoption intention behaviour on IoT technologies. Perceived benefits, however, showed insignificant direct effect whereas the technological inhibitor perspective affects the IoT adoption intention through attitude factor. The research provides further evidence that attitude and digital mindset built up within the individual are crucial elements to be considered in justifying the adoption behavior of IoT. The research findings show how the adoption of IoT could help academic staff and students leverage technologies' benefits to improve work and academic performance. It also highlights the importance of trust and builds the required attitude to support the technology to industry players. This study did not account for motivators such as incentives or influence from authority figures (leaders, top management, government and policy maker) as well as environmental conditions, namely the readiness of the infrastructure and the commonality of the usage in the social group.
Pakistan’s Infrastructure Capital-Growth Analysis
Authors: Mazher Muhammad Ahmad , Dahalan Jauhari 
Published: December 2020

Purpose- This empirical study facet at Pakistan for the period between 1960 and 2017 in the connection between public investment, public capital stock, private investment, private capital stock, and real GDP. Design/Methodology- Using theoretical and empirical literature assessment, to measure the impact of private investment, private capital stock, government investment, and government capital stock on Pakistan's real gross domestic product, we involved the ARDL Bound tests. Findings- A positive and significant connection was revealed between government investment, a private capital stock with real GDP. Private investment showed a substantial but negative impact in the short run, despite capital stocks indicating a positive and insignificant relationship with Pakistan's RGDP. The long-term consequences showed that the government's capital stocks, public investment, private capital stocks, and RGDP from Pakistan are linked positively and significantly. Private investment, however, has shown harmful and detrimental or insignificant relations with Pakistan's RGDP. Practical Implications- Our study may benefit the Pakistani economy, particularly while useful for academics and researchers to understand the basic concept of 'capital-growth' philosophy.
Diagnostic Value of Metagenomic Next-Generation Sequencing for the Detection of Pathogens in Bronchoalveolar Lavage Fluid in Ventilator-Associated Pneumonia Patients
Authors: Fang Xiaowei , Mei Qing , Fan Xiaoqin , Zhu Chunyan , Yang Tianjun , Zhang Lei , Geng Shike , Pan Aijun 
Published: December 2020

Objective: To evaluate the diagnostic performance of metagenomic next-generation sequencing (mNGS) using bronchoalveolar lavage fluid (BALF) in patients with ventilator-associated pneumonia (VAP).Methods: BALF samples of 72 patients with VAP were collected from August 2018 to May 2020. The diagnostic performance of conventional testing (CT) and mNGS methods were compared based on bacterial and fungal examinations. The diagnostic value of mNGS for viral and mixed infections was also analyzed.Results: The percentage of mNGS positive samples was significantly higher than that estimated by the CT method [odds ratio (OR), 4.33; 95% confidence interval (CI), 1.78–10.53; p &lt; 0.001]. The sensitivity and specificity of mNGS for bacterial detection were 97.1% (95% CI, 93.2–101.0%) and 42.1% (95 CI, 30.7–53.5%), respectively, whereas the positive predictive value (PPV) and the negative predictive value (NPV) were 60.0% (95% CI, 48.7–71.3%) and 94.1% (95% CI, 88.7–99.6%), respectively. A total of 38 samples were negative for bacterial detection as determined by the CT method, while 22 samples were positive as shown by the mNGS method. Conflicting results were obtained for three samples between the two methods of bacterial detection. However, no significant differences were noted between the mNGS and CT methods (OR, 1.42; 95% CI, 0.68–2.97; p = 0.46) with regard to fungal infections. The sensitivity and specificity of mNGS were 71.9% (95% CI, 61.5–82.3%) and 77.5% (95% CI, 67.9–87.1%), respectively. mNGS exhibited a PPV of 71.9% (95% CI, 61.5–82.3%) and an NPV of 77.5% (95% CI, 67.9–87.1%). A total of 9 out of 40 samples were found positive for fungi according to mNGS, whereas the CT method failed to present positive results in these samples. The mNGS and CT methods produced conflicting results with regard to fungal detection of the two samples. A total of 30 patients were virus-positive using mNGS. Furthermore, 42 patients (58.3%) were identified as pulmonary mixed infection cases.Conclusions: mNGS detection using BALF improved the sensitivity and specificity of bacterial identification in patients who developed VAP. In addition, mNGS exhibited apparent advantages in detecting viruses and identifying mixed infections.
New Insights in Addressing Cerebral Small Vessel Disease: Association With the Deep Medullary Veins
Authors: Xu Zhihua , Li Fangfei , Wang Bing , Xing Dengxiang , Pei Yusong , Yang Benqiang , Duan Yang 
Published: December 2020

ObjectiveTo assess the suitability of deep medullary vein visibility in susceptibility weighted imaging—magnetic resonance imaging studies as a method for the diagnosis and evaluation of cerebral small vessel disease progression.MethodsA total of 92 patients with CSVD were enrolled and baseline clinical and imaging data were reviewed retrospectively. Neuroimaging biomarkers of CSVD including high-grade white matter hyperintensity (HWMH), cerebral microbleed (CMB), enlarged perivascular space (PVS), and lacunar infarct (LI) were identified and CSVD burden was calculated. Cases were grouped accordingly as mild, moderate, or severe. The DMV was divided into six segments according to the regional anatomy. The total DMV score (0–18) was calculated as the sum of the six individual segmental scores, which ranged from 0 to 3, for a semi-quantitative assessment of the DMV based on segmental continuity and visibility.ResultsThe DMV score was independently associated with the presence of HWMH, PVS, and LI (P &lt; 0.05), but not with presence and absence of CMB (P &gt; 0.05). Correlation between the DMV score and the CSVD burden was significant (P &lt; 0.05) [OR 95% C.I., 1.227 (1.096–1.388)].ConclusionThe DMV score was associated with the presence and severity of CSVD.
Approach and Avoidance Behavior in Female Patients With Borderline Personality Disorder
Authors: Wiesenfeller Jana , Flasbeck Vera , Brown Elliot C. , Brüne Martin 
Published: December 2020

ObjectivesBorderline personality disorder (BPD) is portrayed by unstable relationships, fears of abandonment and heightened sensitivity to social rejection. Research has shown that these characteristics may lead to inappropriate social behavior including altered approach-avoidance behavior. However, it has remained unclear how social exclusion may affect approach-avoidance behavior in patients with BPD.DesignWe assessed social approach-avoidance behavior and the impact of social exclusion in a sample of 38 patients with BPD and 40 healthy control participants.MethodsWe used an explicit joystick-based approach-avoidance task (AAT) after playing a virtual ball-tossing game (Cyberball), which simulates the exclusion of the participant by two other players. In the AAT, participants were required to push or pull emotional stimuli, more specifically happy and angry facial expressions, with either direct or averted gaze direction.ResultsPatients with BPD approached happy stimuli less and showed overall less differential approach-avoidance behavior toward individuals expressing positive or negative facial emotions compared to healthy participants, who showed more approach behavior for happy compared to angry facial expressions. Moreover, borderline symptom severity correlated inversely with the AAT score for happy facial expressions and positively with subjective unpleasantness during social exclusion as well as rejection sensitivity. However, social exclusion did not influence approach-avoidance tendencies.ConclusionPatients with BPD showed altered approach-avoidance behavior, which might affect social interactions in the patient’s everyday lives and may therefore impede social interaction.
Case Report: Refractory Hypotension of GABA B Receptor Autoimmune Encephalitis
Authors: Hanxin Kong , Xiaomin Wang , Hao Ying , Shuihong Zheng 
Published: December 2020

Introduction: With the development of antibody detection technology, Gamma-Aminobutyric Acid (GABA) B receptor encephalitis is a known autoimmune disease. This paper describes a patient with refractory hypotension who suffered GABA B receptor autoimmune encephalitis.Case Report: We describe a 63-year-old man with GABA B receptor autoimmune encephalitis who had hypotension on day 17 of the disease onset. Despite two rounds of immunoglobulin administration, high-dose intravenous steroid injections and immunosuppressive therapy on day 35 of hospitalization, psychiatric symptoms and seizures were significantly improved; however, the patient's blood pressure remained low.Conclusion: This case study and literature review investigated the impairment of autonomic nerve function and its subsequent management in patients with GABA B receptor autoimmune encephalitis.
Screening and Identification of Prognostic Tumor-Infiltrating Immune Cells and Genes of Endometrioid Endometrial Adenocarcinoma: Based on The Cancer Genome Atlas Database and Bioinformatics
Authors: Chen Bingnan , Wang Di , Li Jiapo , Hou Yue , Qiao Chong 
Published: December 2020

BackgroundEndometrioid endometrial adenocarcinoma (EEA) is one of the most common tumors in the female reproductive system. With the further understanding of immune regulation mechanism in tumor microenvironment, immunotherapy is emerging in tumor treatment. However, there are few systematic studies on EEA immune infiltration.MethodsIn this study, prognostic tumor-infiltrating immune cells (TIICs) and related genes of EEA were comprehensively analyzed for the first time through the bioinformatics method with CIBERSORT algorithm as the core. Gene expression profile data were downloaded from the TCGA database, and the abundance ratio of TIICs was obtained. Kaplan–Meier analysis and Cox regression analysis were used to identify prognostic TIICs. EEA samples were grouped according to the risk score in Cox regression model. Differential analysis and functional enrichment analyses were performed on high- and low-risk groups to find survival-related hub genes, which were verified by Tumor Immune Estimation Resource (TIMER).ResultFour TIICs including memory CD4+ T cells, regulatory T cells, natural killer cells and dendritic cells were identified. And two hub gene modules were found, in which six hub genes including APOL1, CCL17, RBP4, KRT15, KRT71, and KRT79 were significantly related to overall survival and were closely correlated with some certain TIICs in the validation of TIMER.ConclusionIn this study, four prognostic TIICs and six hub genes were found to be closely related to EEA. These findings provided new potential targets for EEA immunotherapy.
Computer-Aided System Application Value for Assessing Hip Development
Authors: Jiang Yaoxian , Yang Guangyao , Liang Yuan , Shi Qin , Cui Boqi , Chang Xiaodan , Qiu Zhaowen , Zhao Xudong 
Published: December 2020

PurposeA computer-aided system was used to semiautomatically measure Tönnis angle, Sharp angle, and center-edge (CE) angle using contours of the hip bones to establish an auxiliary measurement model for developmental screening or diagnosis of hip joint disorders.MethodsWe retrospectively analyzed bilateral hip x-rays for 124 patients (41 men and 83 women aged 20–70 years) who presented at the Affiliated Zhongshan Hospital of Dalian University in 2017 and 2018. All images were imported into a computer-aided detection system. After manually outlining hip bone contours, Tönnis angle, Sharp angle, and CE angle marker lines were automatically extracted, and the angles were measured and recorded. An imaging physician also manually measured all angles and recorded hip development, and Pearson correlation coefficients were used to compare computer-aided system measurements with imaging physician measurements. Accuracy for different angles was calculated, and the area under the receiver operating characteristic (AUROC) curve was used to represent the diagnostic efficiency of the computer-aided system.ResultsFor Tönnis angle, Sharp angle, and CE angle, correlation coefficients were 0.902, 0.887, and 0.902, respectively; the accuracies of the computer-aided detection system were 89.1, 93.1, and 82.3%; and the AUROC curve values were 0.940, 0.956, and 0.948.ConclusionThe measurements of Tönnis angle, Sharp angle, and CE angle using the semiautomatic system were highly correlated with the measurements of the imaging physician and can be used to assess hip joint development with high accuracy and diagnostic efficiency.
Epidemiological Investigation and Virus Tracing of a Measles Outbreak in Zhoushan Islands, China, 2019
Authors: Zhang Hui , Chen Can , Tang An , Wu Bing , Liu Leijie , Wu Mingyu , Wang Hongling 
Published: December 2020

Background: Measles transmissions due to case importations challenge public health systems globally and herd immunities in all countries. In 2019, an imported measles case and its subsequently outbreak was found in the Zhoushan Islands. Here, the process of epidemiological investigation and virus tracing were summarized to provide references for the prevention and control of measles in the future.Materials and methods: The data on the demographic, epidemiological, and clinical manifestation of measles cases in this outbreak were collected. The 450 bp fragments of the measles virus (MeV) N gene were amplified and sequenced. The genome of the first imported case was further isolated. Then, the maximum-likelihood and time-scaled phylogenetic analysis was conducted.Results: A total of 28 measles cases were confirmed. Their onsets were between March 13 and May 18, 2019. The first patient was from the Ukraine. He was confirmed at the Fever Clinic in Zhoushan hospital on March 15, 2019 and at the same time, another patient had visited the hospital due to another illness and 10 days later, this second case had onset (March 25, 2019). The epidemic curve shows sustained community transmission. The majority of the following cases (19/26) were clustered on the Donggang street which was close to where the second case worked. The 22 measles virus strains successfully isolated from this outbreak all belonged to the D8.2a sub-cluster and clustered with the KY120864/MVs/GirSomnath.IND/42.16/[D8] which was the predominant genotype in the Ukraine during 2018-2019. The analysis of the complete D8 genotype genome pointed to the fact that this prevailing strain originated from India in 2015 and its substitution rate was estimated as 6.91 × 10−4 (5.64–7.98 × 10−4) nucleotide substitutions/site/year.Conclusion: This outbreak was caused by an imported case from the Ukraine. There was a possible nosocomial infection between the first case and the second case. Then, the second case played an important role in the spread of virus due to her occupation. The molecular phylogenetic analysis could help to track the origin of the virus. Increasing and maintaining the high level of vaccination coverage (≥95%) and an efficient response to imported cases are essential to prevent and control the recurrence and outbreak of measles virus.