bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revisiting the Beighton Criteria: Does Ligamentous Laxity Testing Correlate With Shoulder Range of Motion Norms in a North American, Pediatric Population?
Authors: Cahill Sean V. , Sharkey Melinda S. , Carter Cordelia W. 
Published: June 2020

Background:
Ligamentous laxity testing using the Beighton score is frequently used as part of the pediatric shoulder examination. However, the relationship between generalized ligamentous laxity (GLL) and shoulder range of motion (ROM) remains unexamined in children, and normative data for these clinical tests have not been well established. In this study, we establish normative data for shoulder range of motion and GLL in a healthy, diverse pediatric population and investigate whether Beighton testing correlates with shoulder ROM in children.

Methods:
Healthy subjects age 2 to 18 years with isolated lower extremity complaints were recruited. Passive shoulder ROM measurements for forward flexion (FF), abduction (ABD), internal rotation (IR), external rotation (ER), and extension (EXT) were obtained using a long-armed goniometer. The Beighton score was obtained, with a positive test defined as ≥5. Descriptive statistics were used to stratify data on the basis of age and sex. Interclass correlation coefficients (ICCs) were calculated. Spearman’s r was calculated to determine correlations between the Beighton score and shoulder ROM. Predictive indices of a positive Beighton test to identify patients with high shoulder mobility (ROM in the top 15 percentile, or 1 SD above the mean) were calculated.

Results:
A total of 202 subjects were enrolled and evaluated. Passive ROM norms by age and sex were determined. Intraclass correlation coefficients for all shoulder ROM measurements were substantial to excellent. Female individuals had greater ROM than age-matched male individuals, but this trend was largely statistically insignificant. Pearson’s correlation between age and shoulder ROM was significant for FF, ABD, EXT, and ER (r=−0.52 to −0.20, P<0.001). Based on a Beighton score of ≥5, the prevalence of GLL was 10% in male and 15% in female individuals. Spearman’s correlation between Beighton score and shoulder ROM was significant for 3 of 5 ROM measurements: FF, ER, and EXT (r=0.30 to 0.39, P<0.001).

Conclusions:
Normative pediatric shoulder ROM and joint laxity data have been established in a healthy, diverse population of children. Beighton testing exhibits only a weak to moderate correlation, despite statistical significance, with shoulder ROM and is poorly predictive for high ROM in children.

Level of Evidence:
Level I— Diagnostic.
Combined Phacoemulsification With Goniosynechialysis Under Ophthalmic Endoscope for Primary Angle-closure Glaucoma After Failed Trabeculectomy
Authors: Nie Li , Fu Lin , Chan Yau Kei , Fang Aiwu , Pan Weihua 
Published: June 2020

Precis:
Phacoemulsification with goniosynechialysis under an ophthalmic endoscope (Phaco-OE-GSL) is safe and able to lowering intraocular pressure (IOP) for failed trabeculectomy in primary angle-closure glaucoma with cataract. The larger pupil diameter and younger age are identified as the 2 risk factors for surgical outcome.

Purpose:
To investigate the efficacy and safety of combined Phaco-OE-GSL for primary angle-closure glaucoma with cataract after failed trabeculectomy.

Materials and Methods:
Twenty-five patients (25 eyes) were enrolled in this retrospective study. IOP, best-corrected visual acuity, and number of glaucoma medications at baseline and each postoperative follow-up visit were recorded. Peripheral anterior synechia (PAS) was recorded using gonioscopy. Binary logistic regression was used to analyze the risk factors of surgical failure.

Results:
The mean follow-up duration was 17.9±11.4 months. The mean IOP was significantly lower than the preoperative baseline IOP at all time points (P<0.001). The mean IOP was reduced from 24.4±6.5 mm Hg at baseline to 14.2±3.0 mm Hg at the last follow-up. The mean preoperative number of glaucoma medications was 2.2±1.2, which reduced to 0.9±1.1 at the last follow-up. The complete success rates at 1 year and the last follow-up were 70.6% and 68%, respectively. The total success rates were 96% and 92%, respectively. The most common postoperative complications were IOP spikes (48%) and hyphemas (32%). All eyes had degrees of PAS recurrence, with a range of 96.1±52.5 degrees (30 to 210 degrees) after 4 to 6 months. Larger pupil diameter and younger age were significantly associated with the failure of Phaco-OE-GSL.

Conclusions:
Phaco-OE-GSL is safe and can lower IOP for failed trabeculectomy in PACG with cataract despite the high recurrence rate of PAS.
Drug Eluting Versus Covered Metal Stents in Malignant Biliary Strictures—Is There a Clinical Benefit?
Authors: Mohan Babu P. , Canakis Andrew , Khan Shahab R. , Chandan Saurabh , Ponnada Suresh , McDonough Stephanie , Adler Douglas G. 
Published: June 2020

Goals/Background:
Patients with malignant biliary obstruction (MBO) often require transpapillary stenting for symptomatic relief and biliary decompression. Plastic stents and uncovered metal stents are now replaced by covered self-expanding metal stents (SEMS). However, stent occlusion from tumor overgrowth and chronic inflammation continues to be an issue. Drug-eluting stents (DES), through an antitumor paclitaxel membrane, have been used to combat this problem. The aim of this study was to conduct a meta-analysis comparing DES to SEMS in MBO.

Study:
Multiple databases were searched to identify studies that compared the clinical outcomes of SEMS and DES in patients with MBO. Random-effects model was used to calculate the pooled odds ratio and the pooled individual outcomes. Our primary goals were to assess the stent patency and overall survival in days. Secondary outcomes assessed the individual reported adverse events and/or complications.

Results:
Five studies including 348 patients (175 males and 173 females) were included. The pooled odds ratio of stent patency was 1.03 (95% confidence interval: 0.68-1.54, P=0.9) and overall survival was 1.16 (95% confidence interval: 0.63-2.11, P=0.6). The pooled rate of stent patency was 168.3 (95% 140.7-196.4) days for DES and 149.4 (117.6-181.2) days for SEMS. The pooled rate of overall survival was 267.2 (206.2-328.2) days for DES and 218.2 (148.5-287.8) days for SEMS.

Conclusion:
On the basis of this meta-analysis, DES and SEMS seem to demonstrate comparable clinical outcomes in patients with malignant biliary strictures. Reported adverse events and/or complications were comparable as well.
A study of conventional histological parameters in excision specimens of breast cancer over a 7 year period and association with immunohistochemical categories
Authors: Sanyal Parikshit , Singh Anshuman , Ganguli Prosenjit , Barui Sanghita 
Published: June 2020

AbstractBackgroundAlong with conventional histological examination, immunohistochemistry (IHC) is a useful adjunct to assessment of a breast cancer excision specimen. Previous studies have shown differences in behavior of neoplasms depending on their histopathological as well as immunohistochemical categories; in particular, triple negative breast cancers (on IHC) show the worst prognosis.ObjectivesTo find association, if any, within conventional histopathological characteristics (size, grade, stage, mitotic count, desmoplasia, dense inflammatory infiltrate, lymphovascular invasion) and between the conventional parameters and immunohistochemical categories of breast cancer, in both primary and post neo adjuvant chemotherapy (NACT) specimens.Methods177 breast cancer excision specimens examined over last 7 years were assessed retrospectively, their histopathological parameters were recorded. In cases where immunohistochemistry was performed (N=108) the specimen was placed in one of the immunohistochemical categories: Luminal A, Luminal B, Her2 and Triple negative cancers. The data was then analysed by standard statistical methods.ResultsNo statistically significant association was found between the histopathological parameters and IHC category was. However, a strong correlation was seen between lymphovascular invasion within the primary tumor and increasing lymph node involvement. There was also a reduction in ER and PR expression in neoplasms post NACT, while HER2 expression remained largely unchanged.ConclusionThere might be additional genetic subtypes underlying the immunohistochemical phenotypes which determine the morphological characteristics of the neoplasm.
A Deep Learning Based Cardiac Cine Segmentation Framework for Clinicians – Transfer Learning Application to 7T
Authors: Ankenbrand Markus Johannes , Lohr David , Schlötelburg Wiebke , Reiter Theresa , Wech Tobias , Schreiber Laura Maria 
Published: June 2020

AbstractBackgroundArtificial neural networks have shown promising performance in automatic segmentation of cardiac magnetic resonance imaging. However, initial training of such networks requires large amounts of annotated data and generalization to different vendors, field strengths, sequence parameters, and pathologies is often limited. Transfer learning has been proposed to address this challenge, but specific recommendations on the type and amount of data required is lacking. In this study we aim to assess data requirements for transfer learning to cardiac 7T in humans where the segmentation task can be challenging. In addition, we provide guidelines, tools, and annotated data to enable transfer learning approaches of other researchers and clinicians.MethodsA publicly available model for bi-ventricular segmentation is used to annotate a publicly available data set. This labelled data set is subsequently used to train a neural network for segmentation of left ventricular and myocardial contours in cardiac cine MRI. The network is used as starting point for transfer learning to the segmentation task on 7T cine data of healthy volunteers (n=22, 7873 images). Structured and random data subsets of different sizes were used to systematically assess data requirements for successful transfer learning.ResultsInconsistencies in the publically available data set were corrected, labels created, and a neural network trained. On 7T cardiac cine images the initial model achieved DICELV=0.835 and DICEMY=0.670. Transfer learning using 7T cine data and ImageNet weight initialization significantly (p<10−3) improved model performance to DICELV=0.900 and DICEMY=0.791. Using only end-systolic and end-diastolic images reduced training data by 90%, with no negative impact on segmentation performance (DICELV=0.908, DICEMY=0.805).ConclusionsThis work demonstrates the benefits of transfer learning for cardiac cine image segmentation on a quantitative basis. We also make data, models and code publicly available, while providing practical guidelines for researchers planning transfer learning projects in cardiac MRI.
Deregulated cellular circuits driving immunoglobulins and complement consumption associate with the severity of COVID-19
Authors: Marcos-Jiménez Ana , Sánchez-Alonso Santiago , Alcaraz-Serna Ana , Esparcia Laura , López-Sanz Celia , Sampedro-Núñez Miguel , Mateu-Albero Tamara , Sánchez-Cerrillo Ildefonso , Martínez-Fleta Pedro , Gabrie Ligia , del Campo Guerola Luciana , López-Trascasa Margarita , Martín-Gayo Enrique , Calzada María , Castañeda Santos , de la Fuente Hortensia , González-Álvaro Isidoro , Sánchez-Madrid Francisco , Muñoz-Calleja Cecilia , Alfranca Arantzazu 
Published: June 2020

AbstractBackgroundSARS-CoV-2 infection causes an abrupt response by the host immune system, which is largely responsible for the pathogenesis and outcome of COVID-19. We aimed to investigate which specific responses from either cellular or humoral immunity associate to severity and progression of COVID-19.MethodsA cohort of 276 patients classified in mild, moderate and severe, was studied. Peripheral blood lymphocyte subpopulations were quantified by flow cytometry, and immunoglobulins and complement proteins by nephelometry.ResultsAt admission, dramatic lymphopenia of T, B and NK cells associated to severity. However, only the proportion of B cells increased, while T and NK cells appeared unaffected. Accordingly, the number of plasma cells and circulating follicular helper T cells (cTfh) increased, but levels of IgM, IgA and IgG were unaffected. When degrees of severity were considered, IgG was lower in severe patients, suggesting an IgG consumption by complement activation or antibody-dependent cellular cytotoxicity (ADCC). Activated CD56-CD16+ NK-cells, which mediate ADCC, were increased. Regarding complement, C3 and C4 protein levels were higher in mild and moderate, but not in severe patients, compared to healthy donors. Moreover, IgG and C4 decreased from day 0 to day 10 in patients who were hospitalized for more than two weeks, but not in patients who were discharged earlier.ConclusionOur study provides important clues to understand the immune response observed in COVID-19 patients, which is probably related to viral clearance, but also underlies its pathogenesis and severity. This study associates for the first time COVID-19 severity with an imbalanced humoral immune response characterized by excessive consumption of IgG and C4, identifying new targets for therapeutic intervention.
Machine Learning Models Identify Inhibitors of SARS-CoV-2
Authors: Gawriljuk Victor O. , Kyaw Zin Phyo Phyo , Foil Daniel H. , Bernatchez Jean , Beck Sungjun , Beutler Nathan , Ricketts James , Yang Linlin , Rogers Thomas , Puhl Ana C. , Zorn Kimberley M. , Lane Thomas R. , Godoy Andre S. , Oliva Glaucius , Siqueira-Neto Jair L. , Madrid Peter B. , Ekins Sean 
Published: June 2020

AbstractWith the ongoing SARS-CoV-2 pandemic there is an urgent need for the discovery of a treatment for the coronavirus disease (COVID-19). Drug repurposing is one of the most rapid strategies for addressing this need and numerous compounds have been selected forin vitrotesting by several groups already. These have led to a growing database of molecules within vitroactivity against the virus. Machine learning models can assist drug discovery through prediction of the best compounds based on previously published data. Herein we have implemented several machine learning methods to develop predictive models from recent SARS-CoV-2in vitroinhibition data and used them to prioritize additional FDA approved compounds forin vitrotesting selected from our in-house compound library. From the compounds predicted with a Bayesian machine learning model, CPI1062 and CPI1155 showed antiviral activity in HeLa-ACE2 cell-based assays and represent potential repurposing opportunities for COVID-19. This approach can be greatly expanded to exhaustively virtually screen available molecules with predicted activity against this virus as well as a prioritization tool for SARS-CoV-2 antiviral drug discovery programs. The very latest model for SARS-CoV-2 is available atwww.assaycentral.org.
A new fractal model for the soliton motion in a microgravity space
Authors: Wang KangLe 
Published: June 2020

PurposeOn a microgravity condition, a motion of soliton might be subject to a microgravity-induced motion. There is no theory so far to study the effect of air density and gravity on the motion property. Here, the author considers the air as discrete molecules and a motion of a soliton is modeled based on He’s fractal derivative in a microgravity space. The variational principle of the alternative model is constructed by semi-inverse method. The variational principle can be used to establish the conservation laws and reveal the structure of the solution. Finally, its approximate analytical solution is found by using two-scale method and homotopy perturbation method (HPM).Design/methodology/approachThe author establishes a new fractal model based on He’s fractal derivative in a microgravity space and its variational principle is obtained via the semi-inverse method. The approximate analytical solution of the fractal model is obtained by using two-scale method and HPM.FindingsHe’s fractal derivative is a powerful tool to establish a mathematical model in microgravity space. The variational principle of the fractal model can be used to establish the conservation laws and reveal the structure of the solution.Originality/valueThe author proposes the first fractal model for the soliton motion in a microgravtity space and obtains its variational principle and approximate solution.
Public opinion information dissemination in mobile social networks – taking Sina Weibo as an example
Authors: Wang Xiwei , Xing Yunfei , Wei Yanan , Zheng QingXiao , Xing Guochun 
Published: June 2020

Purpose
Social media, especially microblog, has become one of the most popular platforms for public opinion dissemination. However, so far few studies have been conducted to explore information dissemination under the mobile environment. This paper aims to introduce the approach to analyze the public opinion information dissemination in mobile social networks.

Design/methodology/approach
This paper chooses “network attack” as the research topic and extracts 23,567 relevant messages from Sina Microblogs to study the structure of nodes for public opinion dissemination and the characteristics of propagation paths on mobile internet. Public opinion dissemination is compared on both mobile and non-mobile terminals.

Findings
The results reveal the characteristics of public opinion dissemination in mobile environment and identify three patterns of information propagation path. This study concludes that public opinion on mobile internet propagates more widely and efficiently and generates more impact than that on the non-mobile internet.

Social implications
The methods used in this study can be useful for the government and other organizations to analyze and identify problems in online information dissemination.

Originality/value
This paper explores the mechanism of public opinion dissemination on mobile internet in China and further investigates how to improve public opinion management through a case study related to “network attack.”
Distributional analysis of rural-urban household healthcare expenditure differentials in developing countries: evidence from Ghana
Authors: Ampaw Samuel , Nketiah-Amponsah Edward , Agyire-Tettey Frank , Senadza Bernardin 
Published: June 2020

Purpose
Equity in access to and use of healthcare resources is a global development agenda. Policymakers’ knowledge of the sources of differences in household healthcare spending is crucial for effective policy. This paper aims to investigate the differences in the determinants of household healthcare expenditure across space and along selected quantiles of healthcare expenditure in Ghana. The determinants of rural-urban healthcare expenditure gap are also explored.

Design/methodology/approach
Data was obtained from the sixth round of the Ghana Living Standards Survey (GLSS 6) conducted in 2013. An unconditional quantile regression (UQR) and a decomposition technique based on UQR, adjusted for sample selection bias, were applied.

Findings
The results indicate that differences in the determinants of household healthcare expenditure across space and along quantiles are driven by individual-level variables. Besides, the rural-urban health expenditure gap is greatest among households in the lower quantiles and this gap is largely driven by differences in household income per capita and percentage of household members enrolled on health insurance policies.

Originality/value
The findings show that there are differences in the determinants of household health expenditure along with the income distribution, as well as between rural and urban localities, which would call for targeted policies to address these inequalities.
Leadership and motivation for improved academic performance in schools in low socio-economic contexts
Authors: Heystek Jan , Emekako Raymond 
Published: June 2020

PurposeThis paper examines motivational practices and engagements of schools – through strategies developed by principals with the members of the school management team – to improve academic performance.Design/methodology/approachThe research used an interpretive approach within a qualitative design in which schools were purposefully selected. In each of the sampled schools, individual interviews were conducted with the principal as well as a focus group with the school management team and another focus group was identified teachers.FindingsThe main findings reveal that school labelling (where schools are labelled as underperforming schools) as a public notice was identified as the main push towards intrinsic motivation, especially when positive results in learner performance are eventually achieved. Extra classes, teaching collaboration, monitoring and team building were some of the main strategies used. Efforts appear to focus on performance in Grade 12 examinations. Therefore, the study recommends that attention be spread across all grades as a long-term improvement plan for the education system. Furthermore, since these strategies have worked successfully, the national and the provincial education departments should consider developing plans for academic improvement based on these strategies.Research limitations/implicationsThis research contributed to the understanding of school improvement in a specific context of low socio economic and societal context and schools are able to improve in spite of the challenging context. This is specifically in a developing country's context. More research can be conducted about the specific influence of intrinsic motivation and how extrinsic factors can become internalised as intrinsic motivation factors.Practical implicationsThe findings from this project can provide leadership at schools with the necessary information and examples of what can be done to get teachers to improve the performance in a challenging context. The use of extrinsic as well as intrinsic motivational actions can provide the leadership with the necessary guidelines to implement in their schools. The appointment of principals with specific characteristics needed attention in policy as well as the practice of the appointment process.Originality/valueThe research is contributed to the knowledge of school improvement from a perspective of a developing country and is using motivational theories within this context. The limited literature which links motivation to the process of school improvement is advanced from ice perspective of low socio economic context in a developing country.