bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of a preventive self-care health management program for community-dwelling older adults: a randomised controlled trial
Authors: Wong Arkers Kwan Ching , Wong Frances Kam Yuet , So Ching 
Published: June 2020

Abstract

Objective
To examine the cost-effectiveness of a preventive self-care health management program for community-dwelling older adults as compared to usual care.

Design/Intervention
A cost-effectiveness analysis was executed alongside a randomised controlled trial. Nurse case managers provided interventions, including holistic assessment, empowerment of self-care, preventive health behaviours and self-efficacy with co-produced care planning, supported by nursing students. The control group received social control calls.

Participants/Setting
Community-dwelling older adults were randomly assigned to the intervention (n = 271) or control (n = 269) group. The intervention was conducted in collaboration with 11 community centres under four non-government organisations in various districts of Hong Kong.

Measurements
Cost and quality-adjusted life years (QALYs) were collected pre (baseline, 0 months) and post intervention (3 months) and 3 months after completion of the program (6 months). Incremental cost-effectiveness ratios between the groups were calculated, dividing the difference in cost by the difference in QALYs.

Results
Analysis showed that the net incremental QALY gain was 0.0014 (3 months) and 0.0033 (6 months) when the intervention group was compared to the control group. The probability of being cost-effective at 6 months was 53.2% and 53.4%, based on the cost-effectiveness thresholds recommended by both the National Institute for Health and Clinical Excellence ($200,000/QALYs) and the World Health Organization (Hong Kong gross domestic product/capita, HK$381,780).

Conclusions
The results provide some evidence to suggest that the addition of a home-based, preventive self-care health management program may have effects on cost outcomes for community-dwelling older adults in Hong Kong.
Strangled by Dr Strangelove? Anarchic hand following a posterior cerebral artery territory ischemic stroke
Authors: Murdoch Mhairi , Hill Jenny , Barber Mark 
Published: June 2020

Abstract
Anarchic hand is a rare condition where the complex movements of one hand appear to be goal directed and smoothly executed and yet are unintended and unwanted. Unlike alien hand syndrome, the patients recognise that the affected hand is part of their own body. They know the hand is theirs, but they deny having control over its actions. The syndrome has been reported after surgery on the corpus callosum and with brain tumours, aneurysms, degenerative diseases of the brain and uncommonly with stroke. We present a case of a 74-year-old man who developed an anarchic right hand following thrombolysis for a posterior cerebral artery territory ischemic stroke.
Histology of Liver of the Deceased Due to Harmful Use of Alcohol
Authors: Rorat Marta , Hałoń Agnieszka , Jurek Tomasz 
Published: June 2020

Abstract

Aim
To study types and incidence of histological changes in liver of people deceased due to harmful use of alcohol.

Methods
A retrospective review of medico-legal autopsy of 236 adults who died in the years 2015–2016 due to harmful use of alcohol was done. Histopathological liver samples taken during autopsies were evaluated. Blood alcohol content was analyzed. Serological tests for hepatitis B surface antigen and anti-hepatitis C virus (HCV) were performed.

Results
The most common liver pathology (83.1%) was steatosis, mainly mixed type (50%); 66.9% had high-grade steatosis. Liver fibrosis was detected in 39.4% of cases, with fibrosis of higher than or equal to third grade in 14%, hepatitis in 44.5% and steatohepatitis in 19.1%. Toxic hepatocyte injury features (ballooning degeneration, Mallory–Denk bodies) were found in 20.8% cases and degenerative-damage changes in 41.1%. The correlation between the grade of steatosis and fibrosis (P = 0.0005), toxic injury (0.00000101) and degenerative–traumatic changes (P = 0.00000741) was found. The correlation was found between hepatitis and higher than or equal to third grade steatosis (P = 0.037), cholestasis (P = 0.0139), toxic injury features (P = 2.58 × 10−13), degenerative–damage changes (P = 7.9 × 10−12) and presence of anti-HCV (P = 0.00723) and between progression of fibrosis and presence of toxic injury features (2.28 × 10−19), degenerative–damage changes (P = 4.25 × 10−11) and anti-HCV (P = 0.0263).

Conclusions
Spectrum of histopathological liver changes is broad regardless of sex, and various traits are present in various patterns. Comorbidities have strong influence on the picture of changes in the liver. Exact evaluation how often and what histopathological changes will develop in alcohol liver disease is not possible by reason of variability of external factors.
Epilepsy-causing STX1B mutations translate altered protein functions into distinct phenotypes in mouse neurons
Authors: Vardar Gülçin , Gerth Fabian , Schmitt Xiao Jakob , Rautenstrauch Pia , Trimbuch Thorsten , Schubert Julian , Lerche Holger , Rosenmund Christian , Freund Christian 
Published: June 2020

AbstractSyntaxin 1B (STX1B) is a core component of the N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) complex that is critical for the exocytosis of synaptic vesicles in the presynapse. SNARE-mediated vesicle fusion is assisted by Munc18-1, which recruits STX1B in the auto-inhibited conformation, while Munc13 catalyses the fast and efficient pairing of helices during SNARE complex formation. Mutations within the STX1B gene are associated with epilepsy. Here we analysed three STX1B mutations by biochemical and electrophysiological means. These three paradigmatic mutations cause epilepsy syndromes of different severity, from benign fever-associated seizures in childhood to severe epileptic encephalopathies. An insertion/deletion (K45/RMCIE, L46M) mutation (STX1BInDel), causing mild epilepsy and located in the early helical Habc domain, leads to an unfolded protein unable to sustain neurotransmission. STX1BG226R, causing epileptic encephalopathies, strongly compromises the interaction with Munc18-1 and reduces expression of both proteins, the size of the readily releasable pool of vesicles, and Ca2+-triggered neurotransmitter release when expressed in STX1-null neurons. The mutation STX1BV216E, also causing epileptic encephalopathies, only slightly diminishes Munc18-1 and Munc13 interactions, but leads to enhanced fusogenicity and increased vesicular release probability, also in STX1-null neurons. Even though the synaptic output remained unchanged in excitatory hippocampal STX1B+/− neurons exogenously expressing STX1B mutants, the manifestation of clear and distinct molecular disease mechanisms by these mutants suggest that certain forms of epilepsies can be conceptualized by assigning mutations to structurally sensitive regions of the STX1B−Munc18-1 interface, translating into distinct neurophysiological phenotypes.
Brain Networks Processing Temporal Information in Dynamic Facial Expressions
Authors: Skiba Rafal M , Vuilleumier Patrik 
Published: June 2020

AbstractThis fMRI study examines the role of local and global motion information in facial movements during exposure to novel dynamic face stimuli. We found that synchronous expressions distinctively engaged medial prefrontal areas in the rostral and caudal sectors of anterior cingulate cortex (r/cACC) extending to inferior supplementary motor areas, as well as motor cortex and bilateral superior frontal gyrus (global temporal-spatial processing). Asynchronous expressions in which one part of the face unfolded before the other activated more the right superior temporal sulcus (STS) and inferior frontal gyrus (local temporal-spatial processing). These differences in temporal dynamics had no effect on visual face-responsive areas. Dynamic causal modeling analysis further showed that processing of asynchronous expression features was associated with a differential information flow, centered on STS, which received direct input from occipital cortex and projected to the amygdala. Moreover, STS and amygdala displayed selective interactions with cACC where the integration of both local and global motion cues could take place. These results provide new evidence for a role of local and global temporal dynamics in emotional expressions, extracted in partly separate brain pathways. Importantly, we show that dynamic expressions with synchronous movement cues may distinctively engage brain areas responsible for motor execution of expressions.
Should Contact Bans Have Been Lifted More in Germany?
Authors: Donsimoni Jean Roch , Glawion René , Plachter Bodo , Wälde Klaus , Weiser Constantin 
Published: June 2020

Abstract
Many countries consider the lifting of restrictions of social contacts (RSC). We quantify the effects of RSC for Germany. We initially employ a purely statistical approach to predicting prevalence of Covid-19 if RSC had been upheld after 20 April. We employ these findings and feed them into our theoretical model. We find that the peak of the number of sick individuals would have been reached already end of April. The number of sick individuals would have fallen below 1000 at the beginning of July. If restrictions had been lifted completely on April 20, the number of sick should have risen quickly again from around 27 April. A balance between economic and individual costs of RSC and public health objectives consists in lifting RSC for activities that have high economic benefits but low health costs. In the absence of large-scale representative testing of CoV-2 infections, these activities can most easily be identified if federal states of Germany adopted exit strategies that differ across states.
Vacuum-formed retainers and bonded retainers for dental stabilization—a randomized controlled trial. Part II: patients’ perceptions 6 and 18 months after orthodontic treatment
Authors: Krämer Anke , Sjöström Mats , Hallman Mats , Feldmann Ingalill 
Published: June 2020

SummaryObjectiveTo compare removable vacuum-formed Essix C retainers with bonded cuspid-to-cuspid retainers (CTCs) regarding patients’ perceptions after debonding and 6 and 18 months of retention.Trial designA single-centre two-arm parallel-group randomized controlled trial.MethodsThis trial included 104 adolescent patients, computer-generated randomized, with sequentially numbered, opaque and sealed envelopes, into two groups and stratified by gender. They were treated with fixed appliances with and without tooth extractions in both jaws and were ready for debond. Patients in the intervention arm received a vacuum-formed retainer (VFR) in the mandible (n = 52), and patients in the active comparator arm received a CTC (n = 52). Both groups had a VFR in the maxilla. Treatment outcome satisfaction, quality of care and attention, side-effects during the retention phase, and retainer acceptance and compliance were assessed with questionnaires at baseline (T1, 2 weeks after debond) and after 6 (T2) and 18 months (T3) of retention. Operator was blinded to group assignment during measurements.ResultsNinety-five patients completed the questionnaires at all three time points. Patients were overall satisfied with treatment outcome, quality of care and attention, and how their retainers worked at all three time points, with no differences between groups. At T1 and T3, the VFR group reported significantly more pain and discomfort (T1: P = 0.005, T3: P &lt; 0.0001) and soreness (T1: P = 0.001, T3: P = 0.011) in the mandible compared to the CTC group. The CTC group found it easier to get used to their retainers. After 18 months, 70.5 per cent in the VFR group and 73.9 per cent in the CTC group reported the recommended wear-time of the VFRs. Decreased wear-time was correlated to perceived pain and discomfort (rs = −0.421, P &lt; 0.0001).LimitationsThe results were limited by our retainer design and recommended wear regimen.ConclusionsBoth groups reported high treatment outcome satisfaction and low levels of side-effects during the retention phase. Nevertheless, the VFR group reported more pain and discomfort at T1 and at T3. Self-reported compliance was the same in both groups. The VFR group was more concerned about relapse.Trial registrationNCT03070444 (https://clinicaltrials.gov).
Designing ELF-aware lessons in high-stakes exam contexts
Authors: Sifakis Nicos C , Tsantila Natasha , Masina Aristea , Vourdanou Katerina 
Published: June 2020

AbstractIn ELT contexts, the concept of ELF awareness has been proposed as a means of developing the skills, strategies, and overall outlook that learners require to competently participate in ELF interactions. Depending on the teaching context, this can be a demanding process. We discuss the ELF-aware instructional interventions carried out by two practitioners working in high-stakes exam preparation contexts in Greece. These contexts are predominantly Standard English oriented. The interventions described an attempt to put into practice the principles of ELF-aware pedagogy, namely awareness of language and language use, awareness of instructional practice, and awareness of learning. The innovative aspect of these interventions is that they do not run contrary to the curriculum of these high-stakes exam preparation classes. On the contrary, they complement the courseware used in these contexts with authentic audiovisual materials and original metalinguistic activities that boost learners’ self-confidence as ELF speakers and as candidates of these exams.
Bacteriophage-mediated manipulation of the gut microbiome – promises and presents limitations
Authors: Rasmussen Torben Sølbeck , Koefoed Anna Kirstine , Jakobsen Rasmus Riemer , Deng Ling , Castro-Mejía Josué L , Brunse Anders , Neve Horst , Vogensen Finn Kvist , Nielsen Dennis Sandris 
Published: June 2020

ABSTRACT
Gut microbiome (GM) composition and function are linked to human health and disease, and routes for manipulating the GM have become an area of intense research. Due to its high treatment efficacy, the use of fecal microbiota transplantation (FMT) is generally accepted as a promising experimental treatment for patients suffering from GM imbalances (dysbiosis), e.g. caused by recurrent Clostridioides difficile infections (rCDI). Mounting evidence suggests that bacteriophages (phages) play a key role in successful FMT treatment by restoring the dysbiotic bacterial GM. As a refinement to FMT, removing the bacterial component of donor feces by sterile filtration, also referred to as fecal virome transplantation (FVT), decreases the risk of invasive infections caused by bacteria. However, eukaryotic viruses and prophage-encoded virulence factors remain a safety issue. Recent in vivo studies show how cascading effects are initiated when phage communities are transferred to the gut by e.g. FVT, which leads to changes in the GM composition, host metabolome, and improve host health such as alleviating symptoms of obesity and type-2-diabetes (T2D). In this review, we discuss the promises and limitations of FVT along with the perspectives of using FVT to treat various diseases associated with GM dysbiosis.
Functional Studies with Primary Cells Provide a System for Genome-to-Phenome Investigations in Marine Mammals
Authors: Lam Emily K , Allen Kaitlin N , Torres-Velarde Julia María , Vázquez-Medina José Pablo 
Published: June 2020

Synopsis
Marine mammals exhibit some of the most dramatic physiological adaptations in their clade and offer unparalleled insights into the mechanisms driving convergent evolution on relatively short time scales. Some of these adaptations, such as extreme tolerance to hypoxia and prolonged food deprivation, are uncommon among most terrestrial mammals and challenge established metabolic principles of supply and demand balance. Non-targeted omics studies are starting to uncover the genetic foundations of such adaptations, but tools for testing functional significance in these animals are currently lacking. Cellular modeling with primary cells represents a powerful approach for elucidating the molecular etiology of physiological adaptation, a critical step in accelerating genome-to-phenome studies in organisms in which transgenesis is impossible (e.g., large-bodied, long-lived, fully aquatic, federally protected species). Gene perturbation studies in primary cells can directly evaluate whether specific mutations, gene loss, or duplication confer functional advantages such as hypoxia or stress tolerance in marine mammals. Here, we summarize how genetic and pharmacological manipulation approaches in primary cells have advanced mechanistic investigations in other non-traditional mammalian species, and highlight the need for such investigations in marine mammals. We also provide key considerations for isolating, culturing, and conducting experiments with marine mammal cells under conditions that mimic in vivo states. We propose that primary cell culture is a critical tool for conducting functional mechanistic studies (e.g., gene knockdown, over-expression, or editing) that can provide the missing link between genome- and organismal-level understanding of physiological adaptations in marine mammals.
Respiratory Syncytial Virus Consortium in Europe (RESCEU) Birth Cohort Study: Defining the Burden of Infant Respiratory Syncytial Virus Disease in Europe
Authors: Wildenbeest Joanne G , Zuurbier Roy P , Korsten Koos , van Houten Marlies A , Billard Marie N , Derksen-Lazet Nicole , Snape Matthew D , Drysdale Simon B , Robinson Hannah , Pollard Andrew J , Heikkinen Terho , Cunningham Steve , Leach Amanda , Martinón-Torres Federico , Rodríguez-Tenreiro Sánchez Carmen , Gómez-Carballa Alberto , Bont Louis J ,   RESCEU Investigators, Wildenbeest Joanne , Zuurbier Roy , Korsten Koos , van Houten Marlies , Billard Marie , Derksen-Lazet Nicole , Bont Louis , Drysdale Simon , Snape Matthew , Robinson Hannah , Pollard Andrew , Martinón-Torres Federico , Sánchez Carmen Rodríguez-Tenreiro , Gómez-Carballa Alberto , Heikkinen Terho , Cunningham Steve , Nair Harish , Campbell Harry , Leach Amanda , Openshaw Peter , Beutels Philippe , Molero Eva , Meijer Adam , Sanders Elisabeth , Fischer Thea Kølsen , van den Berge Maarten , Giaquinto Carlo , Esser Mark , Knirsch Charles , Gallichan Scott , Aerssens Jeroen , Rosen Brian , Wildenbeest Joanne , Zuurbier Roy , Korsten Koos , van Houten Marlies , Billard Marie , Derksen-Lazet Nicole , Bont Louis , Drysdale Simon , Snape Matthew , Robinson Hannah , Pollard Andrew , Martinón-Torres Federico , Sánchez Carmen Rodríguez-Tenreiro , Gómez-Carballa Alberto , Heikkinen Terho , Cunningham Steve , Nair Harish , Campbell Harry , Leach Amanda , Openshaw Peter , Beutels Philippe , Molero Eva , Meijer Adam , Sanders Elisabeth , Fischer Thea Kølsen , van den Berge Maarten , Giaquinto Carlo , Esser Mark , Knirsch Charles , Gallichan Scott , Aerssens Jeroen , Rosen Brian 
Published: June 2020

AbstractBackgroundRespiratory syncytial virus (RSV) causes significant morbidity and mortality in infants worldwide. Although prematurity and cardiopulmonary disease are risk factors for severe disease, the majority of infants hospitalized with RSV are previously healthy. Various vaccines and therapeutics are under development and expected to be available in the near future. To inform the use of these new vaccines and therapeutics, it is necessary to determine the burden of RSV disease in Europe. We will prospectively follow-up a birth cohort to obtain incidence data on RSV acute respiratory tract infection (ARTI).MethodsMulticenter prospective study of a birth cohort consisting of 10 000 healthy infants, recruited during 3 consecutive years. RSV associated hospitalization in the first year of life will be determined by questionnaires and hospital chart reviews. A nested cohort of 1000 infants will be actively followed. In case of ARTI, a respiratory sample will be collected for RSV molecular diagnosis.ResultsThe primary outcome is the incidence rate of RSV-associated hospitalization in the first year of life. In the active cohort the primary outcome is RSV associated ARTI and MA-ARTI.ConclusionsWe will provide key information to fill the gaps in knowledge about the burden of RSV disease in healthy infants.Clinical Trials RegistrationNCT03627572.
Synthetic minority oversampling of vital statistics data with generative adversarial networks
Authors: Koivu Aki , Sairanen Mikko , Airola Antti , Pahikkala Tapio 
Published: June 2020

Abstract

Objective
Minority oversampling is a standard approach used for adjusting the ratio between the classes on imbalanced data. However, established methods often provide modest improvements in classification performance when applied to data with extremely imbalanced class distribution and to mixed-type data. This is usual for vital statistics data, in which the outcome incidence dictates the amount of positive observations. In this article, we developed a novel neural network-based oversampling method called actGAN (activation-specific generative adversarial network) that can derive useful synthetic observations in terms of increasing prediction performance in this context.

Materials and Methods
From vital statistics data, the outcome of early stillbirth was chosen to be predicted based on demographics, pregnancy history, and infections. The data contained 363 560 live births and 139 early stillbirths, resulting in class imbalance of 99.96% and 0.04%. The hyperparameters of actGAN and a baseline method SMOTE-NC (Synthetic Minority Over-sampling Technique-Nominal Continuous) were tuned with Bayesian optimization, and both were compared against a cost-sensitive learning-only approach.

Results
While SMOTE-NC provided mixed results, actGAN was able to improve true positive rate at a clinically significant false positive rate and area under the curve from the receiver-operating characteristic curve consistently.

Discussion
Including an activation-specific output layer to a generator network of actGAN enables the addition of information about the underlying data structure, which overperforms the nominal mechanism of SMOTE-NC.

Conclusions
actGAN provides an improvement to the prediction performance for our learning task. Our developed method could be applied to other mixed-type data prediction tasks that are known to be afflicted by class imbalance and limited data availability.