bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Impact of Advanced Age on Clinical Outcomes After Vestibular Schwannoma Resection in the Very Elderly: Cohort Study
Authors: Helal Ahmed , Graffeo Christopher S , Perry Avital , Van Abel Kathryn M , Carlson Matthew L , Neff Brian A , Driscoll Colin L W , Link Michael J 
Published: May 2021

Abstract

BACKGROUND
Vestibular schwannomas (VS) have a peak incidence in the sixth and seventh decades of life. Stereotactic radiosurgery is often the preferred treatment for VS among patients of advanced age. The fraction of elderly patients potentially requiring consideration for surgical treatment is anticipated to expand, mandating an update to management paradigms in this population.

OBJECTIVE
To describe our experience with surgical management of VS in patients aged 75 yr and older.

METHODS
Cohort study of all patients aged ≥75 yr with sporadic VS requiring surgical treatment at our institution between 1999 and 2020. Data included preoperative baseline characteristics and outcome data including extent of resection, facial nerve and hearing status, functional outcome, length of stay, and complications.

RESULTS
A total of 24 patients were included, spanning an age range of 75 to 90 yr. Average tumor size was 2.76 ± 1.04 cm, and average baseline Modified 5-item Frailty Index (mFI-5) score was 1.08 ± 0.93. Extent of resection was gross total in 5 (20.8%), near total in 3 (12.5%), and sub-total resection in the remaining 16 (66.7%). One patient died in the postoperative period because of an acute sub-dural hematoma. Favorable facial nerve function (HB1-2) was preserved in 12 patients (75%) between 75 and 79 yr and 2 patients (28.6%) aged ≥ 80 yr. No cerebrospinal fluid leak or surgical site infection was observed; 3 patients developed hydrocephalus requiring ventriculo-peritoneal shunt placement. Nine patients required out-of-home disposition; all patients eventually returned to independent living.

CONCLUSION
Microsurgical resection of VS can be safely undertaken in patients greater than 75 y/o but may carry an increased risk of poor facial function.
Role of source-to-sink transport of methionine in establishing seed protein quantity and quality in legumes
Authors: Garneau Matthew G , Lu Ming-Zhu , Grant Jan , Tegeder Mechthild 
Published: May 2021

Abstract
Grain legumes such as pea (Pisum sativum L.) are highly valued as a staple source of protein for human and animal nutrition. However, their seeds often contain limited amounts of high-quality, sulfur (S) rich proteins, caused by a shortage of the S-amino acids cysteine and methionine. It was hypothesized that legume seed quality is directly linked to the amount of organic S transported from leaves to seeds, and imported into the growing embryo. We expressed a high-affinity yeast (Saccharomyces cerevisiae) methionine/cysteine transporter (Methionine UPtake 1) in both the pea leaf phloem and seed cotyledons and found source-to-sink transport of methionine but not cysteine increased. Changes in methionine phloem loading triggered improvements in S uptake and assimilation and long-distance transport of the S compounds, S-methylmethionine and glutathione. In addition, nitrogen and carbon assimilation and source-to-sink allocation were upregulated, together resulting in increased plant biomass and seed yield. Further, methionine and amino acid delivery to individual seeds and uptake by the cotyledons improved, leading to increased accumulation of storage proteins by up to 23%, due to both higher levels of S-poor and, most importantly, S-rich proteins. Sulfate delivery to the embryo and S assimilation in the cotyledons were also upregulated, further contributing to the improved S-rich storage protein pools and seed quality. Overall, this work demonstrates that methionine transporter function in source and sink tissues presents a bottleneck in S allocation to seeds and that its targeted manipulation is essential for overcoming limitations in the accumulation of high-quality seed storage proteins.
Predictors and Consequences of Pediatric Pain Symptom Trajectories: A 14-Year Longitudinal Study
Authors: Mun Chung Jung , Lemery-Chalfant Kathryn , Wilson Melvin , Shaw Daniel S 
Published: May 2021

AbstractObjectiveThe present study had three primary objectives. First, pain trajectory from early childhood to early adolescence were modeled. Second, we examined how early childhood individual-, parental-, and family-level factors predict pain trajectories. Third, we evaluated consequences of pain trajectories in terms of anxiety and depressive symptoms, and substance use at age 16 years.DesignThe current paper is a secondary data analysis of a multisite longitudinal study. A total of 731 children and their families were followed from ages 2 to 16 years.MethodsA growth mixture model (GMM) was used to identify pain trajectories from ages 2 to 14 years.ResultsThe GMM revealed three distinct pain trajectories: (1) Low Pain Symptom (n = 572); (2) Increasing Pain Symptom (n = 106); and (3) U-shaped Pain Symptom (n = 53). Children who experienced greater harsh parenting and sleep disturbances in early childhood were more likely to belong to the Increasing Pain Symptom group, and those with greater anxious-depressed symptoms at age 2 years were more likely to belong to the U-shaped Pain Symptom group than the Low Pain Symptom group. Additionally, those youth in the Increasing Pain Symptom group, compared to the Low and U-shaped Pain Symptom groups, showed elevated anxiety symptoms at age 16 years.ConclusionsReducing harsh parenting and children’s sleep disturbances could be important targets for preventing pediatric pain problems. Children with increasing pain symptoms may also benefit from learning adaptive pain management skills to lower the risk of developing anxiety problems in late adolescence.
Sharing Data Collected with Smartphone Sensors
Authors: Struminskaya Bella , Lugtig Peter , Toepoel Vera , Schouten Barry , Giesen Deirdre , Dolmans Ralph 
Published: May 2021

Abstract
Smartphone sensors allow measurement of phenomena that are difficult or impossible to capture via self-report (e.g., geographical movement, physical activity). Sensors can reduce respondent burden by eliminating survey questions and improve measurement accuracy by replacing/augmenting self-reports. However, if respondents who are not willing to collect sensor data differ on critical attributes from those who are, the results can be biased. Research on the mechanisms of willingness to collect sensor data mostly comes from (nonprobability) online panels and is hypothetical (i.e., asks participants about the likelihood of participation in a sensor-based study). In a cross-sectional general population randomized experiment, we investigate how features of the request and respondent characteristics influence willingness to share (WTS) and actually sharing smartphone-sensor data. We manipulate the request to either mention or not mention (1) how participation will benefit the participant, (2) participants’ autonomy over data collection, and (3) that data will be kept confidential. We assess nonparticipation bias using the administrative records. WTS and actually sharing varies by sensor task, participants’ autonomy over data sharing, their smartphone skills, level of privacy concerns, and attitudes toward surveys. Fewer people agree to share photos and a video than geolocation, but all who agreed to share photos or a video actually did. Some nonresponse and nonparticipation biases are substantial and make each other worse, but others jointly reduce the overall bias. Our findings suggest that sensor-data-sharing decisions depend on sample members’ situation when asked to share and the nature of the sensor task rather than the sensor type.
SARS-CoV-2-associated Guillain-Barré syndrome is a para-infectious disease
Authors: Li X , Wang Y , Wang H , Wang Y 
Published: May 2021

Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been linked to the Guillain-Barré syndrome (GBS). The objective of the present study is to identify specific clinical features of cases of GBS reported in the literature associated with SARS-CoV-2 infection. We searched Pubmed, and included single case reports and case series with full text in English, reporting original data of patients with GBS and a confirmed recent SARS-CoV-2 infection. Clinical data were extracted. We identified 28 articles (22 single case reports and 6 case series), reporting on a total of 44 GBS patients with confirmed SARS-CoV-2 infection. SARS-CoV-2 infection was confirmed through serum reverse transcriptase–polymerase chain reaction in 72.7% of cases. A total of 40 patients (91%) had symptoms compatible with SARS-CoV-2 infection before the onset of the GBS. The median period between the onset of symptoms of SARS-CoV-2 infection and symptoms of the GBS was 11.2 days (range, 2–23). The most common clinical features were: leg weakness (61.4%), leg paresthesia (50%), arm weakness (50.4%), arm paresthesia (50.4%), hyporeflexia/areflexia (48%) and ataxia (22.7%). In total, 38.6% (n = 17) were found to have facial paralysis. Among 37 patients in whom nerve-conduction studies and electromyography were performed, of which 26 patients (59.1%) were consistent with the acute inflammatory demyelinating polyneuropathy subtype of the GBS. The present retrospective analysis support the role of the SARS-CoV-2 infection in the development of the GBS, may trigger GBS as para-infectious disease, and lead to SARS-CoV-2-associated GBS.
Hrólfs saga Gautrekssonar and the Originality of Beowulf
Authors: Grant Tom 
Published: May 2021

Abstract
For over a century and a half, scholars have worked to establish links between medieval Scandinavian saga material and the Old English alliterative epic Beowulf. The present article investigates connections between the Anglo-Saxon poem and Hrólfs saga Gautrekssonar—an Old Norse saga unique for preserving a story about a Geatish monster-killer who, like Beowulf, is active in Denmark and then returns to rule his homeland as king. This investigation is first situated within the broader currents of the research field and some key assumptions about the relationship between Beowulf and its Old Norse analogues are set out. The parallels between the monster-fights of Beowulf and Hrólfr Gautreksson are then considered in detail. Hrólfr’s slaying of Grímarr in Denmark, and of his vengeful relative Grímnir further afield, are compared in turn with Beowulf’s fateful encounters with Grendel and his mother. Consideration is then given to the links between the careers and movements of these two heroes. It is demonstrated that intriguing parallels exist between the early life, fosterage and accession of these figures. The narrative links established in this article between Beowulf and Hrólfs saga Gautrekssonar shed new light upon the shape of the folktale from which both texts may ultimately derive. It is argued that the political and geographical connections between these narratives tentatively point to a more significant conclusion: that both Beowulf and Hrólfs saga perhaps draw upon an older narrative concerning a Geatish monster-killer. This allows for a new insight into the relative originality of the Old English epic.
Improving SOGI Asylum Adjudication: Putting Persecution Ahead of Identity
Authors: Dustin Moira , Ferreira Nuno 
Published: May 2021

Abstract
This article addresses the concern that decision-making in sexual orientation or gender identity (SOGI) asylum claims in Europe is often unfair, and that one way to remedy this is by improving the guidance provided to decision-makers when interpreting the Refugee Convention in respect of these claims. We begin by interrogating a number of different decision-making guidelines and models to assess whether they contribute to a fairer asylum system. We show that, for claims based on SOGI, success invariably depends on the decision-maker’s assessment as to whether a claimant is, or would be perceived in their home country to be, a member of a SOGI minority, and so belongs to a Particular Social Group. Such focus risks neglecting analysis of the actual risk of persecution. We set out our own recommendation for a fairer approach based on prioritising SOGI-specific Country of Origin Information (COI) and the risk of persecution, rather than focusing on whether applicants are ‘genuinely’ members of a SOGI minority. We argue that this will lead to fairer outcomes that are less likely to be overturned on appeal and more consistent with the Refugee Convention’s spirit and letter.
Relations Among Anhedonia, Reinforcement Learning, and Global Functioning in Help-seeking Youth
Authors: Akouri-Shan LeeAnn , Schiffman Jason , Millman Zachary B , Demro Caroline , Fitzgerald John , Rakhshan Rouhakhtar Pamela J , Redman Samantha , Reeves Gloria M , Chen Shuo , Gold James M , Martin Elizabeth A , Corcoran Cheryl , Roiser Jonathan P , Buchanan Robert W , Rowland Laura M , Waltz James A 
Published: May 2021

Abstract
Dysfunction in the neural circuits underlying salience signaling is implicated in symptoms of psychosis and may predict conversion to a psychotic disorder in youth at clinical high risk (CHR) for psychosis. Additionally, negative symptom severity, including consummatory and anticipatory aspects of anhedonia, may predict functional outcome in individuals with schizophrenia-spectrum disorders. However, it is unclear whether anhedonia is related to the ability to attribute incentive salience to stimuli (through reinforcement learning [RL]) and whether measures of anhedonia and RL predict functional outcome in a younger, help-seeking population. We administered the Salience Attribution Test (SAT) to 33 participants who met criteria for either CHR or a recent-onset psychotic disorder and 29 help-seeking youth with nonpsychotic disorders. In the SAT, participants must identify relevant and irrelevant stimulus dimensions and be sensitive to different reinforcement probabilities for the 2 levels of the relevant dimension (“adaptive salience”). Adaptive salience attribution was positively related to both consummatory pleasure and functioning in the full sample. Analyses also revealed an indirect effect of adaptive salience on the relation between consummatory pleasure and both role (αβ = .22, 95% CI = 0.02, 0.48) and social functioning (αβ = .14, 95% CI = 0.02, 0.30). These findings suggest a distinct pathway to poor global functioning in help-seeking youth, via impaired reward sensitivity and RL.
Long-term sequelae of congenital gambiense human African trypanosomiasis
Authors: Mudji Junior , Künzli Esther , Molyneux David , Blum Johannes 
Published: May 2021

Abstract

Background
The clinical presentation of gambiense human African trypanosomias (gHAT) is generally considered to be the same among children and adults. In general, when describing the clinical presentation of children with gHAT, no differentiation is made between congenital gHAT and gHAT acquired later. There is a lack of knowledge regarding the signs and symptoms attributable to congenital gHAT and its long-term sequelae.

Methods
Following an evaluation of the hospital register for gHAT, the authors observed that six children born to mothers with gHAT during their pregnancies still had sequelae of the infection. The six mothers were interviewed about their respective pregnancies and the developmental history of the children borne to the infected mothers. Furthermore, the children then underwent a complete physical examination with a focus on neuropsychiatric signs and symptoms.

Results
Five of the six patients are still seriously disabled. Behavioral changes are present in four patients, tremor, speech impairment, involuntary movements and pathologic the Barrés test and Mingazzini test in three patients and convulsions, pyramidal signs and decreased muscle tonus in two patients. Two patients cannot work and one has a sphincter disorder.

Conclusions
Our study suggests that congenital gHAT may lead to long-lasting sequelae in babies born to mothers treated after delivery. The risk of embryo toxicity of treatment of mothers with gHAT must be balanced against the risk of congenital gHAT with long-term sequelae.
Assessing the phacoemulsification learning curve using duration of each step
Authors: Rali Aditya , Grosel Timothy , Fontus Jerry , Aaron Maria , Jones Jeremy , Moore Elliot , Khalifa Yousuf M. 
Published: May 2021

Purpose:
To assess the phacoemulsification learning curve for ophthalmology residents using duration for each step.

Setting:
Single tertiary, training site hospital.

Design:
Cross-sectional study.

Methods:
Emory ophthalmology postgraduate year (PGY) 3 and PGY-4 residents operating at Grady Memorial Hospital between April 2017 and February 2018 were eligible to participate. Duration in seconds for each step of surgery was calculated for incisions, continuous curvilinear capsulorhexis (CCC), hydrodissection, nucleus disassembly, quadrant removal, cortical cleanup, intraocular lens insertion, and closure, and this outcome was analyzed as a function of different experience levels.

Results:
A total of 528 surgeries were included of 549 total surgeries recorded. 6 categories of experience levels were established as A to F, increasing by increments of 50. There was an overall downward trend across various steps across the 8 case categories, and several adjacent categories demonstrate statistically significant differences. The 3 most time-intensive steps early in training were nucleus disassembly (336.5 ± 16.5 seconds), quadrant removal (275.1 ± 18.0 seconds), and cortical cleanup (244.2 ± 24.6 seconds). There was a sustained drop in mean duration for all steps through at least category D, with most steps showing a drop through category F.

Conclusions:
There is a benefit to a higher caseload, well above the Accreditation Council for Graduate Medical Education–mandated 86 cases. Improvements in efficiency were observed after 250 cases, with nuclear disassembly and CCC demonstrating a significant decrease in operative time.
On a class of integrable Hamiltonian equations in 2+1 dimensions
Authors: Gormley Ben , Ferapontov Eugene V. , Novikov Vladimir S. 
Published: May 2021

We classify integrable Hamiltonian equations of the form

u
t

=

∂
x

(

δ
H

δ
u

)

,

H
=
∫
h
(
u
,
w
)

d

x

d

y
,

where the Hamiltonian density
h
(
u
,
w
) is a function of two variables: dependent variable
u
and the non-locality

w
=

∂
x

−
1

∂
y

u

. Based on the method of hydrodynamic reductions, the integrability conditions are derived (in the form of an involutive PDE system for the Hamiltonian density
h
). We show that the generic integrable density is expressed in terms of the Weierstrass
σ
-function:
h
(
u
,
w
) =
σ
(
u
) e

w

. Dispersionless Lax pairs, commuting flows and dispersive deformations of the resulting equations are also discussed.
Conventional PCR as a reliable method for diagnosing invasive mucormycosis in resource-limited settings
Authors: Pandey Mragnayani , Xess Immaculata , Singh Gagandeep , Kumar Rakesh , Mahapatra Manoranjan , Jyotsna Viveka P. , Agarwal Reshu , Ghosh Arnab , Iram Azka , Mani Prashant 
Published: May 2021

Introduction.Invasive mucormycosis (IM) is a life-threatening infection caused by fungi belonging to the order Mucorales. Histopathology, culture and radiology are the mainstay of diagnosis but lack sensitivity, leading to a delay in timely diagnosis and intervention. Recently, PCR-based approaches have been shown to be a promising method in diagnosing IM.Hypothesis/Gap Statement.Molecular-based approaches may be a valuable adjunct to standard conventional methods for diagnosing IM, especially among culture negatives and patients on antifungal therapy.Aim.In the present study we aimed to evaluate the clinical utility of panfungal and Mucorales-specific PCR for diagnosing IM from various clinical specimens.Methodology.This was a prospective study in which 239 clinically suspected cases of IM attending our tertiary care hospital from August 2015 to March 2018 were enrolled. All the cases were defined as ‘proven’, ‘probable’ or ‘possible’ based on EORTC/MSGERC guidelines. In addition to conventional diagnostics (KOH-calcofluor stain and culture), panfungal and Mucorales-specific PCR assays were also performed. The amplified products were sequenced for species identification.In vitroantifungal susceptibility was performed on all the culture-positive isolates.Results.Among 239 clinically suspected cases of IM, only 140 cases were diagnosed by the demonstration of aseptate ribbon-like hyphae on direct microscopy. Culture was positive in 35.7 % (54/140) of direct microscopy-positive samples. Among the proven cases (n=11), the sensitivity for both Mucorales-specific nested PCR and panfungal PCR was 100 %, but specificity was 91.9 and 73.7% respectively. In probable cases (n=129), the sensitivity of both the PCRs was 98.5 % and specificity for panfungal PCR was 73.7 and 91.9 % for Mucorales-specific PCR.Conclusion.Pan fungal PCR in combination with Mucorales-specific PCR, followed by sequencing, may play a significant role in IM diagnosis especially among those negative for both direct microscopy and culture.
Systematic Review and Meta-Analysis Protocol: Beta adrenoreceptor drugs and risk of Parkinson’s disease
Authors: Singh Ambrish , Hussain Salman , Akkala Sreelatha , Klugarová Jitka , Pokorná Andrea , Klugar Miloslav , Antony Benny 
Published: May 2021

AbstractParkinson’s disease (PD) is a progressive nervous system disorder characterised by the loss of dopaminergic neurons leading to motor and non-motor symptoms. Accumulation of α-synuclein protein (SNCA) in the form of Lewy bodies has been observed in dopaminergic neurons of PD patients. Potential relationships between β-adrenergic drugs (agonists and antagonist) and SNCA synthesis in PD have been recently suggested. This study aims to systematically review the evidence from various epidemiological studies that analysed the association between beta-adrenoceptors (agonists and antagonists) and the risk of PD. Biomedical databases such as PubMed and Embase will be searched to identify the individual studies that reported the relationship between beta-adrenoceptors and the risk of PD. JBI critical appraisal tool scale will be used to assess the quality of included studies. The primary outcome will be to compute the pooled risk of PD among beta-agonist and antagonist users. Furthermore, we will consider the pooled risk of PD based on study design, types of beta-agonist or antagonist exposure under secondary outcomes. RevMan 5, STATA 16, and ProMeta 3.0 will be used to conduct the statistical analysis.