bluuebunny/crossref_metadata_2025_split huggingface dataset:
OrthoRehab: Development of a New Methodology for the Comparison Study Between Different Types of Ankle–Foot Orthoses in Foot Dysfunction
Authors: Quaresma Cláudia , Lopes Barbara , Jacinto Jorge , Robalo Tiago , Matos Mariana , Quintão Carla 
Published: January 2021

Foot dysfunction is one of the most likely consequences of rheumatoid arthritis and stroke. It is characterized by severe changes in the gait pattern due to a significant increase in the plantar flexion. Some of these dysfunctions can be compensated by using an ankle–foot orthosis. However, the clinical decision about which orthosis best suits the patient creates a real problem for physicians/therapists.Purpose: The main goal of this paper is to present a quantitative support tool that can assist the physicians/therapists in deciding which orthosis is most suitable for each subject.Methodology: In order to achieve such goal, a platform named OrthoRehab was developed, and it was tested in three conditions: without any orthosis and with two different ankle–foot orthoses. The data were acquired in the Gait Laboratory of Rehabilitation Medicine Center of Alcoitão using a VICON NEXUS 1.8.5® motion capture system that allows the capturing of kinematic and kinetic data.Results: The results reveal that OrthoRehab is a user-friendly, easy to apply tool that analyzes very relevant data for the clinical staff.Conclusion: The developed decision support tool, OrthoRehab, offers a quantitative analysis and provides insight to which orthosis achieves the best performance in comparison with the patient's gait pattern with no orthosis.
Developing and Evaluating a Quality Improvement Intervention to Facilitate Patient Navigation in the Accountable Health Communities Model
Authors: Holcomb Jennifer L. , Walton Gretchen H. , Sokale Itunu O. , Ferguson Gayla M. , Schick Vanessa R. , Highfield Linda 
Published: January 2021

Introduction:The Accountable Health Communities (AHC) Model was designed to address the health-related social needs of Centers for Medicare &amp; Medicaid Services beneficiaries. Bridge organizations across the AHC Model have identified lack of technical assistance and peer planning as potential barriers to Model success, particularly around patient navigation. The technical assistance and peer planning literature lacks an organizing, conceptual framework, but implementation science frameworks could serve as useful guides. The Strengthening Peer AHC Navigation (SPAN) research protocol seeks to fill this gap and will apply three implementation science frameworks, Consolidated Framework for Implementation Research, Intervention Mapping, and the Expert Recommendations for Implementing Change compilation, to develop a multi-level quality improvement intervention and evaluate the impact of peer planning on Model outcomes. The aims of the SPAN study are to implement and evaluate a novel multi-level quality improvement intervention to improve AHC implementation and navigation milestones through structured peer planning and to provide successful technical assistance for the AHC Model.Methods and Analysis:The quality improvement intervention is outlined in four Tasks: (1) Assessment – to conduct an assessment of each bridge organization's current implementation, needs, and readiness in AHC Model navigation activities; (2) Planning – to engage in a peer planning approach to build capacity for AHC Model navigation activities; (3) Implementation with technical assistance – Co-creation of a quality improvement protocol for AHC Model navigation activities; and (4) Evaluation – measure the impact of the peer planning and technical assistance approach. Alongside the development and implementation of the quality improvement intervention, this protocol describes a mixed method, convergent parallel study design which will be used to evaluate whether the quality improvement intervention will lead to better outcomes. Tasks will be replicated with five bridge organizations participating in the AHC Model.Discussion:This research protocol provides a framework that can be used to conduct structured peer planning with technical assistance for social needs programs. This study will provide data on both implementation and outcomes which eventually may impact healthcare cost and utilization.
CLIP4 Shows Putative Tumor Suppressor Characteristics in Breast Cancer: An Integrated Analysis
Authors: Fan Yu , He Lijia , Wang Yu , Fu Shaozhi , Han Yunwei , Fan Juan , Wen Qinglian 
Published: January 2021

Background: CAP-Gly domain containing linker protein family member 4 (CLIP4) plays an important role in cancers. However, its expression, prognostic value, and biological effect in breast cancer remain unclear.Methods: Data on patients diagnosed with breast cancer were retrieved from the TCGA-BRCA and other public omics databases. The expression profile of CLIP4 was analyzed using Oncomine, bc-GenExMiner, and TCGA. The prognostic value of CLIP4 was determined by Kaplan-Meier Plotter and Human Protein Atlas. Identification of genes co-expressed with CLIP4 and potential mechanism analyses were performed using UALCAN, STRING, Metascape, and GSEA. The epigenetic characteristics of CLIP4 were determined by DiseaseMeth and MEXPRESS.Results: CLIP4 was downregulated and its expression was negatively correlated with estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor type 2 (HER2) status, Nottingham prognostic index (NPI), and Scarff-Bloom-Richardson (SBR) grade in breast cancer, whereas it was positively linked to basal-like and triple negative breast cancer status. Ectopic expression of CLIP4 was related with poor prognosis. In the analysis of genes co-expressed with CLIP4, GSEA showed that the Hedgehog (Hh), JAK-STAT, ERBB, Wnt signaling pathway, cell adhesion molecules, and pathways in cancer were dissimilarly enriched in the CLIP4 expression high phenotype. Analysis of the genetics and epigenetics of CLIP4 indicated that its expression was negatively correlated with DNA methylation.Conclusion: Methylated CLIP4 may be a novel prognostic and therapeutic biomarker for breast cancer.
Identification of Heterogeneous Subtypes of Mild Cognitive Impairment Using Cluster Analyses Based on PET Imaging of Tau and Astrogliosis
Authors: Lee Hyun Jeong , Lee Eun-Chong , Seo Seongho , Ko Kwang-Pil , Kang Jae Myeong , Kim Woo-Ram , Seo Ha-Eun , Lee Sang-Yoon , Lee Yeong-Bae , Park Kee Hyung , Yeon Byeong Kil , Okamura Nobuyuki , Na Duk L. , Seong Joon-Kyung , Noh Young 
Published: January 2021

Background: Mild cognitive impairment (MCI) is a condition with diverse causes and clinical outcomes that can be categorized into subtypes. [18F]THK5351 has been known to detect reactive astrogliosis as well as tau which is accompanied by neurodegenerative changes. Here, we identified heterogeneous groups of MCI patients using THK retention patterns and a graph theory approach, allowing for the comparison of risk of progression to dementia in these MCI subgroups.Methods: Ninety-seven participants including 60 MCI patients and individuals with normal cognition (NC, n = 37) were included and undertook 3T MRI, [18F]THK5351 PET, and detailed neuropsychological tests. [18F]Flutemetamol PET was also performed in 62 participants. We calculated similarities between MCI patients using their regional standardized uptake value ratio of THK retention in 75 ROIs, and clustered subjects with similar retention patterns using the Louvain method based on the modularity of the graph. The clusters of patients identified were compared with an age-matched control group using a general linear model. Dementia conversion was evaluated after a median follow-up duration of 34.6 months.Results: MCI patients were categorized into four groups according to their THK retention patterns: (1) limbic type; (2) diffuse type; (3) sparse type; and (4) AD type (retention pattern as in AD). Subjects of the limbic type were characterized by older age, small hippocampal volumes, and reduced verbal memory and frontal/executive functions. Patients of the diffuse type had relatively large vascular burden, reduced memory capacity and some frontal/executive functions. Co-morbidity and mortality were more frequent in this subgroup. Subjects of the sparse type were younger and declined only in terms of visual memory and attention. No individuals in this subgroup converted to dementia. Patients in the AD type group exhibited the poorest cognitive function. They also had the smallest hippocampal volumes and the highest risk of progression to dementia (90.9%).Conclusion: Using cluster analyses with [18F]THK5351 retention patterns, it is possible to identify clinically-distinct subgroups of MCI patients and those at greater risk of progression to dementia.
Long-Term Risk Factors for Intracranial In-Stent Restenosis From a Multicenter Trial of Stenting for Symptomatic Intracranial Artery Stenosis Registry in China
Authors: Guo Xu , Ma Ning , Gao Feng , Mo Da-Peng , Luo Gang , Miao Zhong-Rong 
Published: January 2021

Background: For patients with symptomatic intracranial artery stenosis (sICAS), endovascular treatment has been shown to be feasible and safe in recent studies. However, in-stent restenosis (ISR) risks the recurrence of ischemic stroke. We attempt to elucidate the risk factors for ISR.Methods: We retrospectively analyzed 97 patients with sICAS from a prospective registry trial that included 20 centers from September 2013 to January 2015. Cases were classified into the ISR≥ 50% group or the ISR &lt; 50% group. The baseline characteristics and long-term follow-up were compared between the two groups. Binary logistic regression analyses were identified as an association between ISR and endovascular technique factors.Results: According to whether ISR was detected by CT angiography, 97 patients were divided into the ISR group (n = 24) and the non-ISR group (n = 73). The admission baseline features and lesion angiography characteristics were similar, while plasma hs-CRP (mg/L) was higher in the ISR≥ 50% group at admission (8.2 ± 11.4 vs. 2.8 ± 4.1, p = 0.032). Binary logistic regression analysis identified the longer stents (adjusted OR 0.816, 95% CI 0.699–0.953; p = 0.010), balloon-mounted stents (adjusted OR 5.748, 95% CI 1.533–21.546; p = 0.009), and local anesthesia (adjusted OR 6.000, 95% CI 1.693–21.262; p = 0.006) as predictors of ISR at the 1-year follow-up.Conclusions: The longer stents, balloon-mounted stents implanted in the intracranial vertebral or basilar artery, and local anesthesia were significantly associated with in-stent restenosis. Further studies are required to identify accurate biomarkers or image markers associated with ISR in ICAS patients.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT01968122.
Seizure-Induced Acute Glial Activation in the in vitro Isolated Guinea Pig Brain
Authors: Vila Verde Diogo , de Curtis Marco , Librizzi Laura 
Published: January 2021

Introduction: It has been proposed that seizures induce IL-1β biosynthesis in astrocytes and increase blood brain barrier (BBB) permeability, even without the presence of blood borne inflammatory molecules and leukocytes. In the present study we investigate if seizures induce morphological changes typically observed in activated glial cells. Moreover, we will test if serum albumin extravasation into the brain parenchyma exacerbates neuronal hyperexcitability by inducing astrocytic and microglial activation.Methods: Epileptiform seizure-like events (SLEs) were induced in limbic regions by arterial perfusion of bicuculline methiodide (BMI; 50 μM) in the in vitro isolated guinea pig brain preparation. Field potentials were recorded in both the hippocampal CA1 region and the medial entorhinal cortex. BBB permeability changes were assessed by analyzing extravasation of arterially perfused fluorescein isothiocyanate (FITC)–albumin. Morphological changes in astrocytes and microglia were evaluated with tridimensional reconstruction and Sholl analysis in the ventral CA1 area of the hippocampus following application of BMI with or without co-perfusion of human serum albumin.Results: BMI-induced SLE promoted morphological changes of both astrocytes and microglia cells into an activated phenotype, confirmed by the quantification of the number and length of their processes. Human-recombinant albumin extravasation, due to SLE-induced BBB impairment, worsened both SLE duration and the activated glia phenotype.Discussion: Our study provides the first direct evidence that SLE activity per se is able to promote the activation of astro- and microglial cells, as observed by their changes in phenotype, in brain regions involved in seizure generation; we also hypothesize that gliosis, significantly intensified by h-recombinant albumin extravasation from the bloodstream to the brain parenchyma due to SLE-induced BBB disruption, is responsible for seizure activity reinforcement.
Case Report: IL-21 and Bcl-6 Regulate the Proliferation and Secretion of Tfh and Tfr Cells in the Intestinal Germinal Center of Patients With Inflammatory Bowel Disease
Authors: Yang Youguang , Lv Xiaodan , Zhan Lingling , Chen Lan , Jin Hui , Tang Xinping , Shi Qingqing , Zou Qiyuan , Xiang Jiqiao , Zhang WeiWei , Zeng Zhaojing , Jiang Haixing , Lv Xiaoping 
Published: January 2021

Objective: This study aimed to investigate the effect of interleukin (IL)-21 and B cell lymphoma protein-6 on germinal center follicular helper T (Tfh) cells and follicular regulatory T (Tfr) cells and its relationship with the clinical features of inflammatory bowel disease (IBD).Methods: The expression of peripheral blood cytokines IL-21 and Bcl-6 mRNA was detected by reverse transcription–polymerase chain reaction. The distribution characteristics of Tfh and Tfr cells were detected using the triple immunofluorescence staining analysis.Results: The expression of IL-21 and Bcl-6 mRNA was upregulated in the ulcerative colitis (UC) and Crohn disease (CD) groups compared with that in the control group. Triple immunofluorescence staining showed that the number of Tfh cells in the intestinal germinal center obviously increased in the UC and CD groups compared with that in the control group, whereas the number of Tfr cells reduced.Conclusion: This study suggested that the Tfr and Tfh cells might be involved in the regulation of IBD. Bcl-6 and IL-21 can regulate the Tfh/Tfr ratio in the intestinal germinal center, promoting the occurrence and development of IBD.
Low-Level Vagus Nerve Stimulation Reverses Obstructive Sleep Apnea-Related Atrial Fibrillation by Ameliorating Sympathetic Hyperactivity and Atrial Myocyte Injury
Authors: Guo Yankai , Xiaokereti Jiasuoer , Meng Qingjun , Cao Guiqiu , Sun Huaxin , Zhou Xianhui , Zhang Ling , Tang Baopeng 
Published: January 2021

Background: Previous studies have proved that low-level vagus nerve stimulation (LLVS) could suppress acute obstructive sleep apnea (OSA), which is associated with atrial fibrillation (AF).Objective: This study investigates the underlying electrophysiological, neural, and cardiomyocyte injury mechanisms on acute OSA-induced AF, examining whether LLVS can attenuate or reverse this remodeling.Methods and Results: Eighteen mongrel dogs received endotracheal intubation under general anesthesia and were randomly divided into three groups: the OSA group (simulated OSA with clamping of the trachea cannula at the end of expiration for 2min followed ventilation 8min, lasting 6h, n=6), the OSA+LLVS group (simulated OSA plus LLVS, n=6), and a control group (sham clamping the trachea cannula without stimulation, n=6). In the OSA+LLVS group, the atrial effective refractory period was significantly lengthened while the sinus node recovery time and AF duration decreased after the 4th hour, and the expression level of Cx40 and Cx43 was significantly increased compared to the OSA group. Norepinephrine, TH, and ChAT were significantly decreased in the OSA+LLVS group compared with the OSA group. Mitochondrial swelling, cardiomyocyte apoptosis, and glycogen deposition, along with a higher concentration of TNF-α, IL-6 were observed in the OSA group, and the LLVS inhibited the structural remodeling and expression of inflammatory cytokines.Conclusion: LLVS decreased the inducibility of AF partly by ameliorating sympathetic hyperactivity and atrial myocyte injury after acute OSA-induced AF.
Exercise Limitation in Children and Adolescents With Severe Refractory Asthma: A Lack of Asthma Control?
Authors: Faleiro Rita C. , Mancuzo Eliane V. , Lanza Fernanda C. , Queiroz Mônica V. N. P. , de Oliveira Luciano F. L. , Ganem Vinicius O. , Lasmar Laura B. 
Published: January 2021

BackgroundPatients with severe refractory asthma (SRA), even when using high doses of multiple controller medications in a regular and appropriate way, can have persistent complaints of exercise limitation.MethodsThis was a cross-sectional study involving patients with SRA (treated with ≥ 800 μg of budesonide or equivalent, with ≥ 80% adherence, appropriate inhaler technique, and comorbidities treated), who presented no signs of a lack of asthma control other than exercise limitation. We also evaluated healthy controls, matched to the patients for sex, age, and body mass index. All participants underwent cardiopulmonary exercise testing (CPET) on a cycle ergometer, maximum exertion being defined as ≥ 85% of the predicted heart rate, with a respiratory exchange ratio ≥ 1.0 for children and ≥ 1.1 for adolescents. Physical deconditioning was defined as oxygen uptake (VO2) &lt; 80% of predicted at peak exercise, without cardiac impairment or ventilatory limitation. Exercise-induced bronchoconstriction (EIB) was defined as a forced expiratory volume in one second ≥ 10% lower than the baseline value at 5, 10, 20, and 30 minutes after CPET.ResultsWe evaluated 20 patients with SRA and 19 controls. In the sample as a whole, the mean age was 12.9 ± 0.4 years. The CPET was considered maximal in all participants. In terms of the peak VO2 (VO2peak), there was no significant difference between the patients and controls, (P = 0.10). Among the patients, we observed isolated EIB in 30%, isolated physical deconditioning in 25%, physical deconditioning accompanied by EIB in 25%, and exercise-induced symptoms not supported by the CPET data in 15%.Conclusion and Clinical RelevancePhysical deconditioning, alone or accompanied by EIB, was the determining factor in reducing exercise tolerance in patients with SRA and was not therefore found to be associated with a lack of asthma control.
Neurocognitive Predictors of Treatment Outcomes in Cognitive Processing Therapy for Post-traumatic Stress Disorder: Study Protocol
Authors: Cenkner David P. , Asnaani Anu , DiChiara Christina , Harb Gerlinde C. , Lynch Kevin G. , Greene Jennifer , Scott J. Cobb 
Published: January 2021

BackgroundPost-traumatic stress disorder (PTSD) is a prevalent, debilitating, and costly psychiatric disorder. Evidenced-based psychotherapies, including Cognitive Processing Therapy (CPT), are effective in treating PTSD, although a fair proportion of individuals show limited benefit from such treatments. CPT requires cognitive demands such as encoding, recalling, and implementing new information, resulting in behavioral change that may improve PTSD symptoms. Individuals with PTSD show worse cognitive functioning than those without PTSD, particularly in acquisition of verbal memory. Therefore, memory dysfunction may limit treatment gains in CPT in some individuals with PTSD.Methods and AnalysisHere, we present a protocol describing the Cognition and PsychoTherapy in PTSD (CPTPTSD) study, a prospective, observational study examining how cognitive functioning affects treatment response in CPT for PTSD (NCT# 03641924). The study aims to recruit 105 outpatient veterans with PTSD between the ages of 18 and 70 years. Prior to beginning 12 sessions of CPT, Veteran participants will have standardized assessments of mood and functioning and complete a comprehensive neurocognitive battery assessing episodic learning, attention and speed of processing, language ability, executive control, and emotional functioning. This study aims to fill gaps in the current literature by: (1) examining the specificity of memory effects on treatment response; (2) exploring how baseline cognitive functioning impacts functional outcomes; and (3) examining potential mechanisms, such as memory for treatment content, that might explain the effects of baseline memory functioning on PTSD symptom trajectory.DiscussionIf successful, this research could identify clinically relevant neurocognitive mechanisms that may impact PTSD psychotherapy and guide the development of individualized treatments for PTSD.
Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment
Authors: Zhang Ling , Wang Lei , Cui Shu , Yuan Qiuyu , Huang Cui , Zhou Xiaoqin 
Published: January 2021

Objective: The prevalence of prenatal depression in pregnant women has found to be high, which may adversely affect the intimacy of a mother to her fetus. Few studies have investigated the relationship between prenatal depression and maternal-fetal attachment in pregnant Chinese women. This study is thus designed to evaluate the prevalence rate, predictive factors of prenatal depression in Chinese pregnant women in the third trimester of pregnancy, and the effect of prenatal depression on maternal-fetal attachment.Methods: A total of 340 pregnant women in the third trimester of pregnancy were recruited from a hospital in Anhui Province. The Edinburgh Postpartum Depression Scale (EPDS) was rated to assess the prenatal depression; the Pittsburgh Sleep Quality Index (PSQI) and Zung Self-Rating Anxiety Scale (SAS) were used to assess sleep quality and anxiety level for all participants. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal-fetal attachment.Results: The prevalence of prenatal depression in the participants was high (19.1%) in our study. The scores of prenatal anxiety and sleep disorders were higher with prenatal depression than in those without prenatal depression (47.6 ± 9.5 vs. 38.9 ± 6.9; 8.3 ± 3.3 vs. 6.1 ± 2.7, all p &lt; 0.01). MAAS quality was lower in prenatal depression women than those in non-prenatal depression women (43.8 ± 5.6 vs. 46.4 ± 4.5, p &lt; 0.01). Correlation analysis showed that prenatal depression was associated with parity, prenatal education, education level, marital satisfaction, anxiety and sleep disorders (all p &lt; 0.05). Furthermore, binary logistic regression results showed that anxiety and sleep disorders were risk factors for prenatal depression. Prenatal education, higher marriage satisfaction were protective factors for prenatal depression. In addition, correlation analysis also showed that prenatal depression was positively correlated with MAAS intensity, but negatively correlated with MAAS quality.Conclusions: Our results indicated a high prevalence of prenatal depression in women in the third trimester. Prenatal education and higher marital satisfaction were protective factors for prenatal depression; antenatal anxiety and sleep disorders during pregnancy were risk factors for prenatal depression. Prenatal depression was negatively correlated with MAAS quality, but positively correlated with MAAS intensity.
Use of Modern methods for Evaluation of Motor Performance
Authors: Bjelica Bojan , Cicović Bjelica , Milanović Ljubica , Zelenović Milan , Božić Danijel 
Published: January 2021

The development of instruments and the use of the same is expanding from year to year. The paper aims to determine the usefulness of Myotesta (MT), Optojump (OJ), Globe Ergo System (GES) as modern methods for assessing motor performance. The research included nine original scientific papers. All works satisfied the problem and could answer the set goal. The selection of works from 2009. to 2014. was taken as a method. There are specific differences when comparing the results for each of the instruments. Myotest has stood out as the smallest instrument and is easily portable and therefore effective to use. The assessment of explosive power is easy to perform, and the results it gives are reliable.