bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterizing the electrophysiological abnormalities in visually reviewed normal EEGs of drug-resistant focal epilepsy patients
Authors: Varatharajah Yogatheesan , Berry Brent , Joseph Boney , Balzekas Irena , Pal Attia Tal , Kremen Vaclav , Brinkmann Benjamin , Iyer Ravishankar , Worrell Gregory 
Published: May 2021

Abstract
Routine scalp EEG is essential in the clinical diagnosis and management of epilepsy. However, a normal scalp EEG (based on expert visual review) recorded from a patient with epilepsy can cause delays in diagnosis and clinical care delivery. Here, we investigated whether normal EEGs might contain subtle electrophysiological clues of epilepsy. Specifically, we investigated (i) whether there are indicators of abnormal brain electrophysiology in normal EEGs of epilepsy patients, and (ii) whether such abnormalities are modulated by the side of the brain generating seizures in focal epilepsy. We analysed awake scalp EEG recordings of age-matched groups of 144 healthy individuals and 48 individuals with drug-resistant focal epilepsy who had normal scalp EEGs. After preprocessing, using a bipolar montage of eight channels, we extracted the fraction of spectral power in the alpha band (8–13 Hz) relative to a wide band of 0.5–40 Hz within 10-s windows. We analysed the extracted features for (i) the extent to which people with drug-resistant focal epilepsy differed from healthy subjects, and (ii) whether differences within the drug-resistant focal epilepsy patients were related to the hemisphere generating seizures. We then used those differences to classify whether an EEG is likely to have been recorded from a person with drug-resistant focal epilepsy, and if so, the epileptogenic hemisphere. Furthermore, we tested the significance of these differences while controlling for confounders, such as acquisition system, age and medications. We found that the fraction of alpha power is generally reduced (i) in drug-resistant focal epilepsy compared to healthy controls, and (ii) in right-handed drug-resistant focal epilepsy subjects with left hemispheric seizures compared to those with right hemispheric seizures, and that the differences are most prominent in the frontal and temporal regions. The fraction of alpha power yielded area under curve values of 0.83 in distinguishing drug-resistant focal epilepsy from healthy and 0.77 in identifying the epileptic hemisphere in drug-resistant focal epilepsy patients. Furthermore, our results suggest that the differences in alpha power are greater when compared with differences attributable to acquisition system differences, age and medications. Our findings support that EEG-based measures of normal brain function, such as the normalized spectral power of alpha activity, may help identify patients with epilepsy even when an EEG does not contain any epileptiform activity, recorded seizures or other abnormalities. Although alpha abnormalities are unlikely to be disease-specific, we propose that such abnormalities may provide a higher pre-test probability for epilepsy when an individual being screened for epilepsy has a normal EEG on visual assessment.
Utility of echocardiographic right ventricular subcostal strain in critical care
Authors: Bleakley Caroline , de Marvao Antonio , Morosin Marco , Androulakis Emmanouil , Russell Clare , Athayde Andre , Cannata Antonio , Passariello Maurizio , Ledot Stéphane , Singh Suveer , Pepper John , Hill Jonathan , Cowie Martin , Price Susanna 
Published: May 2021

Abstract

Aims
Right ventricular (RV) strain is a known predictor of outcomes in various heart and lung pathologies but has been considered too technically challenging for routine use in critical care. We examined whether RV strain acquired from the subcostal view, frequently more accessible in the critically ill, is an alternative to conventionally derived RV strain in intensive care.

Methods and results
RV strain data were acquired from apical and subcostal views on transthoracic echocardiography (TTE) in 94 patients (35% female), mean age 50.5 ± 15.2 years, venovenous extracorporeal membrane oxygenation (VVECMO) (44%). RV strain values from the apical (mean ± standard deviation; –20.4 ± 6.7) and subcostal views (–21.1 ± 7) were highly correlated (Pearson’s r –0.89, P &lt; 0.001). RV subcostal strain correlated moderately well with other echocardiography parameters including tricuspid annular plane systolic excursion (r –0.44, P &lt; 0.001), RV systolic velocity (rho = –0.51, P &lt; 0.001), fractional area change (r –0.66, P &lt; 0.01), and RV outflow tract velocity time integral (r –0.49, P &lt; 0.001). VVECMO was associated with higher RV subcostal strain (non-VVECMO –19.6 ± 6.7 vs. VVECMO –23.2 ± 7, P = 0.01) but not apical RV strain. On univariate analysis, RV subcostal strain was weakly associated with survival at 30 days (R2 = 0.04, P = 0.05, odds ratio =1.08) while apical RV was not (P = 0.16).

Conclusion
RV subcostal deformation imaging is a reliable surrogate for conventionally derived strain in critical care and may in time prove to be a useful diagnostic marker in this cohort.
BiSulfite Bolt: A bisulfite sequencing analysis platform
Authors: Farrell Colin , Thompson Michael , Tosevska Anela , Oyetunde Adewale , Pellegrini Matteo 
Published: May 2021

Abstract

Background
Bisulfite sequencing is commonly used to measure DNA methylation. Processing bisulfite sequencing data is often challenging owing to the computational demands of mapping a low-complexity, asymmetrical library and the lack of a unified processing toolset to produce an analysis-ready methylation matrix from read alignments. To address these shortcomings, we have developed BiSulfite Bolt (BSBolt), a fast and scalable bisulfite sequencing analysis platform. BSBolt performs a pre-alignment sequencing read assessment step to improve efficiency when handling asymmetrical bisulfite sequencing libraries.

Findings
We evaluated BSBolt against simulated and real bisulfite sequencing libraries. We found that BSBolt provides accurate and fast bisulfite sequencing alignments and methylation calls. We also compared BSBolt to several existing bisulfite alignment tools and found BSBolt outperforms Bismark, BSSeeker2, BISCUIT, and BWA-Meth based on alignment accuracy and methylation calling accuracy.

Conclusion
BSBolt offers streamlined processing of bisulfite sequencing data through an integrated toolset that offers support for simulation, alignment, methylation calling, and data aggregation. BSBolt is implemented as a Python package and command line utility for flexibility when building informatics pipelines. BSBolt is available at https://github.com/NuttyLogic/BSBolt under an MIT license.
Representation theoretic patterns in multi-frequency class averaging for three-dimensional cryo-electron microscopy
Authors: Fan Yifeng , Gao Tingran , Zhao Zhizhen 
Published: May 2021

AbstractWe develop in this paper a novel intrinsic classification algorithm—multi-frequency class averaging (MFCA)—for classifying noisy projection images obtained from three-dimensional cryo-electron microscopy by the similarity among their viewing directions. This new algorithm leverages multiple irreducible representations of the unitary group to introduce additional redundancy into the representation of the optimal in-plane rotational alignment, extending and outperforming the existing class averaging algorithm that uses only a single representation. The formal algebraic model and representation theoretic patterns of the proposed MFCA algorithm extend the framework of Hadani and Singer to arbitrary irreducible representations of the unitary group. We conceptually establish the consistency and stability of MFCA by inspecting the spectral properties of a generalized local parallel transport operator through the lens of Wigner $D$-matrices. We demonstrate the efficacy of the proposed algorithm with numerical experiments.
AugIR Meets GestureCards: A Digital Sketching Environment for Gesture-Based Applications
Authors: Hesenius Marc , Kleffmann Markus , Gruhn Volker 
Published: May 2021

Abstract
To gain a common understanding of an application’s layouts, dialogs and interaction flows, development teams often sketch user interface (UI). Nowadays, they must also define multi-touch gestures, but tools for sketching UIs often lack support for custom gestures and typically just integrate a basic predefined gesture set, which might not suffice to specifically tailor the interaction to the desired use cases. Furthermore, sketching can be enhanced with digital means, but it remains unclear whether digital sketching is actually beneficial when designing gesture-based applications. We extended the AugIR, a digital sketching environment, with GestureCards, a hybrid gesture notation, to allow software engineers to define custom gestures when sketching UIs. We evaluated our approach in a user study contrasting digital and analog sketching of gesture-based UIs.
Magic and Politics: Conspirituality and COVID-19
Authors: Parmigiani Giovanna 
Published: May 2021

AbstractWhy do people find conspiracy theories attractive, convincing, or useful? In this article, I analyze conspirituality—that is, the relationships between New Age spirituality and conspiracy theories—in Italy during the COVID-19 lockdown. After distinguishing between conspiracy-believing and belief in conspiracies, I claim that conspiracy-believing could be understood as an aesthetic (sensory and artistic) practice. In doing so, I offer a novel interpretation on conspiracism that complements current scholarship while departing from the latter’s focus on the cognitive and emotional weaknesses of those who adopt conspiracy theories. By engaging with the thought of Jacques Rancière, in conversation with studies on contemporary Paganism and Western esotericism, I consider the adoption of conspiracy theories as an expression of dissensus by a community of sense that does not look only for visibility but, rather, wants to be fully acknowledged, recognized, and legitimized in their “participatory”—or “magical”—way of inhabiting the world.
A rare case of primary cutaneous diffuse large B-cell lymphoma, leg type, presenting as cellulitis: a case report
Authors: Huang Shih-Feng , Liu Wen-Chung 
Published: May 2021

Abstract
Primary cutaneous diffuse large B-cell lymphoma, leg type, accounts for only 4% of all cutaneous lymphomas and bears a worse prognosis than other cutaneous B-cell lymphomas. Diagnosis at an early stage may be difficult due to its nonspecific manifestations. We report an 88-year-old female who was brought to our emergency department due to two rapidly growing painful skin lesions with local redness and swelling on her right lower leg. We performed incisional biopsy of the two right lower leg skin lesions and sent the specimens for histopathological examination. The pathological examination was compatible with diffuse large B-cell lymphoma. Primary cutaneous diffuse large B-cell lymphoma, leg type, is a rare condition that can present as skin cellulitis, thereby misleading clinicians and resulting in delayed treatment. This diagnosis should be considered when assessing skin lesions.
Strigolactones regulate sepal senescence in Arabidopsis
Authors: Xu Xi , Jibran Rubina , Wang Yanting , Dong Lemeng , Flokova Kristyna , Esfandiari Azadeh , McLachlan Andrew R G , Heiser Axel , Sutherland-Smith Andrew J , Brummell David A , Bouwmeester Harro J , Dijkwel Paul P , Hunter Donald A 
Published: May 2021

Abstract
Flower sepals are critical for flower development and vary greatly in life span depending on their function post-pollination. Very little is known about what controls sepal longevity. Using a sepal senescence mutant screen, we identified two Arabidopsis mutants with delayed senescence directly connecting strigolactones with senescence regulation in a novel floral context that hitherto has not been explored. The mutations were in the strigolactone biosynthetic gene MORE AXILLARY GROWTH1 (MAX1) and in the strigolactone receptor gene DWARF14 (AtD14). The mutation in AtD14 changed the catalytic Ser97 to Phe in the enzyme active site, which is the first mutation of its kind in planta. The lesion in MAX1 was in the haem–iron ligand signature of the cytochrome P450 protein, converting the highly conserved Gly469 to Arg, which was shown in a transient expression assay to substantially inhibit the activity of MAX1. The two mutations highlighted the importance of strigolactone activity for driving to completion senescence initiated both developmentally and in response to carbon-limiting stress, as has been found for the more well-known senescence-associated regulators ethylene and abscisic acid. Analysis of transcript abundance in excised inflorescences during an extended night suggested an intricate relationship among sugar starvation, senescence, and strigolactone biosynthesis and signalling.
The value of bone marrow biopsy for staging of patients with primary CNS lymphoma
Authors: Margold Michelle , Seidel Sabine , Kowalski Thomas , Ladigan-Badura Swetlana , Baraniskin Alexander , Schroers Roland , Frey Anna Verena , Schmidt-Wolf Ingo G H , Herrlinger Ulrich , Korfel Agnieszka , Schlegel Uwe 
Published: May 2021

Abstract

Background
In patients with presumed primary CNS lymphoma (PCNSL), a systemic manifestation is found only in a small minority. Although bone marrow biopsy (BMB) is recommended for staging, its diagnostic value is unclear.

Methods
A retrospective analysis of 392 patients with presumed PCNSL from 3 university hospitals and 33 patients with secondary CNS lymphoma (SCNSL) and initial CNS involvement from a multicenter Germany-wide prospective registry was performed.

Results
A BMB was performed and documented in 320/392 patients with presumed PCNSL; 23 had pathologic results. One harbored the same lymphoma in the brain and bone marrow (BM), 22 showed findings in BM discordant to the histology of brain lymphoma; n = 12 harbored a low-grade lymphoma in the BM, the other showed B-cell proliferation but no proof of lymphoma (n = 5), monoclonal B cells (n = 3), or abnormalities not B-cell-associated (n = 2). In the group of SCNSL with initial CNS manifestation, 32/33 patients underwent BMB; 7 were documented with bone marrow involvement (BMI); 1 had concordant results in the brain and BM with no other systemic manifestation. Six had additional systemic lymphoma manifestations apart from the brain and BM.

Conclusions
In only 2 out of 352 (0.6%) patients with CNS lymphoma (320 presumed PCNSL and 32 SCNSL), BMB had an impact on diagnosis and treatment. While collected in a selected cohort, these findings challenge the value of BMB as part of routine staging in presumed PCNSL.
A Novel Protocol for Reducing Intensive Care Utilization After Craniotomy
Authors: Pendharkar Arjun V , Shahin Maryam N , Awsare Sohun S , Ho Allen L , Wachira Christine , Clevinger Johnathan , Sigurdsson Sveinn , Lee Yohan , Wilson Alicia , Lu Amy C , Gephart Melanie Hayden 
Published: May 2021

Abstract

BACKGROUND
There is a growing body of evidence suggesting not all craniotomy patients require postoperative intensive care.

OBJECTIVE
To devise and implement a standardized protocol for craniotomy patients eligible to transition directly from the operating room to the ward—the Non-Intensive CarE (NICE) protocol.

METHODS
We preoperatively identified patients undergoing elective craniotomy for simple neurosurgical procedures with age <65 yr and American Society of Anesthesiologists (ASA) class of 1, 2 or 3. Postoperative eligibility was confirmed by the surgical and anesthesia teams. Upon arrival to the ward, patients were staffed with a neuroscience nurse for hourly neurological examinations for the first 8 h. Patient demographics, clinical characteristics, and outcomes were prospectively collected to evaluate the NICE protocol.

RESULTS
From February 2018 to 2019, 63 patients were included in the NICE protocol with a median age of 46 yr and 65% female predominance. Of the operations performed, 38.1% were microvascular decompressions, 31.7% were craniotomy for tumor, 15.9% were cavernous malformation resections, and 14.3% were Chiari decompressions. No patients required transfer to the intensive care unit (ICU). Median length of stay was 2 d. There was an 11.1% overall readmission rate within the median follow-up period of 48 d. Three patients (4.8%) required reoperation at time of readmission within the follow-up period (1 postoperative subdural hematoma, 2 cerebrospinal fluid leak repair). None of these complications could have been identified with a postoperative ICU stay.

CONCLUSION
In our pilot trial of the NICE protocol, no patients required postoperative transfer to the ICU.
Clinical Presentation and Multifactorial Pathogenesis of Necrotizing Enterocolitis in the Preterm Infant
Authors: Andrews Rachael E. , Coe Kristi L. 
Published: May 2021

Background:
Necrotizing enterocolitis (NEC) is a serious infection of the bowel wall induced by multiple pathological factors, which include inflammation and tissue invasion with bacteria known to cause severe infections. NEC is now understood to be several disease processes under one umbrella. The most common form occurs in premature infants and can exert significant impacts to preterm morbidity and mortality.

Purpose:
This narrative review describes current knowledge of the clinical presentation and pathophysiology of NEC in premature infants.

Methods/Search Strategy:
A review of literature was conducted using key words in PubMed and CINAHL with preference for years 2015 to 2020.

Findings/Results:
Several converging and interrelated factors including characteristics of the premature intestinal mucosa, gut ischemia, dysregulation of the microbiome, enteral feeding, and genetics create an environment where NEC is more likely to occur.

Implications for Practice:
To recognize and diagnose NEC in preterm infants, an understanding of underlying factors that create an optimal environment for disease acquisition in premature infants is essential.

Implications for Research:
Prevention of NEC remains the most important strategy for decreasing morbidity and mortality. Multiple areas of potential study exist for NEC pathophysiology including those that consider how the factors discussed in this review are interrelated and how each particular pathway can be optimized to prevent the onset of NEC.
Mindfulness Effects in Obstetric and Gynecology Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic
Authors: Smith Rachael B. , Mahnert Nichole D. , Foote Janet , Saunders Kelley T. , Mourad Jamal , Huberty Jennifer 
Published: May 2021

OBJECTIVE:
To assess the effect of a consumer-based mobile meditation application (app) on wellness in outpatient obstetric and gynecology patients during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS:
We conducted a randomized controlled trial at a university outpatient clinic of obstetric and gynecology patients during the COVID-19 pandemic. Women were randomly assigned to the intervention group, who was prescribed a mobile meditation app for 30 days, or the control group, which received standard care. The primary outcome was self-reported perceived stress. Secondary outcomes included self-reported depression, anxiety, sleep disturbance, and satisfaction with the meditation app. A sample size of 80 participants (40 per group) was calculated to achieve 84% power to detect a 3-point difference in the primary outcome.

RESULTS:
From April to May 2020, 101 women were randomized in the study—50 in the meditation app group and 51 in the control group. Analysis was by intention-to-treat. Most characteristics were similar between groups. Perceived stress was significantly less in the intervention group at days 14 and 30 (mean difference 4.27, 95% CI 1.30–7.24, P=.005, d=0.69 and mean difference 4.28, 95% CI 1.68–6.88, P=.002, d=0.69, respectively). Self-reported depression and anxiety were significantly less in the intervention group at days 14 and 30 (depression: P=.002 and P=.04; anxiety: P=.01, and P=.04, respectively). Sleep disturbance was significantly less in the intervention group at days 14 and 30 (P=.001 and P=.02, respectively). More than 80% of those in the intervention group reported high satisfaction with the meditation app, and 93% reported that mindfulness meditation improved their stress.

CONCLUSION:
Outpatient obstetric and gynecology patients who used the prescribed consumer-based mobile meditation app during the COVID-19 pandemic had significant reductions in perceived stress, depression, anxiety, and sleep disturbance compared with standard care.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT04329533.
Outcomes of the First Pregnancy After Fertility-Sparing Surgery for Early-Stage Ovarian Cancer
Authors: Nitecki Roni , Clapp Mark A. , Fu Shuangshuang , Lamiman Kelly , Melamed Alexander , Brady Paula C. , Kaimal Anjali , del Carmen Marcela G. , Woodard Terri L. , Meyer Larissa A. , Giordano Sharon H. , Ramirez Pedro T. , Rauh-Hain J. Alejandro 
Published: May 2021

OBJECTIVE:
To evaluate the outcomes of the first pregnancy after fertility-sparing surgery in patients treated for early-stage ovarian cancer.

METHODS:
We performed a retrospective study of women aged 18–45 years with a history of stage IA or IC ovarian cancer reported to the California Cancer Registry for the years 2000–2012. These data were linked to the 2000–2012 California Office of Statewide Health Planning and Development birth and discharge data sets to ascertain oncologic characteristics and obstetric outcomes. We included in the case group ovarian cancer patients who conceived at least 3 months after fertility-sparing surgery. The primary outcome was preterm birth, and only the first pregnancy after cancer diagnosis was considered. Secondary outcomes included small-for-gestational-age (SGA) neonates, neonatal morbidity (respiratory support within 72 hours after birth, hypoxic-ischemic encephalopathy, seizures, infection, meconium aspiration syndrome, birth trauma, and intracranial or subgaleal hemorrhage), and severe maternal morbidity as defined by the Centers for Disease Control and Prevention. Propensity scores were used to match women in a 1:2 ratio for the case group and the control group. Wald statistics and logistic regressions were used to evaluate outcomes.

RESULTS:
A total of 153 patients who conceived after fertility-sparing surgery were matched to 306 women in a control group. Histologic types included epithelial (55%), germ-cell (37%), and sex-cord stromal (7%). Treatment for ovarian cancer was not associated with preterm birth before 37 weeks of gestation (13.7% vs 11.4%; odds ratio [OR] 1.23, 95% CI 0.69–2.20), SGA neonates (birth weight less than the 10th percentile: 11.8% vs 12.7%; OR 0.91, 95% CI 0.50–1.66), severe maternal morbidity (2.6% vs 1.3%; OR 2.03, 95% CI 0.50–8.25), or neonatal morbidity (both 5.9% OR 1.00, 95% CI 0.44–2.28).

CONCLUSION:
Patients who conceived at least 3 months after surgery for early-stage ovarian cancer did not have an increased risk of adverse obstetric outcomes.