bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of an exercise-enabling control interface for powered wheelchair users: a feasibility study with Duchenne muscular dystrophy
Authors: Lobo-Prat Joan , Enkaoua Aure , Rodríguez-Fernández Antonio , Sharifrazi Nariman , Medina-Cantillo Julita , Font-Llagunes Josep M. , Torras Carme , Reinkensmeyer David J. 
Published: August 2020

Abstract
BackgroundPowered wheelchairs are an essential technology to support mobility, yet their use is associated with a high level of sedentarism that can have negative health effects for their users. People with Duchenne muscular dystrophy (DMD) start using a powered wheelchair in their early teens due to the loss of strength in their legs and arms. There is evidence that low-intensity exercise can help preserve the functional abilities of people with DMD, but options for exercise when sitting in a powered wheelchair are limited.MethodsIn this paper, we present the design and the feasibility study of a new version of the MOVit device that allows powered-wheelchair users to exercise while driving the chair. Instead of using a joystick to drive the wheelchair, users move their arms through a cyclical motion using two powered, mobile arm supports that provide controller inputs to the chair. The feasibility study was carried out with a group of five individuals with DMD and five unimpaired individuals. Participants performed a series of driving tasks in a wheelchair simulator and on a real driving course with a standard joystick and with the MOVit 2.0 device.ResultsWe found that driving speed and accuracy were significantly lowered for both groups when driving with MOVit compared to the joystick, but the decreases were small (speed was 0.26 m/s less and maximum path error was 0.1 m greater). Driving with MOVit produced a significant increase in heart rate (7.5 bpm) compared to the joystick condition. Individuals with DMD reported a high level of satisfaction with their performance and comfort in using MOVit.ConclusionsThese results show for the first time that individuals with DMD can easily transition to driving a powered wheelchair using cyclical arm motions, achieving a reasonable driving performance with a short period of training. Driving in this way elicits cardiopulmonary exercise at an intensity found previously to produce health-related benefits in DMD.
Central Sensitization Inventory scores correlate with pain at rest in patients with hip osteoarthritis: A retrospective study
Authors: Ohashi Yoshihisa , Fukushima Kensuke , Inoue Gen , Uchida Kentaro , Koyama Tomohisa , Tsuchiya Maho , Uchiyama Katsufumi , Takahira Naonobu , Takaso Masashi 
Published: August 2020

Abstract
Background: Patients with persistent pain due to osteoarthritis (OA) complain of multiple symptoms that cannot be explained solely by structural changes. A poor correlation exists between structural and inflammatory changes in OA and pain levels. Central sensitization (CS) has been identified as a factor that induces chronic pain in patients with OA. Although it is important to identify osteoarthritis patients with CS components, the prevalence and characteristics of CS, especially those in patients with hip OA, are not well understood. Thus, we aimed to determine the prevalence and characteristics of CS in patients with hip OA, in this study. Methods: The CS Inventory (CSI), used as a non-invasive routine clinical tool to evaluate the presence of CS 1 month before surgery in 100 patients with hip OA, was measured at our outpatient clinic, and the data were retrospectively reviewed. We determined the number of patients with a CSI score of 40 points or higher and assessed the relationships between the CSI score and clinical factors (including age, duration of hip pain, degree pain at rest and on activity, by using the visual analogue scale [VAS] and the Harris Hip Score) using the Spearman’s correlation coefficient. Results: The mean age of participants was 63.9±11.6 years, and there were 15 men and 85 women. All patients had hip OA, categorised as advanced and terminal stage (Tönnis grade 2–3) on preoperative plain radiography. The mean duration of hip pain was 4.2±4.4 years. The mean CSI score was 19.5±11.3 and 5 (5.0%) of the patients had a score of 40 or more points. CSI scores correlated significantly only with VAS pain at rest (r=0.348, P<0.001). Conclusion: In this study, 1 out of every 20 hip OA patients had CS components. CSI scores were significantly correlated with pain at rest in hip OA patients. CS approaches to hip OA may be one of the treatment options for pain at rest.
Cardiac radiation dose predicts survival in esophageal squamous cell carcinoma treated by definitive concurrent chemotherapy and intensity modulated radiotherapy
Authors: Pao Tzu-Hui , Chang Wei-Lun , Chiang Nai-Jung , Chang Jeffrey Shu-Ming , Lin Chia-Ying , Lai Wu-Wei , Tseng Yau‐Lin , Yen Yi‐Ting , Chung Ta-Jung , Lin Forn-Chia 
Published: August 2020

Abstract
Background: The prognostic significance of cardiac radiation dose in esophageal cancer after definitive concurrent chemoradiotherapy (CCRT) remains largely unknown. We aimed to investigate the association between cardiac dose-volume parameters and overall survival (OS) in esophageal squamous cell carcinoma (ESCC) after definitive CCRT. Methods: One hundred and twenty-one ESCC patients undergoing definitive CCRT with intensity modulated radiotherapy technique between 2008 and 2018 were reviewed. Cardiac dose-volume parameters were calculated. Survival of patients and cumulative incidence of adverse events were estimated by the Kaplan–Meier method and compared between groups by the log-rank test. The prognostic significance of cardiac dose-volume parameters was determined with multivariate Cox proportional hazards regression analysis. Results: Median follow-up was 16.2 months (range, 4.3-109.3). Median OS was 18.4 months. Heart V5, V10, and V20 were independent prognostic factors of OS. Median OS was longer for patients with heart V5 ≤ 94.3% (24.7 vs. 16.3 months, p = 0.0025), heart V10 ≤ 86.4% (24.8 vs. 16.9 months, p = 0.0041), and heart V20 ≤ 76.9% (20.0 vs. 17.2 months, p = 0.047). Lower cumulative incidence of symptomatic cardiac adverse events was observed among patients with heart V5 ≤ 94.3% (p = 0.017), heart V10 ≤ 86.4% (p = 0.02), and heart V20 ≤ 76.9% (p = 0.0057). Patients without symptomatic cardiac adverse events had a higher 3-year OS rate (33.8% vs. 0%, p = 0.03). Conclusions: Cardiac radiation dose inversely correlated with survival in ESCC after definitive CCRT. Radiation dose to the heart should be minimized.
Evaluation of OAR sparing and plan robustness of beam-specific PTV in lung cancer IMRT treatment
Authors: Chang Yu , Xiao Feng , Quan Hong , Yang Zhiyong 
Published: August 2020

Abstract
Purpose: Margins are employed in radiotherapy treatment planning to mitigate the dosimetric effects of geometric uncertainties for the clinical target volume (CTV). We propose a margin concept that takes the beam direction into consideration, generating a beam-specific PTV (BSPTV) on a beam entrance view. The total merged BSPTV was considered as target using for optimization. We investigated the impact of this novel approach when applied to lung IMRT treatments, and compared the treatment plans generated using BSPTV with conventional PTV. Methods and Materials: We generated the BSPTV by expanding the CTV perpendicularly to the incident beam direction using the 2D version of van Herk’s margin concept. The BSPTV and conventional PTV margin were first analyzed in digital phantom simulation. Then, fifteen lung cancer patients were used in this planning study. First, all patient targets were performed with the CTV projection area analysis to select the suitable beam angles. Then, BSPTV were generated according to the selected beam angles. IMRT plans were optimizted with the conventional PTV and BSPTV as the target volumes, respectively. The dosimetry metrics were calculated and evaluated between these two plans. The plan robustness of both plans for setup uncertainties was evaluated with worst-case analysis. Results: Both conventional PTV and BSPTV plans satisfied the CTV coverage. The BSPTV plans improved the sparing of high doses to target-surrounding lung tissues much better than the conventional PTV plans. Both D mean of Ring PTV and Ring BSPTV were significantly lower in BSPTV plans (38.89Gy and 39.43Gy) than that in the conventional PTV plans (40.27Gy and 40.68Gy). The V20, V5 and mean lung dose of the affected lung were significant lower in BSPTV plans (16.20%, 28.75% and 8.93Gy) than that in the conventional PTV plans (16.69%, 29.22% and 9.18Gy). About 80% of target coverage in all uncertainty scenarios could be achieved for both conventional PTV and BSPTV plans. Conclusions: The results suggested that the plan robustness can be guaranteed in both the BSPTV and conventional PTV plans. However, the BSPTV plans can spare the normal tissues such as lungs significant better than the conventional PTV plans.
Distribution and Prognostic Value of Left Ventricular Global Longitudinal Strain in Elderly Patients with Symptomatic Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement
Authors: Povlsen Jonas Agerlund , Rasmussen Vibeke Guldbrand , Vase Henrik , Jensen Kaare Troels , Terkelsen Christian Juhl , Christiansen Evald Høj , Tang Mariann , Pedersen Anders Lehmann Dahl , Poulsen Steen Hvitfeldt 
Published: August 2020

Abstract
AimsThe aim of present study was to examine the preoperative prevalence and distribution of impaired left ventricular global longitudinal strain (LVGLS) in elderly patients with symptomatic aortic stenosis (AS) undergoing transcutaneous aortic valve replacement (TAVR) and to determine the predictive value of LVGLS on survival.MethodsWe included 411 patients with symptomatic severe AS treated with TAVR during a 5-year period, where a baseline echocardiography including LVGLS assessment was available.ResultsMean age was 80.1±7.1 years and aortic valve area (AVA) index 0.4±0.1 cm2. 78 patients died during a median follow-up of 762 days. Mean left ventricular ejection fraction (LVEF) was 50±13% and mean LVGLS was -14.0%. LVEF was preserved in 60% of patients, while impaired LVGLS >-18% was seen in 75% of the patients. Previous myocardial infarction, LVEF < 50%, LVGLS >-14%, low gradient AS (< 4.0 m/s), tricuspid regurgitant gradient >30 mmHg were identified as significant univariate predictors of all-cause mortality. On multivariate analysis LVGLS >-14% (HR 1.79 [1.02-3.14], p=0.04) was identified as the only independent variable associated with all-cause mortality. Reduced survival was observed with an impaired LVGLS >-14% in the total population (p<0.002) but also in patients with high AS gradient with preserved LVEF. LVGLS provided incremental prognostic value with respect to clinical characteristics, AVA and LVEF (χ2 19.9, p=0.006).ConclusionsIn patients with symptomatic AS undergoing TAVR, impaired LVGLS was highly prevalent despite preserved LVEF. LVGLS >-14% was an independent predictor of all-cause mortality, and survival was reduced if LVGLS >-14 %.
A Multilevel Study of Patient-Centered Care Perceptions In Mental Health Teams
Authors: Durand Francois , Fleury Marie-Josée 
Published: August 2020

Abstract
Background: The combination of interprofessional collaboration in teams and patient-centered care is a necessary amalgamation when it comes to delivering complex mental healthy care and services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines the impact of predictors of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration, informal role self-efficacy in multidisciplinary mental health teams.Method: Cross-sectional multilevel design using self-administered bilingual validated questionnaires.Results: This study showed that belief in interprofessional collaboration’s impact on patient-centered perceptions is increased in teams with high collaboration. We also showed that collaboration is a mediator; that is, a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: In terms of research our results are in line with recent theorising on team processes and specifically established collaboration as key in a multilevel examination of predictors of patient-centered care perceptions. In terms of practice, we showed that multidisciplinary teams should know that working hard on collaboration as an answer to the complexity of patient-centered care impacts the teams’ ability to respond to its challenges but also impacts individuals’ beliefs central to the delivery of interprofessional care.
Invasion-induced root-fungal disruptions alter plant water and nitrogen economies
Authors: Bialic-Murphy Lalasia , Smith Nicholas , Voothuluru Priya , McElderry Robert , Roche Morgan , Steven Cassidy , Kivlin Stephanie , Kalisz Susan 
Published: August 2020

Abstract
Despite widespread evidence that biological invasion influences the biotic and abiotic soil environments, the extent to which each of these pathways underpins the effects of invasion on native plant traits and performance is unknown. Leveraging a long-term (14-yr) manipulative field experiment, we show that an allelochemical-producing invader, Alliaria petiolata, affects native plants through biotic mechanisms, altering the soil fungal community composition, with no apparent shifts in soil nutrient availability. These changes in belowground soil fungal communities resulted in a high cost of resource uptake for native forest perennial herbs and a shift in functional traits linked to their carbon and nutrient economies. Furthermore, we illustrate that some species in the invaded community compensate for high nutrient costs by reducing nutrient uptake and maintaining photosynthesis by expending more water. This demonstrates a trade-off in trait investment that increases nutrient use efficiency as nutrient costs increase. Our results show that invasion-induced disruptions in the soil fungal community belowground can cascade to affect aboveground plant communities via shifts in physiological traits needed to maintain plant water and nutrient economies. These complex above-belowground linkages suggest that plant invasions should be evaluated at the system-level to fully understand and predict their impact on native plants and communities.
Prevalence of High Risk Obstructive Sleep Apnoea by Berlin Questionnaire in Patients with Hypertension: Study from a Tertiary Care Hospital
Authors: Kareem Ozaifa , Tanvir Masood , Bader Ghulam Nabi 
Published: August 2020

Abstract
Background: Obstructive Sleep Apnoea (OSA), a condition characterized by a complete or partial cessation of airflow during sleep, can cause various cardiovascular disorders including hypertension. The aim of the study was to determine the prevalence of OSA in patients with hypertension. Methods: A cross-sectional prospective cohort study of 504 patients with hypertension was undertaken at a tertiary care hospital of India for a period of six months. OSA was evaluated using the Berlin questionnaire while the daytime sleepiness was determined using Epworth Sleepiness Scale. Data analysis was done using SPSS v. 20. Results: High risk of OSA was identified in 120 (23.8%) patients and the prevalence of sleepiness (Epworth Sleepiness score ˃16) was found to be 32.5% (95% CI, p˂0.001) in these patients. The mean neck circumference, waist circumference and waist-to-hip ratio for high-risk OSA group were 37.41 ± 3.396 cm, 105.90 ± 11.28 cm and 1.01 ± 0.065 respectively while for the low-risk group, these parameters were 35.45 ± 2.652 cm, 98.75 ± 10.87 cm and 0.99 ± 0.080 respectively (95% CI, p˂0.001). The mean blood pressure (BP) ≥133.52/84.37 mm Hg was recorded in patients with a high risk of OSA (95% CI, P<0.05), and resistant hypertension (3.3%) was significantly associated with the risk of OSA (95% CI, P<0.05).Conclusion: In the tertiary health care setting, the prevalence of high-risk of OSA in patients with hypertension is high. Screening for OSA should be a part of the hypertensive medical investigation and patients may benefit from a proper evaluation of OSA.
Carbon ion radiotherapy for prostate cancer with bladder invasion
Authors: Miyasaka Yuhei , Kawamura Hidemasa , Sato Hiro , Kubo Nobuteru , Mizukami Tatsuji , Matsui Hiroshi , Miyazawa Yoshiyuki , Ito Kazuto , Nakano Takashi , Suzuki Kazuhiro , Ohno Tatsuya 
Published: August 2020

Abstract
BackgroundThe optimal management of clinical T4 (cT4) prostate cancer (PC) is still uncertain. At our institution, carbon ion radiotherapy (CIRT) for nonmetastatic PC, including tumors invading the bladder, has been performed since 2010. Since carbon ion beams provide a sharp dose distribution with minimal penumbra and have biological advantages over photon radiotherapy, CIRT may provide a therapeutic benefit for PC with bladder invasion. Hence, we evaluated CIRT for PC with bladder invasion in terms of the safety and efficacy.MethodsBetween March 2010 and December 2016, a total of 1,337 patients with nonmetastatic PC received CIRT at a total dose of 57.6 Gy (RBE) in 16 fractions over 4 weeks. Among them, 7 patients who had locally advanced PC with bladder invasion were identified. Long-term androgen-deprivation therapy (ADT) was also administered to these patients. Adverse events were graded according to the Common Terminology Criteria for Adverse Event (CTCAE) version 5.0.ResultsAt the conclusion of our study, all the patients with cT4 PC were alive with a median follow-up period of 78 months. Grade 2 acute urinary disorders were observed in only 1 patient. Regarding late toxicities, only 1 patient developed grade 2 hematuria and urinary urgency. There was no grade 3 or worse toxicity. Gastrointestinal toxicity was not observed. Six (85.7%) patients had no recurrence or metastasis. One patient had biochemical and local failures 42 and 45 months after CIRT, respectively. However, the recurrent disease has been well controlled by salvage ADT.ConclusionsSeven patients with locally advanced PC invading the bladder treated with CIRT were evaluated. Our findings seem to suggest positive safety and efficacy profiles for CIRT.
Thyroid function and non-alcoholic fatty liver disease in hyperthyroidism patients
Authors: Wang Bairong , Yang Yumei , Wang Baomin , Xu Jing , Hong Mengyang , Xia Mingfeng , Li Xiaomu , Gao Xin 
Published: August 2020

Abstract
Background: Although thyroid function has been demonstrated to be associated with non-alcoholic fatty liver disease (NAFLD) in different population, the prevalence and features of NAFLD in hyperthyroidism have not been reported. The present study aims to investigate the prevalence of NAFLD and association of thyroid function and NAFLD in hyperthyroidism patients.Methods: This cross-sectional study was performed in Zhongshan Hospital, Fudan University, China. A total 117 patients with hyperthyroidism were consecutively recruited from 2014-2015. Thyroid function and other clinical features were measured, liver fat content was measured by color Doppler ultrasonically, NFALD was defined in patients with liver fat content more than 9.15% . Statistical analyses were performed with SPSS software package version 13.0.Results: The prevalence of NAFLD was 11.97% in hyperthyroidism. Patient with NAFLD had lower fT3 and fT4 levels than patients without NAFLD (P < 0.05). After adjusting for age, gender, metabolic parameters and inflammation factors, higher fT3 were associated with lower liver fat content (β=－0.072, P=0.009) and decreased odds ratio of NAFLD (OR=0.267, 95%CI 0.087-0.817, P=0.021). Conclusions: The prevalence of NAFLD was 11.97% in hyperthyroidism patients, and FT3 level was negatively associated with the liver fat content in this population.
Effect of a Benign Prostatic Hyperplasia (BPH) Xenobiotic - Croton membranaceus Müll.Arg. Root Extract on CYP1A2, CYP3A4, CYP2D6, and GSTM1 Drug Metabolizing Enzymes in Rat Model
Authors: Asare George A. , Ongong'a Royronald Ochieng , Anang Yvonne , Asmah Richard H. , Rahman Habibur 
Published: August 2020

Abstract
Background

Croton membranaceus Müll.Arg., root extract has been scientifically and clinically proven to be efficacious in the management of BPH. However, its effect on liver drug-metabolizing enzymes has not been established. This study aimed to determine the effect of the plant extract on phase I and phase II drug-metabolizing enzymes.
Materials and methods

Fifteen (15) castrated testosterone-induce BPH male Albino Wister rats weighing between 120–150 grams were randomly divided into 3 groups of 5 rats each (Groups II-IV). Five (5) uncastrated rats in Group I was used as a negative control, receiving only distilled water. Group II was administered 30 mg/kg b. wt extracts of C. membranaceus. Group III was the BPH-model group (administered distilled water) while Group IV was administered 0.5 mg/kg b. wt finasteride and was used as the positive control. BPH was induced in groups II-IV by administering testosterone propionate, 3 mg/kg b. wt for 28 days after a 7-day post castration rest period. Rats were euthanized and individual livers harvested for microsome preparation. The liver microsomes were assayed for, Phase I Drug Metabolizing Enzymes (DME); CYP1A2, CYP3A4, CYP2D6, and phase II; GST-M1 using Enzyme-Linked Immuno-Sorbent Assay (ELISA) techniques.
Results

Significant induction in phase I enzymes CYP1A2 was observed (p = 0.02), while CYP3A4 and CYP2D6 were inhibited (0.00, 0.01, respectively). Phase II enzymes, GSTM1, showed a significant induced (p = 0.01). C.membranaceus induced CYP1A2 strongly, GSTM1 modestly, and had an inhibitory effect on CYP3A4/CYP2D6.
Conclusion

Croton membranaceus induces and inhibits some phase I metabolizing enzymes while moderately inducing phase II metabolizing enzymes. Care should be taken in the use of phytotherapy in conjunction with other drugs.