bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of a One Degree-of-Freedom Linear Robot for Bed-Bound Stroke Rehabilitation
Authors: Berezny Nicholas , Dowlatshahi Dar , Ahmadi Mojtaba 
Published: March 2021

Abstract
A 1DOF lower limb rehabilitation robot is presented for delivering leg extension therapy to bed-bound stroke patients. Such a compact and minimal system may be beneficial in terms of compatibility with pre-existing hospital equipment, ease-of-use, safety, and cost. A set of design criteria was created based on the literature and on previous field work at a local hospital. The device uses admittance control to apply assistive or resistive forces, and can also use haptic feedback to increase user engagement. A pilot study on six healthy participants was used to determine the feasibility of such a minimal system in administering assistance or resistance through the leg extension exercise. Results indicate that a single DOF is capable of decreasing trajectory error with assistance and increasing user effort with resistance. Observations confirm that the minimal system is effective; however, extending the robot with additional DOFs so that it can target multiple bed-bound exercises may help to increase therapy duration.
Association of Self-Reported Frequent Exercise Among a Nationally Representative Sample of Older People in the United States With Self-Reported Pain
Authors: Axon David R. , Emami Niloufar 
Published: March 2021

This retrospective, cross-sectional database study aimed to identify characteristics associated with self-reported frequent exercise (defined as moderate- to vigorous-intensity exercise for ≥30 min five times a week) in older U.S. (≥50 years) adults with pain in the past 4 weeks, using 2017 Medical Expenditure Panel Survey data and hierarchical logistic regression models. The variables significantly associated with frequent exercise included being male (adjusted odds ratio [AOR] = 1.507, 95% confidence interval [CI] [1.318, 1.724]); non-Hispanic (AOR = 1.282, 95% CI [1.021, 1.608]); employed (AOR = 1.274, 95% CI [1.040, 1.560]); having no chronic conditions versus ≥5 conditions (AOR = 1.576, 95% CI [1.094, 2.268]); having two chronic conditions versus ≥5 conditions (AOR = 1.547, 95% CI [1.226, 1.952]); having no limitation versus having a limitation (AOR = 1.209, 95% CI [1.015, 1.441]); having little/moderate versus quite/extreme pain (AOR = 1.358, 95% CI [1.137, 1.621]); having excellent/very good versus fair/poor physical health (AOR = 2.408, 95% CI [1.875, 3.093]); and having good versus fair/poor physical health (AOR = 1.337, 95% CI [1.087, 1.646]). These characteristics may be useful to create personalized pain management protocols that include exercise for older adults with pain.
Feasibility, usability and acceptability of paediatric lung ultrasound among healthcare providers and caregivers for the diagnosis of childhood pneumonia in resource-constrained settings: a qualitative study
Authors: Riaz Atif , Cambaco Olga , Ellington Laura Elizabeth , Lenahan Jennifer L , Munguambe Khatia , Mehmood Usma , Lamorte Alessandro , Qaisar Sana , Baloch Benazir , Kanth Neel , Nisar Muhammad Imran , Volpicelli Giovanni , Bassat Quique , Jehan Fyezah , Ginsburg Amy Sarah 
Published: March 2021

ObjectivesPaediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.DesignProspective qualitative study using semistructured interviewsSettingTwo referral hospitals in Mozambique and PakistanParticipantsA total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.ResultsHCPs highlighted themes of limited resource availability for the feasibility of LUS implementation, including perceived high cost of equipment, maintenance demands, time constraints and limited trained staff. HCPs emphasised the importance of policymaker support and caregiver acceptance for long-term success. HCP perspectives of usability highlighted ease of use and integration into existing workflow. HCPs and caregivers had positive attitudes towards LUS with few exceptions. Both HCPs and caregivers emphasised the potential for rapid, improved diagnosis of paediatric respiratory conditions using LUS.ConclusionsThis was the first study to evaluate HCP and caregiver perspectives of paediatric LUS through qualitative analysis. Critical components impacting feasibility, usability and acceptability of LUS for paediatric pneumonia diagnosis in LMIC were identified for initial deployment. Future research should explore LUS sustainability, with a particular focus on quality control, device maintenance and functionality and adoption of the new technology within the health system. This study highlights the need to engage both users and recipients of new technology early in order to adapt future interventions to the local context for successful implementation.Trial registration numberNCT03187067.
Comparison of the visual outcome between macula-on and macula-off rhegmatogenous retinal detachment based on the duration of macular detachment
Authors: Lee Chang Sup , Shaver Karl , Yun Samuel Huisok , Kim Daniel , Wen Sijin , Ghorayeb Ghassan 
Published: March 2021

ObjectiveTo compare the visual outcomes between macula-on and macula-off primary rhegmatogenous retinal detachment (RRD) based on the duration of macular detachment (DMD).Methods and AnalysisRetrospective study including 96 eyes with RRD (34 macula-on and 62 macula-off) repaired between June 2012 and March 2020. The final visual acuity (VA) was compared after the patients were divided by the status of the macula and their DMD.ResultsThe mean final VA of patients with macula-on RRD (group A) was logarithm of the minimum angle of resolution (logMAR) 0.04±0.07, which was not statistically different from that of individuals with macula-off RRD with DMD ≤3 days (group B; logMAR 0.05±0.06) (p=0.79). There were statistically significant differences in the final VA between group A and patients with macula-off RRD with DMD of 4–7 days (group C; logMAR 0.15±0.15) (p=0.017) as well as between group A and those with macula-off RRD with DMD ≥8 days (group D; logMAR 0.36±0.29) (p<0.001). There was no significant difference in the final VA between group B and C (p=0.33).ConclusionThe mean final VA of patients with macula-on RRD was comparable to that of the macula-off patients with DMD ≤3 days. Our findings suggest that if macula-on RRD could not be immediately repaired, a repair within 72 hours may result in similar outcomes, even if the macula detaches within that time frame. However, once the macula detaches, we do not observe statistically significant differences in outcome for repairs done within 7 days.
Tilsotolimod with Ipilimumab Drives Tumor Responses in Anti–PD-1 Refractory Melanoma
Authors: Haymaker Cara , Johnson Daniel H. , Murthy Ravi , Bentebibel Salah-Eddine , Uemura Marc I. , Hudgens Courtney W. , Safa Houssein , James Marihella , Andtbacka Robert H.I. , Johnson Douglas B. , Shaheen Montaser , Davies Michael A. , Rahimian Shah , Chunduru Srinivas K. , Milton Denái R. , Tetzlaff Michael T. , Overwijk Willem W. , Hwu Patrick , Gabrail Nashat , Agrawal Sudhir , Doolittle Gary , Puzanov Igor , Markowitz Joseph , Bernatchez Chantale , Diab Adi 
Published: March 2021

Abstract

Many patients with advanced melanoma are resistant to immune checkpoint inhibition. In the ILLUMINATE-204 phase I/II trial, we assessed intratumoral tilsotolimod, an investigational Toll-like receptor 9 agonist, with systemic ipilimumab in patients with anti–PD-1– resistant advanced melanoma. In all patients, 48.4% experienced grade 3/4 treatment-emergent adverse events. The overall response rate at the recommended phase II dose of 8 mg was 22.4%, and an additional 49% of patients had stable disease. Responses in noninjected lesions and in patients expected to be resistant to ipilimumab monotherapy were observed. Rapid induction of a local IFNα gene signature, dendritic cell maturation and enhanced markers of antigen presentation, and T-cell clonal expansion correlated with clinical response. A phase III clinical trial with this combination (NCT03445533) is ongoing.

Significance:
Despite recent developments in advanced melanoma therapies, most patients do not experience durable responses. Intratumoral tilsotolimod injection elicits a rapid, local type 1 IFN response and, in combination with ipilimumab, activates T cells to promote clinical activity, including in distant lesions and patients not expected to respond to ipilimumab alone.
This article is highlighted in the In This Issue feature, p. 1861
Virtual Transcriptomics
Authors: Buckler Andrew J. , Karlöf Eva , Lengquist Mariette , Gasser T. Christian , Maegdefessel Lars , Perisic Matic Ljubica , Hedin Ulf 
Published: March 2021

Objective:
Therapeutic advancements in atherosclerotic cardiovascular disease have improved prevention of ischemic stroke and myocardial infarction, but diagnostic methods for atherosclerotic plaque phenotyping to aid individualized therapy are lacking. In this feasibility study, we aimed to elucidate plaque biology by decoding the molecular phenotype of plaques through analysis of computed-tomography angiography images, making a predictive model for plaque biology referred to as virtual transcriptomics.

Approach and Results:
We employed machine intelligence using paired computed-tomography angiography and transcriptomics from carotid endarterectomies of 40 patients undergoing stroke-preventive surgery for carotid stenosis. Computed tomography angiographies were analyzed with novel software for accurate characterization of plaque morphology and plaque transcriptomes obtained from microarrays, followed by mathematical modeling for prediction of molecular signatures. Four hundred fourteen coding and noncoding RNAs were robustly predicted using supervised models to estimate gene expression based on plaque morphology. Examples of predicted transcripts included ion transporters, cytokine receptors, and a number of microRNAs whereas pathway analyses demonstrated enrichment of several biological processes relevant for the pathophysiology of atherosclerosis and plaque instability. Finally, the ability of the models to predict plaque gene expression was demonstrated using computed tomography angiographies from 4 sequestered patients and comparisons with transcriptomes of corresponding lesions.

Conclusions:
The results of this pilot study show that atherosclerotic plaque phenotyping by image analysis of conventional computed-tomography angiography can elucidate the molecular signature of atherosclerotic lesions in a multiscale setting. The study holds promise for optimized personalized therapy in the prevention of myocardial infarction and ischemic stroke, which warrants further investigations in larger cohorts.
Abstract P66: Prediction of Early Post-Stroke Major Neurocognitive Disorder Using Support Vector Machines
Authors: Aamodt Eva Birgitte , Schellhorn Till , Apostolova Liana , Svaldi Diana O , Stage Eddie , Logan Paige E , Sanjay Apoorva B , Saltvedt Ingvild , Beyer Mona K. 
Published: March 2021

Neurocognitive disorder (NCD) appears in 10% of survivors of a first-ever stroke and in 30% after a recurrent one. We aimed to classify clinical- and imaging factors related to the development of major NCD 3 months post stroke, so as to examine whether early development (<1 yr) is mainly of a neurodegenerative or vascular origin. Based on previous literature we hypothesized that early post-stroke major NCD would mainly be of neurodegenerative origin. 227 stroke survivors (age = 71.69 (11.25), NIHSS = 3.79 (4.75), females (43,61%)) were included from the ‘Norwegian COgnitive Impairment After STroke’ study. Clinical- and MRI data at baseline, and neuropsychological data at baseline and 3 months was used. Cortical thicknesses were automatically measured using Freesurfer and white matter hyperintensity (WMH) volumes were semi-automatically measured using FSL Bianca. Stroke lesion volumes were semi-automatically measured using ITK-snap. Support Vector Machine (SVM) classification was used in order to investigate the prognostic value of the neuroimaging findings and the clinical factors. Model performance was measured using Area Under Receiving Operating Characteristics (ROC) and -Curve (AUC). The best model correctly predicted major NCD in 88% of the patients and was driven by 19 features, with the top five features being stroke volume, WMH volume, left hemisphere occipital- and temporal thickness, and right hemisphere cingulate thickness.
In conclusion, clinical- and MRI findings may be used in prediction of cognitive outcome for stroke patients. Various meta-studies of post-stroke major NCD prediction show levels ranging from .48 to .91, showing that the current model is performing well. Early development of major NCD seems dependent not on neurodegenerative causes alone, but also on vascular factors, as well as aspects of the stroke itself. This highlights the complexity of post-stroke NCD and thus also its prediction.

Figure 1: ROC curve of SVM model, with an AUC of .88.
עד דוד הגדיל (1 Sam 20:41) – עד בור הגדול (1 Sam 19:22)
Authors: Goldstein Ronnie 
Published: March 2021

Abstract
This study focuses on the difficult ending of 1 Sam 20:41 in the Masoretic text (MT): וַיִּבְכּוּ אִישׁ אֶת רֵעֵהוּ עַד דָּוִד הִגְדִּיל, rendered normally as “They wept together; David wept the longer.” Many have pointed out the peculiarity of this phrase, and different emendations were proposed, based mainly on the LXX. The present article suggests an emendation of 1 Sam 20:41, according to which the original text read here עד בור הגדול. The mention of the “Great Cistern” at the end of the previous story in the Book of Samuel (19:22), provides strong support for this suggestion. It is proposed that the mention of the “Great Cistern” in the original text intended to narrow the geographical gaps between the different stories about David and Saul.
The Doctor-Patient Relationship in the Renaissance
Authors: Stolberg Michael 
Published: March 2021

Abstract
Based on the practice journals, personal notes, and letters of learned physicians from the German speaking regions, this paper seeks to reconstruct the lived reality of the doctor-patient relationship in the sixteenth century. Even many affluent and educated patients were quick to consult another practitioner when they were not satisfied, and the physicians resorted to various strategies to win and maintain the patient’s trust. These included preferring or outright inventing a diagnosis the patient could not prove wrong and deliberately exaggerating the severity of the disease so the physicians would gain all the more praise (and money) when the patient got better. On the positive side, the physicians respected their patients’ desire for certain medicines and their dislike of others, and went to great lengths to provide them with an explanation of what was happening inside their bodies that made sense to them and matched their personal bodily experience.
Investigating the Roles of External Forcing and Ocean Circulation on the Atlantic Multidecadal SST Variability in a Large Ensemble Climate Model Hierarchy
Authors: Murphy Lisa N. , Klavans Jeremy M. , Clement Amy C. , Cane Mark A. 
Published: March 2021

AbstractThis paper attempts to enhance our understanding of the causes of Atlantic multidecadal variability (AMV). Following the literature, we define the AMV as the SST averaged over the North Atlantic basin, linearly detrended and low-pass filtered. There is an ongoing debate about the drivers of the AMV, which include internal variability generated from the ocean or atmosphere (or both) and external radiative forcing. We test the role of these factors in explaining the time history, variance, and spatial pattern of the AMV using a 41-member ensemble from a fully coupled version of CESM and a 10-member ensemble of the CESM atmosphere coupled to a slab ocean. The large ensemble allows us to isolate the role of external forcing versus internal variability, and the model differences allow us to isolate the role of coupled ocean circulation. Both with and without coupled ocean circulation, external forcing explains more than half of the variance of the observed AMV time series, indicating its important role in simulating the twentieth-century AMV phases. In this model the net effect of ocean processes is to reduce the variance of the AMV. Dynamical ocean coupling also reduces the ability of the model to simulate the characteristic spatial pattern of the AMV, but forcing has little impact on the pattern. Historical forcing improves the time history and variance of the AMV simulation, while the more realistic ocean representation reduces the variance below that observed and lowers the correlation with observations.
Splenic Abscess Complicating Bariatric Surgery : A Systematic Review
Authors: Buksh Md Mahfooz , Tallowin Simon , Al Samaraee Ahmad 
Published: March 2021

Introduction Bariatric surgery has become one of the most rapidly growing subspecialty performed globally, and it has been well reported to be associated with low morbidity and mortality rates. Splenic abscess is a rare but serious complication of bariatric surgery that has not been previously systematically reviewed in the literature. Methods The authors have performed a systematic review of the evidence that has looked into the pathophysiology, clinical presentation, and the management options of splenic abscess complicating bariatric surgery. Results This systematic review has been unsurprisingly based on level-IV evidence due to the rarity of the explored condition. The final analysis included 27 relevant reported cases. The mean age was 38 years and the mean of the time interval between the initial operation and developing splenic abscess was 72 days, with the male to female ratio being 1:1.6. Laparoscopic sleeve gastrectomy was the initial operation in 85.2% of the patients. Nearly half of the patients did not have an objective evidence of local or systemic sepsis that could explain the abscess formation. Nonsurgical management was attempted in 14 patients, with 34% success rate only. Splenectomy was needed in 41.7% of the patients. No mortality was reported. Conclusions Splenic abscess is a rare and rather late but serious complication of bariatric surgery that could result in splenectomy in a relatively young group of patients. It is more commonly reported following laparoscopic sleeve gastrectomy. Early diagnosis with intervention in a timely manner is crucial to avoid life threatening complications.
Large-scale flexible spacecraft mass properties determination using torque-generating control
Authors: Liu Rui , Zhou Jun , Chi Minghe , Li Gongjun , Zhang Jun 
Published: March 2021

It is necessary to determine the mass properties of an on-orbit large-scale flexible spacecraft in order to achieve high-precision attitude control. The mass properties of the spacecraft include the inertia, the center of mass, and the mass. Research in this area had been mostly focused on rigid spacecrafts. The coupling between the rigid body of the spacecraft and the large flexible appendages on it, however, could have significant effect on the mass properties determination. This article proposes a momentum conservation–based determination method that takes into consideration the rigid–flexible coupling factors of large-scale flexible spacecrafts. First, a control method is designed to ensure that the spacecraft stays motionless after the motivation incurred for mass properties determination. Second, an inertia matrix determination method is developed using a Kalman filter, in which the coupling factors are added in the amendment procedure. Third, the Kalman filter with input is applied in the determination of the center of mass: on the one hand, this method can use one the accelerometer placed at the flexible appendages, if the deformation can be measured; on the other side, the method can use three accelerometers placed at three orthogonal points of the rigid part of the spacecraft, when the deformation cannot be measured. Finally, the mass can be gained by estimating the center of mass twice. Simulations were carried out on a large-scale rigid–flexible coupling spacecraft. The results demonstrated that the determination errors in all cases are less than 10%, which meet the engineering requirements.
Parenting stress in autism spectrum disorder may account for discrepancies in parent and clinician ratings of child functioning
Authors: Schwartzman Jessica M , Hardan Antonio Y , Gengoux Grace W 
Published: March 2021

Elevated parenting stress among parents of children with autism spectrum disorder is well-documented; however, there is limited information about variability in parenting stress and relationships with parent ratings of child functioning. The aim of this study was to explore profiles of parenting stress among 100 parents of young children with autism spectrum disorder enrolled in two clinical trials and potential relationships between parenting stress and parent ratings of child functioning at the baseline timepoint. Secondary aims examined differential patterns of association between parenting stress profiles and parent versus clinician ratings of child functioning. A k-means cluster analysis yielded three different profiles of parenting stress (normal, elevated, and clinically significant) using scores on the Parenting Stress Index–Short Form. One-way analyses of variance revealed differential patterns of parent ratings across the three parenting stress profiles on certain domains of child functioning (e.g. problem behaviors and social impairment) and family empowerment, but similar ratings of child receptive and expressive language abilities. Clinicians blinded to study conditions also rated child functioning, but clinician ratings did not differ by parenting stress profile. Findings emphasize the importance of identifying parenting stress profiles and understanding their relationship with parent ratings, with implications for interpreting parent-report measures and measuring child response in treatment trials. Lay abstract Elevated parenting stress among parents of children with autism spectrum disorder is well-documented; however, there is limited information about differences in parenting stress and potential relationships with parent ratings of child functioning. The aim of this study was to explore profiles of parenting stress among 100 parents of young children with autism spectrum disorder enrolled in two clinical trials and to explore relationships between parenting stress level and parent ratings of child functioning before treatment. Secondary aims examined differential patterns of association between parenting stress profiles and parent versus clinician ratings of child functioning. We show that stress may influence parent ratings of certain child behaviors (e.g. problem behaviors) and not others (e.g. language), yet clinician ratings of these same children do not differ. This new understanding of parenting stress has implications for parent-rated measures, tracking treatment outcome, and the design of clinical trials.