bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Robot-Aided Rehabilitation on Improving Ankle and Balance Performance of Stroke Survivors: A Randomized Controlled Trial
Authors: Zhai Xiaoxue , Wu Qiong , Xu Quan , Li Xin , Zhang Yanlin , Fan Senchao , Zhang Li-Qun , Pan Yu 
Published: June 2020

Abstract
Background: Stroke survivors often experience abnormal posture control, which affects balance and locomotion. The ankle strategy is important in maintaining static balance. Prolonged spasticity may result in biomechanical changes at the ankle joint, which may cause balance disorders. The intelligent stretching device may decrease the stiffness of the ankle and improve balance. The purpose of this study was to investigate the effects of robot-aided ankle rehabilitation of stroke survivors with ankle spasticity and the correlations between biomechanical properties and balance in these patients. Methods: Twenty inpatients post stroke with ankle spasticity performed 20 minutes of stretching treatment for 2 weeks. The study group used a rehabilitation robot to stretch the spastic ankle plantar flexors under intelligent control and the control group received manual stretching. Outcome measures included biomechanical, clinical evaluations and Pro-Kin balance test. Results: After training, significant improvements were found in both groups in the active range of motion, muscle strength, Berg Balance Scale, Fugl-Meyer Motor Assessment of Lower Extremity, Postural Assessment Scale for Stroke Patients, 6-minute walk test, and Modified Barthel Index (P<0.05); significant decreases were found in the study group in dorsiflexion stiffness, Modified Ashworth Scale, trajectory lengths, elliptical trajectory, standard deviation medial/lateral, average speed forward/backward with eyes closed, and standard deviation forward/backward with eyes open (P=0.001, P=0.037, P=0.028, P=0.019, P=0.016, P=0.001, and P=0.033, respectively); dorsiflexion stiffness was positively correlated with the Pro-Kin balance test outcomes: ellipse area, trajectory length, average speed forward/backward, average speed medial/lateral with eyes open ( =0.352, P=0.026; =0.522, P=0.001; =0.045, P=0.004; =0.433, P=0.005, respectively); dorsiflexion stiffness was correlated with the Modified Ashworth Scale ( =0.265, P=0.041); the study group improved significantly more than the control group in the activities of daily living after training (P =0 .017). Conclusions: The results suggested that robot-aided ankle rehabilitation had a positive effect on the biomechanical properties of the spastic ankle, and it may be feasible to improve balance post-stroke. Ankle dorsiflexion stiffness affected balance poststroke significantly; it may be a sensitive indicator for evaluating balance. Trial registration: www.chictr.org.cn ChiCTR1900022128. Registered 21 February 2020. Retrospectively registered.
Lithospheric Flexural Isostasy Background of the 2017 Ms7.0 Jiuzhaigou Earthquake and Its Implications on Material Extrusion in the Northeastern Bayan Har Block
Authors: Hu Minzhang , Wu Yunlong , Hao Hongtao , Wang Jiapei , Wang Jian , Li Zhongya 
Published: June 2020

Abstract
We applied a 2-dimensional, non-spectral technique to investigate the spatial variations of the lithospheric effective elastic thickness (Te) in the eastern Bayan Har block and its adjacent areas. Te values were determined by comparison of observed and flexural modelled Bouguer gravity anomalies. The results suggested that Te vary significantly from eastern Tibet to the Sichuan basin. The eastern Bayan Har block and northern Sichuan-Yunan block had low Te (0<Te<20km), indicated easily deformable lithosphere. The Sichuan basin had high Te (40km<Te<100km), and acted as a rigid block which resisted the eastward extrusion of plateau materials. Moderate Te (30km<Te<40km) under the Longmen Shan fault belt indicated that the lithosphere of the Sichuan basin plays an important role in supporting the Longmen Shan topography. The extremely low Te (Te<10km) in the seismogenic zone of the Ms7.0 Jiuzhaigou earthquake indicated that the topography is compensated locally, different from the Longmen Shan significantly. A banded relatively low Te (<40km) region stretched from northeastern Bayan Har block to southwestern Ordos block sketches out a plateau material escaping channel, questions the exiting of crustal flow in the north side of the Sichuan basin.
Effect of hypoglycemia on measures of myocardial blood flow and myocardial injury in adults with and without type 1 diabetes: a prospective, randomized, open-label, blinded endpoint, cross-over study
Authors: Noh Radzi M , Graveling AJ , Lang Ninian N , White Audrey C , Lee Ken K , Mills Nicholas L , Newby David E , Lang Chim C , Frier Brian M 
Published: June 2020

Abstract
Aims Hypoglycemia provokes a profound autonomic response in humans including cardiovascular effects. This study examined the effect of experimentally-induced hypoglycemia on measures of myocardial blood flow and myocardial injury in adults with, and without, type 1 diabetes. Methods and Results In a prospective, randomized, open-label, blinded, endpoint cross-over study, 17 young adults with type 1 diabetes with no cardiovascular risk factors, and 10 healthy non-diabetic volunteers, underwent hyperinsulinemic euglycemic (blood glucose 4.5-5.5 mmol/L or 81-99 mg/dL) and hypoglycemic (2.2-2.5 mmol/L or 40-45 mg/dL) clamps. Myocardial blood flow was assessed using transthoracic echocardiography Doppler coronary flow reserve (CFR) and myocardial injury using plasma high-sensitivity cardiac troponin I (hs-cTnI) concentration. During euglycemia, a non-significant trend for lower CFR was observed in participants with type 1 diabetes than in those without type 1 diabetes (3.66±0.47 versus 3.92±0.85), and a non-significant lower trend also occurred during hypoglycemia (type 1 diabetes: 3.54±0.58 versus non-diabetes: 3.80±0.84). A generalized linear mixed-model analysis was performed, with diabetes status and euglycaemia or hypoglycaemia as factors affecting CFR. No significant statistical difference in CFR was observed for diabetes status (p=0.23) or between euglycemia and hypoglycemia (p=0.31). No changes in hs-cTnI occurred during hypoglycemia or in the recovery period (p=0.86). Conclusions While the observed reduction in coronary flow reserve did not achieve significance during exposure to insulin-induced hypoglycemia in healthy young men with type 1 diabetes, with no evidence of myocardial injury, adverse cardiovascular effects of hypoglycemia cannot be excluded in older people who have coronary disease. Further studies are required to investigate this putative problem.
The burden and correlates of childhood undernutrition in Tanzania according to composite index of anthropometric failure
Authors: Khamis Ahmed Gharib , Mwanri Akwilina Wendelin , Kreppel Katharina , Kwesigabo Gideon 
Published: June 2020

Abstract
Background
Undernutrition is a public health problem worldwide. Tanzania has made significant achievements in the reduction of childhood undernutrition over the past two decades. However, the exact burden of undernutrition was under-estimated when using conventional indices of stunting, wasting and underweight. The objective of this study was to determine the overall prevalence of undernutrition, describe the trends and examine the correlates associated with undernutrition among children under the age of five years using the composite index of anthropometric failure (CIAF). This study aims to understand the real burden and drivers of undernutrition to improve design, implementation and monitoring of appropriate interventions to emeliorate childhood undernutrition in the country.
Methods
We retrieved and analyzed the data of mother-child pairs from the Tanzania Demographic and Health Surveys (TDHS) of 1991, 1996, 1999, 2004-05, 2009-10, and 2015-16 using Stata and SPSS software. Data for 1991 to 2015 were used to determine the burden and trends of undernutrition. The recent TDHS surveys of 2004-05, 2010 and 2015-16 were used to determine the correlates of undernutrition. The main outcome of interest was undernutrition measured using CIAF. This is an aggregated index of conventional indices of stunting, wasting and underweight of children aged below 59 months. We used multivariate logistic regression analysis to identify the correlates associated with CIAF, whereby both crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) were determined.
Results
About one in every three (38.2%) of the surveyed children had anthropometric failure in 2015 compared to half of them (50%) in 1991. The odds of anthropometric failure were significantly higher for boys, older children, living in rural areas, living in poorer households, and being born with non-educated or undernourished mothers. Female-headed households were more likely to have children with anthropometric failure, while age of the household head was negatively associated with anthropometric failure. Children who were born at home, with low birth weight, or having episode of illnesses such as diarhea or fever were most likely to have anthropometric failure.
Conclusion
One in every three under 5 years old children are suffering from either one or multiple forms of anthropometric failure in Tanzania as revealed by CIAF. Multiple factors including those related to mothers, children and household socio-economic characteristics have the potential to influence childhood anthropometric failure. Efforts to reduce the burden of undernutrition should focus on reducing poverty and raising people’s living standards.
Substance use in adults of Yazd Greater Area, 2014-2015: A population based study
Authors: Bagheri Behnam , Mirzaei Mohsen , Mirzaei Masoud 
Published: June 2020

Abstract
Background: Substance use disorders (SUDs), including substance dependence or abuse, have a tremendous impact on individuals, families, communities, and governments. Objective: The purpose of this study was to investigate the prevalence of SUDs in Yazd Greater Area during 2014-2015.Method: This study uses data from the Yazd Health Study (YaHS) recruitment phase which was conducted from 2014 to 2015, to investigate the epidemiology of SUDs among 20-70 year-old adults. We studied 9965 participants 20-70 years old who lived in Yazd Greater Area. Data were collected using a validated questionnaire. Results: The age-adjusted prevalence of illicit substance use was 6.2% (95% CI: 5%-7.4%). for men and 2.5% (95% CI: 1.7%-3.6%) for women. The substance use was significantly correlated with age (r= -0.29, p=0.006), educational level (r= -0.24, p=0.021), tobacco smoking (r= 0.23, p= 0.001), and sex (r= -0.98, p=0.001), But with hookah smoking had no significant relationship (r= -0.01, p=0.891). 35.6% of those consuming drugs had a previous history of addiction treatment. Also, the prevalence of substance use was greater in elders. Conclusion: This study indicated that the prevalence of substance use in adults of Yazd Greater Area which was correlated to the factors including consumption of cigarettes, age, and sex. The prevalence of various addictions is slightly higher than the rest of Iran.
Network Pharmacology-based Research of the Therapeutic Effects of Epimedium Brevicornu Maxim on Diminished Ovarian Reserve
Authors: He Shan , Ning Yan , Jiang Shaoyan , Zeng Dan , Deng Shaojie , Xiong Yi , Liu Dayan 
Published: June 2020

Abstract
Background: Diminished ovarian reserve (DOR) is a common gynecological disease. As a traditional Chinese medicine, Epimedium brevicornu maxim (EBM) is often used to treat sexual dysfunction and irregular menstruation. But whether EBM could alleviate the symptoms of DOR is unclear.Methods: We constructed the DOR rat models and determined the effect of EBM on the development of DOR. Next, we used the network pharmacology to analyze the active ingredients of EBM and the targeted genes of these ingredients. And the critical genes were selected for the next research. ELISA were performed to detect the expression of these genes in the serum of rats.Results: We found that the EBM treatment suppressed the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the ovary tissue of rats. Meanwhile, the levels of estradiol (E2), anti-mullerian hormone (AMH) and Inhibin B (INHB) was promoted after the EBM treatment. The HE staining showed that the treatment of EBM enhanced the formation of follicles. Based on the network pharmacology analysis, we found that EBM has the potential to relieve symptoms of DOR by modulating the levels of steroid hormone receptor.Conclusion: In conclusion, EBM relieved the symptoms of DOR by modulating the steroid hormone receptors, such as promoting the secretion of androgen receptor (AR) and estrogen receptor (ESR1).
Deficits in Skilled Motor and Auditory Learning in a Rat Model of Rett Syndrome
Authors: Adcock Katherine S. , Blount Abigail E. , Morrison Robert A. , Alvarez-Dieppa Amanda , Kilgard Michael P. , Engineer Crystal T. , Hays Seth A. 
Published: June 2020

Abstract
Background Rett Syndrome is an X-linked neurodevelopmental disorder caused by a mutation in the gene MECP2 . Individuals with Rett Syndrome display developmental regression at an early age, and develop a range of motor, auditory, cognitive and social impairments. Several studies have successfully modeled some aspects of dysfunction and Rett Syndrome-like phenotypes in transgenic mouse and rat models bearing mutations in the MECP2 gene. Here, we sought to extend these findings and characterize skilled learning, a more complex behavior known to be altered in Rett syndrome. Methods We evaluated the acquisition and performance of auditory and motor function on two complex tasks in heterozygous female Mecp2 rats. Animals were trained to perform a speech discrimination task or a skilled forelimb reaching task. Results Our results reveal that Mecp2 rats display slower acquisition and reduced performance on an auditory discrimination task than wild-type (WT) littermates. Similarly, Mecp2 rats exhibit impaired learning rates and worse performance on a skilled forelimb motor task compared to WT. Conclusions Together, these findings illustrate novel deficits in skilled learning consistent with clinical manifestation of Rett syndrome and provide a framework for development of therapeutic strategies to improve these complex behaviors.
Identification and validation of a novel prognostic index based on m6A RNA methylation regulators in esophageal carcinoma
Authors: Yang Wanli , Duan Lili , Zhao Xinhui , Wang Xiaoqian , Li Yiding , Niu Liaoran , Zhang Yujie , Zhou Wei , Liu Jinqiang , Zhao Qingchuan , Han Yu , Fan Daiming , Hong Liu 
Published: June 2020

Abstract
Background

The incidence and mortality rate of esophageal carcinoma (ESCA) remains high. This study proposed to explore the promising prognostic markers based on m6A RNA methylation regulators, and finally to improve the prognostic assessment for ESCA patients.
Methods

The RNA sequencing and relevant clinical data of ESCA and normal tissues were obtained from The Cancer Genome Atlas (TCGA) database. Then, we evaluated the expression pattern of 13 m6A methylation regulators in ESCA and normal samples. Two groups of ESCA were divided by the consensus clustering analysis. STRING database and R package were used to construct the protein-protein interaction network and conduct correlation analysis, respectively. Cox regression and least absolute shrinkage and selection operator (LASSO) regression analyses were performed to develop the multiple-gene risk signature. Kaplan-Meier method and receiver operating characteristic (ROC) curves were used to assess the accuracy of the model. The clinical nomogram combining clinicpathological factors and gene signature was built to predict survival rate of ESCA patients. Gene set enrichment analysis (GSEA) and networks prediction analysis were conducted to explore the signaling pathways that related to the risk genes.
Results

Eight m6A methylation regulators (HNRNPC, YTHDF1, METTL3, YTHDF2, WTAP, YTHDC1, KIAA1429, and RBM15) were significantly upregulated in ESCA. Two clusters of ESCA with obvious differences in tumor stage were identified via the consensus clustering analysis. A two-gene signature, ALKBH5 and HNRNPC, was established for predicting the prognosis of ESCA patients. Kaplan-Meier curves illustrated that the overall survival of patients in low-risk group was obviously longer than that of patients in high-risk group (P = 1.411e-02). Importantly, risk score and tumor stage were identified as the independent prognostic indicators. The testing dataset GSE13898 showed that the nomogram had a good capacity to assess the prognosis of ESCA patients. Cell cycle, mTOR pathway, and p53 signaling pathway were found to be related to the dysregulation of risk genes.
Conclusions

m6A RNA methylation regulators ALKBH5 and HNRNPC could act as prognostic indicators and therapeutic targets for prognostic analysis and cancer treatment of ESCA.
Influence of chronic kidney disease on early clinical outcomes after off-pump coronary artery bypass grafting
Authors: Li Xihui , Zhang Siyu , Xiao Feng 
Published: June 2020

Abstract
Backgroud:
Patients with chronic kidney disease (CKD) have a high incidence of coronary heart disease, which is the leading cause of death in these patients. CABG significantly decreases short-term and long-term mortality in patients with CKD compared with PCI. The effect of CKD on the early outcomes of off-pump CABG has been studied less often. We aimed to investigate the effect of CKD on early postoperative mortality and complications following off-pump coronary artery bypass grafting (CABG). Methods: We retrospectively analyzed preoperative baseline and surgery data for 1173 patients undergoing off-pump CABG from January 2010 to December 2017 in the Department of Cardiac Surgery, Peking University First Hospital. Outpatient follow-up was performed until 30 days postoperatively. Patients with estimated glomerular filtration rates calculated according to the Chronic Kidney Disease Epidemiology Collaboration equation ≥ 60 mL/min/1.73 m2 were assigned to the normal renal function group (normal group, n = 924), and those with a rate < 60 mL/min/1.73 m2 were assigned to the CKD group (CKD group, n = 249). Results: Patients in the CKD group were seriously ill with multiple complications, and postoperative 30-day mortality and complication rates were significantly higher than those in the normal group. In the logistic regression analysis, after correcting for common confounding factors, namely, sex, age, and left ventricular ejection fraction, preoperative CKD was a risk factor for postoperative acute kidney injury, perioperative myocardial infarction, gastrointestinal bleeding, secondary tracheal intubation, stroke, chest wound infection, prolonged mechanical ventilation (≥ 24 h), prolonged intensive care unit stay (≥ 72 h), prolonged length of stay (≥ 14d), dialysis requirement, and postoperative death within 30 days. Conclusions: Patients with CKD had more preoperative complications, and their postoperative 30-day mortality and complication rates after off-pump CABG were significantly higher than those of patients with normal renal function. For CABG patients with CKD, the risk of surgery should be assessed carefully, and comprehensive measures should be taken to strengthen perioperative management, with an aim to reduce complications and mortality and improve surgical outcomes.
Continuous Endometrial Volumetric Analysis for Endometrial Receptivity Assessment on Assisted Reproductive Technology Cycles
Authors: Martins Renato , Oliani Antonio Helio , Oliani Denise Vaz , de Oliveira Jose Martinez 
Published: June 2020

Abstract
Research Question: Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. In order to assess endometrial receptivity in Assisted Reproductive Technology (ART) cycles continuous evaluation of endometrial volumetric analysis may have a predictive value on a positive outcome.Design: Serial 3D transvaginal ultrasound performed in women on ART cycle to evaluate a pattern that better predicts implantation rates. 169 subjects on a prospective case control study were assessed. Endometrial pattern, endometrial thickness, endometrial volume and adjusted endometrial volume (ratio between endometrial volume and uterine volume) was performed to all subjects on a continuous process from baseline (prior to ovarian controlled stimulation), day 6, 8 and 10 of controlled ovarian stimulation, trigger day with human chorionic gonadotropin hormone (hCG) and at embryo transfer day.Results: No statistical difference was noted between the two groups in terms of demographics and ART procedures and scores. Endometrium morphology also didn’t show any difference between the two groups. Endometrial volume and adjusted endometrial volume was significantly higher in the positive group as soon as day 6 of ovarian controlled stimulation.Conclusions: Continuous serial 3D endometrial volume and adjusted endometrial volumes may be a useful tool for clinicians in predicting endometrial receptivity enhancing elective embryo transfers in fresh ART cycle, and thus providing a non-invasive continuous technique for endometrial receptivity assessment that reflects endometrial changes during ART procedures.
N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Indicator for 30-Day Mortality Following Out-of-Hospital Cardiac Arrest: A prospective observational study
Authors: Aarsetøy Reidun , Omland Torbjørn , Røsjø Helge , Strand Heidi , Lindner Thomas Werner , Aarsetøy Hildegunn , Staines Harold , Nilsen Dennis Winston Trygve 
Published: June 2020

Abstract
Background
Early risk stratification applying cardiac biomarkers may prove useful in sudden cardiac arrest patients. We investigated the prognostic utility of early-on levels of high sensitivity cardiac troponin-T (hs-cTnT), copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with out-of-hospital cardiac arrest (OHCA).
Methods
We conducted a prospective observational unicenter study, including patients with OHCA of assumed cardiac origin from the southwestern part of Norway from 2007 until 2010. Blood samples for later measurements were drawn during cardiopulmonary resuscitation or at hospital admission.
Results
A total of 114 patients were included, 37 patients with asystole and 77 patients with VF as first recorded heart rhythm. Forty-four patients (38.6%) survived 30-day follow-up. Neither hs-cTnT (p = 0.49), nor copeptin (p = 0.39) differed between non-survivors and survivors, whereas NT-proBNP was higher in non-survivors and significantly associated with time to death, with a hazard ratio (HR) for patients in the highest compared to the lowest quartile of 4.6 (95% CI 2.1–10.1), p < 0.001. This association was attenuated in the multivariable analysis [HR 2.18 (95% CI 0.83–5.72)], p = 0.11. NT-proBNP was significantly higher in asystole- as compared to VF-patients, p < 0.001.
Conclusions
In OHCA, NT-proBNP was significantly associated with 30-day survival in univariate analysis, but associations were attenuated after multivariable adjustment. Hs-cTnT and copeptin did not provide prognostic information following OHCA.
Clinical Trial Registration:
ClinicalTrials. gov, NCT02886273.