bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECT OF LOWER EXTREMITY EXOSKELETON ROBOT IMPROVING WALKING FUNCTION AND ACTIVITY IN PATIENTS WITH COMPLETE SPINAL CORD INJURY
Authors: BAI XINGANG , GOU XIANG , WANG WENCHUN , DONG CHAO , QUE FANGXU , LING ZESHA , WANG LAN , ZHOU TINGTING , CHEN TIAN , PANG RIZHAO , ZHANG ANREN , CHENG HONG 
Published: December 2019

The objective of this research was to evaluate the effectiveness and safety of Lower Extremity Exoskeleton Robot improving walking function and activity in patients with complete spinal cord injury. A prospective, open and self-controlled trial was conducted which include eight patients with complete spinal cord injury accepted Lower Extremity Exoskeleton Robot training with Aider 1.0 and Aider 1.1 for 2 weeks. The 6[Formula: see text]min Walk Test (6MWT), 10[Formula: see text]m Walk Test (10 MWT), Hoffer walking ability rating, Lower Extremity Motor Score (LEMS), Spinal Cord Independence Motor (SCIM), Walking Index for Spinal Cord Injury Version II (WISCI II) were recorded before, 1 week and 2 weeks after training. During the training, the incidence of adverse events (AE), the incidence of serious adverse events (SAE), the incidence of device defects and other safety indicators were observed. Compared with the pre-training, indicators (6MWT, 10MWT, Hoffer walking ability rating, WISCI II) were significantly different after 1 week of training and after 2 weeks of training. Four adverse events occurred during the training period and the incidence of adverse events was 50%. And there was no SAE or device defects. Therefore, it is safe and effective to use the lower extremity exoskeleton robot to complete the walking ability of patients with complete spinal cord injury.
Integrated Multiomics Approach to Identify Genetic Underpinnings of Heart Failure and Its Echocardiographic Precursors
Authors: Andersson Charlotte , Lin Honghuang , Liu Chunyu , Levy Daniel , Mitchell Gary F. , Larson Martin G. , Vasan Ramachandran S. 
Published: December 2019

Background:
Heart failure (HF) may arise from alterations in metabolic, structural, and signaling pathways, but its genetic architecture is incompletely understood. To elucidate potential genetic contributors to cardiac remodeling and HF, we integrated genome-wide single-nucleotide polymorphisms, gene expression, and DNA methylation using a transomics analytical approach.

Methods:
We used robust rank aggregation (where the position of a certain gene in a rank order list [based on statistical significance level] is tested against a randomly shuffled rank order list) to derive an integrative transomic score for each annotated gene associated with a HF trait.

Results:

We evaluated ≤8372 FHS (Framingham Heart Study) participants (54% women; mean age, 55±17 years). Of these, 62 (0.7%) and 35 (0.4%) had prevalent HF with reduced ejection fraction and HF with preserved left ventricular ejection fraction, respectively. During a mean follow-up of 8.5 years (minimum–maximum, 0.005–18.6 years), 223 (2.7%) and 234 (2.8%) individuals developed incident HF with reduced ejection fraction and HF with reduced ejection fraction, respectively. Top genes included
MMP20
and
MTSS1
(promotes actin assembly at intercellular junctions) for left ventricular systolic function;
ITGA9
(receptor for
VCAM1
[vascular cell protein 1]) and
C5
for left ventricular remodeling;
NUP210
(expressed during myogenic differentiation) and
ANK1
(cytoskeletal protein) for diastolic function;
TSPAN16
and
RAB11FIP3
(involved in regulation of actin cytoskeleton) for prevalent HF with reduced ejection fraction;
ANKRD13D
and
TRIM69
for incident HF with reduced ejection fraction;
HPCAL1
and
PTTG1IP
for prevalent HF with reduced ejection fraction; and
ZNF146
(close to the
COX7A1
enzyme) and
ZFP3
(close to
SLC52A1
—the riboflavin transporter) for incident HF with reduced ejection fraction. We tested the HF-related top single-nucleotide polymorphisms in the UK biobank, where
rs77059055
in
TPM1
(minor allele frequency, 0.023; odds ratio, 0.83;
P
=0.002) remained statistically significant upon Bonferroni correction.

Conclusions:
Our integrative transomics approach offers insights into potential molecular and genetic contributors to HF and its precursors. Although several of our candidate genes have been implicated in HF in animal models, independent replication is warranted.
Stroke Risk Analysis, a System With a High Detection Rate of Atrial Fibrillation in Stroke and Transient Ischemic Attack
Authors: Gomis Meritxell , Dávalos Antoni , Purroy Francisco , Cardona Pere , Rodríguez-Campello Ana , Martí-Fábregas Joan , Pagola Jorge , Pardo Laura , Muñoz-Narbona Lucía , Benabdelhak Ikram , Lara-Rodríguez Blanca , Cuadrado-Godia Elisa , Martínez-Domeño Alejandro , Juega Jesús Maria , Serena Joaquin , Alvarez-Ballano Jesús , Paipa Andrés , Roquer Jaume , Abilleira Sònia , Neeter Rob , van de Groep Abraham , Molina Carlos 
Published: December 2019

Background and Purpose—
Stroke Risk Analysis (SRA) comprises an algorithm for automated analysis of ECG monitoring, enabling the detection of paroxysmal atrial fibrillation (pxAF) and identifying patterns indicating a high risk of atrial fibrillation (R_AF). We compared Holter-enabled continuous ECG monitoring in combination with SRA (hSRA) with standard continuous ECG monitoring for pxAF detection in patients with acute ischemic stroke. Also, we sought to identify whether the detection of R_AF patterns during the first cycle (first 2 hours) of hSRA recording was associated with the detection of pxAF during the Stroke Unit stay.

Methods—
We enrolled 524 consecutive patients admitted in the Stroke Unit with acute ischemic stroke or transient ischemic attack with neither history of AF nor AF at admission into a prospective multicentric observational analytic clinical study with intrapatient comparison, who received both continuous ECG monitoring as well as hSRA up to 7 days. Investigators were blinded to hSRA results unless pxAF was detected on SRA.

Results—

Of the 524 consecutive acute stroke patients (median age, 70.0 years; 60% male; acute ischemic stroke 93%, transient ischemic attack 7%), 462 were eligible and included in the study. Among 462 patients with hSRA available for 66 hours, AF was documented by hSRA in 79 patients (17.1%). From this group, 45 AF cases (9.7%) were confirmed after review by an independent and blinded cardiologist. continuous ECG monitoring detected 21 AF cases (4.3%;
P
<0.0001). hSRA detected R_AF patterns in 92 patients. 35 out of the 92 R_AF patients showed an episode of AF during the Stroke Unit stay. Predictive values of R_AF patterns within the first cycle of hSRA were: sensitivity 71%, specificity 86%, positive predictive value 38%, and negative predictive value 96%.

Conclusions—
Automated analysis using SRA technology strongly improves pxAF detection in acute ischemic stroke patients compared with continuous ECG monitoring. The predictive value of a R_AF pattern, as detected by hSRA during the first few hours after admission, deserves further investigation.
Environmental Philanthropy and Civic Engagement: a Comparison of Mainland China, Taiwan, Hong Kong, and Singapore
Authors: Zheng (郑文娟) Wenjuan , Chen (陈臻祥) Zhenxiang , Ong (邓道明) Paul 
Published: December 2019

Abstract
Using the data from the World Value Survey, this paper uses a comparative lens to assess environmental philanthropy by focusing on four predominantly Chinese societies – mainland China, Taiwan, Hong Kong, and Singapore, which contributes to the debate on whether culture can sufficiently explain cross-regional variation in civic engagement, particularly in the domain of environmental philanthropy. We find that residents in mainland China shared similar environmental concerns and beliefs with people from the other regions, but they are least likely to volunteer, donate, and demonstrate for these causes. After accounting for personal characteristics, the sizeable interregional gaps on pro-environmental behaviors remain. These findings are consistent with the argument that structural differences, particularly the developing nature of civil society in mainland China, hinders environmental civic engagement.
Laryngeal Web in the Pediatric Population: Evaluation and Management
Authors: Lawlor Claire M. , Dombrowski Natasha D. , Nuss Roger C. , Rahbar Reza , Choi Sukgi S. 
Published: December 2019

ObjectiveTo discuss the presentation, evaluation, and management of pediatric laryngeal web.Study DesignRetrospective case series.SettingSingle tertiary care center.SubjectsAll patients with laryngeal web at Boston Children’s Hospital in the past 22 years.MethodsNo exclusion criteria. Charts mined for age at presentation, presenting symptoms, degree/location of web, associated syndromes, number/type of surgical procedures, and postoperative outcomes.ResultsThirty‐seven patients were included (13 male, 24 female). Average age at diagnosis was 3.7 years (0‐19.5 years). Mean follow‐up was 4.4 years (range, 0‐16.4 years). There were 26 congenital webs (70.2%) and 11 acquired webs (29.8%). Presenting symptoms were vocal (29 patients, 78.4%) and respiratory (22 patients, 60%). Underlying syndromes or synchronous airway lesions included the following: premature (n = 5), congenital heart disease (n = 18), subglottic stenosis (n = 5), 22q11.2 deletion syndrome (n = 10), and recurrent respiratory papillomatosis (n = 4). There were 20 type 1 webs, 6 type 2 webs, 8 type 3 webs, and 3 type 4 webs; 10 had subglottic extension of the laryngeal web. Twelve patients were managed conservatively with observation. Eighty‐four interventions were performed: 18 open and 66 endoscopic (sharp division, 32; dilation, 33; mitomycin C, 14; laser, 5; keel, 6; triamcinolone injection, 8; stent, 15; removal of granulation tissue, 5). Tracheotomy was required in 11 patients, and 5 patients were decannulated. Voice improved in 12 patients, with respiratory symptoms in 12 patients. Web recurred in 17 patients. One patient died due to airway complications.ConclusionsPediatric laryngeal web is an uncommon but challenging lesion. Patients need to be evaluated for comorbid syndromes and synchronous airway lesions. Management includes open and endoscopic procedures. Procedures should be tailored to the child’s presentation.
Therapeutic effect and mechanism of action of quercetin in a rat model of osteoarthritis
Authors: Zhang Jun , Yin Jing , Zhao Daohong , Wang Chaoran , Zhang Yuhao , Wang Yingsong , Li Tao 
Published: December 2019

Objective To study the therapeutic effect and mechanism of action of quercetin in a rat model of osteoarthritis (OA). Methods The OA rat model was established by intra-articular injection of papain. Changes in knee diameter, toe volume and histopathology were measured. Levels of interleukin (IL)-β and tumor necrosis factor (TNF)-α were assessed by ELISA. Relative expression of Toll-like receptor (TLR)-4 and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) was evaluated by western blotting. Results Compared with rats treated with papain alone, changes in knee diameter, toe volume and Makin' s score were less apparent in OA rats treated with quercetin. Levels of serum IL-1β and TNF-α were also reduced in quercetin-treated OA rats. Expression of TLR-4 and NF-κB was significantly suppressed in a dose-dependent manner in quercetin-treated OA rats. Conclusion Quercetin exhibited a therapeutic effect in OA rats, which may be related to inhibition of IL-1β and TNF-α production via the TLR-4/NF-κB pathway.
Syndesmotic Overload in 3-Component Total Ankle Replacement
Authors: Ruiz Roxa , Susdorf Roman , Krähenbühl Nicola , Barg Alexej , Hintermann Beat 
Published: December 2019

Background: Mobile-bearing total ankle replacement (TAR) potentially enables motion at the tibial implant–polyethylene insert (PI) interface. Such additional freedom of movement may overload periarticular ligaments and subsequently result in coronal translation of the talus. The aim of this study was to assess whether syndesmotic overload affects clinical and radiographic outcomes following mobile-bearing TAR and whether tibiofibular fusion is an effective treatment option. Methods: Thirty-one patients who underwent revision surgery for syndesmotic overload after mobile-bearing TAR were retrospectively analyzed. Clinical and radiographic outcomes were assessed before and after index TAR, preoperatively to revision surgery, and at the last follow-up after revision surgery. Computed tomography scans were also analyzed. Results: Ankles with lateral talar translation prior to revision surgery were about 10 times more likely to have valgus tibial implant position ( P = .003). A wide tibiofibular distance at the level of the syndesmosis after index TAR was associated with an increased hindfoot moment arm at revision surgery ( P = .025). Decrease of PI height at revision surgery and a PI fracture were evident in 10 (32%) and 4 (13%) cases, respectively. Talar cyst formation at revision surgery was evident in 12 (39%) cases. Tibiofibular fusion was effective in restoring function of the replaced ankle and providing pain relief. Conclusion: Syndesmotic overload impaired clinical and radiographic outcomes after mobile-bearing TAR. Proper implant positioning and additional realignment procedures may prevent overload of periarticular soft tissue structures after mobile-bearing TAR. Level of Evidence: Level IV, retrospective case series.
Assessment of scapholunate instability with dynamic computed tomography
Authors: Athlani Lionel , Rouizi Kamel , Granero Jonathan , Hossu Gabriela , Blum Alain , Dautel Gilles , Gondim Teixeira Pedro Augusto 
Published: December 2019

We performed a prospective study to evaluate the values of dynamic four-dimensional computed tomography in assessing suspected chronic scapholunate instability. Forty patients were evaluated with radiographs, arthrography, and four-dimensional computed tomography. On plain radiographs and computed tomography, we found 16 patients with definite scapholunate instability, five with questionable scapholunate instability, and 19 with absence of scapholunate instability. We used four-dimensional computed tomography to evaluate the size of the scapholunate gap during radioulnar deviation. The mean and maximal values of the gap size were lowest in the patients with absence of scapholunate instability and highest in those with definite scapholunate instability. When comparing the scapholunate gap sizes of the patients with absent and questionable scapholunate instability, the range of the gap sizes was significantly higher in the patients with questionable scapholunate instability. We conclude that four-dimensional computed tomography aids assessment of chronic scapholunate instability, which allows the differentiation between patients without and those with definite or questionable scapholunate instability. Level of evidence: II
Tribe and Tribal Welfare in Gandhian Thoughts
Authors: Chakrabarty Kakali 
Published: December 2019

Gandhi is best known for his sarvodaya movement where he talked of ‘welfare for all’. His focus was on the deprived section of the countrymen who constituted a majority of India’s population. Thus, the term was often referred to as antodaya, i.e., ‘Rise to the last men’. Gandhi was not very particular about ‘tribe’, as to him, tribes were a part of rural communities who were exploited by the powerful class of people; thus, they required welfare measures. Gandhi’s mission and vision towards tribes was mainly an outcome of his constant association with Thakkar Bapa, who had been well exposed to the exploitation and helpless misery of tribal life, especially of the Bhil people of Gujarat under the British rule. To Gandhi, tribal welfare and rural welfare were same. However, he believed that tribals were simple people. His interaction with the Zulu people in Africa exposed him to the bare truth of exploitation of the tribal people by the colonial rulers. To his idea, the tribes should be approached on the basis of non-violence, accepting the principles of a democratic society and the fundamental equality and unity of man. The process of social domination and political imposition should be avoided. Welfare measures should be taken up on the basis of understanding their society and culture. Gandhi’s concept of Sarvodaya, i.e., welfare of all also had a purpose to bring the majority of Indians in the struggle for independence. He believed that India’s independence cannot be achieved without participation of its rural masses that formed the majority of Indian population. Gandhi dreamt of a society with equity among all members in fundamental necessities of life including education. His dream is yet to be chased.
Comparison of Neuromuscular Firing Patterns of the Superficial Quadriceps in Soft Tissue Quadriceps Tendon Versus Bone–Patellar Tendon–Bone ACL Autografts
Authors: Letter Michael , Baraga Michael G. , Best Thomas M. , Kaplan Lee D. , Buskard Andrew N.L. , Catena Lauren , Eltoukhy Moataz , Oh Joenghoon , Strand Keri , Signorile Joseph 
Published: December 2019

Background: Soft tissue quadriceps tendon (QT) autografts are increasingly popular as a primary graft choice for anterior cruciate ligament reconstruction (ACLR), but no study has compared superficial quadriceps activity levels and leg extension strength for QT versus bone–patellar tendon–bone (BTB) autografts. Hypothesis: Harvesting the central portion of the QT will alter rectus femoris (RF) firing patterns during maximum voluntary isometric contraction. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 34 patients (age range, 18-40 years) who underwent ACLR using a BTB (n = 17) or QT (n = 17) autograft at a single institution participated in this study. Participants, who had no neuromuscular injury or prior surgery on either lower extremity, were at least 1 year after ACLR, and were cleared for full activity. Postoperative rehabilitation protocols were consistent across participants. Synchronized electromyography (EMG) and isometric torque data were collected from participants in the seated position with the hips flexed to 90° and the knee at 60° of flexion. Participants were asked to extend their knees as quickly as possible and perform maximum voluntary isometric contraction for 3 seconds. A practice trial and 3 test trials were completed with 30-second rest intervals. Mixed (2 graft × 2 limb) analyses of variance were used to examine differences in average and peak torque values and RF/vastus lateralis (VL) and RF/vastus medialis (VM) ratios. Lysholm and International Knee Documentation Committee (IKDC) scores were compared between groups using unpaired t tests. Results: Significantly lower values were seen for the operative compared with the nonoperative extremity for average ( P = .008; η2 = 0.201) and peak torque ( P < .0001; η2 = 0.321), with no significant difference between graft types. Additionally, no significant differences in RF/VL or RF/VM ratios between limbs or graft types were observed. Conclusion: At 1 year after ACLR, QT and BTB autografts showed similar isometric strength deficits, with no differences in quadriceps muscle EMG ratios seen between the 2 graft types. The results support the use of a QT autograft for ACLR, as its graft harvest does not adversely affect quadriceps firing patterns in comparison with BTB graft harvest.
Prevalence and risk factors of pre-sick building syndrome: characteristics of indoor environmental and individual factors
Authors: Nakayama Yoshitake , Nakaoka Hiroko , Suzuki Norimichi , Tsumura Kayo , Hanazato Masamichi , Todaka Emiko , Mori Chisato 
Published: December 2019

Abstract
Background
With the aim to prevent sick building syndrome and worsening of allergic symptoms, primarily resulting from the indoor environment, the relationships among people’s residential environment in recent years, their lifestyle habits, their awareness, and their symptoms were investigated using an online survey.

Methods
In the survey, respondents experiencing symptoms specific to sick building syndrome, although they were not diagnosed with sick building syndrome, were categorized in the pre-sick building syndrome group. The relationships among individual characteristics, residential environment, and individual awareness were analyzed.

Results
Results showed that the prevalence of pre-sick building syndrome was high among young (aged 20–29 years) population of both sexes. In addition, “condensation,” “moisture,” “musty odors” in the house, and the “use of deodorant and fragrance” were all significantly associated with pre-sick building syndrome. Conversely, there was no significant association with recently built “wooden” houses that are highly airtight and have thermal insulation.

Conclusions
Efficient “ventilation” plans and “ventilation” improvement and air conditioning systems to prevent mold and condensation in rooms are necessary to maintain a good, indoor environment that is beneficial for health. Efforts should also be made to encourage individuals to regularly clean and effectively ventilate their homes.
Investigating confounders of the association between survival and adjuvant radiation therapy after breast conserving surgery in a sample of elderly breast Cancer patients in Appalachia
Authors: Camacho Fabian , Anderson Roger , Kimmick Gretchen 
Published: December 2019

AbstractBackgroundTo explain the association between adjuvant radiation therapy after breast conserving surgery (BCS RT) and overall survival (OS) by quantifying bias due to confounding in a sample of elderly breast cancer beneficiaries in a multi-state region of Appalachia.MethodsWe used Medicare claims linked registry data for fee-for-service beneficiaries with AJCC stage I-III, treated with BCS, and diagnosed from 2006 to 2008 in Appalachian counties of Kentucky, Ohio, North Carolina, and Pennsylvania. Confounders of BCS RT included age, rurality, regional SES, access to radiation facilities, marital status, Charlson comorbidity, Medicaid dual status, institutionalization, tumor characteristics, and surgical facility characteristics. Adjusted percent change in expected survival by BCS RT was examined using Accelerated Failure Time (AFT) models. Confounding bias was assessed by comparing effects between adjusted and partially adjusted associations using a fully specified structural model.ResultsThe final sample had 2675 beneficiaries with mean age of 75, with 81% 5-year survival from diagnosis. Unadjusted percentage increase in expected survival was 2.75 times greater in the RT group vs. non-RT group, with 5-year survival of 85% vs 60%; fully adjusted percentage increase was 1.70 times greater, with 5-year rates of 83% vs 71%. Quantification of incremental confounding showed age accounted for 71% of the effect reduction, followed by tumor features (12%), comorbidity (10%), dual status(10%), and institutionalization (8%). Adjusting for age and tumor features only resulted in only 4% bias from fully adjusted percent change (70% change vs 66%).ConclusionQuantification of confounding aids in determining covariates to adjust for and in interpreting raw associations. Substantial confounding was present (60% of total association), with age accounting for the largest share (71%); adjusting for age plus tumor features corrected for most of the confounding (4% bias). The direct effect of BCS RT on OS accounted for 40% of the total association.
Correction to: Total hip arthroplasty with modular stem for Crowe I and II developmental dysplasia of the hip
Authors: Kong Xiangpeng , Sun Yunming , Yang Minzhi , Zhou Yonggang , Chen Jiying , Chai Wei , Wang Yan 
Published: December 2019

In the original publication of this article [1], an sentence needs to be added in the end of the caption of Figure 1 and Figure 3: cited in our previous study [18].