bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delineating the Association Between Soluble CD26 and Autoantibodies Against G-Protein Coupled Receptors, Immunological and Cardiovascular Parameters Identifies Distinct Patterns in Post-Infectious vs. Non-Infection-Triggered Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Authors: Szklarski Marvin , Freitag Helma , Lorenz Sebastian , Becker Sonya C. , Sotzny Franziska , Bauer Sandra , Hartwig Jelka , Heidecke Harald , Wittke Kirsten , Kedor Claudia , Hanitsch Leif G. , Grabowski Patricia , Sepúlveda Nuno , Scheibenbogen Carmen 
Published: April 2021

Soluble cluster of differentiation 26 (sCD26) has a wide range of enzymatic functions affecting immunological, metabolic and vascular regulation. Diminished sCD26 concentrations have been reported in various autoimmune diseases and also in Myalgic Encephalomyelitis/Chronic fatigue syndrome (ME/CFS). Here we re-evaluate sCD26 as a diagnostic marker and perform a comprehensive correlation analysis of sCD26 concentrations with clinical and paraclinical parameters in ME/CFS patients. Though this study did find significantly lower concentrations of sCD26 only in the female cohort and could not confirm diagnostic suitability, results from correlation analyses provide striking pathomechanistic insights. In patients with infection-triggered onset, the associations of low sCD26 with elevated autoantibodies (AAB) against alpha1 adrenergic (AR) and M3 muscarinic acetylcholine receptors (mAChR) point to a pathomechanism of infection-triggered autoimmune-mediated vascular and immunological dysregulation. sCD26 concentrations in infection-triggered ME/CFS were found to be associated with activated T cells, liver enzymes, creatin kinase (CK) and lactate dehydrogenase (LDH) and inversely with Interleukin-1 beta (IL-1b). Most associations are in line with the known effects of sCD26/DPP-4 inhibition. Remarkably, in non-infection-triggered ME/CFS lower sCD26 in patients with higher heart rate after orthostatic challenge and postural orthostatic tachycardia syndrome (POTS) suggest an association with orthostatic regulation. These findings provide evidence that the key enzyme sCD26 is linked to immunological alterations in infection-triggered ME/CFS and delineate a different pathomechanism in the non-infectious ME/CFS subset.
Assessment of the Safety and Therapeutic Benefits of Convalescent Plasma in COVID-19 Treatment: A Systematic Review and Meta-Analysis
Authors: Barreira Daniela Ferreira , Lourenço Rita Adubeiro , Calisto Rita , Moreira-Gonçalves Daniel , Santos Lúcio Lara , Videira Paula Alexandra 
Published: April 2021

Background: The coronavirus disease (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), prompted a global health crisis, with no available specific treatments. Convalescent plasma (CP) with neutralizing antibodies could be a promising therapeutic approach to reduce mortality.Objectives: To evaluate the therapeutic potential of CP for COVID-19 and to assess its safety and efficacy in reducing the patients' mortality.Methods: We retrieved clinical trial references from multiple Databases (e.g., PubMed, B-On, SCOPUS), for complete studies until November 26th 2020. We included Randomized controlled trials (RCT) and controlled non-randomized trials (CNRT), that assessed the efficacy of CP to treat hospitalized COVID-19 patients. Trials were included regardless of concomitant medications in the intervention's arms. Eleven trials met our eligibility criteria. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We defined a methodological protocol to extract and evaluate all pertinent baseline demographics and interventions' characteristics from trials. The primary outcomes were the safety profile of CP, measured by the type, frequency and severity of adverse events, and CP effectiveness in reducing mortality, measured by the number of deaths registered for this therapy.Results: We assessed 11 trials (5 RCT and 6 CNRT) with 3,098 participants, of whom 923 patients were treated with CP. Only 32 (3.5%) of the treated patients suffered adverse events (from which 9.4% serious transfusion-related adverse events). The overall mortality rates were significantly decreased by CP administration {risk ratio (RR) 0.71, p = 0.005, 95% confidence interval (Cl) [0.57–0.90]}, with low heterogeneity. In the sub-analysis by period of transfusion, CP transfusion within a week of hospitalization contributed to diminished mortality rate (RR = 0.71, p = 0.03, 95%Cl [0.53–0.96]). CP therapy also led to significantly reduced viral loads at 72 h after transfusion (RR = 0.61, p = 0.04, 95%Cl [0.38–0.98]), despite high heterogeneity due to disease severity.Conclusion: This meta-analysis established CP as a safe and potentially effective therapy for COVID-19, decreasing the mortality rates and promoting a swift viral clearance. Further studies are necessary to provide stronger evidence.
Development of a Nomogram to Predict 28-Day Mortality of Patients With Sepsis-Induced Coagulopathy: An Analysis of the MIMIC-III Database
Authors: Lu Zongqing , Zhang Jin , Hong Jianchao , Wu Jiatian , Liu Yu , Xiao Wenyan , Hua Tianfeng , Yang Min 
Published: April 2021

Background: Sepsis-induced coagulopathy (SIC) is a common cause for inducing poor prognosis of critically ill patients in intensive care unit (ICU). However, currently there are no tools specifically designed for assessing short-term mortality in SIC patients. This study aimed to develop a practical nomogram to predict the risk of 28-day mortality in SIC patients.Methods: In this retrospective cohort study, we extracted patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Sepsis was defined based on Sepsis 3.0 criteria and SIC based on Toshiaki Iba's criteria. Kaplan–Meier curves were plotted to compare the short survival time between SIC and non-SIC patients. Afterward, only SIC cohort was randomly divided into training or validation set. We employed univariate logistic regression and stepwise multivariate analysis to select predictive features. The proposed nomogram was developed based on multivariate logistic regression model, and the discrimination and calibration were verified by internal validation. We then compared model discrimination with other traditional severity scores and machine learning models.Results: 9432 sepsis patients in MIMIC III were enrolled, in which 3280 (34.8%) patients were diagnosed as SIC during the first ICU admission. SIC was independently associated with the 7- and 28-day mortality of ICU patients. K–M curve indicated a significant difference in 7-day (Log-Rank: P &lt; 0.001 and P = 0.017) and 28-day survival (Log-Rank: P &lt; 0.001 and P &lt; 0.001) between SIC and non-SIC groups whether the propensity score match (PSM) was balanced or not. For nomogram development, a total of thirteen variables of 3,280 SIC patients were enrolled. When predicted the risk of 28-day mortality, the nomogram performed a good discrimination in training and validation sets (AUROC: 0.78 and 0.81). The AUROC values were 0.80, 0.81, 0.71, 0.70, 0.74, and 0.60 for random forest, support vector machine, sequential organ failure assessment (SOFA) score, logistic organ dysfunction score (LODS), simplified acute physiology II score (SAPS II) and SIC score, respectively, in validation set. And the nomogram calibration slope was 0.91, the Brier value was 0.15. As presented by the decision curve analyses, the nomogram always obtained more net benefit when compared with other severity scores.Conclusions: SIC is independently related to the short-term mortality of ICU patients. The nomogram achieved an optimal prediction of 28-day mortality in SIC patient, which can lead to a better prognostics assessment. However, the discriminative ability of the nomogram requires validation in external cohorts to further improve generalizability.
Prevalence, Risk Factors, and Comorbidities of Obstructive Sleep Apnea Risk Among a Working Population in Kuwait: A Cross-Sectional Study
Authors: Al-Qattan Husain , Al-Omairah Hamad , Al-Hashash Khaled , Al-Mutairi Fahad , Al-Mutairat Mohammad , Al-Ajmi Mohammad , Mohammad Anwar , Alterki Abdulmohsen , Ziyab Ali H. 
Published: April 2021

Background: Obstructive sleep apnea (OSA) affects a considerable proportion of adults globally and is associated with elevated morbidity and mortality. Given the lack of epidemiologic data on the burden of OSA in Kuwait, this study sought to estimate its prevalence, associated risk factors, and comorbid conditions among a working population in Kuwait.Methods: This was a cross-sectional study of a sample of working adults (n = 651) from public institutions in Kuwait. High/low risk for OSA was ascertained according to the Berlin Questionnaire criteria. Participants self-reported their coexisting health conditions. Associations were assessed using Poisson regression with robust variance estimation; adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated.Results: Overall, 20.0% (130/651) of participants were classified as being at high risk for OSA, with more male than female subjects being at high risk (24.0% [56/233] vs. 17.7% [74/418], P = 0.053), though this difference did not gain statistical significance. Moreover, a high risk for OSA was more common among older and obese subjects. Factors associated with increased prevalence of a high risk for OSA included current smoking status (aPR = 1.58, 95% CI: 1.02–2.06), longer hours spent watching television (1.76, 1.10–2.81), and lower self-perceived physical health (2.11, 1.15–3.87). However, decreasing trends in the prevalence of high risk for OSA were observed with frequent engagement in vigorous physical activity and longer nightly sleep duration. Compared to those at a low risk for OSA, the subjects at high risk for OSA were more likely to have insomnia disorder (2.83, 1.81–4.41), diabetes (1.94, 1.15–3.27), hypertension (3.00, 1.75–5.16), and depression (4.47, 1.80–11.08).Conclusion: This study estimated that 1/5 of working adults in Kuwait were at high risk for OSA, and the prevalence varied according to personal characteristics and lifestyle factors. Also, a high risk for OSA classification was associated with multiple comorbid health conditions.
Dietary Inflammatory Index Is Related to Heart Failure Risk and Cardiac Function: A Case–Control Study in Heart Failure Patients
Authors: Moludi Jalal , Shivappa Nitin , Alisgharzadeh Soghra , Hébert James R. , Alizadeh Mohammad 
Published: April 2021

Aims: Previous studies suggest that diet and inflammation are important risk factors for heart failure (HF); however, the associations remain unclear. The Dietary Inflammatory Index (DII®) was established to measure the inflammatory capacity of individuals' diet. This study aimed to explore the DII in HF subjects compared with controls.Methods and Results: We conducted a case–control (116 cases and 113 controls) study that recruited in the similar clinics. DII scores were calculated based on dietary intakes. N-Terminal pro-brain natriuretic peptide (NT-proBNP) levels and ejection fraction (EF) were assessed in both groups. In order to analyze DII scores with HF as the outcome, we used conditional logistic regression. A linear regression was applied to explore the associations between the DII and left ventricular EF (LVEF).There was statistically significant difference in DII scores in cases vs. controls (−0.16 ± 1.37 vs. −0.33 ± 1.67; p = 0.040). Conditional logistic regression has shown that subjects with higher DII scores had higher risk of HF. For every one-point rise in DII score, the odds of having HF increased by 30% (OR: 1.30; CI: 1.03, 1.69; p = 0.047). The EF was inversely associated with saturated fatty acid (β = −0.34, 95% CI: −0.61, −0.07; p = 0.012). Subjects with higher DII scores had higher NT-proBNP levels and had lower EF.Conclusion: The DII score was associated with high probability of HF. It appears that consumption of anti-inflammatory diet may lead to the prevention of HF and therefore suggests that dietary modification with the goal of reducing DII scores could be a valuable strategy for improving clinical outcomes in these patients.
Coordinated Reset Vibrotactile Stimulation Induces Sustained Cumulative Benefits in Parkinson’s Disease
Authors: Pfeifer Kristina J. , Kromer Justus A. , Cook Alexander J. , Hornbeck Traci , Lim Erika A. , Mortimer Bruce J. P. , Fogarty Adam S. , Han Summer S. , Dhall Rohit , Halpern Casey H. , Tass Peter A. 
Published: April 2021

BackgroundAbnormal synchronization of neuronal activity in dopaminergic circuits is related to motor impairment in Parkinson’s disease (PD). Vibrotactile coordinated reset (vCR) fingertip stimulation aims to counteract excessive synchronization and induce sustained unlearning of pathologic synaptic connectivity and neuronal synchrony. Here, we report two clinical feasibility studies that examine the effect of regular and noisy vCR stimulation on PD motor symptoms. Additionally, in one clinical study (study 1), we examine cortical beta band power changes in the sensorimotor cortex. Lastly, we compare these clinical results in relation to our computational findings.MethodsStudy 1 examines six PD patients receiving noisy vCR stimulation and their cortical beta power changes after 3 months of daily therapy. Motor evaluations and at-rest electroencephalographic (EEG) recordings were assessed off medication pre- and post-noisy vCR. Study 2 follows three patients for 6+ months, two of whom received daily regular vCR and one patient from study 1 who received daily noisy vCR. Motor evaluations were taken at baseline, and follow-up visits were done approximately every 3 months. Computationally, in a network of leaky integrate-and-fire (LIF) neurons with spike timing-dependent plasticity, we study the differences between regular and noisy vCR by using a stimulus model that reproduces experimentally observed central neuronal phase locking.ResultsClinically, in both studies, we observed significantly improved motor ability. EEG recordings observed from study 1 indicated a significant decrease in off-medication cortical sensorimotor high beta power (21—30 Hz) at rest after 3 months of daily noisy vCR therapy. Computationally, vCR and noisy vCR cause comparable parameter-robust long-lasting synaptic decoupling and neuronal desynchronization.ConclusionIn these feasibility studies of eight PD patients, regular vCR and noisy vCR were well tolerated, produced no side effects, and delivered sustained cumulative improvement of motor performance, which is congruent with our computational findings. In study 1, reduction of high beta band power over the sensorimotor cortex may suggest noisy vCR is effectively modulating the beta band at the cortical level, which may play a role in improved motor ability. These encouraging therapeutic results enable us to properly plan a proof-of-concept study.
Functional Disability in Psychiatric Patients With Deliberate Self-Harm as Compared to a Clinical Control Group
Authors: Nilsson Magnus , Lundh Lars-Gunnar , Westrin Åsa , Westling Sofie 
Published: April 2021

Background: Deliberate self-harm (DSH) is a common behavior in psychiatric populations. However, little is known regarding how DSH impacts daily life. The concept of functional disability, adopted by the World Health Organization (WHO), refers to the impact of disorders on six domains of daily functioning. The aim of the current study was to explore the functional disability of psychiatric patients with DSH as compared to a psychiatric control group.Methods: 32 psychiatric patients with DSH and 31 psychiatric patients without DSH were assessed with regards to demographic information, functional disability, psychiatric illness, DSH, general cognitive functioning, and measures of psychopathology. Group comparisons were made by means of t-tests, Mann-Whitney-tests, and Chi-square tests. Correlation analyses were done to assess the association between measures of psychopathology and functional disability.Results: The results indicated that patients with DSH had a lower ability to self-care as compared to the patients without DSH (p = 0.001, d = 0.90). Also, the patients with DSH reported a significantly higher number of days when they were totally unable to carry out usual activities in the past month (p = 0.008, d = 0.70) and that they were admitted in an inpatient setting significantly more days over the past year compared to the patients without DSH (p &lt; 0.001, d = 0.58). The group with DSH was significantly younger (t = 3.00, p = 0.004) and reported significantly more BPD-symptoms (p = 0.013, d = 0.64) as well as higher current suicidality (p &lt; 0.001, d = 1.32) compared to the group without DSH. The group with DSH also included a significantly higher number of patients diagnosed with borderline personality disorder (χ2 = 13.72, p &lt; 0.001). There were no differences between the groups regarding general cognitive functioning or severity of depression. More research is needed to understand the underlying factors involved.
Mental Health, Social and Emotional Well-Being, and Perceived Burdens of University Students During COVID-19 Pandemic Lockdown in Germany
Authors: Kohls Elisabeth , Baldofski Sabrina , Moeller Raiko , Klemm Sarah-Lena , Rummel-Kluge Christine 
Published: April 2021

Background: The COVID-19 pandemic has been affecting everyone's daily life in unknown measures since its outbreak. Nearly all Universities around the globe were affected. Further, young people and University students in particular, are known to be vulnerable for developing mental disorders. This study aims to examine the mental health social and emotional well-being and perceived burdens of University students during COVID-19 pandemic lockdown in Germany.Materials and Methods: This cross-sectional and anonymous online survey among University students assessed mental health status with standardized measures (depressive symptoms, alcohol and drug consumption, and eating disorder symptoms), attitudes toward the COVID-19 pandemic and perceived burdens, and social and emotional aspects of the pandemic (social support, perceived stress, loneliness, and self-efficacy).Results: In total, N = 3,382 German University students participated. Nearly half of the students (49%) reported that they are worried or very much worried about the COVID-19 pandemic. The majority supports the governmental lockdown measures (85%). A Patient Health Questionnaire-9 (PHQ-9) sum score of 10 or above, indicating clinically relevant depressive symptoms, was reported by 37% (n = 1,249). The PHQ-9 sum score was on average 8.66 (SD = 5.46). Suicidal thoughts were indicated by 14.5% of the participants. Levels of depressive symptoms differed significantly for the different self-rated income changes during the pandemic (increase, decrease, no change in income). Further, levels of depressive symptoms and suicidal ideation differed significantly for students from different faculties. Multiple regression analyses revealed that not being a parent, having no indirect social contact one or two times a week, higher perceived stress, higher experienced loneliness, lower social support, and lower self-efficacy significantly predicted higher scores of depressive symptoms, also higher hazardous alcohol use, and higher levels of eating disorder symptoms. Other aspects of lifestyle such as social and cultural activities, dating, and hobbies were reported to be negatively affected during the pandemic.Conclusion: The present study implies that University students are vulnerable and due to elevated depressive symptoms at risk, being hit hard by the pandemic, but are in general coping adaptively. Low-threshold online interventions promoting help-seeking and also targeting various mental health conditions might bridge the gap the COVID-19 pandemic opened up recently.
The Importance of Understanding COVID-19: The Role of Knowledge in Promoting Adherence to Protective Behaviors
Authors: Miller Lisa M. Soederberg , Gee Perry M. , Katz Rachael A. 
Published: April 2021

Background: Past research suggests that knowledge supports- but strong illness expectations thwart- adoption of protective behaviors (e.g., handwashing). Strong illness expectations may place COVID-19 essential workers at risk. It is unclear, however, whether knowledge can moderate the negative effects of pessimistic illness expectations on protective behaviors. We test COVID-19 knowledge as a moderator of the effects of (1) pessimistic illness expectations and (2) essential worker status on adherence to protective behaviors.Methods: Participants (n = 350) completed measures of knowledge, illness expectations, and protective behaviors. We used chi-square tests to examine associations between variables and logistic regressions to test the moderation models predicting adherence (low, high) while controlling for demographics.Results: Knowledge, illness expectations, and adherence were significantly associated with each other (p &lt; 0.05). Essential workers had stronger illness expectations and lower knowledge than did non-essential workers (p &lt; 0.001). Logistic regressions showed a non-significant Worker Status × Knowledge interaction (p = 0.59) but a significant Knowledge × Illness Expectations interaction (p &lt; 0.05) indicating that those with strong illness expectations and low knowledge were disproportionately at risk of failing to adhere to recommended behaviors.Conclusions: Knowledge promotes protective behaviors by buffering the negative effects of pessimistic illness expectations. Essential workers are more likely to have low levels of knowledge with strong illness expectations, suggesting that educational policies may be warranted.
Narrar y describir: ékphrasis, relato e imagen en el centón Christus Patiens
Authors: Rivas Ezequiel Gustavo 
Published: April 2021

La época de los emperadores Comnenos (1081-1204) se caracterizó por un predominio de la prosa narrativa, plasmada en la novela, en los relatos hagiográficos y en las crónicas históricas. Durante el mencionado período, gracias a la influencia de intelectuales del siglo XI como Mauropos o Psellos en la corte constantinopolitana, se constata un renacimiento de la actividad artística y literaria, especialmente en relación con la tradición clásica. Varios especialistas de los estudios bizantinos ubican hoy en este período la redacción del centón Christus Patiens. Aunque adscripto al género dramático, el texto admite la aplicación de lineamientos teóricos en torno a la narración y a la descripción. Objetivo de este artículo será centrarse en el análisis narratológico e iconográfico en la escena doble de la herida del costado, ubicada en el momento de la muerte de Cristo y en el inicio de la escena de la sepultura. La hipótesis de lectura afirma que la repetición del motivo de la herida indica, a nuestro entender, la voluntad de resaltar una conjunción paradójica entre lo somático y lo dogmático, sostenida a su vez por una red intertextual proveniente de la tragedia euripidea. A tal fin, entre otro de los objetivos, resaltaremos recursos –como el de la focalización– que alternan entre la narración y la ékphrasis. En las conclusiones de nuestro análisis sostenemos que estos procedimientos se revelan como productores de imagen de gran relevancia dentro de la poética del centón.