bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of dry needling of active trigger points in the scalene muscles in individuals with mechanical neck pain: a randomized clinical trial
Authors: Arias-Buría José L , Monroy-Acevedo Álvaro , Fernández-de-las-Peñas César , Gallego-Sendarrubias Gracia M , Ortega-Santiago Ricardo , Plaza-Manzano Gustavo 
Published: March 2020

Objective: The aim of this study was to compare the effects of dry needling (DN) versus pressure release over scalene muscle trigger points (TrPs) on pain, related disability, and inspiratory vital capacity in individuals with neck pain. Methods: In this randomized, single-blind trial, 30 patients with mechanical neck pain and active TrPs in the scalene musculature were randomly allocated to trigger point dry needling (TrP-DN; n = 15) or pressure release (n = 15) groups. The DN group received a single session of DN of active TrPs in the anterior scalene muscles, and the pressure release group received a single session of TrP pressure release over the same muscle lasting 30 s. The primary outcome was pain intensity as assessed by a numerical pain rate scale (NPRS, 0–10). Secondary outcomes included disability (neck disability index, NDI) and inspiratory vital capacity. Outcomes were assessed at baseline and 1 day (immediately post), 1 week, and 1 month after the treatment session. Data were expressed as mean score difference (Δ) and standardized mean difference (SMD). Results: Patients receiving DN exhibited a greater decrease in pain intensity than those receiving TrP pressure release at 1 month (Δ 1.2 (95% CI–1.8, –0.6), p = 0.01), but not immediately (1 day) or 1 week after. Patients in the DN group exhibited a greater increase in inspiratory vital capacity at all follow-up time points (Δ 281 mm (95% CI 130, 432) immediately after, Δ 358 mm (95% CI 227, 489) 1 week after, and Δ 310 mm (95% CI 180, 440) 1 month after treatment) than those in the pressure release group (p = 0.006). Between-group effect sizes were large at all follow-up time points (1.1 > SMD > 1.3) in favor of DN. Conclusion: This trial suggests that a single session of DN over active TrPs in the scalene muscles could be effective at reducing pain and increasing inspiratory vital capacity in individuals with mechanical neck pain. Future studies are needed to further confirm these results.
Stability of extemporaneously compounded temozolomide 10 mg/mL suspensions in Oral Mix SF® in glass and plastic bottles and plastic syringes
Authors: Lingertat-Walsh Karen , Weilnau JoEllen , Cober M Petrea , Ostrenga Andrew , Poon Betsy , Sales Pacita , Law Shirley , Dupuis L Lee , Walker Scott E 
Published: March 2020

Background Temozolomide oral suspension is not commercially available. Objective To evaluate the stability of three temozolomide 10 mg/mL suspensions prepared in Oral Mix SF® in three container types stored at 4°C and 23°C. Methods Using commercial capsules, three separate batches of three different temozolomide 10 mg/mL formulations (Oral Mix SF® with PK-30; PK-30 and citric acid; and neither PK-30 nor citric acid) were made and stored in three container types (amber glass bottles, amber polyethylene terephthalate bottles, and polypropylene oral syringes). The aliquots in each container type were stored protected from light, half at 25°C and half at 4°C. On study days 0, 5, 8, 14, 21, 28, 35, 42, and 56, physical properties of samples from each container type at each temperature were assessed, and the temozolomide concentration was determined using a stability-indicating method. The beyond-use-date (time to achieve 90% of initial concentration calculated using the lower limit of the 95% confidence interval of the observed degradation rate) was calculated. Results Samples stored at 25°C turned from white to orange within seven days. Temozolomide crystals were observed in all samples. Concentration changes due to study day and temperature (p < 0.001) were observed but not due to container (p = 0.991) or formulation (p = 0.987). The beyond-use-date of all formulations in all container types was 56 days at 4°C and 6 days at 23°C. Conclusions We recommend that these temozolomide 10 mg/mL formulations be stored at 4°C and be assigned a beyond-use-date of 30 days.
Evaluation of the ‘ring sign’ and the ‘core sign’ as a magnetic resonance imaging marker of disease activity and progression in clinically isolated syndrome and early multiple sclerosis
Authors: Blindenbacher Nelly , Brunner Eveline , Asseyer Susanna , Scheel Michael , Siebert Nadja , Rasche Ludwig , Bellmann-Strobl Judith , Brandt Alexander , Ruprecht Klemens , Meier Dominik , Wuerfel Jens , Paul Friedemann , Sinnecker Tim 
Published: March 2020

Background Brain lesions with a hypointense ring or core were described in multiple sclerosis on susceptibility weighted imaging. Objective The purpose of this study was to study the evolution and prognostic relevance of susceptibility weighted imaging hypointense lesions in clinically isolated syndrome and early multiple sclerosis. Methods Sixty-six early multiple sclerosis and clinically isolated syndrome patients were followed over a median period of 2.9 years (range 1.6–4.6 years) and underwent 3T magnetic resonance imaging including 3D susceptibility weighted imaging and T2-weighted fluid-attenuated inversion recovery. We assessed the presence of susceptibility weighted imaging hypointense core or ring lesions, and Expanded Disability Status Scale at baseline and follow-up. Results Of 611 lesions at baseline, 64 (10.5%) had a susceptibility weighted imaging hypointense core, and 28 (4.6%) had a susceptibility weighted imaging hypointense ring. Hypointense ring lesions were larger ( p < 0.001) and more T1w hypointense ( p = 0.002) than others. During follow-up, hypointense core lesions became susceptibility weighted imaging isointense (52 lesions, 81%); few developed into hypointense ring lesions (two lesions, 3%). Hypointense ring lesions did not shrink on T2-weighted fluid-attenuated inversion recovery images ( p = 0.077, trend towards more enlargement compared to others), while hypointense core lesions more often shrunk in comparison to lesions without a hypointense core ( p = 0.002). The number of susceptibility weighted imaging hypointense ring lesions at baseline correlated with Expanded Disability Status Scale progression at follow-up ( p = 0.021, R = 0.289). Conclusion In our cohort of patients with clinically isolated syndrome or early multiple sclerosis, susceptibility weighted imaging hypointense ring lesions were only rarely detectable, but did not shrink and were associated with future disability progression.
A pragmatic randomised controlled trial of SAFMEDS to produce fluency in interpretation of electrocardiograms
Authors: Rabbitt Louise , Byrne Dara , O’Connor Paul , Gorecka Miroslawa , Jacobsen Alan , Lydon Sinéad 
Published: March 2020

Abstract
Background
SAFMEDS (Say-All-Fast-Minute-Every-Day-Shuffled) is a flashcard-type behavioural instructional methodology, involving one-minute learning trials that function both as practice and assessment, used to facilitate the development of fluency in a behaviour.
The primary research question was whether SAFMEDS engenders improvement in performance beyond that conferred by usual teaching. A secondary research question was whether SAFMEDS is an effective method of producing fluency in Electrocardiogram (ECG) interpretation.

Methods
A pilot study was conducted to determine sample size required to power the pragmatic randomised controlled trial (RCT). For the subsequent RCT, participants were randomly assigned to a “usual teaching” control group (n = 14) or the SAFMEDS intervention group (n = 13), with the recognition of 15 cardiac conditions on ECGs (e.g., atrial fibrillation, complete heart block) targeted. Intervention group participants’ performance was tracked over eight weeks as they worked towards achieving the fluency criterion. Percentage accuracy in ECG interpretation was assessed at baseline and post-test for both groups. An ANCOVA was conducted to assess for differences in the performance of the intervention and control group at post-test while controlling for the baseline performance of participants. At post-test, the numbers of participants achieving fluency within the intervention group was examined.

Results
A large effect size of SAFMEDS (partial η2 = .67) was identified when controlling for the effects of baseline performance. At post-test, the intervention group significantly outperformed (M = 61.5%; SD = 12.1%) the control group (M = 31.6%; SD = 12.5%, p < .001). In total, 7 of 13 intervention group participants achieved fluency. Participants required an average of 51.9 one-minute trials (SD = 18.8) to achieve fluency.

Conclusions
SAFMEDS offers a useful adjunct to usual teaching within medical education. Further research could assess whether learning retains, is stable, and transfers to clinical practice.
Factors associated with institutional delivery in Ethiopia: a cross sectional study
Authors: Ketemaw Asmamaw , Tareke Minale , Dellie Endalkachew , Sitotaw Getachew , Deressa Yonas , Tadesse Getasew , Debalkie Desta , Ewunetu Mesafinet , Alemu Yibeltal , Debebe Daniel 
Published: March 2020

Abstract
Background
In spite of the promotion of institutional delivery in Ethiopia, home delivery is still common primarily in hard-to-reach areas. Institutional delivery supported to achieve the goal of reducing maternal and neonatal mortality in Ethiopia. The objective of this study is to assess the determinants of institutional delivery in Ethiopia.

Methods
Cross sectional survey was conducted in 11 administrative regions of Ethiopia. The Ethiopian demographic and health survey data collection took place from January 18, 2016, to June 27, 2016. The study subjects were 11,023 women (15–49 years old) who gave birth in the preceding 5 years before 2016 Ethiopian demographic health survey. This representative data was downloaded from Demographic Health Survey after getting permission. The Primary outcome variable was institutional delivery. The data was transferred and analyzed with SPSS Version 20 statistical software package.

Results
Of 11,023 mothers, 2892 (26.2%) delivered at a health facility and 8131 (73.8%) at home. Women with secondary education were 4.36 times more likely to have an institutional delivery (OR: 4.36; 95% CI: 3.12–6.09). Institutional delivery was higher among women who were resided in urban areas by three fold (OR: 3.26; 95% CI: 2.19–4.35). Women who visited ANC (Antenatal care) were about two times more likely to choose institutional delivery (OR: 1.81; 95% CI: 1.58–2.07). Respondents who watch television at least once a week was two times more likely to experience institutional delivery than those who did not watch at all (0R: 1.90; 95% CI: 1.35–2.66). The wealthiest women were 2.61 times more likely to deliver in an institution compared with the women in the poorest category (OR: 2.61; 95% CI: 1.95–3.50).

Conclusion
Women having higher educational level, being richest, residing in urban area, visiting antenatal care at least once, and frequent exposure to mass media were factors associated with institutional delivery. Improving access to education and health promotion about obstetrics and delivery through mass media will increase the uptake of institutional delivery.
The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring blaNDM/OXA-48 carbapenemases in a tertiary care center of Iran
Authors: Pajand Omid , Darabi Narges , Arab Maedeh , Ghorbani Raheb , Bameri Zakaria , Ebrahimi Ali , Hojabri Zoya 
Published: March 2020

Abstract
Background
Klebsiella pneumoniae is a public health concern because of its ability to develop multidrug resistance and hypervirulent genotypes, of those capsular types K1 and K2 cause community and nosocomial life-threatening infections. This study aimed to determine the antibiotic susceptibility patterns and genotypic traits of a collection of Klebsiella spp. isolates. Furthermore, the clonal relatedness of blaNDM producing strains was investigated.

Methods
During a 19-months surveillance study, 122 Klebsiella spp. isolates were cultured from extraintestinal specimens of patients admitted to the tertiary referral hospital in Semnan, Iran. Isolates were identified using biochemical tests and subjected to determination of phylogroups, capsular types and virulence/resistance genes content. Hypervirulent K. pneumoniae (hvKp) strains were detected genotypically, and Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR fingerprinting was used to determine the clonality of blaNDM producing strains.

Results
Multidrug resistant phenotype was detected in 75 (61.5%) isolates and amikacin was found as the most potent antibiotic with the susceptibility rate of 85.2%. The carbapenemase genes were detected in 45 (36.8%) strains, including 21 (17.2%) blaOXA-48, 7 (5.6%) blaNDM-1, 14 (11.4%) blaNDM-1/OXA-48 and 3 (2.4%) blaIMP- carrying strains, while 55 (45.08%) isolates showed carbapenem resistant phenotype. The first blaNDM-1 carrying strain was cultured from a sputum specimen on March 2015, while the last positive one was recovered from blood culture on September 2016. Most of the isolates (80.3%) belonged to phylogroup I, and blaNDM-1 was identified among all three phylogroups. The ERIC-PCR clustered the 101 blaNDM negative and 21 blaNDM-1 positive isolates into 25 and five clusters, respectively, and the latter group belonged to clonal complex 147 (CC147). One K1 and 15 K2 blaNDM-1 negative isolates were detected, of those three strains were identified as hvKp. Five K2 positive strains, including four blaOXA-48 producer and one hvKp sequence type 86 (ST86) were carbapenem resistant. Among carbapenem resistant isolates, CC147 strains harboured higher rates of siderophores iutA and ybtS.

Conclusion
The present findings showed a hospital circulation of CC147 blaNDM-1 or blaNDM-1/OXA-48 producing strains, disseminated in different wards. The hvKp/ST86 strain expressing K2 capsular type and carbapenem resistant phenotype wasn’t reported from Iran so far. So, it seems that we must be aware of the emergence and spread of new K. pneumoniae clones associated with resistant and hypermucoviscous phenotypes.
Electro-clinical and neurodevelopmental outcome in six children with early diagnosis of tuberous sclerosis complex and role of the genetic background
Authors: Savini M. N. , Mingarelli A. , Peron A. , La Briola F. , Cervi F. , Alfano R. M. , Canevini M. P. , Vignoli A. 
Published: March 2020

Abstract
Background
Seizures in individuals affected by tuberous sclerosis complex (TSC) commonly develop in the first year of life, are often preceded by a progressive deterioration of the electroencephalogram (EEG), and likely influence developmental outcome. Although early diagnosis of TSC has offered a tremendous opportunity to monitor affected patients before seizure onset, reports of the neurological manifestations of TSC in infants before seizure onset are still scarce. Here we describe early EEG activity, clinical and genetic data and developmental assessment in a group of TSC infants, with the aim of identifying possible prognostic factors for neurodevelopmental outcome.

Methods
We report on six infants diagnosed with TSC pre- or perinatally, who underwent serial Video-EEG recordings during the first two years of life. EEGs were classified based on distribution and intensity of interictal epileptiform discharges, and Vigabatrin was introduced in case of ictal discharges. Psychomotor development, cognitive functioning and behavioral problems were assessed through standardized scales. Molecular testing included analysis for point mutations and deletions/duplications in TSC1 and TSC2.

Results
EEG abnormalities appeared at a mean age of 4 months. Four of the six patients developed seizures. EEG abnormalities preceded the onset of clinical seizures in all of them. The two individuals with good seizure control showed normal development, while the other two exhibited psychomotor delays. The patients who did not develop seizures had normal development. A pathogenic variant in the TSC2 gene was detected in all patients but one. The one without a mutation identified did not develop seizures and showed normal neurodevelopment. Of note, the two patients presenting with the worst outcome (that is, poor seizure control and intellectual/behavioral disability) both carried pathogenic variants in the GAP domain of TSC2.

Conclusion
Our report supports the importance of EEG monitoring before seizure onset in patients with TSC, and the correlation between prompt seizure control and positive neurodevelopmental outcome, regardless of seizure type. Our results also indicate a possible role of the genetic background in influencing the outcome.
Microbial nitrogen fixation and methane oxidation are strongly enhanced by light in Sphagnum mosses
Authors: Kox Martine A. R. , van den Elzen Eva , Lamers Leon P. M. , Jetten Mike S. M. , van Kessel Maartje A. H. J. 
Published: March 2020

AbstractPeatlands have acted as C-sinks for millennia, storing large amounts of carbon, of which a significant amount is yearly released as methane (CH4). Sphagnum mosses are a key genus in many peat ecosystems and these mosses live in close association with methane-oxidizing and nitrogen-fixing microorganisms. To disentangle mechanisms which may control Sphagnum-associated methane-oxidation and nitrogen-fixation, we applied four treatments to Sphagnum mosses from a pristine peatland in Finland: nitrogen fertilization, phosphorus fertilization, CH4 addition and light. N and P fertilization resulted in nutrient accumulation in the moss tissue, but did not increase Sphagnum growth. While net CO2 fixation rates remained unaffected in the N and P treatment, net CH4 emissions decreased because of enhanced CH4 oxidation. CH4 addition did not affect Sphagnum performance in the present set-up. Light, however, clearly stimulated the activity of associated nitrogen-fixing and methane-oxidizing microorganisms, increasing N2 fixation rates threefold and CH4 oxidation rates fivefold. This underlines the strong connection between Sphagnum and associated N2 fixation and CH4 oxidation. It furthermore indicates that phototrophy is a strong control of microbial activity, which can be directly or indirectly.
A multilevel features selection framework for skin lesion classification
Authors: Akram Tallha , Lodhi Hafiz M. Junaid , Naqvi Syed Rameez , Naeem Sidra , Alhaisoni Majed , Ali Muhammad , Haider Sajjad Ali , Qadri Nadia N. 
Published: March 2020

AbstractMelanoma is considered to be one of the deadliest skin cancer types, whose occurring frequency elevated in the last few years; its earlier diagnosis, however, significantly increases the chances of patients’ survival. In the quest for the same, a few computer based methods, capable of diagnosing the skin lesion at initial stages, have been recently proposed. Despite some success, however, margin exists, due to which the machine learning community still considers this an outstanding research challenge. In this work, we come up with a novel framework for skin lesion classification, which integrates deep features information to generate most discriminant feature vector, with an advantage of preserving the original feature space. We utilize recent deep models for feature extraction, and by taking advantage of transfer learning. Initially, the dermoscopic images are segmented, and the lesion region is extracted, which is later subjected to retrain the selected deep models to generate fused feature vectors. In the second phase, a framework for most discriminant feature selection and dimensionality reduction is proposed, entropy-controlled neighborhood component analysis (ECNCA). This hierarchical framework optimizes fused features by selecting the principle components and extricating the redundant and irrelevant data. The effectiveness of our design is validated on four benchmark dermoscopic datasets; PH2, ISIC MSK, ISIC UDA, and ISBI-2017. To authenticate the proposed method, a fair comparison with the existing techniques is also provided. The simulation results clearly show that the proposed design is accurate enough to categorize the skin lesion with 98.8%, 99.2% and 97.1% and 95.9% accuracy with the selected classifiers on all four datasets, and by utilizing less than 3% features.
A case of a primary pulmonary meningioma mimicking a metastasis from a papillary thyroid carcinoma due to a size reduction after radioactive iodine therapy
Authors: Fujikawa Ryo , Arai Yoshifumi , Otsuki Yoshiro , Nakamura Toru 
Published: March 2020

Abstract
Background
Primary pulmonary meningiomas (PPMs) are a rare mostly benign disease presenting as a solitary pulmonary nodule and are hardly distinguishable from a metastatic tumor because of a lack of specific radiological features. We described a case of a PPM initially diagnosed as a metastatic lung tumor from thyroid cancer with a size reduction after radioactive iodine therapy.

Case presentation
A 62-year-old woman who had undergone a total thyroidectomy for a papillary thyroid carcinoma 6 years prior presented with an enlarging pulmonary nodule. The nodule had decreased in size from 7.0 to 5.5 mm after adjuvant radioactive iodine therapy and enlarged to 8.7 mm over the next 5 years. Under a clinical diagnosis of a metastatic lung tumor, she underwent a thoracoscopic pulmonary wedge resection and was pathologically diagnosed with a PPM.

Conclusion
A surgical resection is required for histological diagnoses of PPMs especially in patients with a history of a malignancy.
The Grandhotel Cosmopolis – a concrete utopia? Reflections on the mediated and lived geographies of asylum accommodation
Authors: Zill Marielle , Spierings Bas , Van Liempt Ilse 
Published: March 2020

AbstractThis paper argues that perceptions towards asylum seekers are shaped by both media representation as well as lived experiences in and around asylum accommodation. Drawing on Lefebvre’s spatial triad, the paper aims at disentangling the conceived, perceived and lived spaces of asylum accommodation in order to understand asylum accommodation as a space that is produced and re-produced in everyday life. The paper discusses the case of the Grandhotel Cosmopolis (GHC), a prominent example of local innovation in asylum accommodation located in southern Germany. It compares and contrasts the GHC’ media representation in national and local news media with local residents’ evaluation and direct experiences with this project and its effects on how asylum seekers are perceived. The results of the media analysis highlight a difference between a national ‘utopian’ framing and a local ‘experiment’ framing of the GHC. Local residents’ direct experiences proved influential in their evaluation of the project, yet could not overrule dominant media representations of asylum seekers. The paper concludes by suggesting that the GHC’ relative openness produces a space which allows for contact and familiarization between local residents and asylum seekers, yet that dominant framings of asylum seekers as criminals or victims also contributed to a perceived closedness of its space and discouraged contact and familiarization.
Proposed directions for suicide research: incorporating successful approaches from other disciplines
Authors: Mou David , Kleiman Evan M. , Nock Matthew K. 
Published: March 2020

SummaryDespite decades of suicide research, our ability to predict suicide has not changed. Why is this the case? We outline the unique challenges facing suicide research. Borrowing successful strategies from other medical fields, we propose specific research directions that aim to translate scientific findings into meaningful clinical impact.