bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of feasibility and utility of universal referral to specialty palliative care in a multidisciplinary amyotrophic lateral sclerosis clinic: A cohort study
Authors: Hafer Julia , Jensen Sarah , Wiedau‐Pazos Martina , Mehta Ambereen K. 
Published: February 2021

AbstractIntroductionAlthough the value of palliative care integration in multidisciplinary amyotrophic lateral sclerosis (ALS) clinics has been increasingly recognized, limited data are available demonstrating the feasibility and utility of a palliative care specialist embedded in an ALS clinic. The purpose of this study is to describe the feasibility and utility of a universal outpatient referral model for specialty palliative care for patients with amyotrophic lateral sclerosis.MethodsThis is a retrospective cohort study of initial patient visits with a palliative care physician in a multidisciplinary ALS clinic at an academic institution. All patients were referred to an embedded palliative care physician from January to December 2019.ResultsWithin the study period, 52 of 69 (75%) patients with a confirmed diagnosis of ALS were seen by the palliative care physician. The most common reason patients were not seen by palliative care was a lack of insurance authorization (n = 5). At the visit, 94% of patients discussed at least one advance care planning or goals of care topic. The most common advance care planning topic discussed was code status (40%). The most common goals of care topic discussed was meaning and values (57%). Symptom management was discussed with 40 patients (77%). The most common symptom addressed was pain and/or muscle spasms (33%).DiscussionThese data support the feasibility and utility of universal, outpatient palliative care referral for patients with ALS. Further research is necessary to determine the long‐term effect on outcomes for this population.
Assessment of small fiber neuropathy in patients carrying the non‐classical Fabry variant p.D313Y
Authors: von Cossel Katharina , Muschol Nicole , Friedrich Reinhard E. , Glatzel Markus , Ammer Luise , Lohmöller Benjamin , Bendszus Martin , Mautner Victor‐Felix , Godel Tim 
Published: February 2021

AbstractIntroductionThe pathophysiological significance of the Fabry‐related, non‐classical variant p.D313Y still remains to be solved. This study assesses the involvement of the peripheral nervous system with respect to small fiber neuropathy and neuropathic pain in female patients carrying p.D313Y.MethodsThis study examined nine females carrying the Fabry‐related p.D313Y variant by obtaining skin punch biopsies above the right lateral malleolus. Intraepidermal nerve fiber density was determined for each patient and compared to reference values matched for the patientʼs decade of life and sex. Moreover, each patient was characterized by a detailed neurological examination and by pain assessment via questionnaire.ResultsCompared to sex‐matched lower fifth percentile reference values per decade, intraepidermal nerve fiber density was decreased in seven out of nine patients. Four patients reported acral paresthesias and neuropathic pain with an average visual analogue scale score of 7 out of 10 points. Two patients experienced acute pain crises. Six out of seven patients diagnosed with small fiber neuropathy had a their medical history of hypo‐ and/or hyperhidrosis.DiscussionThe diagnosis of small fiber neuropathy was made in seven out of nine females carrying the non‐classical variant p.D313Y. Moreover, neuropathic pain and symptoms indicative of autonomic nervous system dysfunction seem to be common findings that may be of clinical significance and may warrant therapeutic intervention.
ATP shows more potential as a urinary biomarker than acetylcholine and PGE2, but its concentration in urine is not a simple function of dilution
Authors: McLatchie Linda , Sahai Arun , Caldwell Anna , Dasgupta Prokar , Fry Chris 
Published: February 2021

AbstractAimsTo determine whether the amount of ATP, prostaglandin E2 (PGE2), and acetylcholine (ACh) in voided urine are influenced enough by that released within the lower urinary tract (LUT) for them to be useful biomarkers of bladder function.MethodsParticipants without LUT symptoms collected total urine voids at 15, 30, 60, and 120 min (20 males/23 females) and 240 min (18 males/26 females) following the previous void. Aliquots of urine were immediately frozen at −20°C and later used to measure ATP (luciferin‐luciferase), PGE2 (enzyme‐linked immunosorbent assay), ACh (mass spectrometry), creatinine (colorimetric), and lactose dehydrogenase (colorimetric).ResultsThe amount of ATP in voided urine correlated strongly with the rate of urine production, suggesting that the majority, if not all, the ATP in voided urine has an LUT, and likely bladder, origin. In contrast, there appeared to be no significant net LUTs release of creatinine or ACh into the urine. PGE2 was intermediate with an LUT component that increased with urine production rate and contributed about 25% of the total at 1 ml/min in women but a smaller fraction in men.ConclusionWhereas the majority of the ATP measured within the voided urine originates in the LUT, ACh reflects that extracted from the plasma in the kidneys and PGE2 is a mixture of both sources. ATP has the most potential as a biomarker of benign bladder disorders. Expressing urinary ATP concentration relative to creatinine concentration is questioned in light of these results.
A hierarchy of manganese competition and entry in organotypic hippocampal slice cultures
Authors: Petrus Emily , Saar Galit , Daoust Alexia , Dodd Steve , Koretsky Alan P. 
Published: February 2021

AbstractContrast agents improve clinical and basic research MRI. The manganese ion (Mn2+) is an essential, endogenous metal found in cells and it enhances MRI contrast because of its paramagnetic properties. Manganese‐enhanced MRI (MEMRI) has been widely used to image healthy and diseased states of the body and the brain in a variety of animal models. There has also been some work in translating the useful properties of MEMRI to humans. Mn2+ accumulates in brain regions with high neural activity and enters cells via voltage‐dependent channels that flux calcium (Ca2+). In addition, metal transporters for zinc (Zn2+) and iron (Fe2+) can also transport Mn2+. There is also transfer through channels specific for Mn2+. Although Mn2+ accumulates in many tissues including brain, the mechanisms and preferences of its mode of entry into cells are not well characterized. The current study used MRI on living organotypic hippocampal slice cultures to detect which transport mechanisms are preferentially used by Mn2+ to enter cells. The use of slice culture overcomes the presence of the blood brain barrier, which limits inferences made with studies of the intact brain in vivo. A range of Mn2+ concentrations were used and their effects on neural activity were assessed to avoid using interfering doses of Mn2+. Zn2+ and Fe2+ were the most efficient competitors for Mn2+ uptake into the cultured slices, while the presence of Ca2+ or Ca2+ channel antagonists had a more moderate effect. Reducing slice activity via excitatory receptor antagonists was also effective at lowering Mn2+ uptake. In conclusion, a hierarchy of those agents which influence Mn2+ uptake was established to enhance understanding of how Mn2+ enters cells in a cultured slice preparation.
A new method for optimizing the topology of hinge‐free and fully decoupled compliant mechanisms with multiple inputs and multiple outputs
Authors: Rong Jianhua , Rong Xuanpei , Peng Luo , Yi Jijun , Zhou Quan 
Published: February 2021

AbstractCompliant mechanisms with multiple inputs and multiple outputs have a wide range of applications in precision mechanics, for example, cell manipulations, electronic microscopes, and so on. The movement uncoupling and maximum desired output displacements among these devices all become critical because many inputs and outputs are involved. The topology optimization design of compliant mechanisms, which can solve output coupling and input coupling problems, hinge and gray region problems, and the multiple‐objective optimal problem, is an important topic of researches for achieving fully decoupled motion. It is also a challenge area of research due to serious conflicts of between the four of output and input uncoupling constraints, volume constraint, the hinge‐free requirement, and the good black/white solution requirement. In order to comprehensively solve these problems, a simple optimization model overcoming these serious conflicts is posed, which includes small change rate constraints of structural compliances corresponding to the driving input loads and output point virtual loads. Then, the multiple output displacement functions of the model are equivalently converted into non‐negative functions. The multiple‐objective model is converted into a single‐objective optimization model by using a bound variable. The method of moving asymptotes (MMA) algorithm is adopted to solve it. Several examples are presented to demonstrate the validity of the proposed method.
Acoustic scattering in nonhomogeneous media and the problem of discontinuous gradients: Analysis and inf‐sup stability in the method of finite spheres
Authors: Nicomedes Williams L. , Bathe Klaus‐Jürgen , Moreira Fernando J. S. , Mesquita Renato C. 
Published: February 2021

AbstractIn this paper we focus on a meshfree formulation for the solution of time‐harmonic acoustic scattering problems and verify the stability of the procedure. The sound waves propagate in nonhomogeneous media, giving rise to discontinuities in the gradients of the pressure field across the interfaces between regions of different material properties. Meshfree methods usually do not reproduce accurately the discontinuities in a numerical solution. We overcome this issue by introducing Lagrange multiplier fields defined at the interfaces in order to treat the discontinuities in the gradients of the pressure field. The method does not depend on any kind of adjustable parameter. We show by a numerical study of the applicable inf‐sup conditions that the resulting mixed formulation leads to well‐posed problems. The use of the proposed method is illustrated in the solution of a number of problems of wave propagation through nonhomogeneous media.
Implementation of hybridizable discontinuous Galerkin method for time‐harmonic anisotropic poroelasticity in two dimensions
Authors: Barucq Hélène , Diaz Julien , Meyer Rose‐Cloé , Pham Ha 
Published: February 2021

AbstractWe apply a hybridizable discontinuous Galerkin (HDG) method to numerically solve two‐dimensional anisotropic poroelastic wave equations in the frequency domain given by Biot theory. The motivation for choosing HDG method comes from the complexity of the considered equations and the high number of unknowns. The HDG method possesses all the advantages of discontinuous Galerkin method (hp‐adaptivity, accuracy, ability to model complex tectonics, etc.) without a drastic increase in the number of degrees of freedom. After a description of its implementation, we illustrate the accuracy of the proposed method by comparisons with analytical solutions. We then perform a sensitivity analysis of the method as a function of stabilization parameters and frequency, and show in particular that there exists optimal values of these parameters in order to obtain a very good level of accuracy. We also show the ability of the method to reproduce the different types of poroelastic waves including the slow Biot wave.
Cigarette Use and Adolescent Metabolic and Bariatric Surgery
Authors: Zeller Meg H. , Kidwell Katherine M. , Reiter‐Purtill Jennifer , Jenkins Todd M. , Michalsky Marc P. , Mitchell James E. , Courcoulas Anita P. , Inge Thomas H. 
Published: February 2021

ObjectiveThis study aimed to track conventional cigarette smoking behaviors and associated correlates in adolescents with severe obesity who did or did not undergo metabolic and bariatric surgery to 4 years after surgery/baseline.MethodsUtilizing a prospective controlled design, surgical (n = 153; mean BMI = 52) and nonsurgical (n = 70; mean BMI = 47) groups that completed assessments before surgery/at baseline and at Years 2 and 4 post surgery (Year 4: n = 117 surgical [mean BMI = 38]; n = 56 nonsurgical [mean BMI = 48]) were compared. Separate logistic regression models tested correlates of Year 4 current smoking.ResultsMore than half of participants (surgical: 55%; nonsurgical: 60%) had ever smoked a cigarette, with current smoking increasing with time. Groups did not differ in Year 4 current smoking (surgical: 23%; nonsurgical: 33%), with ≈ 50% meeting criteria for “heavy” smoking (≥ half pack/day) and ≈ 40% smoking their first cigarette before ninth grade. Factors associated with higher odds of Year 4 current smoking included dysregulation (P < 0.001), internalizing symptoms (P = 0.01), alcohol use (P = 0.04), caregiver smoking (P < 0.001), friend smoking (P = 0.001), and perceiving low harm (P = 0.02), plus greater percent weight loss (P = 0.03) in the surgical group.ConclusionsSmoking is a clinical health challenge for adolescents and young adults with severe obesity, including those who have undergone metabolic and bariatric surgery. Upstream identification, monitoring, and intervention to prevent smoking uptake and escalation in youth with obesity across settings should be prioritized.
Association Between Liver Fat and Bone Density is Confounded by General and Visceral Adiposity in a Community‐Based Cohort
Authors: Li Belinda T. , Simon Tracey G. , Wang Na , Chung Raymond T. , Corey Kathleen E. , Dichtel Laura E. , Samelson Elizabeth J. , Kiel Douglas P. , Long Michelle T. 
Published: February 2021

ObjectiveNonalcoholic fatty liver disease (NAFLD) is associated with low bone mineral density (BMD); however, it is not known whether early‐stage NAFLD may be associated with BMD after accounting for BMI or visceral adipose tissue (VAT).MethodsThis was a cross‐sectional study of 3,462 Framingham Heart Study participants who underwent computed tomographic measurement of liver fat, VAT volume, volumetric spine BMD, vertebral cross‐sectional area (CSA), and vertebral compressive strength. This study excluded heavy alcohol consumers. Multivariable linear regression models were used to assess the association between NAFLD and volumetric BMD, CSA, and vertebral compressive strength after accounting for covariates, including BMI or VAT.ResultsA total of 2,253 participants (mean age, 51.2  [SD 10.7] years; 51.1% women) were included. In multivariable‐adjusted models, positive associations between NAFLD and integral BMD, trabecular BMD, and vertebral compressive strength were observed. However, results were attenuated and no longer significant after additionally adjusting for BMI or VAT. NAFLD was observed to be weakly associated with a lower vertebral CSA in adjusted models.ConclusionsIn a community‐based cohort, the associations between NAFLD and BMD and vertebral strength were confounded by BMI and VAT. However, NAFLD was associated with a reduced vertebral CSA in adjusted models.
POLICIES TO REDUCE AND PREVENT HOMELESSNESS: WHAT WE KNOW AND GAPS IN THE RESEARCH
Authors: Evans William N. , Phillips David C. , Ruffini Krista 
Published: February 2021

AbstractHomelessness may be both a cause of and one of the more extreme outcomes of poverty. Governments at all levels and private organizations have a variety of tools to combat homelessness, and these strategies have changed dramatically over the past quarter century. In this paper, we catalog the policy responses and the existing literature on the effectiveness of these strategies, focusing on studies of individual‐level effects from randomized controlled trial evaluations and the best quasi‐experimental designs. We conclude by discussing outstanding questions that can be addressed with these same methods.
Neuroblastoma: The basis for cure in limited‐resource settings
Authors: van Heerden Jaques , Kruger Mariana , Esterhuizen Tonya Marianne , Pinxten Wim 
Published: February 2021

AbstractBackgroundNeuroblastoma (NB) contributes the most to the mortality of childhood malignancies worldwide. The disease spectrum is heterogenous and the management complex and costly, especially in advanced disease or disease with adverse biology. In low‐ and middle‐income countries (LMICs) the majority of NB presents in advanced stages. Therefore, with limited resources and poor prognosis the treatment of NB is often not a priority. The aim of the study was to evaluate the research activities and perceptions of the management of NB that determine the research and treatment approaches in LMICs.MethodsData were sourced from https://www.clinicaltrials.gov/ identifying NB trials open to LMIC. Abstracts on NB research presented at the International Society for Paediatric Oncology (SIOP) Congresses between 2014 and 2020 were evaluated according to income status. An online survey evaluating medical views on NB in LMICs and the effect on the management was conducted. Descriptive analysis was done. Where appropriate categorical association between covariates was assessed using the Pearson chi‐square (χ2) test or Fishers exact test.ResultsThere were 15/562 (2.7%) trials open to LMIC. Only six of 138 (4.3%) LMIC participated in NB trials. Of the 688 abstracts presented between 2014 and 2020 at the SIOP International Congress on NB as primary subject, 297 (42.7%) were from LMICs. Only two were from low‐income countries (LICs). Sixty‐one countries responded to the NB survey. Positive views towards NB management were present when treatment was based on a national protocol, the availability of trimodal or advanced treatment options were present, and when a balance of metastatic or local disease were treated.ConclusionManagement of NB in LMICs should include increased advocacy and research as well as implementation of national management strategies.
Safety and efficacy of concurrent carboplatin during full‐dose craniospinal irradiation for high‐risk/metastatic medulloblastoma in a resource‐limited setting
Authors: Gupta Tejpal , Sinha Shwetabh , Chinnaswamy Girish , Vora Tushar , Prasad Maya , Bhat Vasudev , Goda Jayant Sastri , Krishnatry Rahul , Chatterjee Abhishek , Epari Sridhar , Sahay Ayushi , Moiyadi Aliasgar , Shetty Prakash , Patil Vijay , Khatua Soumen , Jalali Rakesh , Kurkure Purna 
Published: February 2021

AbstractPurposeTo assess the safety and efficacy of concurrent carboplatin during craniospinal irradiation (CSI) in high‐risk/metastatic medulloblastoma defined as either residual tumor >1.5 cm2 or leptomeningeal metastases.MethodsThis single‐arm combined prospective (2005–2011) and retrospective (2011–2019) study was undertaken at a tertiary care cancer center in India. Following surgery, patients with newly diagnosed high‐risk/metastatic medulloblastoma received concurrent carboplatin (35 mg/m2) for 15 days (day 1 to day 15) during CSI plus posterior fossa/tumor bed boost, followed by six cycles of standard adjuvant chemotherapy.ResultsAll 97 patients completed their planned course of radiotherapy without interruptions, except for two (2.1%) patients who had brief gaps due to treatment‐related toxicity. Grade 3–4 anemia, neutropenia, thrombocytopenia, and febrile neutropenia were seen in four (4.1%), 41 (42.2%) 21 (21.6%), and 18 (18.6%) patients, necessitating packed cell transfusion, granulocyte colony‐stimulating factor, and platelet support in five (5.1%), 41 (42.2%), and five (5.1%) patients, respectively, during the concurrent phase. Following myelorecovery, 92 (94.9%) patients completed the planned six cycles of standard adjuvant systemic chemotherapy. There were no treatment‐related deaths during the concurrent chemo‐radiotherapy phase, while three (3.1%) toxic deaths were ascribed to adjuvant chemotherapy‐related complications. At a median follow‐up of 82 months, the 5‐year Kaplan–Meier estimates of progression‐free survival and overall survival were 60.2% and 62.1%, respectively. On univariate analysis, leptomeningeal metastases (M0/M1 vs. M2/M3) and histological subtype (large cell/anaplastic vs. others) emerged as significant prognostic factors for survival.ConclusionAddition of concurrent carboplatin to RT as radiosensitizing chemotherapy is a simple and effective way of treatment intensification in high‐risk/metastatic medulloblastoma.
Hematopoietic stem cell transplantation for mitochondrial neurogastrointestinal encephalopathy: A single‐center experience underscoring the multiple factors involved in the prognosis
Authors: Zaidman Irina , Elhasid Ronit , Gefen Aharon , Yahav Dovrat Anat , Mutaz Sultan , Shaoul Ron , Eshach Adiv Orly , Mandel Hanna , Tal Galit 
Published: February 2021

AbstractBackgroundMitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a progressive autosomal recessive disorder characterized by cachexia, gastrointestinal (GI) dysmotility, ptosis, peripheral neuropathy, and brain magnetic resonance imaging (MRI) white matter changes. Bi‐allelic TYMP mutations lead to deficient thymidine phosphorylase (TP) activity, toxic accumulation of plasma nucleosides (thymidine and deoxyuridine), nucleotide pool imbalances, and mitochondrial DNA (mtDNA) instability. Death is mainly due to GI complications: intestinal perforation, peritonitis, and/or liver failure. Based on our previous observations in three patients with MNGIE that platelet infusions resulted in a transient 40% reduction of plasma nucleoside levels, in 2005 we performed the first hematopoietic stem cell transplantation (HSCT) worldwide as a life‐long source of TP in a patient with MNGIE.ProcedureHSCT was performed in a total of six patients with MNGIE. The multiple factors involved in the prognosis of this cohort were analyzed and compared to the literature experience.ResultsCell source was bone marrow in five patients and peripheral stem cells in one, all from fully human leukocyte antigen (HLA)‐matched related donors, including four who were TYMP mutation carriers. Four of six (66%) survived compared to the 37% survival rate in the literature. Reduced intensity conditioning regimen contributed to secondary graft failure in two patients. Fifteen years post HSCT, the first transplanted patient is seemingly cured. Severe GI symptoms before transplantation were mostly irreversible and were poor prognostic factors.ConclusionsAllogenic HSCT could constitute a curative therapeutic option for carefully selected, young, presymptomatic, or mildly affected patients. Timing, donor selection, and optimal conditioning protocol are major determinants of outcome. HSCT is inadvisable in patients with advanced MNGIE disease.
The impact of family violence incidents on personality changes: An examination of social media users’ messages in China
Authors: Li Sijia , Liu Mingming , Zhao Nan , Xue Jia , Wang Xuefei , Jiao Dongdong , Zhu Tingshao 
Published: February 2021

AbstractChanges in personality tend to be intertwined with life events (e.g., family violence [FV]). This study aimed to examine the personality changes before and after an FV incident using Weibo data. Samples were selected from 1.16 million Weibo users in China who had posted their own FV experience as victims. We used Linguistic Inquiry and Word Count (LIWC) to extract the linguistic features of these unstructured texts as the scores of participants’ personality. We built prediction models to measure and compare personality differences between the victim group and control group in Sample 1; and personality changes between the victim group and control group before and after an FV incident in Sample 2. Results showed that the victims’ neuroticism increased and conscientiousness decreased after experiencing FV. At the same time, their agreeableness and openness levels were lower than those of the control group. Implications and limitations are also discussed.