bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving diabetes control for Syrian refugees in Jordan: a longitudinal cohort study comparing the effects of cash transfers and health education interventions
Authors: Lyles By Emily , Chua Stephen , Barham Yasmeen , Pfieffer-Mundt Kayla , Spiegel Paul , Burton Ann , Doocy Shannon 
Published: May 2021

Abstract
Background
Cash transfers are an increasingly common intervention in the Syrian refugee response to meet basic needs, though there is little known of their potential secondary impact on health outcomes in humanitarian settings.

Methods
A quasi-experimental prospective cohort study was implemented from October 2018 through January 2020 to assess the effectiveness of multi-purpose cash (MPC), community health volunteer (CHV)-led education, combined with conditional cash transfers (CCT) with respect to health measures among Syrian refugees with type II diabetes in Jordan.

Results
CHV + CCT participants had the highest expenditures at endline and were the only group with statistically significant increases in payments for outpatient diabetes care (25.3%, P < 0.001) and monthly medication costs (13.6%, P < 0.001). Conversely, monthly spending on diabetes medication decreased significantly in the CHV only group (− 18.7%, P = 0.001) yet increased in the MPC and CHV + CCT groups. Expenditures on glucose monitoring increased in all groups but significantly more in the CHV + CCT group (39.2%, P < 0.001).
The proportion of participants reporting regular diabetes care visits increased significantly only in the CHV + CCT group (15.1%, P = 0.002). Specialist visits also increased among CHV + CCT participants (16.8%, P = 0.001), but decreased in CHV only participants (− 27.8%, P < 0.001). Decreases in cost-motivated provider selection (− 22.8%, P < 0.001) and not receiving all needed care because of cost (− 26.2%, P < 0.001) were significant only in the CHV + CCT group.
A small significant decrease in BMI was observed in the CHV + CCT group (− 1.0, P = 0.005). Decreases in HbA1C were significant in all groups with magnitudes ranging from − 0.2 to − 0.7%. The proportion of CHV + CCT participants with normal blood pressure increased significantly from baseline to endline by 11.3% (P = 0.007).

Conclusions
Combined conditional cash and health education were effective in improving expenditures, health service utilization, medication adherence, blood pressure, and diabetes control. The lower cost health education intervention was similarly effective in improving diabetes control, whereas unconditional cash transfers alone were least effective. Study findings suggest that conditional cash or combined cash and health education are promising strategies to support diabetes control among refugees and that where the purpose of MPC is to improve health outcomes, this alone is insufficient to achieve improvements in the health of refugees with diabetes.
scDesign2: a transparent simulator that generates high-fidelity single-cell gene expression count data with gene correlations captured
Authors: Sun Tianyi , Song Dongyuan , Li Wei Vivian , Li Jingyi Jessica 
Published: May 2021

AbstractA pressing challenge in single-cell transcriptomics is to benchmark experimental protocols and computational methods. A solution is to use computational simulators, but existing simulators cannot simultaneously achieve three goals: preserving genes, capturing gene correlations, and generating any number of cells with varying sequencing depths. To fill this gap, we propose scDesign2, a transparent simulator that achieves all three goals and generates high-fidelity synthetic data for multiple single-cell gene expression count-based technologies. In particular, scDesign2 is advantageous in its transparent use of probabilistic models and its ability to capture gene correlations via copulas.
Optimising AVATAR therapy for people who hear distressing voices: study protocol for the AVATAR2 multi-centre randomised controlled trial
Authors: Garety Philippa , Edwards Clementine J. , Ward Thomas , Emsley Richard , Huckvale Mark , McCrone Paul , Rus-Calafell Mar , Fornells-Ambrojo Miriam , Gumley Andrew , Haddock Gillian , Bucci Sandra , McLeod Hamish , Hardy Amy , Peters Emmanuelle , Myin-Germeys Inez , Craig Thomas 
Published: May 2021

Abstract
Background
AVATAR therapy is a novel intervention targeting distressing auditory verbal hallucinations (henceforth ‘voices’). A digital simulation (avatar) of the voice is created and used in a three-way dialogue between participant, avatar and therapist. To date, therapy has been delivered over 6 sessions, comprising an initial phase, focusing on standing up to a hostile avatar, and a second phase in which the avatar concedes and focus shifts to individualised treatment targets, including beliefs about voices. The first fully powered randomised trial found AVATAR therapy resulted in a rapid and substantial fall in voice frequency and associated distress that was superior to supportive counselling at 12 weeks. The main objective of this AVATAR2 trial is to test the efficacy of two forms of AVATAR therapy in reducing voice-related distress: AVATAR-brief (standardised focus on exposure, assertiveness and self-esteem) and AVATAR-extended (phase 1 mirroring AVATAR-brief augmented by a formulation-driven phase 2). Secondary objectives include the examination of additional voice, wellbeing and mood outcomes, the exploration of mediators and moderators of therapy response, and examining cost-effectiveness of both forms of therapy compared with usual treatment (TAU).

Methods
This multi-site parallel group randomised controlled trial will independently randomise 345 individuals to receive AVATAR-brief (6 sessions) plus TAU or AVATAR-extended (12 sessions) plus TAU or TAU alone (1:1:1 allocation). Participants will be people with a diagnosis of schizophrenia spectrum and other psychotic disorders who have heard distressing voices for more than 6 months. The primary outcome is the PSYRATS Auditory Hallucinations Distress dimension score at 16 and 28 weeks, conducted by blinded assessors. Statistical analysis will follow the intention-to-treat principle and data will be analysed using linear mixed models. Mediation and moderation analyses using contemporary causal inference methods will be conducted as secondary analyses. Service costs will be calculated, and cost-effectiveness assessed in terms of quality-adjusted life years accrued.

Discussion
This study will clarify optimal therapy delivery, test efficacy in a multi-site study and enable the testing of the AVATAR software platform, therapy training and provision in NHS settings.

Trial registration
ISRCTN registry ISRCTN55682735. Registered on 22 January 2020. The trial is funded by the Wellcome Trust (WT).
The efficacy of repetitive transcranial magnetic stimulation (rTMS) for young individuals with high-level perceived stress: study protocol for a randomized sham-controlled trial
Authors: Wu Jingsong , Han Mengyu , He Youze , Xie Xiaoting , Song Jian , Geng Xiujuan 
Published: May 2021

Abstract
Background
High level of perceived stress may result in negative effects both psychologically and physically on individuals and may predispose onset of mental disorders such as depression, anxiety, and posttraumatic stress disorder. However, there is no suitable intervention for it. Repetitive transcranial magnetic stimulation (rTMS) studies have shown its therapeutic efficacy in treatment resistant patients with stress-related disorders. Here we describe an exploratory study protocol to investigate the effect of the intervention for the individuals with high level of stress.

Method
This is a single blinded, randomized sham-controlled trial, targeting at young healthy adults aging from 18 to 24 years old. Forty eligible volunteers will be recruited and randomly divided into active and sham rTMS group. All subjects will take a set of neuropsychological and biological assessments and MRI scanning before and right after the intervention. During the interventional period, 12-session stimulations will be performed in 4 weeks with three sessions per week. The primary outcome will detect the difference of Chinese 14-item perceived stress scales between active and sham rTMS groups after intervention. Secondary outcomes will examine the differences of other affective measurements, level of cortisol, and MRI-derived neural functional measures between the two groups after intervention.

Discussion
This trial aims to examine the effect of the 12-session rTMS intervention on individuals with high level of perceived stress. Positive or negative findings from any of the outcome measures would further our understanding of the efficacy of the stimulation and its neural impact. If effective, it would provide an evidence for a new treatment for high perceived stress.

Trial registration
Chinese Clinical Trial Registry (ChiCTR1900027662). Registered on 23 November 2019. And all items of the WHO Trial Registry Data set can be found within the protocol.
First record of Goldlined seabream Rhabdosargus sarba (Forsskål 1775), Sparidae, in the Mediterranean Sea (Syrian waters)
Authors: Hamwi Nader , Ali-Basha Nour 
Published: May 2021

AbstractThis paper presents the first record of Rhabdosargus sarba (Forsskål 1775) in the Mediterranean Sea and the Syrian marine waters. One specimen (163 mm TL, 66.45 g TW) was caught by trammel nets at a depth range between 50 and 60 m, from Lattakia coast, on 31 January 2021. This record represents the first sighting of this immigrant species that entered the Mediterranean Sea to Syrian waters from the Red Sea. the key to the species of Rhabdosargus is provided.
Reinforcement learning in local energy markets
Authors: Bose Samrat , Kremers Enrique , Mengelkamp Esther Marie , Eberbach Jan , Weinhardt Christof 
Published: May 2021

AbstractLocal energy markets (LEMs) are well suited to address the challenges of the European energy transition movement. They incite investments in renewable energy sources (RES), can improve the integration of RES into the energy system, and empower local communities. However, as electricity is a low involvement good, residential households have neither the expertise nor do they want to put in the time and effort to trade themselves on their own on short-term LEMs. Thus, machine learning algorithms are proposed to take over the bidding for households under realistic market information. We simulate a LEM on a 15 min merit-order market mechanism and deploy reinforcement learning as strategic learning for the agents. In a multi-agent simulation of 100 households including PV, micro-cogeneration, and demand shifting appliances, we show how participants in a LEM can achieve a self-sufficiency of up to 30% with trading and 41,4% with trading and demand response (DR) through an installation of only 5kWp PV panels in 45% of the households under affordable energy prices. A sensitivity analysis shows how the results differ according to the share of renewable generation and degree of demand flexibility.
Postindustrial Waterfront Redevelopment and the Politics of Historical Memory
Authors: Feinsod Harris 
Published: May 2021

AbstractHow have cities reorganized attention to their waterfronts after the decline of urban seaports? What kind of cultural record attends this reorganization? This article investigates the politics of historical memory at several sites of postindustrial harbor redevelopment since the 1960s. It locates the aesthetic sensibilities of waterfront renewal in a scattered network of comic tableaux in literature, art, and moving images, including the documentaries of Dutch filmmaker Joris Ivens, the sitcom Arrested Development, and a mural at Baltimore’s National Aquarium. Like fragments of Benjamin’s dialectical image, these scenes bring together the allegorical ruin of the urban seaport with comic efforts to inaugurate its future as a commercial esplanade, as if virtualizing and intensifying those two phases of Benjaminian historiography (early modern allegory and nineteenth-century commodity). Intermittently, where this dialectical image begins to be realized, these sites have erupted in acts of de-monumentalization by anticolonial and alter-globalization activists. The article locates fragments of this dialectical image in seaports including Rotterdam, Baltimore, Barcelona, Long Beach, and Genoa, studied under the names given to their harbors by developers: Europoort, Harborplace, Port Vell, Rainbow Harbor, and Porto Antico.
Postnatal prolongation of mammalian nephrogenesis by excess fetal GDNF
Authors: Li Hao , Kurtzeborn Kristen , Kupari Jussi , Gui Yujuan , Siefker Edward , Lu Benson , Mätlik Kärt , Olfat Soophie , Montaño-Rodríguez Ana R. , Huh Sung-Ho , Costantini Franklin , Andressoo Jaan-Olle , Kuure Satu 
Published: May 2021

ABSTRACT
Nephron endowment, defined during the fetal period, dictates renal and related cardiovascular health throughout life. We show here that, despite its negative effects on kidney growth, genetic increase of GDNF prolongs the nephrogenic program beyond its normal cessation. Multi-stage mechanistic analysis revealed that excess GDNF maintains nephron progenitors and nephrogenesis through increased expression of its secreted targets and augmented WNT signaling, leading to a two-part effect on nephron progenitor maintenance. Abnormally high GDNF in embryonic kidneys upregulates its known targets but also Wnt9b and Axin2, with concomitant deceleration of nephron progenitor proliferation. Decline of GDNF levels in postnatal kidneys normalizes the ureteric bud and creates a permissive environment for continuation of the nephrogenic program, as demonstrated by morphologically and molecularly normal postnatal nephron progenitor self-renewal and differentiation. These results establish that excess GDNF has a bi-phasic effect on nephron progenitors in mice, which can faithfully respond to GDNF dosage manipulation during the fetal and postnatal period. Our results suggest that sensing the signaling activity level is an important mechanism through which GDNF and other molecules contribute to nephron progenitor lifespan specification.
Long-term memory of configural learning is enhanced via CREB upregulation by the flavonoid quercetin inLymnaea stagnalis
Authors: Batabyal Anuradha , Rivi Veronica , Benatti Cristina , Blom Johanna M. C , Lukowiak Ken 
Published: May 2021

ABSTRACTAnimals respond to acute stressors by modifying their behaviour and physiology. The pond snail Lymnaea stagnalis exhibits configural learning (CL), a form of higher order associative learning. In CL snails develop a landscape of fear when they experience a predatory cue along with a taste of food. This experience results in a suppression of the food response; but the memory only persists for 3 h. Lymnaea has also been found to upregulate heat shock proteins (HSPs) as a result of acute heat stress, which leads to the enhancement of memory formation. A plant flavonoid quercetin blocks the upregulation of HSPs when experienced prior to heat stress. Here, we used this blocking mechanism to test the hypothesis that HSP upregulation plays a critical role in CL. Snails experienced quercetin prior to CL training and surprisingly instead of blocking memory formation it enhanced the memory such that it now persisted for at least 24 h. Quercetin exposure either prior to or after CL enhanced long-term memory (LTM) up to 48 h. We quantified mRNA levels of the transcription factor CREB1 in the Lymnaea central nervous system and found LymCREB1 to be upregulated following quercetin exposure. The enhanced LTM phenotype in L. stagnalis was most pronounced when quercetin was experienced during the consolidation phase. Additionally, quercetin exposure during the memory reconsolidation phase also led to memory enhancement. Thus, we found no support of our original hypothesis but found that quercetin exposure upregulated LymCREB1 leading to LTM formation for CL.
Voluntary Cooling during Exercise Is Augmented in People with Multiple Sclerosis Who Experience Heat Sensitivity
Authors: VARGAS NICOLE T. , CHAPMAN CHRISTOPHER L. , REED EMMA L. , LIZARRAGA ALEXIS , FISHER NADINE M. , DAVIS SCOTT L. , SCHLADER ZACHARY J. 
Published: May 2021

ABSTRACT

Introduction
We tested the hypothesis that people with multiple sclerosis (MS) who experience heat sensitivity voluntarily engage in cool-seeking behavior during exercise to a greater extent than healthy controls.

Methods
In a 27.0°C ± 0.2°C, 41% ± 2% RH environment, seven participants with relapsing–remitting MS who exhibited heat sensitivity and seven healthy controls completed two randomized trials cycling for 40 min (EX) at 3.5 W·kg−1 metabolic heat production, followed by 30 min recovery (REC). In one trial, participants were restricted from engaging in cooling (CON). In the other trial, participants voluntarily pressed a button to receive 2 min of ~2°C water perfusing a top (COOL). Mean skin and core temperatures and mean skin wettedness were recorded continuously. Total time in cooling provided an index of cool-seeking behavior. RPE, total symptom scores (MS only), and subjective fatigue (MS only) were recorded every 10 min.

Results
Core temperature (+0.5°C ± 0.1°C) and skin wettedness (+0.53 ± 0.02 a.u.) increased but were not different between groups or trials at end exercise (P = 0.196) or end recovery (P = 0.342). Mean skin temperature was reduced in COOL compared with CON at end exercise (P ≤ 0.002), with no differences between groups (P ≥ 0.532). MS spent more total time in cooling during EX (MS, 13 ± 3 min; healthy, 7 ± 4 min; P < 0.001) but not REC (MS, 2 ± 1 min; healthy, 0 ± 1 min; P = 0.496). RPE was greater at end exercise in MS (P = 0.001). Total symptom scores increased during exercise (P = 0.005) but was not different between trials (P = 0.321), whereas subjective fatigue was not attenuated in the cooling trial (P = 0.065).

Conclusion
Voluntary cooling is augmented in MS but does not consistently mitigate perceptions of heat-related symptoms or subjective fatigue.
Transcranial Direct Current Stimulation in the Treatment of Subacute Post-Stroke Thalamic Aphasia
Authors: William Campanella  , Riccardo Pedrini  , Lucilla Vestito  , Lucio Marinelli  , Carlo Trompetto  , Laura Mori  
Published: May 2021

Background: Although many studies have demonstrated the effectiveness of transcranial direct current stimulation (tDCS) in improving speech recovery in post-stroke aphasia, as far as we know patients affected by thalamic aphasia have never been investigated. Patient and method: A 65-year-old man with severe non-fluent aphasia due to a left thalamic haemorrhagic stroke underwent intensive daily speech therapy combined with tDCS. Results: The patient showed progressive improvement with almost complete recovery of his speech disorder, behavioural disinhibition and apathy. Conclusions: Our findings suggest that tDCS with concurrent speech therapy can be useful in patients with subcortical stroke lesions.
COVID-19 in a Patient with Accidental Drug-Induced Neutropenia
Authors: Pascal B Meyre  , Milos Radosavac  , Lukas Baumann  , Rein Jan Piso  , Matthias Hoffmann  
Published: May 2021

Background: Coronavirus disease 2019 (COVID-19) presents with a wide range of illness severity, from asymptomatic disease to severe acute respiratory distress syndrome (ARDS). Immunosuppression is considered a risk factor for severe COVID-19, but there are only few reports on disease progression in immunocompromised patients. Case Summary: We report the case of a 50-year-old patient with acute COVID-19 pneumonia, who had iatrogenic, clinically relevant bone marrow suppression due to accidental overdose with hydroxyurea, and decreased lung capacity due to a left-sided pneumonectomy 6 months earlier. Symptomatic treatment with oxygen supplementation and pulmonary physical therapy was initiated, and hydroxyurea was discontinued. Over 14 days, the patient’s blood counts slowly recovered, and his clinical condition gradually improved, such that supplemental oxygen was no longer necessary and he could be discharged. Discussion: A gradual increase in neutrophil and lymphocyte counts may be preferable to dampen a potentially detrimental immunological response triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whether patients with severe COVID-19 benefit from immunosuppressive therapy should be further evaluated.
COVID-19 in a Patient Treated for Granulomatosis with Polyangiitis: Persistent Viral Shedding with No Cytokine Storm
Authors: Pascale Daniel  , Marc Raad  , Rami Waked  , Jacques Choucair  , Moussa Riachy  , Fady Haddad  
Published: May 2021

Introduction: The coronavirus disease COVID-19 is considered a pandemic disease that has developed rapidly all over the world. As of today, it is unclear whether immunosuppression confers an increased risk for pulmonary complications, or conversely, whether it can be a protective factor with respect to a cytokine storm. Case description: We report the case of a 55-year-old male patient with granulomatosis with polyangiitis treated with rituximab who was infected with COVID-19 pneumonia. To the best of our knowledge, only 1 case has been reported in the literature with similar characteristics. The patient had a non-classic evolution of clinical symptoms with persistent fever and viral shedding, in addition to a negative serology. Conclusion: This case emphasizes the management and immunity response to COVID-19 pneumonia in such patients. Data are still needed regarding patients who have prolonged B-cell depletion, which may put the patient at a higher risk for reinfection.
Midthoracic Pain, Sentinel Arterial Haemorrhage and Exsanguination after a Symptom-Free Interval (Chiari's Triad) is Diagnostic of Arterio-Oesophageal Fistula: A Life-Threatening Cause of Gastrointestinal Bleeding
Authors: Andra Glodean  , Rainer Grobholz  , Karim El-Hag  , Mairi Ziaka  , Jean-Paul Schmid  
Published: May 2021

Introduction: Arterio-oesophageal fistulae are a very uncommon cause of severe gastrointestinal bleeding, and mostly result from an aberrant right subclavian artery and mediastinal surgery or prolonged endotracheal/nasogastric intubation. Material and Methods: We present the case of a patient with an oesophageal adenocarcinoma and haematemesis due to a subclavian arterio-oesophageal fistula after mediastinal radiotherapy. Conclusion: We discuss the rare, life-threatening condition of acute erosion of the left subclavian artery caused by an oesophageal tumour and presenting with Chiari's triad.
Colonic Pseudo-obstruction as a Rare Complication of Pheochromocytoma
Authors: Kin Wai So  , Hoi Ling Tsui  , Kim Hung Tsang  
Published: May 2021

Colonic pseudo-obstruction is characterized by dilatation of the colon without a structural lesion causing the obstruction. It usually involves the caecum and right side of the colon and is commonly observed in patients with severe illness or after surgery; it is rarely caused by pheochromocytoma. The diagnosis of colonic pseudo-obstruction can be established by abdominal imaging including computed tomography (CT) of the abdomen or use of a water-soluble contrast enema. In additional to conservative or surgical treatment, alpha-blockers can be used in this setting to relieve the pseudo-obstruction.
The VEXAS Syndrome: Uncontrolled Inflammation and Macrocytic Anaemia in a 77-Year-Old Male Patient
Authors: Andreas Himmelmann  , Rolf Brücker  
Published: May 2021

The VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a recently described X-linked autoinflammatory condition caused by a somatic mutation of the UBA1 gene and characterized by an evolving phenotype. This includes inflammatory processes such as recurrent fever, Sweet’s syndrome of the skin, pulmonary fibrosis, relapsing polychondritis and venous thromboembolism. An important feature, present in almost all cases, is the development of a macrocytic anaemia with vacuolization of myeloid and erythroid precursors. Usually, these patients require high doses of steroids to control symptoms and respond poorly to disease-modifying drugs. We describe a new case of the VEXAS syndrome presenting with Sweet’s syndrome which has now been followed for 6 years.