bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective multicenter assessor-blinded randomized controlled study to compare the efficacy of short versus long protocols of electroconvulsive therapy as an augmentation strategy to clozapine in patients with ultra-resistant schizophrenia (SURECT study)
Authors:   SURECT Group, Moulier Virginie , Krir Mohamed Wassim , Dalmont Marine , Guillin Olivier , Rothärmel Maud 
Published: April 2021

Abstract
Background
Although clozapine is the most effective antipsychotic drug for treatment-resistant schizophrenia, it leads to a poor or partial response in 40 to 70% of patients. Augmentation of clozapine with electroconvulsive therapy (ECT) is a highly effective and relatively safe treatment for these clozapine-resistant patients. However, parameters are not yet well specified, such as the optimal number of sessions, their frequency, and the relevance of maintenance ECT. Our objective is to compare the efficacy and tolerance between two protocols of combined ECT and clozapine treatment in patients with ultra-resistant schizophrenia (URS): a 6-month protocol (short protocol with 20 ECT sessions) and a 12-month protocol (long protocol with 40 ECT sessions).

Methods
Sixty-four patients with schizophrenia with persistent psychotic symptoms despite clozapine treatment will be enrolled in a prospective multicentric assessor-blinded randomized controlled trial. Patients will be randomly assigned to the short or the long protocol. The main outcome is the response rate assessed by the Positive and Negative Symptoms Scale (PANSS) 3 months after the end of the treatment in patients following the long protocol compared to those following the short protocol. The response was defined as a 30% reduction on the PANSS baseline. Clinical assessments (PANSS, BPRS, HAMD-21, YMRS, CGI, GAF, Modified Overt Aggression Scale (MOAS), and Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS)) and plasma clozapine concentration will be performed at baseline and at 2, 4, 6, 9, 12, and 15 months. Neuropsychological measures (MMSE, RL/RI-16, Doors test, D2 Test of Attention, Copy of the Rey-Osterrieth complex figure) will be performed at baseline and at 6 and 15 months.

Discussion
The aims of this research are to optimize protocols of combined ECT with clozapine in patients with URS and to offer specific recommendations for these patients’ care.

Trial registration
ClinicalTrials.gov NCT03542903. Registered on May 31, 2018. Id RCB: 2017-A02657-46
Vaspin in atherosclerotic disease and cardiovascular risk in axial spondyloarthritis: a genetic and serological study
Authors: Rueda-Gotor Javier , López-Mejías Raquel , Remuzgo-Martínez Sara , Pulito-Cueto Verónica , Corrales Alfonso , Lera-Gómez Leticia , Portilla Virginia , González-Mazón Íñigo , Blanco Ricardo , Expósito Rosa , Mata Cristina , Llorca Javier , Hernández-Hernández Vanesa , Rodríguez-Lozano Carlos , Barbarroja Nuria , Castro Rafaela Ortega , Vicente Esther , Fernández-Carballido Cristina , Martínez-Vidal María Paz , Castro-Corredor David , Anino-Fernández Joaquín , Peiteado Diana , Plasencia-Rodríguez Chamaida , Galíndez-Agirregoikoa Eva , García-Vivar María Luz , Gualillo Oreste , Quevedo-Abeledo Juan Carlos , Castañeda Santos , Ferraz-Amaro Iván , González-Gay Miguel Á. , Genre Fernanda 
Published: April 2021

Abstract
Background
Vaspin is a novel anti-inflammatory adipokine associated with cardiovascular (CV) disease and inflammation in chronic inflammatory conditions different from axial spondyloarthritis (axSpA). Given the high incidence of CV disease (mainly due to accelerated atherosclerosis) exhibited by axSpA patients, we wondered if vaspin could also be a key molecule in this process. However, data on the role of vaspin regarding atherosclerotic disease in the context of axSpA is scarce. For this reason, we aimed to evaluate the implication of vaspin, at the genetic and serological level, in subclinical atherosclerosis and CV risk in axSpA.

Methods
This study included 510 patients diagnosed with axSpA. Carotid ultrasound (US) was performed to evaluate the presence of subclinical atherosclerosis. Three vaspin gene variants (rs2236242, rs7159023, and rs35262691) were genotyped by TaqMan probes. Serum vaspin levels were assessed by enzyme-linked immunosorbent assay. Statistical analysis was performed using STATA® v.11.1.

Results
Serum vaspin levels were significantly higher in female patients than in males and also in obese patients when compared to those with normal weight (p < 0.05). At the genetic level, we disclosed that the minor allele of rs2236242 (A) was associated with lower serum vaspin levels in axSpA, while the rs7159023 minor allele (A) was linked to higher serum levels (p < 0.05). When the three polymorphisms assessed were combined conforming haplotypes, we disclosed that the TGC haplotype related to high serum levels of vaspin (p = 0.01). However, no statistically significant association was observed between vaspin and markers of subclinical atherosclerosis, both at the genetic and serological level.

Conclusions
Our results revealed that vaspin is linked to CV risk factors that may influence on the atherosclerotic process in axSpA. Additionally, we disclosed that serum vaspin concentration is genetically modulated in a large cohort of patients with axSpA.
A survey demonstrating that the procedural experience of residents in internal medicine, critical care and emergency medicine is poor: training in ultrasound is required to rectify this
Authors: Souleymane Mamdouh , Rajendram Rajkumar , Mahmood Naveed , Ghazi Amro M. T. , Kharal Yousuf M. S. , Hussain Arif 
Published: April 2021

Abstract
Background
Training in procedural skills is often suboptimal. The aim of this study was to quantify the needs of residents in internal medicine (IM), critical care (CC), and emergency medicine (EM) for instruction in ultrasound-guided procedures.

Methods
All IM, EM and CC residents (n = 200) at King Abdulaziz Medical City, Riyadh, Saudi Arabia, were invited to participate in a questionnaire-based survey to identify skill and experience gaps. The contribution of procedural skills to patient care (i.e. applicability) and proficiency in the sterile technique required to perform ultrasound-guided procedures were rated on Likert scales. Data on training, accreditation, and experience with and without ultrasound were collected.

Results
The overall response rate was 72% (IM 91%, CC 100%, EM 40%). Although the sample reported that procedural skills were very applicable, 19% (IM n = 25, EM n = 2) had not performed any procedures. However, five residents were accredited in point-of-care ultrasound, 61% of the sample had performed ultrasound-guided procedures and 65% had used landmark techniques. Whilst more internists had performed procedures using landmark techniques, CC and EM residents had performed more ultrasound-guided procedures. Whilst CC residents had not missed any opportunities to perform procedures because supervisors were less available, EM (6) and IM (89) residents had. Whilst skill gaps were only identified in the IM residency programme, experience gaps were present in all three residency programmes. The IM residency programme had larger experience gaps than the CC and EM programmes for all procedural skills.

Discussion
Residents in IM, CC and EM perceive that ultrasound-guided procedures are relevant to their practice. However, the IM residents performed fewer procedures than CC residents and EM residents at least partly because internists also lack skills in ultrasound. Training in ultrasound-guided procedures may reduce the use of landmark techniques and improve patient safety. Residents in IM, CC and EM therefore require training in ultrasound-guided procedures.
Prediction of Johne’s disease state based on quantification of T cell markers and their interaction with macrophages in the bovine intestine
Authors: Jenvey Caitlin J. , Shircliff Adrienne L. , Obando Marrero Elsa , Stabel Judith R. 
Published: April 2021

AbstractCell-mediated immune responses to Mycobacterium avium subsp. paratuberculosis (MAP) are regulated by various types of T lymphocytes. The aim of this study was to quantitate T cell subsets in the mid-ileum of cows naturally infected with MAP to identify differences during different stages of infection, and to determine whether these subsets could be used as predictors of disease state. Immunofluorescent labeling of T cell subsets and macrophages was performed on frozen mid-ileal tissue sections archived from naturally infected dairy cows in either subclinical or clinical disease status, and noninfected control cows. Comprehensive IF staining for CD4, CD8α, TcR1-N24 (gamma delta), FoxP3, CXCR3 and CCR9 served to define T cell subsets and was correlated with macrophages present. Clinically affected cows demonstrated significantly higher numbers of CXCR3+ (Th1-type) and CCR9+ (total small intestinal lymphocytes) cells at the site of infection compared to the subclinical cows and noninfected controls. Further, predictive modeling indicated a significant interaction between CXCR3+ and AM3K+ (macrophages) cells, suggesting that progression to clinical disease state aligns with increased numbers of these cell types at the site of infection. The ability to predict disease state with this model was improved from previous modeling using immunofluorescent macrophage data. Predictive modelling indicated an interaction between CXCR3+ and AM3K+ cells, which could more sensitively detect subclinical cows compared to clinical cows. It may be possible to use this knowledge to improve and develop an assay to detect subclinically infected animals with more confidence during the early stages of the disease.
A cooperative DDoS attack detection scheme based on entropy and ensemble learning in SDN
Authors: Yu Shanshan , Zhang Jicheng , Liu Ju , Zhang Xiaoqing , Li Yafeng , Xu Tianfeng 
Published: April 2021

AbstractIn order to solve the problem of distributed denial of service (DDoS) attack detection in software-defined network, we proposed a cooperative DDoS attack detection scheme based on entropy and ensemble learning. This method sets up a coarse-grained preliminary detection module based on entropy in the edge switch to monitor the network status in real time and report to the controller if any abnormality is found. Simultaneously, a fine-grained precise attack detection module is designed in the controller, and a ensemble learning-based algorithm is utilized to further identify abnormal traffic accurately. In this framework, the idle computing capability of edge switches is fully utilized with the design idea of edge computing to offload part of the detection task from the control plane to the data plane innovatively. Simulation results of two common DDoS attack methods, ICMP and SYN, show that the system can effectively detect DDoS attacks and greatly reduce the southbound communication overhead and the burden of the controller as well as the detection delay of the attacks.
On a class of solvable difference equations generalizing an iteration process for calculating reciprocals
Authors: Stević Stevo 
Published: April 2021

AbstractThe well-known first-order nonlinear difference equation$$ y_{n+1}=2y_{n}-xy_{n}^{2}, \quad n\in {\mathbb {N}}_{0}, $$yn+1=2yn−xyn2,n∈N0,naturally appeared in the problem of computing the reciprocal value of a given nonzero real numberx. One of the interesting features of the difference equation is that it is solvable in closed form. We show that there is a class of theoretically solvable higher-order nonlinear difference equations that include the equation. We also show that some of these equations are also practically solvable.
Multidimensional sampling theorems for multivariate discrete transforms
Authors: Hassan H. A. 
Published: April 2021

AbstractThis paper is devoted to the establishment of two-dimensional sampling theorems for discrete transforms, whose kernels arise from second order partial difference equations. We define a discrete type partial difference operator and investigate its spectral properties. Green’s function is constructed and kernels that generate orthonormal basis of eigenvectors are defined. A discrete Kramer-type lemma is introduced and two sampling theorems of Lagrange interpolation type are proved. Several illustrative examples are depicted. The theory is extendible to higher order settings.
Calcium bilirubinate sludge causes early onset of congenital biliary dilatation: a report of two cases
Authors: Kato Shoko , Kaneko Kenitiro , Matsushita Nozomi , Kurahashi Shintaro , Osawa Takaaki , Matsumura Tatsuki , Saito Takuya , Fukami Yasuyuki , Komatsu Shunichiro , Sano Tsuyoshi 
Published: April 2021

Abstract
Background
Symptomatic congenital biliary dilatation (CBD) during early infancy is always characterized by cystic dilation of the common bile duct with a narrow segment connecting the pancreatic duct.

Case presentation
In two consecutive infants with a prenatal diagnosis of CBD, we found that biliary sludge had formed in the cyst upon the appearance of symptoms including acholic stool and hypertransaminasemia. Infrared absorption spectrometry revealed that the sludge consisted of calcium bilirubinate.

Conclusion
We suggest that overproduction of bilirubin by neonatal hemolysis causes sedimentation of bilirubin calcium, resulting in obstruction of the narrow segment and development of symptoms.
Preoperative imaging optimized for epiretinal membrane surgery
Authors: Philippakis Elise , Thouvenin Raphaël , Gattoussi Sarra , Couturier Aude , Tadayoni Ramin 
Published: April 2021

Abstract
Background
To compare imaging modalities for visualizing primary epiretinal membrane (ERM) with each other and with intraoperative digital images (IDI) after blue staining.

Methods
The records of consecutive patients operated for primary ERM over a 12-month period were retrospectively reviewed. Preoperative imaging included color fundus photography (CFP), En Face spectral-domain optical coherence tomography (OCT), 45° infrared- (IR) and blue-reflectance (BR) scanning laser ophthalmoscopy. All images were qualitatively analyzed and scored from 0–4 according to the ability to visualize ERM details (0 = no visible ERM or vessel contraction, 1 = vessel contraction, 2 = retinal folds, 3 = ERM limits, 4 = elevated ERM edge). The preoperative ERM morphology was then compared to that seen on the IDI acquired after 1-min blue dye staining when available.

Results
Seventy eyes were included. The highest score for ERM visualization was obtained on BR and En Face OCT. A score of 3 or 4 was obtained in 68.5%, 62.1%, 17.9% and 13.6% of cases on En Face OCT, BR, CFP and IR images, respectively. IDI were available for 20 eyes, and showed a similar ERM morphology compared to preoperative images in most cases: a negative staining pattern corresponded to a plaque on En face OCT in 91% of eyes. However, IDI failed to show the ERM edges in 37.5% of cases.

Conclusion
ERM morphology was better visualized preoperatively by BR and En Face OCT, in a similar way to the IDI after staining. Future intraoperative visualization systems could integrate both imaging modalities overlaid with the IDI for guiding ERM removal instead of staining.
Hyperbranched polymer surfactant: synthesis, characterization and surface tension activity
Authors: Ren Longfang , Tang Zheng , Qiang Taotao , Zhang Guoguo 
Published: April 2021

Abstract
A series of hyperbranched polymer surfactants (HBP-C8, HBP-C12 and HBP-C16) were synthesized by the reaction between hydroxyl-terminated hyperbranched polymers (HBP) and fatty acyl chloride. The structure of obtained hyperbranched polymer surfactant was characterized by FTIR, NMR and GPC. The results showed that the products have amphiphilic structure. The thermal property of the hyperbranched polymer surfactant investigated by DSC and TGA was strongly influenced by the length of end alkyl chain. Surface activity of hyperbranched polymer surfactant was analyzed by surface tension method and UV spectrophotometry, respectively. The results showed that hyperbranched polymer surfactant took on better surface activity, which can effectively reduce the surface tension of the water. The hyperbranched polymer surfactant has a lower critical micelle concentration (CMC) and displays single molecular micellar properties, which can package small hydrophilic molecules in relatively low concentration.

Graphical abstract
Permafrost thaw and ground settlement considering long-term climate impact in northern Alaska
Authors: Yang Zhaohui Joey , Lee Kannon C. , Liu Haibo 
Published: April 2021

AbstractAlaska’s North Slope is predicted to experience twice the warming expected globally. When summers are longer and winters are shortened, ground surface conditions in the Arctic are expected to change considerably. This is significant for Arctic Alaska, a region that supports surface infrastructure such as energy extraction and transport assets (pipelines), buildings, roadways, and bridges. Climatic change at the ground surface has been shown to impact soil layers beneath through the harmonic fluctuation of the active layer, and warmer air temperature can result in progressive permafrost thaw, leading to a deeper active layer. This study attempts to assess climate change based on the climate model data from the fifth phase of the Coupled Model Intercomparison Project and its impact on a permafrost environment in Northern Alaska. The predicted air temperature data are analyzed to evaluate how the freezing and thawing indices will change due to climate warming. A thermal model was developed that incorporated a ground surface condition defined by either undisturbed intact tundra or a gravel fill surface and applied climate model predicted air temperatures. Results indicate similar fluctuation in active layer thickness and values that fall within the range of minimum and maximum readings for the last quarter-century. It is found that the active layer thickness increases, with the amount depending on climate model predictions and ground surface conditions. These variations in active layer thickness are then analyzed by considering the near-surface frozen soil ice content. Analysis of results indicates that thaw strain is most significant in the near-surface layers, indicating that settlement would be concurrent with annual thaw penetration. Moreover, ice content is a major factor in the settlement prediction. This assessment methodology, after improvement, and the results can help enhance the resilience of the existing and future new infrastructure in a changing Arctic environment.
Development and validation of stability-indicating RP-HPLC method for estimation of dalfampridine in bulk drug and tablet dosage form
Authors: Bagal Dipali , Nagar Akhil , Joshi Aditya , Chachare Aishwarya , Shirkhedkar Atul , Khadse Saurabh 
Published: April 2021

Abstract
Background
In the current study, a simple, improved, precise, rapid, and accurate reverse phase liquid chromatographic method was produced for the estimation of dalfampridine in bulk and tablet dosage form which is a potassium channel blocker used for the treatment of multiple sclerosis (MS). The separation of dalfampridine was achieved isocratically on a C18 column (250 × 4.6 mm, 5 μm) using (0.1% v/v) buffer pH 3.0 ± 0.05 adjusted with diluted orthophosphoric acid (OPA) and acetonitrile (ACN) in the ratio of 60:40% (v/v) as a mobile phase, at a flow rate of 0.5 mL/min, and column temperature of 40 °C. HPLC grade methanol as diluents was used. Five microliters of the standard solution of the drug was injected, and the eluted analytes were detected at 262 nm.

Results
Dalfampridine was eluted at 4.5 min with a run time of 10 min. Linearity in the method was measured in the concentration range of 25–75 ppm with a correlation coefficient of 0.999. Limit of detection and limit of quantitation were found to be 0.711 μg/mL and 2.154 μg/mL, respectively. Dalfampridine was subjected for forced degradation stability study in conditions of thermal, acid, alkali, and oxidation and photo-degradation condition. The degradants were well resolved from the dalfampridine main peak. Validation of the developed method is carried as per USFDA and ICH guidelines.

Conclusion
The results of the analysis prove that the method is simple, improved, precise, accurate, and rapid for estimating the content of dalfampridine in bulk drug and tablet dosage form and can be applied for routine analysis.
Effectiveness and Safety of Thermal Ablation in the Treatment of Primary Hyperparathyroidism: A Multicenter Study
Authors: Wei Ying , Peng Cheng-Zhong , Wang Shu-Rong , He Jun-Feng , Peng Li-Li , Zhao Zhen-Long , Cao Xiao-Jing , Li Yan , Yu Ming-An 
Published: April 2021

Abstract

Context
Ultrasound (US)-guided thermal ablation has generated recent interest as minimally invasive treatments of primary hyperparathyroidism (pHPT). But definitive evidence for the efficacy of thermal ablation in treating pHPT is not well characterized.

Objective
This work aims to evaluate the effectiveness and safety of thermal ablation for pHPT.

Methods
From January 2015 to March 2020, data pertaining to patients who received thermal ablation for pHPT at 4 centers were retrospectively analyzed. The median follow-up duration was 18.1 months (interquartile range, 6.5-42.2 months). A cure referred to the reestablishment of normal values of serum calcium and intact parathyroid hormone throughout the entire follow-up period, at least more than 6 months. The technical success, effectiveness, and safety of treatment were analyzed.

Results
A total of 119 patients (mean age, 57.2 ± 16.3 years; 81 female) with 134 parathyroid nodules were enrolled. The mean maximum diameter of the parathyroid glands was 1.6 ± 0.9 cm. Ninety-six patients underwent microwave ablation (MWA), and 23 patients underwent radiofrequency ablation (RFA). The technical success rate was 98.3% and the cure rate was 89.9%. Significant differences were found in the maximum diameter between the cured patients and the patients who did not undergo ablation of the target lesions. Except for cases with pHPT nodules less than 0.6 cm in diameter, the cure rate was 95%. There were no difference in cure rates at 6 months between the MWA and RFA groups (MWA vs RFA, 90.6% vs 87.0%; χ 2 = 0.275, P = .699). The volume reduction rate of the ablation zone was 94.6% at 12 months. The complication rate was 6.7% (8/119). With the exception of one patient with persistent voice impairment, other symptoms spontaneously resolved within 6 months.

Conclusion
Thermal ablation is effective and safe for pHPT.